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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How the Standing Rock fight will continue

Bureaucratic ability to hold corporate interest account will be more necessary now than ever.

Fireworks lit up the sky in rural North Dakota on Sunday night, as protestors celebrated at what is being widely hailed as a major victory for rights activism.

After months spent encamped in tee-pees and tents on the banks of the Canonball river, supporters of the Standing Rock Sioux Tribe finally received the news they’d been waiting for: the US Army Corps has not issued the Dakota Access pipeline with the permit it requires to drill under Lake Oahe.

“We […] commend with the utmost gratitude the courage it took on the part of President Obama, the Army Corps, the Department of Justice and the Department of the Interior to take steps to correct the course of history and to do the right thing" said a statement released by the Standing Rock Sioux tribe’s chairman, Dave Archambault II.

With the camp’s epic setting, social-media fame, and echoes of wider injustice towards Native Americans, the movement has already earned a place in the history books. You can almost hear the Hollywood scriptwriters tapping away.

But as the smoke settles and the snow thickens around the thinning campsite, what will be Standing Rock’s lasting legacy?

I’ve written before about the solidarity, social justice and environmental awareness that I think make this anti-pipeline movement such an important symbol for the world today.

But perhaps its most influential consequence may also be its least glamorous: an insistence on a fully-functioning and accountable bureaucratic process.

According to a statement from the US Army’s Assistant Secretary of Civil Words, the Dakota Access project must “explore alternate routes”, through the aid of “an Environmental Impact Statement with full public input and analysis”.

This emphasis on consultation and review is not big-statement politics from the Obama administration. In fact it is a far cry from his outright rejection of the Keystone Pipeline project in 2015. Yet it may set an even more enduring example.

The use of presidential power to reject Keystone, was justified on the grounds that America needed to maintain its reputation as a “global leader” on climate change. This certainly sent a clear message to the world that support from Canadian tar-sands oil deposits was environmentally unacceptable.

But it also failed to close the issue. TransCanada, the company behind Keystone, has remained “committed” to the project and has embroiled the government in a lengthy legal challenge. Unsurprisingly, they now hope to “convince” Donald Trump to overturn Obama’s position.

In contrast, the apparently modest nature of the government’s response to Dakota Access Pipeline may yet prove environmental justice’s biggest boon. It may even help Trump-proof the environment.

“Although we have had continuing discussion and exchanges of new information with the Standing Rock Sioux and Dakota Access, it’s clear that there’s more work to do”, said the Jo-Ellen Darcy, the Army’s Assistant Secretary for Civil Works.

Back in July, the same Army Corps of Engineers (which has jurisdiction over domestic pipelines crossing major waterways) waved through an environmental assessment prepared by the pipeline’s developer and approved the project. The Standing Rock Sioux Tribe subsequently complained that the threat to its water supply and cultural heritage had not been duly considered. This month’s about-turn is thus vital recognition of the importance of careful and extensive public consultation. And if ever such recognition was needed it is now.

Not only does Donald Trump have a financial tie to the Energy Transfer Partners but the wider oil and gas industry also invested millions into other Republican candidate nominees. On top of this, Trump has already announced that Myron Ebell, a well known climate sceptic, will be in charge of leading the transition team for the Environmental Protection Agency.

Maintaining the level of scrutiny finally granted for Standing Rock may not be easy under the new administration. Jennifer Baker, an attorney who has worked with tribes in South Dakota on pipeline issues for several years, fears that the ground gained may not last long. But while the camp at Standing Rock may be disbanding, the movement is not.

This Friday, the three tribes who have sued the Corps (the Yankont, Cheyenne River, and Standing Rock Sioux Tribes) will head to a hearing before the Inter-American Commission on Human Rights, seeking to increase pressure on the government to comply with both domestic and international law as it pertains to human rights and indigenous soveriegnty. 

What the anti-pipeline struggle has shown - and will continue to show - is that a fully accountable and transparent bureaucratic process could yet become the environment's best line of defence. That – and hope.

India Bourke is an environment writer and editorial assistant at the New Statesman.