Having been a GP, an NHS manager, and a chair of social services, Liberal Democrat MP Jenny Tonge has a rare perspective across the rugged landscape of health and social care.
As a family doctor in the 1960s she saw what she regarded as 'absolutely appalling' financial management of the old NHS.
As a councillor who chaired Richmond social services in the 1980s she got 'fed up with the arrogance of the NHS'. Later, as a community services manager, she despaired of the 'bureaucracy' of social services.
The MP for Richmond Park has now brought her sceptical eye to bear on the government's plans for primary care groups. 'I think they are living in cloud-cuckoo land.' She recalls attempting to manage community services for West London Healthcare trust between 1992 and 1997. 'I was trying to get GPs into locality groups. It was impossible. They didn't want to know.'
As someone who was pro-GP fundholding, she keeps watch on the development of local PCGs, and worries that GPs' historical failure to get along with one another will lead to patchy progress. 'There is one PCG at stage two, about to move to stage three next year; another group of GPs haven't even started - they're still warring.'
Born in Walsall, Dr Tonge trained at University College Hospital. First a GP, she moved into community health with a special interest in family planning. That led her to campaign for easier access to emergency contraception, the topic of a recent Commons adjournment debate which she called her 'contribution to the NHS 50th anniversary.' It also led to a vicious counter attack from anti-abortionists, and a Daily Mail article headlined 'Abortion over the counter', which she says still rankles. But she is confident that she can get government support for the measure.
Other legislative ambitions may prove less fruitful in the short term. She favours voluntary euthanasia in the form of living wills - a subject of controversial debate at the Lib Dems' annual conference last year. Then there's legalising cannabis. She has embarrassed the government by pointing out that it recently reclassified Khat - a potent hallucinogenic foodstuff imported for theYemeni community - as a 'herbal stimulant', which allows it to levy VAT.
As Lib Dem spokesperson on international development, she now has another perspective on healthcare. 'We talk of xenotransplants and IVF, and on the other side of the world they have not even got enough water to drink. It makes you think where your priorities lie.'