UK, Malta seek deal to shield Maltese doctors’ NHS training

Following concerns about the impact a UK Bill would have on Maltese doctors pursuing specialist training in the UK, the two governments are set to work on formulating an agreement that would safeguard existing arrangements and enable Maltese doctors to gain experience in the UK’s National Health Service, Health Minister Jo Etienne Abela told The Malta Independent on Sunday.

A new bill making its way through the UK’s Parliamentary procedure raised concerns about the impact it would have on Maltese doctors who undertake specialisation training in the UK, as the bill proposes the prioritisation of graduates from medical schools in the United Kingdom, among certain others, for places on medical training programmes. 

Graduates from Malta would not be given prioritisation under this bill.

Health Minister Abela had written to UK government officials airing his concerns, stating that this strategy puts the training and specialisation of Maltese graduates in jeopardy. The minister, speaking with The Malta Independent, explained why he is so concerned by the bill. He said that many Maltese specialists-in-training travel to the UK to pursue further training, using it as a “finishing school” so to speak.

It is understood that Prime Minister Robert Abela had also written to the UK’s Prime Minister, Keir Starmer, about the matter.

Concerns regarding Malta’s situation were highlighted by a number of Members of the House of Lords during a debate which had taken place in January about the bill.

Information on the House of Lords website explains that the proposed Medical Training (Prioritisation) Bill would, for foundation placements, prioritise UK and Ireland medical graduates and graduates from priority list countries. For offers for specialty training posts in 2026, it would prioritise UK and Ireland medical graduates, graduates from priority countries, those who completed foundation training or a relevant earlier stage of training in the UK, and those with certain immigration statuses.

For offers and interviews for specialty training posts from 2027 onwards, it would prioritise UK and Ireland medical graduates, graduates from priority countries, those who completed foundation training or a relevant earlier stage of training in the UK, and those with significant NHS experience, to be defined in regulations. 

Malta is not included as a priority list country in the bill.

But it has now emerged that the UK and Maltese governments are going to enter into talks to find some form of agreement.

While it does not seem Malta will be added to the UK Bill’s list of priority countries, following discussions with Malta’s High Commissioner to the UK Stephen Montfort, the UK’s Minister of State for Health and Secondary Care, Karin Smyth, informed the Maltese government that the UK government will work with Maltese officials to come up with an agreement which safeguards existing agreements and that enables doctors from Malta to train and gain experience through sponsored non-numbered fellowship posts, Minister Jo Etienne Abela said, when speaking to The Malta Independent on Sunday.

Minister Abela explained that in order to specialise in the UK, a National Training Number (NTN) is issued, which would mean that the person has been earmarked for run-through training which leads to a certificate of completion of training. The UK’s prioritisation bill, he said, means that priority for those numbers will be allocated to people who graduated in a UK university. If Maltese were to apply for a NTN in the UK, they would be at a disadvantage under the bill, Abela said. 

But the UK is offering to hold discussions leading to a potential agreement for Malta to have non-numbered fellowship posts, the minister further explained. 

Fellowship posts are for doctors who would have already achieved a certificate of completion of training, or are on their way to achieving it, the Maltese minister said. Such doctors could then take up such a fellowship post for part of their training in the UK, “which would, for all intents and purposes, be the same training as a person in a National Training Number post”, Minister Abela said. The minister added that under such an agreement, the government would allow doctors to take up such a fellowship post under contract that they then return to work in Malta afterwards.

When asked whether the proposals outlined in the letter would still negatively affect the training of Maltese doctors under the bill, Abela said that if agreement is found along the lines of what is stipulated by the UK minister in the letter, “we shouldn’t have any problems. Without that commitment from the UK government, yes we would have had problems”. 

The UK Ministry also assured Malta’s minister that Malta’s Foundation School and its affiliation with the UK Foundation Programme Office are not going to be affected by the bill in the UK, Minister Abela said, explaining that this means Maltese applicants for UK speciality training won’t need to fill out a Certificate of Readiness to Enter Specialty Training. Malta’s Foundation School runs The Malta Foundation Programme, which is a two-year training programme for newly-graduated doctors and is a bridge between medical school training and specialty training. 

Completion of such a programme is required for a full licence, Minister Abela said.

The bill in the UK will also affect the Queen Mary University of London campus in Malta. It is understood that its students would not be prioritised under the UK Bill. 

While the UK government, in its letter to Minister Abela, did not mention tackling this point, Minister Abela said that when he had brought the issue up at Cabinet level, Cabinet agreed that all QMUL students from the campus in Malta will be offered the opportunity to enter the Malta Foundation Programme. “They are graduating in Malta and it would be good for our health service to also employ them,” he said.

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