This week: Labour MP for Stockton South, Dr Paul Williams
Why he matters: Prior to the 2017 general election Dr Williams worked as a GP in Stockton and was also the chief executive officer of Hartlepool and Stockton Health GP Federation. After securing a shock election victory, he has wasted no time in using his new role as an MP to champion a range of health issues – as part of the House of Commons Select Committee and in the chamber.
“I got totally elected by accident,” says a laughing Paul Williams.
“For a long-time I’d harboured a secret ambition to be an MP, but I’d kind of accepted that I should just get on with my life. I’ve got a young family, I’d thrown myself into trying to improve the quality of life and cohesiveness of local general practice. Nobody was expecting an election, the seat that I stood in looked like it was going to be a Tory landslide. It was almost seen as a favour to the Labour party that I stood in that seat, [so] not much attention was paid [to my candidature by the party].”
Which is how a man who backs the limited use of private sector providers by the NHS and supports the UK remaining in the EU was swept to power on a wave on Corbyn euphoria to become the elected representative of the leave-voting Stockton South.
Dr Williams still works two mornings a month as a GP “to just about keep my hand in” and to experience “a massive dose of reality” away from the Westminster bubble.
He says the biggest shock to his system has been the suspicion with which he is now sometimes treated outside the consulting room.
“Nobody questioned my motives until the moment I became a MP, and then suddenly people start to think I’m somehow doing this for some reason that I might benefit from. I haven’t changed one little bit, and I’m often saying the same things to the same people. I’m conducting myself with the same level of integrity that I always have, but people are massively suspicious. It’s really uncomfortable for me. I feel like I have to prove to people all the time that I’m genuine.”
Dr Williams echoes the views of his fellow medic MP Philippa Whitford in being “disappointed” by the quality of the parliamentary debate on health but impressed by the “deep integrity” of most individual politicians.
He suggests the central weakness in parliament’s approach to healthcare issues is that it is not driven by evidence.
“Most parliamentarians’ views about the about health services are very much rooted in their own experiences. There are loads of worthy campaigns [championed by] parliament, but they’re largely not [chosen] because somebody has done an analysis of what are the greatest issues [facing the NHS].”
Dealing with constituents has made him realise how much pressure MPs can come under to support almost any cause.
“A constituent contacted me yesterday and said that her dad was dying of advanced prostate cancer and ‘would I campaign for PSA testing for everybody because, you know, that’s obviously that’s a good thing in order to be able to identify prostate cancer earlier.’”
He acknowledges it is very hard not to feel sympathy for someone in that sort of situation and want to do something to help, “but I’m scientist. I’ve got to apply scientific methods to my politics as well. I want to see evidence-based politics, not anecdote -based politics”.
He says he has taken the same approach to Brexit: “I’ve looked at the facts and I’ve decided to do what I think is in the best interest of the people that I represent. I’m not going to be the kind of politician that is suddenly going to pretend that I believe something different just because it’s convenient.”
Dr Williams admits, however, that he has learnt that evidence is rarely enough to win a political argument. He says he’s just started to learn how to use “narrative” and “emotional connection” to become a more effective politician.
“But anecdote should support the science, not replace it”.
The market can work
The Stockton MP is no fan of the Health Act 2012, which he says was mistaken in “giving all the power to GPs”. Primary care doctors, he says, have a good idea of the “demands” made by local populations but may not necessarily understand their “needs”.
The reforms took GPs’ “inherent conflicts of interest” too lightly and increased tendering, which often “wastes an awful lot of time and energy”.
Despite his objection, Dr Williams got involved and became his clinical commissioning group’s clinical lead for mental health, saying: “Even though you might not agree with the system, you have to use whichever system exists in order to try to achieve the things you believe in.”
He also says the NHS’s adoption of the market can benefit patients.
“I found that by involving loads of different providers in the provision of IAPT services, it was much better for patients because it massively increased the availability. It drove down waiting times [and] it took services out into places where people wanted them to be. The ‘market’ resulted in something that was better for patients and helped nip [mental health] problems in the bud.”
The former GP federation lead is a strong supporter of the moves to develop integrated care organisations.
Dr Williams robustly rejects the idea that accountable care organisations (as they were previously known) are a Trojan horse for a Tory conspiracy to privatise the NHS. He cites the report produced by the Commons health committee which “didn’t find any evidence” of systematic privatisation.
He recognises this view will put him at odds with many prominent Labour NHS campaigners, but declares: “When people are presenting me with a political argument for which there is no evidence, I’ll stick with the evidence, thanks.”
Dr Williams said he “can’t see any reason why” Labour should not support a change in legislation along the lines proposed in the NHS long-term plan.
He recognises that “both sides are likely to try and play some tricks” with legislation to reform the Health Act 2012, but states: “You then have to work out whether to completely dismiss the legislation because of that or to try and find a way to make it work.”
Dr Williams is clearly in the latter camp.
A view that might find more favour with his Corbynista colleagues is his desire to end the independent contractor status of GPs.
“I’d love to see the NHS being completed by the addition of general practice,” he says.
For a start, Dr Williams believes this shift would support the “emerging model of a larger population-based health unit that is as well led and as strong as a hospital” and provide a “much more secure employment model” for the changing GP workforce.
He believes the current structure of general practice “makes it very hard for the NHS to make the kind of investments it needs to in primary care, because, you have to build in the fact that when you contract with a practice it is often going to want to make a margin on that”.
“The vast majority of GPs do the work for very altruistic reasons. But… I’ve tried to persuade GPs to do health checks for people with learning disabilities [and they’ve said] ‘I’m not making any margin on that, why should I do it?’
“I went to see [medic turned comedian] Adam Kay and he had a real rant about Jeremy Hunt [suggesting] doctors were in it for the money, and he sort of said, ‘there are no doctors that do it for money’. I sat in my seat and squirmed and I thought, ‘There are some that are’. It’s like in any profession, it’s just natural.”
Next week: The Guardian’s Polly Tonybee
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