The Big Questions: Are we facing a winter health crisis? Should hospitals ban smoking?

This week's questions are answered by Conservative MP Sarah Wollaston

The new law would make it easier to close hospital wards (Christopher Furlong/Getty Images)

Is Britain facing a winter health crisis?

I worked in the NHS for 24 years before entering Parliament, and winter pressures are nothing new. This year, as in previous years, the Secretary of State has had to wield his chequebook to try to soothe the headache. It needs more than a temporary fix. The number of older people with complex long-term conditions is increasing, and with this their medical complexity. Bed capacity on wards is at breaking point and care in the community to allow for safe discharge home is harder to find. The answer, in part, is to prevent avoidable admissions by spending money differently and support more people to remain in their own homes if they suffer a setback. This kind of care not only makes good financial sense but, more importantly, it saves lives.

Are GPs overpaid and underused, or are they already at the limits of their capacity?

GPs are fairly paid for the work they do. The contract negotiated under Labour in effect allowed them to maintain their income while dropping out-of-hours work altogether. Had the balance of payment between in-hours and out-of-hours work been realistically assessed, we would not be in the position we are today. That said, I don’t agree with the general “doctor-bashing” over this issue. There is a serious and growing shortfall in the numbers of doctors in primary care and very many are working at the limits of capacity. We need to focus on GP recruitment and on broadening the primary care workforce.

Should staff and patients be banned from smoking in hospitals?

Why not? Personally I’d allow “vaping” with e-cigarettes as I do feel that these are a low-cost way of reducing the harm from smoking. There is no evidence that they are a gateway into smoking and I would not want the EU to pile on expensive regulation without evidence of harm from e-cigarettes.

Why is there so much pressure on hospital A&E departments and what can be done about it?

Many reasons, mostly the complexity of the patients attending, but the exact reasons depend on several local factors. One of the greatest predictors is the distance you live from your nearest A&E, another is knowledge about the alternatives. Where people are aware of good local GP out-of-hours services they are more likely to use them. In future we will need to make sure that full use is made of services which help to prevent re-attendance such as liaison psychiatry, and reduce the numbers attending such as paramedic ambulances. If they weren’t full of drunks who had preloaded on ultra-cheap alcohol on weekend nights, that might help too.

How worried should we be about gender-based abortions in the UK?

The scale of this in the UK is likely to be small, but it is a growing problem internationally and should never be tolerated. It reinforces misogyny and gender violence for clinicians to collude with a view that sons are more valuable than daughters. To further reduce the likelihood of it occurring in the UK, the General Medical Council must set out far clearer guidance because the current lack of consistent guidelines contributes to the difficulty in taking forward prosecutions.

And how worried should we be about cancer waiting lists being manipulated to meet targets?

I am concerned about this and about the report we heard at the Health Select Committee that some cancer specialists have sought to use competition law to try to block reconfigurations of specialist services, even where their own are below standard. Clinicians have a duty to put their patients’ interests above embarrassing data. A statutory duty of candour for NHS hospitals will help.

As you’re a GP turned MP, what can be done to ensure that politics does not become the preserve of career politicians?

It will change only if more people come forward to apply for the job. Keep hammering on the door and don’t take no for an answer.

Does the UK risk being seen as a “nasty” country because of David Cameron’s plan to deny benefits to immigrants from Romania and Bulgaria?

No, if anything I suspect other nations will follow suit. That said, language matters and I am appalled at some of the grotesque racial stereotyping of Roma people that we have seen from some quarters over recent weeks.

Nick Clegg’s proposal for shared leave for parents has been described as a “nightmare” by businesses. Where should our priorities lie?

Women are regularly faced with subtle (and not so subtle) questions about current or future pregnancies at interview. Shared parental leave makes gender-based discrimination more difficult as anyone could be “holding the baby”. More importantly, those trailblazing men who choose to share more of their children’s care will reap great benefits. It will bring choice and flexibility for couples but will also include a responsibility to give eight weeks’ notice to help businesses to plan ahead. What’s not to like?

As a nation we’re having less sex than we used to. Does that matter?

We should all stop looking at our phones and laptops in bed and look at our partners! It’s important to be with the person in the room.

Sarah Wollaston is Conservative MP for Totnes, Brixham and the South Hams and a former GP