This week: Sarah Wollaston, Conservative MP for Totnes and chair of the Commons health committee
This week: Sarah Wollaston, Conservative MP for Totnes and chair of the Commons health committee
Why she matters: A regular feature in the top 20 of the HSJ 100 – our ranking of the most influential people in healthcare. Dr Wollaston’s independence and willingness to challenge the government has earned respect across the House. A former backbencher of the year, she has moulded the select committee into an effective forum for exploring consensus on health policy.
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“I’m still rattling cages. I haven’t had it knocked out of me. I think that when you’ve stopped caring about things as a politician, when you’re not prepared to put your head above the parapet, then it’s probably time to leave.”
Sarah Wollaston is perhaps the unlikeliest rebel the Commons has played host to.
A self-confessed “pragmatist” and “centrist”, she was one of three MPs elected under the Conservative Party’s experiment with open primaries – in which parliamentary candidates were chosen by all eligible voters living in a constituency. She readily admits she got the nod because her CV was light on politics.
Even now, after eight years as an MP and three as chair of the health committee, she readily acknowledges her bewilderment with the political process.
“I remember someone saying to me when I first arrived [at Parliament], ‘just wait two years and it’ll all make perfect sense’. And you know, it still doesn’t.”
But the former GP is rocking the boat as hard as anyone.
She is a fervent remainer and has been one of the leading proponents on the right of a second referendum. The Daily Telegraph front page identifying her as one of the Tory “Brexit mutineers” has been framed and given a prominent position in her Westminster office.
This stance has earned her the attention of the wealthy Brexit champion Aaron Banks, whom Dr Wollaston accuses of running “a very aggressive campaign to de-select me”.
She has worked hard as the health committee chair to raise the dangers she believes are posed to healthcare by Britain quitting the EU. A no deal she says, “will be very, very serious for patients”.
Brexit poses a real threat to sustaining an adequate NHS workforce, she says, and to the “complex interactions” and “close networking” that is essential in the development, manufacturing and supply of pharmaceuticals and medical devices. Such disruption would cause “profound” harm, she declares.
Dr Wollaston justifies her support for a second referendum thus: “I’m banging on about having a second referendum once we know what the shape of the deal is because I think there is an issue around informed consent. You wouldn’t go into surgery based on the consent form signed two years ago for an unknown operation. You would want to know what the surgery is, what the evidence is, what the risks are.”
This desire to respect the “evidence” has also led her to be “at odds with some of the rest of my party”, particularly on public health issues.
“I’m often accused of wanting to impose some kind of nanny state. One of the big challenges I faced coming into politics, having been a clinician, is that I’m very much interested in being evidence-led in my approach. But I realised when I got here that the evidence [sometimes] runs into what is politically popular.”
She finds it “deeply disappointing” that England has not followed Scotland on minimum-pricing for alcohol and questions the government’s commitment to sufficiently funding public health measures.
“If you’re cutting public health budgets, you have an even greater responsibility in my view as a government to make sure that the policy levers are there in other areas that could make a difference. Take, for example, this recent Budget. We have the chancellor saying that he wants to make a difference to the tragedy of lives lost by suicide, but then at the same time not taking action to bring forward changes to fixed odds betting terminals that have been agreed.”
She recognises that public health “is right down the bottom” when it comes to what the electorate would like money spent on but says if the PM is sincere in her Downing Street pledge “to tackle the burning injustices of health inequality” she needs to respect the evidence and back “a whole systems approach to public health”.
You suspect some Tory MPs might believe that the open primary process has led to someone who would be happier in a Blairite Labour Party being elected under their ticket.
Dr Wollaston’s office was one of the rooms used by the Social Democratic Party plotters to plan their break-away and when I suggest that she would be happier in such a party she simply smiles and looks at the floor.
However, asked if there is distinctive Conservative approach to healthcare, she gives a clearer answer than may.
Whereas the current Labour party wants all publicly funded care supplied by NHS organisations, she says that as long as it remains “free at the point of use [and] available to all based on need and not the ability to pay” then Conservatives want the ability to “commission from other sources”.
This is not a privatisation agenda, she insists, just a “pragmatic view” of how to get the best care for NHS patients. She also claims it is “nothing new”, noting that as a GP she was “an independent contractor”.
She continues: “I think that the trouble is that there’s a kind of narrative out there, which I think is the wrong narrative, that Labour almost own the NHS. I think it’s really unfortunate [that] they’ve managed to persuade people of that. If we did see a hard left government coming in and completely making [the NHS] a monolithic provider, this sort of airless room as some people describe it, I don’t think people would like that at all.”
Dr Wollaston acknowledges that in the past the NHS has used “the private sector in the wrong way” and has ended up “destabilising the rest of the system”. Private sector involvement in the NHS “has to be done in a thoughtful way”, she states.
She rejects the idea of charging for elements of care that are currently free – pointing out that it either increases inequalities or gives rises to so many exemptions that it is not worth doing in the first place. Intriguingly, however, the Totnes MP says she does see the argument for introducing charges which might improve the convenience of accessing NHS care – for example, arranging a diagnostic appointment at the weekend.
She would ask those introducing such charges to be sure that the proceeds would be easy to administer and help the department involved by enabling it to expand its service. “As long as it would benefit everybody, I think that [charges for convenience are] reasonable”.
This is part one of an extensive interview with Dr Wollaston. Part two, which focuses on the work of the Commons health committee, will be published next week.
Next week: Wollaston Part 2
Coming up: Johnny “shit show” Mercer
If there is any political figure you would like me to interview, please email alastair.mclellan@wilmingtonhealthcare.com or if you are reading this on the website leave them in the comments box.
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