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The MP Interview: Caroline Lucas

On proportional representation, the failure of austerity, and growing up with the <em>Daily Mail</em

What made you go into politics?
I come from a very conventional and non-political background. The only newspaper in our house when I was growing up was the Daily Mail, and we would never have dreamt of discussing politics around the dinner table. So my involvement in politics came about through activism. I joined the Campaign for Nuclear Disarmament in the 1980s and protested at Greenham Common. I supported other causes too – fighting discrimination and environmental degradation – but it was only on reading Seeing Green by Jonathan Porritt in 1986 that I realised all these issues were underpinned by the political process. The Green Party offered a political solution which recognises the connections: how our economy is built on the use of finite resources in other countries; how this leads to the exploitation of the people of those countries, interference in their political freedom, even military commitments and involvement in wars; and how those who make their money and gain their power through such economic relationships are all too well-placed to influence decision-making behind the scenes.

What job did you do before you became an MP?
I worked for Oxfam for 10 years, most recently as head of their Trade policy team, and also had a year's secondment to help set up a new international trade department in Dfid. I also held various positions in the Green Party, including national press officer, Principal Speaker, and now Leader, and won our second council seat in the UK on Oxford County Council. In 1999 I was elected to the European Parliament as the Green member for the South East and served until 2010, when I became the UK’s first Green MP, representing my constituency of Brighton Pavilion.

Which law would you scrap?
I’d like to be even more ambitious and change the central policy of this government – that of budget cuts and austerity.   A government can’t cut its way out of a recession any more than you can dig yourself out of a hole. It’s not just a question of "too far too fast", as Labour claims, but the fact that it's precisely in a recession that the government needs to invest in jobs – and particularly green jobs, since a green economy is far more labour intensive than the fossil fuel economy it replaces.  In terms of where to find the money, the government could start by scrapping Trident, cracking down on tax evasion and avoidance, and introducing significant green quantitative easing directly into the economy.

And if you could pass one law, what would it be?
I’d bring proportional representation – nothing would do more to open up British politics and give a greater voice to people up and down the country who have become completely disillusioned with the three main Westminster parties.

Do politics and religion mix?

Who is your favourite prime minister from history, and why?
Can I cheat and choose someone from the present day? The Prime Minister of Iceland, Jóhanna Sigurðardóttir – the country’s longest-serving member of Parliament, first female Prime Minister, and the world's first openly lesbian head of government, she has also blazed a trail on women’s equality.

Name three dream dinner-party guests.
Mary Wollstonecraft, Gandhi and Jeanette Winterson.

Which politician from a different party do you most admire?
Salma Yaqoob, for being so honest, principled, compassionate and articulate.

What's your karaoke song of choice?
Bit predictable really, but it would have to be "Sweet Caroline" by Neil Diamond.

What's the last film you saw?
Marley – a really excellent biopic, which makes you appreciate just what a huge impact one individual can have on the world.

What’s the last work of fiction you read?
The secret intensity of everyday life, by William Nicholson – it’s an incredibly compassionate novel, as well as being very witty and intelligent.

Newsnight or Question Time?
I like both, but probably Question Time – it reaches a wider audience and you get far more input from real people, as opposed to just politicians and media commentators.

Humphrys or Paxman?
I really like Carolyn Quinn – can I choose her instead?

Who is your favourite blogger?
Too many to choose from, but I particularly follow the blogs on False Economy.

Who is your favourite newspaper columnist?
Laurie Penny at the Independent.

If you could change one thing about your job, what would it be?
The hours. I’d love to spend a bit more time with my family and dog.

What's the funniest or saddest thing you've ever heard at a surgery?
Unfortunately, I hear far more sad stories than funny ones. Many of the constituents who come to see me are struggling against Kafka-esque levels of bureaucracy, whether it’s claiming the welfare payments they are entitled to or battling with the byzantine and seemingly inhuman procedures of the Border Agency.

What was your worst doorstep campaigning moment?
No one moment springs to mind, but I’ve had a few slammed doors.

Who is the most important person in your life, and why?
That’s easy  - my husband Richard and our two sons, for their love, support and – fortunately - superhuman patience.

Do you think you will ever be prime minister - and if not, why not?
No. Until we have proportional representation, no-one from the smaller parties stands a chance. On the positive side, I don’t think I’d like to live in Downing Street – I’d miss Brighton too much.

Samira Shackle is a freelance journalist, who tweets @samirashackle. She was formerly a staff writer for the New Statesman.

Christopher Furlong/Getty Images
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Want to know how you really behave as a doctor? Watch yourself on video

There is nothing quite like watching oneself at work to spur development – and videos can help us understand patients, too.

One of the most useful tools I have as a GP trainer is my video camera. Periodically, and always with patients’ permission, I place it in the corner of my registrar’s room. We then look through their consultations together during a tutorial.

There is nothing quite like watching oneself at work to spur development. One of my trainees – a lovely guy called Nick – was appalled to find that he wheeled his chair closer and closer to the patient as he narrowed down the diagnosis with a series of questions. It was entirely unconscious, but somewhat intimidating, and he never repeated it once he’d seen the recording. Whether it’s spending half the consultation staring at the computer screen, or slipping into baffling technospeak, or parroting “OK” after every comment a patient makes, we all have unhelpful mannerisms of which we are blithely unaware.

Videos are a great way of understanding how patients communicate, too. Another registrar, Anthony, had spent several years as a rheumatologist before switching to general practice, so when consulted by Yvette he felt on familiar ground. She began by saying she thought she had carpal tunnel syndrome. Anthony confirmed the diagnosis with some clinical tests, then went on to establish the impact it was having on Yvette’s life. Her sleep was disturbed every night, and she was no longer able to pick up and carry her young children. Her desperation for a swift cure came across loud and clear.

The consultation then ran into difficulty. There are three things that can help CTS: wrist splints, steroid injections and surgery to release the nerve. Splints are usually the preferred first option because they carry no risk of complications, and are inexpensive to the NHS. We watched as Anthony tried to explain this. Yvette kept raising objections, and even though Anthony did his best to address her concerns, it was clear she remained unconvinced.

The problem for Anthony, as for many doctors, is that much medical training still reflects an era when patients relied heavily on professionals for health information. Today, most will have consulted with Dr Google before presenting to their GP. Sometimes this will have stoked unfounded fears – pretty much any symptom just might be an indication of cancer – and our task then is to put things in proper context. But frequently, as with Yvette, patients have not only worked out what is wrong, they also have firm ideas what to do about it.

We played the video through again, and I highlighted the numerous subtle cues that Yvette had offered. Like many patients, she was reticent about stating outright what she wanted, but the information was there in what she did and didn’t say, and in how she responded to Anthony’s suggestions. By the time we’d finished analysing their exchanges, Anthony could see that Yvette had already decided against splints as being too cumbersome and taking too long to work. For her, a steroid injection was the quickest and surest way to obtain relief.

Competing considerations must be weighed in any “shared” decision between a doctor and patient. Autonomy – the ability for a patient to determine their own care – is of prime importance, but it isn’t unrestricted. The balance between doing good and doing harm, of which doctors sometimes have a far clearer appreciation, has to be factored in. Then there are questions of equity and fairness: within a finite NHS budget, doctors have a duty to prioritise the most cost-effective treatments. For the NHS and for Yvette, going straight for surgery wouldn’t have been right – nor did she want it – but a steroid injection is both low-cost and low-risk, and Anthony could see he’d missed the chance to maximise her autonomy.

The lessons he learned from the video had a powerful impact on him, and from that day on he became much more adept at achieving truly shared decisions with his patients.

This article first appeared in the 01 October 2015 issue of the New Statesman, The Tory tide