The Operation of the Parliamentary Standards Act 2009

Written evidence from Dr Ira Madan, the House’s Occupational Physician


I have been contracted from Guy’s and St Thomas’ NHS Trust to the Houses of Parliament for one day per week since 1999. My role at the House of Commons is as a consultant occupational physician and senior medical advisor to the House authorities. My clinical work with Members of Parliament is based on-site on the Parliamentary Estate, within the Safety, Health and Wellbeing Service (SHWS). We offer a 3-yearly medical screening for MPs and approximately 40% of MPs take up the offer. I personally undertake 50-70 screenings per year. The health screening focuses on the detection of cardiovascular risk factors, audiovisual deficits, diabetes and mental well-being. An important component of the screening programme is detection of risk factors for psychological distress and psychiatric illness. Therefore, the screening includes direct questioning on hours of work, enjoyment of work, perceived stressors at work, travel to and from the constituency, travel to and from London residence, hours of work, effort / reward balance, family, children and social support.

In addition, I undertake medical assessments of MPs with disabilities and report the degree of disability and adaptations that may be needed to fulfil the role of a MP. With the MPs’ consent, a copy of my report is sent to the Independent Parliamentary Standards Authority (IPSA), in order for IPSA to consider if the MP is eligible for extra allowances to allow them to undertake the full duties expected of a MP.

Observations during screening medicals

1) Since May 2010, a number of MPs have expressed concern to me about the amount of their working time which they perceive they are spending on completing and checking their expenses claims prior to them being submitted to IPSA.

2) Many MPs have stated to me that supervising the completion and checking of expense forms for IPSA typically takes up to a over 20 % of their time at Westminster and requires 10 hours per week or more of an assistant’s time.

3) Many Members specifically state that they find themselves becoming increasingly frustrated by the ‘facelessness’ of IPSA and the bureaucracy of the system.

4) Many Members have expressed deep concern that the way IPSA publishes itemised details of their expenses are open to misrepresentation when their local constituency newspapers publish the story.

5) Since May 2010, the number of Members with dependent children has increased. A frequent complaint is that the travel of children and spouses to and from London is not adequately covered by Members’ allowances. This leads to either a financial burden to members and / or tension in the family. The Members frequently state that their London flats are often not large enough to accommodate family during the week.

Medical perspective

1) As an independent medical advisor to Parliament, my main concern lies in the contribution that the current allowance system has on impairing the relationship that Members have with their families. Those MPs who develop psychological problems during their time in Parliament frequently find that the additional pressure placed on their personal relationships (through long hours and geographical separation, for example) is a significant factor. Common concerns are a lack of time spent with a partner and /or children. Spouses increasingly expect a larger contribution from partners in the upbringing of their children. MPs recognise that the nature of their job will inevitably disrupt their family life; but the current allowance system appears to obstruct rather than encourage members to spend as much time as their job allows with their families.

2) My second concern lies with extra demand that the current allowance system is making on MPs and their office staff compared with the previous system. A mismatch in effort as compared with rewards in a job is known to be a major risk factor for psychological problems, especially depression. The role of a MP is hugely demanding. Not only do most MPs report working in excess of 70 hours per week, they also spend many of those hours away from their families and their social support network and they are increasingly scrutinised by the media. Although many of the rewards of the job of a MP have remained unchanged, in general, MPs are less trusted by the public than they were prior to the ‘expenses scandal’ of 2009. From what MPs have told me during the medical screenings, it is apparent that the current allowance system is leading to a substantial increase in the effort that it takes for MPs to fulfil their role. It is my view that Parliament should ensure that the effort required to fulfil the role of a MP is reduced as far as possible in order to minimise the risk of Members developing psychological symptoms during their elected period.

Dr Ira Madan MB; BS (Hons), MD, FRCP, FFOM

Consultant occupational physician, Guy’s and St Thomas’ NHS Trust

Honorary senior lecturer in occupational medicine, King’s College London.

3 October 2011

Prepared 2nd November 2011