The Operation of the Parliamentary Standards Act 2009

Written evidence from Dr Fiona Alexander

We have offered an emergency GP service to both the House of Commons and the House of Lords since the beginning of 2004. This enables an overview of aspects of the general health and wellbeing of those Members seen.

In the first 2 years of our service we had a 30% higher attendance rate than for subsequent years, but clinics then settled into a pattern. 2010 and 2011 have been unusual. 2010 saw the lowest annual attendance, and 2011 is on course to be the highest attendance, with more Members seen from January to August 2011 than are usually seen in a normal year.

Towards the end of 2009 and during 2010 we were aware that some Members were concerned that the service could be viewed negatively in light of the expenses publicity. Certainly within consultation there were some who were extremely concerned about security of medical notes and were nervous about being ‘caught’ at the Medical Centre. This and the General Election we felt were responsible for the drop in numbers.

Since the beginning of Parliament in autumn 2010 there has been a notable increase in appointments. It would be difficult to extrapolate our findings to the whole of Parliament since we have seen approximately 10% of Members in this time. However the striking difference over the past 18 months is that consultations have been longer and Members less well. Over the winter, flu-like illness and chest infections were common and lasted for longer than in previous years. There were a number of cases requiring two and even three consultations for the same problem. This was not our experience with our usual GP population where there was little difference. Another significant change has been a large increase gastrointestinal complaints compared to all previous years.

It would be reasonable to assume that stress and fatigue have played a part in this. Many of the cases I saw had been ill for 2-3 weeks with chest infections, or longer for other complaints, before seeing a GP. Gastrointestinal complaints in particular can be associated with stress.

Simple figures do not clearly show the degree of variation, giving only an indication of diagnosis. My overall feeling, having been the GP attending most of last winter’s clinics, is that the Members I saw were physically more run down than has been the case in previous years and there were indications that stress was a contributing factor. Clearly this is a subjective opinion and there are many reasons why this may be the case. However with 25 years experience as a doctor, 16 of those as a GP, it is part of my clinical skill base to be able to assess psychological as well as physical factors within a short consultation.

In my opinion, from the specific point of view of Members Expenses, any factor affecting workload or travelling time will directly impact on stress levels and general health, whatever other factors are in operation at the time.

14 October 2011