28 JUL 2017

Ambulance Services in South Devon

Following concerns about long waits for ambulances and the withdrawal of local Rapid Response Vehicles, I invited South Western Ambulance Service NHS Foundation Trust, SWASFT, to an open meeting at Kingsbridge Community College. Chief Executive, Ken Wenman and the team leading operations in South Devon came to set out why services are changing and to answer questions. Many volunteer Community First Responders also joined the audience to share their experiences.

The Ambulance Service has undergone huge changes from one which primarily transported people to hospital to one staffed by highly trained paramedics with specialist equipment also capable of delivering treatment at home, backed up by a network of community first responders and co-responders from other emergency services.

The key challenge has been the rise in demand for their services. Over the past five years the number of calls has risen by 19.2% in the Totnes area, 29% in Plymouth and 23.7% in Torbay. One effect of this has been that once ambulances based in the rural South Hams have taken a patient to hospital in Torbay or Plymouth, they often get diverted to other calls in those urban areas rather than returning to base. The way that targets have been set in the past can mask poorer services in rural areas. Until now, those response targets only covered the most urgent calls with a requirement that a vehicle arrived on scene within 8 minutes in 75% of cases. Overall SWASFT met that target for the South Devon and Torbay CCG area at 75.65% of calls over the past year. But the figures I obtained for the Totnes constituency, which is more rural, tell a different story, with ambulances reaching just 61.1% of those calls in 8 minutes over the past three months. Targets need to be set in a way that doesn't lead to unintended consequences such as focusing on urban areas where they are easier to reach or allowing the arrival of an inappropriate ambulance vehicle to 'stop the clock' when measuring response times.

Now that many more treatments are available in specialist centres to help people who have suffered conditions like acute stroke and heart attack, it is more important than ever that the right vehicle attends a call. Ambulance cars, known as Rapid Response Vehicles, cannot take people to specialist centres but can distort the figures for waiting times. These vehicles are being removed but the meeting was told by SWASFT that overall ambulance hours cover would increase for the South Hams through a double crewed ambulance based at Totnes and use of a 'dynamic coverage tool', otherwise known as getting vehicles back out from urban centres to be closer to respond to emergencies across rural areas like the South Hams. Changes to targets will mean that all calls will count, and using mean average response times as well as the time taken to reach 9 in 10 calls will help to keep a focus on reducing long waits especially in rural areas. I will be following this carefully to make sure that the changes do lead to improvements in the service. These are being put it in place following the national Ambulance Response Programme trial and the following links give further background to this and to the changes:

https://www.england.nhs.uk/wp-content/uploads/2017/07/ambulance-response-programme-letter.pdf

https://www.england.nhs.uk/2017/07/new-ambulance-service-standards-announced/

At the meeting, volunteer community first responders spoke of their concern about not being able to deliver pain relief whilst waiting for an ambulance to arrive. Ken Wenman confirmed the good news that they will now be able to receive training in the use of pain relieving gas and air.

The service has been under increasing pressure due to rising demand and this has meant that it has been coping with 2.46% less funding per call over a three year period. SWASFT's operations director Neil Chevalier, told the meeting that they had received a £3.6m uplift in funding to implement the changes from the Ambulance Response Programme trial and, in response to questions about pay, said that paramedic staff had been put onto band 6 of the NHS pay scale up from band 5.

SWASFT representatives heard direct from volunteer community first responders and local residents about the pressure on services including examples of long waits and these were all examples of why the service needs to provide a better response to rural areas. I will be following this closely.

The message that came over loud and clear was the value that we all place on our ambulance service. Thank you to all our paramedics, support staff and volunteers.

3 comments

Very useful update. Can I encourage St John's ambulance to train its community volunteers in emergency IM hydrocortisone for relief of adrenal crisis? This authorised under Schedule 19 of the Human Medicines Regulations. Our charity's experience has been that this is straightforward to master, and saves lives. We have a first hand report from an untrained office first aider who successfully gave IM hydrocortisone earlier this year for adrenal crisis prevention: he watched our How To training video on his phone. http://www.addisons.org.uk/forum/index.php?/videos/category-2-emergency-injection-videos/ See www.addisons,.org.uk for more information and case studies about this life-saving technique.
- Katherine White

I'm pleased that attention is being given to the response times in rural areas after waiting three and a half hours in my next-door neighbour's house after he fell in his kitchen and broke his hip. He was not classified as life-threatening, though he died a few days later. Even the 999 system did not work as it should have. Everything under great stress. There is line in the sand, which when crossed in the quest to deliver greater efficiencies and particular Ministerial targets get in the way of caring for the customer. Delivery of patients to A&E and Ambulance crews having to wait crazy times in order to hand over patients (queueing in corridors) is another pinch point for availability of manned Ambulances. We need a good shake of the money tree for the NHS in particular.
- mike north

So the response to the ARP trial has been to reduce ambulance cover in S. Hams by removing all the RRVs. The ambulances spend most of their time in the urban areas leaving the residents of S.Hams with less medical help than before, a paramedic in a car can still give life saving treatment as Katherine Whites's post shows. Hypoglycaemic patients are another group of patients as are those with major blood loss etc etc. If the number of 999 calls has gone up so much the question is are all these calls appropriate? J. Hunt was pushing the idea that the NHS should be a 24/7 organisation, has that contributed to people calling 999? Perhaps the Government could help by not listening to lobbyists from the tobacco and food industry but to the health service instead. Educate the public on when and how to access the health service. Encourage people to take responsibility for their own health and not expect the health service to fix the problems arising from smoking, overeating and being lazy.
- S. Hams resident

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29 JUN 2017

Public Sector Pay and the NHS

Public sector pay increases, including for NHS staff, have been capped at 1% since 2013–14 and for two years prior to that subject to a pay freeze affecting the majority. NHS employees' pay fell by 10 per cent in real terms between 2009/10 and 2014/15 and continues to fall.

It is time in my view for pay restraint to be loosened but that cannot be done without a clear plan for how it will be funded.

In 2015–16, the Department of Health spent £48.7 billion on NHS provider staffing costs. The IFS estimates that each 1% increase in staff pay would add approximately £0.5 billion to the pay bill, just for the NHS. This means either additional funding for the service or painful reductions in other areas of the NHS or DH budget.

I agree with the pay review body that there are also costs in ignoring the need to increase pay. As the gap between NHS pay and jobs outside the public sector widens, this is hitting the recruitment and retention of key staff, especially when there is fierce international competition for skilled healthcare professionals. The fall in real incomes is also affecting morale, especially where staff are having to work under greater pressure to compensate for unfilled posts. Vacancies and staff shortages can also affect patient safety as well as lead to higher agency costs. Pay restraint is becoming a false economy.

For all these reasons I believe it is time for a rethink but it will require a clear plan from the Treasury as to how it will be paid for. Ending the pay cap won't happen through a simple amendment to the Queen's speech.

It is essential for all Political Parties to face up to the scale of the funding challenge across the NHS and social care and to work together to find a way forward. The reality is that the wider challenge in funding these vital services, in the face of an extraordinary increase in demand and costs, will be there for which ever Party is in Government after the next election. It is in everyone's interests for MPs to work constructively together across Party lines in the national interest. We have a responsibility to level with the public and with each other because the reality is that we are all going to have to pay more to put the NHS, social care and our other valued public services on a sustainable long term footing.

Much of the ground work has already been carried out and we should look again at the full range of proposals from the Barker Commission and the House of Lords inquiry into the sustainable long term funding of the NHS and social care.

24 comments

I admired your stance on public sector pay in parliament yesterday, you told us how the folks we regard as heroes could take no more. Then you voted against them. I require my MP to be driven by conscience, not by a desperate need to cling to power.
- Christopher Mockridge

Brexit u-turner mid campaign. Now this slap in the face. Find a way to fund it? It took your leader five minutes to find a billion to prop your party up. Sickening. I don't believe you understand the anger at this vote; this cheering that went on. It's a game once you get into the Common, where you can forget about the salt of the earth. Like that policeman that died right there at the mother of parliaments - laid down his life for a hardened political class.
- Rosalind Salter

In my 62 years I have never been so disgusted with a party as I currently am with the current Conservative party. To see the cheering following yesterday's vote denying essential public sector workers a raise after 7 years of falling wages sickened me. Your sheer hypocrisy, claiming on your blog and twitter feed to support a loosening of the pay cap whilst voting for the opposite shows that you have no morals or integrity and are clearly in politics for the benefit of your party, not for the good of the British people. Utterly shameful.
- Ian Scott

So, why not grow a backbone and vote with the opposition last night? Austerity is a political choice, not an economic necessity. And your leader proved it by finding £1.5 billion down the back of the sofa for her bigoted DUP friends in 5 minutes. Nurses having to use food banks, policeman & fireman driven to suicide because of the pressure cuts have put them under. You and your party should be ashamed. I really don't know how any Tory MP sleeps at night. At last, the country is awakening to Tory fraud. The quicker there is another GE, the better.
- Mark Jones

You write all that and then troop through the lobies opposing any increase.It is this sort of behaviour that gets politicians a bad name.This is why Jeremy Corbyn is different.During the last Labour government,if there was a policy he disagreed with he voted against it.I hope you were not one of the hooligans who cheered when the amendment was defeated.If the amendment had been passed It would have forced the treasury to look at ways of finding the money.I am 86 and owe my life to doctors and nurses in the NHS and it's time they were adequately rewarded.The firefighters and police who risked their own lives in recent events are praised by Mrs May,but are still seeing their wages fall behind and yet a billion pounds is found to keep your party in power by bribing a party that were hardly going to oppose the government.It stinks.
- Alan Bailey

Blah blah blah. "It is in everyone's interests for MPs to work constructively together across Party lines in the national interest." You had your chance yesterday.
- Figrat

I can only agree with other posters above. Funding public serve is is a choice. Finding the money reflects choices made elsewhere. Austerity has been, and continues to be, a brake on the growth of the economy, never mind the suffering it continues to cause. Choosing to spend a billion on shoring up the outcome of a pitifully poor performance around the general election (which cost another, what, £130 million of taxpayers' money and was entirely unnecessary?) is also a choice, isn't it. The public do not want this. Our elected representatives are presumably there to serve the wishes and needs of the public, for the good of our society. We are being very very badly let down, and this public hand-wringing while continuing to support these poor decisions is hypocritical in the extreme. Cross the floor, Sarah. Please.
- Veronica Conboy

Could you please explain to us WHY you voted to keep the cap Sara? Speaking in favour of lifting the freeze and then voting to keep it is pure hypocrisy! Especially since MP's have been given a pay increase and they are public sector workers, and they are also able to claim extortionate expenses. Its a slap in the face! I work in the NHS as a Emergency ambulance crew, many of my colleagues in London and the country don't want to be hailed as hero's, we just want a right to earn a decent wage.
- Noelle

The Barker Report is wide ranging but has a very important conclusion: "With a view to raising additional revenue, we recommend a comprehensive review of wealth taxation". If you also agree with this maybe it is time to cross the house or at least vote in line with your beliefs.
- Ken Pickering

Agree with all the other comments on here, SHAME ON YOU ALL!! Unbelievable scenes yesterday, cheering the decision! I had to explain to my 6 year old why all the people of TV were so happy ! Disgraceful behaviour!! VOTE for what you believe in and stop being a May Puppet. Oh and reply to your constituents and enjoy your pay rise!
- Jack

I wish I could say I was shocked by the two faced, cowardly and selfish approach shown by yourself and other members of your party. There is no point in anyone saying shame on you, for you all lack integrity and any moral standing. Of all the people to cower to, a leader who is scared, has sold members of her own party, who saved her skin,down the river and won't stop short of buying her way out with public money. You are a representative of the people yet all you do is take for yourselves, you are pathetic and immoral, all of you. Sadly you all think this is acceptable.
- Dave Hennig

As a new constituent I was at least reassured by your public pronouncements and apparently principled response to the Leave campaign's complex relationship with the truth. However I can only agree with the other posters here: You have really let yourself, and us the people you represent, down.
- Nick Quine

Many of us in the Southwest had high hopes following your election that at last there was a person who came from and really understood the health service, its needs, pressures, and the welfare of its staff and patients. So very disappointed that after all the rhetoric, in which you appeared to understand the impact that the pay freeze has had on morale aand recruitment, and therefore patient safety, that you voted against the words you had spoken. Thank goodness most of us in the NHS are advocates for our patients and not afraid to speak out, and refuse to simply toe the line if we feel something is wrong. Let's now look forward to spending even more money on agency and locum staff, and see services wither, such as dermatology at Taunton which another Conservative lady wrongly stated that she had saved.....
- Teresa

You are a disgusting person, a disgrace to your profession and your country.
- Birte Evenden

I have always been a fan of your political stances as you always seem To represent fairness and stand up for the principles You hold dear., however I was very disappointed to see you vote against the pay rise for Nhs staff despite your entry, statements and blogs to the contrary. This would seem hypocritical and you certainly have lost a lot of this integrity in my opinion with this vote. It is also maddening when politicians have a 10%pay increase that you can credibly take this stance.
- Ed Schwallins

I think your blog and the work you do is excellent. Unfortunately, your excellent work in the commons health committee failed to hold the sec of state for health to account for misleading the house regarding "increased spending"; by changing indexing, adding a year to the period and including monies already promised. As you point out retention is disasterous, and for nursing means 1 in 5 posts vacant, and applications to nursing dropped significantly since the bursary was removed. This means more "bank/locum" work with increased costs. The SOS for health plans to privatise the body which has saved money in providing locum/bank staff. Really? When you state "an amendment in the queens speech isn't the way to address this" you are being politic. The DUP deal cost £1.5 billion. That was also being politic. Honesty is required. The govt states the NHS is "safe in our hands". It is not. We need 8% of GDP (or more) to fund the NHS. The suggested cuts have been criticised by practically every body that has commented that it is not possible. The govt should be honest that the plan is for privatisation of the NHS. Why aren't you? It's called being politic; you know anyone stating this would not get into power. So you made a choice to be politic. That's your choice. But please accept that's what it is. The cheer when the ammendmemt failed was an insult to all of us working in the emergency services (including you of course as a Doctor), and was disgusting.. I was in Washington DC last week and saw live at Capital Hill the speeches made to fight against the repeal of Obama Care which would mean 22 million people not having access to health care in the U.S. if repealed. This govt seems to be demonstrating privatisation through stealth, as per the motion passed at the BMA ARM. I ask you to consider your role in that, as I have really admired you taking SOS to task; however it seems misleading the house is just accepted these days...
- Dr Peter Taysum MBBS MPhil MSc MA (home)

I always thought you were one of the good Tory MPs. I feel sickened to see that you voted for keeping the pay cap in Parliament. You are a wicked person.
- Dimer Caprol

And despite Labour having a clear unambiguous plan on how to fund the long over due pay rises you flatly refuse to accept it as it doesnt fit in with your ideology. Meanwhile you continue supporting a failing system that has seen unfettered growth for one part of society whilst at the same time sending public servants along to food banks, leaving in huge numbers and retiring as early as they possibly can to escape the unfair pressures that your 'Austerity ' plans have created. Even Marie Antoinette offered cake. All the Tories do is offer platitudes. Ive yet to see one cooked and served up on a plate that will fill the belly of anyone. Your blog on the public sector pay cap is apropos of nothing. Nothing by way of a solution offered except bread tomorrow, if you live that long. As usual in all areas where money has to be spent its 'Lets set up a review panel and procrastinate a little longer' But it just aint good enough, Sarah . And deep down you know it. Trouble is you are stuck in the middle of this Tory quagmire and dont really know how to extricate yourself without losing a lot of your friends and being rescued by getting to the Socialist side of the mire, where I think your heart as a doctor would love to take you. The Tory patient is terminally ill no chopping off of the parts of the poor to use as transplants can save it as the one ingredient medicine cannot provide is spirit and its long gone from the tory body.
- steve howard

It seems to me, you took the Hypoctritic oath. Shame on you.
- Derek Robinson

you, your party..sicken me..You are lacking in everything that I regard as decent.Ashamed that my beautiful home Town ever considered you as someone that could represent them.
- Virginia Keyes

There is no excuse for Theresa May and your so-called government to find a huge sum of money when it suits them to prop up an unworkable majority by stitching up a deal with a bunch of ulta-right thugs. We all know it. You know it. Droning on about how to help the NHS is a little thin in the circumstance - especially as everybody knows that the Tories want to privatise it bit by bit. Your party is morally bereft, ethically corrupt and has sacrificed what little respect it might have expected.
- Sam Richards

Well said all of the above. Take heed Dr Wollaston. Your constituents are watching & they are not happy.
- Jane Begley

Absolutely disgusting behaviour in the commons the other day. You had your chance Sarah but you blew it. You just join a long list of MP's we can't trust.
- Alex Clough

Where is the fair society Theresa May promised before the election ? 1. BBC presenters vastly overpaid (at license payer expense and we have no option but to pay it) whilst public sector workers get a pay freeze. 2. Even public sector workers are much better off than those who are unable to work and only get Employment Support Allowance which is less than £6,000/PA and has also been frozen since 2104 ? Theses people need help more and long term poor health can happen to anyone. There is a lot that could be done to help theses people such as unfreezing the benefit, bringing in a council tax exemption and more.
- Stuart

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19 MAY 2017

Social Care is at a tipping point but increasing funding needed intergenerational fairness

This is the original article I wrote that appeared in the Times today.

One of the the most striking figures set out by the Chief Executive of NHS England, Simon Stevens, in his recent update to the NHS Forward View was that life expectancy is increasing by five hours a day. This extraordinary success has also driven an unprecedented rise in demand for health and social care to levels which can no longer be met from current spending. The Care Quality Commission is not alone in describing social care as being at a tipping point. In her manifesto, Theresa May has acknowledged that the elastic can stretch no further and promised to increase funding for social care as well as per capita spending on the NHS. The manifesto also includes a much needed boost for capital projects described as 'the most ambitious programme of investment in buildings and technology that the NHS has ever seen'. Funding promises have to be realistic and fair. The Prime Minister is right not to duck the issue of intergenerational fairness in meeting the challenge of funding social care and it would not be fair for the increasing costs of both the NHS and social care to fall entirely on the working age population. The options were never going to be easy but failure to increase spending risked the collapse of social care provision and a downward spiral of NHS performance. Hard choices on the means testing of winter fuel payments and downgrading a triple lock to a double lock on pensions after 2020 are fair if the money raised rescues social care from the brink for those who will need it the most.

It still takes many people by surprise that if they have assets over £23,250, they are liable to meet the full costs of their residential care and raising that threshold to £100,000 will be welcomed but the long awaited cap on the total that families will have to spend meeting the cost of care has been dropped. The greatest change however, is that many more people will be liable for care costs because the value of their family home will no longer be exempt if they need care in their own home. Any policy must avoid unintended consequences and ministers will need to clarify what period of grace will be applied for those who may only need short periods of care. Currently this so-called 'disregard' is set at 12 weeks for those needing residential care and it is essential that this also applies to home care. If not, it will exacerbate rather than reduce delays to hospital discharges.

The dropping of the care cap sadly leaves social care uninsurable, leaving in place the miserable lottery of care costs. A future government should at least look again at supporting state backed insurance for those who have not yet reached retirement age, so that they can begin to protect against this.

0 comments

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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.

0 comments

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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.

12 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

We spoke to several Americans, including students, while on holiday in Florence recently. I said we felt that there must have been something seriously wrong in America for people to vote for him. They said that the alternative was worse and Hilary Clinton was not popular. The students said that they would wait and see.
- Irene Allum

I agree with George. Most of what Sarah stands for flies in the face of what the conservative government is actually doing from social cuts, women's rights Trump and environmental issues Sarah is clearly at odds with her government and its leader. Please get off the fence and fight for a opposing political that can and will make a difference.
- Rupert Eden

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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
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@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

Post a comment


09 JUN 2016

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

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

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

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

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

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

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

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

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

132 comments

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Ch Ching Sarah Doctor of deceipt!
- Disgraceful

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

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

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

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

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

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

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

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

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

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

I hope you get deselected you utter liar.
- Shelly

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

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

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

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

What did Cameron promise you?
- Tony Robinson

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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23 MAY 2016

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

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

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

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

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

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

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

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

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

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

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

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

35 comments

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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17 APR 2016

Community Hospitals; a precious community resource

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

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

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

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

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

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

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

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

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

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

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

7 comments

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

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

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

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

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

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

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

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04 APR 2016

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

I wrote the following article for the Guardian

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

5 comments

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

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

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

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

Can anyone explain to me why it is that in a country like ours where we have thousands of highly qualified young people lining up to study medicine and dentistry we only have half the amount of doctors and a third the amount of dentists per capita compared to a country like Greece ,which is relatively poorer. On top of that many of our doctors come from countries much poorer than ourselves. This is a problem that has dogged the NHS since its inception, and this artificial shortage has a knock on effect throughout the service??????
- michael dillon

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18 MAR 2016

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

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

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

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

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

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

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

3 comments

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

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

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

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21 FEB 2016

Britain Will Be Stronger Out of a Federal EU

The European Union has missed an important opportunity for reforms that could have benefited all its member states and their citizens.

As a result, the prime minister has returned with a threadbare deal that has highlighted our powerlessness to effect institutional change. If this is the very best that can be grudgingly conceded when EU leaders express concern at the prospect of a British exit, what hope is there of any meaningful reform in the future?

Come the referendum in June, the deal will be a distant memory and unlikely to influence decision-making so much as gut reaction and weighing the balance of individual and national interest. I expect that those campaigning for us to remain in the EU will win the day if they can persuade people that doing so is the only way to guarantee security and prosperity. They will not win because people have any love for the institution itself.

Referendums have a tendency to deliver the status quo. The point needs to be made, however, that neither choice delivers the status quo because, like it or not, within a decade our relationship with the EU will look radically different, whatever the outcome. Last week's deal has underlined the reality that our Eurozone partners are continuing their separate journey towards full political and monetary union. We will inevitably be bound by and disadvantaged by the decisions they make in their own interest.

The time has come for us to frame a new independent relationship as good neighbours rather than remain a discontented junior partner picking up the bills but with no power to influence the rules of the club.

The costs go far beyond our considerable net financial contribution, annually variable but between £8.5bn and £10.5bn over the past three years. The Common Fisheries Policy has been disastrous both for fish stocks and for our once thriving industry. Nearly a quarter of our quota is now landed overseas by a single Dutch trawler and policy has been mishandled for decades with no accountability to parliament. There is a tendency to think of EU regulations and the European Court of Justice as benign, but interference with decisions like minimum unit pricing in Scotland show the power of big business interests to win out over important public health protections.

The concern about the level of migration is genuine and could have been addressed but the EU has failed to take the opportunity for measured and sensible reforms to benefits. The emergency brake is cosmetic, merely adding rafts of bureaucratic complexity with no meaningful impact on migration.

For all the dire warnings from Project Fear, I simply do not believe that co-operation on issues as important as trade, security, defence and science would collapse in the event of a vote to leave. No possible good would come for either the EU or Britain in an acrimonious separation.

We would set out on a new path as the world's fifth largest economy, confident, outward looking, keen to maintain close co-operation with our European allies and open for business. We would regain control over our own laws and borders and be free to negotiate our own trade deals with emerging markets.

There would undoubtedly be turbulence in the short term but we should balance that against the long-term risks of remaining bound to an institution that we will never learn to love.

I am always struck by the scale of our disengagement from the EU. When I ask at public meetings, few people can name a single one of the MEPs; fewer still have ever contacted one. It is hard to see why they would bother, given the democratic deficit at the heart of the institution.

In June, we face tying ourselves in for the long term to be increasingly governed by a body that few understand or trust and whose powerful commissioners we cannot vote from office. For anyone concerned about issues such as TTIP or the "tampon tax", the reality is that these are the domain of the unelected and unaccountable in Brussels and the list will only get longer.

In the run-up to the referendum, the most compelling request I hear is for more information and the opportunity to debate the issues without the shouting or sneering. People want clear, unbiased information from trusted independent sources.

Commentators should also set out their own voting intention so that their messages can be judged accordingly. We should not shy away from any aspect of this debate but the public do not want a campaign that is dominated either by immigration or by Project Fear.

My vote will count for no more than anyone else's but, for what it's worth, I am optimistic for our future, I believe the balance of our national interest now lies outside the EU and I will be voting to leave

25 comments

Sorry Sarah, but this a sad read. Descending level of argument and persuasion, lowest common denominators, isolationist. 'Tampon tax', 'project fear' - who is shouting and sneering? Predominantly negative. Bleak. Scary. Unpersuasive, weakening position that seems increasingly shallow intellectually. Will have to consider Health Select committee work with a much more careful and critical eye I think. Really disappointed. Bad bad call.
- Richard Stanley

Great Post - let's hope common sense prevails and the electorate of the UK stops our money being spent on the EU gravy train! PS Have the European Commiissions accounts ever been signed off by Audit, yet?
- David D

Sorry Richard Stanley but I think its a great post. Clearly "out" with a positive view ahead but still wanting the arguments aired by as many independents as possible. What's not to like..?!
- Tim Page

As a Uk taxpayer for over 50 years I take exception to the millions being wasted on the EU which could be better spent at home. The UK is an island and not part of the European continent and our laws should not be overruled by Brussells. Well done Dr Woollaston for making your postion clear by wanting out.
- Peter Clinton

Mr Cameron has returned from negotiations with little more than a bag of smoke and a few mirrors. The so-called "deal" that he has secured is worthless. So an "in" vote means nothing changes, while an "out" vote means we might have some chance to regain power over our own destiny, rather than be dictated to by an unelected crowd of trough-snufflers in Brussels. I can't help but wonder what ripples a Brexit might cause in the rest of Europe. Anyway, well said Dr W!
- Mike

It is certainly causing quite a few ripples in Scotland if you heard Nicola Sturgeon on the Andew Marr show last Sunday! The only divorce that is likely to occur on Brexit is the disintegration of the UK when Scotland leaves and reapplies to rejoin the EU! If I were one of the Footsie 100 CEOs' signing the letter in the "Times" today I would already be looking to relocate my headquarters north of the border. If I were one of the hundreds of thousands of UK pensioners happily living in Spain, France,Portugal and Cyprus, I would be extremely concerned at the plummeting pound caused by the current uncertainty and whether, on our exit, our reliance on the European Health Insurance Card Scheme would be affected. The citizens of Gibraltar must also be very alarmed if we Brexit and their land border with Spain is once again sealed. The EU will be weakened by our exit but will survive and we will no longer be able to rely on 500 million people and the world's largest trading bloc to shelter us from heavily, state subsidised goods coming from authoritarian countries like China and Russia. Yes, Peter we are an Island but no longer an empire and I am all too aware of that fact when there is a dispute in Calais and the M20 is grid locked and hundreds of lorries are stacked up hindering our 43% trade with our nearest neighbours that 3 million UK jobs are dependent upon! When it comes to bureaucracy Sarah, huge advances have been made in Fisheries with Hugh Fearnley Whittingstall playing a prominent role in abolishing discards and the UK FINALLY setting up Marine Conservation Sites! Instead of continually, complaining about EU bureaucracy it may be an idea to look closer to home! Stuart Goodall, the chief executive of the Confederation of Forest Industries is extremely frustrated at the "too bureaucratic" Government woodland creation grant scheme. Only 10% of land in England is wooded against an EU average of 38%! I thought wooded areas reduced the risk of flooding that many households have suffered this year.
- John Roadknight

With regard to the EU Accounts, I was under the impression that the only reason why the European Court of Auditors was unable to sign off the accounts for regional and social funds for 10 years was because the treaties did not give them the power to force national governments to disclose how the money had been spent. This was not the case for farm and fishing grants that were signed off. I understand that the above problem was resolved 6 or 7 years ago and the accounts have been signed off every year since.
- John Roadknight

I agree we should rid ourselves of the unnecessary bureaucracy of Brussels and we should be free to create trade treaties that suit our needs. However, we should stay in the EU, the benefits considerably outweigh the negatives. Norway and Switzerland sit ostensibly outside the EU and continue to contribute to the EU but have next to no say in how it the EU is run and suffer even more than we currently do (with the exception of the banking sector) from the volatility of exchange rates, oil prices and raw material price changes that can make a regional manufacturing unit and jobs redundant over night. A huge amount of our GDP depends on trade with the EU, harmonisation has created secure revenues that allow businesses to plan for the future and create jobs.In the future it will be our tech savvy children working with companies all over the EU that will in part create the wealth and tax flows that will support us our communities. We should be making it easier for them to compete not harder.
- Ged Yardy

Sorry Sarah; you have got this one wrong. Wrong strategically and wrong in relation to loyalty to the Conservative party.
- Malcolm Mackley

Dr Wollston is wise to carefully consider the implications of the federalization of the EU. We did not sign up for this in the EEC and neither did we imagine that it would become a club of 28 disparate nations dominated by the stifling maw of a massive bureaucratic administrative machine that hides its calamitous spending behind poorly drafted policies on auditing in earlier treaties. The economy. In my business I traded for over 30 years with companies in most of the present Member States and beyond. We gave our customers the products they needed, of the right quality and price and also delivered on time – result, a growing repeat order business. Our success owed absolutely nothing to the UK being a Member of the EEC nor the EU. The UK imports more from Member States than it exports to them, not simply because those suppliers are EU Members but because we get the goods and services we prefer, against offers from other sources. So people who scaremonger about the potential damage to our economy have little confidence in themselves, their companies nor the grit and determination of the people in our Nation. Laws Taxes and Sovereignty As a nation we need to demand the right to live under the laws and regulations agreed by our Parliament of MPs who can only remain in power by the will of the people they govern. The Federated EU will reduce our ability to do so, to an infinitesimal shadow of that right. Security The Politico/Administrative fiasco of the handling of the present immigrant Diaspora illustrates to me the abject failure of security offered by the politicians and administration of a combined 28 Member State organization (the EU). Scotland During the run up to the Referendum on Scotland “In or Out” of the UK, Nicola Sturgeon made much of demanding Scotland must have much more autonomy. Our Government listened and understood this demand and acted to give Scotland a great deal more “home control”. Now, Nicola Sturgeon is saying that if UK leaves the EU, she would fight to get Scotland in to the EU – what an extra ordinary volte-face in wanting to plunge the people of Scotland into a much much less responsive quagmire !!! In my travels, I have talked to hundreds of ordinary folk across Scandinavia, Germany, The Netherlands, Belgium, France, Italy, Spain and recently Portugal. I can honestly say that I met some “on the fence ditherers” but the vast majority of ordinary folk I talked to right across the heartland of Europe are fed up with and distrustful of the present EU machine as it is now constituted and run. MEPs and Administrators beware the turning worm !!
- Bob Hattersley

I agree with your statement about the reasons for brexit. Those who want to stay in Europe do not explain the lack of democracy at the top of the EU. It has been an eye opener as to how long it has taken David Cameron to gain any kind of reform. If the prime minister himself believes further reform is needed - how does he think that can be achieved?
- Roger Whitehead

I think that the only quagmire that will result from a Brexit is an isolationist "Little England" that will be much diminished both economically and politically. When Scotland exits and the UK fractures will we still hold onto our seat as a permanent member in the UN Security Council? With English being the world's international language and many foreign CEOs being able to speak it,many overseas companies such as Nissan, Honda and Jaguar Landrover choose to set up their subsidiaries over here in order to access the world's largest single market. I certainly do not want to endanger our next generation's economy and security by a leap into the dark that no-one can determine.
- John Roadknight

I am afraid that I have much more confidence in our Prime Minister and Chancellor and the G20 finance ministers than I do with the Brexit campaigners who wish to play Russian Roulette with our economy and security and cannot guarantee a safe,prosperous, secure outcome to their gambling.The status quo may not be perfect but at least we know where we stand and David Cameron has fought very hard to win concessions and safeguards. Below is a recent BBC statement from our Chancellor. I note that he states "Britain" as opposed to "Great Britain" comprising all the countries that make up the UK. Presumably he has taken account of Scotland's exit from the UK! What will we call our fragmented nation after Scotland leaves? The chancellor told the BBC: "The financial leaders of the world's biggest countries have given their unanimous verdict and they say that a British exit from the EU would be a shock to the world economy - and if it's a shock to the world economy imagine what it would do to Britain." He added: "This isn't some adventurous journey into the unknown, with all the humour attached to it, this is deadly serious."
- John Roadknight

Pull up the drawbridge, put up a wall, it is an unfortunate and dangerous trend. It is damaging to the economy, national security and the future for our next generation. Better fix the shortcomings from within than no doubt be exposed to them outside.
- Paul Churcb

Sarah, if, as Ian Duncan Smith told Andrew Marr this morning the Le Touquet Agreement is such a "benefit" to the French, can you tell me why, when the Eurostar Terminal in Calais was being breached by migrants last year, the UK Government poured millions of pounds of taxpayers money into shoring up its defences? If it is such a "benefit" to the French to police and secure the "Calais Jungle" on their territory and prevent thousands of mainly English speaking migrants from being processed in Dover and Folkestone why were they not prepared to pay the cost in full? Could it be that David Cameron and Theresa May knew full well from speaking to Sir Peter Ricketts, until recently our French Ambassador, how fragile the agreement is and did not want a "Dover and Folkestone Jungle" whereby it would be up to UK Border Agency staff located in the UK to process thousands of migrant applications many of whom had destroyed their identities? As well as Ian Duncan Smith's pie in the sky belief that we would be able to secure a better deal than Norway and Switzerland (Most divorces to not end amicably!) he obviously did not hear his fellow Scot, Nicola Sturgeon on the same programme last Sunday say that if Scotland was forced against its will to leave the EU it would spark another referendum that would likely lead to the disintegration of the UK.
- John Roadknight

We both had a long, hard think about all the "for and against" arguments and reflected back on our vote to stay in the Common Market last time. My wife and I decided without any doubts that we want OUT. Having just heard that our MP is voting the same, I came to look at her arguments in this Blog. We couldn't have put it better! Just get the "Outs" together with a good strong leader and show the UK the way. Well done Sarah!
- Gordon

Out to what Gordon? That is the problem! No-one in the "out" campaign can DEFINITELY tell us what our future will be! It will pretty certainly be without Scotland!
- John Roadknight

So now we have the UK French Ambassador on this evening's Channel 4 news as well as our previous British French Ambassador telling us that on Brexit they have no idea whether the Le Touquet Agreement will be maintained that could well lead to thousands of English speaking migrants without identities in France being processed in the UK (probably minus Scotland!) as opposed to Calais. If I were a UK citizen living in Dover or Folkestone I personally would want to learn from Sarah and her Brexit followers what contingency plans she has in place to deal with the influx but unfortunately all we get when we ask pertinent questions is that we are contributing to "Project Fear"! If I were one of Sarah's constituents with family or friends living in Spain, Cyprus,France or Portugal and heard Matthew Hancock report that he did not know what the status of The European Health Insurance Card, that so many of us rely on when we holiday in the EU, would be if we Brexit I feel that I would have every right to be concerned. There are hundreds of thousands of UK citizens,many elderly,living out there that rely on this EU insurance and many would be forced back to the UK because they would either be denied private health cover or could not afford it. Is this "Project Fear"? Those of us who like the protection of the EU in connection with health care or protecting us against unfair competition from China and Russia are just asking questions Sarah and unfortunately all we get from you is "Project Fear" and no answers or contingency plans.
- John Roadknight

You don't always get what you want! Even Norway's Prime Minister would like to be part of the EU! Speaking to the BBC, Norway's prime minister, Erna Solberg, said she would like her country to be part of the EU because it lacked influence over important decision making and had "basically... left part of our democracy to Europe". Asked if she thought Britain could retain access to the single market without being subject to free movement of people, she said: "To believe you'll get everything you want without giving something back does not happen in any political body."
- John Roadknight

John R, whose blog is this? You've already written more than the MP, far less coherently, and most of it other people's opinion. You appear to have an excessive respect for those you consider "experts" (the chancellor, the Norwegian prime minister, FTSE 100 companies) and you are unable to assess their potential for conflict of interest, or for being just plain fallible in their predictions. For one thing, a person's position or seniority does not make their argument right, and for another, there are plenty of eminences, ex chancellors, business-people etc on the other side. To address but one of your arguments, no-one is saying we will get exactly what we want by leaving - but we are clearly not getting what we want by staying either. Leavers have made a judgement that by continuing as 1/28th of the current unwieldy, unresponsive, undemocratic hegemony we have little or no influence over anything in Europe. On leaving, we might get some influence, as well as the obvious benefit of sovereignty. This argument was beautifully illustrated when Cameron used his veto back around 2011; the Liberals wailed that this was "just not done", and that to be so rude would remove all influence we could have. So, by their logic and that of the remainers, we should go along with something we completely disagree with - not attempting to exert any influence - in order to retain influence! Also, don't insult our intelligence by talking about draw bridges, little England (neither is proposed by any serious leave campaigner), or the idea that the EU invented free trade or peace. We have had and can have both without the EU, nor does the EU look like having any positive impact on disasters like Putin, Middle East instability or the rise of extremists of all colours. Quite the opposite in fact. No doubt we need Europe-wide and world-wide cooperation; but let's dare to think a better structure than the EU could exist, and help bring it about. The EU is the FIFA of world politics.
- Tom Ball

Tom,as Sarah I am sure will endorse, I raised my concerns over our exit from the EU 5 years ago soon after she was elected. They were similar, apart from the very possible influx of English speaking migrants into this country, to all the ones I have raised on her two blogs so I am afraid it is a little demeaning of you to suggest that I am just taking "other people's opinion"! In relation to" unwieldy,unresponsive,undemocratic, hegemony perhaps it would be sensible to look a little closer to home before we once again start blaming all our woes on the EU! If you watched "Spotlight" last night you will have seen a scathing attack by our farmers on late subsidy payments due to Whitehall, DEFRA bureaucracy. There was then the case of patient medical notes being filed in a laundry bag so whenever we cast aspersions at our EU neighbours it would be a good idea to reflect on our own bureaucratic, inefficiencies.Philip Hammond very clearly set out the alternatives to our continuing EU membership yesterday and none of them remotely compares to the one negotiated by David Cameron recently that maintains our economic and political status in the world. I am afraid that all your arguments are drawn on hypotheses because you just do not know and have to rely on "project fear" and "dodgy dossiers" when you are presented with facts! I am sorry that you have little or no regard for CEOs of FTSE companies that employ millions of people and on which many of us depend upon for our pensions. I would much prefer to rely on their judgement as well as our Prime Minister and Chancellor than people promising us a land of milk and honey without any certainty as to how it will be achieved.I have not actually raised, as you pertain, the case of the EU and peace but being a post war child I remember how pleased my father and his close sailing friends were when we joined the EU. They all served and included Stanford Tuck, a Battle of Britain hero, my godfather with an MC from the desert campaign and Bill Dean a GP who volunteered to stay behind at Dunkirk,escaped 3 times and came back a skeleton after being put in solitary confinement after his third escape. My father several times took me back to his Oxford college to show me the memorial plaque with so many of his close friends on. The EU has a tremendous role to play in maintaining peace on our continent and that should never be forgotten. What will you do next time Spain seals its land border with Gibraltar and cannot rely on the EU for protection?
- John Roadknight

John you have successfully defeated a series of straw man arguments, none of which I made! I did not mention bureaucracy (this is a nebulous concept, hard to argue for or against, and by no means the preserve of the EU). Sure, let's improve DEFRA. I accept your point 100%. The fact that someone's medical notes got lost once is deplorable but entirely irrelevant to our discussion; I am sure you wouldn't use a one off UK-based mistake to argue for a Brussels take-over: I thought that sort of non sequitur was supposed to belong to the more irrational, anecdote-based out-ers. The other non sequitur is to say that only remainers know the future; you and the FTSE chaps (not all of them by the way) don't know what will happen for sure any more than I will, so to call their grim predictions "facts" is a misrepresentation - they are well informed opinion, educated guesses; I am sure in the short term there would indeed be some instability, but I trust and hope for medium and long term gains, but surely you can see that the CEOs' interest is themselves, not their employees or your pension. Leaving might create some administrative headaches for multi-nationals; I can live with that, and I am not sure that companies larger than many countries' GDP are an unmitigated good anyway. The remainers are gradually being forced to admit that trade would not halt overnight, they can't afford to make us a pariah, nor would 3 million jobs evaporate, a figure Nick Clegg used to bandy about. Threatening 3 million job losses is scare mongering, no other way to name it. Hundreds of small business owners wrote to the Telegraph this week advocating leaving - is their voice not important? I admire the 5 year longevity of your concerns - I myself am rarely so sure, and constantly question and reassess my opinions - but as with the appeal to arbitrary authority, the longevity of an opinion does not equate to infallibility - in fact it is more a marker that someone is not responding the the ever changing evidence. People thought the Earth was flat for centuries, they were still wrong. I am moved by your family's connection to WW2; they were truly heroes. But I humbly submit that the story doesn't support the conclusion you draw. The alternative to EU membership is not WW3. Don't allow the fear of a WW3 to justify all the wrongs of the EU. The EU did not bring about peace, nor can it claim to have preserved it, and were it to do so, it would be remarkably (but characteristically) arrogant. After WW2 it was the USA / UK / France (or more accurately the well-balanced antagonism between USA and USSR) which kept the "peace" of sorts, succeeded by NATO. The EU had nothing to do with it. It had the luxury of a largely pacifist outlook through the cold war, with very few arms, only because America protected it via its European bases.The EU then sat by while the Balkans reignited, and it was Clinton et al who finally ended that war; some say Germany helped start it by recognising Croatia but I wouldn't go so far myself. I am slightly contradicting myself here because as I say, the EU, despite its aspirations, is largely irrelevant when it comes to world peace. Its response to Putin over Georgia and Ukraine was pathetic, and merely emphasised the West's weakness (a wider issue, I'll admit). Or, more sympathetically to Russia, the EU provoked Putin by its aggressive economic imperialism in the old USSR, without then backing it up militarily; either way, an incompetent intervention which the UK and probably most other Euopean governments would never have countenanced. It wants political union between peoples who are so different in outlook and needs that they couldn't possibly want union. The only gain from political union is more power to a few unelected people. It is unresponsive in that we have no say in who governs it (unlike our own admittedly imperfect democracy) - even our PM couldn't influence appointments to the Commission - and when Ireland said "no" to the Lisbon treaty the EU merely threatened her and repeated the vote in order to get a different answer. Its monumental failure of Greece, Spain etc through the financial crisis - who would have been far better off outside the Euro - and its failure to recognise the mistakes made, is a sure sign that it is past its sell-by date. Its lunatic Schengen agreement, coupled with poor policing of borders, is another example. Of course we need peace, trade, treaties, migration etc but let's tear up the Brussels-based oligarchy and start again. It clearly has no desire or ability to change. Fair point about Spain and Gibraltar, but I am not sure the EU prevented that or dealt with it brilliantly; there is still clear enmity and non-cooperation, despite our apparent alliance, as there is with our French friends and their threats this week over Calais; I suppose one would have to appeal to international law or other conventions, which the Spanish were anyway breaking, alliance or not. Many conflicts have, after all, been resolved outside the EU paradigm. As for our political and economic status in the world, the former is largely historical and waning, but is partially maintained by our occasional clear leadership (Sierra Leone) or misguided first-in mentality (Libya), our still-active military, our UN-based diplomacy, and Trident; and our economic status is due to, er, our being the 5th largest world economy, not our EU membership. The more economically literate leavers point out that the EU in fact hampers our ability to trade with countries like China, India, Canada, Brazil... pie in the sky maybe, nostalgia, or just a longer memory for the centuries when we thrived as an independent nation... but there's only one way to find out. Respectfully,
- Tom Ball

Tom, you are quite right that the remainers do not know the future but we do know the status quo in that the UK is the 5th largest economy in the world, a member of the largest single market in the world with 500 million people on which 3 million jobs and 42% of our trade relies upon, is a NATO member,has a permanent seat on the UN Security Council and Scotland is still part of the UK. I am also still old enough to remember when the UK was the "sick" man of Europe with our economy lagging behind Italy and our plumbers,electricians and carpenters going over to Germany to find work on which the series "Auf Wiedersehen Pet" was based on. It is this scenario that I do not want to be repeated on a speculative leap into the dark.Instead of trying to refute Philip Hammond's analysis of the alternatives point by point I am afraid all that you can do is come up with "Prospect Fear" and "Dodgy Dossiers" because the reality is that as opposed to the status quo you just do not know what will come about on Brexit with most analysts believing it will be no better than Norway's, whose Prime Minister would like to join the EU! In relation to hundreds of small business owners writing to the "Telegraph" I would question why they are not trying harder to export their goods to our neighbours across the Channel. I believe that 45% of German small and medium sized businesses export their products as opposed to 19% of ours. This is probably due to our appalling linguistic skills. It can be quite disconcerting negotiating contracts when the other party suddenly reverts back to their native language with their colleagues and you cannot understand a word!Many of the countries you list like China, India,Canada and Brazil would like us to remain within the EU in order to access the world's largest single market as does the US both economically and strategically. I hugely value the number of foreign companies outside the EU who have set up their subsidiaries here in order to access the EU, and would hate to see companies like Nissan,Honda and Jaguar Rover possibly curtail their operations here and set up plants across the Channel. German companies like Siemens with their hospital scanner and wind turbine factories and BMW are also extremely concerned at the prospect of our exit.It makes perfect economic and business sense to first of all concentrate on the world's largest single market that is, at the most, a few hours or a couple of days away as opposed to weeks or months away or alternatively a costly and environmentally damaging flight away. I would also prefer to trade with a market that we hold so much more in common with such as freedom and culture rather than China who is able to restrict the movements of the Dalai Lama through their economic clout and has an abysmal human rights record. The Balkans was a terrible conflict as Paddy Ashdown knows all too well but all the countries there are, or want to be, part of the EU. On Ukraine I believe that most world leaders think that it would have generated into a much worse conflict without Angela Merkel's intervention.In respect to your comments regarding"bureaucracy" I did feel that bureaucracy was somewhere hidden in your "unwieldy,unresponsive,undemocratic hegemony" and felt that we should also sometimes look closer to home! I certainly do not want to gamble our future generations' prosperity and security with a huge, hypothetical leap into the dark and I am pleased that our Prime Minister and Chancellor, as well as most of his cabinet colleagues, are doing everything to prevent this from happening.
- John Roadknight

Does anyone in their right mind think that the UK will be able to negotiate a better trading deal with Europe then it has now, if the UK chooses to leave? If this was the case then every EU member would leave. The EU would not allow this to happen. As the German finance minister said on the Andrew Mar show, if the UK wanted access to the single market, it would have to accept free movement of people and pay into the pot but would not be able to shape rules or policy, so what is the benefit here? Finally, when negotiating these incredible free trade agreements with India and China that the BREXIT politicians say we will be free to do on leaving, who will get the better free trade deal, the UK or a massive trading block like the EU? India and China don't need the UK (hence weak negotiating position) but they do need the EU, the world's largest free trading block (very strong negotiating position).
- P. Morley

Quick take this post down! Seriously do you think you are kidding anyone? This figure has been out there for months and no one is saying it would go to the NHS. Clearly you are part of a really puerile ploy to try to dupe the British people. Stop taking people for fools. Your party is going to be destroyed if we vote Remain. But the EU is more important to all of you politicians than the NHS (soon to be destroyed by TTIP) than your own party and certainly the people of this country. Shame on you.
- Unimpressed.

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09 FEB 2016

Why, as a Europhile, I'm heading towards the Brexit Door

I have always been a Europhile and before becoming an MP would not have imagined voting to leave the European Union. So why am I heading towards the door? I am in love with the possibilities of the EU but can no longer ignore the grinding reality of the institution.

The Prime Minister has set out the terms of his provisional deal with the leaders of our EU partners and it is a threadbare offering. What use are 'emergency brakes' when the driver has no control or 'red cards' that have no credible chance of being deployed? Apart from a small concession on sham marriages, the truth is that the proposals will have no significant impact on our ability to limit inward migration from the EU. They will however, usher in rafts of bureaucratic cost and complexity with sliding scales for length of residency and nationality for child benefit.

David Cameron was right that the EU will need further reform but if this is the best that can be grudgingly conceded when there is a serious risk of a British exit, what chance of any meaningful further reform if and when we are tied-in long term by the referendum? The proposed red card system to halt unwanted EU diktats will need a majority of other leaders in support...so it is vanishingly unlikely to be of use if future policies are imposed against our national interest.

I am glad there has been recognition that we will never join the Euro and that non-Eurozone countries are on a different course rather than ever closer union but the safeguards remain too weak. It is inevitable that the Eurozone bloc will make decisions in their best interests. We have in effect already opted for life on an outside track, tolerated largely for our considerable net financial contribution but the renegotiation has made clear that we are powerless to change the rules of the club.

Those who wish for us to remain in the EU, are ramping up the rhetoric, warning about a risk to our national security in the event of Brexit due to a collapse in cooperation. It will clearly be in everyone's best interests for such cooperation to continue and to foster positive relationships on both security and trade. We are warned that we will become like Norway, subject to all the rules and fees but with no hand on the levers of power but arguably that sounds pretty much like the current situation, except of course that Norway control their own fishing grounds. In the event of Brexit there would be every incentive for Norway and others to join Britain in a different and more positive relationship with the EU based on trade and cooperation.

The case is often made that we should vote to remain in order to prevent internal conflict in Europe, but the anti-democratic nature of the EU is already fomenting the rise of extremism across the continent. When it comes to external threats, our national security has long depended on our membership of NATO rather than the EU.

When I ask at public meetings, few can name a single one of their six MEPs, fewer still have ever contacted one. Why would they bother when their representatives are powerless in comparison to the elite corps of unelected, remote and unaccountable commissioners?

Referendums have a habit of delivering the status quo, especially as project fear gets into gear. If they are to have any hope of persuading the undecideds, the leave campaigns must settle their differences and inspire. We need a clear blueprint for Britain working alongside the EU in a constructive new partnership. We would join as the world's fifth largest economy, not isolated but confident, outward looking and open for business.

71 comments

A very defeatist and sad post utterly introspective and frankly ignorant. I could ask you a hundred questions which would reveal the poverty of your arguments. But I'll confine myself to just one. Why are 27 members of the European Union content to work with each other to further both Europe and themselves? And why should we be the odd man out picking up our ball and running away? Running away to God knows where and ensuring isolation not just from our erstwhile partners but from credibility and respect. Grotesque.
- Paddy Briggs

This is a catastrophic failure of judgement by a very intelligent person who I much respect. I am incredulous that you arrived at this conclusion.
- Stephen Perry

I am pleased to see you are leaning towards supporting Brexit, but rather disappointed by the apparently superficial nature of your understanding of Norway's influence. In addition to owning their fishing grounds, they are also solely responsible for their own trade policy and can form trade agreements on mutually acceptable terms. The UK does not have this power. The EU tells us what agreements we must honour and the tariffs and non tariff barriers we must implement. Norway also has its own seat on the global bodies where regulations and standards are shaped before being handed down to implement. Norway helps shape the rules, while not one EU member state can directly influence them. If the UK leaves the EU, the safest course of action would be to rejoin the EEA, aided by membership of EFTA. In that, we would be joining Norway, rather than Norway joining us. If you haven't already, I recommend you read 'Flexcit' which is the only Brexit plan in existence and is backed by Helena Morrissey as the best work in this area. We can have a bright future outside the EU, cooperating with its member states in areas of common interest, but without having our laws determined by unelected and unaccountable people from 27 other countries, and without being subject to the decisions of the European Court of Justice. Brexit will be a big step towards a more democratic UK.
- Mr Brexit

One point about the perceived lack of democracy in the EU structures. I believe it is that way because the nation states (not least the UK) would not allow a more powerful directly elected pan-EU leader or parliament precisely because it would diminish the status of the elected leaders and parliaments in the member states.
- James

Full credit...
- tom

Because, Paddy Briggs, we ARE the "odd man out". That's why so many Britons are profoundly uncomfortable with "ever closer union" and it's why Euroscepticism is much more common here. We are an island with a completely different political and legal heritage from our Continental neighbours. We, unlike them, are also not in retreat from a horrendous 20th-century experience scarred in almost all cases by exposure to totalitarian regimes, either imposed by invasion or cooked up domestically. Being dictated to by a bunch of jumped-up bureaucrats in Brussels or Berlin is understandably better in those people's eyes than what they've previously suffered. But that isn't the case for the UK, which has enjoyed freedom from foreign occupation and a representative system of government for many centuries. Frankly if you're so ignorant that you don't know any of this about Britain's and Europe's very different histories and about the obvious reasons why many of them favour trying to create a powerful Europe-wide statehood to replace national decision-making and we overwhelmingly do not, then you really shouldn't be daring to criticise Dr Wollaston's understanding of this topic.
- John Jones

Very sad to say I am afraid that I am inclined to agree with you. I was so excited when Ted Heath took us into the common market. But it has got worse and worse.
- Robert

Great post and great to have you on board Sarah. Sounds like sour grapes from Paddy Briggs. Out of the hundred questions he claims to have, I can't understand why he chose such a silly one, exposing his own ignorance. The U.K. Will be "content" to work with EU member states post Brexit but the EU are doing nothing to "further Europe". Unless of course you're referring to expansionism?
- Lee

If the UK has the good sense to leave I think others would be inclined to take our lead and follow. Paddy, there are none so blind as those that can't see.
- Peter

Wonderful to see that Sarah, a respected and decent MP, has seen the reality of the sham negotiation and the awful prospect of staying on the EU juggernaut. As for Paddy Briggs, there are so many answers as to why the 27 wish to remain members (at least for now), the most obvious being that in most years 25 or 26 of those members are net recipients of EU largesse, often with only Germany and the UK being net contributors. P.S. Sarah, you have a typo: 'breaks' should be 'brakes', though both work in different contexts :-)
- Andrew

A lot of people agree with what you say. In your position as an MP, please envision the alternative and propose it clearly. Without a good understanding of that, people will likely vote for the status quo and we will miss the opportunity to re-position ourselves, for the better, for the next 50 years. This matters.
- VB

It was refreshing to read your well argued piece which made the key points with clarity and commonsense. You will be rewarded for your courage in speaking out rather than being silenced by Whips. We need more MP's like yourself who have built a successful career outside Politics before being elected which gives you the self-confidence to speak up. The UK has a large (and growing) trade deficit with the EU which means that the EU needs to trade with us more than we need to trade with them. This means that it's in the EU's self-interest to give us an advantageous trade deal after Brexit. The bungled EU policies of the single currency, Schengen and CAP, etc, have created misery and economic hardship for many millions of European citizens. The EU is a failing declining political entity dragging us further behind the US and Asia in relative prosperity. We can either decide to exit now on our own terms or be stuck in the inside when the EU finally breaks under the weight of its own failed and inefficient policies. Everyone thanks you for your bold stand in putting the long-term prosperity of the British people first and making the argument to help persuade the undecided's that Brexit is the best way to secure the UK's future freedom and prosperity.
- Richard

"If they are to have any hope of persuading the undecideds, the leave campaigns must settle their differences and inspire." I don't think they need to. The lack of a united Leave campaign with a single leader means that the Remain campaign must attack the ball rather than the man. They must win the political, economic and social arguments rather than running a smear campaign against a particular personality. After all, what better postion could the Leave campaign be in other than to have a bunch of widely-distrusted politicians and corporate leaders telling us that remaining within the EU is a Good Idea.
- Steve

It's clear that Paddy & Stephen need to re-read what Sarah wrote and spend a while thinking it through to be sure they've understood it accurately. It's interesting that neither Paddy nor Stephen put forward any arguments in favour of being in the European Union. Paddy asked two questions: 'Why are 27 members of the European Union content to work with each other to further both Europe and themselves?' 'work with each other' is one thing, subordinate themselves to a supranational government and eradicate themselves as Nation States is something else. Sarah outlined a future in which the UK would always work together with its allies not just on the continent of Europe but in the whole world. That's what the UK has always done. What sort of weird ideas are in your head that cause you to think that anyone is advocating stopping that inter-national cooperation?? Please do try to think clearly and stop accusing other people of advocating things they haven't advocated. Secondly, in every country in the EU you will find people who aren't happy about being in the EU. Why would you hold such a strange idea that the UK is the only country containing people who aren't happy about it??? Bizarre. Thirdly, you're getting mixed up about Europe and the EU. They're two completely different things. We work with European countries that aren't in the EU. We work with non-European countries that aren't in the EU. We work with countries that are in the EU and in Europe. We always have. We always will. 'And why should we be the odd man out picking up our ball and running away?' That's a straw man argument, Paddy. See above.
- Jim

Excellent blog. You are a brave lady. I admire you.
- Onnalee Cubitt

I congratulate sarah on a well argued and thought out position. It is one i have much sympathy with. I am not a reflexive Outer, and genuinely felt there was a real chance at this point that Cameron could come back with a real change and progressively redefined way for states (not just the UK) to relate to the EU. It was a golden opportunity to reconfigure the EU into an organisation fit for the 21st century and not just a 1950's statist answer to 1930's questions about nationalism (questions which, in any case, have far less relevance to the UK). But it was;t to be - and as Sarah points out, if such derisory concessions are made with the looming possibility of Brexit then that just goes to show how little actually influence we have with the EU.
- Patrick

This gives me some faith in our elected MPs. Ms Wollaston has reviewed the extensive evidence that membership of the EU is not in our national interest; Cameron's "deal" is worthless and the EU will not implement the major reforms it so badly needs. On the basis of the evidence - not the scaremongering being issued by the Remain campaign - she has changed her mind. Co-operation with our continental neighbours doesn't need us to be under their political control. Trade with other countries doesn't require an anti-democratic political union. Our security will be enhanced when we can control our own borders. Our economy will be strengthened when we are not transferring £350 million a week to Brussels. I hope Ms Wollaston will join the cross-party Grassroots Out campaign.
- Donna

Well done Sarah, for having courage and conviction to speak out from under the Cameron ban on his party to speak against support of Brexit. A measured and non emotive account of your position. Alongside the excellent speech from David Davis, we are seeing facts based arguments that provide the public with a balanced view without the scaremongering and rhetoric from both sides of the argument
- IMcW

The rest of the EU has different ways of doing things from us based on their individual national histories. Our history is over a thousand years old, the foundation of our legal system, Common Law, was established in the villages of England in Saxon times, before the Norman invasion. The principle of Habeas Corpus was set down in Magna Carta in 1215 and all Britons are free under the law. None of these apply in the rest of the EU. We can trade perfectly well with any other country we don't have to be ruled by them. People need to seperate trade and co-operation from political union. Lord Tebbit sets out the case for leaving the EU very well. http://getbritainout.org/lord-tebbit-britain-must-rescued-eu/
- Roger

Congratulations to Dr Wollaston on reaching her conclusions. To Paddy Briggs: I would suggest that most of the other 27 EU members are happy in their membership of the EU because they get out of it a lot more than they pay into it. And that's not just in terms of money, just think what a boon it is to countries like Romania, Bulgaria and Poland to send most of their unemployed to richer countries like the UK and benefit from salaries and much higher child benefit being sent back to those countries. Why would your average Pole want to leave such a beneficial arrangement?
- Ian G

Bravo Dr W! And a brave Sarah you are, standing up for evidence based policy rather than fear based policy. I too am surprised to find myself supporting Brexit, having been a Europhile all my life. Ever since the 'expansion' of the EU decided largely by German interests seeking cheap well educated workers sitting just across the border....the place have become ungovernable. The shenanigans of the Greek debt crisis culminating in uncontrolling flows of refugees is proof enough that current structures do govern, they do no manage and they do not deserve support.
- Penny

One of the reasons why the rest of Europe joined the Euro, and the European Union is because they were; in the the majority of cases, all poorer countries. They all benefited from; in some cases massive financial boosts. We were never in that situation, and by staying part of the European would loose more than we gain. Migrants coming to this country are doing it for that very reason, otherwise; why come here. There are not many Brits that would consider going to the poorer parts of Europe to start new jobs, because the money simply isn't there, and there are no benefits to back up the lack of wages, so it's an unfair system. And why on earth would a country put itself up to be dictated to by an unelected regime, and have to ask permission if it can do certain things. What is the point in having an elected government! You may as well just elect a head boy/girl to run to the headmaster, and save a fortune on running a government.
- Sean

Very well argued piece. Quite annoyed by the scaremongering and the fact that the so-called pro-European politicians have not, as far I can see, laid out how staying within the EU benefits British citizens in the UK. The EU arguments on human rights are decent, but on the flipside I think it's inappropriate that the EU dictates to the UK on some areas of its legislation.
- Sandy

Unfortunately we will see many posts across the web similar to those of Paddy and Stephen. Whether one agrees with it or not you make and substantiate your case Sarah, life; and it's been longer than most; has taught me that such responses are invariably used by those who do not have a tangible, coherent counter argument. Like you I probably agree with the concept of a cooperative Europe however as I see the for and against arguments and place them into a lifetimes context I'll be looking to leave 'the project'.
- Kevin

A good decision and a well argued rationale, the EU no longer works for the people of Europe but for the Corporate masters and well provided for unelected minions.
- Roy

We hear so much of the failed rhetoric regarding safety within the EU and how THEY the EU have maintained the peace for over 70 years...Poppycock...it was NATO of which I've served many times as a soldier....I have been uplifted that a convinced europhile can see a failure of this elitist club for what it is. Well done Miss Sarah Here’s a brilliant quote from the book about the EU: Written Dr David Owen in the 80s.....GET's RIGHT TO THE NUB OF THE EU.......30 YEARS AGO....AND VERY TRUE TO THIS DAY........ “It is the weak nerve centre of a flabby semi-state, with almost defenceless frontiers, where humanitarian rhetoric masks spinelessness.”....For me it say all that is required....before this disgraceful project we were self reliant and most surely self-assured..
- Bill L

Well done Sarah. Eloquently put. The logic of Brexit is unarguable. David Cameron's pathetic attempts to gain the concessions he thinks he needs to persuade us to remain in the EU emphasises just how little influence we have in this undemocratic monster. None. The EU is trying to build a single country to rival the USA and it simply isn't going to work in the same way. There is no way Britain will ever stop cooperating with other nations politically and economically outside the EU. But it will be by choice and not because it we are forced to against our will. And that huge financial burden running at £55 million/day will be lifted. We really will be better off out.
- Alan

Britain never signed up to cede sovereignty and it is to me neither morally right nor in our gift, considering those who'll come after, to allow this country to be governed from abroad. That's the way the EU is goiong and it's part-way there. To say sovereignty is 'pooled' as was once said fails to recognise the inevitable reality of this arrangement. The cannot work for the UK either politically or economically, not least because it's an anti-democratic construct. It's impolitic to say so but people fight and die every day and since time immemorial for national independence. I am an Australian, with a British family, who runs a small business and has lived more than half my life here, all of which I feel qualifies me to say - the British have the best legal system, the best mode of government, some of the best institutions and arguably the best, most secure national culture of any nation. Vote to keep these priceless things or you're bound to lose them.
- peter

Would like to have heard more about what happens to our economy while the years of negotiations take place with the EU and others. We can be certain the the UK will not get all it wants. EU without UK will also probably become more protectionist. We also need to be prepared for a UK without Scotland. Agreed though that the EU is not working as it is.
- Martin

Brilliant article. Sums up the need for Brexit. As Alan above says you can't argue against the logic for Brexit. I expect the result will be 60:40 in favour of Brexit as the more people know about the EU the ore they will vote to leave. What I want to know is, why so many MPs are campaigning for in?
- Bob A

I think you call out the limited effect of Cameron's renegotiations very well. And I think you were right to call out Cameron for his overegging security. But you've fallen into the political trap that Cameron dug for himself- ie he's made the Referendum about his renegotiations rather than membership in broader sense. The UK's actually been very influential in creating the Single Market, and if influence has waned that's down to Cameron being hopeless. If you don't think that the EU could make things very awkward for Britain when it left, you are being very naive. See how the EU is strangling Swiss banking, and ask yourself if you want it doing the same to the City. I urge you to reconsider.
- Tubby Isaacs

If Sarah's view prevails it will trigger a second Scottish referendum and the break up of the United Kingdom Then Scotland will close the Faslane Trident submarine base which will be transferred probably to Falmouth at the cost of many billions And the army and RAF bases in Scotland will close too Devon farmers will lose their EU subsidies and the NFU will expect the UK government to pick up the tab And manufacturers like Nissan will close their UK factories and move them into Europe The immigration camp in Calais will close and all those migrants will end up in Dover for screening There are up and down sides to staying in or exiting Europe and since this will affect the lives of the next generation, young people must be given a vote on this Brian
- brian

One more point, Sarah. There's already an alternative body to the EU- EFTA. Why do you think this is better than being in the EU? Why do you think Norway, Iceland and Switzerland (which is outside EFTA) will want to reshape the way they relate to the EU to fit in with Britain? In every case, it's the relationship with the EU that matters for them, not the one with the UK. I think it's hard to make any case that Britain will have a better trading arrangement than now.
- Tubby Isaacs

Welcome aboard Sarah! Great to see momentum (and i don't mean the labour group) building for Brexit. Democracy is the key point for me. I liken the current UK situation to that of a dementia patient who has signed over their decision making powers to a friend. The problem is in the UK's case, Brussels is not our friend. Lets get our democracy back!
- Tim Jenkins

It is certainly high time that we had a "clear blueprint" from the Brexit side, whose rhetoric thus far (yes there is rhetoric on both sides -- see above for some examples) boils down to the claim that we will be able to magically keep all the good bits of EU membership and slough off the bad bits. A similar approach was, incidentally, used by the Independence campaign in Scotland. We now need to address specifics. A couple of examples: - It seems pretty much certain that from the EU side, post Brexit, one of the main conditions of a trade deal would be the retention of the free movement of people (as is the case for the deal with Norway and Switzerland). Do you think we could get a satisfactory deal without this? Would we want to continue to allow the free movement of people? If not, what arrangements will be made for the British citizens currently living in the EU? - When it comes to sovereignty, and "being dictated to by Europe", which laws would you change and what would you replace them with? Frankly, I worry far less about where laws are made and more about whether they are good laws or not. British governments (of all political stripes) have shown themselves to be perfectly capable of enacting bad laws, and stubborn in their refusal to remove or improve them once they are in place. It is no longer enough to claim, blithely, that Brexit will remove all ills and produce nothing but good. The case is not unarguable, as has been claimed above. As Sarah's original post recognises, it relies on a judgement of the balance of benefits and harms of staying in or leaving. To make that judgement, we need a far clearer picture of how a post-Brexit future would look. Lastly, I would welcome a commtiment from Sarah, as my MP, that should the referendum turn out to support our continued membership she will support the will of the people and back a policy of constructive engagement with the EU. A substantial part of the difficulties in Britain's relationship with Europe has been self-inflicted by a wilful "semi-detached" approach, motivated most often by the decades-old schism in the Conservative party. If the British people vote to stay in then this government, and its successors of whatever party, should reflect that in a new, more constructive and cooperative approach to membership.
- Simon

So you too wanted a European Community but have been disappioned to have been foisted with a European Union. The difference is that I realised this in 1973.
- John S Churchill

Good for you Sarah ,I have yet to see one truthful,intelligent and worthwhile comment for staying in.Too many people are scaremongering,saying we cannot be on our own and the rest of Europe will not trade with us if we leave but I am sure our country will be fine and it will be the rest of Europe who will be the losers.
- Grahame Powell

As a member of the LABOUR PARTY I am glad & proud to be at one with you on this issue. Great post. Democracy transcends party boundaries every day for me. If the British public think there is a Westminster bubble and its out of touch then they have not seen anything yet when it comes to the undemocratic and out of touch Eurocrats. To stay gives them a green light. Yes, we are tolerated for the net £8-10B they get from us each year. There really is a better world wide view. Just got to convince the rest of my party now....
- Tim Page

I was just about old enough to vote in the 1975 referendum and voted to come out of the common market, as it was then called. I have seen nothing since then to change my mind that we would be better off out of the EU. We simply do not get value for money from an outrageously bureaucratic and non democratic organisation. Well done Sarah.
- Steve Tucker

Great post. Good to see that politicians can think through the pros and cons, and come to a reasoned conclusion that's not borne out of panic or blindly following party-line.
- Jacqueline

So sorry that our fine MP has chosen the Brexit route whose only near certain outcome will be the break up of the UK after Scotland holds another referendum, quite possibly followed by Wales and Northern Ireland after they feel the impact of our economic downturn. The UK is a magnet for Far Eastern and other national companies to set up subsidiaries in order to trade with the largest single market in the world..Look at Nissan, Honda and Jaguar Landrover. Because of our colonial past and more recently U.S. influence and UK/US cultural popularity, especially in music, English is most peoples' second language. It must be far easier for English speaking foreign CEO's to communicate with their work forces here without the need for interpreters. Do we want many of these to relocate north of the boarder? On migration, Sarah would do well to listen to Sir Peter Ricketts, until recently our French Ambassador and David Cameron's national security adviser who has warned us, and should know more than anyone else,of the fragility of the Le Touquet agreement where UK immigration checks are carried out in Calais. What possible advantage would it be to the French to continue to police the Calais"Jungle" on our exit? It would be far easier for EU countries to play pass the parcel with their migration problems and send them to our island to be processed where they have nowhere else to move on to. Heaven help our Boarder Agency staff processing thousands of applicants who have destroyed their identities! Many migrants quite naturally want to settle here because many speak a smattering of English as their second language,essential for getting a job, and we do not have identity cards. Being part of the EU gives us much more influence politically and economically and the US certainly wants us to remain a partner. Where does our Foreign Secretary go when there is a problem? Brussels to garner EU support. At present Germany, France and the UK are drawing up plans to impose a tariff on China and Russia dumping heavily subsidised steel on our shores as the EU did with heavily subsidised Chinese solar panels. We are far stronger negotiating as a member of 500 million people as opposed to 60,less after Scotland leaves the UK! Do we really want to be subservient to larger economies like China who use their power to control the movements of the Dalai Lama? What will be the status of the 2 million UK citizens happily living in the EU? Will they, as well as us, continue to enjoy our European Health Insurance cards? Could many elderly residents unable to afford private medical insurance be forced back to the UK.? How about the residents of Gibraltar who have sheltered behind EU protection for many years against Spanish hostility? The EU, like many of the UK Government policies is not perfect but I feel that David Cameron deserves the support of his MPs' in his negotiations. I really dread the prospect of an isolationist little England that many Brexit supporters feel is still an empire. We are far stronger in than out.
- John Roadknight

Well put, Dr W. I love Europe but detest the EU. I will vote OUT. Project Fear is dark. If we shine light upon it by rational analysis, it will disappear.
- Stewart Brown

Dr Wollaston like you I was a Europhile who supported the ideal of a Europe at peace with itself. However the European Community has morphed into a European (political) Union ruled undemocratically from Brussels by unelected bureaucrats who disregard the sovereignty and the elected parliaments of its member states. Cameron's negotiations with the EU are a disaster. He has failed to gain even a fig leaf from the EU to cover his own embarrassment. And most significantly he has failed to get protection for the City of London from the predations of the EU to vest financial services from the City. Cameron's Brexit scaremongering is very likely to backfire on him. Winston Churchill rallied the British people and stirred up their spirit of defiance and determination to see off the threat from Europe. A British vote for exit from the EU would be the signal for the beginning of the end for the EU and would soon cause the whole of the EU to implode economically, socially and financially. A financial crisis is looming in the global economy. This is a crisis that is very likely to blow the European Union away.
- John Collins

One can feel only a sense of betrayal now that Sarah Wollaston, my M.P., has made her statement on Europe. Clearly, she was flying under false colours when she made her pre election statements to get approval in South Hams. Her reasons are quite paltry for joining the Leave group. I thought it was rather shabby that the first thing we heard was through the Sun newspaper quoting her stating that "Tory MP Sarah Wollaston also weighed into the tow saying Mr Cameron's claim was "simply not credible" and complained pro-EU campaigners were taking voters "for fools". The Sun, that progressive and pro equality newspaper. Much better informed sources, such as Sir Peter Ricketts, the British Ambassador in Paris stated that same day that there was every possibility that France would indeed end the British border in Calais if we vote to leave. Folkestone folk will no doubt be pleased with Sarah Wollaston if they get the Calais Jungle in their midst, but Sarah Wollaston will be safe in South Hams, where it is indeed rare to see anything other than a white face. Not much of a threat here of a diverse society, Mrs Wollaston? The statement which was broadcast on the TV this evening which showed an interview with Mrs Wollaston was insulting to my intelligence and was "simply not credible". According to Mrs Wollaston, she will vote to leave as the other EU countries have not offered enough to David Cameron given that we have threatened to leave the EU. So Mrs Wollaston favours the blackmail approach. If you don't give us what we want, we shall walk out. There's principle for you and a person of integrity. No substantive reasons given, no reference to the three million jobs that will be lost, the massive farm subsidies that will go at a stroke, the huge development money that has poured into Cornwall for the last 10 years of more (over one billion pounds), no mention of the estimated £3000 a year benefit to every household in the UK, no mention of the fact that the EU accounts for half of our trade and is the biggest market in the world, no mention of the fact that if we leave we shall have to pay into the EU but have no say in its decision making, no mention of the estimated £66 million a day that EU countries invest in the UK, no mention of the employee and work benefits that the EU has brought to British workers, a stark contrast to the Conservatives' plans to further decimate workers' trade union rights...finally, no mention of the progressive force that the EU represents for all the peoples of Europe and indeed in the world. Sarah Wollaston has retreated in a world of Little Englanders, xenophobes and people like Liam Fox who are embittered Tories.She is welcome to them and will never receive my vote. This country is founded on a huge mixture of races and cultures. What percentage of non whites do we have in your constituency, Mrs Wollaston? Most of the immigrants are from the Midlands and the North West. I am one of them. Another politician whose manifesto promises have evaporated once elected. A shameful performance by someone who once showed signs of a positive vision for British people.
- Tom Jolliffe

To the scaremongers who say that leaving the EU will lead to the break up of the UK, don't worry, it won't. Britain leaving the EU will not change how the majority of people in Scotland feel about being British, which was clearly demonstrated in the recent referendum with a 90% turnout. The SNP would have another referendum tomorrow if they thought they could win it, but they wouldn't, so they won't. Their la-la-land economic policy didn't fly in 2014 with oil over $100 per barrel and it certainly won't fly now at $30-$40.
- Andrew

For those scaremongers who claim that leaving the EU will lead to the 5,000 migrants (economic migrants, as they are already in a safe country, France) and those who follow after them being waved through France to turn up at Dover and claim asylum, don't worry, they won't. Even IF the French were to resile on the existing Le Toquet agreement, return the UK border to Dover and wave through their unwanted guests, our government would simply impose more stringent obligations on the ferry companies and the tunnel operators - just as we already do with airlines and their passengers, which is why we don't have Calais style camps around Heathrow (which we would if Cameron and other scaremonger claims about Calais were true!).
- Andrew

I don't believe our 19 or so frigates with engine breakdowns are going to be much of a solution to policing the channel! Have you not observed the chaos that ensues when there is a dispute in Calais? Nearly 50% of our trade and over 3 million jobs is dependent on our EU membership. You would do well to listen to Sir Peter Ricketts our previous French Ambassador who knows more than anyone else how fragile our border is.
- John Roadknight

Scotland has very close historical links with France and is far more pro EU than Little England. The last thing this proud nation will want is to be dictated by Little England as to their relations with the EU.
- John Roadknight

I am sad to see that you have joined the exit camp. It seems shortsighted in the long term. Russia is breathing down our necks on the border of Europe - how will we respond as an island race? The days of empire are long gone - yet many in the Tory party still vote and operate from that perspective. I want a Conservative party rooted in the 21st century with politicians who can see beyond their own limited career objectives and take this country forward not backwards. So David Cameron did not manage to force the EU to change, it doesn't matter - what matters is that we continue with what we started when we joined the Common market back in the 1970's. We fought two world wars to bring peace and stability to Europe. It is time for us to unite get behind the EU and make it work for us. Turning back now will be catastrophic in every way.
- Cathy Koo

Sarah, it's important to distinguish between (dis)approval for the Tories, David Cameron, the renegotiation terms and the EU itself. You are giving too much emphasis to the new terms, rather that the benefits of continued membership. You say you've always been a Europhile - think again about why. You are in favour of evidence-based medicine; how about some evidence-based policy making on this subject? Colin P
- Colin P

I am old enough both to remember post war austerity and the vote to join the EEC. At that time we were lied to by the politicians as history has now proven. The EU is intent on forming a European State, it has been stated by many European leaders over the years, part of which we will be a minor player if we allow that to play out. We are being lied to now by the IN politicians and scaremongering is not the way to conduct an adult reasoned debate bout the merits of staying or leaving. The EU has shown its true colours on many many occasions but to describe a Brexit as like a game that we don't like so are taking our ball home, is idiotic and childish in the extreme. This is a serious issue and requires a serious debate, not petty point scoring. Our relationship with the EU is a business that has a contract with benefits and defecits on both sides. The British people, through their MP's, have indicated our contract needs re-negotiating. In business, if either party fails to agree terms that is in their interests, then they go their separate ways. If the EU is not prepared to change or meet the terms that the UK requires to continue its partnership, then that speaks volumes of what the EU thinks of the U.K., so it is time to go our separate ways. Before the EU we managed quite well, but the politicians KNEW back then that the EEC would morph into the EU and that political union was the ultimate goal. Had they told the truth at the time then the result of the vote back then may have been very different. In my view the result was illegitimate. As a result of their deceipt I believe we are being lied to now by politicians who have been proven to be dishonest and will NOT tell the truth. Dr. Wollaston has put forward a cogent argument and I for one believe she is being honest in her change of mind. It would be so easy for her to 'go along with' party lines, but this issue is more important than party politics but is an issue of conscience. I admire her courage and I hope she remains true to herself, whatever way she chooses to vote in the end.
- Gary

Heading for BREXIT? I feel the same pain. Having worked more than 4 decades to achieve realistic and sensible requirements in a highly regulated industry both at EU and ECE in an industry that cannot afford the R&D needed just for the UK market, this decision we soon face is highly concerning, whichever conclusion we as a nation come to. Even if a majority of those voting south of a line slightly north of Hadrian’s Wall want to remain in, our friends, colleagues, relatives north of that line might be sufficient in numbers to vote the UK OUT, so that they can then take a vote to stay IN as an independent nation – provided of course Spain will accept that, risking Catalonia and Basque applying for independence as well! However we are where we are, mostly because Member States such as ourselves allowed EU too much power in past EU treaty changes, that we could have vetoed. Having shown we were OK with those decisions, was the EU so wrong to think the UK Government wanted closer integration? We should have stood our ground more firmly then! Much of where we are is due to unprofessional 5 second sound bite politics that we have in the UK and a lowering of the professionalism of the political and official decisions of state. One example - The UK Ministry of Transport having sought a change in EU regulations which was agreed and enacted in 2012, have in 2016 still not yet implemented that change in UK national regulations, resulting in a nonsense of anal administrative burden to continue, costing consumers more for absolutely no safety of environmental benefit whatsoever. Should BREXIT occur, national regulations will need a total overhaul to bring them up to date to the standards that society has today with the EU requirements. On the basis that the DfT does not have enough manpower now, that is the reason given for 4 years of delay above, will it be able to cope in the event of BREXIT? The civil service will certainly need more staff to match the very few knowledgeable ones that are there now who still have enough skill and experience to provide a professional service for society as a whole that can be delivered in a timely sustainable manner. Unfortunately we are only most likely to get even more 5 second sound bite political decisions which will need reviewing almost as soon as they are passed to clear up the mistakes made. The EU did at least look at a longer term perspective rather than the max 5 year – often 6 month between budget statements – policy positions we lurch from in UK politics today. Industry and service sectors cannot work with such short lead-times and even the financial services sector has shown that it cannot deliver what society needs – only looking to satisfy its own greed.
- Ray

A well presented view. We can only gain by leaving the decrepit and corrupt EU. The Mafia would be proud of the EU.
- J Karna

In complete agreement. My impressions from campaigning in The general election last year is that 90% of Brixham would vote for a Brexit and 70% in the remainder of the South Hams. Sarah can rest assured that these views would be overwhelmingly supported in her own constituency.
- Dr Katy Bowen

I agree with Paddy Briggs. With politicians having such a poor understanding of major policy issues and/or engaging in populism, it is no wonder why citizens do not trust them. The leavers are the real EU scaremongers. We pay only 1% of our tax money on the EU (which returns 9 times as much to us in terms of jobs and foreign investment). The EU is directly accountable to UK citizens through the participation of our elected Ministers who make decisions in the European Council and our directly elected European Parliamentarians. The problem is less to do with Europe and more to do with Westminster.
- Nick Hopkinson

having voted originally to go into the EEC I am now totally against the whole current EU stet up. Why have I changed my mind? 15 YEARS BEING IN BUSINESS IN FRANCE
- simon

Well done Sarah. One of the few politicians who has had a proper job in the real world and has realised the billions of pounds we pay into corrupt European bureaucrats can be better spent for the benefit of the people of this country. Roads repaired, a better health service, protection of our own boarders, better schools and the ability to reject the immigrant scroungers taking advantage of crass EU laws and gaining access to our housing and welfare benefits. Charity begins at home.
- Graham

Sarah when were you a Europhile? Remember having conversations with you on the EU soon after you were elected and you were a complete Europhobe then with nothing complimentary to say about our important relationship with the EU and the largest single market in the world that gives us so much more influence politically and economically in the world when negotiating with countries like China and Russia. May soon be the case of "Little England", after the fragmentation of the UK on Scotland's exit and quite possibly the remainder of the UK apart from England, negotiating how many Burberry coats equate to us accepting 1000 tons of their heavily subsidised steel! Heaven knows how many years it will take "Little England" to negotiate, at a much lower advantage, the number of trade deals that are currently in existence with us being a member of the EU?If you get your way you could be one of the last UK members of Parliament and David Cameron,against his will, our last UK Prime Minister! After Scotland's exit from the UK we will certainly not be able to call ourselves a "United" Kingdom! Will we, in our diminished status, still have a seat as a permanent member on the UN Security Council?
- John Roadknight

Do not forget The European Free Trade Association
- simon

I have the utmost admiration for Sarah and am delighted that she has decided on BREXIT. When I read through some of the comments about her post, I can't help but feel that the honest way for this debate to be framed is between joining a federalist club and rescuing our democracy by reclaiming our independence. Ultimately it is as simple as that and people should remember that the only way we are able to contemplate BREXIT is because we wisely avoided being sucked into the Euro. The relentless drive towards centralisation by countries that are not at all homogeneous has busted Europe's flush and exposed that members like Germany and Greece have about as much in common as a fish and a dog. The sooner we reverse ourselves out of this dead end the better. BREXIT now, you know it makes sense!
- David Craggs

Reverse us where? No one knows! George Osborne has been cosying up to China whose economy is plummeting and who executes more criminals than the whole of the rest of the world put together. It also has an extremely corrupt judicial system and is currently using its power to expand its military presence in the South China Sea. Economically and politically we are FAR stronger negotiating with China and Russia as part of the EU and not as a "Little England". I believe the vast majority of the UK share the same values,culture and liberties as our EU neighbours and do not want to be dominated by authoritarian regimes.The only near certain outcome of a Brexit is the disintegration of the UK. I am sure Nicola Sturgeon is licking her lips at the prospect!
- John Roadknight

I do wonder what level of real understanding people, like you Sarah, have of the day to day workings of trade within and between EU countries? I have worked as a Senior Executive in a FTSE 100 company on some of the biggest, and most profitable, multi-national projects, with partners from other EU member states. These projects have brought many billions of pounds into the UK. One of the reasons why these projects were, and continue to be, successful is because of political will and the ease of trade between EU member states. Frankly, whilst I appreciate your loyalty, David Cameron has failed to set out clearly, the pros and cons of the various arguments in commercial terms. If, and this has not been made clear, the cost of trading with EU member states rises post Brexit, then UK Plc will be seriously damaged, possibly fatally. Neither you Sarah, or anyone in government has addressed this in clear, commercial terms. From what I have read thus far, Cameron's position is founded upon immigrant access to the Welfare State. I am not condoning this. However, this would amount to an estimated saving of some £30 million pounds. That is small fry compared to the potential long-term loss of billions. Finally, can I say that many of the arguments above are, with respect, akin to closing the stable door after the horse has bolted. Most former British companies are now owned by other EU companies. We no longer have any control over them. Today, in 2016, the profits go out of this country. That was clearly not the case when Britain joined the, then, EEC. We no longer have a British owned industry, coal industry, steel industry or electronics industry. Regardless of who is to blame, Britain has record levels of debt and is a poor collector of corporate taxes. If Britain is left to paddle its own canoe, people might care to ponder upon what I have said before taking a potentially irreversible decision. Like it or not, commerce has changed. If Britain leaves, it cannot flip the calendar back to the 1970s and pretend that global integration hasn't happened.
- Gary

Leave one, leave all. Germany will be left alone to welcome the Turks.
- Brexit

Bet you feel more comfortable now George Galloways on board! Can't believe you"re really in the same boat as him and Farage? Don't think that will go down too well with your supporters who voted for you.
- Peter

We have one chance to get out of this increasingly undemocratic failure known as the EU. We can again be a world leader in the new technologies if we regain control. My vote was never in as we never got a vote. It is definitely out now we have one.
- Sam Seal

Really very sad to see such a big mistake from a usually clear thinking, thoughtful fellow GP, who has often commanded my respect. Sarah, I urge you to carefully reflect on your position. Consider its basis on short term, small-picture analysis. Consider your focus, almost entirely on our differences, ignoring the far greater scope of our shared problems and shared interests. Consider the huge potential for leadership the UK has to offer as the EU evolves. If only we were to engage without reluctance, on these new terms, particularly with this significant shift in emphasis in accommodating diversity, which is very likely to strengthen. We are a far stronger country now than when we entered the EC, in no small part because of it. Has it really, in totality, served us so badly? Who knows their MEP, indeed. But how many more people actually know their MP? Their county counsellor? Their district counsellor? Their Police Commissioner? Yes, we do have a big problem with broken democracy. This is a big worry at local and national level, but your focus is solely on this problem at a European level, ignoring the rest. Again. Your position on European democracy follows through that we either abolish or withdraw from local and parliamentary democracy as the answer... non sequitur, surely. Your position runs high risk of breaking up the UK, resulting in increasing division at many levels, and greatly diminishing our influence at every level. Far better to remain a United Kingdom, being British and European, and maintain our position in the world on the back of the strength of all these partnerships, surely? Your choice appears bleak and defeatist - misplaced nationalism leading to a much diminished, very little England. My choice is Great Britain, showing leadership and sharing ties amongst friends in a diverse Europe. Give it some thought - seriously. With best wishes.
- Richard Stanley

Get out to what? No-one knows! Into a fictitious land of "milk and honey" as David Cameron put it? Scotland looks very likely to leave so it will be goodbye to the UK as we will no longer be United.You would do well to read Gary's excellent resume above who knows much more than me about the dangers that lie ahead in the event of Brexit. Are we going to send gun boats to Gibraltar next time Spain seals its land links after we exit?We have much more power and influence staying a member in the largest single market in the world.
- John Roadknight

Richard Stanley: I think you will find we all need counselling if we stay in the EU superstate. And thanks - I do know my councillors and MEP.
- Boris the Blonde

What will happen to UK farmers if we leave EU? I can immediately see EU farmers, ie French, immediately saying UK farm produce should have tariffs imposed, to protect the EU farmers. The French farmers could see this as a great opportunity for themselves at great cost to UK farmers. Currently London is the financial capital of Europe much to the German's -in particular Frankfurt's- annoyance. If the UK leaves EU, then a lot of city institutions will relocate to Frankfurt.This might seem irrelevant to us in South Devon, but the fact is, the City of London subsidises much of the UK. The BREXIT politicians constantly state, that is is in everyone's best interest for the UK and the EU to continue to trade freely and, therefore, this is what will obviously happen. But since when, have governments and politicians ever taken the sensible path? There is no guarantee that the EU and the UK will come to a mutually beneficial agreement. The EU governments will have to answer to their populace, which can easily be swayed by populist politicians. The end result may be very self destructive to both parties. The UK will soon become the largest economy in the EU, overtaking Germany. The UK's interests are best served by being the big fish in a big pond and using its might to make the EU more democratic and accountable.
- P. Morley

What a short sighted position, we should be leading Europe and not abandoning it. No-one knows what life outside the EU will look like and the leave campaign will not, or cannot, give any details about whether we will be better off materially or socially. This makes me think that things are going to be difficult and painful for the majority of people as we adjust to this new order which includes a large swathe of Sarah's constituents whom she is supposed to represent. Whilst the independently wealthy, retired or well employed can afford to insulate themselves from this turmoil the rest of us will suffer so that they can wallow in their ideological mire. Hardly the 'One Nation Conservatism' we were sold.
- Nick

Excellent post, Sarah. I am a Europhile too, and want a free trade area BUT not at the price of the loss of democracy. The EU was powerless to act decisively on Bosnia or the Greek, migrant and banking crises. Loss of democracy is too high a price to pay for its membership. 'Ordinary' people that their vote no longer matters.Ultimately European instability and the rise of extremism will be the consequence. This may not do your political career much good in the short term but it is better to stand on the side of what is right. so thank you for having the courage to stand by your beliefs.
- Maureen

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21 JAN 2016

It's time for a bold and brave strategy on childhood obesity

I wrote the following article for PoliticsHome

On the morning of the 2012 track cycling Olympics, the architect of Team GB's victory, Sir David Brailsford, attributed their success to the relentless pursuit of 'marginal gains'. He looked at absolutely everything that goes into riding a bike, from the rider and their bike to the environment around them. It was by improving every aspect, even if that was by a small margin, that the sum total struck gold.

There is no single easy solution to the crisis of obesity which is blighting the lives of our nation's children and I hope that David Cameron will look at the success of team GB and apply the same principle of marginal gains.

Some firmly believe that tackling obesity is all about education and information, others that exercise is the answer. Some will focus on the role of marketing and promotions, tackling super-sizing and reducing the levels of sugar in food or the role of taxation.

The fact is that we need all of the above, and far more. We need a bold and brave obesity strategy because of the sheer scale of the problem and the implications both for individual children, their families and wider society.

A third of children are now moving on to secondary education obese or overweight. Independent data also highlights the stark and widening health inequality associated with obesity. A quarter of children from the most disadvantaged families are leaving primary school obese, more than twice the rate for children from the most advantaged families.

The consequences for the physical and mental health of the individual children who are falling down that gap are serious: they face a significantly increased risk of type two diabetes, heart disease and cancer and they are more prone to bullying and marginalisation.

There are costs too to wider society and the NHS because of our failure to take effective action - diabetes care already consumes around 9% of the NHS budget and the total cost of obesity is estimated to exceed £5bn per year.

It makes sense to prioritise the measures that will produce the greatest gains and especially where they can produce those changes quickly.

The greatest gains lie in tackling our food environment because, whilst exercise is important whatever a child's weight, no strategy can succeed without tackling the prime culprit; too many calories. That is why we must tackle promotions, advertising and marketing, portion sizes and reformulation. The government must also take into account the potential of a sugary drinks tax.

Price helps to determine choices and relatively small changes can have an enormous impact.

The 5p plastic bag levy has driven a 78% reduction in the use of plastic bags at Tesco. It changed behaviour in part because most of us just needed that final nudge to change the way we shop and its acceptability was increased because all the money raised goes to good causes. One paper suggested that apparently outraged customers could defy the imposition of the tax... by taking their own bag... which was of course the whole point of it in the first place.

The same applies to a sugary drinks tax. No one would need to pay it at all because its primary purpose is to nudge consumers to low calorie alternatives. It should be included because we know that it works and that it works quickly. It particularly helps the heaviest consumers as demonstrated by the 17% fall within this group in Mexico one year after the introduction of a 10% levy on sugary drinks. If every penny raised went to funding programmes to benefit children and young people, it could provide financial backing for additional school sports, education and to teach cooking and nutrition skills.

The Prime Minister is right to focus on a childhood obesity strategy and his action list will need to be far longer than space in this article allows, including clearer information for consumers and giving local authorities and schools greater powers to tackle obesity. My plea would be to follow the lead of British Cycling on marginal gains and make a lasting and positive difference to our children's future.

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30 NOV 2015

It is time for bold and brave action to tackle childhood obesity

There is a single fact which demonstrates the compelling case for bold and brave action on childhood obesity. A quarter of the most disadvantaged children in England are now obese by the time they leave primary school. This is double the rate among the most advantaged children, setting out in stark terms the scale of the health inequality from obesity – and that has profound implications for children's health and wellbeing both now and in the future.

Obese children are at greater risk of bullying and of developing heart disease, diabetes, cancer and joint problems later in life. The cost to the NHS of obesity is estimated to be £5.1bn annually, and treating diabetes accounts for about 10% of its entire budget. Prevention is a central theme of the NHS's own long-term plan, yet there has been a further cut in the resources for public health under the November spending review. This places an even greater responsibility on the prime minister to make sure the policies in his obesity strategy can make a lasting difference to children's wellbeing and life chances. This cannot be stuck in the "too difficult" box just because effective action requires politically difficult decisions.

There is no individual course of action that will solve this epidemic; the scale and consequences of childhood obesity demand bold and brave action in as many areas as possible.

In our report published today, the Common's health committee urges David Cameron to include a 20% tax on sugary drinks. We do not believe that this is an attack on low-income families as industry lobbyists will no doubt claim, but rather an essential part of trying to reverse the harm caused by these products. That harm is not confined to obesity; we know for example that dental decay is the commonest reason for hospital admission in children between the ages of five and nine.

While not the only source of dietary sugar, sugar-sweetened drinks account for around a third of intake in four to 18 year olds. A levy on these products need not hit the pockets of low-income families as there would always be an alternative, untaxed and cheaper equivalent. One of the main purposes of a sugary drinks tax would be to encourage healthier choices, and that has clearly been the effect in countries such as Mexico.

There is also a compelling case for any revenue raised to be used entirely to support children's health, and to be especially directed to the most disadvantaged schools and communities. A sugary drinks tax would also have the advantage that it could be introduced quickly – and given the scale of the problem, there is no time to lose.

A successful strategy must include education and increasing physical activity but it would be a huge mistake to imagine that obesity can be tackled wholly by this approach. There needs to be an unequivocal message that exercise is enormously beneficial for children and adults alike, whatever their weight. When it comes to preventing obesity, however, no policy will be effective without tackling our food environment.

To be effective, the strategy has to get to grips with the saturation marketing and promotion of junk food and drink. Price promotions have reached record level, with some 40% of our spending on products consumed at home now coming from these apparent deals. The evidence is that they do not save us money, just encourage us to spend more on unhealthy food and drink, where the bulk of promotions are targeted. Who benefits from junk food promotions at the point of sale alongside non-food items or the chicanes of junk alongside checkout queues?

Reformulation has reduced the amount of salt in processed foods, and its time to ask industry to do the same for sugar – and to go further in "downsizing" rather than "supersizing" standard portions. While voluntary agreements have some advantages, industry will need a level playing field with regulation if that does not succeed.

Education messages are dwarfed by the power and persuasion of junk food and drink advertising. Our children are not protected by regulations as they stand, and these must be extended to include internet advertising, especially through so-called "advergames". It is also time to end the TV advertising of unhealthy food and drink before the 9pmwatershed and the use of celebrities and cartoon characters to peddle junk food.

No one would add 14 teaspoons of sugar to a cup of tea, so why not make it clear when that is what is hidden in a small bottle of sweetened drink? Information is powerful when it comes to making choices. Finally, our report recommends giving our local authorities the power to put health at the heart of their planning decisions, be that the design of active communities and safer travel, or the density of fast food outlets near schools. Its time too for a consistent policy for the latter with food standards applying wherever our children are educated.

There are no single or simple answers, but an obesity strategy that is thin on action will condemn another generation of children to a lifetime of obesity.

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27 NOV 2015

I opposed Syria bombing in 2013, but now David Cameron has my support

I wrote this article that appeared in the Telegraph today

Two years ago, I voted to oppose military action against the Assad regime in Syria. If David Cameron returns to the Commons next week, I will be voting to stand with our allies in extending air strikes against Isil, wherever they hide. It has not been an easy decision because, whatever the accuracy of our weaponry, the innocent are likely to be among the victims of future bombing. Right now, however, countless thousands across Syria and the wider region living under Isil barbarity are subject to systematic enslavement, rape, torture, murder and genocide. Isil cannot be reasoned with and it shows no shred of humanity or mercy to those under its barbarous control.

The first duty of any government is to protect its people and, unlike Assad, Isil also poses a direct threat to all of us here in the UK. Far from making it more likely, the threat of mass casualty attacks remains irrespective of any decision to extend our operations. Seven terrorist plots against the UK have been disrupted in just 12 months and 30 of our citizens were murdered on the beaches of Tunisia. The same carnage we witnessed on the streets of Paris is being actively planned against us here at home. We need to do everything we can to disrupt Isil at the nerve centres of their operations in Syria as well as Iraq.

There are those who claim that our action will be meaningless tokenism. I do not agree. We have an important contribution to make through our precision Brimstone missile systems and the capabilities of our Tornado aircraft. Our Reaper drones are providing a significant amount of intelligence from the skies above Syria but cannot currently deploy their missiles against targets which have been identified. Our action in Iraq has already helped to prevent ISIL taking control of a far wider territory and pushed them back from key strongholds. We have learned the lesson that Western forces should not intervene on the ground but we can play a crucial role in supporting local forces from the air.

The cloud of the Iraq war has long hung over decision-making but at long last the UN has woken up to the horror of the humanitarian crisis. Resolution 2249 states unequivocally that "Isil constitutes a global and unprecedented threat to our international peace and security" and it calls on all member States to take "all necessary measures" to prevent and suppress their terrorism and to "eradicate the safe haven they have established over significant parts of Iraq and Syria."

Military force alone cannot defeat Isil and we have to step up international efforts to disrupt the flow of Isil's finances and their internet poisoning of young people. There is also a pressing need for regional States and religious leaders to acknowledge and address the vicious sectarian divide and bigotry which ultimately fuels the bloodshed.

International efforts must be redoubled to work towards a just peace if the millions of refugees are ever to be able to safely return to their homeland. But however desirable it would be to see a change of Assad's leadership in Syria, we cannot wait for that to happen before we act because Isil is too great and present a threat to us here, right now, in the UK.

It is time in my view to stand with our allies and the countless thousands living in fear, and to play our full part in a just war against an unspeakable evil.

18 comments

Hi Sarah I strongly disagree with your stance on military action in Syria and I urge you to vote against David Cameron on this issue. Recent military intervention in Iraq and Libya has demonstrated that similar action has not discouraged terrorism or civil war. I believe that military intervention by western countries in this case will not solve the civil war in Syria and will make the refugee crisis worse. I also believe that ISIL will not be deterred. I believe instead we should be concentrating on home security to protect ourselves from terrorism and that we should be working with the UN on non military means to tackle Syria
- Celia Minoughan

Dear Sarah, UK AIR STRIKES IN SYRIA Whilst I agree with your assessment of the nature and severity of the threat posed by ISIL, and that negotiation with genocidal fanatics is not an option, I am not convinced that the solution proposed by the UK Government is effective or appropriate. An effective and appropriate solution would need to target ISIL militants without causing mass civilian casualties, it would need to improve the long-term prospects for residents, the remedy must not be worse than the problem being treated and there needs to be a clear exit strategy. Our intervention in Iraq and Afghanistan and Libya has failed on most or all of these points and I see no evidence in the latest proposals that we have learned from our mistakes. The biggest unlearned lesson is that is counter-productive for intervention in the Middle East to be “western led”. America and Britain, in particular, seem incapable of learning this lesson. Whilst most people in the Middle East are wary of Islamist fundamentalists, they are also generally hostile to western intervention in Moslem nations without their consent – a view that can be traced back past the Iraq war to colonial times and even to the time of the Crusades. If every ISIL militant killed by western forces results in the radicalisation of two moderate Moslems, which appears to be the situation, then western-led intervention can only exacerbate the problem. Tactless and arrogant intervention doesn’t just radicalise more people in the Middle East, it can also radicalise people in the minority communities in the UK. If western forces are involved they must, in the interests of diplomacy, be seen to be clearly acting under the command of a coalition of Middle Eastern nations such as Jordan, Turkey, Egypt, Kuwait or the UAE – which at present they are not. Western forces dropping bombs from the air have failed to prevent the spread of Islamist militancy in any nation where they have intervened. ISIL, the Taliban, Boko Haram and other Islamist forces have only ever been defeated by local troops on the ground. One of the unforeseen consequences of removing Saddam and Gadaffi and Assad and Mubarak from power, though our Ambassadors to the Middle East did repeatedly warn us, was that it was Islamists rather than democrats that took advantage of the resultant power vacuum. Those dictators, when they were in power, were infinitely more effective at preventing the spread of religious fundamentalism than any western air force. The proposed air strikes would not be carried out in partnership with any organised army on the ground – unlike the air strikes currently being carried out by Russia. Russia, like the West and most Middle East nations, wants stability in the area and a defeat of Islamist forces. The failure to find common ground with this obvious potential partner, and the resultant dangers of escalating conflict between Russia and the West, should increase our caution. Finally, it is the lack of a coherent exit strategy that remains my most serious concern. If we have no idea what type of government should replace Assad or how it could be established then should we really be getting involved at all? Assad is undoubtedly a brutal dictator, but if he has the ground forces to defeat ISIL, which we don’t have, then – having already seen what happened following our intervention in Iraq and Libya – should we be acting to destabilise his government when we have no coherent strategy of our own? Whilst the people of Syria desperately need our help, this is not the way to help them. Kind regards, Robert.
- Cllr Robert Vint

Dear Dr. Wollaston, I am disappointed to read your post and to see that in spite of your courageous, and very right, stance in 2013 you are backtracking and supporting air strikes this time round. Of course ISIS/daesh poses a threat. But will air strikes really lessen this threat and make us (in Europe) any safer? The 2003 war in Iraq, opposed by a majority of UK citizens whose views were blatantly ignored by politicians who thought they knew better, has not made us any safer. Quite the contrary. There is nothing to suggest bombinf ISIS will make us any safer either. The most shocking, in my opinion, of your comments is your acknowlegement that innocent people will die in these airstrikes - in order to protect innocent people in Europe from dying! How can that be right? are you saying a life in the UK is worth more than one in Syria? It is a sad state of affairs if those are the values of our society. I agree with the comments posted above too, and urge you to change your mind and VOTE AGAINST airstrikes.
- Philippa Candler

I also feel that I have to state my disagreement. As someone who has just turned 18 and therefore hasn't yet had the chance to vote it can often feel like I have very little power with regard to politics in my country and a part of that extends to an idea that there are very rarely things in politics that I feel this strongly about. I feel that this decision would be a huge mistake, not only for the innocent victims in the areas directly affected by the attacks but also for the victims of senseless racism that may be caused by this in the UK. The decision to agree with the attacks may have huge repercussions to both civilians in Syria and Europe. This becomes an attack on the general Muslim population and extends much further than defending our country. Your acknowledgement of the innocent civilians who will be affected by these attacks shocks me but also suggests that there may be a hope in you deciding to vote against this decision. Please, please don't make this decision in the name of our town. If it is decided to be carried forward it will be the end of any chance of me voting for your party in the future and I am aware of many, many other young people who also strongly disagree.
- Ella Watkins

I do not believe that David Cameron has made a compelling case to bomb Syria. I do not believe the way to support "countless thousands across Syria and the wider region living under ISIL barbarity ... subject to systematic enslavement, rape, torture, murder and genocide" is to drop bombs on those very people. You said yourself that those people are being used like human shields and there will be 'collateral damage'. I'm deeply disturbed by the images of French and American bombing campaigns, children being lifted from rubble. If this doesn't prove to ISIL that the West does not care about the people of Syria, I don't know what does. See this article from the Guardian 'Voices from Raqqa, We can't hide from your bombs, tell your MPs to say no'. http://www.theguardian.com/world/2015/nov/29/raqqa-exiles-bashar-al-assad-isis-bombing Two years ago David Cameron asked for a vote to support a bombing campaign AGAINST Assad. Now the French and Americans have asked for support in bombing Assads enemies... this is a multi-sided war that western nations have intervened in enough already; western nations funding different factions depending on their political interests. It is extraordinary that David Cameron wishes to go to war when we don't know who are allies are. Indeed the western nations currently bombing Syria aren't in agreement as to the extent of regime change required. So, what happens next.. when we've bombed the life out of Raqqa, maybe defeating a few targets underneath the remains of those human shields? The failures of the American Government and Islamist rebels to topple authoritarian regimes—in Iraq, Libya, and now Syria—created power vacuums that will be filled with extremists without persistent local forces to suppress them. (ref http://www.theatlantic.com/international/archive/2015/10/how-isis-started-syria-iraq/412042/) I am unconvinced that there are 70,000 moderate fighters in Syria to do this. Julian Lewis, chairman of the Defence Committee was surprised at this 'revelation': "Where are these magical 70,000 people and if they are there fighting, how come they haven't been able to roll back Isil/Daesh? Is it that they're in the wrong place? Is it that they're fighting each other? Or is it that in reality they're not all that moderate and that there are a lot of jihadists among them?" as quoted from Sky News. The UK may be at risk of terrorist threats. I am grateful to our Intelligence Forces in protecting us from those recent threats in the UK, identified and thwarted.... but I feel compelled to tell you as my representative in Westminster that I refuse to allow your party to use 'fear' as the evidence to create untold suffering and fear in another land. This is simple to my 7 year old daughter, to looked at me wide eyed when I asked her whether the British should bomb another country and she said 'of course not! Why would we do that to them when we wouldn't want them to do it to us? They tell us about that kind of thing in school every day.' I hope that your invitation to respond to your letter is taken up by the people of the Totnes constituency and that you get a clear mandate for your vote from your constituency as I do not see my voice nor the voice of anyone I know represented in the media to date. I hope that you get sufficient responses to change your vote to 'no'.
- Cat Radford

Dr. Sarah, I can understand that this has been a difficult decision, but as a constituent you have my support in taking it. ISIS represents a truly barbaric medieval force that stands against everything that the liberal-minded folk of Totnes stand for. Politics often comes down to 51-49 decisions, but in this case if we cannot take action against this vile cancer, it is pretty damned hard to envision when we would ever use our armed forces.
- Mark Marshall

Dear Dr Wollaston, Lest we forget I saw you at Brixham War Memorial on Memorial Day so I was surprised that you support the bombing of targets in Syria in order to combat terrorism in the UK “even though the innocent are likely to be among the victims of future bombing.” Here are some points that should be considered 1. In your lifetime the majority of terrorist atrocities in the UK were committed by the IRA. In the 40 odd years since the 1971 bombing of the Post Office Tower over 3500 people have been killed. Even last year Europol recorded 109 shooting and bombing incidents in Northern Ireland. Would you have supported bombing the IRA homelands of the Falls Road and Bogside? Would that have made the UK a safer place? The Bloody Sunday massacre didn’t . 2. DAESH is only one group amongst many such as Al Quaeda, Al Shabaab, and Boko Haram that have a similar ideology. Bombing Raqqa will be like beheading the Lernaean Hydra which caused the monster to grow two more. There are already reports that DAESH is establishing another headquarters in Sirte in Libya to control the oil and gas trade with Europe. How will we know when to stop the bombing? 3. Given that the crusades instigated by Pope Urban II in 1096 led to 200 years of Holy War by Roman Catholic Europeans on Muslims, other Christians, Jews and Pagans throughout the Middle East and Europe, there is a strong possibility that we will run out of money before we bomb DAESH and its affiliates into oblivion. How long do you think we can last financially in a war situation? 4. The 13th century Franciscan friar Roger Bacon said of the crusades "Those who survive, together with their children, are more and more embittered against the Christian faith". Do you think that is not happening already? My experience of muslim friends and colleagues in the UK, Saudi and Indonesia is that many assume that a European is, de facto Christian. 5. In about 2006 King Abdullah of Saudi Arabia visited China starting the “Look East Policy” in which there will be financial and technical cooperation in oil extraction and refining. I have seen a construction crane with Chinese writing along its boom in Saudi Arabia. The Chinese navy have built or are pursuing agreements to build ports at Darwin in Australia, Hambantota in Sri Lanka and Djibuoti in Africa. This will give them bunkering facilities for their warships to protect their trade from the Gulf to China. In April this year a Chinese naval frigate evacuated 225 foreign citizens from strife-torn Yemen. The Chinese are not judgemental in their dealings with foreigners and have no colonial baggage. Do you think that bombing Sunni Muslims will help the security of the oil supplies that our society is based on? I wish you well in coming to the best decision for us all. Edward Stone
- Edward Stone

Dr Dr Wollaston You state a good case but like all but one of the comments above I can't see the point in more British military action over Syria. Serious sanctions need to be put in place against those that fund these groups. We can't just pretend we are going to destroy them from the air. They will just move further into Libya and the other areas laid lawless by decades of Civil war and corrupt governance to which, in some cases, the West has turned a blind eye. As your constituent I beg you to desist on voting for Military action in Syria and urge you to consider bringing all our troops in the region home. Alastair Prichard
- Alastair Prichard

Dear Dr Wollaston. I am most concerned that we are likely to use air strikes in Syria. First we need to consider the people of Syria and then look at our involvement in Iraq, Afghanistan and Libya, these countries are not considered safe since our military action, Please no air strikes, this is extremely complicated and we need to act with great care. June Wood
- June Wood

Will we never learn! Having created and trained ISIL in order to help overthrow Assad because he wouldn't allow the gas pipeline we wanted built across Syria what we actually created was an inhumane mess. This is an extraordinary and dangerous situation. The Russians are backing Assad because of course they do not want an alternative supply of gas to theirs in Europe whilst the USA want the pipeline to reduce Russian influence Neither Russia nor NATO wish the pipeline that Assad is backing built by Iran so increasing Iranian power and influence. Is it any wonder that the Wests cavalier attitude to the lives of people in the Middle East has resulted in the increase in terrorism? This is a war of smoke and mirrors. Have you really been given intelligence from David Cameron which makes you as a doctor believe that our killing more civilians in the Middle East is actually going to have a positive affect? Surely there are still too many lies and deceptions to make the decision to increase bombing.
- Timothy Kendall

Dear Dr. Wollaston, I cannot equal the excellent and eloquent arguments posted here in opposition to bombing, but alike, and for all those informed reasons, I urge you to use your conscience and agency to vote against the barbarous and presumptive act of bombing a people based on the rationale you have listed in your argument. It can only be disastrous to add to the present chaos. I sympathize with the difficulty of your position, but I hear unmistakably in your and the Party's statements the monotone of rhetoric that allows us to slide words over the possible death of civilians as implicitly justified under the guise of protecting our own. In the smallest matters of life, and all the more at this scale, the deepest wisdom at times is inaction, waiting, and listening, until we know what is the right thing to do, to have the ethical courage of non-action until we know what part to play, rather than forge ahead with the bombast of our collective ego. Is this not the ultimate opportunity for all politicians trapped within their party identities to test their own truths, act on them, and change the foundations on which we govern? Please consider carefully the concerns that your constituents and many members of the public are expressing, Regards, Vaughn Barclay
- Vaughn Barclay

This article for the Telegraph is merely a propaganda puff for which Dr Wollaston will I am sure be amply rewarded by Mr Cameron in the future. ( gong or peerage ? ) Most of the funds for ISIL comes from Qatar and Saudi and ISIL taking root in Syria and Iraq is a consequence of the US policy of regime change. As for the Paris bombers , most of them lived in Brussels not in Raqqa and has more to do with modern France's attempt to absorb and integrate millions of its former colonial subjects from north Africa. Today we see the first bombs falling on Syria from the RAF which are not " precision " British Brimstone missiles but in fact Paveway bombs manufactured in the United States. End result ; more money for arms manufacturers at the same time as increasing refugee flows in Syria and adding to the toxic mix in the Middle East.
- Peter Thompson

What eloquent letters above. I cannot attempt to match with understanding and knowledge of the complexity of the matter but I liked the phrase by the last writer; 'propoganda puff'...... One evening I watched ITV, BBC and C4 news one after the other. Each carried exactly the same news reports and video clips. Surely there is more than 4 news stories on the immense beautiful and diverse planet that we live on. (Yet we don't hear much about corporate pollution, the struggles of the amazon rainforest people, the fires in Indonesia etc. etc.) Years ago, when my sister lived in South Africa we were really concerned about the riots we heard about on the news over there, so called her. She barely knew of what we were talking about. Then she called us when she heard on her news about riots over here: Again, life was carrying on as normal to us. I read George Monbiot's bio. a little while ago (he writes for the Guardian) and he said he had been so excited about working for the BBC but when Thatcher became prime minister she got rid of the chairman in the 80's and the new ruling was 'no more investigative journalism'!! Replaced by propaganda puff? (So, after all this austerity by the Conservatives, suddenly there is millions and billions for killing people again.) Where DID Cameron get his emotive speel from? (Same place as Blair?) Can we believe what we hear on the news? Is it only countries 'we don't like' that have propaganda? Do politicians really question what is going on? Who is behind everything? What are the motives? Who will benefit....... Follow the money. I was struck watching the film 'Amazing Grace' that the slave trade continued for 500 years. Not least because politicians were making money out of it. 100 years ago over a million men were killed and traumatised in the trenches fighting over a metre of mud. Why? What lies were they told? (Apart from the shaming if they didn't do it) Oh where are the wise elders that make decisions led by their heart, not media, propaganda and profit?
- Karen Evans

Disappointed. If a foreign government ordered the bombing of Totnes due to a possible radical/ terrorist cell would you let that happen? D
- DAVID ROPER

Why did it take you so long to decide to go against vote leave if you knew the figure of £350 million a week to be wrong?
- Rob

The figure of £350 million is not wrong - that is our gross contribution out of which the EU dolls out money back to us on any project they see fit. Even if we continued to spend our own money on such questionable projects we would still have approximately half that amount left over out of which we could spend £100 million on the NHS. Sarah's latest stunt is purely political manipulation of the situation probably orchestrated by Slippery David Cameron.
- Brian - Brixham

Quote " I have neither sought or been offered promotion." You insult the intelligence of the public and perpetuate the low regard in which politicians are held. I trust your constituents will reward your 'moral' decision accordingly.
- John Gosport

I think your disgusting about turn to remain has more to do with you 1 being a remain all along. 2 you like all the political class have much much more for your own benefit to remain so you can keep the money rolling in, I hope you sleep well in later years when we the general public suffer your selfish decisision.... VERY VERY but not surprised TRAITOR desssision. . x
- wayne andrews

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25 NOV 2015

Social Care and Public Health are Essential for Individuals and the Future of our NHS

I wrote this article which appears in today's Telegraph

Britain spends 8.5% of GDP on health care, just below average among the OECD group of rich nations. But while our spending on health has been virtually static in real terms since 2009, the same is not true of demand, which has risen inexorably. Anyone listening to those on front line will hear the unequivocal message that our NHS is under unprecedented strain from the increase in the number of patients with complex long-term conditions, and the shortage in staff and funding to cope. Hospital trusts are heading for a record end of year deficit of around £2bn.

George Osborne faces enormous pressures as he tries to balance the books but he is right to commit an additional £3.8bn to the NHS next year, bringing forward a significant down payment on the £8bn promised by 2020. No one should be under any illusion, however, that this £3.8bn will solve the financial challenges facing our health service.

The fate of the NHS will also depend on the settlement for social care funding outlined in today's spending review. Any Accident & Emergency department will tell the Chancellor that winter pressures are mainly the result of so-called "exit block". Staff time is taken up caring for patients with complex problems who cannot be admitted to wards because those already in beds cannot be discharged due to the lack of social care packages. Social care cannot be divorced from health care and if you combine budgets for both, overall heath and social care spending has seen a worrying decline.

The widening gap in social care funding is set to become wider still as councils fund the living wage. Any further squeeze on their already thin payments to care providers risks prompting a mass exit from the sector. The NHS would then, even more regularly, become the default backup, incurring wasteful and disproportionate costs when people would far rather be at home.

Can more money be set aside for social care provision? There are suggestions that the Chancellor may allow councils flexibility to raise revenue themselves to do just that. But doing so will be most challenging in the very areas with greatest deprivation and need.

Without the ability to manage these extra costs, hospitals will have to make tough choices about priorities.

This is not the time to push for routine seven-day NHS services without the realistic funds to match. The extra costs of routine services on a Sunday were not included in the NHS's own long term plan, the "Five Year Forward View". So any promise that the service can operate at the same level of convenience on a Sunday as on a Tuesday is simply unrealistic. We must prioritise safety and follow the evidence about the measures which will genuinely make a difference. With staffing stretched, there is a danger of unintended consequences and we have to make sure that improving weekend services does not simply result in worse outcomes for patients treated on a weekday.

Today we will see the small print of the spending review. Boosting funding for NHSEngland should be transparently achieved with "new money", not at the expense of bodies like Public Health England or Health Education England, which is responsible for workforce training.

Public Health is the front line of the NHS. Further cuts would hit already stretched services like mental health, drug and alcohol addiction services and sexual health. Action on prevention and early intervention was central to achieving the savings set out in the "5 Year Forward View" as these are key to stemming the rise in demand from preventable disease. Obesity, for example, is estimated to cost the NHS over £5bn per year and the wider economy £27bn, yet we spend a tiny fraction of that on prevention.

Public Health England is not some dry outpost of the NHS, it is both core clinical business and crucial to future savings. Driving it onto the rocks could sink the ship.

Meanwhile it hardly needs saying that it would be unwise to scupper our ability to train the future workforce by cuts to Health Education England.

I really welcome the Chancellor's boost to NHS funding but the time has come to look at how much more we could do to reduce the future costs to individuals and society through preventing illness. We must also follow the evidence when it comes to getting the best out of a tight budget and that requires a serious plan for social care and a review of the key priorities for a seven day NHS.

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28 OCT 2015

Tampon Tax

Many people have contacted me about VAT on sanitary products. Of course I am opposed to VAT being placed on these essential items but I did not support Paula Sherriff MP's amendment on this topic to the Finance Bill as this matter is entirely devolved to the EU and it would have been entirely misleading to pretend otherwise.

Unfortunately, we are in this situation as VAT replaced the UK scheme when we joined the then European Economic Community. Anything we already had as zero rated tax was allowed to remain that way but the EU have not allowed the UK to add new categories for zero rating since then. I am pleased that the European Commission has now stated that a review of VAT rules will take place next year, which is the realistic opportunity we have to tackle this issue and I would urge those who have concerns to contact our MEPs to ask them to lobby for sanitary products to be zero rated for VAT and you can do so via the following link.

1 comment

Stop blaming the EU for this non issue! The fact of the matter is that VAT on tampons is only 5%. It's 20% on toothpaste, razors, pain killers and glasses (and of course many other products). I can't function without my prescription lenses so why should I have to pay VAT on them?
- Marc Cornelius

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16 OCT 2015

Half-Baked and Reheated; the Medical Anecdote Bill Returns to the Commons Today

This article appeared first on Huffington Post

We all want to be able to access effective treatments as quickly and safely as possible. Why then do the overwhelming majority of research and medical bodies alongside the Patients Association and Action against Medical Accidents so firmly oppose the Access to Medical Treatments (Innovation) Bill?

In a nutshell because it will do nothing for genuine innovation or to improve access to treatments but it will confuse the legislation, remove important protections for patients from reckless practitioners and undermine research.

This bill is a reheated version of the half-baked Medical Innovation Bill which was thrown out in the last Parliament. If it was a turkey pie, you wouldn't touch it.

It starts from the false premise that fear of litigation is the key impediment to innovation. The Academy of Medical Royal Colleges, The Academy of Medical Sciences, Cancer Research UK, The Wellcome Trust and a very long list of other research charities have all made it clear that they disagree...that they do not see the need for this legislation and that they do not believe the bill will achieve it stated aims. They all speak of the unintended consequences for patients and for medical research alike.

It is hard to see why the government is not firmly opposing this bill.

Existing legal and professional ethics arrangements already allow responsible innovation. Action against Medical Accidents set out the risk of creating a 'Heaton Harris' legal defence which would make it easier for rogue doctors to carry out risky but 'innovative' procedures or 'have a go' treatments. Under the proposals, these doctors would only be required to obtain the views of at least one other doctor with experience of patients with the condition in question. There is nothing to protect patients from doctors who selectively seek the views of peers who are themselves profiting from newly permissive experimentation.

Faced with a dreadful diagnosis, people are at their most vulnerable to the siren call of innovation. Why take part in a clinical trial if seeing a private clinic would guarantee something innovative? The problem of course is that innovative treatments may turn out to be more harmful than existing treatment or none but a series of anecdotal treatments means that neither we nor patients will ever know.

The bill seeks to address this by tagging on powers for the government to set up a database of these anecdotal treatments. If publicly searchable it would make for wonderful free advertising for private clinics but a vast sprawling register of treatments is no substitute for a proper evaluation of evidence and simply fails to understand the science.

There is no need for legislation to create a database that would be of genuine value to patients and the research community alike, it does however, require funding.

Clinical trials already struggle to find enough participants without this undermining legislation; far better for government to build on improving access and information about clinical trials for those who would like to take part and to focus on their 'Accelerated Access Review' which is examining how to speed up access to new drugs, devices and diagnostics for NHS patients.

When I worked on a children's ward as a junior doctor in the late 1980s, the outlook for childhood leukaemia was grim. That so many of those diagnosed with the same conditions today will survive and thrive is not thanks to a series of anecdotal treatments but because of the meticulous research which allowed us to discover the best treatments. Patients today benefit thanks to the thousands who took part in clinical trials before them and very many go on themselves to take part in the studies that will help others in the future.

None of us will benefit from undermining clinical research with unwanted and ill-judged legislation. MPs should send it to the sluice.

2 comments

Having some past knowledge of the "alternative" health market and having been somewhat naive in their anecdotal testimonials, any legislation should only aim to encourage the efficacy and funding of clinically based trials. As someone with cancer I appreciate all the research that has and continues to take place and which is helping me to improve my treatment outcomes. I was unaware of this legislation and will call upon my MP to vote against it. Oh but I suspect he won't because he is a colleague of yours who blindly toes your party's line. You have my greatest respect for attempting to educate your colleagues on this and other health matters.
- David Westwood

The expression, "Don't confuse me with facts [and logic]", comes to mind! Sadly, successive governments have demonstrated the ability to ignore expert advice for the sake of perceived political advantage. But don't be discouraged, you put the case so well. Keep up the excellent work. Good luck...
- Chris Bulleid

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12 OCT 2015

Sugar Tax Report

I wrote the following article for the Telegraph that appeared this morning.

Sitting on the desk of Jeremy Hunt is a detailed and impartial review of the international evidence on measures which could reduce our consumption of sugar.

But the Secretary of State for Health is refusing to publish this study - compiled by Public Health England (PHE) - despite repeated requests to make it available to the public.

This matters because the public health community and campaign groups need to be able to access unbiased evidence to fully contribute to the Government's forthcoming childhood obesity strategy before the ink is dry on the paper.

It also matters because an important principle is at stake around the transparency of evidence and data.

The Secretary of State regularly speaks of the need for timely publication of data by NHS staff, even if that is inconvenient or embarrassing for the organisations concerned - and we rightly no longer accept that pharmaceutical firms delay or conceal evidence from their clinical trials.

Leadership on transparency however, has to come from the top.

It sends a dangerous message when NHS staff see delayed publication of data on NHS finances and now an unreasonable refusal to share key evidence on reducing sugar.

This week the Commons health committee begins its inquiry into what should be included in the childhood obesity strategy. This will also be Parliament's response to the e-petition signed by 147,000 people, initiated by Jamie Oliver and Sustain, which calls for a tax on sugar sweetened drinks.

Why should campaigners be denied access to an important evidence base paid for by the public purse for the benefit of the nation's children? Given the refusal of Mr Hunt to publish, the health committee has formally requested Duncan Selbie, the chief executive of PHE, to use his powers to do so. At the time PHE was set up as an executive agency of government, there were concerns about the possibility that ministers might lean on officials.

For this reason it was made explicit that its credibility would be based on its "expertise, underpinned by its freedom to set out the evidence, science, and professional public health advice it presents without fear or favour".

Mr Selbie has, however, agreed with Mr Hunt it is inappropriate to publish in advance of the obesity strategy.

He should re-read the framework agreement which sets out PHE's operational autonomy and which requires him to operate "transparently and proactively and provide government, the NHS, Parliament, public health professionals and the public with expert, evidence-based information and advice".

The wider public health community will not understand a refusal to use his powers to publish this evidence.

Mr Hunt must practise what he preaches on timely transparency of data and evidence.

If he will not do so, the chief executive of PHE needs to act in the public interest and do so in his place.

4 comments

Whilst i live in Bingley, West Yorkshire, i fully support your campaign, it is crazy to keep the costs low for such a harmful product to peoples health. As a prominent MP on health issues will you support the continued provision of free school lunches for primary school children. This may increasingly become the main meal of the day for children from low income house holds.
- John Burns

Thank you for taking such a firm position. It is scandalous that this report is so delayed. It seems that the leadership of the Conservative Party are in thrall to the global companies that pedal sugar to children.
- Andy Christian

Keep up the good work Sarah. I can't believe that Mr Hunt and the Prime Minister refuse to support you and the committee on introducing a sugar tax. It's like a repeat of the failed attempt for many years to ban smoking by sweeping the bad news under the carpet. The voices of the sugar lobby are bordering on the immoral. Please continue your sane battle for the health of the nation and especially our youngsters.
- David Westwood

Hi Sarah, Well done and thank you for all that you are doing to promote this issue, despite getting no support at all it seems from the rest of your party. I am so angry about the delay in making public , and now the negative response from the Government to the sugar tax report. I have sent the link to Jamie Oliver's petition to everyone I know. I work in the level 3 Obesity team for TSDFT. is there anything more that we can do to support you keep up the good work , and best wishes from Emma Stubbs
- Emma Stubbs

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04 SEP 2015

We can and should do more to help the humanitarian disaster at our door

Aylan Kurdi is not the first child to drown in the Mediterranean Sea or to suffocate in an airless lorry at the hands of people traffickers but his image burns into our humanity. As we witness the scenes of refugees desperate to reach the sanctuary of our shores the question is whether Britain could and should do more to help and if so in what way?

A mass movement of people is underway, not only of those fleeing conflict in the Middle East and North Africa but of others trying to escape from conditions of grinding poverty. Children just like Aylan die every day from malnutrition and disease but we cannot provide a home for everyone.

In the year ending March 2015 we received 25,020 applications for asylum but just 2,222 of these were from Syrian nationals. Those accepted make up a tiny fraction of the 330,000 annual net migration into the UK and yet, in a democratic country, there is a need to listen to the expressly articulated concern about our ability to cope with the scale and pace of change. I do not believe there is support for us to match the 800,000 refugees welcomed by Germany in addition to our existing migration from other sources and we simply could not provide housing on that scale. Neither is there support for delegating compulsory decisions about quotas to the EU without the leadership to look at all the options. At a time of such humanitarian disaster however, we can and I believe that we should accept more refugees There is also a case for the EU suspending the rules on free movement to seek work to allow greater flexibility to offer those opportunities instead to refugees in desperate need.

International leadership is paralysed despite the scale of the unfolding disaster and there are so many factors beyond our control. Britain cannot force an end to the vicious regional religious sectarian struggles; that will take their own religious and political leaders to actually show true leadership. In the meantime Russia's shameful ongoing support for Assad blocks a negotiated transition of power in Syria. The UN has been entirely impotent in effecting an international military response to the situation and the hard reality is that ground intervention by Western nations acting alone would become a recruiting sergeant for the likes of ISIS and Al-Qaeda. In short, the exodus of desperate refugees is set to continue.

There are clear dangers if a perilous journey with traffickers becomes the surest way for those escaping the conflict to gain asylum and, even if they cannot agree a means to end the war, it is time for the international community to review the way that we assist and prioritise help for the civilian victims. Recognised refugee assessment centres in countries jointly funded to host them should be established in addition to the existing mechanism from refugee camps as the only routes to gaining asylum from conflict zones but that would take a change in international law. If nothing changes then we will continue to play into the hands of the criminal gangs profiting from their trade in human misery. There is also a question about who is in greatest need, the (mostly) young men trying to break through the fences at Calais or the unaccompanied children out of sight in refugee camps? We should in my view prioritise those in the refugee camps.

Unless there is a clear message that arriving by sea will not result in direct entry to the EU, we will simply condemn more people to attempt these treacherous journeys. Fast track assessment centres would also need powers to repatriate those who are are not granted asylum. The current situation is placing intolerable and growing pressure on countries at the front line and countries like Greece cannot possibly cope especially in the midst of their own financial crisis.

We can all be proud that Britain is one of the few countries to commit 0.7% of our income to international development and that we are the second highest financial contributor to the relief effort for Syrian refugees. Yet there are loud and growing calls for overseas aid to be slashed in favour of spending at home. In a democracy consent matters and my sense is that there would be greater support for our aid if the rules for spending the budget could allow it to include humanitarian relief and operations like Mare Nostrum by our armed forces. There is also a case for it to fund onward support in their countries of origin for those denied asylum alongside continuing efforts to prevent the need to leave in the first place.

Britain has a long tradition of welcoming people fleeing persecution. Our anxiety about net migration and especially about EU economic migration has hardened attitudes but this is hitting the most vulnerable. We cannot help every child in need but we could play our part by accepting an increase to 10,000 refugees. In particular I hope that David Cameron will consider the call for a modern day equivalent of the Kindertransport, which was a beacon of hope in Europe's darkest hour.

6 comments

I have not voted for you .. Please do not speak for me ... From a very old Brixham family. Thank you ..
- G.Bedford..


- One of the best blogs I have read on he issue. Agree entirely that help for women and children should be the priority not young able bodied men and that setting up safe havens in contiguous countries is safest, most sensible answer. However, I am not sure you are right about Putin. Much as I disl

I agree with these views. We need to help not only the refugees but also those countries that border Syria and are struggling to cope with the influx of refugees. Greeks, suffering from severe austerity, have shown more compassion than we have. They have sheltered those flooding into their country and of course they encourage them to move elsewhere - how could they cope it all the refugees stayed? To stop the refugees drowning in the Med we need to help improve conditions in the camps near Syria and take refugees direct from those camps. This is not only a moral obligation but also a political one - we need to aid the neighbouring countries, help them remain stable and reduce the pressure on their own infrastructure.
- J Sanders

You cannot separate the massive net immigration numbers from the debate about asylum seekers. All MP's are responsible for the failure to provide leadership and to vote on sensible controls to limit the numbers to ease the social and financial pressures we now face. The health and social services face pressures, yet the proposal by Dr Wollaston is for even higher numbers of refugees. If we did not have the mistakes made by successive governments the situation may be different. No, it is time for other countries to play their part now.
- Phil

This is worrying. I've never voted Tory and probably never will, but I find that Dr Sarah seems sensible, well-informed and intelligent on a range of topics and I find myself agreeing, even modifying my views.. I agree with most of this blog although I am a bit worried about our government's role in the disintegration of Syria. I'd like to ask the refugees how their current situation compares with how things were 5 years ago before the Arab spring, and our ill-thought out response to it.
- TW

I agree with these views, but feel that we are not doing enough and cannot turn our backs on these people when we contributed to the problems in the region. I am part of a CUK initiative to help Syran Refugees who are coming to this country following David Cameron 's pledge to take 1000 before Christmas. Anyone interested in helping the Syrian Refugees or finding out about what is going on in the South Hams should look at the Beyond Borders website which is a hub for various initiatives taking place. Furthermore, in mid December there will be a register of interest for private sponsors featured in the Sunday Times, this ill involve a number of high profile, faith, civil society and celebrity figures. Will you Sarah Wollaston be one of the 50 -100 MP's to add your name to the Refugee Commitment ( RC) ? Items being considered for the RC: Private sponsorship creating safe migratory routes , letting in up to 50,000 vulnerable refugees humanitarian visas Cathy Koo
- Cathy koo

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03 AUG 2015

Care Cost Lottery

For anyone hit with a debilitating illness, it comes as a huge shock to find that there is no entitlement whatever to receive help with the costs of social care if their assets are worth more than £23,250.

Through no fault of their own, around one in 10 people aged over 65, many of whom have saved all their lives, face catastrophic costs especially if they need long-term residential care. This was not an issue at the general election in May because, during the last Parliament, the Government responded to the Dilnot Commission and passed ground-breaking legislation through the Care Act to place a cap on the total amount that anyone would have to pay, alongside a major increase in the asset threshold.

The Government has now kicked that promise into the long grass. The announcement was silently delivered via a written statement, snuck out in the Lords on a Friday afternoon, two working days before the Commons went into its long summer recess. Despite affecting thousands of families, the timing effectively prevented this major shift in policy being properly debated in Parliament.

There were many unanswered questions, and the Health Committee, which I chair – wrote to Jeremy Hunt, the Health Secretary, to ask them.

In his response, Mr Hunt noted that it was important to announce the decision as soon as possible after it was taken. This was, he explained, because many organisations were continuing to work to deliver the reforms to the original timetable.

I believe these organisations, and all of us, deserve to know when and by whom these decisions were taken.

The Local Government Association (LGA) requested the delay – but this was because of the financial reality of implementing the policy, rather than an argument against the principle of protecting people against overwhelming care costs.

The resulting delay is unacceptable, but it is not the fault of local government. Throughout the passage of the Care Bill, the need to fully fund the proposals, which would have greatly increased the number of people entitled to free care, could not have been made clearer. Reassurances were given at the time that the government understood and had allowed for those costs. Since then, however, the LGA received no indication that new funding would cover both mainstream adult social care and the cap reforms. In the absence of funding for both, they therefore made it clear that existing care, which is already at breaking point, must be the priority.

The LGA estimate that the already yawning funding gap for social care is growing by a minimum of £700 million a year, chiefly as a result of rising demand. Implementing the National Living Wage may add an extra £1 billion to their costs by 2020 to pay the wages for residential and homecare staff. This may have been the straw that broke the camel's back.

Thousands of eldery men and women could still be forced to sell their homes

In a further blow, Mr Hunt's response to the Health Committee confirms that the asset threshold limits will remain at their current levels of £23,250 for the upper limit and £14,250 for the lower limit. This has long been a bitter pill for anyone who has done the right thing and saved for retirement, only to face what amounts to unlimited care costs.

The care costs lottery looks set to continue until at least 2020 but there can be no excuse for any delay in clamping down on the absolute disgrace of cross subsidies. Those who fund their own residential care are too often being charged extra to top up shamefully unrealistic fees paid by local authorities for those who do not. In his response on that point, Mr Hunt maintains that there may be "good reasons why councils can often pay less than self-funders for care: they often buy in bulk and have responsibilities to drive the best deal possible to ensure value for taxpayers' money." This grossly underplays the appalling scale of the practice.

There is now statutory guidance setting out how local authorities must consider the actual costs of care and support when negotiating fee levels. The Health Secretary says he will be taking action in partnership with local authorities and providers to make sure this happens. I hope that care homes and affected individuals alike will send him the evidence, wherever and whenever that continues not to be the case.

The government promised fairness for those who have saved for decades only to see their assets decimated because they need to rely on social care. The delay may have been a reflection of the financial reality that councils would have been bankrupted by the costs of the National Living Wage alongside the bill for fully implementing the Care Act. The government claims that the delay is in response to a direct plea from the LGA. A better answer would have been to address the gross underfunding of social care. Instead they have used the LGA's request as covering fire to ditch a cornerstone of legislation and a clear promise to older people and their families.

The Care Act should not have been shelved and certainly not in this manner.

My article first appeared in the Telegraph today.

1 comment

Thank you for taking up this cause. I do not own a home and have little savings having spent my money on eye operations to save my sight. Sick of the run around of clinics and long journeys. I am 76 and more disabled as my years of heavy lifting have taken their toll. We are told we are living too long and the health service can't cope. Care homes are mostly in private hands with wealthy owners who pay their staff a pittance, or employ foreigners who do not speak proper English the elderly cannot understand.--The reason the home in Chillington was closed. I dread old age as do my friends. In their late 70s and 80s. One is 95 and luckily quite wealthy but terrified of going in a care home. We have worked all our lives and feel we are being used as a scapegoat, using scarce recorces, whilst foreign aid seems to have been guaranteed to every tin pot dictator, as funding to Zimbabwe to help to bring about democracy!! I lived there and assisted my friend to run a hospital and clinics. At the sharp end. Anybody can come here and get free medical treatment. I know from experience. Our people are being short changed while money is scattered like confetti to all and sundry. We have to care for our own first! Part of the N.H.S. cradle to grave. Thank you.
- Margaret Newton.

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30 JUL 2015

Coerced Consent is no Consent

There is a dark question at the heart of Professor Black's call for evidence on the work challenges facing benefit claimants who are struggling with addiction and obesity and it should worry us all. She asks, 'What are the legal, ethical and other implications of linking benefit entitlements to take up of appropriate treatment or support?

The inclusion of this question calls into doubt the independence of her review as Professor Black cannot be in any doubt about the fundamental principles of medical consent; that it must be freely given and informed. There are only a few strictly limited circumstances, covered by the Mental Health Act, when people may receive medical treatment against their wishes. It would be abhorrent for the State to extend that to others in order to tackle a perceived reluctance to accept help for conditions of which society disapproves.

A threat to remove benefits unless a claimant accepts treatment, would represent coerced consent to that treatment and that is no consent at all because it would not be freely given. Treating a patient without valid consent would put any clinician in breach of their duty as a doctor let alone in breach of the law.

Any proposal to change the law to allow such coerced consent would be a seismic change and threaten us all. Where would it stop?

It would also be completely pointless. The roots of addiction are complex and treatment is far more likely to be successful when the person affected is actively seeking help. We would also end up depriving or delaying access to the people who want to benefit in favour of those who are not yet ready or willing to change. It would be a criminal waste of time and resources to fill NHS clinics with addicts reluctantly gaming the system or issuing prescriptions for discarded medicines.

Professor Black's call for evidence also misses an important opportunity to comment on the clear evidence base for prevention of alcohol harm. There is still time to follow Scotland's lead in implementing a minimum price for alcohol. It would be perverse indeed for government to be coercing people into treatments from which they are unlikely to benefit at the same time as failing to act on the saturation access to and promotion of ultra cheap booze which fuels their addiction.

4 comments

Well said Sarah. It's clear too that those who ask for help are often unable to source it; funding is limited.
- Lynne Roper

It also raises the question of what is 'appropriate treatment and support' and where are the resourses to provide it? What training will staff in local jobcentre's have that will enable them to address this question before referring a claimant for such treatment or support and considering whether to sanction them for a failure to comply? Bearing in mind that 60% of referrals to a decision maker to consider a sanction under the current provisions are found to be inappropraite (and the number of actual sanctions imposed that are overturned at the revision or appeal stage is significant). This is another example of the governement pandering to the predudices of the public about claimants (whipped up by politicians and the media over recent years) in return for cheap sound bites (which then obscures any informed debate on how to tackle the complex health & social issues that undurly addiction).
- Peter

Well said! I wonder as well why an outsider was brought in. The DWP has a team of about 50 medics and support staff who consider this question regularly - they must be miffed!
- Greg Wood

10 years on full duties with the Ambulance service, gave a huge insight into drug and alcohol addiction amongst other types as with gambling and eating disorders. Most had social or mental problems but others used their addiction as a way of life and the benefits it gave, without working for a living. One arrived here from South Africa with his family. Always worked but after coming to U.K. has become obese deliberately, his wife is his carer and they have all the benefits including being housed, car and scooter etc. Classed as disabled are now on easy street. Just one example. And not even British!
- Margaret Newton.

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13 JUL 2015

Time to consign hunting to history

Rural voters deserve better than to be typecast as pro blood sports by the hunting lobby. It is clear to me that most people, living in both rural and urban areas of the Totnes Constituency, would prefer to see the hunting of foxes by packs of hounds consigned to the history books. There is no clamour from the countryside to relax the ban, rather a plea for government to focus on the issues which would really make a difference to their lives, like improving infrastructure and addressing the inequality of rural funding for schools and healthcare. This week's vote on relaxing the ban will, if passed by the Commons, cast a shadow over the reputation of the Conservative Party. MPs voting in favour will have failed to listen to the majority on an ethical issue about which public opinion could not be clearer. Few people go to the polls with hunting uppermost in their minds but reputation matters. I hope my colleagues will reject the shallow narrative from the hunting lobby that the proposals are a necessary measure for the countryside; they are not.

A free vote was promised in our manifesto. I hope that Conservative MPs will use it to send a clear message that the Party has moved on from hunting and instead signal our intention to focus on the real issues facing rural Britain.

45 comments

Sarah As a proud Devonian, and someone who has worked in London -- the centre of the political sphere and where everything now appears focused -- I can't see this Government, or the next, focusing on the issues that matter most to the people that live here or want to move here. If they did, then we wouldn't be having the same conversation as we did 30 years ago. In my view, if there was an appetite to 'fix' the infrastructure etc, then by now it would have been sorted. Perhaps the system itself is at fault -- let's face it if we had a 50 or 100-year strategy for the region then we wouldn't need to argue about different policies from different parties. Julian
- Julian Summerhayes

Thank you for this Sarah, I hope the ban is upheld and you are in the majority, and blood sports are consigned to the history books.
- Charlotte Davis

So pleased to see this, Sarah. Thank you.
- Ann Collyer

So glad to hear your comments. And yes the real issues are what MP's should be looking at, not a minority bloodsport that 80% oft this country don't want back. I have had many holidays in the South West for many years but the badger cull and now hunting could put me off from returning. I love the area and want to support our own holiday businesses but not at the cost of our wildlife.
- Simon Clarke

Also thank you. Riding out with other people on a drag hunt is a lovely day out but there should never be more than two hounds with the riders it is far too easy for the hounds to get involved in chasing a fox as they are definitely not the brightest dogs which is why the huntsmen can't always call them off.
- Lin Lobb

Thank you Sarah for being one of the enlightened MPs in this government. I am a rural landowner who suffers the same frustration as the rest of the country does on this issue. Fox hunting and other barbaric blood sports need to be assigned to the history books forever.
- Mary Dowson

Thank you for representing the views of many country folk. I graduated from agricultural college and worked in the agricultural industry for many years. I have also kept and ridden horses all my life. I am 100% opposed to foxhunting and I very much hope that the ban is retained - and made tougher and easier to enforce. I voted Conservative in the election and I hope that the MPs will give the country what the majority wants rather than bowing to the very loud and rather arrogant demands of the hunting fraternity.
- Hilary Boughton

Well said Sarah.
- Chris Libby

Thank you Sarah for presenting both a rational and democratic argument for retaining the ban. As you say, this issue is a moral one not a matter of freedom or choice, or even national boundaries. Fox hunting is neither necessary nor effective as the recent case of a hunt breeding foxes to kill proves. Killing animals for 'sport' is an act of gross depravity, which you rightly point out needs to be left in the past. Equally, this action by the pro-hunting element in Parliament is profoundly undemocratic as the Statutory Instrument cannot be amended by debate and is therefore a disingenuous attempt to subvert our normal legislative process. Hunting, whilst not the most pressing problem on the nation's mind is nevertheless a highly contentious matter that needs thorough examination before any amendments are made. I hope many other MPs will take note of this and vote down this measure on that basis alone if not on animal welfare grounds. I am concerned also that the elements of this amendment referring to terriers and underground working are aimed at further weakening the protection offered to badgers under the Protection of Badgers Act 1992 against interference by the hunts. The current situation regarding sett blocking and digging out by hunt members is already very bad and much of it goes on undetected let alone prosecuted by the authorities. As a previous poster has said, the reputation of the West Country in general and the Conservative party in particular has been severely damaged by the badger cull and now this. All power to your elbow in trying to bring it to an end.
- Peter Martin

Thank you Sarah for your opinions on what most consider a barbaric practice. I might even vote Conservative if there were more like you in the Party. Unfortunately I'm in the Tiverton and Honiton constituency - enough said!
- Jenny Keen

Fantastic news, thank you so much x
- Jenny Rogers

Thank you for representing our views so well. I am much relieved - you are so right that the torture of animals as a form of entertainment should be consigned to history. We support you in your stand.
- Lynn Alderson

Sarah, I would have hoped that you would have been better informed !. Without some control of the fox population (Hunting may in fact be the most humane method, culling the deceased/injured foxes). How do you think they will be controlled ?.... The Farmers, Keepers will have no choice but to shoot them, resulting inevitably in wounded foxes. Foxes as natural predators of other wildlife have to me managed.
- Charles Eyston

This isn't about 'relaxing the ban'; instead about making for more effective and humane control and management of the fox population. We know that farmers, including those in your constituency, would welcome these changes- please listen to them.
- Tom

Thanks. DEFRA doesn't even publish figures for fox predation on livestock because it's so minuscule yet it does for other causes. Farmers don't call in the hunt to control predators. Why would they when you see hunts like the Middleton Hunt raising cubs in outbuildings that can be hunted later in the season. You've restored my faith in the Tory party.
- David Thompson

I think it a great shame that there are still people that cling to the now comprehensively discredited notion that foxes 'need controlling' by humans. As a lifelong country dweller and keeper of free range chickens I fend these argument not only false but mendacious. The vast majority of foxes die of cold and starvation in the countryside because modern farming has stripped the rural landscape of much that foxes can eat (which is why so many end up in urban areas). The idea that ripping a fox apart is 'humane' would be laughable if it wasn't so cruel. Even if foxes did need controlling then hunting is the least humane method of all. However, no form of 'pest control' needs 40 people dressed up in 19t century costumes, riding horses over other people's land, damaging crops, fences and walls chased by forty out-of-control dogs. What other form of pest control begins with a glass of sherry? The public has rightly become tired of the dissembling, the lame excused and the outright lies put forward by the hunting lobby. MPs like Sarah Woolaston and Tracy Crouch are right to stand up to the bullying and patronising blandishments of those who claim to know about the countryside and the ecology of it's wildlife, but who clearly don't. Dr Woolaston and Ms. Crouch's attempts to bring the regressive rump of Conservative party into the 21st century are to be applauded. Their views not only represent those of the majority of the British people but also the true nature of the anachronistic horrors of hunting.
- Peter Martin

Thank you for respecting the views of the vast majority. Tom, hunts actually breed foxes for hunting...it isn't humane to tear foxes to pieces alive!
- Dave c

1. There is no evidence hunting is cruel: the Burns Inquiry rejected that suggestion. 2. Foxes are predators and require control - farmers (including us) DO call in the hunt to deal with foxes. 3. The Hunting Act was admitted by its proponents after the event to be class warfare ignoring the social mix of the hunting populace - it was a pure sop by Blair to his backbenchers (and he has consistently expressed his regret about it since). 4. The Hunting Act is bad law - unenforceable, illogical and wasteful of police and court time and limited resources. It is legal to use a dog below ground to flush a fox killing game birds, but not one killing lambs or chickens - that is about as illogical as one can imagine. 5. These amendments bring the law in England into line with that in Scotland. 6. All aspects of countryside management are a balance - lose the balance in respect of wildlife and disease soars - TB and mange being classic examples. 7. Evidence, not sentiment, is the proper basis for decision making in public office. 8.Laws are there to protect minorities rather than to persecute them. 9. A wrong, based on ill-conceived spite, was perpetrated on the hunting community in 2004 - the passage of time does not render that wrong any more justifiable - the Nazi theft of pure property of the Jews is only now being rectified 70 years later. 10. These amendments do NOT make hunting legal (more's the pity) but at least they make the ban logical and enforceable. 11. Your constituents deserve proper responses rather than a round-robin "Dear All" brush-off. 12. Try donning a pair of willies and leave the brown rice and sandals of Totnes alone for a few days - education is a worthwhile continuing process.
- Mark Treneer

Obviously my comment has not met with the approval required to actually appear on this page - censorship of a constituent's views is contrary to the fundamentals of democracy. Its rather unsurprising you claim a majority supports your view if you only read and post the one's you agree with and the most gentile of the others.
- Mark

The fox population does need controlling, I have given up keeping sheep because of the loss of twin lambs to foxes, adding insult to injury this morning I discovered all 19 of my lovely hens dead in their pen, a fox has scaled a 6 foot fence and killed the lot, eaten 3 heads and left the rest as it couldnt get the bodies out of the run. Terrible shame, but hunting with hounds still the best and most humane way to control their numbers. Predation much worse since the ban JANE
- jane

Sarah, The harsh reality is that foxes need controlling and this amendment provides for a sensible way ahead.
- David Larmour

What a pleasure to listen to sense being spoken by a politician! Well said Sarah, I wish you were my MP not Mel Stride. How is it that people think it perfectly acceptable to tear a fox to pieces but if it were their pet cat they would find it unacceptable - A fox kills to live, a cat kills for fun, neither deserve to be torn to pieces alive. PLUS I thought that the fox was supposed to be shot not killed by the hounds? I have yet to see a huntsman able to control the bloodlust in hounds that they have taught to kill!
- Diana D

Dr. Wollaston you are quite right: the desperate need for better rural housing, faster broadband, better bus services etc are all more important than fox hunting. It's a pity the Coalition didn't address these vital issues during the last parliament and of course the Labour government devoted 700 hours of Parliamentery time to banning fox hunting that could and should have been spent improving rural services. So you should therefore support your government's suggested changes to the Hunting Act to bring clarity to a defective law and to finally take fox hunting off the rural agenda so it can be replaced by issues that more directly affect the future and prosperity of the countryside. To that extent you are right, fox hunting should be consigned to history, but leaving the law ion the muddled state of the 2004 Act will only perpetuate its prominence on the rural agenda. By supporting your government's proposals you and your colleagues will create the space you need to concentrate to the more important issues affecting the country and the countryside.
- Henry Harington

Sarah, please consider your social conscience. Whatever opinions in and around Totnes may be, this great country of ours is underpinned by social and cultural diversity. Relative values vary regionally, for good and understandable reasons. Mutual respect for those differences is essential. I question your logic in assuming that local opinion is either relevant or appropriate on a national scale. More people hunt to hounds now than ever did before the ban. As such, your headline, “Time to consign hunting to history” appears as an attempt to impose, and possibly to curry local favour, rather than a considered appreciation of the many synergistic interrelations that comprise our national interest.
- Tony Hawkins

Sarah, you said you would listen to your constituents' views, that must include the hill farmers of Dartmoor that are in your constituency. So please respect their position and support this Bill.
- Margaret

Again, some quite astonishing intellectual vacuity on display here. Cruelty is not a matter of 'diversity' or 'opinion', or worse still 'tradition'?! What kind of thinking is that? We don't allow dog fighting on the grounds of 'diversity' or 'choice' and thankfully it's a 'tradition' that has long been illegal. That is because it is both cruel and immoral. The same applies to fox hunting; it is cruel and immoral and should be consigned to history. The fact that people actually enjoy it is a matter of grave concern. It is well established that people who are cruel to animals are also cruel to people. Equally, the fact that a law is badly drawn up is not an excuse for relaxing it but tightening it up. The law on hunting as it stands was a compromise designed to allow the tradition and socio-cultural aspects of it to continue but without the cruelty. It relied on those who continued with it to uphold their side of the bargain by being honest about what they were doing and to keep to the trail. The fact that the law has become 'unenforceable' is because the hunts have deliberately made it so. They have done everything in their power to subvert it, to lie and cheat and to go on killing. To then claim it should be repealed on these grounds is mendacious in the extreme. Shame on all of you. You bring shame on our nation, on our values and on our democracy.
- Peter Martin

Am very relieved to hear that you will be voting against. Thank you.
- Sarah Matthews

So many misinformed opinions regarding fox population control. Foxes are self regulating predators. They control their own population. This is governed by availability of habitat and food. Removing foxes only encourages more to enter the now vacant territory. This nothing more than basic ecology and backed up by hard scientific evidence. Those who believe foxes need to be controlled are either driven by a pro hunt agenda or are simply ignorant of the facts and blinded by pro hunt propaganda. The simple fact is hunts encourage and breed foxes to hunt. A somewhat strange situation when they cry "pest control" to justify their passion for cruelty. Lets hope these are the first steps to a total ban on all hunting with dogs, including the Beagling for Hares and Stag hunts.
- Accidental

This proposed amendment does not legalise fox hunting but merely brings the law into line with that in Scotland. I don't hear anyone suggesting that the Scots are more cruel as a result of their laws on hunting!! Indeed there is evidence to show that animal welfare is better supported by their law. The rumour that the SNP now intend to vote against this amendment is the sort of hypocrisy that brings politics into disrepute. Clearly this is an issue that still stirs strong emotions on both sides but this limited amendment would possibly lay it to rest for a generation and I therefore urge you to support the amendment.
- Graham Grose

Thank you for speaking for the majority unlike my MP charlie elthick who did not even have the courtesy to reply to my e mails !!
- Paula baker

There is no EVIDENCE that foxhunting is cruel. The Burns Inquiry established that, on the EVIDENCE. Fact. To assert that foxhunters are cruel to people is ridiculous - they do not go about in balaclavas and with staves in hand as the antis do. There is no EVIDENCE that foxhunters are baby-bashers or otherwise cruel to people. Fact. Evidence is the foundation of reason. Absence of reason is bigotry. A law based on bigotry rather than evidence has no place in a civilised society. Law based on evidence is the opposite of being mendacious - rather it is the illiterate in pursuit of the illogical.
- Deborah

You are very welcome to your new best friend Nicola Sturgeon and the SNP. They seem to want to vote on English domestic matters when it suits them. Where do you stand on that Dr W? It is pretty hypocritical of the SNP to want to vote against the amendments which bring the law in England into line with that in Scotland - which the SNP advocated.
- Barney

Killing foxes with a pack of hounds cannot be compared to pitching dogs bred for fighting against each other as a spectacle. That pack of fox hounds work together to kill efficiently and quickly. Hence the conclusions of Burns Enquiry; that there is no evidence for associated cruelty. There is no spectacle, other than of horses, hounds and people working together in the countryside, the kill itself very rarely being witnessed by any other than hunt staff. Working together, that is, because the fox population needs controlling. Hunts operate by invitation and permission of the landowner. If that landowner did not need foxes controlling, the hunt would not be there. In turn, the hunt needs financial support from its members, both landowners and others, who take pleasure and pride interacting within their community both to enable and help their huntsman effect such control. That huntsman trains his hounds to kill foxes more humanely than any known alternative. Whether in a majority or nearly so, the huge numbers of people that understand and support the control of foxes with hounds would not do so if, for a moment, they thought the practice either unnecessary or cruel. Anybody is welcome to support that practice and community. Those that prefer not to participate, perhaps because they have no immediate personal reason to see foxes controlled, should maintain respect for those that do, recognising that the patchwork comprising our diverse landscape and society will inevitably lead to different needs and priorities in space and time.
- Tony

Sarah, Put very simply to ease some troubled minds....In the real world, foxes need controlling - fact- and this proposed legislation therefore is a modification ONLY. The Hunting Ban was extremely bad legislation making a mockery of English Law and this will slightly improve things. Please listen to the countryside and vote with your party and not the SNP.
- Gavin Dollard

There is a great liberal tradition of tolerance here in the West Country and as a result your blog made sad reading. I urge you not only to read the Burns Report for a thorough science-based assessment (and endorsement) of hunting with hounds, but also to consider whether your own personal prejudices are not finding a convenient echo among a strident and illiberal few. Perhaps the greatest irony is that by voting against the amendment which will bring the English law in line with that currently operating in Scotland you will be handing a gift to the SNP. In your blog on Sept 20th 2014 you say "In my view that should mean that MPs representing English constituencies for Laws only affecting England should be considering devolved issues without interference from MPs representing other Nations within the UK".
- Gill L

So sorry that you appear so entrenched in your views Sarah and that you appear to have misunderstood the Amendment being presented. The vote tomorrow is NOT about repealing the Hunting Act, merely and at the request of hill farmers who suffer the most fox predation, to bring the Act into line with the law in Scotland. It is not about so called toffs on horseback, not about tearing apart a sentient animal, not about popularist blood lust. What is IS about is improving the ability of farmers, and hill farmers in particular, to control a pest species when necessary. I urge you to listen to your farming constituents and vote in favour of the Amendment. Not to support the Amendment will be to merely support the SNP and Labour in their attempt to give our PM a bloody nose. Do you want to be responsible for that? I had thought better of you.
- Suzy

Those stating fox hunting isn't cruel and there is no evidence to prove it is are very ignorant to the plethora of photographic and video evidence that exists already. What planet are you on? In addition, the hunters breed foxes for the purpose of hunting them, (again, proven) which immediately negates the argument that it is for control. The only animal that needs controlling are the hunters themselves.
- Sarah

As someone from a hill farming family (hundreds of sheep, 250 cattle) I couldn't disagree more with Suzy, if the farmer has a problem, he/she deals with it them self, or brings in a local marksman to dispatch of the animal quickly and humanely, not invite a bunch of want to be countrymen on horseback to tear up the land and knock down walls all in the pursuit of pleasure, what a ridiculous argument, you should be ashamed of yourself for being an apologist for this barbaric practice.
- Adrian

The fox hunting supporters disgust me to no end. I would welcome the opportunity to hunt you with horses and a pack of dogs and see how enjoyable you find it. Once we've cornered you and you're exhausted and terrified, then I will make a feeble attempt to call off the dogs as they rip into your flesh...but rest assured your agony will be short as I will then shoot you if you haven't been devoured. Then I will smear your blood on a child's face...indeed what a civilised way to spend a day. Time to end your archaic, bloodthirsty and psychotic views and step into the 21st century...are you surprised you're viewed as backward by city folk?
- Sabateur

Sarah, I was disappointed to read your comments, and receive your letter which I considered to be biased. Foxes do kill livestock! Predominantly hens and lambs. When they get into a hen coup it is not a case of taking one bird away for food, but a massacre of all the birds they can catch. This is not a pretty sight, and is most distressing for the owner. We need to control fox numbers as they have no natural predators, and flushing out foxes to a gun is more efficient and humane than ordinary shooting. When fox numbers become excessive they become diseased and often get mange, which they then pass on to domestic dogs and cats. Any dog walked in the country is in danger of catching mange which is a very unpleasant for both the pet and the owner. When we had a mangy fox locally it infected 9 pet dogs, and finally came into my barn to die where a friend put it out of its misery. It was in a terrible state, raw and skin and bones. The Amendment to the Act merely seeks to allow the hunts to go about their business in a more efficient manner and to help the farmers by controlling fox numbers. I am not asking you to agree with ‘hunting’, merely to point out that you blog is rather emotive and biased with the use for example of ‘blood sports’. You represent a constituency which has a large farming population and you are totally failing to give any consideration to their opinions and needs. I would urge that you re consider your stance. It is so important that our MPs are even handed and fair to all. Margaret
- Margaret

This amendment was not about hunting with hounds, it was about allowing the use of more then two hounds to flush a fox to guns, a change that would have animal welfare benefit, that is wanted by farmers and would have brought the rest of the UK into line with Scotland. You have shown understanding of this case; which makes your blog all the more disappointing. A 'shallow narrative' indeed.
- Jonathan

Adrian, no matter how many sheep and cattle your “family” may run, you cannot really believe that landowners “invite a bunch of want to be countrymen on horseback to tear up the land and knock down walls all in the pursuit of pleasure”. Landowners and farmers already find making ends meet quite difficult enough. Instead, hunts do all they can not to damage pasture etc, followers on horseback riding the margins or taking another route as may be appropriate, returning to repair any remaining accidental damage to walls and gates. Otherwise, the 190 fox hunting packs that thrive throughout the UK would not be invited back, and could not continue. Further to which, call me old fashioned if you like, but getting outside to help achieve something worthwhile in a broad social context deserves to be applauded, rather that sneered at.
- Hazel

The decision by Nicola Sturgeon on behalf of her Scottish Nationalist MPs in the English Parliament to vote against this amendment which would have only brought the law in line with that in Scotland which was supported by both the SNP and Labour party, proves without doubt the hypocritical and unprincipled manoeuvring of the SNP to give a bloody nose to the PM. The Westminster Parliament does not legislate on matters devolved to Scotland without the consent of the Scottish Parliament, and it is proposed that this be formally enshrined in legislation rather than existing as a parliamentary convention. Why should Scotland have the right to vote on matters affecting only England and Wales? Please Sarah can I ask you to join those asking for a strengthening of the proposals on English votes for English laws otherwise the rest of this Parliament is going to be dominated by a party led by a person who does not even represent a constituency in Parliament. A sad state of affairs whatever your view on the Hunting Act amendments.
- Suzy

Re. Peter Martin. Is it the hunting or the age old bitterness of those who seem obsessed by "gentry" ( nothing is further from the truth) out hunting .Hunts only traverse land over which they have permission ( more than some ramblers!!), hunt members are responsible to follow up any hunt and replace any broken fence etc( would members of the public were as good when traipsing happily through fields of growing corn, lambing fields or carefully managed coppices).By the way, can YOU recall your pet dog as well as the master's control over 20 couple of hounds? Try it !Go out with your friends with all their dogs ...20 will do for a start. Let 'em go in the local park and see how long it takes you to get them all back. By the way being a landowner is not the same as making your living from the land .Last but not least why is there no outcry over poisoning rats, which is not a kind death,or killing them with terriers? Or do you only care about "pretty" animals? Wind in the Willows mentality but real life is not like that..sorry.
- Ann

As a owner of land (who banned the hunt) in your constituency but living in an adjoining area, I can only wish you were my MP. Have a word with that woman Ann-Marie Morris will you? I understand she thinks this barbaric form of 'entertainment' should continue, no doubt believing she'll get some 'brownie points' from Dave for towing the party line. Well done you though, having intelligence, compassion and the balls to stand up for your principles.
- Tony

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29 JUN 2015

Tunisian Tragedy

18 of our citizens are amongst those confirmed dead in Tunisia and we can only imagine the grief of their families. Once again, ISIL has waged its cowardly war against the softest of targets. In times of war we should stop helping their propaganda machine to act as a gruesome recruiting sergeant.

Instead of publicising the names and smirking faces of terrorists or their sympathisers, let's see and hear the personal stories of the courageous Tunisians who formed a human shield on the beach; theirs is the true face of Islam. As David Cameron announces his resolve to end the online grooming through social media, isn't it time for the print and broadcast media to question their own editorial policies? The killers crave publicity for their crimes not just for their own vanity but because they know that this draws others to follow their example. We rightly criminalise child pornography but must now also stop the pictures and links to horrific snuff videos which enable ISIL to deploy the oldest weapon in history; to terrorise and undermine the enemy.

Whilst we grieve with the families of all the dead we should also keep countering ISIL's message of twisted grievance against the West by being clear that overwhelmingly it is Muslims who are being slaughtered by ISIL.

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23 FEB 2015

Why I will not be voting to undermine the Abortion Act

There is no doubt that female foeticide, notably in China, India and Korea, is distorting the gender balance of their societies and devaluing women and girls. That has consequences for all women reinforcing disempowerment and a lesser status.

There is no room for complacency in the UK and we need to remain vigilant.

The Department of Health has updated their analysis of male to female birth rates with data from 2008-2012 and this now includes ethnicity. Without exception, birth ratios were within the expected range for all UK communities, including analysis by ethnicity and birth order.

There may be individual cases but it would be entirely wrong to stigmatise entire communities in Britain by suggesting that this is in any way a common or systematic practice here ...it is not.

For those individual women who do feel under pressure not to continue with a pregnancy purely on the grounds of gender, Fiona Bruce's proposed amendment to the Serious Crimes Bill, will have unintended consequences. Far from protecting them, fear of criminalisation means that these women will not attend their doctor's surgery or clinic prepared to discuss the pressures they face but will present with an entirely different reason for requesting a termination of pregnancy. The opportunity will be lost to talk about any threats or actual domestic violence an individual may face for giving birth to female children.

The amendment is also unnecessary because doctors already know that it is against the law to carry out an abortion solely because of the gender of the foetus unless there are other grounds, for example the risk of a sex-linked inherited medical condition. The updated guidance from the Department of Health and the Chief Medical Officer clearly allows the Director of Public Prosecutions to prosecute should any cases arise. The Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives have made it clear that they consider the amendment unnecessary as sex selection is already unlawful. Their members know this.

If passed there is a grave danger however, that it will create uncertainty in the law for those families affected by serious sex-linked medical conditions for example X-linked severe combined immunodeficiency syndrome and X-linked spinal muscular atrophy. There are a number of these conditions and it is not always possible to detect them by genetic testing. The proposed amendment may make it impossible for these families to retain the choice not to proceed with pregnancies where there is a risk of one of these terrible diseases.

There is another reason to oppose the amendment and that is because it is a veneer, its underlying effect will be to erode the Abortion Act. The term 'unborn child' within this amendment completely changes the framework of abortion law. Across our legislation and common law, children are afforded a wide range of protections and rights that are not afforded to the foetus.

It would be entirely wrong to effect such a major change on the basis of a short debate on an amendment sneaked onto the coat tails of wording which appears at first sight to have the intention of protecting women.

This is a Trojan horse. The underlying agenda of many of those behind this amendment is to erode women's access to safe and legal abortion altogether and I will be voting against it.

6 comments

Thank you for voting against this, and for speaking out.
- Cicely

Thank you. I agree with everything you had said. I do wish people would also be brave enough to stand by the pro-choice principle completely though. That sex-selective abortions happen is horrible for what it indicates - that some value women and girls less than men and boys. We absolutely should work on tackling gender discrimination. But abortion rights shouldn't even be up for discussion. Women shouldn't be forced to continue with a pregnancy. At all. What their reasons are for not wanting to do so is irrelevant.
- Nic

Thank you for taking this seriously and thank you for your decision to vote against this amendment.
- Claire

I have recently been made aware of your comments about stigmatising communities. I am incredulous at the logic - where something is wrong, it is important that we say so. Sex selective abortion is wrong and whoever is guilty of it, from whichever community should be brought to justice.
- Paul

Paul is right. The argument about "stigmatising communities" is disingenuous. Perhaps FGM should be allowed?
- David

Doctors are going around the law - as the Telegraph investigation proved. A private prosecution, as the CPS disregarded their duty, was started. It has now been taken over by the CPS and shut down. They must have waited until the vote was lost before doing this, knowing full well that had they shut it down before the vote it would have proven that the existing law is not being enforced. Whether you agree or not with the law as it currently stands, it's highly deceitful to claim that it is being enforced when it's plain as day that it isn't. This is an attempt to pretend it's being enforced so as to prevent the new amendment going ahead, which would make sure we protected female babies. And if the existing law isn't being enforced, and you are opposed to the amendment that clarifies it, then ipso facto you are saying that you agree that the current position of allowing female foeticide in practice but not in name is acceptable. The numbers are also secondary, would we allow the murder of born female children as long the numbers were low and it was done by nice people and mostly ignored so as not to trouble us when we read the newspaper at breakfast? Of course not.
- EK

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23 FEB 2015

Remember The Real Victims of IS

Several press reports describe the latest trio of teenagers as 'jihadi brides' fleeing the country for Syria. In what sense can their actions be described as 'fleeing' when that is defined as running away from a place or situation of danger? There are risks in glamourising these girls by describing them as 'A-grade' students yet in the same paragraph portraying them as if they are merely passive victims of social media grooming. That is an insult to the countless thousands of women and girls who are the real victims of IS. Even the most cursory of Internet searches starkly sets out the consequences for brave women human rights defenders like Samira Saleh Al-Nuaimi, tortured and publicly murdered last year in Mosul. Do those who actively choose to join IS bother to consider, let alone care about the mass murder, enslavement and rape of Yazidi girls, Shia, Christians, atheists, members of the LGBT community or in fact anyone not following the same bigoted world view as IS? Do bright teenagers with capacity share any responsibility for doing their homework on the horrors that lie ahead or the lives they may endanger in any attempted rescue?

Girls sometimes join ultra-violent gangs because they are forced to do so as a result of extreme coercive control and abuse; they desperately need help and support rather than punishment. Ultimately it is for the courts to decide the capacity these teenage gang members have to make decisions for themselves and the degree to which they are victims of grooming or culpable for colluding with terrorism.

In the meantime it only helps to fuel the pipeline if they or their actions are glamourised as 'jihadi brides'. Try replacing that term with 'ultra-violent gang member' to tell it how it is.

Time too to ask why it is so easy for unaccompanied minors to fly to countries that have become the known supply routes for the murderous ranks of IS.

4 comments

I am in complete agreement with your blog post. It is ridiculous to victimise, or pathologise these girls. If they return, they should be assumed to represent a danger to our security, and lives. In that cicumstance, they should be held in a secure environment until such time that it is proven that this is no longer the case. In my opinion, the fact that they were prepared to with hold their plans from their parents, whilst making, and acting upon, their plans, proves that they were fully aware.
- Mark

Very well said, these girls are not victims but young women who despite being well educated have chosen to leave their families and turn their backs on this country to join a vile band of thugs. They have read the stories and seen the videos of the atrocious acts that these people commit and yet have chosen to leave the UK to join them. I hope they find what they are looking for and do not try to return to this country.
- Jan Cadle

Exactly - keep saying this out loud.
- Claire

Extremely well put
- Susan Morrison-Jones

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21 JAN 2015

Health Select Committee Complaints and Concerns Inquiry

Most people experience really great care in the NHS but sometimes things can go wrong. Most of those who complain about NHS services do not seek financial redress. They do so because they wish to have their concerns and experiences understood and for any failings to be acknowledged and put right so that others do not suffer the same avoidable harm.

Where such errors occur, patients and their families deserve to be met with a system which is open to complaints, supports them through the process and which delivers a timely apology, explanation and a determination to learn from mistakes.

The current system for complaints handling however, remains variable. Too many complaints are mishandled with people encountering poor communication or at worst, a defensive and complicated system which results in a complete breakdown in trust and a failure to improve patient safety.

The Committee welcomes the progress made since our last report but in this, our final report on complaints and concerns in this Parliament, we set out an overview of the developments and recommendations to date as well as those expected in 2015. We also make a number of recommendations where we feel further action is required.

As we aim to move to a culture which welcomes complaints as a way of improving NHS services, the number of complaints about a provider, rather than being an indicator of failure, may highlight a service which has developed a positive culture of complaints handling and it will be important for system and professional regulators alike to be able to identify the difference.

Complaint handling remains overly complex and we recommend a single gateway for raising complaints and concerns with clearer, adequately resourced arrangements for advocacy and support.

The removal of primary care complaints handling from local areas has resulted in a disconnection from local knowledge and learning and led to unacceptable delays. We recommend that this is rectified.

There is also a strong case for integrating complaints about health and social care under the same umbrella and this should start with a single rather than separate ombudsmen. There is now no excuse for any health or care organisations not to implement the recommendations of the 'My Expectations' report on first tier complaints as this has clearly set out a user led guide to best practice.

Just as we expect the NHS to respond in a timely, honest and open manner to patients or families raising complaints or concerns, we should expect the same for staff. The treatment of whistleblowers remains a stain on the reputation of the NHS and has led to unwarranted and inexcusable pain for a number of individuals. The treatment of those whistleblowers has not only caused them direct harm but has also undermined the willingness of others to come forward and this has ongoing implications for patient safety. Whilst this committee is clear that professionals have a duty to put patients first and to come forward with their concerns we recommend that those who have suffered harm as a result of doing so and whose actions are proven to have been vindicated, should be identified and receive an apology and practical redress.

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12 JAN 2015

Cartoonists have protected us for centuries, long may they continue

How should we respond to the murderous attack in Paris at the offices of Charlie Hebdo? Their editor, Stephane Charbonnier, wrote that he would 'rather die standing than live on his knees'. He was murdered defending for all of us the right to free speech, which includes the right to mock and deride. Cartoonists have been holding the powerful up to ridicule on our behalf for centuries, especially those who exert power through religious oppression.

Across Europe, but not in the UK, a number of papers responded to the murders by covering their front pages with Charlie Hebdo cartoons. Good for them. Who had the greater courage, the masked murderers armed with assault rifles or the cartoonists armed only with their pens? It will be a tough decision for editors as printing cartoons poking fun at Islam now means weighing up the risks not only to themselves and their families but to their staff.

If that means we all pay to increase their protection if they decide to do so, that is a price we should be prepared to pay.

Around the world fundamentalism seeks to crush freedom, be that the right to an education for girls or even the right for women to express an opinion or show their faces in public. The West must respond to this chilling advance of barbarism and be prepared to stand up for our values, including the right to lampoon religion, or we too will live on our knees.

Muslims were among the victims in Paris and worldwide the fanatics have especially targeted their vicious hatred against those not following their own warped version of the faith. Of all the responses to the massacre, the most cowardly would be to stigmatise or attack the vast majority who reject violence. It is time for the media to give a louder voice to the outrage of the many Muslims who are saying loud and clear; not in my name.

Earlier this week, before the long shadow from events in Paris, the news was focused on waiting times in A&E. They matter because are a barometer of pressures across the whole NHS. The underlying causes are often complex and vary from hospital to hospital. Delayed discharges leading to difficulties admitting to the wards may be the principle cause in one area or a surge in demand and complexity at the front door in another. Across England the NHS is coping with around 2500 more people every day in casualty alone compared with 2010 and they are arriving with more complicated conditions. Anyone who has spent a Friday night in A&E will also know the unwelcome and avoidable strain caused by those arriving drunk and insensible. In some areas, staffing levels are a contributing factor as there is a national shortfall in doctors training to become A&E specialists and GPs. NHS 111 also needs to go further in reviewing how and where it signposts callers needing further face to face advice.

Politicians must not pretend there are simple causes or solutions, in fact A&E waiting times are far worse in Labour run Wales despite higher spending power per head and across Europe. It is an insult for Ed Milliband to have spoken of 'weaponising' the NHS for political gain. There has been no extension of charging for health services in England and neither are we moving towards a 'US style' health system because both Coalition Parties are absolutely committed to healthcare remaining free at the point of use, based on need and not ability to pay.

Instead of the mud slinging, it's time for all Parties to back the independent NHS Five Year Forward View and to set out in their manifestos whether and how they will commit to funding it in the long term.

To those talking down the NHS a reminder from the international Commonwealth Fund, it remains the best in the world.

1 comment

I agree entirely with the above and I feel Sarah Wollaston is in tune with the majority of UK citizens.
- Jeff Clarke

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02 JAN 2015

We owe a debt of gratitude to returning aid workers, subjecting them all to compulsory quarantine would be counterproductive and unnecessary

As the nurse Pauline Cafferkey fights her own battle with Ebola at an isolation unit in London, questions have been raised not only about why she was allowed to board a flight from Heathrow to Glasgow, but also about whether all returning aid workers should be placed in quarantine.

In fact, the greatest risk to the UK from Ebola would undoubtedly come if the disease raged further out of control across west Africa. Aid workers, our Armed Forces and NHS volunteers are putting their lives on the line to help to stop this happening. They deserve our thanks and huge respect, not to be treated as pariahs on their return as a result of alarmist reporting.

Some of the commentary on social media about returning humanitarians – from the likes of Katie Hopkins – has also been ugly. There will be serious consequences to whipping up a panic that appears to blame aid workers for exposing us to an avoidable risk, when the truth is that we are all far safer as a result of their courage.

Ebola continues to take a terrible toll across west Africa, having caused more than 7,000 deaths, so no one doubts the need for extreme caution. Thankfully, the efforts of our aid workers are already making a difference: the R0, the number of new cases passed on by someone who is infected, has fallen from 1.6 to 1.2 as a result of our involvement in Sierra Leone.

Education about the risks from body fluids and traditional burials, alongside measures such as early identification, isolation and treatment of those affected, are helping to turn the corner where fragile local health systems had collapsed. Other measures – such as the mass treatment for malaria – have reduced the number of people with near-identical symptoms but who do not have Ebola turning up for avoidable isolation and testing.

In the UK, any outbreak would be rapidly contained as our isolation and treatment facilities are ideally placed to cope with the very small numbers of expected cases in exposed aid workers.

It's worth remembering that brave nurses like Pauline Cafferkey are at risk because they are treating patients at their most infectious – in the later stages of the disease, when diarrhoea and vomiting have set in. They are also doing so in extremely difficult conditions.

The call for mandatory quarantine on their return to the UK may at first sight look reasonable but Public Health England (PHE) is right to weigh up the potential unintended consequences of such a policy, which could encourage those returning from high-risk areas not to report their travel history for fear of being placed under virtual house arrest.

It's surely far better to have a system where returning aid workers and high-risk travellers can remain under active surveillance with regular contact from the NHS and clear pathways to immediately report the earliest onset of any symptoms. The risk to others in the first stages of Ebola is negligible as it is spread by direct contact with infected body fluids. Sitting next to someone incubating Ebola does not carry a risk because the virus isn't airborne.

The disgraceful hounding of the aid worker Kaci Hickox in Maine exemplified the dangers of a panicked response to returning humanitarians. Her quarantine order was eventually overturned by a judge in favour of our own evidence-based active surveillance and reporting approach.

Of course, PHE will urgently need to review their criteria for transferring at-risk returning aid workers for formal testing, given that Pauline Cafferkey reportedly raised concerns about early symptoms but was checked several times at Heathrow and found not to have a fever. It must also issue clear, consistent advice on social contact for those returning from Sierra Leone and share that with the public.

If, however, we deter future aid workers by ostracising them or submitting them to draconian confinement, even if they have no signs or symptoms, we will risk fuelling the humanitarian disaster in west Africa. If we lose the fight there, we would soon be fighting it on multiple fronts here in Britain. The real danger would then be from an influx of returning travellers and those trying to escape the risk of infection who had already been exposed. It's all the more depressing, therefore, to read the mean-spirited and alarmist comments about returning aid workers. If risking your life to help strangers and to protect us at home in the UK doesn't make you a hero, what does? The very least we owe them is a decent welcome at the airport and an individual journey home. Would I be happy to share a cab with one of them? It would be an honour.

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