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Yes.

I declare an interest, as my entry in the register of members’ interests shows, I am a practising NHS GP.

I agree with the expansion of the multidisciplinary team, because we need to ensure that we have appropriate staff. However, I have a number of concerns about physician associates and anaesthetic associates. The first is about confusion. Why did the name change from “physician assistants” in 2003 to “physician associates” in 2014, and why are we sticking with “physician associates”?

The GMC has said that that is not its role. In the work that you have put out, you have not defined what supervision means.

Are you doing work on that? Are you planning to set up a programme?

No—and the work that I do with my MDT, including our pharmacists and nurses, is absolutely vital. In fact, my practice nurse handles diabetes better than I do, because it represents is a lot of what she does. However, my argument is that, instead of looking to get doctors into practices, we are seeing expansion of the PA role, and thereby creating that dichotomy.

I have also heard of reports of PAs setting up privately and saying that they can offer all the same services. It is difficult to regulate if we cannot define the supervision level or the scope of practice. They have to be very tight and defined, in the same way as the situation that Emma Harper spoke about when we were talking about what happens in the US.

What about my point about the cost of regulating a PA being half that of regulating a doctor?

In order to regulate, it is necessary to have very tight definitions of what it is that the profession is doing. There are very tight definitions around nursing and expanded roles and around what doctors do. Given the scope of practice of AAs and PAs, 69 per cent of respondents to a BMA survey said that they were concerned that their role had been expanded more than it should have been. An example that I have heard of is the medical registrar bleep being held by a PA. The holding of that role is one of the most senior positions in a hospital. What is the scope of practice for a PA when it comes to the complaints procedure and the regulation process?

We now regularly have more than 1,000 drug-related deaths each year, and we seem to be going backwards in the care that we give to people with drug dependency. There has been a reduction, in real terms, in the budget. What is your commitment to that figure and to reducing the number of deaths, and how do you expect people to do that with less money?

What are your top three priorities with the budget that you have set out? What are the three things that you would want and expect at the end of this year and as we go into the next year?

They are not regulated currently, so if you are creating legislation, you can put in any name you want.