27 FEB 2017

The 2017 Budget Needs to Provide a Lifeline for Social Care and a Plan for the Future

This is an article that I wrote for the Times.

As the Chancellor finalises his 2017 Budget he can no longer afford to ignore the stark warnings about the impact on individuals and the NHS from the crisis in adult social care. Last year the Care Quality Commission described the fragility of the system as approaching a 'tipping point'. The situation looks set to worsen without an immediate lifeline and one that goes beyond the uneven and inadequate sticking plaster of a 3% increase in council tax precepts. To put this in context, last year's uplift in the precept raised £382m but this was entirely swallowed by the £612m increase in costs from the National Living Wage. Precepts also entrench inequality as those areas least able to raise money also have a greater proportion of residents who are fully dependent on their local authority to fund their social care. The 2017 Budget needs to bring forward the so-called Better Care Fund already planned for later in the spending review and it needs to be 'new' money, not a smoke and mirrors device to transfer funding from an already overstretched NHS.

Over the last review period 09/10 to 14/15, local authority spending on adult social care fell by 10% at a time of profound and ongoing demographic change. Despite rising demand for services, more than a million people are estimated to be going without the care they need. It is a false economy because they are increasingly ending up in A&E or stuck in hospital when they could and should have been discharged. The knock on effect on NHS services has been the marked rise in waiting times, 'trolley waits', and cancelled appointments and admissions. What is surprising and unacceptable is that no government has assessed the full impact and cost of the shortfall in social care on the NHS.

The number of people with care needs is expected to rise by more than 60% over the next 20 years whilst the proportion of individuals of working age will continue to shrink in relation to those living in retirement.

It's time to stop presenting longevity as if it were a negative. It is amongst the greatest achievements of our age and government needs to highlight and support the extraordinary value that older people add to our communities. It also needs to set out how we will fund social care for the rising numbers of people who will need help to live with dignity in older age. There has been an abject failure of successive governments to plan for the future. Councils also need certainty about the Care Act provisions, delayed to 2020, which bring in a cap on care costs and change the financial threshold for entitlement.

The Prime Minister has already confirmed that she is looking at social care but it is worrying that her review currently excludes the NHS. The two systems are inextricably linked.

In his 2017 Budget, the Chancellor must show that he has grasped the seriousness of the situation and announce an immediate cash injection for social care. He should also set out plans to tackle the greatest domestic challenge of all; how to bring forward a fair and sustainable long term settlement for both the NHS and social care.

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30 JAN 2017

Trump Trading on Prejudice

This is an article that I wrote for The Guardian

Donald Trump made no secret of his deeply divisive instincts during his long campaign for the White House. Vile racial and religious stereotyping, misogyny, his support for torture, even parodying those with disabilities. All his prejudices were worn as a badge of honour, displayed from campaign platforms and television studios for months on end.

Locker room talk, we were told, of his boasts of 'grabbing women by the pussy' as voters were assured that the office of Presidency would surround him with wise counsel and bring out the statesman in him. Less than a month since his inauguration, the stark reality must be dawning on Americans, that their choice of President isn't 'draining the swamp' but dragging them into one of his own making. We don't have to join them.

It would be a mistake to dismiss Donald Trump as some oafish 'man baby' impulsively blurting whatever comes into his mind. His actions seem calculated to offend, bully and control.

Some touted the hand holding with Theresa May as the seal of a special relationship and a gentlemanly gesture. To me it smacked of the unwelcome infantilising of a strong female leader, more than capable of negotiating the White House steps on her own.

In the rush to forge a trade deal Mrs May should remember that Trump's executive orders since assuming office don't just affect millions of Americans but our own citizens. Nadhim Zahawi MP, is just one of many thousands of our fellow Britons who are now barred from the USA for no reason other than the nation of their birth. All those countries on his banned list are predominantly Muslim countries apart from, as Andrew Neil points out, 'those where Trump Org has business interests'.

A shameful curtain of prejudice and discrimination is drawing across the Land of the Free and, if we are truly in a special relationship, true friends should be frank in saying so. By his actions as well as his words Trump is also turning back the clock on women's rights across the world. His executive order bringing in the so called 'global gag' will restrict access to safe contraception and healthcare as well as to safe termination of pregnancy for the world's most disadvantaged women.

The State Visit looks set to go ahead but symbols matter. Westminster Hall has long been reserved for those Statesmen and Stateswomen who have made a lasting and positive difference in the world. That does not include Mr Trump. No doubt there will be those who wish to fawn over him, but that must not be from the steps of our nation's greatest hall.

10 comments

Thank you, Sarah, for your brave and principled article in the Guardian. Bob
- Dr Robert Lawson-Peebles

Donald Trump's first week should be a warning to the UK to tread carefully. We should not appease him just as Chamberlain should not have appeased Hitler. We should not turn a blind eye to his brand of evil in case it hurts our wallets. There are those, like the Sun, who have a go at you for your stance, Sarah but they are plain wrong. Please carry on with your efforts to debar him from Westminster Hall. He has no place there, and if he finds one our democracy is diminished. Those who say we should accept him as the USA's democratically elected president and leader of the free world should remember that Hitler was democratically elected too, and in a very similar way in the first year made a grab for power that left him unassailable. Let us not make the same mistake with this 'sickening piece of work'.
- Peter Scott

Peter Scott seems to go for Godwin's law at the outset. ! The US is the largest most powerful country in the world and has elected a President who will put the interests of the American people first. We as a nation need to work with the US if we are to make Brexit ( opposed by Ms Wollaston ) a success. Most of Ms Wollastons article it is a mixture of half truths and MSM propaganda.
- Peter Thompson

Excellent article. Thank you. I am very opposed to honouring him with a state visit or the opportunity for him to talk in Parliament. Teresa May has jumped the gun in inviting him. Please pass on my thumbs down to her.
- Tracy Harris

How about adding to the rapidly growing number of Britons who are fed up with people undermining the strategy of our courageous Theresa May and sign the 'other' government petition at: https://petition.parliament.uk/petitions/178844 and trust the Queen and our PM when they invite President Trump to visit and see what we can do.
- David

Thank you for making such a principled stand.
- Andy Christian

Just the guy to take on Putin!
- Sam Seal

I really cannot work out why Sarah continues to sit with the Tories in the Commons. She has scarcely a Conservative bone in her body and hardly a positive thing to say Brexit or Theresa May. Joining in the hyperbole about Trump is about the level I expect these days. Why not just resign, and let the Tores stand a candidate in the constituency more in tune with their values?
- George, Paignton

Well done on your opposition to Trump speaking in Westminster Hall. This week you also expressed your opposition to 3000 child refugees being allowed to come to Britain. Could you please explain your thinking behind that?
- Chris Davison

Thank you for your principled stand - I am deeply worried about turning our backs on our biggest trading partner and allying ourselves with Trump. I believe tats a lot of people are now wondering how safe our country is economically following Brexit and Trump's nomination. By the way Chris Davison Sarah did not express opposition this week against the child refugees. Sarah remainsin favour of resettling child refugees. The decision was made by the Home Office.
- Alison Williams

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26 JAN 2017

The global gag will hit the world's poorest women

A few days into his Presidency, Donald Trump has signed an executive order dubbed the "global gag rule". It will have the effect of cutting off funding for overseas NGOs whose work is associated in any way with abortion services. This means that many international health workers and organisations, even those who receive part of their funding from other private sources for work or advice linked to abortion services, will have to decide whether or not to continue. These services risk losing crucial funding – meaning cuts to choice based contraception and other health services for the most disadvantaged women worldwide. Because the US is the largest health donor this will have an impact on unwanted pregnancies and could have a knock on effect on other areas of women's health care like screening programmes, prenatal check-ups and support for HIV sufferers.

President Trump's policy is also counterproductive – fewer abortion services does not necessarily mean fewer abortions but more unsafe 'backstreet' abortions and maternal deaths. It turns back the clock on women's rights to exercise control over their own bodies.

While organisations are being coerced by the new rules into reconsidering their future programmes, it is a relief to hear that the Netherlands have already announced plans to try to compensate for the new administration's draconian policy, by considering an international fund to help provide these services.

Britain should join with the Netherlands to help protect women's right to access safe contraception and termination of pregnancy alongside the other health services that will be hit by the global gag.

7 comments

You really are something aren't you . You pontificate from the lofty heights of Totnes on the policies of the elected leader of the United States. Your only contact with Islam is when you pop into the Indian take away . It was a disappointment for you when the " plebs " voted for Brexit and devastating when the Yanks voted for Trump. Instead of getting in your pulpit why don't you try and understand what is going on and the reasons for it. get out of your politically correct bubble.
- Peter Thompson

It would be excellent if Mr Thompson would explain the relevence of Brexit and Islam to a policy that will cut health aid being delivered in countries across the world. Thank you Dr Wollaston for pointing out that this policy is not about abortion at all, but about cutting sexual health services. There is nothing pro-life about limiting HIV prevention and treatment, or leaving desperate people with no legal options.
- R Edwards

Sarah Wollaston's article is well thought out and something I agree with. Peter Thompson's abusive comment is a pathetic rant with no content whatsoever. Would you say it if you were face to face with her, or do you only get abusive from behind the veil of a computer screen? Next time string two thoughts together into a coherent sentence and perhaps we might listen to you.
- Peter Scott

To R Edwards, given the stated criterion "whose work is associated in any way with abortion services" it very clearly IS about abortion. The other services are collateral damage. Those organisations can, presumably, get access to the funding again by stopping abortion work. However, this may not be of interest. As has been demonstrated on occasion, too often "woman's health" is used as a fig-leaf of attempted respectability to distract attention from the headline act - abortion.
- Dave R

Thanks Mr Scott but I think my comment was on the nail. As for abusive rant I would think Ms Wolastons comment " Trump really is a sickening piece of work. That's the story " rather fits the bill .
- Peter Thompson

Well done, Peter Scott, for highlighting the vacuous and abusive nature of Peter Thompson's post. All he can do is repeat his point, not engage in debate. Hasn't it occurred to him that political correctness may at time be - er - correct?
- Dr Robert Lawson-Peebles

I think Sarah Wollaston's stand is principled and impressive. Peter Thompson's wild assertions and obnoxious tone make it rather hard to see whether he has any logical point of view. I am sorry her convictions have upset him but I would wager he is a man who is easy to upset if you don't fall into line with him. I am not a Conservative but I am pleased to have an independent, intelligent, well informed and progressive woman representing us.
- Andy Christian

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22 JAN 2017

My response to the consultation on re-shaping community services

Following their recent consultation, the South Devon and Torbay Clinical Commissioning Group has now published its recommendations . These will be put to their governing board when it meets in public on 26.1.17.

The most controversial aspect is that the CCG continues to recommend that several local community hospitals will close as part of their plan to introduce a new model of care. In my constituency that would mean the closure of Dartmouth hospital. Many Paignton residents will also be affected by the closure of their community hospital in the neighbouring Torbay Constituency.

Reading the document I am deeply concerned at the statements on page 24 which imply a lack of support for Dartmouth hospital from local residents and their representatives. This is simply not the case. There is huge support for our local community hospital and gratitude for the dedicated work of the staff. There was however pragmatism that the consultation was likely to result in the closure of the hospital, if nothing else by further undermining the ability of the trust to recruit staff, and therefore a determination to work to make sure that we have a commitment to an effective alternative.

Dartmouth would benefit from modern primary care facilities on the same site as Dartmouth Caring, community clinics and an enhanced primary care minor injuries service. The new service must also include commissioned beds in River View for local people who need extra care and re-ablement as a step between hospital and home, or to support them close to home at the end of life. A new combined facility could also allow us to provide better training and development for our local workforce. We know that there is a serious shortage of staff across community teams which is increasing the risk of unnecessary hospital admissions. But the support for this approach will depend on a clear commitment to put this in place and have the new facilities up and running before any closure goes ahead of our much loved community hospital. Clumsy language implying a lack of support for Dartmouth hospital should be withdrawn.

On the issue of Paignton hospital, I will be supporting Kevin Foster MP and again point out the need to have high quality alternative facilities in place before any closure goes ahead. It is also vital that the community are reassured about the quality of provision of social care following the damning CQC report on Mears.

I remain deeply concerned about the financial pressures across health and social care and will continue to press at national level in my role as chair of the Health Select Committee for an urgent review of and increase in the short and long term settlements. The pressures are not just financial but also as a result of a very serious workforce shortfall across health and social care and I would like to see greater emphasis on maximising training opportunities in the final CCG document.

I also remain deeply disappointed that there will not be a minor injuries unit with X-ray support at Brixham hospital. Concentrating services and facilities at Torbay hospital not only risks driving more people to A&E and increasing the risk of avoidable admission but also far longer travel times for Brixham residents.

I will be attending the public meeting this week to put these points to the board.

On a separate note, I have also been speaking in Parliament and directly to NHS leaders about the recent threats to Torbay's nationally and internationally respected model of integrated care. Whilst I have every confidence that Torbay council and the local NHS will continue to work closely together within the Integrated Care Organisation, ICO, it makes no sense to see their work undermined by outside threats to stop them pooling their resources to work in the best interests of patients.

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09 JAN 2017

The current pressures in the NHS

I wrote the following article for the British Medical Journal (published on 3rd January 2017)

The current pressures in the NHS can be traced back to 2009 and what became known as the Nicholson challenge. In the aftermath of the economic crash this ushered in an unprecedented period of efficiency savings against a headwind of rapidly rising demand and costs. The incoming coalition government then imposed a disruptive and demoralising reorganisation that distracted from the key challenges. Rather than seizing the opportunity to integrate health and social care and to design a sustainable long term financial settlement, the Health and Social Care Act 2012 led to greater fragmentation at a time when our demographic changes demanded a different approach.

In the decade to 2015, the number of people living to age 85 and beyond increased by 31%.1That is a cause for celebration, but there has been a striking failure to plan for what this means for health and social care. The same is true for the rapidly rising cost of preventable conditions and expensive new drugs and technologies.

Over the last parliament, funding for the NHS increased annually by an average of just 1.1%, far below the actual increase in costs or the long term average of around 3.8% since 1978-79.2 The real terms increase in Department of Health spending for the current review period is just £4.5bn3 (€5.3bn; $5.5bn) and will result in reduced spending per person.2 The accompanying cuts to social care combined with a serious workforce shortfall have left more than a million older people going without the personal care that they need to live with dignity in their own homes.4 It is no surprise that so many are ending up in more expensive settings in an already overstretched NHS.

The political response to a health and care system in severe distress, and more importantly to the people it serves, has been dismal. No one listening to the yah boo of debate in the Commons would be filled with optimism. There has been a failure to grasp the scale of the financial challenge facing both health and social care and the consequences and inefficiency of their continuing separation. A serious shortfall in capital, as a result of ongoing raids to plug deficits, is undermining the prospects for the transformational changes necessary to produce future savings.

Likewise, area based joint commissioning is at risk if the financial squeeze is so unrealistic that health and social care retreat to protect their own budgets. Sustainability and transformation plans hold the possibility of moving away from a competition based approach to one based on integrated commissioning but they must be realistic and supported by the funds to deliver.

There have also been missed opportunities in public health. In her first speech on the steps of Downing Street, the Prime Minister, Theresa May, spoke compellingly of tackling the burning injustice of health inequality. That ambition now needs to be matched by effective cross government policies across the wider determinants of health. It will also require investment in public health in order to achieve the radical upgrade in prevention which underpinned the Five Year Forward View.5

At her recent appearance before the Liaison Committee of all select committee chairs, Theresa May confirmed that the government is working on a new settlement for social care but also that this doesn't currently include the NHS or involve other political parties. She should urgently revise her terms of reference to include them both.

The public has repeatedly made clear the value it places on our NHS and that it wants to see it properly funded. The financial challenge of providing sufficient funding for health and social care to cope with inexorably rising demand will be the same for whichever party is in power over the coming decades. It is in all our interests for them to work together to agree a way forward compatible with the founding principles of the NHS. Political instincts, however, have tended to focus on division and to duck the problem through arguments about data.

The most remembered statistic of the EU referendum campaign was the £350m a week for the NHS—a cynically deployed and rapidly disavowed non-fact for which no one can be held to account. Misleading data have consequences. If the chancellor believes that the NHS is receiving an extra £10bn, it is easier to see why he and the prime minister might resist the calls for more, especially having overseen far reaching cuts to the Ministry of Defence and the Home Office in their former roles.

The public has a right to expect accurate and consistent figures on total health spending, and it matters that we correctly insist on the true figure of £4.5bn. It also matters to keep setting out the facts on rising demand as well as the efficiency, fairness, and value of our NHS.

I often meet health professionals who think that politicians have no grasp of the scale of the problems they are facing. Never underestimate the impact you can make during a personal visit to MPs' surgeries or through an invitation to your workplace. We need as many MPs as possible to understand the urgency that they work together to find a sustainable long term settlement and the consequences for their constituents of political failure.

References

  1. Care Quality Commission. State of care. 2016. http://www.cqc.org.uk/content/state-of-care
  2. Office for Budget Responsibility. Economic and fiscal outlook, March 2016. http://budgetresponsibility.org.uk/efo/economic-fiscal-outlook-march-2016/
  3. Commons Health Select Committee. Impact of the spending review on health and social care. 2016. http://www.publications.parliament.uk/pa/cm201617/cmselect/cmhealth/139/13902.htm
  4. Age UK. 1.2m older people don't get the social care they need. 2016. http://www.ageuk.org.uk/latest-news/12m-older-people-dont-get-the-social-care-they-need/
  5. NHS England. Five year forward view. 2014. https://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf

3 comments

As a Wirral GP in my mid 50s I whole-heartedly agree with much of the above, especially the first sentence of your final paragraph, sadly I very much doubt that individual MPs have any impact on government policy however sympathetic to the GP 'cause' they maybe. Assuming the majority of the your colleagues on the Health Select Committee share your views, why is it that you have not been more effective in persuading the Government to change tack? I see from your Twitter feed that you have criticised Thersa May's latest demoralising attack on GP's, but I believe a far stronger, more public, response from you is essential if you are to retain any credibility in the eyes of the medical profession. If the PM continues in this vein unchallenged may I suggest that you should carefully consider your position as chair of the committee?
- Neil Cookson

I do not support the Conservatives but I admire and respect what Sarah Wollaston is saying and doing about the N H S . She obviously cares about the way in which is it currently being undermined and I hope that there is some way on which we can do some perching to save a system that was widely admired and which did so much good for our people and their health. I hope she gains support and tHat she is able to achieve what she is trying to do
- I do notservatives but I must say how impressed

I do not support the Conservative party but I wholeheartedly support and admire what Sarah Wollaston is saying and doing. Our Health Service did so much for the nation's health and was admired world wide. Now doctors and nurses are being over stressed and hospitals are under far too much pressure. They still do great work under enormous pressure but they are reaching breaking point. I hope Sarah can get support and that we can save our wonderfully caring system from disintegrating under too much pressure and inadequate support. Go for it Sarah, and your supporters"
- Audrey Webb

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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.

43 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

Please Dr Sarah confirm that you will support our Prime Minister and trigger Article 50 before the end of March. Then we can discuss the ins and outs from a more sane viewpoint. For the doubters, I would say that it is the people who are sovereign and that sovereignty is only delegated to parliament (on the understanding that it cannot be further delegated - to the EU or others). And when that responsibility is occasionally referred back to the people via a clearly defined (or clearly undefined) referendum, a democratic UK majority is final and must be enacted. On the question of lies (from both sides) most sensible people do a little research (like checking online Treasury documents about the £350m contribution) and apply some basic economics (realistically only a fraction of any saving will go to the NHS). Sadly some losers will continue to propagate misleading statements. And to say that people who want to leave didn't anticipate the risks, the vitriol from the EU elite and some of yesterday's men, the difficulty of coming out of the shadow of the world's largest organisation, is rather insulting and belies our hope for another golden age for these amazing islands.
- DH Paignton

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