Health in Focus: National Cancer Plan and Medical Training Bill

Following the explosive fallout over resident doctors’ pay and job conditions towards the end of 2025, Wes Streeting set out that the Government would introduce emergency legislation, now titled the Medical Training (Prioritisation) Bill, to Parliament.

The Bill is set to alter the hierarchy of prioritisation in the current UK Foundation Programmes, creating a new tier of priority for UK medical graduates (who have obtained their qualification primarily in the UK). This is followed by a prioritised group of graduates with specific trade agreements, then by all other international medical graduates. The Bill also sets out a priority system for specialty training programmes, which creates a single top priority group for the UK and for other prioritised groups.

The implementation of the Bill is to be staggered across 2026 and 2027 and beyond, with those with indefinite leave to remain granted priority only in 2026, before this is shifted to those who have ‘significant NHS experience’ from 2027; prioritisation will also be limited to the offer stage in 2026, whilst from 2027 applications will be assessed at the shortlisting and offer stage.

The Bill has passed through the Commons and will go on to be scrutinised by the Lords. The Bill must be passed by 5 March 2026 to have an effect on 2026 places. In the Commons Committee stage, the Conservatives called for UK graduate prioritisation through both the UK Foundation Programme and specialty training programmes, and for all UK citizens to be prioritised even in cases where they do not have primary qualifications in the UK, citing the UK-Malta healthcare partnership, which could be undermined by the Bill.

Another concern of the Bill has been the balancing act between merit and prioritisation. This argument posits that rather than adding a fixed structural differentiator to improve graduates’ chances in world-leading courses, the UK should better equip universities to deliver the best graduates to win these places on merit more comfortably. Thus, the fixed prioritisation system could lead to the UK becoming staffed by less-qualified doctors, while better ones sit in the wings blocked by their origin.

Another concern is that the Bill will be used as a ‘bargaining chip’ by the Secretary of State given that its implementation is at the discretion of the Secretary of State rather than upon Royal Assent. Thus, Streeting could withhold the Bill until the BMA has met the Department’s criteria, leveraging the law-making powers of the Commons over the union. Despite this accusation, the Bill’s contingency on ministerial operation is likely being enforced to ensure the Bill’s passing does not blow up in their face if, come the renewed BMA mandate for strikes, the BMA stands equally resolute in opposition to Government proposals.

Streeting has publicly stated his desire to ‘hit the reset button’ on BMA relations, and build a long-term solution away from ‘fractious’ and volatile disagreements, and early discussions in 2026 have been described as ‘constructive’. Although this may be a common politically-polite shield, Streeting will hope his efforts and the introduction of the Bill will offer the BMA an olive branch into negotiations and hope to develop a more sustainable footing for the workforce. In fact, a recent report from The Guardian has suggested that Streeting is willing to provide another pay rise for resident doctors, a decision that could have seen this entire fiasco over the last few months quelled much earlier. If this rumour does materialise, there will be no doubt that the Opposition will frame this move as the Government being weak to industrial action and held to ransom by the BMA.

Last week, the Government published the National Cancer Plan, which has been framed as a once-in-a-generation opportunity to shift the prospect of cancer care in the UK from ‘breaking point’ to a renewed world-leading status. Crucially, the target of 85% of cancer patients being diagnosed and beginning treatment within 62 days, which the Government is politically accountable to, has not been met since 2015.

In the Plan, the Government has pledged to meet this target along with two other key targets: 96% of patients starting treatment within 31 days of a decision to treat; and 80% of patients getting a diagnosis or all-clear within 28 days of an urgent suspected cancer referral. To reach these targets expansion is key, and the Plan announced that £2.3bn will be invested in diagnostic transformation through Community Diagnostic Centres (CDCs). This correlates strongly with the community shift of the 10-Year Health Plan, where the Government is hedging its bets on cutting waiting lists through early detection and diagnosis, delivered through care closer to home. CDCs’ capacity will also be expanded at thirty sites, with all ordered to offer 12 hours a day, 7 days a week services to communities.

The announcement of 154,000 more MRI scanners by 2029, investment of £96m into automated histopathology and a new campaign to reduce low-value referrals all work to target this same window of opportunity in the early stages of cancer, improving the ‘quality’ of patient inflow, and tackling cancer early, quickly and efficiently. The sector has long called for a Young Cancer Patient Travel Fund to compensate families for the travel costs to the 19 specialist Principal Treatment Centres in the UK, with costs averaging at £250 every month. In the Plan, the Government set out £10m for this initiative to help support families and ensure treatment non-compliance is not driven by financial difficulties or regional disparities. The Plan also took steps to ensure more support for childhood cancer, including more involvement from paediatricians in the process, increased post-cancer surveillance for secondary cancers and further psychological support and care.

The Plan took a strong focus on early detection and diagnosis. The introduction of a new three-year Neighbourhood Early Diagnosis Fund will coordinate Cancer Alliances and neighbourhood health services to work directly with local communities, screening commissioners and providers to develop targeted campaigns aimed at reducing the gap in screening uptake. The Plan also sets out the national rollout of lung cancer, cervical self-test, and prostate cancer screening, with the latter subject to judgment of the UK National Screening Committee’s decision in March. One of the key concerns arising from the reaction to the Plan is the worry, as neatly put by the King’s Fund, to not put ‘the cart before the horse’ and push rapid AI innovation on an overwhelmed, underequipped, and understaffed workforce. Whilst AI diagnostics and genomics may increase productivity, when these services are hinged on outdated IT systems and infrastructure, trusts will struggle to realise the benefits. Predicated on the upcoming workforce plan, there is also concern that without the staffing capacity or training, expansions of services, such as more MRI scanners, will see its potential wasted.

Quite notably, the Plan put rare cancers at the core of its mission, dedicating a chapter to the issue. The chapter set out that rare and less common cancers will be advanced through improved data infrastructure, prioritisation for research by the National Institute for Health and Care Research, increased funding and the passing of the Rare Cancers Bill. A national clinical rare cancer lead will also be appointed, who will have a mandate to speak up for rare cancers, provide clinical advice and sit on the National Cancer Board, which will oversee the Plan. The Plan also took steps to improve clinical trials for rare cancers, improving access and trial opportunities through the NHS App, and setting greater clarity of direction through a new Cancer Clinical Trials Accelerator.

The Plan included initiatives into preventative public health measures including the implementation of ID checks for sunbeds, and the banning of unsupervised sessions, given the inherent risk of UV radiation emitted. The Department of Health and Social Care will consult on this issue this year before moving ahead with a ban. It will also consult on mandatory health warnings and nutritional information on alcohol labels. A recent report from the Institute of Alcohol Studies found that a series of coordinated lobbying across Government departments had prevented the inclusion of alcohol marketing restrictions in the 10 Year Health Plan back in July. This consultation will seek to further discourage alcohol take-up as a leading risk factor in poor public health and long-term conditions. This move will likely have a large impact on supermarkets who have long been seen to remain insulated from the cost and tax burdens associated with alcohol, with pubs bearing the brunt. A common concern, and one that reared its head in the 10 Year Health Plan, is the absence of accountable milestones for the Plan. In responding to the statement on the Plan in Parliament, the Shadow Health Secretary Stuart Andrew took aim at this lack of immediate delivery, calling for clear, funded milestones which show patients when they will see improvements in the next year or two.

While the Plan sets out expansive measures, and sticks to meeting fundamental metrics, the Plan does not rip up the manual for cancer care. There is a focus on prevention and improved diagnostics, but investment in these areas isn’t eye-watering and does not present a wholesale change to proceedings. Equally, while there is a whole chapter for rare cancers, this has been a key focus reiterated by the Government, so its prevalence is of little surprise. Ultimately, policy makers and public affairs professionals will not have had to react or change their workbook to adapt to this Plan which has swayed more on the side of consistent policy rather than radical change. This long-termism in policy has long been called for, especially set on the backdrop of tumultuous policymaking of the previous Conservative Government. However, the Plan will likely have minimal impact for a Government finding it seemingly impossible to communicate any success or improvements it sets in motion. With the current political standings probably as volatile as ever, from Lord Mandelson’s saga, the resignation of the Chief of Staff in No 10 and Scottish Labour Leader Anas Sarwar calling for Starmer’s resignation, any policy long-termism will be and has been overshadowed by the chaotic unravelling of Starmer’s premiership.

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