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LOS ANGELES TIMES INTERVIEW : Virginia Bottomley : Britain's Health Secretary Balances Costs and Care for a Nation

August 30, 1992|William Tuohy and Thomas Plate | Thomas Plate is editor of the editorial pages for The Times. William Tuohy is London bureau chief for The Times. They interviewed Virginia Bottomley in the health secretary's office

LONDON — She has brought more than a touch of glamour to the British Cabinet--so much so that Health Secretary Virginia Bottomley is depicted on the irreverent Spitting Image TV show as Prime Minister John Major's girlfriend. But she is hardly the dumb-blonde caricature of the series. Rather, Bottomley, 44, holds one of the toughest jobs in the Cabinet--con stantly under fire from the opposition, which accuses the government of trying to undermine Britain's famed National Health Service.

And as health secretary, boss of one of the big "spending" departments in government, she is frequently locked in battle with Treasury officials who are in the business of trimming her $62 billion-a-year NHS budget. However, she has had plenty of training for her arduous job.

Born in Scotland as Virginia Hilda Brunette Maxwell Garnett, she grew up in a middle-class, socially aware family. "For me, there wasn't really a decision about whether or not to do something in the public arena," she recalls. "It was almost taken for granted that I would."

She studied sociology at Essex University and took a master's degree at the London School of Economics. At 19, she married Peter Bottomley, who became a member of Parliament and transportation minister. A mother of three, she was a researcher in child psychiatry, and was appointed a magistrate at age 27. She won election as a Conservative MP in 1984. In government, she served in various sub-Cabinet posts: in the Departments of Education, Overseas Development, the Foreign Office and Environment, before moving to Health, from which she was appointed to the Cabinet as secretary last April.

Bottomley denies that the Major government is trying to privatize the NHS, insisting that she herself has never received private medical care, and points out that her daughter is a doctor with the NHS.

She supports women's rights and equality, and is responsible for the governmental department that is the country's largest employer of women--some 750,000--mostly nurses.

If she doesn't blot her copybook, her political future is bright indeed. As opposition Labor MP Frank Field, with whom she worked on joint committees, says of her "English rose" attraction and clear speaking voice: "She knows that she is incredibly good-looking--and this government is short of talking heads on the box that don't make voters beg for the return of steam (early) radio."

Question: There is growing criticism that, over the years, the medical research Establishment has wavered on issues that concern women more than men. For example, many critics both inside and outside the medical Establishment insist that breast cancer research has been neglected in relation to its incidence among women. Does that resonate in Britain?

Answer: I think there is little resonance of that here. Indeed, in this country we have taken forward a number of health programs directly related to women's health. We were one of the first countries in the world to have a national call and recall program for breast cancer and cervical cancer screening. And the new steps we have taken in our general practitioner contract--our family doctors contract--give them additional rewards for reaching almost universal coverage in the cancer-screening program. So one of the strengths of the National Health Service is its universality, its accessibility to all and, through the family doctor service, we are particularly determined to reach the groups who would otherwise be reluctant to come forward for health care, and, within that target audience, the needs of women--both in terms of cancer-screening and maternity services--are a clear priority.

Last year I launched a document, "Your Health--a Guide to Services to Women," available free to anyone who applied for it. It was extremely popular. Women are interested in health. They want to know what is available--they want to know for themselves and they want to know for their families.

Q: The allocation of resources here has been a running argument. As people live longer, health care costs are higher. How does your government, or any government, cope with these costs vs. treatment? Do you foresee solutions as to how to deal with this in a time of dwindling revenues?

A: Around the world it is clear that every country is facing the same challenges: aging population, rising expectations and the incredible ability of new medical techniques to combat diseases and disabilities that in the past would have been inconceivable. Our health service is one of the most efficient in the world. We spend a smaller share of our GNP, although a rising one, than many other countries, and it has great strength in that it is universally available, accessible to all and free at the point of delivery.

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