Chamber and committees

I recognise that there has been an expedited timetable, particularly in the House of Commons—as the convener set out, that was needed in order to meet this year’s recruitment rounds—but the Scottish Government has been discussing these matters with the UK Government for quite some time. As I said in my opening statement, we believe that the bill contains the most proportionate legal proposals that the UK Government has made and, critically, that the proposals are workable.

It is for the committee to determine its work programme—I cannot direct it—but I believe that the bill is balanced and the right course of action to take. That is why we recommend that the Parliament should give its legislative consent.

That is correct. Anyone who has started their medical education at a UK university will be treated as a UK-domiciled graduate. Anyone who has carried out their foundation year programme in the UK will be prioritised as a UK medical graduate, but the prioritisation will start in relation to those who are entering for the first time to take up a specialty position. That is where the difference lies.

I recognise Emma Harper’s long-standing interest in and advocacy for ScotGEM, so I understand her desire to ensure that ScotGEM is not impacted by the process that is proposed by the bill. I can confirm that ScotGEM will not be impacted by it.

Are you asking about specialty training places?

Ms Mochan will recognise my ministerial background in that regard and my determination to do all that we can to ensure that we support displaced Ukrainians in the health and social care system and those who bring with them skills and qualifications that are much in demand across the public sector and wider economy. Discussions continue to be had about the sharing of qualifications and qualifications standards. I will need to provide Ms Mochan with the status of that. Because it is to do with regulation, some of it lies outwith our control here in Scotland.

In principle, I will say now what I have been saying for four years: we expect our Ukrainians who have been displaced to be able to work to their qualifications, because we need their skills and experience, and we can offer them an opportunity to rebuild their lives here in Scotland. I care deeply about that, and I will make sure that I provide a more formal update to the committee on the progress of those discussions.

I will bring in Ms Gibbons in a second to provide a bit more detail. In our negotiations, we secured a number of conditions, including Scottish ministerial consent, that will ensure that the devolution settlement is respected. For all the reasons that I set out in my opening statement, we recognise that operating on a four-nations basis on the issue is advantageous to us, because that will avoid unintended consequences and detriment to the Scottish system. I ask Ms Gibbons to provide additional information on how that was achieved.

Convener, colleagues, thank you for inviting me to speak with you today. The committee will be aware that the bill passed through the House of Commons unamended on 27 January. Across the UK and here in Scotland, the dedication of our NHS staff continues to be remarkable, but we must be honest about the challenges that are facing our medical workforce. I thank those doctors who took part in phase 1 of the future medical workforce project and who shared their views on those challenges candidly.

We cannot ignore the increasing pressures within the UK medical training pipeline that are affecting our resident doctors. Demand for the foundation programme and specialty training posts has grown sharply. In 2025, 12,000 UK-trained and 21,000 internationally trained doctors competed for 9,500 specialty training places. That bottleneck threatens the progression and retention of doctors who have trained in the UK and who are most likely to stay and build their careers here.

To match the increase in the number of undergraduate places, the Scottish Government has created 252 foundation-year places since 2021 and will add a further 72 in 2026. Furthermore, in line with anticipated future workforce needs, approximately 850 additional specialty training posts across multiple specialties have been added since 2014. To address concerns about training bottlenecks this year, the draft Scottish budget provides an additional £14 million for specialty training posts. That will increase the number of available posts in 2026 by approximately 10 per cent.

Although the Scottish Government can take action in Scotland, the impact of that on the UK-wide pool of posts and, ultimately, the experience of resident doctors in Scotland is influenced by the actions of other Governments in the UK. It is against that backdrop that the Medical Training (Prioritisation) Bill is being enacted. It is right that training posts are determined by future workforce needs, but we cannot risk losing those whom we have trained in our world-class universities. Although Scotland experiences those pressures to a lesser extent than other parts of the UK, the reality is that we operate within a UK-wide recruitment system, so moving together on a four-nations basis is the only way to ensure that Scotland is not negatively impacted. If prioritisation were to apply without Scotland, we would experience displacement effects.

The bill provides a lawful and proportionate mechanism to prioritise UK medical graduates alongside other priority groups where limits are required. It also ensures that, from 2027 onwards, we can recognise and value internationally trained doctors who have made significant contributions within the NHS by enabling them to be prioritised through future regulations. The concurrent regulation-making powers with safeguards around Scottish ministers’ consent provide the necessary assurances that our devolved responsibilities are fully respected.

I stress that the bill will not prevent international recruitment. Indeed, international students will always be welcome in Scotland for their positive contribution to our campuses, our economy, our NHS and our local communities. The bill will support a sustainable and reliable future supply of doctors and ensure that those who have trained here have the opportunity to progress their careers. On that basis, and having considered the legal, financial and operational implications, the Scottish Government recommends that the Scottish Parliament grants legislative consent to the bill.

11:00

Yes, it covers GPs.

That opportunity will remain, and there might be expanded opportunities as a result of the prioritisation being on a four-nations basis. There will be reduced competition for UK-based medical graduates, and it will be proportionately harder for international medical graduates.

However, I reiterate that, given the issue that you mentioned relating to places that are harder to fill, international medical graduates will still be required and will still be very much valued by the Scottish Government. In our discussions with the UK Government, we were not comfortable with previous iterations of the policy because we felt that they would impinge on our ability to recruit internationally. I want to leave the committee in no doubt that the Scottish Government’s position is that we will still require international medical graduates, even under this policy.

That is correct.