Build support for reform, urges MP

When Devon GP Dr Sarah Wollaston was elected to parliament she pledged to stand up for the NHS.

Dr Wollaston: ‘The legislation has led to a div­isive atmosphere. The secondary care sector and other professions feel they are being marginalised’ (Photograph: South Devon Conservatives)
Dr Wollaston: ‘The legislation has led to a div­isive atmosphere. The secondary care sector and other professions feel they are being marginalised’ (Photograph: South Devon Conservatives)

Her first eight months as Conservative MP for Totnes suggest she aims to keep her promise.

Dr Wollaston was recently told by party whips she could only sit on the committee scrutinising the Health Bill if she agreed not to table any amendments.

Dr Wollaston not only refused the offer but spoke publicly about what happened. 'I felt there needed to be more effective scrutiny,' she says. 'To my mind the whole purpose of being on the scrutiny committee if you have experience is to say in an independent way: "I welcome this Bill but there are key aspects of it that need to be amended".'

Broader support
Dr Wollaston says it is important that the Health Bill is not pushed through without a broader consensus of support.

'There are certainly concerns within the profession and my view is that the government will have better legislation when there is consensus,' she says.

To achieve this, Dr Wollaston argues that key areas of the Bill need to be addressed, namely the role of Monitor in enforcing competition. She identifies this as a major reason why the profession has moved from a position of 'widespread support' for the reforms to one of concern.

Dr Wollaston says she wants to see Monitor as an enabler of competition, rather than forcing GPs to 'always be considering competition at every turn'.

Echoing concerns set out earlier this month in GP, she says: 'I'm concerned that there aren't sufficient safeguards within the legislation to prevent Monitor interpreting its powers in a way that isn't intended.

'What I don't want to see happen is that Monitor comes in as this enforcing organisation that gets in the way of commissioners being able to design very good care pathways.'

It also needs to be clear from the start how Monitor will be regulated to ensure its actions are not causing 'unintended consequences', she says.

Building commissioning plans around GPs alone is causing concerns for other health professionals and needs to be addressed, she says.

'The way the legislation is worded has led to a kind of divisive atmosphere. The secondary care sector and other professions feel like they are being marginalised.'

Commissioning decisions
Dr Wollaston says the DoH should consider requiring consortia to have other healthcare professionals on their boards, or to consult them over commissioning decisions.

'I think it is better to have people represented at a board level because then there is a sense of inclusiveness, isn't there?' she says. 'I think it would make for much happier working relationships if they were included.'

GP consortia board meetings should be open to the public to allay fears that GPs will be making decisions that serve their own interests rather than those of patients, she adds.

Dr Wollaston gave up her career as a GP to become an MP. She says she misses general practice, but had to make a choice between the two.

'I would have been doing two jobs badly rather than throwing myself into one,' she says.

Dr Wollaston says she still feels 'very much like a doctor' particularly as 'around half' the people visiting her MP constituency surgery come with medical problems.

She spends most of her time in parliament talking about health-related issues, particularly given her role on the House of Commons health select committee. 'Being a GP and an MP are surprisingly similar,' she says. 'If you are interested in medico-politics and healthcare it is a very interesting place to work.'

Dr Wollaston says she doesn't know whether she will stand for re-election. 'They might not have me back,' she says. Then again, perhaps by speaking her mind Dr Wollaston can raise her profile enough to avoid being pushed aside.

Health Bill concerns
  • Health Bill needs greater safeguards to prevent Monitor enforcing competition in a damaging way.
  • Consensus of support for reform must be built among profession.
  • All health professionals, not just GPs, should run commissioning.
  • Consortia board meetings must be open to the public.

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