Witney GP: "Nobody supports the NHS changes"

Senior GP in David Cameron's own constituency tells New Statesman "things are going to fail, hospita

In an exchange over the government's controversial health reforms at Prime Minister's Questions last Wednesday, David Cameron cited "a supportive GP . . . who hails from Doncaster [Ed Miliband's constituency]".

In this week's New Statesman (on newsstands tomorrow), Sophie Elmhirst travels to David Cameron's own Witney constituency in West Oxfordshire, where a senior partner of a local GP practice tells her:

"I would say very few GPs are happy with [the NHS reform] at all . . . Not a question of supporting it, it's a question of going along with it."

"In my practice, nobody supports the changes . . . people think there should be more clinical involvement in commissioning. But I don't think many people think that GPs are the right people to commission. They need input into it - but if we wanted to be managers we would have trained to be managers, not doctors. "

The GP adds:

"Most GPs are incredibly worried about conflict of interest. How can you be a patient's advocate and look after the money? A lot of people think the whole thing's designed to fail so they can bring private providers in. It's the one big bit of the economy that hasn't got private money in it."

Of the effects to patients from the health service overhaul, the Witney GP says:

"The public have just got no idea what's hitting them . . . Things are going to fail, hospitals will close, because the money's not going to be there. Things will get taken over. And if you're going to have to make a profit out of it, you're not going to have the same service."

In the same report, Elmhirst speaks to Dr Paul Roblin, the chief executive of Berkshire, Buckinghamshire & Oxfordshire Local Medical Council, which covers Cameron's Witney constituency. Speaking about the health and social care bill, currently working its way through the House of Lords, Roblin, a retired GP, says:

"It's a major change which is quite experimental at a time when the NHS is trying hard to save money. The timing doesn't seem to be good. Among GPs there's a huge spectrum of enthusiasm from those that think commissioning will work to those who think that think it's another fad in the NHS and will soon pass."

"There is a large bulk in middle just watching events, and waiting to see what happens. [They are] slightly perturbed - they didn't go into medicine to do that sort of thing [commissioning] and it's a distraction from actually seeing patients."

"Many GPs are fed up with continual NHS restructuring.... The actual job... takes a back seat for many years while the restructuring is taking place. It's a very wasteful process."

Roblin issues a personal message to the prime minister:

"Produce an environment where people within the NHS can concentrate on what really matters which is patient care rather than structural reorganisation. Because continual change is draining and wasteful. They describe it as modernisation. I think they should stop using that political euphemism."

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Mass surveillance doesn’t work – it’s time to go back to the drawing board

Lacking an answer to the problem of radicalisation, the government has confused tactics with strategy.

This week saw the release of not one but two parliamentary reports on the government’s proposed new spying law, the first from the Intelligence and Security Committee and the second from the Joint Committee on the Draft Investigatory Powers Bill.

Both reports suggested the government hasn’t fully made the case for some elements of mass surveillance put forward in the Bill. But neither went so far as to ask the most important question in this debate – does mass surveillance actually work?

The proposed law, known as the Investigatory Powers Bill, looks set to enshrine almost all the government’s mass surveillance powers and capabilities in a single law for the first time. It has been touted by the Prime Minister as a vital weapon in the UK’s fight against Islamic State.

Most of the noise about mass surveillance since the Snowden revelations has predictably come from civil liberties groups. But the privacy and safeguards debate skips over the highly dubious assumption underpinning the Investigatory Powers Bill – that mass surveillance will stop terrorists.

In fact, mass surveillance is not only ineffective but downright counter-productive.

A 2009 report by the US government found that only 1.2 per cent of tips provided to the FBI by mass surveillance techniques made a significant contribution to counter-terrorism efforts. Another recent study by the New America Foundation found that National Security Agency mass data collection played a role in, at most, 1.8 per cent of terrorism cases examined. By contrast, traditional investigative methods initiated 60 per cent of investigations. Suddenly mass surveillance doesn’t seem so vital.

This is because the technology is far from perfect. As computer scientist Ray Corrigan has written, “Even if your magic terrorist-catching machine has a false positive rate of 1 in 1,000—and no security technology comes anywhere near this—every time you asked it for suspects in the UK it would flag 60,000 innocent people.”

Perversely, this lack of precision means mass surveillance can actually frustrate counter-terrorism efforts. Michael Adebolajo, who brutally murdered Fusilier Lee Rigby in 2013, was so well known to the security services prior to the attack they had even tried to recruit him as an informant. Yet insufficient monitoring later on let him slip through the net. The same thing happened with the Hebdo killers. Mass surveillance means intelligence analysts are forced to spend their time fruitlessly sifting through endless reams of data rather than carrying out the targeted monitoring and detection that’s really needed.

Counter-radicalisation experts have meanwhile argued that mass surveillance may alienate Muslim communities, making them distrustful of the police and possibly even contributing to radicalisation. In 2014, Jonathan Russell from the counter-extremism group Quilliam wrote that the “introduction of a sweeping [mass surveillance] law…will be exploited by extremists to show that the government wants to spy on its own citizens [and] that all Muslims are suspected of being terrorists.” This will set alarm bells ringing for those who know the fight against terrorism will ultimately be won only by preventing radicalisation in the first place.

And therein lies the real problem with this Bill. It’s tactics, not strategy. If we stop for a second and think about what the problem is – namely that thousands of young Britons are at risk of radicalisation – we’d never prescribe mass surveillance as the answer. It would be nonsensical to propose something that risks making alienation worse.

The trouble is we don’t have a convincing answer to the actual problem. The government’s counter-radicalisation strategy is mired in controversy. So instead a different question is being posed. Not how do we stop people from signing up to join Islamic State, but how do we gather as much communications data as possible? GCHQ have an answer for that. It’s a classic case of confusing a tactic – and a highly unreliable one at that – with a strategy actually designed to tackle the root of the problem.

Never mind our privacy for a moment. For the sake of our security, it’s time to go back to the drawing board and think of something better.

 

Andrew Noakes is Senior Advocacy Officer at the Remote Control Project. He writes about covert and unconventional methods of warfare, counter-terrorism, and human rights.