It’s common to get trolled on social media, especially when you’re an MP. Recently, I had a comment on Facebook from someone urging me to return to medicine. I’m not sure you would all thank me for the considerable cost to the taxpayer of a by-election (around £200,000 - £300,000), so I politely declined!
This month I wanted to write to you about something I’ve been working on recently, as Shadow Health Minister, which is a prime example of the difference that can be made when you use a profession – such as medicine – in politics.
At the start of the year, the Government said it was reforming NHS referrals. In reality, it was redefining access to specialist care by restricting it.
As summer approaches, many people are booking holidays. Some do it themselves. Others use a travel agent. But imagine being told you must go through an agent, who may redirect you somewhere else, or tell you that you are not going anywhere at all.
That was, in effect, what was being proposed for NHS referrals.
For years, GPs have been able to refer patients directly to specialists when clinically appropriate. Alongside that, Advice and Guidance has existed as a voluntary system to support decision-making. Used properly, it helps avoid unnecessary hospital visits and gets patients the right care. What was proposed went much further.
Advice and Guidance was set to become a mandatory gateway, combined with a Single Point of Access, with a clear drive to divert patients away from specialist care. It was directly stated in the Government paper to “redirect 25% of referrals”, that is 1 in 4 patients who the GP feels need to see a hospital specialist.
That is not reform. It’s rationing.
I raised those concerns publicly and in Parliament. The response from ministers was swift and dismissive. My warnings were branded “total nonsense”.
And yet, within days, NHS England issued a formal letter to “address concerns” about the very policy in question.
If those concerns were nonsense, why did they need addressing?
The ‘clarification’ is welcome. But it also proves the point.
The original direction created real and justified concern. It risked placing administrative processes between patients and the care they need. It risked turning clinical judgment into something that could be delayed or overridden.
However it is still worth stating, those risks have not fully disappeared.
Even without a formal target, the structure remains. A Single Point of Access. A stronger emphasis on Advice and Guidance. A system still designed, in part, to control demand.
The danger is not that patients are treated faster. It's that they are held elsewhere in the system.
Waiting lists may fall on paper, but patients continue waiting. Unseen, unrecorded, and unresolved.
Think of a woman suffering from endometriosis. She may already have waited years to be taken seriously. A GP who recognises the signs should be able to refer her directly. Under this model, that pathway can still be slowed, redirected, or questioned. Her pain does not pause. Her condition does not improve. But she may no longer be counted in the same way.
This raises a fundamental question: who is accountable when things go wrong?
If a GP believes a referral is necessary, but that decision is delayed by process, who carries the responsibility? The GP? The consultant giving remote advice? Or the system that imposed the barrier?
And who is making decisions at the single point of access? A consultant? A specialist nurse? An administrator? These are not minor details. They go to the heart of patient safety.
None of this is an argument against Advice and Guidance itself. Used voluntarily, it is very valuable. It supports clinicians and improves care. But there is a clear line between support and control. Between advice and obstruction. That line was crossed.
The fact that NHS England has now stepped in to “address concerns” shows that pressure works. It shows that scrutiny matters. And it shows that those concerns were real all along.
With all this in mind, it’s been rewarding to use my medical experience to make a definitive impact. Be it for our area or on things that affect the whole nation, this desire to make a difference is why I stepped into politics in the first place. I hope I have and can continue to do so.
