What Westminster gets wrong about the NHS

Parliament Matters

We are joined this week by two guests who bring invaluable insight into the intersection of health policy and parliamentary life. Dr. Sarah Wollaston and Steve Brine – both former MPs, health policy experts, and co-hosts of the podcast Prevention is the New Cure – share their experiences of how the House of Commons handles health and social care.

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Both chaired the Commons Health Select Committee during their time in Parliament, and both bring broader career experience: Sarah as a former GP and Steve as a former Health Minister. They offer a candid and often striking comparison between GP surgeries and MP surgeries, revealing how health and social care concerns often dominate the concerns constituents bring to their representatives. Their experiences underscore how central the NHS is to public life and how fraught it is in political terms.

We explore the dangers MPs face when navigating NHS policy, particularly around controversial local hospital closures and service changes. Steve recounts his own strategic focus on healthcare in Winchester and the delicate balance between constituency advocacy and ministerial responsibility. While Sarah shares her frustration with the legislative process, particularly during the Lansley reforms, when her medical expertise was side-lined by the party whips.

The conversation moves to Labour’s current proposals for NHS reform. Our guests reflect on the gap between political rhetoric and delivery, particularly the challenge of achieving meaningful change in a system under financial and structural pressure.

Turning to the role of Parliament, Sarah and Steve reflect on the importance – and limits – of select committees in influencing policy. Drawing on their own time as committee chairs, they describe the committee corridor as one of the few places in Parliament where serious scrutiny and cross-party collaboration take place. Yet they also lament MPs broader failure to engage seriously with evidence or exercise proper scrutiny of departmental spending.

Finally, as more than 100 Labour MPs signal a potential rebellion over proposed cuts to Personal Independence Payments, we explore the culture of dissent at Westminster. Steve and Sarah – both with a track record of principled rebellion – offer advice to the new intake of MPs weighing loyalty against conscience. Their message is clear: in the long run, the votes you regret are the ones where you didn’t make a stand.

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Parliament Matters is a Hansard Society production supported by the Joseph Rowntree Charitable Trust.

Presenters: Mark D’Arcy and Ruth Fox

Producer: Richard Townsend

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