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Stand to lose?

Medicine Balls

Phil Hammond

Tuesday, 12 March 2019

Chess board_AdobeStock_44460476.jpgAs I ponder whether to stand against my local MP, Jacob Rees-Mogg, at the next election (2022 or next week, depending how Brexit goes), I’m reminded of the reaction of the best friend of former nurse Anne Milton when she won the Guildford seat: ‘What have you done? Oh my God. What the f*** have you done?’

MPs are set up to fail
This anecdote opens Isabel Hardman’s excellent book, ‘Why We Get the Wrong Politicians’. The book could more properly be called ‘Why would anyone want to be an MP?’ It sets out in graphic detail how MPs are set up to fail. Their parties make ludicrous fantasy pledges that can never be achieved, and even when legislation is attempted to achieve such pledges, MPs do not receive any training in how to scrutinise it, so those who used to be lawyers tend to hold sway. Even worse, the government is so keen to avoid the public humiliation of its legislation failing to get through parliament, that independent-minded MPs are heavily whipped, the time for scrutiny is strictly limited and scrutiny committees are packed with ‘yes’ people licking their way up the greasy pole, who would sooner write their Christmas cards than ask awkward questions and hold their leaders to account. As a result, many of the laws passed are bad laws. They do not achieve their intended consequence and the unintended consequences that might have been foreseen with proper scrutiny end up doing more harm than good.

MPs then have to witness the chaos their harmful legislation (or failure to stop such legislation) has caused when they do their constituency surgeries. Like a deep-end GP surgery, there is often a stream of very distressed people clutching carrier bags full of official paperwork who are about to be evicted from their homes, or don’t have any shelter at all or who have no job or who are bullied into doing mindless jobs for low pay or who are being evicted from the country or are deeply ashamed at having to use food banks or whose children’s schools are closing a day a week due to lack of funds or who are breathing in soot and living with debt, dementia, depression or domestic abuse. To make life even tougher, trust in MPs has all but evaporated. As Dr Sarah Wollaston (former Tory, now of the Independent Group of MPs) observed when she took up office: ‘“I’m the same person, but when you change your initials from GP to MP, just that one letter, the biggest shock is the change in how people feel about you. As a GP people are inclined to trust you and like you until proven otherwise, whereas as an MP people are inclined to mistrust you until proven otherwise.”

The lesson of Brexit
Brexit has at least taught us a useful lesson. The same tricks that ministers have used for decades to get dodgy legislation through Parliament were used on the public. Such fantastical promises and misinformed consent would get us struck off as doctors, but it persuaded enough people sick of austerity and desperate for English identity to break free from the EU. Now the reality has come home to roost, politicians, the press and the public are finally doing their job and Theresa May’s Withdrawal Bill has been scrutinised to destruction. So desperate is she to get it through, that she is making already fearful, sleep-deprived MPs scrutinise her latest legal wheeze overnight in the hope of blind-siding them today. My prediction is that she won’t succeed. Parliament has finally rallied around the need for proper scrutiny.

Scrutinising the Health and Social Care Bill
My only real attempt at scrutinising a Parliamentary legislation was the Health and Social Care Bill. I was invited onto BBC1’s Question Time in 2011 to debate it with health secretary Andrew Lansley, so I bought it from the shop opposite the House of Commons and attempted to read it (the night before the recording). I initially thought the critical reading skills for analysing scientific papers would make this easy, but I was faced with over 350 pages of impenetrable legal guff. Cut through the guff at 3am and the danger became apparent. The Secretary of State was going to absolve himself of the obligation to ‘provide’ universal healthcare and merely ‘promote it.’ Providers would become even more powerful, independent legal entities competing for business, which would be put out to repeated competitive tendering alongside the private sector, which would in all probability be extremely time consuming, expensive and wasteful, not improve care and make the joining up of health and social care services near impossible. And non-profitable services would whither on the vine.

I pointed this out to Andrew Lansley, as many others did, but this predictably disastrous piece of legislation still passed through after a pause and multiple cack-handed amendments. Now, the NHS in England is desperately trying to join up care and reverse the worst elements of the Act, but there isn’t sufficient will nor Parliamentary time for a full-scale repeal. The Conservatives admit it was a disaster in secret but dare not admit their mistake in public. When Sarah Wollaston asked to join the bill committee in order to table a series of amendments that she hoped would improve the way that legislation would reorganise the health service she had worked in for 24 years, she was told she wouldn’t get a place on the committee unless she agreed to table only amendments that were acceptable to the government.

Crushed ambitions
Wollaston has since served with distinction as chair of the Health Select Committee, but her ambition to introduce evidence-based politics to the Conservative Party has clearly failed. In 2015, when the combined effects of austerity and Lansley’s Act was making severe dents in the access to universal health and social care services, the Tories had the nerve to make a manifesto promise that the NHS would be ‘the safest and most compassionate health service in the world.’ They have clearly failed to deliver again on a grand scale, but with the domination of Brexit, this is passing largely unnoticed.

Wollaston told me she works even more hours as an MP than she did as a GP, and is deeply frustrated that our feudal, tribal system of politics so rarely changes people’s lives for the better. I don’t particularly want to be an MP (I think I do far more good as a doctor and a comedian), but when I hear Rees-Mogg say ‘We have nothing to fear from a no-deal Brexit… Boris Johnson would make an excellent Prime Minister…  we need to forge closer ties to Donald Trump’, I have to at least speak up and try to find an antidote to the poison.

Still worth trying?
It’s extremely unlikely Rees-Mogg will be defeated unless all the parties to the left of him unite in a progressive alliance around the strongest candidate. But parties are generally too proud and too tribal for such constructive collaboration, so they end up splitting the vote and waving the ideology they most fear back in. In a first past the post system, you may as well burn your money than stand in a safe seat. And Rees-Mogg has far more money to burn than any of his opponents. But it may still be worth trying…

Dr Phil is returning to the Edinburgh Fringe with ‘The Great Health Con’.Tickets available here.

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Phil Hammond

Phil Hammond is an NHS doctor, journalist, author, broadcaster, speaker and comedian. He qualified in 1987 and worked part time in general practice for over 20 years. For the past seven years he has worked in a specialist NHS team for young people with chronic fatigue. He presented five series of Trust Me, I’m a Doctor on BBC2, encouraging patients to be more involved, assertive and questioning. Phil is Private Eye’s medical correspondent; in 2012, he was shortlisted with Andrew Bousfield for the Martha Gellhorn Prize for Journalism for ‘Shoot the Messenger’, an investigation into the shocking treatment of NHS whistleblowers. In 2013 and 2014, he was judged to be one of the top 100 clinical leaders in the NHS by the Health Service Journal. As a comedian, Phil was half of the award-winning double-act Struck Off and Die, with Tony Gardner. He has done five solo UK tours, appeared on several TV shows, and has written five books.
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