Interview: A GP in Westminster

Halfway through her first term as an MP, Dr Sarah Wollaston tells Nick Bostock she is determined to continue speaking her mind.

'Can I just finish off this one email? I'm so sorry.' Dr Sarah Wollaston half-turns and grins apologetically.

She has lost none of the personal touch from her days in the consulting room, but as her first term in Westminster has shown, Dr Wollaston has also retained the determination and advocacy skills of an independent-minded GP.

Her office, in a building on Victoria Embankment that until the mid-60s was home to Scotland Yard, is small and unglamorous.

The Conservative MP for Totnes, Devon, and former GP sits facing a high window at a desk swamped in papers and folders butting up against her laptop. She sits back to back with a colleague working at the room's other desk.

Non-stop work

The stacks of paperwork and last-minute email are testament to the non-stop nature of work as an MP.

'This is the most challenging job I've done,' Dr Wollaston says. 'It feels like being a junior doctor in the 1980s again. If you do the job properly, it does rather take over your whole life.'

Being an MP resembles general practice because you have to be a true generalist, she says.

'Anyone can come through the doors, often with very complex problems. So my MP surgeries are very similar to my GP surgeries.'

The difference is that, while GPs train for years before anyone lets them loose on a patient, MPs get no training at all.

'Nobody teaches you how this place operates, so there are lots of things you realise afterwards you might have done differently if someone had sat down and given you some proper training.'

One thing Dr Wollaston might have done differently is to tone down the 'incendiary' language she used to criticise the Health Bill during its passage through parliament. After hitting the headlines for commenting that it looked as if someone had 'tossed a grenade' into PCTs, she faced a struggle to regain the ear of senior party figures.

'If you use very incendiary language it can result - and it did for me - in your being viewed as hostile, and you find that you can be less effective when you are trying to negotiate about something that you care passionately about when you talk to the people who are making the decisions.'

Lobbying the ministers

Since then, Dr Wollaston has played a part in successfully lobbying the coalition front bench to back a minimum price for a unit of alcohol. The paradox of working on initiatives to cut alcohol misuse while MPs continue to drink heavily in parliament is not lost on her.

She says: 'Clearly people are more likely to listen to you if you practise what you preach, but nobody wants to be moralised at.'

When it comes to the government, however, she says it is very much the backbench MP's role to challenge ministers on policy matters.

'We need to hold their feet to the fire,' she says.

Ministers' toes are currently being slowly roasted over an issue Dr Wollaston believes is a modern-day scandal - the mountains of clinical trial data that remain unpublished.

'I think people would be truly shocked at the extent to which data is hidden from them in relation to clinical trials,' she says. 'Why is it that governments take such a supine position?'

Drugs should not be licensed without 'full accountability', she says, and the GMC should investigate the ethics behind doctors signing gagging clauses, agreeing not to release drug data without permission from companies.

For all that laws need changing in the outside world, it is perhaps within the House of Commons itself that the Totnes MP believes the most radical overhaul is needed.

'The way this place operates would not be tolerated in any other organisation,' she says. 'You are performance-managed on everything the whip's office would like you to do.

'Your performance is genuinely not managed on how hard you work for your constituents or what effort you are putting into the job. That surprised me. Genuine public dissent and argument aren't valued in this place unless they are directed at the opposition in a tribal fashion.'

Committee fodder

MPs are routinely sent to sit on committees debating subjects they know nothing about, with instructions to 'turn up on time, say nothing and vote with the government'.

'It is a surprise to me how little opportunity you get to actually help to influence health policy. That, I would say, would be my main criticism.'

People are ready to see politicians behave more independently, she believes, and to express their views, rather than parrot party lines. This stance is not one likely to propel her to the front benches. 'I'm unlikely to be promoted because... ' she hesitates. 'Because I'm probably too awkward, really.'

Although she talks about independence, she is quick to point out that she never considered running as an independent MP.

'I am what it says on the tin. It would be wrong to stand on an election ticket if you weren't actually a member of that party. The point for me is that I had never been to a political meeting in my life before I applied for the job, so I didn't come at it with that tribal party political background.'

Key issues for general practice remain high on Dr Wollaston's agenda and she has been working to press for 'more realism' in the training of young doctors. For years, governments have 'ducked' the fact that too many junior doctors are training for jobs that don't exist. Half of all medical students should be aiming for general practice to address a looming workforce crisis, she says.

Hard times for all

She won't be drawn into giving specific views on the pay deal the government is threatening to impose on GPs, but accepts that times are hard for the profession.

However, she urges GPs to take a step back and bear in mind that the whole country is suffering similar problems.

For all the frustrations, Dr Wollaston has never considered anything other than standing for re-election in 2015.

'It's a great job. There is a real shortage of scientists in this place, and I'd say to any GP - if anyone's interested, tell them to come and see me and I'll tell them how to apply.'

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