15 NOV 2016

Cirl Bunting

Celebrating the success of nature friendly Devon farmers:

This Friday (18th November) I will be celebrating the great progress in saving a bird that was nearly lost and the great contribution of Devon's farmers in making this possible.

The bird is the lovely cirl bunting, for which I am delighted to be a 'species champion MP'

Often called 'Devon's Special Bird' because, while it was once much more common across southern Britain, by the 1980's its numbers had declined and range pulled back into a small zone in south Devon. At this stage then, this bird of mixed farmland was in real decline and it began to look as if we might lose it altogether in this country. Devon had a special role to play. With these signals something stirred, the nature organisations, especially the RSPB, got stuck in. What was the problem? What has happening on the farms? Could farmers help save the bird? From what I have heard about the work, something wonderful began to happen.

Collaboration around the RSPBs research, the trialling and testing of farm based solutions, all swung into place. Saving this bird of farmland was absolutely dependant on farmers rising to the cause, and they did. The RSPBs 'recovery project' supported farmers, helping them turn the key that opened recovery success.

Local communities woke up to their special bird too, schools projects, a football team with the bird as its badge, and even a Devon village – Stokeinteignhead - celebrating the countryside around it as being special for this bird, all signalled peoples support for our special bird.

So, I will be enjoying celebrating some great news from Devon this Friday. And alongside this I'll take a serious message with me – that with the right approaches, and done well, we can do so much more for nature. The story of the cirl bunting - the bird we nearly lost - the farmers who have helped so much, the nature bodies like the RSPB, and all with the right kind of support from government and others, shines a light on how we can all do better.

This could not be more important right now as we look beyond Brexit and how subsidies might operate. I'm clear that these must continue to support the vital habitats for the cirl bunting and so many of our other native species.

(Photo courtesy of Matt Adam Williams)

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01 SEP 2016

Public Health is in Crisis

I wrote the following article for The Guardian

In her first speech as Prime Minister, Theresa May promised to tackle the nine-year gap in life expectancy between rich and poor, placing this at the top of her list of burning injustices. This yawning inequality has defeated successive governments, and the gap is even wider between rich and poor for years lived in good health. Closing it will require action across areas such as poverty, housing and education, as well as those more conventionally thought of as affecting health. May will need to start early and look far beyond the short-term political cycle for results.

Public health seldom makes headlines. We tend not to recognise, let alone thank it for preventing disease or life-changing accidents, despite public health measures transforming our life expectancy. We are more likely to focus on and appreciate the specialists who treat a condition than to complain about the absence of the expertise or policy that could have helped to prevent it.

The childhood obesity strategy was the first test of the government's determination to take action on health inequality. It was greeted with near-universal dismay because of the wasted opportunities to make a difference. Whole sections from earlier drafts, covering promotions and advertising, were conspicuously erased and reformulation yet again left to ineffective voluntary agreements. The final paragraph sums up the tone that it will be "respecting consumer choice, economic realities and, ultimately, our need to eat". This crass statement entirely misses the point; of course children need to eat, but the childhood obesity strategy needed to make sure that they benefitted from a better diet.

Five years ago, amid the huge controversy surrounding the Health and Social Care Act, one proposal received a cautious welcome: the transfer of responsibility for public health from the NHS to local authorities. It was felt that local authorities could make a greater difference to the health and wellbeing of their communities if the right expertise, powers and funding were based there rather than within a health service more focused on treatment than prevention of disease. In a report published today, the Commons health select committee has looked at those changes and made a number of recommendations about how public health could be strengthened to make sure that it has the tools to do the job. These will be key to helping to narrow health inequalities.

The chief executive of the NHS, Simon Stevens, has rightly called for a "radical upgrade" in public health and prevention, not only for the benefits to health but because it will be essential to reducing future demand for health services. The future financial sustainability of the NHS depends on the prevention of more expensive long-term conditions. This was not the time to undercut the role of public health with budget reductions, including in-year cuts. Witnesses before the committee described their extreme frustration at these decisions, which they described as "irrational" given the current focus on reducing demand.

While local authority public health teams are doing their best to cope with funding cuts, the potential impact of this was clear, and unsurprising – figures from a survey conducted by the Association of Directors of Public Health show that large proportions of local authories are already having to reduce a wide range of different public health services.

Perhaps more surprising was that we heard from witnesses – both from local authorities and from NHS organisations – a sense that prevention is no longer seen as the responsibility of people practising in the NHS. While local authorities now hold the ring for funding and co-ordinating public health and preventative work across their local area, every NHS professional has the potential to advance the prevention agenda in every patient appointment they carry out – but they will also need the time and space to do so. It is also a shame that those messages on improving health will continue to be drowned out by the unfettered advertising and promotion of junk food and alcohol.

While the local mechanisms are in place to embed health in all policy decisions, this will not succeed without stronger, more joined-up action at a national level. At a time of budget cuts it is more important than ever that local authorities have the levers to make a difference. Unfortunately, they have their hands tied when it comes to negotiating with business interests even where the health of local communities is at stake. The government could and should introduce health as a material consideration in planning and licensing to allow proportionate action to develop healthier communities, homes and workplaces.

I hope that the government will prioritise health inequality, but the early signs are not encouraging. If future policy is to be judged by the childhood obesity "plan", we can expect little real progress. Tackling health inequality requires far more than warm words on education and personal responsibility.

5 comments

Supporting the EU, now writing letter for the Guardian. It's hard not to see this bitter article as sour grapes at May's failure to promote Sarah.
- George, Paignton

Really George? Of course, one can read the article anyway they choose, but it would appear that you started off with a formed opinion, rather than concluding one having read the article and seeing that what Sarah is saying, is the absolute truth. Excellent Sarah, and thank you for standing strong.
- David M.

On the contrary. I have followed Sarah's conduct closely, and have formed the view that she is comfortable neither as an MP or a Conservative. I will continue to contribute to local press on the subject. I know an awful lot of Conservative voters in the constituency who feel the same. Her nanny ways seem to me at odds with the values of a country where subjects make their own choices and take responsibility for them. These are Tory values and seem alien to Sarah. She seems to think that "respecting consumer choice" is crass, and seems to favour the kind of minimum pricing strategies for alcohol that are so offensive in a free society (I see the SNP like this too, which speaks volumes about where she is on the political spectrum). Her inability to accept that there will always be a gap in life expectancy between the rich and the poor (for so many reasons there isn't space to write about...suffice to say that we have a public health service that is free at the point of delivery, so I feel rather less responsible for it than Nanny Sarah seems to want me to) is the kind of political naivety that would have worried me about someone who only became a Tory at 44. Her letter today regarding the apparent lack of funds in the NHS...when this is demonstrably not true...is the standard response of the Left when reform is just too difficult for the kind of vested interests that Sarah is actually a part of. More money is always the remedy they seek. I have a number of other problems with our MP, and have little confidence in her. Labelling decent Christian people (including a former Archbishop of Canterbury) bigots before the last election, simply because they didn't agree with her view at the time on Gay Marriage. Her volte face on the EU Referendum (going in moments from describing "the threadbare deal" attained by Cameron, our "powerlessness" in Europe, and saying our national interest lay outside the EU...to "the prime minister has returned with a threadbare deal that has highlighted our powerlessness to effect institutional change" and that "the balance of our national interest now lies outside the EU", to switching to back the Remain due to her apparent failure to understand the difference between a net and a gross contribution). Praising the SNP Health Service when it has failed by any measure. Indeed even her Twitter feed seems to praise Nicola Sturgeon, Anna Soubry and Emily Thornberry. Dear oh dear. It would be better for all that Conservative members in the constituency get the vote they were denied by David Cameron before 2010 and could elect an a candidate seems to be more in tune with fairly basic and sensible Tory values. It won't be Sarah Wollaston.
- George, Paignton

Hi! Not sure how to start this as the end-point is fixing the economy, but this is surely what you mean by closing gaps on health and income etc? Miliband and Balls joined with your former prime minister and coalition in writing the banks out of the narrative of the economic hardship of middle and lower income earners. Corbyn's business and regional banks put idiots who mean well in charge or put public finance into the hands of bankers who already operate massive frauds. It is extremely easy to simply arrange the tax and regulatory system so that banks investing in the real economy is in the banks' own best interests. Imagine if in 2008 "we" had said to the bankers, "Your top-rate of income tax is now set at ten times the percentage unemployment rate, and this will be set monthly with ONS labour market statistics. Additionally the bank-levy total will be the cost to the State of paying Jobseekers Allowance; this total to be divided among the banks pro-rata with the how the bank-levy is calculated". With 8.3% peak unemployment this would have set bankers' top-rate income tax at 83%; the total raised by the bank-levy doesn't matter, just note that unemployment benefit will not cost the State anything ever again; obviously other benefits aren't funded this way - yet. Any economist will tell you that getting SMEs access to honestly priced finance will kickstart the whole economy, and also that Brexit means that UK internal markets are even more important than ever. So that's not just inequalities sorted, but also Brexit made easy. The only people against this idea are ... well you can work that out. See here for a "FAQ": http://bailoutswindle.com/QuestionsProtestationsAnswered.html
- Harry Alffa

I would say that is surprising ro read Sarah's article since Sarah voted to reduce human rights, to reduce pensions and disability by £30 per week claiming it is better spent elsewhere, and that probably nobody else outside officialdom will agree with her. Now she wants to waste 65 billions each year exiting the EU just in exchange rates, pay 7% of our budget on nuclear rearmament and "defence", (far more than the EU "cost" us although they give us 50 % of ALL their grants) because of Brexit, and we will lose our pensions which are at the moment being removed from index linking to pay for Brexit and really bad financial managing by the government. Millions affected by Brexit were not given a vote, we are charging £1050 if their children want British passports whilst we are selling EU passports to commondwealth citizens as long as they have the money = so they see the benefit of the EU. Sarah is now disenfranchising us by saying she will vote for Article 50 for "democracy"!!! If you really want to go against our wishes, Sarah, resign and stand in a by-election. That is because she wants to be a fat cat Tory politician and not face an election or apologise for making the mistake and not going on with the suicide of Brexit. Why is Brixham is "Totnes" anyway and not Torbay? We do not want fishermen AND farmers wanting out of the EU but wanting us to pay their grants for them. We want compensation from them.
- siv white

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21 AUG 2016

Childhood Obesity; A Plan for Inaction

The childhood obesity strategy has been downgraded. The final paragraph sums up the tone that it will be 'respecting consumer choice, economic realities and, ultimately, our need to eat'. This crass statement entirely misses the point; of course children need to eat, but the childhood obesity strategy needed to make sure that they benefitted from a better diet.

Trying to capitalise on the feel good factor of the Olympics, the messaging has distorted the underlying evidence. Of course we need children to be more active but exercise matters whatever a child's age or weight. The key message on childhood obesity should have been front and centre about the importance of reducing junk calories with evidence-based action to match.

In completely removing whole sections from the draft strategy, it is hugely disappointing that the obesity plan puts the interests of the advertising industry ahead of the interests of children. The plan misses the opportunity to improve children's diets by reining in the saturation marketing and promotion of junk food. A staggering 40% of the food and drink we buy to consume at home is bought through promotional deals and the overwhelming majority of those deals are on junk food or alcohol. This was a missed opportunity to shift the balance of those promotions to healthier alternatives and to make them more affordable for those struggling on lower incomes. The plan has also completely failed to take junk away from the checkouts or restrict the hugely profitable end of aisle displays or deals flogging impulse purchases at point of sale. Responsible retailers wanted a level playing field in making those changes but their efforts will be undermined by the abject failure of the obesity 'plan' to recognise the impact of promotions and marketing.

Whilst it is good to see confirmation of the sugary drinks levy, the watered down obesity strategy is completely at odds with the pledge to tackle the burning injustice of health inequality. Even its title has been downgraded to 'plan' but it would perhaps have been better named a plan for inaction as even the proposals to reformulate are voluntary. Without 'teeth' voluntary reformulation looks set to be as ineffective as the miserable 'responsibility deal' which precedes it. Progress will be monitored against worthy but voluntary targets until 2020 but with no consequences for those manufacturers and retailers which put profits ahead of children's health.

Whilst all those in contact with children suffering from obesity are rightly urged to make every contact count in trying to help, they will be hopelessly undermined in their efforts. Big industry interests have been given free rein to continue to promote and advertise as they please including those that do so through online marketing masquerading as games or through the powerful use of cartoon characters on junk food aimed at children.

The confirmation of the increase in funding for school sport from a levy on sugary drinks manufacturers is very welcome but the levy will not come into force until 2018 and needs to be broadened to include all drinks with high added sugar content. The plan should also have given greater powers to local authorities to make changes to improve public health at local level. Especially at a time when their public health budgets are being cut, it was more important than ever to give them the levers to do the job by making health an objective in the planning system.

The gap between rich and poor children when it comes to obesity has widened every year since measurements began. One in four of the most disadvantaged children now leaves primary school not just overweight but obese, more than twice the rate for those from the most advantaged families. This plan for inaction will be remembered for its wasted opportunities, delays and spin when it could and should have been the opportunity to show that government is serious about tackling the gap in life expectancy between rich and poor. We will all be picking up the tab in the future costs of obesity for the NHS, already more than the police, fire service and judicial system combined, but no one will be paying a heavier price than the individual children facing a lifetime blighted by the consequences.

6 comments

As a constituent who didn't vote for you, I am glad to have ended up with an MP who will still speak up when she believes that the government makes such a big error as this. Cheers. A Smith Follaton, Totnes
- Andy Smith

Well said Sarah...I always said that you were one of the few decent tory mps. You're in the wrong party! Bravo
- Byron Jones

I fully agree! Short-term thinking continues to compromise the possibility of a better life for this and future generations, including threats to the planet generally, as outlined in a recent Press Release by the global One Health Commission...It really is time "to stop and think" what we are doing to ourselves, animals and the environment (i.e., One Health and Well-Being).The proposed One Health Commission education initiative might help to turn things around in due course: http://www.onehealthinitiative.com/publications/6-10-16 OH Education Press Release-Final.pdf
- George Lueddeke

P/try this URL re Press Release https://www.onehealthcommission.org/documents/filelibrary/commission_news/press_releases/61016__OH_Education_Press_ReleaseFi_F7644A48F9910.pdf
- George Lueddeke

The country has been waiting a long time for a national obesity strategy. It is therefore deeply disappointing that now it has finally arrived the government has not in fact published a strategy at all, not even a strategic plan for a whole system approach to tackling the obesity epidemic, but merely a lukewarm policy document that squanders both a critical window of opportunity and a wave of public support for bold and ambitious action. It needs to be judged more for what it does not include than for its timid plans to 'challenge' the food and drinks industry to reduce sugar content in some products by 20% over the next four years, to 'review' the 10 year old nutrient profile so that it can 'encourage' companies to make products healthier, to introduce a 'voluntary' healthy rating scheme for primary schools, and to launch a campaign to 'encourage' academies and free schools to commit to the new School Food Standards. The commitment to continued funding of the Healthy Start Scheme, and to ensuring that 30 minutes of physical activity is delivered daily in primary schools, assessed by Ofsted, are welcome. But the plan includes no mandatory actions (apart from the proposed levy on sugar sweetened drinks), either at national level or devolved to local government, that would have a strong and lasting impact on obesity. It needs measures such as mandatory reformulation of unhealthy foods; robust, mandatory restrictions on the marketing, advertising and promotion of high fat, high sugar food and drink; robust planning laws that would make unhealthy foods less accessible and journeys by foot and bike easier; major investment in physical activity infrastructure; or compulsory requirements for schools to tackle childhood obesity through the curriculum and whole school environment. This so-called ‘plan for action’ on childhood obesity gives the impression of a government that doesn't take the obesity epidemic seriously and prefers instead to prioritise the vested interests of some of the least healthy elements within the food industry. This is both morally questionable and economically foolish. We face a growing crisis of non-communicable diseases, already costing over £5 billion a year, and the chief executive of the NHS has warned that obesity threatens the sustainability of the health service itself. A comprehensive obesity strategy that imposes tough restrictions on the businesses that drive this huge burden of ill health is urgently needed but this ‘plan’ falls far short of this, and will fail to dent the crisis of non-communicable diseases that causes so much ill health and misery. London, and especially the more deprived parts of the city, is carrying a larger burden of child obesity than any other region in the country. The city has already taken action, locally and regionally to tackle this urgent public health crisis. We needed the national plan to take those actions that can only be taken at a national level. The only positive action to come out of the national plan, around schools, is already in place in London through the successful Healthy Schools London programme which reaches over 75% of schools and already means that schools are providing healthy food and physical activity to our children. London’s children have been let down by this plan.
- Danny Ruta

i would like to highlight a project started in WEST COUNTRY #milkandsarnies getting single pints of fresh milk out along side those sugary drinks offering a healthy alternative ..96% Fat free =full fat milk Great for bones and teeth putting milk next to the sandwiches in supermarkets..NeilParish another great west country MP ..is Twittering about this ALL is being done by suggestions at customer services by the public.. Milk v Fizz is simple 45p v £ plus cheaper too its filling the stomach so helping the need too snack ... look up #milkandsarnies better for rehyration too !!
- sylvia crocker

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08 JUL 2016

What next following the Chilcot Report?

The independent Chilcot Report was expected to report rapidly, but such was the volume and detail of the evidence examined and the sensitivity of its conclusions that in the end it took seven years. It runs to 12 volumes and 2.6m words and the final summary should be compulsory reading for all who will in future be tasked with the heaviest decision for any government, to commit our forces to war. 179 British servicemen and women lost their lives alongside 24 British civilians and over 150,000 Iraqis. The consequences for their loved ones of our failures in Iraq have been appalling and the terrorism and violence continue to this day across the region and worldwide.

Chilcot is damning in his conclusions including that:

• Military action was not a last resort as all peaceful options had not been exhausted

• Policy on the Iraq invasion was made on the basis of flawed intelligence assessments. This assessment was not challenged as it should have been, preferably by an independent body

• The continuing threat from weapons of mass destruction was presented with unjust certainty

• The circumstances in which the legal basis for military action were established were "far from satisfactory" and the authority of the United Nations Security Council was undermined.

• There was too "little time" to properly prepare. The risks were neither "properly identified nor fully exposed" to ministers, leaving our troops dangerously exposed as a result of inadequate equipment.

• Plans for post-Saddam Iraq were wholly inadequate

• The consequences of the invasion were underestimated and this left a space for extremists to flourish.

I listened to Tony Blair's apology and his acceptance of responsibility but like many was aghast to hear that he would take the same course of action again.

Next week Parliament has dedicated two full days to debate this crucial report and how this should influence the future conduct of those who advise on or take the final decisions to take us to war. Whilst I do not feel that the lesson from the Chilcot Report is that we should never engage in military action, it should be a last resort and all future governments must make sure that the grave lessons are learnt from this catalogue of disasters.

8 comments

Sarah I honestly do feel you should return to your original career, as there is a great shortage of GP s. You seem in your political career to wander from this side to the other going in whichever way the wind blows or as a cynic might say whichever way is the more promising for your career. First you were for not bombing Syria and then when Mr Cameron asked you again you became a willing propagandist for RAF bombing . In the Brexit debate you ended up on the losing side after a last minute conversion giving some spurious reasons which were frankly risible. Your thoughts on Chilcot are just a repetition of the mainstream and appear glib. I see today you have hitched your wagon to Theresa May with a twitter comment . The Home secretary of course is the establishment pro Remain choice. The aim of the pro Remain group is to thwart the will of the people and to stay in the EU. If that is the aim and the end result then we truly do live in a dictatorship.
- Peter Thompson

@Peter Thompson Surely the behaviour you describe is ideally suited to being a politician but in a GP would be rather worrying. Though hardly unexpected, I am still a little surprised by the apparent relish with which former Remain politicians are embracing their role in taking us out. They told us how devastating it would be for the UK to leave. Now May for instance has been quoted as saying that we have a "better, brighter future" outside the EU. Surely, if leaving was a bad for our country before the referendum then it still is and former remainers should still be resisting our exit rather than blindly chanting "The People Have Spoken" @Dr Woolaston As you appear to be in the 'people have spoken' camp, don't forget that your constituents have spoken and they want to stay in.
- JW,Totnes

@jw,Totnes. The nation as a whole voted by a majority of over a million to leave the E.U. That may disappoint you but with a 72 % turn out it is pretty clear. Perhaps you feel that the South Hams should remain part of the EU by declaring itself independent ? Where would you put the border posts ?. You also make a significant error by confusing the boundaries of the Totnes constituency with the boundaries of the South Hams. The Totnes constituency contains Brixham which voted overwhelmingly to leave the E.U.
- Peter Thompson

@ Peter Thompson I admit that it was bit speculative of me to assume correlation between the South Hams and the Totnes constituency. However, I was not aware that separate figures for Brixham voting were available. Perhaps you could supply a reference for that so that we can work which way it went in the Totnes Constituency overall. Of course I am not suggesting independence for the S Hams. Please do not be so disingenuous as to suggest that I might subscribe to such a ridiculous notion. The Prime Minister, along with most(?) politicians from the main parties told us 'Brexit' would be a disaster for this country. I just wonder why many of them now seem so enthusiastic to proceed in that direction. I fear, coming back to your original point, that this is due to political expediency rather than a conviction of what is best for our country.
- JW, Totnes

@jw,Totnes. The vote in Torbay for Leave was 63 % on a turnout of 74 % and living and working in Brixham I would suggest the Leave proportion of the electorate was of this level if not higher . You do realise that it is a fishing port do you ? Here is a link to help you .. http://www.torquayheraldexpress.co.uk/brixham-s-fishing-port-celebrates-uk-s-vote-to-leave-eu/story-29439365-detail/story.html
-

@Peter Thompson I presume the anonymous comment above is from you. "You do realise that it is a fishing port do you ?" - No need for sarcasm. If we apply the Torbay percentages to the population of Brixham we get the following: Leave 7823, Remain 4555. Adding these to the S Hams result we get Leave 33965, Remain 33863. I agree that the Brigham result may have been better than that for the Leavers so I concede that there was likely to have been at least a small majority of leavers in the Totnes constituency. As a former member of the fishing community I have to say that I fear that they will not gain any great advantage from being out of the EU. I hope I'm wrong about that too.
- JW, Totnes

That should be '...'the Brixham result...' of course. Curse you autocorrect.
- JW, Totnes

Sarah we need a stronger lead from you to stop Hinkley Point: 1. Nuclear power is expensive - £18bn is too much plus EPR reactors in Finland and France are up to 7yrs late and £5bn overspent. 2. Nuclear power is unsafe - 1979 US Three Mile Island partial meltdown, 1986 USSR Chernobyl disaster, Japan 2011 Fukushima disaster, UK Windscale (cynically renamed Sellafield) disaster, repeat radioactive discharges to atmosphere and Irish Sea, clusters of nearby childhood leukaemia, falsified records, safety checks, management coverups. 3. Nuclear power is under foreign control - French government (EDF) own and operate eight of UK's ten existing nuclear power stations, plans to build three new ones. Chinese will part own Hinkley Point plus new project at Sizewell and will build their OWN reactors in Essex. The new designs have not worked anywhere and are completely unproven - and we will have no control. 4. Nuclear power is being phased out by most countries - Germany is closing all of its reactors, Belgium, Spain, and Sweden decided not to build new plants or will phase out nuclear entirely. Countries with no nuclear plants or restricting are Australia, Austria, Denmark, Greece, Italy, Ireland and Norway. 5. Spying on top - EDF partner at Hinkley Point, China General Nuclear Power, and senior adviser charged in the US conspiring to help Chinese government develop nuclear material in series of illicit transfers of US nuclear secrets. 6. Please show your support for wind, wave, solar and biomass with interim use of fossil fuel using CCS. National Grid say the country’s climate commitments achievable WITHOUT major increase in new nuclear - but only if Carbon Capture and Storage technology is developed on a large scale instead. But last November George Osborne cancelled a £1bn competition to help companies develop the technology, saying too expensive - worst decision ever. CCS is a technology that can capture up to 90% of the carbon dioxide emissions produced from the use of fossil fuels. And renewable biomass is one of the few carbon abatement technologies that can be used in a 'carbon-negative' mode actually taking carbon dioxide out of the atmosphere. Please Sarah state your position and help Theresa May stop this madness.
- DRH Broadsands

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26 JUN 2016

EU Referendum

Britain has spoken and now it is for Government and Parliament to respect the result of the referendum and carry forward the instruction to take us out of the European Union. It has been a long campaign which has divided families, communities and the nation. Almost three quarters of those under 24 voted to remain whilst their grandparents' generation voted decisively to leave. In Torbay the clear majority embraced Brexit whilst in the neighbouring South Hams most people did not. Scotland and Northern Ireland wanted in whilst England and Wales voted out. In the end, months of complex arguments seemed to boil down to a tug between immigration and sovereignty on the one hand versus the economy, stability and our links with Europe on the other. Now it is time to put the divisions behind us and move on.

My job as your MP will be to do everything I can to help to support the long task ahead. Taking us out of a 43 year relationship will not happen quickly. The tone of the debate with our 27 partners must remain positive if we are to grow Britain's place alongside them as European neighbours rather than descend into an acrimonious divorce. In setting that tone, the government must set out early to reassure those who are already living in the UK from other EU nations that they are welcome to stay. Without the 130,000 valued staff who qualified elsewhere in Europe, currently working in health and social care for example, our NHS would not be able to function. An atmosphere of mutual friendship and respect will be equally important for the hundreds of thousands of our fellow citizens living across the Channel. Britain has voted to leave the institution of the EU, not Europe and voted to be able to control our borders in the future, not to slam them shut.

David Cameron has made a dignified decision to step down to allow fresh leadership to negotiate the complicated path which lies ahead of us. My view is that this needs to be someone with experience, statesmanship and stamina who can be a unifying figure at home and command respect on the world stage. Britain needs us to move quickly and decisively on this so that the negotiations can begin. A long period of uncertainty will be damaging for an economy already under pressure as a result of such a seismic shift.

Our next leader will also need to be someone capable of handling complex negotiations at home as well as with our EU partners. So much of our own legislation is in some way connected with EU directives or regulations that it will be necessary to adopt the majority of them and then take a thoughtful measured approach to repealing or amending them in our best interests. Whilst the most urgent issues can be prioritised, given the timescale for legislation to pass through Parliament, this is likely to take many years and put many other important issues on hold.

Some have called for an early General Election, but under the Fixed-Term Parliaments Act 2011, no Prime Minister or their Government can dissolve Parliament without a 2/3 majority in the Commons. Others are calling for Parliament to block the result and there is a rapidly growing petition to re-run the referendum but I would strongly oppose such a move because Britain has already delivered its verdict. Those MPs who, like myself, came to a different view during the campaign must not seek to obstruct the decision of the people but actively to make it a reality in the most constructive way possible. My job as chair of Parliament's Health Select Committee will also be to hold Leave campaigners in the future Government to account for the promises they made to provide extra support for the NHS from the money which we currently send to the EU. The Government should also continue the essential support for farmers and poorer communities which flows back from our gross EU contributions as well as the scientific research which has long been a net beneficiary.

Challenging times lie ahead for all of us as a result of this momentous decision but our leaders must work together, not sow further division as a result.

42 comments

In the days since the referendum the Leave campaign have back-peddled on claims that there would be £350m for the NHS and that immigration would be reduced. They sold false hope and their supporters are now questioning their vote as the reality of Brexit begins to emerge. This is not what democracy is supposed to look like. The impact on the young is massive, their universities will be weaker without EU research funding, their prospects will be weaker as the economy can't support so many jobs and they won't have the freedom of movement to seek opportunities elsewhere. As a parent and South Hams constituent I continue to support Remain and feel passionately that I do not want my MP to support Boris Johnson or other prominent leavers to become PM. They lied to Britain and it is insane to think they could become PM as a result.
- Laura, Totnes

Thank you .As usual amid confusion!! you have given a measured and honest explanation of the situation. although I voted for Remain like the majority of young under 24s, as you say, MPs must try to influence whatever problems lie ahead. Helen Lindsay ( 84yrs young)
- helen lindsay

The demand about 350m a week extra for the NHS is ridiculous, and Sarah should know that. It was never promised. Vote Leave were never a government and never suggested they had the power to do this. They suggested that if the British people took back control, our democratically elected government could decide how to spend taxpayers' money. And so they will. But Philip Hammond (and I suggest a cabal of establishment figures who must be hard of hearing) seems keen to deny the logic of last week's expressed will of the British people. He argued this morning that we would be kept in the Single Market even if it meant continued Freedom of Movement. Presumably he would also be happy to continuing paying the membership fee for 'access'. Thus there would be no more money and no possibility to control immigration. I think not Mr Hammond. Sarah has no right to hold anybody to account after her behaviour during this debate. The local party should surely seek to hold her to account via a de-selection meeting. This is how democracy works...the people instruct their political leaders, not the reverse.
- George, Paignton

The majority of the electorate, disenfranchised by our unfit-for-purpose voting system, have given The Establishment a good 'kicking' in this two-horse referendum vote. When will we all realise that for the health of our democracy we desperately need a proportional voting system.
- Laurie, Totnes

I am appalled at this result and, considering the position of my eldest grand-daughter (16) I believe that, had the 16 & 17 year olds of this country (around 1.5 million of them) been given the opportunity to vote, the result would very probably have been different. Their influence in not only debate within their own circles but on their parents and grandparents, may well have been crucial. The reason for 16 and 17 year olds not being eligible to vote was rather lost and ignored by most of us at the time of the legislation being passed, but having now read the Briefing Paper (no. 07249 dated 11 December 2015), the decision of the House of Commons in my opinion beggars belief: "Because it would involve a charge on public funds, and the Commons do not offer any further Reason, trusting that this Reason be deemed sufficient." Then, when it was returned to the Lords, the vote against was by a majority of 17, to prevent young people voting in an issue which would affect their lives far more than many of those who were eligible to vote. As Baroness Morgan of Ely said: "Young people are the future of this country. This is their one chance to have a say in the country’s relationship with the EU. It is an exceptional vote." An application to the European Court of Human Rights, to declare the referendum unsound on this basis, should be considered, if there is anyone in a position to take the matter further. Given all the other factors which have led to the result with which we have all been saddled, it is a travesty of democracy that the youth of this country has been denied its say in its future, a clear breach of their human rights. Apart from this aspect, the UK was asked to vote for something upon which there was no definitive outcome if the result were to leave. What were we voting for if we voted to leave? No-one knew. There should therefore be a second referendum, after the principal terms of departure are settled, which can be put to the electorate in clear, unequivocal terms. At that referendum, 16 and 17 year olds should have the vote. (I am 68 years old.)
- Richard, Bovey Tracey

72 hours on from the seismic result, I'm surprised how furious I still feel...and it doesn't look like it will be diminishing any time soon. And my anger is directed right across the spectrum... With the outright lies and cynical manipulation of decent people by the Leave campaign. With the Sun, Mail and Express harnessing terminally bewildered readers with 40 years of myths and fabrication about bonkers Brussels, bendy bananas and Johnny Foreigner trying to undermine us. With the Labour leadership...or I would be if there were any to speak of. With the Remain campaign for a set of lacklustre and uninspiring messages that drove away as many as they attracted. With every successive government that has allowed communities across the UK to become disenfranchised and burning with desire to give the perceived elite a kicking they richly deserve, regardless of any connection with the UK's membership of the EU. With myself; for not speaking up to friends, family and surrounding individuals about the horrendous risks, damage and missed opportunity that I and many others believe we may now face. And with Cameron and the Conservative Party as a whole, for promising an utterly unnecessary, simple majority referendum in the first place to placate the jingoistic wing of their party. The division across the country is equally your responsibility. And for those who propose that we should respect that "the people have spoken" and that this is "democracy in action", I've got a couple of additional thoughts: 1) A key facet of democracy is the people being able to hold those in power accountable. Who are we to hold to account as a nation if/when Leave promises are not delivered and the British grass for British people turns out not to be quite so verdant? We can't vote them out and replace them...as is our democratic right...as they aren't in power? 2) Democracy on a single issue referendum means you align yourself in a binary way to others. Clearly not all Leave voters are terrible, foaming-at-the-mouth racist bigots, just as not all Remainers are effete middle class champagne socialists who think Minimum Wage is a bearded hipster band on the Pyramid Stage at Glastonbury. But the terrible, foaming-at-the-mouth racist bigots now think have the support of the nation behind them in a way that legitimises their attitudes and behaviours as never before. That's democracy in action I'm afraid. So don't expect anyone who feels passionately about this but finds themselves on the losing side to stoically accept the events of the last few days with an ever-so-British "never mind, we're all friends after all; let's roll up our sleeves and make the best of it". However hyperbolic you think it might be, we're grieving at the moment - well meaning cajoling might not be as well received as you think it should be. Oh, and if I see that Pooh and Piglet meme once more, I may well go full Howard Beale (one for the kids there...look it up).
- Adrian, Totnes

I absolutely agree with everything that Adrian, above, has said; this is exactly how I feel. The leave campaign has been reckless and misleading to such an extent that I cannot accept that it can be legal. This is not simply a case of accepting that other people have a different opinion to you because people have formed those opinions based on, let's face it, lies. I am not ready to accept that this is a legitimate outcome.
- Lisa, Diptford

Sarah, you say “Others are calling for Parliament to block the result … but I would strongly oppose such a move because Britain has already delivered its verdict.” But please consider the following: 1 The country is split down the middle. The majority in favour of Brexit is very small. It is hardly a clear mandate for an irreversible course of action. It is the tyranny of a simple majority. 2 The referendum is advisory, not legally binding. Parliament is sovereign. 3 MPs in constituencies where a majority of voters backed Remain (e.g. London and Scotland) can legitimately vote against the repeal of the European Communities Act, as can Labour MPs as it is their party policy. And so can you, as a majority of your constituents voted to remain. 4 Many leave voters, and some politicians too, clearly regret voting for Leave, only four days after the referendum! A majority of the population is, in all likelihood, in favour of remaining in the EU. 5 Finally, if the economy continues to suffer, if the pound collapses, if negotiations with the EU get bogged down in the summer, if the rosy future predicted by the Brexiters fails to materialise, if Scotland looks like going for independence, if there is unrest in Northern Ireland, then MPs can legitimately vote down the referendum in the national interest. Please be courageous and vote against the repeal of the European Communities Act when the time comes. Tim, South Milton
- Tim

I am really surprised by your blog post, Sarah Wollaston. MPs have the power - and a responsibility - to stop this huge threat to our economic and political stability, by using their sovereign vote. It is not about respecting the marginal majority that voted 'leave' but doing what is best for the country. Please speak up for us in Parliament, our MPs are our only hope now.
- Bethan

"Now it is time to put the divisions behind us and move on." Why, the Brexiters got the result that they wanted with a £350 million lie. There will be no putting divisions behind us. Those of us, like me, who voted Remain, will be expected to bow down to our new overlords.
- Robert, Kingsbridge

I agree with Bethan you must speak up in Parliment and try to stop this threat to our economic and political stability and vote down the referendum. It is in the country's interest.The referendum was won on the back of lies.
- Jacqueline

What has surprised me - and repeated here - is the anger felt by so many. We live in a democracy. We must try to respect the views of others. As for the claim that "almost three quarters of the young people voted to remain" this is simply not true. The best estimate of voter turnout amongst the 18-24 year olds is that 36% of that group actually voted. So when you hear that 73% of young people voted to remain what this really means is that 26% of young people voted to remain and 74% were either indifferent or voted for exit: Not quite the same is it?
- Andrew

What Tim said. We are a parliamentary democracy not a referendum led society. Please stick to your guns and oppose the repeal
- David

Standing for what is right is something that should be fought for, rather than meek acceptance of others views, or votes. Farage and the independence minded Scots didn't give up in their quest at the first set back so nor should we, when only a little over a third of the electorate actually voted to leave. Yes they won the battle, but not the war against intolerance, economic ruin, continued poverty for the most vulnerable and the end of the UK as an inclusive, outward looking, successful, thriving country, respected (but not always loved) by the rest of the world. The economy is already stuttering, with the floor of certainty having evaporated, which underpins the ability of companies to invest. Banks and funding bodies are in a state of panic, Europe won't allow us to leave on the terms the Brexiters naiively assume are theirs to demand. We need leadership not acquiescence and parliament should indeed consider what the proposals are and then decide what is best for the country. Its becoming obvious to many that last weeks decision was a flawed emotional cry of protest.
- Nick Remainian ex English

Dr Wollaston, I would urge you to read Geoffrey Robertson's article in The Guardian of 27th June. I will not repeat the points he raises, but it is essential that all right thinking MPs who do not agree with Brexit should not approve the triggering of Article 50. There is no obligation on Parliament to accept the result of the referendum; if there is any obligation it is on us all to be courageous and honest and do what we know is right. These are exceptional times and they call for exceptional measures if we are to pull ourselves out of the divisive, ugly, aggressive tailspin into which we are rapidly falling. Furthermore, whilst the cost of a new referendum logistically and financially would be huge, it is a mere drop in the ocean compared to that which going ahead with this flawed and increasingly unwanted withdrawal will create. Please, do not sleep walk into this catastrophe. Be brave and you will find the groundswell of opinion is behind you. Thank you.
- Nola

As you know, the 'Leave' vote was won by a narrow margin on the back of lies and half truths and consequently there can be no obligation to respect the result of the referendum. You and many of your constituents voted to remain in the European union so I urge you to stick to your guns and vote against the triggering of Article 50 when the time comes.
- Phil, South Hams

I am appalled by Nigel Farages triumphalist outburst in Th European Parliament today. He was rightly called a liar, and he and his outer space have employed lies and manipulative and zenaphobic propaganda to persuade British people to walk into a ghastly situation. Furthermore, Boris Johnson, a stranger to truth and honesty, is now posted as a front runner for the office of Prime Minister. I am truly terrified by the conduct of our politicians, and beg you, Sarah, to do all you can to nullify the disaster faced by my 15 year old daughter and other young people,and win back their respect in our democratic process.
- Bernard,South Hams

Dr Wollaston, in the result of an MP vote I would urge you to respect the wishes of the majority of your constituents and vote against leaving the EU. The majority of people in the South Hams have made it clear they want to remain and I believe it is correct that, as our representative, that you fight for that if it comes down to a vote as I am sure MSPs in Scotland are going to do.
- Liam, Totnes

Correct me if i'm wrong but close to 17.5 million people voted to leave the EU despite the international political,economic and business elites with their media accomplices threatening us with economic and social suffering,the loss of the welfare state and international isolation.I suggest that those who voted Remain spend some time on the ECJ and Commission websites to see the EU's plans for ever closer political,economic and social integration.Don't believe the media hype about immigration being the key vote Leave factor.We who voted leave did so because we value national identity,sovereignty,and democratic control of our destiny. Yesterday,outside Parliament we saw a Cabinet level Minister and the Leader of the Lib.Dems address a witless mob with placards displaying foul and abusive language and worse.This after a Labour MP(joke) attempted to get Parliament to subvert the will of the people in a Referendum that Parliament had voted on and agreed to.I look forward to the next General Election when that or any MP elected democratically is challenged by an unsuccessful candidate on the grounds that the result was different to that required. For Scotland,the sooner we let them go the better.We can then use the £30billion gross annual Block Vote for the benefit of people in England and Wales.I'm still unclear how Sturgeon is going to explain to the people of Scotland how she is going to replace the Block Vote,find their EU contribution and explain Scotland's use of the Euro.Good luck with that.The 8 EU countries that do not yet use the Euro are to be made(the Commission's word) to use the Euro. We are leaving the EU not Europe and to address the concern about leaving the EU by one young person she'll still be able to go clubbing in Magaluf.
- Dave Sussex

As our representative in Parliament, I feel you should represent the will of the majority of your constituents, which is those of us in the South Hams, and vote against invoking Article 50. This presents no conflict with your own beliefs or the collective will of your constituents.
- Anna, Totnes

There is no doubt that there was not a sufficient mandate [ of 1.7m people or so - less than 4% majority - only 38 per 1000 more people ] that can morally be allowed to take us on such a divergent path from our past 43 year relationship with our neighbours. Anecdotally we have probably all heard of 'leave' voters who didnt expect the world reaction or the financial reverberations from their actions . They have not yet seen the change in buying patterns and commercial activity that will accompany a decision of this nature . There is a question of tax rises or cuts in services - these are inevitable when the economy slows down . Money changes hands with less regularity and that means less taxes are paid [ Vat , Income taxes etc ]. That eventuality will take a year or two to become apparent. With reference to the variance in the youth vote. We want our young voters to make their voice heard . For some this is the first occasion they have cast a vote - [many more than the last General election]. If the UK does leave the EU - we have effectively ignored them - It is their future - they are our future . We cannot ignore what vote. The ramifications of this Referendum vote are so far reaching that we cannot simply trust a majority of 3.8% to have got that decision right - it is far far more complex than that. I employ 46 people, I have serious concerns for the future of the UK economy in the short and medium term. As things stand we are holding off on day to day business decisions - and that is slowing up commerce across the UK and Europe [ not to mention inward investment ]. The EU model is not perfect , but we have stability and a huge market to sell to - we need stability after one of the deepest Recessions in history. I ask , as our representative in Parliament that you vote against invoking Article 50 of the Lisbon Treaty - thank God we have that treaty . There remains a glimmer of hope yet - however controversial that may be .
- Gabriel - Rattery

What an interesting day yesterday.About 10 countries lined up for trade deals with the UK.We had the release of the 56 page EU Global Strategy for Foreign and Security Policy,complete with proposals for an EU Army and closer economic,political and military union,and George Soros asking for the creation of an EU superstate.We had the Commission,France and Germany fresh from their humiliation of the PM giving the Sturgeon the right old runaround.Then we discover you have hitched your horse to the Teresa May for PM wagon.As she went AWOL during the EU Referendum campaign perhaps you can remind her that about 9 million Conservative voters chose Vote Leave according to the psephologists.It'll be interesting to see what out is out means to her and her supporters.I suppose if she loses she can refuse to accept the result because the winner's mandate wasn't large enough according to the psephology of Kim Jong Un,Vladimir Putin,Jean-Claude Juncker,and Robert Mugabe. Finally,as someone who understands the power and influence of Select Committees I hope you have read the Foreign Affairs Select Committee Report on the costs and benefits of EU membership.It's a corker but not necessarily a good bedtime read for Remain supporters.
- Dave Sussex

@Dave Sussex Is Sussex your name or your location? In other words are you one of Dr Woolaston's constituents?
- JW,Totnes

@JW Totnes Neither.To avoid cybernats one should never give any indication of name and location. Dr Wollaston's blog is on the internet,she is the Chair of the HoC Health Select Committee,her move to the Remain camp received national and international media coverage and she appeared for Remain in front of 7000 people at Wembley and 4 million people on the BBC.She is a national politician now.If she would like to restrict her blog to her Totnes constituents she should let us know.We can always upload WhatsApp in that case.I'm looking forward to Mrs May coming down to see us in Totnes so we can be assured Brexit is Brexit.
- Dave Sussex

I think Dr Wollaston is a brilliant MP and was delighted at her eventual support for the Remain campaign. South Hams voted to Remain in the EU and Dr Wollaston should definitely represent that view by voting against invoking article 50 of the Lisbon treaty.
- Vivienne Kingsbridge

We should definitely not proceed blindly into the unknown. Time will undoubtedly demonstrate the futility of the current direction of travel. We should not invoke art 50 too soon.
- Paul church

In this potential move out of Europe , is there a very slight echo of the futility of the Battle of the Somme . It feels wrong to make an analogy in some ways but in others perhaps it is right. Surely we know the ramifications of leaving Europe . Boris Jonson may have whipped up emotions to go fearlessly head and wreak a relationship, but where is he now , He was the only 'General' who had the weight of authority to get such backing for an absurd move and he has left the battlefield in the same way . I cannot help feel that we have got into something as huge as absurd as the futility of war .
- Gabriel

Sarah, I totally agree our leaders must now work together, but much more importantly they must work together to make a great success of Brexit. Equally important will be achieving the understanding and acquiescence of those on the Remain side. Incredibly some still seek to variously overturn, neutralise, ignore or discredit the wishes of the near 17.5 million who voted for Brexit. The biggest number voting in favour of anything ever! My plea to you first and foremost is to throw your support for the Tory leadership behind someone who has declared themselves strongly in favour of Brexit. It would be a nonsense to expect someone not so disposed, someone not fundamentally supporting the position they were taking, to negotiate a way through the complexities of Brexit. Such a position would be seized upon as totally open to manipulation and ridicule by our EU counterparties and regarded as deeply suspicious amongst the 17.5 million who voted for Brexit. For me this rules out support for both Theresa May and Stephen Crabb. It would be totally bemusing to be told that either of them are capable of the necessary conviction and toughness in the exit negotiations that lie ahead. And pleas from them that they are passionate about making a great success of our newly won independence would not be credible. We desperately need a leader we can believe in. Johnson, Leadsom and Gove have clearly demonstrated their support for Brexit (Liam Fox though equally supportive did not shine in recent weeks prior to the vote?). Boris Johnson seems to have lacked speed and clarity in furthering his leadership bid and a way forward, and as a result has fallen by the wayside. So the final choice has to be between Andrea Leadsom and Michael Gove both of whom seem decisive and impressive in their understanding of what is needed. Lastly, even though a lifelong Tory supporter, and I know I am far from alone in this, I don’t see myself voting at all at the next election if anyone tainted by the Cameron/Osborne/May approach to Europe becomes the next Conservative leader.
- Stephen, Totnes

Agree with Stephen, support should be for a Brexit candidate, preferably Andrea Leadsom.
- Linda

We voted in a democratic referendum, this was called by a Government who promised to carry out the decision of the majority; this is called democracy. Our voting system is certainly not perfect but by participating you accept the outcome. Remainers have to get over it and we must all pull together, to do anything else invites civil confusion and..............!
- John. Dartington

I agree that Sarah should represent the interests of her constituents and vote against invoking Article 50. But before Parliament considers putting it to a vote we must have a clear idea of where we are going. The referendum did not give us that. Do we stay in the single market or not? Also, EU leaders are meeting in Slovakia in September to discuss their response to BREXIT. The Dutch have a general election in March 2017 and Geert Wilders, whose party wants to take the Netherlands out of the EU is leading in the polls. Will the EU finally come to its senses and take account of widespread public concern throughout the EU about the direction it is going? This is such an important decision and an irreversible one, we must not rush into anything we might later regret
- Richard Peters, South Hams

Dr Woolaston, you stood out during the referendum campaign as a person of principle and conscience. Please consider the arguments of Professor A C Grayling in his letter to MPs on 1st July. The referendum result represents by a small majority the popular accclaim at a moment in time based on misinformation and false promises and the reduction of complex political and economic considerations to a few angry slogans. There is every reason to suppose that it does not reflect the views of the electorate today and it is surely not a sound enough basis to justify Members of Parliament refusing to exercise their own competence and duty to consider whether the UK should leave the EU. Please act in the best interests of Britain and especially its young people to avert a mistake of incalculable gravity. https://www.nchlondon.ac.uk/2016/07/01/professor-c-graylings-letter-650-mps-urging-parliament-not-support-motion-trigger-article-50-lisbon-treaty-1-july-2016/
- JB, Totnes

I think I know what Sarah means, that she will support democracy. Hope she doesn`t change her mind again.
- John. Dartington

Is this the place for such a discussion? My apologies, but I cannot let it pass. I would not want my MP to take too much notice of Professor Grayling’s extraordinarily one sided thought processes. The college of which Professor Grayling is Master proudly states its purpose is to teach people how to think, not what to think. A noble objective. But what follows is entirely about what he and his students think about the outcome of the recent referendum - how appalled they are - that the outcome can be and should be disregarded. Surely he should be thinking ‘how do we interpret the result’. He clearly thinks the electorate made a huge mistake. But might it be that he and the majority of MPs who favoured Remain, are just a little bit out of touch? How can he be so vociferously certain Remain is right when the country is pretty evenly divided? He has grave doubts about the basis on which votes were cast, especially amongst those who voted ‘Brexit’ and is particularly critical of the probity of the Leave propaganda. But as Mervyn King has said, the tone was set by the government. The Professor says the wishes of the young should be given more weight! Well I was young once and the mistake my generation made in backing EEC membership in 1975, was to assume that that would be the end of it. Little did we realise the extent to which further changes would be forced upon us over the intervening years without recourse to democratic processes, hard won over many centuries. Should not young voters have considered very carefully whether in voting Remain they were really prepared to accept all the unknowns that might be foisted upon them over the next 40 years without consultation at the ballot box? I regard my vote to leave as correcting a mistake made all those years ago. for which I apologise to the young. Maybe as an exercise in ‘how to think’, the Professor ought to have proposed to his young students that they consider the benefits of joining the present day EU, had we not voted as we did in 1975? Maybe they should have considered also just how much influence they think we might have in the EU in future years given how little we have had in the past? Do they really want to spend the next 40 years ‘arguing against’ as we have done over the last 40 years?
- Stephen, Totnes

I am utterly dismayed by the result of the referendum, and shocked that so many people believed the lies on which the Brexit case was built. I am one of the many older people who voted to remain part of the EU, and am exasperated that so many younger voters didn't vote at all. I said all along that a referendum is no way to make important and complex decisions on our economy. If there had to be a referendum , it should have required a two-thirds majority, or at least a majority of the total electorate, rather than a simple majority of votes cast, before taking such a huge decision. Now we have a choice made by about 37% of the electorate, many of whom are already expressing regret, embarrassment and confusion at the result of what they have done. This decision is not binding on Parliament, and after the disgraceful walk-out by our Prime Minister (who had assured us he would stay and do the country's bidding), there is no competent leader to negotiate our exit from the EU. All our best political leaders are, quite rightly, still opposed to Brexit. Please, Sarah, do whatever you can to stop this madness. It will take true political courage to admit that the referendum was a badly organised and and misleading campaign that deceived too many voters into making a choice they now regret, but it is not too late. Do not let this issue become David Cameron's Iraq.
- Marjorie

Thank you, Dr Wollaston, for your carefully considered reasoning, as ever. I applaud your desire to heal the divisions created by this referendum - but believe the best way to do so (on balance) is to vote against the triggering of Article 50. Professor Grayling has now responded to a reply from Rob Marris MP, which I could not endorse more strongly: https://www.nchlondon.ac.uk/2016/07/01/professor-c-graylings-letter-650-mps-urging-parliament-not-support-motion-trigger-article-50-lisbon-treaty-1-july-2016/ Please heed his advice, in the interests of your constituents and of the country as a whole.
- Kathleen, Kingsbridge

I refer you to Ian Hislop's comments on Question Time: http://www.bbc.co.uk/news/video_and_audio/headlines/36742691
- JW, Totnes

It is clear that there are precedents for a repeat referendum. This referendum was, legally, only advisory. Following the complete rout of the leaders of the Leave campaign, it is folly to pursue Brexit. Let the 'Leavers' make an honest case for leaving the EU, and we'll see how many people will be convinced in a second referendum. Please vote against triggering Article 50 - it is clearly against your belief as a Remain supporter.
- Jennifer, Brixham

Sarah, I would ask you to vote against triggering Article 50. The majority of your constituents voted to stay in the EU and it has quickly become clear to many of those who voted leave that they were told lies to persuade them to vote for Brexit. Most importantly the Remain voters knew what they were voting for, ie a continuation of the same, while the Leave voters had no idea, and we still don't know, what they were voting for. The only fair and democratic result would be for a second referendum when the conditions under which the UK would leave the EU are actually known. Then people could make an INFORMED choice.
- John Dartmouth

I agree with others who ask you, please, to do all you can to prevent Article 50 being triggered. How can such major change be brought about because people voted in ignorance of the lies and misinformation being presented? Since we have a parliamentary democracy and MPs are duty bound to vote for what is best for our country, as they see it, why bow to mob rule?
- Ann Collyer, South Milton

The referendum result has done its damage. We are now in recovery mode. I was pleased that Sarah was brave enough to review her initial stance and support Remain, bearing in mind Remain is not a status quo, it is an ongoing EU project. I would have equally understood if her initial stance had been to Remain and then to choose Leave. The point is, she's done what is required as an MP, which is to weigh issues carefully and come to a conclusion on our behalf. On this occasion, however, every eligible voter was also given the opportunity to go through that difficult thought process; no surprise that lots of folk ducked the opportunity and well done to those who voted for the first time ever after years of abstention. For those that chose to vote in the EU referendum I think most folk recognised the exaggeration of idiotic rhetoric on both sides for what it was. I think that the choice boiled down to whether we want 'our own idiots' in London or 'other idiots' in Brussels making decisions about how the UK is run from now on. It turns out that, by a narrow margin, we want 'our own idiots' in London making decisions about how the UK is run. Mrs May has been very astute with her selection of post-holders to her cabinet; this story has a long way to run yet. I just love having Boris Johnson responsible for Foreign Policy and MI6, where he will need to explain his gaffes around the world, and Mrs Leadsom at the Environment, where she will have to square her support for fracking with maintaining water resource quality; Mr Hunt is still stuck with sorting out the problems he has with running the health service. The thing is, if this new cabinet (which is variously talented, despite my 'idiot' branding) really does deliver on its reconciliations, then we're going to be in very good shape Brexit or not. It's not so much about Article 50 now, its about the repeal/changes to the 1972 EU Communities Act that is going to matter more, what we keep that is good about EU regulations and what we repeal that is not. So I would say, get busy, get prepared, but hold fire M'lady until we are sure we are ready to go. Meanwhile, will someone solve the housing and energy shortages...
- Derek Parsons, Dartmouth

Sarah - Parliament should vote on any proposals to leave the EU. I don't buy the Brexiteers attempts to stifle further democratic votes on proposals. So far the following have been proved false: 1. There never was 350 million available for the NHS. If this is correct, it will be swallowed up by Barristers, Negotiators in leaving EU, and in hiring more Civil Servants. 2. To think Australia (population 25 million) can replace a market of 500 million is absurb. 3. The EU will never let us have single market and free movement, unless they have a fundamental reorganisation, which we wanted all along. So companies from Japan etc in UK will have tariffs to cope with, and loss of economic growth. 4. The Australian Points system heavily promoted by Boris, has been ruled out. That's just a start. 5. So we want parliament to vote on any changes to EU relationship (doing their job) then possibly another Referendum depending on terms. If favourable terms only needs Parliament vote.
- Ian Sainsbury

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09 JUN 2016

I will be respecting the outcome of the referendum, but my personal vote will now be to remain in the EU

My postal vote sits unopened in the kitchen. Far from tearing it open to do my bit for Brexit, I have been imagining how it would feel to wake up to that result on June 24th. It would not be elation or freedom but a profound sense that something had been lost and guilt too if my vote had contributed to the turmoil ahead.

It's far easier as a politician to stick immovably to a declared position but more honest to set out why I will now be voting for Britain to remain a member of the EU.

I came into politics to campaign on health so I've listened carefully to the evidence from both sides on this. The claims about health from the leave campaign have been shameful. They have knowingly placed a financial lie at the heart of their campaign, even emblazoning it on their battle bus alongside the NHS branding to imply a financial bonanza. It's an empty promise and one which would soon backfire. A strong economy has always been the cornerstone of funding for the NHS and for all the arguments about the scale of the economic turbulence, the clear consensus is that the effects would be significant and negative. Far from a leave dividend there would be an economic penalty and the NHS would suffer the consequences. The chilling effect would not just be financial, but on the workforce. If you meet a migrant in the NHS, they are more likely to be treating you than ahead of you in the queue and very many of our core health and social care workforce come from the EU. How does it feel for them? I know from my correspondence and from private conversations how intensely painful and alienating many of my EU constituents have found the tone of the debate.

The NHS is not just a passive beneficiary of a strong economy, health is a key driver for economic growth. Listening to the evidence, the EU has played a positive role in promoting good health whether that be in terms of water and air quality or the scientific research for which the UK is clearly a net beneficiary. We contribute 11% of the EU research budget and receive 16% of its allocated funding. The UK also plays a strong leadership role in the surveillance, shared intelligence and response to the health threats which are no respecters of national boundaries as evidenced by our ability to respond to the Ebola outbreak, saving countless lives.

Could services, research and public health be put at risk in the event of a vote to leave the EU? I believe the balance of evidence is that the isolation and instability of Brexit should come with a health warning.

I've also spent time over recent weeks observing the professionalism and care of the NHS from my father's bedside as he recovered from a heart attack and a triple bypass. We had the time for long conversations about the referendum and our place in Europe. Now 81, he started training whilst still a teenager, as a mine clearance diver with the Royal Navy. For him, the risk of war in Europe is not some abstract debate but a fearsome horror against which the EU, for all its imperfections, has brought us the protection of peace. He pressed this home all the way to the doors of the operating theatre. Whilst some would celebrate the instability that would be triggered across the EU by Britain's exit, even if that lead to its collapse, I do not. We all benefit from a stable Europe.

The leave campaign has redrawn its battle lines around immigration for the final weeks of the campaign. It looks increasingly indistinguishable from UKIP but the immigration card may prove an empty promise if the price of trade with the EU requires the free movement of people. It will also have left a bitter legacy of division.

This has been an unnecessarily acrimonious and divisive campaign. It has also highlighted the scale of our disconnect from the European institutions which control so many aspects of our daily lives. If the outcome is a vote to remain then we urgently need to reset that relationship and, before we slide back into indifference, start to connect with our MEPs and make our voices count in Europe.

132 comments

These are all sensible arguments. Thanks for your integrity.
- Chris

I have just looked at your history of statements on the EU in the last four months. Regardless of the merits of the debate on either side, it is obvious that you are simply too flakey to be an MP. Your actions are the best advert for recall of MPs I have ever seen. A by-election now would be the honourable thing. My vote will be for another candidate.
- Shona Hegarty

When you were selected then elected I thought "at last, an MP I can trust. This feeling was confirmed as I heard you on "Any Questions?" and other media. With this latest intervention you have shown yourself brave enough to change your mind in the light of the evidence. Yes, it's very exciting to vote to leave, but a sober assessment of the consequences is what we need. You have shown leadership and responsibility in doing just that. You have my support.
- Dave Morgan

Seriously, you've only just realised where you stand on the EU... because of the NHS? So you never weighed it up before? That's not very clever. I thought MPs were supposed to be clever. .. How about you find out what your constituents think. Some of them might be thinking you are a closet Europhile... well actually there is no question now. Well done Agent Wollaston. BBC headliner. Well at least you can't defect to the remainers again.
- Jim

You knew all the facts when you wanted to leave. The cynical side of me sees you in a "Double Agent" guise and were a plant by the Remain camp. Also mentioning your Father who worked in security during the war that he fears for our security is also lamentable.
- Glenn

This isn't brave. Instead you are consistently inconsistent. I used to like you as a strong independent MP. But now, many people will never ever believe a word you say again . You campaigned for brexit for months and now all your new found pro-EU statements contradict your previous arguments. You have now been all over the place on this issue and now support the lying OTT project fear based remain campaign which you were rightlly critical of. FARCICALI can only believe Mr Cameron/Osborne have bought your obedience on this issue as I find all your arguments unbelievable and totally contradictory . In the future try thinking first before doing anything and then stick to your position honourably. Instead the way you have behaved is totally dishonourable. As a previously loyal Tory voter - why should we ever trust either you or the government again ?
- Richard

What nonsense. If we stop in the NHS will be under total control of these UNELECTED people Plus they will have the absolute right to CHANGE anything including they want regardless. We will have lost ALL control forever. PLUS our elected MEPs and MPs will be redundant Your self interest maybe shines OUT.
- Mr Smyth

Though not in your constituency, I have been a long time supporter of your expressed views. I am puzzled by your switch which appears to me to be mostly motivated by one dishonest Brexit claim rather than a broader appreciation of the pros and cons of the EU. (I am still undecided)
- Sean Haffey

As someone who works in life sciences in the UK & Europe I can see the advantages of remaining in terms of the improved benefits for treatments for example in cancer / dementia and for ultimately NHS patients. Thank-you for having the strength of character to make what must be a difficult decision.
- Ged Yardy

This move was planned a long time ago, wasn't it?
- Dunwich

An excellent interview last night. You are very brave to step forward and lay out the reasons for the change of heart. I am hoping you will take a leading role to try and heal the rift this country faces once the dust settles regardless of the referendum outcome. You have restored my faith in politics! Thank you
- ZV

Maybe it is media misreporting but you are quoted as saying that the full £350 could not be spent on the NHS whereas I thought Leave had acknowledged the rebate and wanted only £100 per week spent on the NHS? Also, your about turn came on the day the chancellor was torn apart by Andrew Neil, implying the economics, though maybe marginally bad, are grossly exaggerated too. Both sides are guilty. Can you reassure us you haven't been promised anything, such as Health Secretary?
- Karen Long

I have a great deal of respect for you however I find you argument is built on sand and am disappointed in your acquiescence to a concoction of opinions based on vested interests. The EU is a project is to govern without having to face elections. Whilst our government's adherence to their manifesto's once elected is risible, we do have the right and ability to sack them at the ballot box if we don't like the direction they are taking. The EU too produces manifestos, the latest being the 'Five Presidents Report' and the EU has a habit of delivering on their manifestos. The only problem is the general public cannot directly influence the direction the contents of the manifesto with the threat or actuality of sacking should they go in a direction we don't want. Not one of the five presidents who authored the report have any accountability. By the way, The Five Presidents Report has the catchy title of 'Completing Europe's Economic and Monetary Union' and is about the completion of the federal superstate of Europe. The opening line of the report 'The euro is a successful and stable currency' tells you all you need to know about the acknowledgement of responsibility the presidents take for the 50% youth unemployment in Greece, 47% in Italy etc., and coming to a town near you soon should we choose to remain. That's an import we can do without. You must be aware of the developments on personal & corporate taxation proposed and the creation of the European armed force; The first will enable direct taxation of citizens by the EU without the unpleasant recourse of accountability to the citizens and the corporation tax proposals will crowbar any attempts we may have to compete and attract investment; The second won't scare Putin, will affect NATO and should scare us. Continued membership of the EU will be a disaster for the economy hence damaging the NHS and relegating our children to low wages/poor opportunity for the foreseeable future. I would never have believed that you would take a position which denies your fellow man
- Paul Ingram

So the battle bus proclaims a lie. The majority of people have worked out for themselves that all that money wouldn't be ploughed into the NHS, but a proportion of it. How many lies and scaremongering tactics have Remain employed? You have accurately previously described the issues with the EU, yet suddenly you have jumped ship on the basis of said lie, and possible economic instability being detrimental to the NHS. You are clearly aware of the EU malfunctions, yet you seem to be ignoring them, presumably now willing to accept them! You have said the EU will not change, yet you still want to be part of it. The President of the ECB has admitted that a Brexit will be disastrous for the EU, as they need us to kick start their economy. How much more is that going to cost us? I hope you can still stand by your decision in future years, but sadly, I doubt it.
- Liz Hill

Thank you. I was, frankly, embarrassed that my MP supported leaving the EU. The Leave campiagn is fanciful with its promises, clearly ignoring evidence from every major independant institution. This isn't a question of voting for the EU or the UK, it is about our position in the world and our future economy. An outward looking, fully engaged and inclusive UK isn't just a vision, it is our reality today. It would be almost criminal to walk away from that. The South Hams would be much diminished if we left, culturally, economically, and morally. You've taken a personally brave but entirely logical decision, and I thank you for it.
- David

As above my thoughts entirely, another yes person, thinks she can get a better position kowtowing to the smary Cameron & co. Why do I get the impression that MP's are only there for their own egos and not their constituents as they claim
- Marj

As one of your constituents I wholeheartedly support your decision to back the "remain" campaign. It is refreshing to be represented by an MP who steps back and re-assesses the evidence, before then having the courage to openly alter their previous stance.
- Sara

You bottled it. Known the figures for weeks. Hope you think the price for the NHS is worth paying. Your credibility as an MP has just dropped to zero. How can you be trusted if you cannot make up your own mind and stick to the principle, not the statistics, which anyone with a modicum of intellect understands can be manipulated to look favourable or otherwise. Glad you weren't my GP as how could I trust your professionalism?
- RG

I am amazed at your about turn decision to remain in.The government have not kept their promises on issues such as immigration yet you remain a tory. There is no guarantee that the NHS would benefit from the sum Brexit claim but there would certainly more money available for the NHS on leaving the EU. It is a flimsy excuse to change your mind and I have lost the rare respect I had for a Conservative MP.
- Peter Clinton

Respect your record and views greatly. I think dubious sums are being thrown around on both sides. Certainly our NHS is under strain and needs better resources all round. During the recent lengthy illness of a family member with ME, I became only too aware of lack of co-ordination and an unwillingness to refer to specialist management which the GP practice clearly couldn't provide. We just had nine months of tests and after the appointments at Chronic Diseases, Addenbrookes often found the blood testing centre full of families from the newer EU countries with poor English which took so much time that we had to go back, further exhausting the patient to the point of collapse. I know there are no easy answers, but EU decision making processes need fundamental reform.
- Angela

I'm sorry, but this looks more like a promise of a promotion come the reshuffle after the vote than an integral doubts about either the leave or remains position on the NHS. The fact also remains that we would save money from leaving the EU which can be spent on the NHS although not the £350 million a week which is sent to the EU. Does this also mean that you believe every stated fact & figure coming out of the remain camp? The fact the treasury can't correctly forecast the economic output 3 months or six months in advance why are we supposed to believe the doomsday 500,000 job losses
- Gary Smith

Don't believe you! Do you honestly think the public are that stupid to accept your last minute conversion? It is no wonder that MP's are so little trusted. You are only thinking of your own career as you probably think the remain side will win. I am so disappointed with you as I thought you were a person of integrity.
- Brenda Sharp

Well that is your parliamentary career over. People will accept an MP with strong convictions on either side of the debate but not one who so publicly damages a cause wanted by the majority of their constituents. You are suppose to represent our views, not your own....it is called being an elected MP
- andrew

I am not in your constituency but I have to salute your integrity and bravery. If you were standing in my constituency I might even break the habit of a lifetime and vote Tory.
- MF

I am interested to know why you have performed such a huge volte face since February this year, when you said 'concerns about the level of migration are genuine'. Are none of the things you said were true then, not true? Surely if Vote Leave's tactics made you uncomfortable, you could just have declared that you don't support it.
- wilfulsprite

Well done that Doctor ! There is little honesty in Politics and the Administration of the NHS It takes courage to stand up for what is right .Isolation and segregation will not enhance the reputation of the UK
- Dr Peter Tlusty

With the austerity arising from the 2008 crash, that Remain's economic experts failed to predict,you and your ilk have imposed on the British people a financial burden of about £35 billion.In the same time frame the UK's net contribution to the EU is some £90 billion.Your conversion is remarkable in light of these figures.Judas sold his soul for 30 pieces of silver but you've sold yours for an Osborne shilling.The EU humiliated your leader and they have brought Brexit on themselves.
- Dave Sussex

Is there a reason you've cut off 2/3's of my previous post? I honestly believe that the only reason you have chosen to join the remain camp is to make a major political statement because pro leave have been gaining ground & even won a couple of recent polls on the promise of a cabinet position
- Gary Smith

Your career has become one to watch in the future. You are either an incompetent ditherer who changes her mind depending on the direction of the wind or you have been planted in the Leave campaign early on to muddy the waters close to the referendum. The path of your career over the coming months and years will give us the answer.
- Unity Mitford

Dear Sarah I sincerely hope that you were a bit more concise as a gp when giving a diagnosis. This sounds a bit like you have a headache take a couple of aspirin everything will be OK - oops sorry on second thoughts it's a brain tumour.
- Colonel blimp

To swap sides, and clearly court publicity in doing so, demonstrates at best a complete lack of integrity and at worse shameless self interest. You should be ashamed of yourself, no doubt many of your electorate now are.
- Philip James August

In a campaign in which both sides and the politicians involved have shown what a corrupt and misleading group they are, this is another typical disgraceful about face! Cunningly timed or planned? Threats or promises for your future career? You represent a constituency which includes many major fishing interests at Brixham, Dartmouth and Salcombe. Their industry is being destroyed by the EU, willingly assisted by incompetent civil servants in DEFRA and ignorant politicians of both sides. Over 90% of fishermen want out of the EU. You are not fit to represent them! Your overriding concerns about the Health service, failed by your current government, just as it is failing on much of the social infrastructure in the UK, clouds your judgement! A vote for UKIP seems the better option now!
- David Pakes

" If you meet a migrant in the NHS, they are more likely to be treating you than ahead of you in the queue " This may be the case in sleepy market towns in Devon, but come ' up north' Doctor and you will see a different side to the problem, a problem that is increasing daily.
- A voter

You are an intelligent woman and I cannot understand how you can change your opinion of the EU at the last moment. You have known for weeks what the Vote Leave have been saying and up to now you have agreed with them. Most people should have known straight away how they were going to vote in this most important decision, if they have followed the path of the EU since its beginning where it has gone more and more towards taking away Democracy from the Countries involved. If it continues along this path and we remain with it, the UK will have a minority say in what happens, Our Country will be changed forever. .
- Jen

I am from your constituency in the South-West. I'd like to say thank you for standing up for what you believe in. I've been frustrated by the £350m a week figure for quite some time, and the clear mistruth that "all" of this exaggerated sum will be invested into the NHS. I am fine with both sides having their say in the debate, but clearly misleading the public is simply not fair. Claims of "more democracy" by the Leave campaign are completely undermined by this poor attempt at propaganda. I am glad to see that some Conservative politicians can stand up for principles like truth and duty to your constituents. I think the trend of spin and twisting the facts is becoming a more and more worrying part of the Conservative party and it is important that intelligent people put a stop to it.
- John Wilkes

That €350M includes a "rebate" that is entirely in the gift of the EU to spend as it thinks fit, so we do not get the money back, we are told how we are to spend our money. Try telling your grandson that the tenner you gave him for his birthday will be spent as you dictate.
-

Sarah, You say that "If you're in a position where you can't hand out a Vote Leave leaflet, you can't be campaigning for that organisation." I can understand that but because you don't agree with a statement made by the leave campaign you switched camps to support the opposing side !!! How does that work exactly ?? I am rather glad that in general the UK public do not follow your example and apparent lack of integrity, just imagine how many would flock to join ISIS if they did !!!! Have you no integrity at all ? It must be said that you either didn't before this or cant have now one of the two !!
- Stevo

Well, well, well. You turncoat! You are never to be trusted. What promotion and how much money is in it for you? My decision on Europe has been made for years and no one will change my mind. I know my own mind. You obviously do not. I suggest you are in the wrong job and should do the honourable thing and step down.
- Claire

I was heartened this morning to read that you changed your mind and will be voting to remain, a vote for common sense. Let's put an end to 'post truth politics'.
- Naresh Giangrande

It is sad to say that you are just another one of the spineless individuals involved in the running and ruination of this once great country of ours, we held our own long before any european union and we can again, your lame excuse for switchning sides is typical of the cowardice of members of the stay campaign. The BILLIONS saved with an exit would benefit the NHS with additional funding, staying in Europe will just increase the burden put upon it. You are supposedly educated, so why can`t you and all those other clowns get your heads round the fact that the whole world cannot live in the UK. Go on brand me a racist.... actually i`m a realist. I might not have all your qualifications and bundles of money, i went to the University of life and have a masters degree in common sense. WAKE UP!
- stephen walker

Saw your interview on Sky.Your Dad,and I really hope he's recovering well,served his country in WW2.He will tell you that the British people resented being belittled,bullied,lied to and threatened by the Axis powers.Your conversion to Remain,genuine or otherwise,means you have joined a Remain campaign who have labelled people from all walks of life,from all political parties, and all income and social strata as little Englanders,quitters,racists and worse.We will not forget.We will remember.
- Dave Sussex

The European Union is edging closer to collapse, and you wish for our still Great (although broke) country to go down with it ? Out of the EU we can control our own destiny far better, It will be hard, although some of us have felt these last 8 years of Austerity much more than others ! You have chosen to put your full confidence in Dave and George and all their world wise buddies, all of debateable Integrity ! You are turning your back on " the few " who in time will be proven to have been right ! !
- Stanley Sussex.

I have just seen your interview with Sky News and support your level headed approach and your ability to change your mind on Brexit. I understand clearly why you have taken this stance. I also applaud you for saying that people have a right to hear the truth on matters rather than be fed with spurious data. I wish more MPs possessed your integrity which might begin to give some credence to once again the belief that a Politician works for the benefit of it`s electorate. It would have been more interesting and informative had the interviewer had stopped interrupting you and allowed you to finish your sentences in answering his initial questions. I am not a Tory supporter (but don`t hold that against me!) but wish more Politicians had your honesty and openness. Re all this talk about Democracy being ceded to Europe it is interesting that so called only 23% of the UK electorate voted for the present government.
- AH

Thank you so much for voicing what so many 'normal' people are feeling about the appalling lack of dialogue and honesty that has characterised the referendum campaign. Your dignified words and demeanor are a breath of fresh air in a polluted atmosphere. I appreciate that you also bring a historic perspective to the conversation. 100 years ago we were battling on the Somme and 70 years ago beginning to clean up the devestation of the 2nd World war. Great Britain has a responsibility to stand by and work together in Europe to keep the peace not be a source of dangerous instability. Thank you again for your leadership.
- Andrew Davies

I think you are a disgrace. How can you change your opinion based on what you call a lie by the leave campaign and then decide to vote for the remain campaign who have told so many lies, their noses put together should reach from lands end to john of groats. You have one vote and could have voted for remain privately; but, no, you had to make it public for your own rewards. The health service is a mess while we are in the EU. Why continue with this mess when we have an opportunity to put it right with more funds available if we leave. Even if the net amount we give to the EU is as little as 5 billion, this will still free up money to put into the NHS. You are a traitor to your constituency and if I lived there I would certainly vote you out!
- vsb

Well, I for one am happy that an MP has had the bravery and judgment to reconsider, judge and then decide and admit she was wrong, You have stuck your head above the parapet, and can expect a load of grief, but I admire your bravery
- Richard

It takes a brave person to admit they were wrong, especially in such a heated debate as this one. I'm impressed with your integrity and respect your work. I don't live in your constituency, but if I did I would likely vote for you (and I'm not a Tory voter!)
- LS

I guess you've taken the thirty pieces of silver. Hope it brings you as much happiness as it did Judas ...
- ChrisH

I must applaud your honesty. It is heartening to know that there was one honest person in the Brexit campaign. When I look at the leaders of this campaign I feel deeply concerned for the future of this country. John Major best expressed what is the likely future of the NHS if these men gain power. I do not believe that France, Germany, Holland, Denmark, Italy, Spain, Portugal, Poland (and hopefully Britain) etc are incapable of keeping this part of the world a pleasant and prosperous place to live, work or visit, and I do not believe that there is something odd about the British that we should be isolated from our neighbours and relatives.
- Keith Best

As mentioned by a few of those who have taken the time to reply, I am gratified by your decision. Although not an expert of the NHS (apart from being an occasional user of NHS services over the years), I do have strong concerns over the leave argument in other areas, specifically immigration. I now live in Turkey, and have been privately studying Turkish and late Ottoman political history for over fifteen years. I can guarantee that I know more about the chances of Turkey joining the EU than most in the leave campaign, even though Boris Johnson has family connections to the last Ottoman government (his great grandfather was Ali Kemal, a minister for the interior). I can also guarantee that Turkey will never, ever join the EU. Despite talks starting in July 1959, they are still barely past preliminary stage. The Turks themselves are fed up with Europe dangling carrots in front of them and with a significant rise in GDP and a growing middle class, they don’t see it as a necessity anymore. The only Turkish friends I have who have recently left have gone to Spain. The UK was never an option as they wouldn’t be able to stand the climate and, despite the rise in GDP, it’s still too expensive. If it ever got to the stage where they were ready to join, regardless of what Cameron says now, the PM at that time would have a veto. As would France, Austria and Germany – the first two would definitely block it and the latter may well do. The leave campaign keep dangling the "78 million Turks" figure in front of the electorate as an immigration scare tactic – it’s just plain wrong, and insulting to Turks to suggest they would be beating a path to UK shores should accession ever happen.
- Graham, Istanbul

Isn’t it funny. According to Cameron and Co we will be having another war if we leave the EU. Families will be over £4000 worse off if we leave the EU and yet Sarah Wollaston thinks that these outlandish claims are somehow better than the £350 million a week claim! Seriously?! I think she has been "got at" with a promise of promotion after the vote to change her mind. I used to respect David Cameron. No more after his pitch to keep us in the EU.
- Richard Goulden

Thank you for stating that the concentration on immigration as being a negative aspect of our membership of the EU is, at best, a misguided stance. I'm proud that we have at least one MP who can admit she has changed her mind.
- Joe Vorlicky

It seems to me that there has been a lot of suspect data from both Remain and Leave camps being reported as "fact". Most people will, I believe, end up voting on gut instinct since the actual facts seem to be so thin on the ground - something rather worrying, considering this is such an important decision. To my mind, there are arguments on both sides regarding the economy and immigration. However, the overriding concern for me is that of democracy. By voting to Remain, this to me sends a green light to an unelected, unaccountable elite in the EU to dictate (and I don't use the word lightly) what laws are determined in Britain and how they are carried out. Let me stress this - if we vote Remain and the EU Commission implement legislation that we do not agree with, there is NOTHING either we as the general public or our elected MEP's can do about. Nothing. This is what I do not understand about those who wish to vote Remain. Do you seriously want to be governed by people who you cannot vote out? Ever? I shall be voting Leave (as you may have gathered!) as I believe we approach a major crossroads in our social history. That crossroads for me is defined as the freedom to vote for who governs us via Westminster (and kick out if they don't do the job properly) versus subjugation by unelected faceless bureaucrats who can legislate how we are governed and never be removed. To those worried about the uncertainty of leaving the EU, I'd like to quote Kate Hoey MP who said: "The price of freedom is uncertainty. The price of certainty (i.e. remaining in the EU) is servitude and we need to set our country free from that servitude." I sincerely hope the majority of us Vote Leave on June 23rd.
- Jeremy

Well said, Sarah. I am a constituent of yours aged 70, who had never voted Tory until you became our MP. Since that time, you have been a breath of fresh air who has often voted across party lines because you follow your conscience. I'm even more impressed now. Of course people should be open to changing their minds, whether it is because of new information or any other reason. If that is the way your conscience leads you, then please let's have more MPs like you! The negative reaction of some people, with their cynicism and conspiracy theories, says everything about themselves rather than about you. You are the least likely of any MP I have ever known, to be swayed by any "inducement" or threat. I am honoured to have as my representative someone who is so open-minded and honest. In one word, you have that all important quality that is so rare in public life: INTEGRITY. I am so proud to have you as my MP.
- Peter Douglas

What a sop ! This sounds like she has done a deal with the devil ! probably offered a well paid job on an EU health committee in 10 years. The UK is full of wishy washy MPs like this in both Labour, Conservatives and the rest. She speaks on the BBC website just like a meak condescending GP who is trying to put you on every drug going and enjoying a Ski holiday from the large medical company pushing them.. humm I have personally witnesses the NHS in action while dealing with my father in laws recent stroke (in what can be classed as an affluent area of the UK) and i am now personally quite scared how it will be in 20 years time when i may need the same sort of treatment. Over streched, reliant on a labour force that doenst speak engloish as a first language and not a overpaid qualified consultant to be found. Its like waiting in a queue in a pound shop, the goods your buying are cheap and nasty and its all on a buget and no tills are open and someone that just jumped walked into the shop and jumped straight the queue gets served first ! I hope the Devil reaps his goodies on you and you sleep well taking it all.
- Dicky Cappel

Dr Wollaston I voted for you twice - once when I lived in Totnes and again last time - but never again! I thought someone with integrity and communication skills as well as hard-working real-life experience as a GP was unusual in politics. Which makes it the more surprising and sad that you give such flimsy excuses for reneging (of course £350 million isn't the net benefit and only a small part will go to the NHS, but our European cousins will continue to work with us in the NHS no-one is being sent home). And for that you've given up on what is a vote for freedom (yes to make mistakes, but also the courage to create a second Elizabethan renaissance). Osborne and Cameron are playing a dirty game too and the temptation is to believe someone has promised or threatened in return for this last-minute betrayal. I agree with others that thinking people consider carefully their position before publically backing an idea and that, especially in a position of trust, people rely on you to stay true in the absolute absence of any new evidence.
- David Hopkins

Another example of a self serving muppet trying to gain their crony position by deceit and cowardice. It is your duty to consult your constituency and provide them with facts, not hitch your wagon to whoever promises to help your political career or stick your finger in the wind and see which way the political wind is blowing and spit rhetoric and double speak. You should be walking door to door to explain yourself, not hobnobbing in media green rooms for your own self satisfaction.
- Ashamed for you

You are a contemptuous liar. You have repeatedly said that you despised the EU and now you are campaigning for it. Why not enlighten us as to what you have been offered and by whom to bring about this sea change of opinion? I hope the voters of Totnes deselect you at the earliest opportunity. You have deceived them.
- Epigenes

We can't believe that someone previously so firmly in the "out" camp has had a Road to Damascus moment and realised that a totally undemocratic and over-bureaucratic EU is suddenly preferable to a democratic self-governing United Kingdom. Having recently moved to your constituency from the West Midlands, we can assure you that the NHS problems with immigration are far from exaggerated. We have personally witnessed non-British nationals not only jumping the queue, but insisting on doing so (one of us worked in a busy GP practice). We suspect that your conversion is more to do with future political enhancement than a heartfelt personal view. Whatever your reasons, you have just lost the support of two more lifelong conservative voters.
- Roger

Good luck in your re election campaign......I suspect it will be rather uphill. A cynic might suggest that a job offer alternative has just turned up..... More seriously, what now your argument on migration, sovereignty, EU mismanagement, poor accountability, gravy train....and so on. TTIP, an enlightenment on this would be nice.....as would your current view on the economy an IN vote will deliver....
- Steve Trumm

Saw you on the Daily Politics show.You were systematically and forensically filleted. Your insincerity shone like a beacon in the dark.Integrity my foot.
- Dave Sussex

Well done for a courageous and sound decision. The £350 million is highly misleading as the cross-party Treasury Committee report of 27 May makes clear. Since your decision, the Leave campaign is maintaining that the money that does not leave the UK or comes back is only at EU officials' discretion: again untrue; it never goes in the case of the rebate negotiated by our Prime Minister and comes back for programmes agreed by UK Ministers and by Member States, which provide essential support for farmers, research and structural funds for regional development and social programmes.
- Tim

Ch Ching Sarah Doctor of deceipt!
- Disgraceful

Totally unbelievable ! You have demonstrated that you have no integrity . Do you also lie about your MPs salary by saying it is over £74,000 per year or do you call that a lie because the amount MPs receive is lower after tax ?? You and your cheating party will be toast at the next election.
- John Hughes

Staying in means we become associate (second tier) members (see the FIVE presidents report) as the EU is developed around the single currency and one-size-fits-all political control. Even our security will be diluted as EU border controls and policing is integrated, with the possibility of a European army and the weakening of NATO. The EU worked for us when it was a smaller group of similar countries based on trade and common standards. Our economy grew and is still growing despite the burden of beaucracy and incompetent attempts at trade agreements with the US, India, China, Africa, Asia, Arabia, S America. We have experience of doing all these alone, plus we have unique links with most of these growing (not stagnating like the EU) global powers. We will still be part of Europe as friends with mutual interests, and do trade with those we choose when it benefits us both. That the EU won't reform is their funeral. For us it is the chance to wake up, be brave and innovative - those are our strengths. Signed: the quiet majority of sensible courageous Britons (not self-interested establishment figures and organisations). And Sarah I haven't mentioned immigration once.
- Jean Xavier

It's so welcoming to see a politician who isn't afraid to speak their mind. Like many people in this country who would have changed their minds regarding the EU over the last few months, I don't see how it should be any different for a politician. I commend your courage.
- Ali

You move is totally cynical and political. You are right about the headline Leave claim, but Remain have told far bigger lies in their campaign, so your justification for your change is flimsy at best. Further - this issue has been there for weeks - so your timing is clearly cynical too. I guess you're just another liar, like the rest of them.
- Jeremy Penwarden

There is only one word for what you have done!! GUTLESS. You should stand down and allow someone with backbone do the job It is clear that what Dodge said about getting his own back on all Brits voters. Resignh now its the only honorable thing that you can do!!
- Dave

I find it difficult to believe that the public can't see through the likes of Boris J, Nadine D, John R, IDS, Farage etc., all people patently driven by a love of discord and hunger for the limelight. Dr Wollaston's level headed intervention today should be a powerful addition to the Remainers' message. Yvette Cooper is also doing well today, pressing home the message that blatant lying from Johnson will not stand. Heartening day. (9/6)
- Robert Cook

I'm not a Tory supporter, but you have earned my respect today by actually thinking rather than blindly following some position for the sake of it. On the other hand - the sheer vitriol in some of these comments just shows the loutish behaviour of the other side.
- Iain

30 PIECES OF SILVER! ALTHOUGH YOU WOULD PROBABLY TAKE 29!
- mark dorey

Judas Iscariot was rewarded with 3o pieces of silver, what can you look forward to after the referendum, a ministerial job or even bigger promotion?Turn coats always are mistrusted later.
- michael o'sullivan

Thank you for doing this. I am pleased. The £350 million figure.is of course a lie; I believe the actual net weekly figure is 100 million Euros!! ( about £80 million). And the 'rebate' (which the £350 million includes) is not so much a rebate as an amount that is never sent to Brussels in the first place. This 'rebate' is no more under threat than are other EU contribution rebates negotiated by the Netherlands and by Sweden. Worth mentioning too that Norway and Switzerland, non-EU members both, have much greater numbers of EU immigrants than we do, relative to the size of their populations - between three and four times as many. It if far from certain that Brexit would result in any reduction in EU migration to the UK.
- John Walton

I hope you get deselected you utter liar.
- Shelly

You will find that your duplicity will haunt you for the rest of your life and you will not be able to escape it. Who would ever, or would want to, trust a double agent?
- jan barnningham

I am sorry to read the abusive and (mostly) ill-thought-out responses you have received from those Brexiteers who have posted on your blog. They just prove your bravery and wisdom in changing sides. I have never been a Tory voter, but I admire your carefully considered words in support of your decision. I wish you and your equally courageous father well. Bob
- Robert Lawson-Peebles

What about TTIP and the NHS then doctor?
- Julian Hancock

Thank you Sarah for the courage to re-assess and change your mind on your individual referendum vote. I only wish the other Leavers would remove their blinkers. Let's look at some more of their scares: 1. Immigration from the EU - a) half of the recent 330k migrants to UK came from outwith the EU so what control does UK place on them? b) if the other half are returned to the EU then EU countries are likely in turn to send back to UK circa 1million mainly elderly and pensioned citizens living in their countries and how then will UK's social services cope with that burden? 2. The invasion of circa 80million Turks - as Graham from Istanbul above comments and as even Turkey's EU negotiation minister has admitted, Turkey will never join the EU even though they've been trying since 1959; besides which each individual current EU country including little Cyprus has a power of veto. 3. Loss of sovereignty - a) the cross-party commission on nuclear deterrence found that the UK's deterrent fully depends on the US, no weapon can be fired without the say-so of the US and the US only has to stop maintenance for it to fail; so, sovereignty on nuclear weapons has been given to the US; b) extradition of UK citizens can be demanded by US and UK can not refuse, the same is not true in reverse; again sovereignty ceded to US. Last time I looked the US was not part of the EU. As you conclude in your last sentence Sarah, better to stay and reform from inside rather than irrevocably exit and regret forever looking back in with noses pressed to the window.
- Dimitri, Cyprus

What did Cameron promise you?
- Tony Robinson

Well said, Sarah . . . and what a welcome breath of fresh air too!! I really admire your bravery in admitting publicly that you've changed your mind and also for explaining why. Incidentally, please pass on my warmest congratulations to your Father for his dogged persistence in seeking to persuade you to think carefully about your vote on 23 June. Although I'm not quite as old as him just yet (69 now, 70 later this year), I'm still old enough to share his perspective on the incalculable value the EU has already delivered by ensuring peace in western Europe for an unprecedentedly long period in modern history. Sadly, there are many voters today who take peace in Europe as 'a given', and simply cannot image the devastation caused by incessant wars between the major western nations in the past. Having spent 19 years serving as an officer in the British Army and Commando Forces Royal Marines, I'm acutely aware of the value of peace in Europe. Meanwhile, I do hope your Father is well after his recent major surgery. Please send him my very best wishes for a speedy recovery. He certainly deserves a medal for persuading you think deeply about Britain's future in the EU :-) Alan Meekings alanmeekings@hotmail.com
- Alan Meekings

Each person is entitled to vote according to their conscience. However, I wonder if you have seriously considered what would happen when, thanks to the EU free movement policy, more and more migrants from EU countries arrive on our doorstep to live or even to work for a short time and go back to their countries. The NHS is already on the brink of meltdown barely able to cope with the demand for its services. Sooner or later these EU visitors or migrants will get sick or have babies. In the year ending September 2015, 172,000 persons (net) came to UK from the EU which will add to the burden of on the NHS. In 2014, the number of births in NHS hospitals to EU mothers was 64,067 (UK Statistics Authority, 15 March 2016) With the estimated cost of maternity care in the NHS being £2,800 per patient, the cost of providing NHS services to those families works out at £1.8 million. And that his just a hit on the maternity services what about the other NHS services that these 172,000 EU persons will call on - and those that will come next year and the year after? Then there is the knock on effect costs to the UK economy. The growing number of births to women from other EU countries means our population is growing and those children will need schools to go to and other childcare facilities and services. Our NHS, our schools and our transport structure are all under pressure from immigration that we cannot control. So while the UK remains a member of the EU we cannot control the levels of migration from the EU and the long term impact and pressures it places on this country will be disastrous in the future. The BBC reality check website says that "We do know there are around three million people from other EU countries resident in the UK and all are entitled to use NHS services. That definitely adds to demand." You do the maths. Talking about maths, you said "that the claim that a Brexit would unlock up to £350m a week for the NHS “simply isn’t true”. On this I would like to provide real data. It is true that we we do not send £350 million worth of contributions to the EU each week, but over a year we actually do send on average of £350 million a week to the EU, if not more. At first glance, this may sound like a contradiction in terms but as always, the devil is in the detail. This figure is made up of the following based upon the 2014-2015 fiscal year figures. EU Gross Contribution = £18 billion pa (£350 million per week)(Gross) Minus £4 billion rebate = £13 billion pa ((£250 million per week)(net) That is what we send but during the year Britain receives money from the EU in the form of grants and subsidies, and the British Treasury pays out expenses that are directly attributable to being a member of the EU. These are: DEDUCTIONS Grants and Subsidies from the EU = £4 billion This deducted from EU Contributions = £13 billion minus £4 billion = 9 billion net. Total Deductions = £4 billion This deducted from EU Contributions = £13 billion (net) minus £4 billion = 9 billion (net) EXPENSES ADDED 1. Cost of EU regulations administration = £4.1 billion pa 2. Additional EU Contribution to the EU = £1.7 billion pa 3. Health Payments to EU citizens deficit = £0.7 billion (£723 million pa) 4. Cost of 73 British MPs in EU parliament= 0.13 billion (£131 million pa) Total Expenses = £ 6.63 billion Add these expenses to the £9 billion net = £15.63 billion (£300 million per week) Thus the minimum we paid to the EU for the fiscal year 2014-2015 was (£300 million per week) base on these figure. Cleaerly this is no small figure. However, there is one additional expense that the British economy has to pay out to the EU and that is the cost to businesses of the 100 most burdensome EU-derived regulations as outlined by the Open Europe Think Tank which is estimated to be £33 billion. 5. Cost to Businesses of the 100 most burdensome EU-derived regulations = £33 billion (£635 million per week. So if we to factor this in to the equation the British economy pays out anything between £300 per week and £935 per week. In conclusion therefore, the UK does pay on average £350 million each week over the year to the EU. And, even if the cost of to business of the 100 most burdensome EU-derived regulations, we are still paying out £300 million a week net, an enormous figure that we could take control of and use for the benefit of the British economy and some of that can go to the NHS. In view of the information I have supplied, I wonder if perhaps your decision to Vote Remain was premature. You decision was understandable under the circumstances, but now that you have more of the details and not the headlines, you might reconsider your position.
- Fred Harding

It would interesting to hear how you suddenly became "enlightened" about the £350m figure, even though it has been bandied around for months. Clearly you are not one for due diligence before you make decisions. And apparently you are now claiming that none of the £11-12bn NET we would save would go to the NHS. Er, how exactly? Is this one of Dave's cast-iron pledges? That he will simply fritter away any money saved? The NHS will be destroyed by TTIP and you know it. The British people and British government are not involved in the negotiations and cannot veto it. If you have helped swing this fix of a referendum, history will not remember you kindly.
- Come off it

Dr Wollaston, I believe you are to be congratulated on your decision. A conscientious politician is a rare thing and in any other scenario would be lauded, yet I note, without surprise, the derision and spite typical of the Leave campaign, gleefully propagated by its loathsome leadership. Heed not your critics, but continue to follow your conscience. I have never, and will never, vote Conservative, but know that you have my respect and admiration for your bravery.
- Luke Gage

Many of the immigrants from E.U countries are unable to speak or understand English, where most from commonwealth countries can ! In the 1930's with a population of approx. 45.000000 300 to 350000 houses were being built a year, 50's 60's 200 to 250,000 per year, very little mechanisation through these years, No JCB's, Fork Lifts. Just Hardworking British commonwealth some Italian & Polish Trades and Labour. 21century, struggling to build 140,000 are all these EU migrants not working as hard as Daves Government think they are, or is it that they can't understand each other. When Turkey join the club, there will be a potential 75000 people with the right to access UK, of course not all will but if 10 or 20 % want to, it will still be a major problem. The potential 500,000,000 Market place, are these All very wealthy people ? what does the UK have to sell them ? financial services ? what sort of % are going to be purchasing anything from UK. We need to look after ourselves and get our own countries debt sorted out , Almost £ 2 trillion
- Stanley Sussex.

Sorry, you have sold out, did the whips pressure you, did they offer you career progression, even a post in the cabinet? Whether the £350m is correct or not, we still send at least £160m to the EU that WE NEVER GET back, part of that could be used to help our ailing NHS. I'm afraid that your about turn will have ramifications the next time there is a general election, the people of your constituency will tell you how they feel about your decision and sorry, but you are a sell out and gutless coward.
- Peter Nottingham

Many comments that support you come, like mine, from non-Tory voters. Something to think about. I hope that you are genuine, do not seek a ministerial post and continue to challenge the Government on the NHS and other scandalous policies. Boris/Michael/Chris/Iain v Dave/George (and all their respective "arguments") is a tricky choice - but I think you've got it right in the end.
- Paul Hart

With due respect to your father, peace in Europe since both our fathers did their bit in our defence is not exactly due to the Union. It is NATO, which includes the US and Canada, which has brought us the protection of peace ever since the US-funded Marshall Plan. Its commitment in Article 5 is an agreement that “an armed attack against one of us… shall be considered an attack against all” and each will take “such action as it deems necessary, including the use of armed force". Yugoslavia is just one example of being put to the test - the EU was helpless. In 1995 NATO's no-fly zone and airstrike campaign played a major role in ending the conflict. NATO deployed a UN-mandated, multinational force of 60,000 soldiers to help implement the peace agreement and create the conditions for a self-sustaining peace. Not until 2004 did NATO hand over this role to the European Union. And NATO does more than the EU can ever do - as a political instrument for détente in areas like Asia and the Middle East with military cooperation and support around the world. And, in or out of the EU, we remain a founding member in NATO.
- Dee

I've not seen any of your TV appearances; I've simply read your blog post - and as a result also read your Blog posts from February. I have no axe to grind on either side - but I do have expectations of those who inhabit public office. From reading your comments it would appear that one of the following four scenarios is true. I do not pretend to know which - only your conscience and your electorate really matter in the end: 1) You made a public statement in February of your voting intention without actually thinking about the issues. In my view, that is not the behaviour I want to see from the political class. Thinking later and choosing to correct yourself in public later would be an admirable action - but doesn't make me feel any better about your original failure to give proper consideration to an issue. 2) Conspiracy theory / stalking horse: others have talked about that enough above. I don't need to add to this one. 3) You did think in February, but you're ignoring February in June: your current post seems to entirely ignore the concerns you argued as key in February. By ignoring them today it makes you look as if you are led by sentimentality and emotion rather than by conviction. I do not mind a politician having a heart - but it is surely necessary that a politician makes a sober analysis rather than being blown around by the breeze. Politicians have a huge responsibility as our law-makers - and law made on the basis of emotion is generally poor law once that emotional context dies down. 4) Your change of mind is actually due to more than the two things noted in the June blog - but you've done a terrible view of expressing them. This still leaves questions about conviction and analysis of complex issues - but adds a question about how well you can communicate to your constituents the realities of the issues at hand. Sadly, none of these options actually makes me feel good. I'm sure other commenters will add any scenarios I've missed. The quality of debate is influenced by the quality of debaters. Politicians are fortunate to be paid to inhabit this world while the rest of us are working - so they should be able to take a strong lead - yes, based on facts - so that the citizens can make an informed choice. It seems you had the opportunity to do this over a period of 6 months or so, and the performance seems poor. Even more sadly, the rest of the political class seems to have done no better (...let alone the Media).
- Dave M

Well it's nice to see you have the opinions of your constituents in mind. Or at least one of them. Your dad does live in Totnes doesn't he? Meanwhile I'm sure the NHS will do just splendidly with the large numbers of East European car valets paying their £500 a year tax on minimum wage into the HMRC in return for £1560 of free health cover.
- Phil Hoy

Given your comment on the Daily Politics show today that you are not part of the official Remain campaign it's surprising the amount of media output you've been associated with-from TV interviews to national newspaper articles to social media.Given the timing of your conversion perhaps we might now enjoy a period of silence from you as you come to terms with your epiphany.
- Dave Sussex

Many comments say what I think in a far more elegant way than I can. So I will just say how disappointed I am that my M.P. is not the person I thought they were, and only hope that not too many will follow suit and land us in a situation of which we have little control. My vote in future elections could well be affected.
- Barry Devon

As a Conservative Party Member and one of your constituents, I am entitled to ask for a more detailed explanation for your extraordinary intervention in this Referendum. You will be well aware of the impact of your rejection of Leave and joining of Remain at so critical a time in this Referendum. So I question how it is that you have based your rejection of Leave because of assertions made over the condition of the NHS after Brexit? Is not this Referendum about rather more than the NHS? Did you weigh in the balance on the one hand the assertions of Leave about the NHS and on the other Cameron's grubby and unethical campaign and dodgy 'Project Fear' dossier of conjecture and scaremongering - and really conclude that the NHS and claims made by Leave constituted the full scope of this Referendum decision? In your proclamation, you have in the eyes of the public explicitly rejected all of the arguments for Leave and endorsed all of the arguments for Remain. So what assertions about the NHS really drove you to this extraordinary action and how much worse could they have been than the myriad claims made by Remain? Like the outrageous lie that pensioners would be worse off after Brexit, for example? History is either going to be on the side of Leave or Remain. European countries will either reclaim their nationhood or submit to autocracy. Consider that federalism across national borders has not and will never work because people have always fought to be free to govern themselves. I find it astonishing that you have either not grasped this or consider the questionable economic benefit of remaining to be preferable to the subjugation of this Nation to a group of incompetents.
- Rupert Hanmer Grant

A great disappointment after giving months of creditable arguement on why Brexit made sense. Suddenly a conversion based on very flaky logic. We know that threat/promise pressures are in progress or maybe a temporary confusion has taken hold ! 'Trust Me I'm a Doctor' has never been more comical.
- John

Sarah, the actual net figure we provide to the EU each week is £180 million. That's the membership fee and it's been verified by the BBC's own fact-finding team - amongst others. Vote Leave are quite right to contest that the gross figure is over £350 million each week and Michael Gove has fully supported a further independent assessment of the amount. Refreshingly different from Dodgy Dave's state funded Project Fear - masquerading as truth. Was this really the justification for your decision to put a knife into Vote Leave? £180 million is still a vast amount of money - and it's loss to the public purse is made all the more grotesque when one considers that the funds go largely to support the grandiosity of the EU beurocrats and their lifestyles. For integrity, I vote for Vote Leave because they believe in this great country and recognize that we have been prosperous BECAUSE WE HAVE RESISTED THE EU's CORE DIRECTIVES - and haven't sold out to vested interests and group think like career politicians.
- Elaine Grant

Sorry Sarah, as one of your local constituents you have just lost my confidence and my vote. You have known about the £350m claim since the start of this campaign, this is more about your concience following the appeal to switch sides from your own father. Why not be honest and say that you have changed your mind for personal reasons? You would at least have won some grudging respect from some. Instead you just appear to be lacking in conviction and staying power when the fight gets dirty. Not qualities of an MP that I would wish to have representing me.
- Peter Devon

I will not be voting for you again. You say that you will feel a sense of 'loss' if you wake to a Leave vote? Surely you mean 'liberation'? Loss of what exactly: the 'loss' of more eurozone bailouts? The 'loss' of paying ever higher penalties for our successful economy? The 'loss' of the increasingly autocratic ECJ? The 'loss' of the 2,000 unelected and unaccountable beurocrats who rule our lives? The 'loss' of the UK as employer of last resort for the rest of Europe? The 'loss' of un-scrutinized EU accounts? The 'loss' of unsustainable immigration that provides no net benefit and only ever greater pressure on public services? Honestly, I am shocked at such woolly thinking.
- Nicola Maguire

What took you so long to change ? Nothing changed on the Leave side, how come it took you so long to work it out? Stinks to me
- Sylvia Loosley

Another one of your constituents you will never get a vote from again. You have made yourself look a joke. Conviction MP don't think so, pre planned stitch up disappointed but not suprised. Thought you may have had more integrity. How can you be trusted on anything now?
- steven Marldon

Dear Sarah, I think your change of mind was right. I share your views on membership you outlined above. I think seeing the bigger picture is so much needed in a time when the EU is used for mere hateful scapegoating. Also, I believe a politician who dares to say "I was wrong., I change my mind" is a stance that contrasts well the bitterness and radicaility that unfortunately marks this campaign now. On a more personal level, I believe your change is brave and shows character. I do hope that you wont have to face to much hate mail and that people remember that they are addressing a human being when writing to you. I wish you all the best!
- Henning

When politics goes back to normal on 24 June, all of the Labour, Lib Dems and Greens who are singing Sarah's praises on here will go back to opposing this Tory Government. But after Cameron and Osborne's lies, insults to most of the people who voted Tory, and Sarah's collusion in this stitch-up, who on earth is going to support this government? In the face of all this intimidation, Remain might win. But the scars of this will ruin the Tory Party, and they will have only themselves to blame.
- Maria, Totnes

I cannot believe it was pure coincidence that you made it so public today that you were switching to the In campaign on the same day of the ITV debate as the Inners cited with much glee your change of sides. This was simply a political stunt coordinated by the In side - shame on you.
- Neil

I could understand that a fence-sitting MP might at a late stage opt for Remain or Leave. Fair enough. But, I cannot understand any MP jumping - at a late stage - from Leave to Remain (or vice-versa). I can only think: there's more to this than meets the eye.
- John Gibson

Your argument against Leave's 'dishonesty' over the 350 million figure is implausible. You know that Remain's 'World War 3,' 'Global Financial Meltdown' and ' £4,300 Worse Off' claims are at least as bad, and arguably far worse, and yet you're happy to support their case. If you'd quietly withdrawn from Leave to take a neutral stance, there might have been more sympathy for your change of heart. However, the timing and delivery seem designed to cause the maximum damage for Leave and maximum support for Remain. There's something very fishy about this.You haven't done your reputation any good with these weasel words. Perhaps more mole than weasel?
- J. Fox

Before watching the three Remain Harpies give us rant,cant,bile and personal insult yesterday evening I went to a Townhall event at my local leisure centre.Place packed.Addressed by constituency MP who's for Remain.The straw poll at the end was about 90%/10% in favour of Leave.The MP looked rather pale.Keep up the good work for Remain because your oddly timed Damascene conversion is having the opposite effect to that intended.
- Dave Sussex

Spot on Sarah. The consequences of brexit don't bear thinking about. It about the economy, jobs and keeping the 'U' in UK. We have to fix the deficiencies of the EU from within rather than be exposed to the consequences on the outside.
- Paul church

Sorry to have to say this, but your Damascan "volte-face" is extremely suspicious. I am a constituent of yours but never have/never will vote Tory - ever! Other commentators have expressed their doubts over your true intentions. Like you, I also have my postal voting papers waiting on my kitchen table. I shall be voting to Remain, yet I have allowed myself ample time to weigh up the pros and cons and I am still listening to all sides of the debate. I feel that you would have engendered much more support and would have appeared far more credible if you had not initially come out so strongly in favour of leaving the EU. Indeed, I was extremely puzzled that you ever were "for" brexit - and I have been thoroughly vindicated. We will watch and see with great interest in exactly how your future public office/political/medical career develops!
- C, Torbay

Your last sentence says it all " start to connect with our MEP's". This is the problem, these MEP's our in charge of our future and you feel we need to "start to connect with them". That is a exactly why I am voting to leave, I feel we are and always will be disconnected to the people who are deciding on our country's future.
- Sue, Dartmouth

I lived through the agony of lies in the Scottish Independence vote. With only a few days left, the Yes campaign was in the lead. Then the result. What changed the vote? The sudden declaration of financial and economic meltdown. That was the lie told. With this in / out debate the first lie was to say how each family would be thousands of pounds poorer in 2024. A prediction which no human could have made. We have still to hear from George Osborne his apology. I am voting Exit because our fishermen's lives have been irreparably damaged by EEC policies. Because I know the Euro is doomed and sadly the EEC is heading down the drain and sinking with each new country it wants to eat bup. Even Germany is chocking. Its such a toxic organization I hope we all give it a wide mark on voting day. Except me. I have already posted my exit vote.
- M Caldwell

You should be thoroughly ashamed of your about-turn. What have you been promised for doing so. You know only too well the huge amount of pressure this uncontrolled immigration puts on our Health Service, which you purport to care so much about. I voted for you in the last election, I assure you I shall not be voting for you again. Those wishing to remain in an unelected institution, one where their own auditors have refused to sign off their accounts for the last 19 years, must either have ulteriop motives or be incredibley nieve. If this was a company they would have been closed down long ago. The word traitorous springs to mind.
- Jon

Sorry Sarah, another constituent who voted for you, but like others you have "lost my confidence and vote".
- Charles

I write as one who has never voted Conservative in his life. As most do, I do find myself forgiving the errors of my team all too easily and all too often. Your integrity shines through. When next I am tempted to let something slip by even though I know it is not right but suits my side I shall recall your example. I have also been impressed by David Cameron's professional and statesman like approach. Just reading the other comments to your post I can see this will be a case of letting no good deed go unpunished. I sincerely with your party was not running the country. But I must salute someone doing the right thing when it is all too easy not to.
- John Samuel

MP for Totnes. The self-serving spirit lives.
- Vicar of Bray

Sarah, you are the most deceitful person I have ever known. You work in the NHS and so do I. The NHS is suffering, most hospitals have been placed under special measures by the CQC because the can't meet the requirements placed by CQC. It's mainly about funding, and not being able to meet the agreed waiting times for paints in A and E. The agreed maximum waiting time in A&E is for hours, but patients are bad to wait for more than 6 hours. I am sure you are seeking overnight fame, after being promised a big fat BROWN ENVELOPE. you do not deserve to be an MP....... You can't be trusted!! I will never vote for you again!!
- J. Collins

You have clearly been struggling with your position - which at least is an honest admission. The arguments you make have been pretty clear to me from day 1 - but I salute the fact that you have set out the reasons for the change of heart. I hope you can take a leading role in healing the rift this country faces once the dust settles regardless of the referendum outcome - but which really needs to be a future within the EU. You are one of a band of MPs who deserves respect and support in your difficult role in parliament.
- Graham Davenport

Anyone who has the slightest doubt about the EU should read this article about James Dyson. http://www.telegraph.co.uk/men/thinking-man/sir-james-dyson-so-if-we-leave-the-eu-no-one-will-trade-with-us/ I have never come across a clearer picture spoken honestly
- simonrandal

I used to think you were one of the honest ones but after this turnaround and your outright support for ttip I certainly would never vote for you again. Another career politician in the making sigh ....
- Jc

Very surprised. To my mind a very flimsy repudiation of your previous support for Brexit. (Anyone with a modicum of intelligence understands the basis of the Battle Bus £350m.) The arguments for and against our continuing EU membership rest on weightier things than the NHS - important though this is. Most people agree that the four long standing problems with our continuing membership of the EU are loss of sovereignty, lack of democracy, inadequate control of our borders and limitations on achieving our full economic potential. You have failed to properly justify your sudden switch in respect of these four primary concerns. With respect, these are the things that those of us who support Brexit are focussed on, not the NHS. You owe a much better explanation to the likes of myself who have previously been happy with how you have represented us. Why do you now believe after what you have previously said that these major issues can be addressed by remaining in the EU? All the indications are that the problems we face by staying in are likely to become more and more intractable.
- Stephen, Totnes

The EU is indeed bigger than the NHS, important though that is, and it has conferred stability on a Europe that has all-too-often gone to war as nation after nation sought economic dominance. This has to be avoided, and the EU has brought the stability that is needed. The leave campaign complain about the EU and Brussels as being undemocratic. Really. If that was such an issue, they should campaign against the House of Lords, the Monarchy, corporate greed, and globalisation. They don't, do they? The leave campaign complains about the EU and bureaucracy. Yes, it's bureaucratic - because governments trust in civil servants rather more than other politicians. But, without the EU every company trading overseas, and every public institution coming to agreement with institutions overseas would have no framework with which to work. They would need to negotiate time after time. The EU bureaucracy gives us a common set of regulations and therefore saves us from engaging in masses of administration - transfer costs - when negotiating or bargaining with overseas partners. BREXIT - would be a complete disaster for the UK, and for much of the EU itself.
- David

It must be remembered that each one of us, including you Sarah has but ONE voteand use it how we will While you are entitled to change your mind for for your own vote it is now vital that that after the Referendum is decided that you and every other politician totally honours the decision of the people in the United King dom. David Cameron's latest "frightener" to Old Age Pensioners to withdraw bus passes and TV licenses sadly demonstrates that he believes we are lacking in backbone as much as he and his Government is. Has he forgotten that most of us OAP's actually lived through being bombed , seeing the death of loved ones and a 2 oz butter ration? We want Brexit so that we can reap the rewards of this great sacrifice we made in two world wars. We know that our younger generations have both the brain power and work ethic to put the GREAT back into Britiain.and win an economic war. There is no reason why apart from cerebrally disadvantaged politicians and overpaid bureaucrats that can stop usThe fact is that the EU is like a leach sucking the lifeblood out of our nation perhaps in a more subtle and cunning way that the killing fields of Europe did in 1939-1945 managed Just as my generation could not forecast the outcome of our war with Hitler at this moment no one, even Mr Carney, cannot forecast the outcome of an economic war.Neither can Cameron but is tops at inventing frighteners. Have successive Government made us too lily livered to fight in this new way to retain real sovereignty and law ? Thise that vot Brexit still have a spine!
- Loris Goring

Am amazed at the lack of understanding of some here. The idea that the EU is the reason for Europe's peace after 1945 is laughable. NATO? The wars of the past have not been about economic dominance, rather a refusal of some to accept the self-determination of peoples. The best safeguard against war in the future is the restoration of democracy across the continent, so that free thinking nations can work together in peace and harmony. By denying self-government and justice to the peoples of Europe, the EU is the greatest barrier against this endurable peace.
- Maria, Totnes

I was sad to hear the news that you have changed your mind about Brexit as I believed you were initially very brave to stand up against your fellow Tory MPs on the Remain side and hope for a better Britain outside the failing EU system. I am a retired GP having worked 17 years in the Armed Forces and then 17 years in the NHS. I do not believe the problems with the struggling NHS has anything to do with the EU other than it has to deal with more and more immigrants as well as everything else that the medical profession has to cope with. I have served in two wars including the First Gulf War and The Yugoslavian war, neither of which I felt had any influence from the EU but aided by the UN and NATO countries. The issues of The NHS and Defence are not affecting my decision of how to vote but the issues of trying to get back control of our own country, laws and self respect as a Great Britain are. I am also very concerned about the way Brussels governs including lack of regulation and accountability. I think that Europe is less stable now than it was 10 years ago and struggling countries such as Spain, Greece and Italy have suffered greatly not improved under this EU system. If we stay in the EU and more countries join I think things will get worse not better. If the EU was just about trade in a common market then I think that would work but it is now about far more and eroding all our ways of life. I am British first and live in Britain which happens to be in a region of the world called Europe. I love to travel to other countries and appreciate their ways of living and culture but I live in Britain and want my own MP and Government to help us live our lives and build a better future for our children. Please listen to your constituents Sarah and I am sorry that you must be now in a very difficult situation having changed your mind, not an easy thing to do. Do wish I could meet and talk to you about EU referendum but I have phoned your office and they said you were not doing Q&As.
- Tina Marldon

There are many factors to consider for what is best for the UK. Like many I was on the fence at the beginning as Sovereignty is an emotive subject, and there are aspects of the EU I dislike. If we are to believe Boris he was on the fence before he tipped towards the Brexit camp which he now promotes with gusto. He is rallying support by playing on the emotions of people and taking advantage of their concerns and fears making unsubstantiated promises that all will be resolved with Brexit. The impartial analytical documents Sarah has pointed us towards demonstate a more even and considered position which help form better judgement on the implications of Brexit. Unfortunately many people will not have the time or inclination to study these documents and take in the hype promoted by Johnson Gove and Farage. I can fully understand how people can over time come to a different conclusion than where they started. For a politician to openly declare a change in the views based on having continued to review and evaluate the issue during the cause of the debate is to be applauded. Of course those supporting the opposite camp will be less than happy but some of the comments from Brexit supporters have been disgraceful. Cutting off our nose to spite our face will resolve nothing. We have not been strong enough at the negotiated table in the EU and that is where we will start to deal with the concerns people have, not outside it without a voice to be heard. This referendum has been a wake up call for the UK and the whole of Europe and as a member we can make an impact, and start to tackle issues such as better managing immigration which has become the focus of the leave campaign. With 45% of our exports going to the EU it remains vital to our economy and the EU will impose terms on us that will be harsher than we currently experience, including free movement of people. Outside EU we resolve nothing.
- Mike Allen

This isn't your finest hour Sarah. The overriding perception of you now is of a flaky individual who can't make her mind up on anything important. It's very mystifying why you have suddenly changed your mind.
- Steve Tucker

Sarah we understand your nervousness about making the wrong decision. But you knew about all the NHS issues you mention back in February, and you must also have been aware then that lies or exaggerations have always existed on both sides. A quick visit to the relevant government websites gives anyone who cares to check, the accurate gross and net contribution, the varying rebate, the grants and subsidies. And there are estimates of the costs of the regulatory overheads on business, the MEPs, the legislation, the regulations administration. Surely, in or out of the EU, cooperation and financial help from Britain on European research projects, university education, and environmental protection, and Britain leading the response to international health emergencies, will be welcomed by all European countries, irrespective of their political masters. It helps us all. Have faith in your judgement over the past few months. And reassure your father about instability and security in Europe. Remind him of the strength and reputation of NATO (and the UN) that others have mentioned, and the risks that the EU runs in continually trying to expand eastwards. Immigration is not about UKIP. It is about wanting to invite people from Europe and the world to live and work here using a common and fair set of rules e.g. have skills we are desperately short of (doctors and nurses yes please), a good command of English, a job offer, and the absence of a criminal record or extremist associations. Most people in Britain want that, but they feel helpless when the filters aren’t there and people all come in at once (it is an endearing British characteristic to queue, but we know from experience that it is the only fair and safe way). So be honest again and review all the arguments - and the goodwill of those wanting to make it work - against your not unreasonable fears of turmoil and yes, against offending your father. Don’t be immovable, read carefully all the feedback and caring advice written to you above. They care because they want to believe in you. You can’t lose credibility twice – so follow your heart and hopefully REDECLARE YOUR SUPPORT FOR A DEMOCRATIC AND INDEPENDENT UNITED KINGDOM Love and best wishes
- J Cricket

Why did you give up medicine was you also awful at that also ? Too many wrong diagnosis ? Not good in politics either .
- JD

As one of your constituents in Totnes, I admire your decision and agree with it.t I find I am shocked and saddened by some of the toxic comments , and the personal nature of them, on here. I didn't vote for you, but you have been a terrific MP, responding to my questions or offering support and intelligent interest in local charities I am involved with. Personally, I wish the referendum had never been called, with the bigotry and hatred it has stirred up. With best wishes,
- Charlotte

Congratulations on your change of heart. It is vital that our country engage with "the other" and Remaining In is an important part of this, preventing us from becoming inward looking and isolationist.
- Simon Chater

Dear Sarah You decision to change your vote to remain impressed me. I come from a farming background but the information below is about fishing. I remember the Cod Wars and French farmers burning live sheep but the rest is educational to me, but life changing to others. It reflects the complex tension between scientific management and politics. https://en.wikipedia.org/wiki/Cod_Wars Details a fishery zone dispute between two NATO countries, Britain and Iceland that included Britain banning the importation of fish caught by Icelandic boats leading to the USSR buying the fish , the Royal Navy bearing arms against a fellow NATO country, Britain withdrawing and the devastating decline of Grimsby. http://www.cornelisvrolijk.eu/about-usis reported to have 23% of UK fish quotas. https://www.fqaregister.service.gov.uk/browse#tabs=0 In the fish quota allowance register web page above enter the vessel’s name, for example Cornelis Vrolijk or Nina May (the Exeter dinghy with 17% of the South West’s quota) scroll down and press SEARCH then on the next page press VIEW for the types of fish in their quota http://www.bxta.co.uk/index.php/general-area/rss-news/190-european-stocks-eighteen-times-more-sustainable Brixham Trawler Agents web site http://nffo.org.uk The National Federation of Fishermen's Organisations http://www.torquayheraldexpress.co.uk/brixham-lands-pound-28million-record-catch/story-18136886-detail/story.html In general, upbeat articles about success by people in the industry. Mr Portus said: "That's amazing as long as the export buyers pay the bills, but could we sell it in the UK? We import thousands and thousands of tonnes of haddock and cod into this country, but we have the top quality fish in Brixham if only we would eat it." http://www.nytimes.com/1990/09/17/world/french-protest-of-sheep-imports-turns-ugly.html http://www.dailymail.co.uk/news/article-3173410/Mob-200-furious-French-farmers-hijack-convoy-seven-British-lorries-throw-cargo-200-000-worth-fish-road-dispute-foreign-food-imports-takes-vicious-turn.html No comment.  
- Ted Stone

Look forward to seeing you elected to a senior cabinet post on Friday, to mark Cameron's appreciation of the action you have taken on his behalf. You demonstrated all the nauseating traits of a star-struck wannabee at Wembly last night. Enjoy it while it lasts....hopefully the decent people of Britain will succeed despite people like you.
- Peter

"I don't feel any sense of 'freedom' today but my job is to make sure that Parliament respects the result & work positively to implement it." Your job now is to represent the views of your constituents, most of whom want to remain. The leavers won by a pathetically small percentage. Far too small for a decision as momentous as this. This referendum is not binding as people on TV keep trying to tell us. Work for your constituents and try to get this terrible mistake overturned.
- Chris Glover

I agree with the remarks above by Chris Glover. I doubt that the petition of 1.5 million signatures will have any effect, but the government must take account of the problems presented by a country clearly (and bitterly) divided by age, nationality, social status and environment. May I suggest that one of your early jobs as a member of the Parliamentary Conservative Party is to prevent Boris Johnson becoming Prime Minister. Bob
- Robert Lawson-Peebles

Please read this this information about leaving the Union found on ta Government website while looking for information on the Petition EU Referendum Rules triggering a 2nd EU Referendum March 2016. It states that it is a process that is expected to take a decade or more. Given that Article 50 only allows 2 years and that then the matter is closed even if there is no agreement, it would appear that we are not going to come out unscathed. THE PROCESS FOR WITHDRAWING FROM THE EUROPEAN UNION The Government has published a paper on “The process for withdrawing from the European Union”. This fulfils a commitment made to Parliament during passage of the Referendum Act 2015 to provide information to the public on the process of leaving the EU. The document sets out the process that would follow a vote to leave the European Union, and the prospects for negotiations. The rules for exit are set out in Article 50 of the Treaty on European Union. The report makes clear that this is the only lawful route available to withdraw from the EU. The report highlights that: • It could take up to a decade or more to negotiate firstly our exit from the EU, secondly our future arrangements with the EU, and thirdly our trade deals with countries outside of the EU, on any terms that would be acceptable to the UK. • This long period of uncertainty could have an impact on financial markets, investment and the value of the pound, and as a consequence on the wider economy and jobs. • Issues such as the rights of the approximately two million British citizens living elsewhere in the EU, access to markets for vital industries, and the status of Irish and Gibraltan borders would all need to be addressed. The process of withdrawal would be a complex negotiation requiring the involvement of all 27 remaining EU Member States, the European Commission and the European Parliament. It would mean unravelling all the rights and obligations which the UK has acquired during more than 40 years of membership - from access to the Single Market, to structural funds for poorer regions, to joint action on sanctions. Crucially, the negotiation would include the status and entitlements of the approximately 2 million UK citizens living, working and travelling elsewhere in the EU who currently enjoy a range of specific rights to live, to work and to access pensions, healthcare and public services that are only guaranteed because of EU law. Article 50 foresees a two year process but the Government believes that it would be difficult for the UK to complete a successful negotiation in this timeframe. Any extension would require the agreement of all 27 remaining EU Member States. It is unclear from Article 50 how far the arrangements for the UK’s future relationship with the EU would be included in a withdrawal agreement. But it is likely that the scope of those arrangements would require the negotiation of a separate agreement with the EU. An ambitious agreement on trade and wider co-operation could require the unanimous support of all 27 Member States and ratification by some countries’ national parliaments too – presenting a further opportunity to block the agreement for any reason. The Government believes that while these negotiations continued, the UK would be constrained in our ability to secure new trade agreements with countries outside the EU. Those countries are likely to want to know the terms of our new relationship with the EU before opening negotiations with the UK. Countries like the United States, which are already negotiating with the EU, are likely to want to conclude those deals first before negotiating with the UK. This means that a vote to leave the EU would be the start, not the end, of a process that could take up to a decade or more. The report sets out the impact of withdrawal on a number of specific sectors such as car manufacturing, farming and financial services while also setting out a number of broader issues that would need to be resolved during the withdrawal process such as: • access for UK citizens to the European Health Insurance card • cross border security arrangements including access to EU databases • the rights of UK fishermen to fish in traditional non-UK waters including those in the North Sea • access to the European Medicines Agency, responsible for safety monitoring of medicines developed by pharmaceutical companies for use in the EU. The full analysis is available at: https://www.gov.uk/government/publications/the-process-forwithdrawing-from-the-european-union
- Ted Stone

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23 MAY 2016

Both sides should stop treating the public as fools in this ugly referendum campaign

With a month to go until the EU referendum, the public deserve better from this campaign. I came into politics urging for better use of data and, like so many who are grappling with the questions at the heart of the debate, I'm dismayed by the disingenuous and at times downright misleading claims from both official campaigns.

We have seen a spiral in recent days, with both sides making ever more outlandish claims. Most recently Vote Leave has blamed EU migration for NHS pressures, brazenly hijacked their branding and continued to make the absurd claim that Brexit could divert £350million extra per week to the NHS.

There are many reasons for the pressures on the NHS, but largely because we are living longer and with multiple and complex conditions. As many have commented; if you meet a migrant in the NHS they are more likely to be caring for you than ahead of you in the queue. The NHS Chief Executive, Simon Stevens, set out the stark dependence of the service, on overseas staff during his interview on the Marr Show and, whilst many health and care workers come from outside the EU, a vote to leave would have consequences if those from the EU were made to feel unwelcome. He also highlighted the dependence of the NHS on a strong economy and the knock on consequences for any uplift in funding of financial turbulence. In my view, it is an increase in the percentage of our national income that we spend on health and care that will save the NHS, not Brexit. After the rebate and funds already committed to support farmers, exporters, regional development projects and science, the leave campaign clearly does not have an extra £350m per week to promise the NHS and they should stop treating the public as fools.

There are legitimate concerns about pressures of population growth on housing, schools and certain areas of health provision but the current pre-occupation exploiting the NHS, and its protected branding, to support the leave campaign's argument on the EU is a cynical distortion which undermines the credibility of their other arguments. I will not hand out Vote Leave's deliberately misleading leaflets about the NHS.

The issues around this referendum are complex. People are sick of the deluge of misinformation and don't know who to trust. We cannot point to either official campaign as a trusted source. I'm suggesting people look at websites like Full Fact or the detailed research published by the House of Commons library.

I remain very torn about this referendum. I had never imagined that I would vote to leave the EU and welcomed the renegotiations as an opportunity for the institution to take account of the serious concerns not just from Britain but from across the continent. I wanted to stay in a reformed EU and yet the renegotiation only served to highlight that the EU appears neither interested nor capable of genuine reform. The democratic deficit at the heart of the institution and our own detachment from it are deeply troubling.

We tend to think of the EU as benign and remote but what if a federal and ever more centralising Europe moves against our national interest? We will be powerless to effect meaningful change just as we are already unable to vote its leaders from power. The situation in Austria should act as a wake up call to those who feel that the direction of the EU could not change. My fundamental concern is that in our own mature democracy we must retain the ability to remove from power those who make the decisions which govern our lives.

I am concerned about the increasingly ugly tone of the Leave campaign but I'm also sceptical about the wild claims of a descent into chaos, war and the collapse of security from the Remain camp. In the event of Brexit wise heads would surely prevail to ensure essential cross border cooperation.

Project fear however, appears to be working. I meet many people who are switching to Remain because they have been spooked by the relentless messaging on security and the economy. They will be holding their noses to vote for remain, not endorsing the status quo. There is still a powerful feeling that people want a relationship based on trade rather than tied to the rim of an ever more centralised and powerful federal Europe.

If the majority vote to stay - which I think is likely – we must fundamentally rethink how we engage with the EU and develop a meaningful relationship between people and the currently remote bodies which make up this institution.

The remain campaign is anxious, and as a result – they and the government are overhyping both the risks of leaving and the benefits of remaining rather than leading a nuanced and honest debate. The danger of that approach is that the result will be interpreted by the EU as a ringing endorsement of business as usual.

35 comments

I think it is a great shame that leaders of both campaigns are resorting to sniping, when they could be laying out the facts. Regrettably, this could be our only chance to leave an increasingly federal Europe, and we need our sovereignty back. The UK's influence in Europe is diminished, and membership is inhibiting our ability to negotiate elsewhere in the world. Of course we will have pain if we leave, but it will be much less now than in the future, when we can no longer bear the EU's stranglehold, and quest to subsume us completely.
- Jacky Davis

I agree totally with your views however do believe the cost to the UK economy if we leave will be too high a price to pay. The Brexit campaign has been abysmal and Boris has been totally unconvincing. The statistical and analytical arguments to stay are far greater, but I agree the campaign has at times been foolish and far less effective than it should have been. Trade with with the EU is vital to our economy. We cannot afford to lose circ. 45% of our exports. Some may argue the EU needs us as much as we need them but if we leave they will set an example of us the same way Russia stopped imports that harmed them more than their suppliers. Brussels will have the stronger hand in any future trade negotiations which will no doubt result in onerous terms, probably including a free movement of EU citizens such as the agreement with Norway. We will be over a barrel. Leaving the EU therefore may not resolve our immigration issues and with less influence to determine EU policy we could have less control than we have now. The answer has to be staying in Europe but getting tough, using our influence and using our veto. There will be other member Countries that share our concerns and who want to retain sovereignty and move further away from being a Federal state. We have as much right as any other EU member Country to determine the future of the EU and it is time we made our voice heard. We should oppose any more member Countries unless we get agreement on tighter controls on freedom of movement.
- Mike Allen

What is wrong these days with the word traitor. Those that are prepared to throw our sovereignty away,allow our legal system to fall pray to a foreign legal system are nothing less.
- Loris Goring

I very much respect your position on this Sarah, and as ever your tone is measured. There are clearly faults on both sides of this debate. Leave have run a poor campaign and seem destined to lose. I really don't think the campaign is helping the party or the country. I started off as a soft leaver (probably similar to yourself) and have become more convinced of Leave as the campaign has gone on. The issue is one of long-term economic prosperity and democracy. The PM's renegotiation in some ways only served to confirm for me that this organisation is incapable of the serious reform needed. As you suggest, it looks like Remain is winning. Since the campaign has been largely about the economy (the worst kind of short-termism, empty speculation about the value of the sterling in the weeks after a referendum and so on), and the general public largely doesn't understand these issues, it is reasonable to assume that many people will be swayed by the volume of information when their prosperity is threatened. This is a shame, because the economic record of the EU is hardly unblemished. The EU seems to have no idea how to resolve long-term structural weakness and achieve growth. The Prime Minister has led poorly on this, and has damaged the party. He has compromised the hard won reputation of independence in the Civil Service, Bank of England and the NHS (Mark Carney and Simon Stevens had no need to get involved in such a partisan way). The Treasury has left itself open to ridicule with its claims. I resent Mr Osborne calling Leave campaigners "economically illiterate" (many Leave supporters are clearly not such a thing), when it is many of these people who have supported him over the past six years (often against many of his new found friends), even when he has missed a succession of economic targets The spending of £9 million on a leaflet promoting the Remain view was equally embarrassing, and a breach of basic fair play that does the Party little good. Having voted for the Party and been a loyal supporter, I am angry beyond words at his claims that Brexit is unpatriotic and immoral, and that "Al Baghdadi will be smiling". The PM should remember that a great number of the people on the Leave side are (or at least were) his supporters. I am grateful for the opportunity of this referendum...it was one of the main reasons to vote Tory in 2015...and I respect his right to disagree...but his conduct during this campaign has been disgraceful. He may argue with good reason about the conduct of some on the Leave campaign...but he is the party leader, his responsibilities were clear and his conduct has been appalling. Clearly the PM believes that the end justifies the means. I disagree. Such a campaign means that the vexed issue of Europe will not be settled, and will surely be the dominant theme in the coming leadership election (which it shouldn't have). The Parliamentary group and the wider party have been ignored and insulted on this issue. I have always supported Tory candidates in all elections, but I will not be able to continue this unless Mr Cameron names a date for his departure. After 24 June the PM will be reliant on MPs who he has insulted...he cannot surely believe that he can breeze back into the 1922 Committee and say "good game chap, let's get on with governments" after that performance. There may be no Brexit (and I am scared enough about that prospect), but change is coming nonetheless.
- George, Paignton

I am heartened by this thoughtful post. I don't agree that the distortion of data falls equally on both sides of the Leave/Remain campaigns, especially when it comes to data concerning the NHS. But it is good to see a recognition that the misuse of the NHS brand in the Leave campaign is not something that goes unremarked, or without consequence, as you imply by your refusal to use material which does this. I hope that we can encourage a discussion about the EU and its decision-making processes that both recognises that our own constitutional arrangements are far from perfect, and that accepts that "the EU" isn't "them" - it is often "us" - look, for instance at the European Medicines Agency, located in London, or the many partnership arrangements between regional bodies and EU institutions for capacity-building and infrastructure investment. The EU hasn't remained the same since it was established, so we can confidently expect there will continue to be opportunities to change it for the better. (T.hervey@sheffield.ac.uk)
- Tamara Hervey

Dear Dr Sarah, I would like to say that your post is one of the most inspiring I have ever read from a politician and I respect your reason for voting to leave...if only more UK politicians could be so clear about the debate...before I comment on/repeat anything I hear, I always do my own research to get to the real truth behind the claim..my biggest concern is that our successive governments and oppositions continually put party politics before the best interests of the UK, the EU and the world...people are genuinely tired and frustrated of what's happening in the UK Parliament...I have come to the sad conclusion that it's better to trust the collective views of MEPs from 28 democratic countries rather than my own Parliament and that is the main reason I will be voting to remain in the EU...Kind Regards, David
- David Coole, Andover

What a breath of fresh air amid the incessant wind tunnel of bogus claims, lies and polarised opinions!
- Daniel Sainty

Hear! Hear! 👏🏼👏🏼👏🏼 Although I am for IN, I think your article is a good well thought out argument and I, along with many others, are sick of BOTH sides going to extremes to support their case!
- Dr Stanley Ooi

I would just like to quote from a speech made by Winston Churchill in 1946 regarding the avoidance of another catastrophe in Europe (and hope not to be called traitor by Loris Goring) : "Yet all the while there is a remedy which, if it were generally and spontaneously adopted, would as if by a miracle transform the whole scene, and would in a few years make all Europe, or the greater part of it, as free and as happy as Switzerland is today. What is this sovereign remedy? It is to re-create the European Family, or as much of it as we can, and provide it with a structure under which it can dwell in peace, in safety and in freedom. We must build a kind of United States of Europe." People of reason realise that some compromise is necessary in any democratic agreements between groups of countries. Consider the state of the British economy when we joined the EU in 1973; surely nobody will claim that the EU has prevented our economic development since then.
- Keith Best

Well, good to see a well balance article, well constructed, which even i am a remain voter, it good to see a outer, who is agreeing with my point of view, on this subject,while we can disagree on other points with the outers, this is a breath of fresh air, well said and done
- Geordie best

"Consider the state of the British economy when we joined the EU in 1973; surely nobody will claim that the EU has prevented our economic development since then". Our prosperity has an awful lot more to do with Thatcher's supply side reforms in the 1980s than the anti-trade EU. With so many EU economies on their knees, how on earth is membership of this crumbling relic an economic necessity for the world's fifth largest economy?!
- George, Paignton

Your article represents a sneaky attempt at damping down the patriotic effort to gain freedom from this monster called the EU. Lecturing to the "fools" about not treating us like "fools" is perverse. All this psychobabble double talk has evolved into a political double speak, originating from the old Tony Blair school of PR chicanery.
- Jack Hough

Sarah Your integrity is an example to us all. But I think you misinterpret the threat to democracy in Europe. The big threats to democracy in Europe are not coming from some vague top down institution "the EU" but from individual countries. As they react to the triple of challenges of immigration, terrorism and slow growth, far-right movements ride a wave of populism (as in Austria) and when in power erode democratic fundamentals (as in Hungary and Poland). The question is how best to respond to this. Do we isolate ourselves - content with the assumption that we can always vote out our national government if we don't like it - or work with and improve the EU to maintain and promote a set of democratic values and human rights that can challenge undemocratic member governments. The isolation option seems to me badly mistaken. We would be rash to assume that just because our government has been democratic and moderate in the past that we are immune to these same forces that affect currently affect Poland and Hungary. We already see some fundamental rights being challenged and our popular press, while far from being under government control, is rabidly right-wing, xenophobic, and appears to have even less interest in the truth than the politicians. But even if we maintain our democracy - we would be an individual state in a Europe of many individual states some of which are developing in very unpleasant ways. David Cameron never implied that Brexit would lead to WWIII - that was Boris's fertile imagination - but we have been there before and this scenario is ripe for conflict of some kind - perhaps in the East with an expansionist Russia keen to take advantage. The stay and improve option is not easy either. The EU is very far from bridging the democratic deficit but it is slowly moving in the right direction (e.g. the parliament has moved from being essentially advisory to having a veto), has some impressive achievements in promoting democracy in Europe (e.g. the incorporation of the ex-totalitarian countries of Eastern Europe), is more democratic them many realise (e.g. elected MEPs that are prepared to contribute, can and do sit on committees and participate in policy-making just as MPs do in the UK) , and if the EU should no longer be benign we can withdraw - an option that is not available to the people if we should get an undemocratic national government.
- Mark Frank

Dr. Wollaston, Sitting on the fence simply will not do, I'm afraid. Whether it's £180 million a week or £350 million a week that we hand over to the EU is hardly the question posed by this Referendum. I find it staggering that even Conservative MP's hesitate when the decision is so clear - based on the sanctity of our democratic tradition and ancient sovereignty. Has the blood price for our independence been so quickly forgotten? There will never be an occasion when we should hand over our sovereignty and the future of our Nation to un-elected and unaccountable beurocrats - even for marginal at best, short-term assurances of continued prosperity! The EU is a relic from the past that serves the interests of banks, politicians and civil servants - fast collapsing under the weight of its' own contradictions. 'Democratic deficit' hardly covers it, Dr. Wollaston. The EU is simply a shrinking protectionist racket that is hopelessly out of touch with modern economics. We can't run and hide behind it's walls. Commerce is King and if we remember why we have been successful for 600 years then the EU becomes just one more continental empire built on sand. Our future is in a global economy! If you have the integrity which many of us believe you have then you must surely stand against Cameron's Project Fear and against the tyranny of the EU.
- Rupert Hanmer Grant

I just spent a lovely night at the Dartmouth, Royal Castle Hotel. Pretty much all their staff (who served us anyway) came from all over Europe. They were polite, hard working, really lovely. Anyone supporting Brexit, including you Sarah Wollaston, should go down to Dartmouth and explain to these people why they are not welcome in our country.
- Piere Morley

Dear oh dear. If the rumours in tonight's Telegraph are true then I am genuinely sorry. Quite how the use of one statistic by (some of) the people campaigning for a Leave vote can change the entire fundamentals of the choice faced by this country is anyone's guess. It is possible to respectfully disagree about this subject, but to change one's mind on such a basis is simply not worthy of a elected representative. I won't comment again here, and I will no longer vote Tory in such circumstances.
- George, Paignton

So the lady has now turned into a Remainer . I hope Dave has made it worthwhile for you Sarah ; a peerage perhaps? Then of course you lied in your support for Cameron over bombing Syria with your assertion that the RAF would use Brimstone missiles . You didn't have a clue before Cameron's mob handed you your speech what a Brimstone missile was. Needless to say no Brimstone missiles have been used by the RAF. This will leave many people very bitter with you ; the only chance to escape the pending European Superstate dictatorship and you prefer to do a Quisling.
- Peter Thompson

I have to assume that either (a) you weren't telling the truth when you set out the case for Leave in the Dartmouth Chronicle on Sunday or (b) you aren't telling the truth now.
- Sean Fear

Very disapointed in you.David Cameron's project fear is worse than anything the Leave group have done or said.Were you always a remainder and are trying to do maximum damage. t doesn't make sense.
- Maria Hutchins

I'm very suprised at tonight news as previously I respected you as a strong independently minded MP whether remain or leave. But now Im not sure why anyone should believe another word you say. Only 3 days ago an article with your name was published for Dartouth Today stating ''... I am optimistic for our future, I believe the balance of our national interest now lies outside the EU and I will vote to leave ''.. Now to turn to remain just over the use of a single statistic is pure madness. You are now utterly unbelievable !! . If you genuinely believed in leaving the EU and honourably disagreed with the use of this single number then you should have publicly argued your case. But always be true to your beliefs, perhaps resign from leave campaign while still advocating leaving the EU. That would be the honourable and strong thing to do. Instead you've apparently now become a Remainer . So I guess you think their figures and statistics are more believable ? This beggars belief ! ..The remain campaign which you previously criticised has consitently lied and engineered the most OTT ridiculous campaign ever . Im sorry but many people will only conclude that George & Dave offered you enough sweeties to make you swtich. Im afraid you remainers in the Tory Party are destroying all your credibility. Why should Tory voters like me ever vote for you again ?
- Richard

The plan all along, a contrived defection. I hope you had a better grasp of medicine than you do of the EU or reality. You're obviously not bothered by Osborne's fantastical fiscal figures which have been debunked. p.s Totnes of course has really bore the brunt of migration, it's probably almost in double figures, so you are well placed to understand the very real concerns and fears of the public.
- James Lay

Dear Sarah, before this referendum I was completely ignorant to politics and had no real interest at all but this referendum, and my husbands encouragement for me to learn and research the truth, has really inspired me. I've now learnt so much about EU & UK politics and the importance of the UK staying in the EU as a leading nation. I had already formed the opinion some time ago that you are a decent, honest politician (few and far between unfortunately), even when you were voting Brexit and I think it's very honest and honourable of you to be brave enough to publicly change your mind, after considering all the facts and lies. However, in Boris' case I think it was dishonourable of him to change his mind as I believe he only did it to further his career. You are the type of politician this country needs....it's so important to always be true to yourself. Kind regards, Jo
- Joanne Coole

MP goes back on her word to join those who habitually go back on their words. Democratically-elected MP pledges support for an undemocratic organisation. Voters would be foolish to trust such a person again. We will remember.
- Ian G

Regarding Joanne comment above.....I’m sorry but I think this is very naive. We are not a leading nation within the EU. We should be but we most definitely not and I note the lack of reasoning as to why you think this. If we were a leading nation then Mr Cameron’s recent ‘renegotiation’ would have comprised of REAL REFORMS including such areas of immigration, subsidiarity, democracy and parliamentary control. Instead we got empty meaningless reforms dressed up as if they were real thing (eg. red cards, benefits etc). As for the 'truth', I wonder where this 'truth' she reads comes from. Instead many people are looking at Sarah's sudden change of heart and concluding that Sarah is doing this for her own career. I wonder what dark threats were recently thrown at Sarah, Jonny Mercer and Kelly Tolhurst ? In the last few days all 3 have miraculously changed their views from pro-brexit to pro-remain . This is unfortunately the grubby reality of politics and currently Cameron/Osborne appear to be the masters of using bullying tactics to try to get their way. Unfortunately for them not everyone believes them . Unfortunately for Sarah she is totally expendable to Cameron even if remain wins and if as I predict Leave wins she will not be trusted again. I say this with regret as I previously believed Sarah to be a very decent MP. But the key here is with our Westminster politicians is that if WE don’t like them , then WE can kick them out. That’s our UK democracy. Conversely the EU is anti-democratic and nothing is changing I would suggest Joanne researches Margaret Thatcher and the EEC/EU. This was my introduction to politics as a young teenager in 1990 . I remember Margaret Thatcher being stabbed in the back and destroyed by a treacherous cabinet for speaking the truth about Europe. She was a true leader who wouldn’t have just made nice sounding speeches about EU reform and then having empty bland renegotiations. She would have delivered reform OR she would have left the EU. She was no fool . She prophesied exactly where the EEC was going with the Maastricht treaty and a federal Europe (EU). Before she was destroyed she famously said ‘No No No’ in response to Jacques Dolors . He was the European Commission president who called for the European Parliament to be the democratic body of the European Community, the commission to be the executive and the Council of Ministers to be the senate. And she predicted the eroding of the nation state by the EU by signing Maastricht. Well guess what – that’s exactly what’s occurred before our very eyes. Try reseaching that !
- Richard

Dear Sarah I watched Scotland 2016 on the 7th June and a MSP from Sweden said the EU is planning to introduce EU national insurance number for all EU citizens and in time all income tax will go straight to Brussels. If this is the case as I believe it is as I have read about the EU wanting to take over all welfare can you give assurance they will support the NHS I would also like to say the true cost of being in the EU is far greater than is talked about when you take in --- The cost to UK is set to go up that is why they have not yet put forward this years figures and they are going to try and force UK to take on the euro. 2.4 billion in vat paid direct to EU 1.7 billion" punishment for success " because we had a higher growth than expected 642 million fine for poor accounting on farm subsides ( from our own money ). 1 billion towards bail out of Greece. 150 million for not flying EU flag on projects partly funded by EU with our own money. 300 million fine per year till we meet pollution targets set by EU. 900 million per year to treat EU tourists on NHS. 22 billion to France to help boost French economy. 40 million in lost revenue in EU student loans which are unpaid and the students have disappeared back to EU. 5% vat higher costs than any other EU country for our energy bills. You could also add in 300 million costs to businesses for EU red tape. With EU water directive, which makes it virtually impossible to dredge rivers, means flooding and this has cost people and insurance companies millions. The EU has also forced the UK government to pay back tax taken from big companies when they have went to EU . The TTIP deal listening to a reporter talking to the EU trade commissioner about TTIP and all the protesting about the deal would this not lead to the deal being dropped as it stood she was told by the commissioner that she did not take her remit from the European people. I have looked into this a lot as I have two disabled sons and I worry what will be added from the EU if we remain I know they are holding back on a lot of new legislation and the fact the deal our PM has is still to go before the EU but the new legislation may well supersede his deal. I hope if the result is to remain we do not regret this in a big way. I hope to that the NHS will be safe but I think some of the money mentioned above would be better of spent at home rather than the EU. I was very angry the other night when a ex forces man staying in Spain had to come back to the UK as they were not going to pay for his meds anymore HOW MUCH DOES THE UK PAY TO OTHER EU COUNTRIES TOWARDS HEALTH CARE ?????????.
- D Owen

I find your reasons for defecting from Leave to Remain confusing. You don't want to campaign for Leave because of the £350m figure 'simply isn't true' - this is gross amount ring fenced for EU so it is an accurate figure, but you don't have absolutely no problem with the £4,300 figure used by Remain which has been proven to be an outright lie...
- Mark Williams

Dear Sarah, Sorry to hear about your change of heart. There has been very little new hard information recently, except perhaps immigration figures from ONS, just more and more outlandish claims, based on the spun statistics, by both sides. I will be voting for Leave and nothing will change my mind, however I will also be doing a proxy vote by post for a respected relation who wishes us to Remain. Thus both our votes will be negated. I don't have to, but it is to me, the decent British thing to do. We must all follow our inner feelings whilst also respecting the views of others. Good Luck in the future whichever path we choose.
- Spa

Whilst I admire Sarah's stance regarding the lying statistics, I do ask her to consider why she supports the greater lie by her silence.That lie of course is the fact that all the UK treaties since the first treaty of Rome were signed contrary to our laws. This was made clear to Prime minister Edward Heath in a letter to him by the top law officer at the time Lord Kilmuir. Because of the explosive content of this letter it was kept hidden for over 30 years and even today very few know of it;s existence because all goverments since 1972 have given notices to the medias stopping them discussing the subject or even memtioning it's existence.Fortunately this secrecy was so all pervasive that the parliament petitions committee did not realise the significance of the petition it accepted, "We require parliament to debate Lord Kilmuir's letter to prime minister Edward Heath", Now Sarah . are you honest enough to call a media conference and insist it goes out live, otherwise it will be censored, and tell the public about the Kilmuir letter. Alternatively you could make a point of order and ask the speaker to rule on the legal points made in the letter. The letter can be read here by following the link, https://petition.parliament.uk/petitions/122770
- John Timbrell

Are you up for the okey cokey? Think you would be great at it.
- john

hello, I can respect someones decision to change their mind but find it curious that you are keen for correct data & transparency in the figures when the remain side are constantly quoting that migrants contribute more than in tax than they take out! These figures also are seriously questionable. A huge number of those migrants will be unskilled
- Ruth

Vote leave never,ever said that the 350mill would go back to the NHS
- Colonel blimp

I am old enough to have been part of the original referendum regarding entry into a much smaller EU. With all its undoubted faults I still believe w are safer, more prosperous etc.etc. within the EU than outside it. Your bravery in sharing your decision to leave an organisation which you feel unable to support has restored some of my faith in MPs. I have felt disillusioned, disenfranchised and powerless to change a system which I feel is run by those who seek self aggrandisement rather than an opportunity to serve the community and electorate as a whole. One swallow does not make a summer and your gesture may not have a great effect on the debate as a whole. There are many comments in this blog which I find cynical and unworthy. Good luck to us all.
- Yvonne

Well what a turncoat and a disgrace to the medical profession to boot. What ever the exact amount we give to the EU are you happy that in many areas of the UK individuals are waiting several weeks for an appointment with a GP. Personally I have just had to wait 3 weeks just for a telephone appointment with my GP. At a Patient Participation Group meeting I attended this week it was stated that 20% of GP vacancies countrywide remain unfilled. I would suggest that being in the EU and throwing millions of pounds at it daily is not particularly contributing to that problem. Do you condone the fact that the EU operates at great cost from both Brussels and Strasbourg. This includes the fact that MEPs and staff decant from Brussels to Strasbourg for 4 days a month at a yearly cost of £93 million a year? How about the EU visitors center that cost 21 million euros are you ok with that? These are just 2 examples of gross waste of funds and all you give as an excuse for jumping ship is the possible inaccuracy of how much the NHS may gain when we vote to leave. Basically you are happy to "jump in bed" with scaremongering Cameron and his fat cats from both sides of the Atlantic to enable the EU "gravy train" to continue to grow at our expense!!!
- Ivor Williams

you are a disgrace, I do hope the position /job offers you have been bribed with are enough to get over your disregard of the British people and Democracy.. shame shame shame on you...
- wayne andrews

I thought you were amongst the few politicians to command respect, who had showed some integrity, and I very much regret that you have decided to join Project Fear in such a contrived and dishonest manner. Were you leaned on or worse? Both my late father and my great aunt have had to rely on the NHS in recent times. Our family's experience is manifestly clear; the NHS is under enormous pressure. Whilst there was much to praise, we were also appalled by the shocking communication, poor language skills and inept leadership. Any amount of additional spend to the NHS from money saved by leaving the EU/Brussels bureaucratic waste machine would be most welcome; why wouldn't such an opportunity be taken, not least by a Conservative government happy to lean on Simon Stevens to accept £8Bn rather than the £15Bn he considered was necessary in the next five years or to allow Big Pharma to continue to take vast profits with over-inflated pricing? There are so many untruths and unknowns from the Remain camp that I'm amazed that anyone can be so gullible or naive as to believe their cant. The EU has proven to be dysfunctional (look at the Eurozone and immigration), economically protectionist and inefficient and profligate beyond accountability and reform. So what happens to the NHS with unfettered immigration? Will you still be holding the Government to account in the select committee?
- John Langley

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17 APR 2016

Community Hospitals; a precious community resource

Our community hospitals are immensely valued and so any changes, especially those that could lead to bed closures are a serious concern. Community hospitals are about far more than their bricks and mortar, they are at the heart of delivering a service to local communities that allows people to be cared for closer to home, sometimes to be able to be cared for near loved ones at the end of their lives or to avoid having to be admitted to a larger hospital too far away for friends and family to be able to visit. Community hospitals provide personal, high quality and supportive care and are extraordinarily important to all the communities and individuals they serve.

To be clear, I do not want Paignton or Dartmouth hospitals to close. But our ageing population and the rising demand for services especially as a result of the growing number of people living with long term conditions mean that those planning services have to look at how we can care for as many people as possible close to home within the resources available. That means looking at the whole system of primary care, community nursing, social care, mental health services and voluntary services alongside community hospitals and Torbay hospital. We cannot look at them in isolation.

Across South Devon our primary care and community services are under great pressure with difficulty recruiting staff and in some cases working from totally inadequate premises. The closure of the minor injuries service at Dartmouth happened because they could not recruit or retain the highly skilled staff to maintain a safe level of service. Local health and social care is also under great financial pressure and our Clinical Commissioning Group is on course for a £15million shortfall in 2016/17.

Torbay and South Devon Foundation Trust and the CCG will be publishing their final plans on April 22nd but it is worth looking now at the links from the CCG website for Paignton and Brixham as well as Moor to Sea. These set out the challenges around age, deprivation and health inequality as well as the financial pressures facing our local area alongside the draft proposals.

If the plans just involve cuts to services and beds I will not support them. If a strong case can be presented for how money would be invested in genuinely improving services for patients then I think there must be a clear promise about how that will be guaranteed and greater detail on what it will look like.

The beds that are so valued by communities, close to home, can sometimes be provided as beds with extra support within a nursing home or residential care but there must be complete honesty about what the money saved, estimated at £3.9m would be invested in to make the overall service better at allowing people to be supported in their own homes without needing hospital admission in the first place.

Our community hospitals were gifted to local communities and supported over many years by generous donations and bequests. If any are sold, and it remains a big if, that resource must stay for the benefit of the local communities to which they were gifted and be used to build primary and community care facilities that are fit for the needs of today's patients. Those changes must have the support of communities and that will only come if the case can be clearly made for why the service could be better if provided in a different way. We know for example that NHS community bridge workers working alongside voluntary services can make a great difference in supporting people as they leave hospital and in reducing the risk of unnecessary admission. Community teams can include physiotherapists, occupational therapists and community mental health professionals as well as community nursing and social care but they need a base. Multidisciplinary teams can work even better if located alongside primary care so the consultation needs to set out a vision for the whole service and clear evidence for why that would be better than our highly valued local network of existing community hospitals. There is a strong case for community hospitals to do more, not less but that may mean using them in a different way focusing on prevention and care for people living with long term conditions.

There is not enough detail in the draft proposals on how the new arrangements would improve or work alongside GP services and far more detail is needed about where nursing home or residential 'intermediate care' beds would be provided if not at the local community hospital. The proposed closure of 28 beds at Paignton and 16 at Dartmouth would be a great loss and local people will need a clear explanation of how the money saved from closures would be invested both to improve services for local people and allow care to provided more efficiently rather than it just being sucked into plugging a financial gap.Whilst some admissions can be avoided with better community care, that is not always going to be the case. Torbay hospital is already under pressure and, without a clear plan for community beds, there is a danger that we could see people being admitted to even more costly hospital beds further from home as well as greater difficulty discharging patients at the end of their stay, one of the main causes of delays in casualty departments. It is very important that the beds from St Kildas are also taken into account.

The proposed closure of minor injuries units also means more people turning up in A&E from where they are more likely to be admitted unless there are really effective measures in place to avoid this. Anyone who has tried getting from Brixham to Torbay at peak times in the summer will know how difficult this can be and a Brixham hub should include access to a MIU in my view.

Amongst the many principles set out for the proposed reorganisation, there is a specific reference to improving life expectancy especially in the most deprived areas. There is a serious question therefore about the impact of closures on our most deprived communities in Townstal and Paignton and what services would be put in their place to reduce inequality and improve health and wellbeing.

I will be closely studying the final plans once these are published and attending as many of the community consultation meetings as possible. As Paignton hospital is in the Torbay Parliamentary constituency, Kevin Foster MP will be leading the discussions on the proposals there whilst I will be doing so for Brixham and Dartmouth hospitals. We will be working together as people from across the Bay use and value all our community hospitals.

7 comments

Dartmouth Hospital is seen as prime real estate. It'll be sold to the highest bidder and turned into luxury waterside penthouses.
- Anon

as both Sarah and Kevin Know that in truth the deal has already been done all this rubbish about public consultation is a smoke screen the true Conservative policy is to CUT and promise to invest in better alternatives ,which will not happen this is yet another move to eventually have the N H S dismantled and private profiteer organizations to take over I fear for the younger generations that will be at the total mercy of corporations profit margins
- victor freeman

The problems with staffing have a lot to do with the gross lack of affordable housing. The problem with housing is that too many houses are being built to be sold on the open market to the highest bidders. The solution to the housing problem could well be the solution to the staffing problem - build more decent affordable housing.
- Victoria Trow

If there is closure of some community hospitals it is my understanding that staff that work in these hospitals are expected to offer an intermediate care service that would prevent hospital addmisions and allow people to remain in their own homes. Whilst this is a good idea and no doubt many people would prefer to remain and be nursed at home ,it would prove extremely difficult in practice. Many staff do not have their own transport and rely on public transport or lifts to work. How are these staff going to deliver a service in an area that has many rural and outlying villages . Its a logistical nightmare and if two staff are required to attend a patient that may have mobility problems and need the assistance'of two staff ,then the problem becomes even greater. Has anyone actually worked out how much more time and effort in delivering this service is likely to cost?
- valerie Husband

The loss of the MIU at Dartmouth is a very regrettable event. With the population of Dartmouth and Kingswear, as well as Kingsbridge/Salcombe and surrounding holiday sites swelling to capacity in the summer months, it puts lives at risk--especially children's--during these periods. If people are meant to travel to Totnes or Torbay for help it could mean people fail to get needed attention. A minor injury (if not addressed in a timely way) can become more serious and perhaps disfiguring if help is not prompt and effective. Dartmouth hospital needs to be saved not only because of the community element of care to local people, but also to reinstate, as soon as is practical, the MIU. The lifeblood of the area is tourism, and if the South Hams cannot take care of its own communities, it won't be able to care for visitors either. One would think that with all the private money pumped into the area for real estate and tourism, that a decent emergency and urgent care facility would be a basic priority of the local commissioning groups and councils.
- Prana Simon

I really do not want any small hospital to close. As we do not have Convalescence homes any more we need feeder hospitals to allow beds to become free in the main hospitals. . It also allows patients with less serious complaints to be nursed nearer home even though nursing patients in their home can be valuable at times. The cost of care homes is extortionate. For example, my mother needs an urgent cardiac procedure. The waiting time for an urgent procedure is 6-8 weeks. My mother is desperate for a replacement hip and at present is immobile. On her surprise on the time the Consultant commented that he had to cancel all his operations that day as there were no beds and that the NHS was "falling to pieces" . We need more beds, consultants, nurses etc and more local facilities. Travelling from Bude to Plymouth each day for a visit? Just think of that toll on families.
- Anon

Is the NHS safe, or soon to be franchised out ? Apparently a young man at Totnes Station yesterday had to wait 3 hours for an ambulance after hurting his back.
- worried devonian

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04 APR 2016

In this junior doctors row, both sides have lost sight of the patient

I wrote the following article for the Guardian

I have great respect for junior doctors; it has always been a demanding role. Alongside my clinical practice, I spent over a decade teaching them before changing my initials from GP to MP. I should also declare a personal interest as my daughter is one of them, albeit currently working in Australia.

There is a long tradition of juniors spending a year or two abroad early in their careers before settling down to specialist training back in the UK, but now there is a genuine concern about the balance between leavers and returners. Many of my daughter's colleagues are not planning to join her on the journey home next year and there has been a marked increase in the numbers applying for certificates to work overseas.

The toxic dispute between the government and our core medical workforce risks driving an exodus of skills that we cannot afford to lose.

The contract sits like a festering boil with neither side ready to agree a way forward, and the dispute looks set to erupt into a dangerous full walkout by junior doctors. The British Medical Association (BMA) claims that the contract will harm patients by stretching doctors too thinly across seven days while reducing their take-home pay. The government insists that patients are being put at risk by understaffing at the weekends and that the contract reduces doctors' maximum hours and consecutive shifts while increasing basic pay by 13.5%.

The Department of Health and the BMA have spent so long shouting at cross purposes that they have forgotten their common purpose. In using them as pawns, both sides have lost sight of patients, the very people both claim to want to protect.

It was perfectly reasonable for the government to try to tackle the higher mortality at 30 days for those admitted to hospital at weekends, but entirely unreasonable to blunder on asserting that the new contract is the answer. Ministers are undermining their case and inflaming tensions by misquoting the evidence, which points more to the need to improve senior decision-making, nursing cover and rapid access to investigations at the weekends than to increase junior doctor cover. If the objective is to tackle excess weekend mortality at 30 days, the government should have followed the evidence and focused elsewhere.

It seems to me that the contract is more about the manifesto commitment to a seven-day NHS and the perceived barrier of premium Saturday pay rates. There needs to be a far clearer and more consistent definition of what the government means by a seven-day NHS and how it will be staffed and funded. Is it about convenient seven-day access to routine services and surgery, or about making sure that urgent and emergency care is available to the same standard every day of the week?

The Department of Health should have been more robust with No 10 that a routine seven-day NHS is unachievable within the current workforce and financial pressures and refused to accept underfunded new commitments.

Mine was the last generation of doctors to endure crushingly unsafe 120-hour working weeks and I have no romantic nostalgia for the 72-hour shifts commonplace in the late 1980s. Tired doctors can be dangerous doctors. What struck me, however, from the juniors I taught before coming to parliament, was that they felt every bit as exhausted and demoralised, not through lack of sleep but because while on duty they too often felt stretched to the limit. Medicine has also lost the supportive team structures and flexibility to work near partners and accommodation that once compensated for the stresses of the job. Today's juniors, feeling powerless and undervalued, are now prepared to walk out on their patients – but that will have lasting consequences.

A failure to recognise this until too late in the negotiations, alongside a disastrously timed and clumsy announcement, risks scuppering an important opportunity for change. The appointment of Professor Sue Bailey, chair of the Academy of Medical Royal Colleges, to examine how to improve juniors' working lives, should have been unequivocally welcomed by the BMA. Anyone who knows her will know that Prof Bailey is no mouthpiece for government and would be a powerful advocate for change.

Pressing ahead with a full walkout however, will serve only to harden attitudes and solves nothing. Most importantly, it will be disastrous for patients. The BMA has no doubt calculated that people will blame the government, but a strike that leaves patients without junior cover even for emergencies puts lives at risk. It cannot justify such drastic action by claiming to protect patients.

Given the agreement to pay the premium rate all day to any doctor working one Saturday or more every month, how can it be argued that patients will be safer only if all Saturdays are paid at the premium rate, however infrequently worked? Given the scale of concessions and protections on maximum hours and consecutive shifts, the BMA could have declared victory and moved on to focus on the deeper and longstanding causes of discontent.

Junior doctors are understandably concerned about being pressured into working unsafe hours despite the proposed safeguards, but this was all the more reason to work with Prof Bailey and new provisions in the contract to make sure that whistle-blowers are confident to come forward and fully protected when they do.

Both sides now need to put patients first and step back from this dispute. The government should do as it promised under the Health and Social Care Act and to stop trying to micromanage the NHS. If there was a clearer definition of their purpose behind a seven-day NHS, the service could better design the solutions and set out the costs.

It would also help for the government to make a clear statement of the obvious: that come August, junior doctors will see little change to their shift patterns. The simple reason is that there are not yet enough of them to achieve a truly seven-day service. That ambition requires a change in the workforce and a commitment to supporting and working alongside it rather than in an atmosphere of conflict.

NHS England, Health Education England and the BMA should work with Prof Bailey to undertake a fundamental review of junior doctors' training programmes, responsibilities and working lives, including facilitating them to coordinate placements with partners. Many more of their duties could be shared with others such as pharmacists, physician associates and admin staff. Patients are already benefiting from the greater use of the professional skills of specialist nurses and far more could be achieved.

In some hospitals, such as Salford Royal in Manchester, electronic patient records are finally reducing the scandalous waste of time and resources that come with duplication and paper trails. More could be done to make sure that best practice benefits patients everywhere.

A constructive relationship between doctors and government will take time to rebuild; it cannot be imposed and it will not happen unless both sides put patients first and start listening. Saving lives must take priority over saving face.

4 comments

I agree fully with you when you say: "The Department of Health should have been more robust with No 10 that a routine seven-day NHS is unachievable within the current workforce and financial pressures and refused to accept underfunded new commitments." The problem is that government has pressed ahead with the plan without the additional funding required. This is the crux of the dispute - although the genuine concerns of doctors have since been magnified ten-fold into utter anger and frustration by the way in which Jeremy Hunt has treated them. The BMA have asked for talks to resume - but received the response that 'the matter is closed'. The most important thing now is for the threat of imposition to be removed so talking can start again. Without talks nothing can move forward and the situation can only worsen.
- Jonathan

What a shame that you are not our Health Minister. Our daughter is a new GP. Having seen her experience in training and now as a salaried GP I can only say that there is a significant void in the planning and delivery of the NHS' staffing requirements and a profoundly callous approach to the employment and development of valuable and dedicated young professionals. We desperately need a Health Minister who understands the issues and who commands the respect of staff and patients alike, able to go beyond sloganeering into long-term planning.
- David H

Took the liberty of writing you in as my choice for Leader in the latest Con Home survey. Cons need to be seen to be safe with public services. I greatly valued this article, but I'm still not clear about the money. How much is the "premium rate", and how much might be lost with the new contract please?
- John Bald

Dear Dr Wollaston, I read your "in a personal capacity" article in the Guardian pointing out that available evidence suggests that increased weekend-admission-mortality is due, not to the lack of junior doctors on duty but to poor senior decision-making, inadequate nursing cover and insufficiently rapid access to investigations at the weekend. As a Conservative MP, a doctor and the Chair of the health select comittee, are you not able/allowed to convey this simple piece of information to Mr Hunt and Mr Cameron? Is it that you are ignored? Your puzzled colleague, Miriam Wohl, MB ChB, JCCCCert, MSTAT
- Dr M Wohl

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18 MAR 2016

Taxing sugary drinks companies helps to boost funding for children's sport

George Osborne's announcement in the Budget that he wants to help fight childhood obesity through a tax on sugary drinks has provoked the usual grumbles. But this is not a 'pious, regressive absurdity', as some claim. It is practical action that will help to tackle an avoidable health disaster for the nation's children, a quarter of whom from the most disadvantaged families are leaving primary school not just overweight but obese. This is double the rate for the most advantaged children and the inequality gap is rising every year. If that had no consequences for them, there would be no case for action, but obesity blights their future health and life chances. It also adds to the rising and unsustainable bill for the NHS of at least £5bn per year.

Finally, the manufacturers and importers of sugary drinks have an incentive to reduce the sugar content of their products so that they are below the 5 or 8g/100ml thresholds if they are to avoid paying increasing levels of levy.

'Why pick on sugary drinks?' bleat some of the manufacturers. Of course they are not the only cause, and this measure wouldn't work in isolation, but sugary drinks are the single biggest source of sugar intake in older children and teenagers' diets, making up around 29% of the total. These are wasted calories with no nutritional value whatsoever. Sugary drinks are also rotting children's teeth and, at a time when admission for dental extraction is also the leading cause for hospital admission for young children, isn't it time that manufacturers took some responsibility?

I hope they were listening to the Chancellor as he pointed out that passing the levy on in the form of a price differential at point of sale would have a further impact on consumption. In Mexico, there was a 17% fall in sales of sugary drinks amongst the heaviest users one year after a modest differential in the form of a sugary drinks tax. It is childhood obesity that is regressive, not a levy that will make a positive difference, especially because it will most benefit disadvantaged children through doubling the school sports premium and funding for breakfast clubs.

Manufacturers may choose to swallow the costs themselves, but the tax could still push them to get on with cutting down on the amount of sugar in their products, in the same way as we have successfully cut back on salt in food.

This is a victory for children's health and manufacturers and retailers should now step up to the plate, show that they understand the scale of the problem, embrace the change and prioritise the health of their customers.

3 comments

Do you think there is a risk of diet drinks, with their proven to be carcinogenic sweeteners (eg aspartame) becoming even more prevalent, and there being significant unintended consequences in the long run?
- tim

Well done Sarah in supporting a sugar tax that is blighting disadvantaged families and the NHS with an obesity crisis. As you mention it does appear to be working in Mexico but Tim makes a very valid point in that any substitute should be safe and not lead to long term side effects of a different nature.I believe Sucralose has been deemed to be a safe alternative.
- John Roadknight

It is not safe at all John!, reinforcing Tim's and my own very valid point. We need to look very long term, fail safe, in fact! David
- David Cassell

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