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[January 18, 2014]
From dealing with MPs' expenses to coming to terms with terminal cancer: Illness is forcing Andrew McDonald to step down as head of the body that oversees MPs' pay - but, he says, it's vital to talk about it: LIFE AND TIMES
(Observer (UK) Via Acquire Media NewsEdge) Over the last few years, Andrew McDonald has grown used to having conversations about MPs' expenses in the most unusual places. As chief executive of the Independent Parliamentary Standards Authority (Ipsa), the body charged with overhauling politicians' pay and pensions in the wake of the 2009 expenses scandal, McDonald has become practised at batting away awkward inquiries.
But perhaps the strangest exchange came as he was being wheeled into theatre for a second operation for prostate cancer in 2011. "The anaesthetist's last question before I went under was, 'Come on, Andrew, who are the two most difficult MPs to deal with?'" McDonald recalls when we meet in his offices in London's Victoria. "I'll never know what I'd have said." His good humour masks a more serious truth. That operation was not successful. Nor was a subsequent course of radiotherapy. Three months ago, 51-year-old McDonald, who was also diagnosed with Parkinson's disease in 2007, was told by his oncologist that the prostate cancer was incurable. As a result, he announced his decision to step down from Ipsa last week and will leave at the end of March.
It is, he says, the fatigue that has been the most debilitating aspect of his combined illnesses. The Parkinson's has left him with "severe insomnia" and that, combined with the hormonal treatment he is still receiving for his terminal cancer, has been "a real issue". McDonald has seen Ipsa through some tricky times - most recently when it released a report calling for an 11% pay rise for MPs, which was criticised by the leaders of all three main parties.
"I think we knew that . . . the pay element was not going to get a terribly warm welcome from the public and that it was going to be difficult to get an endorsement from MPs," he concedes.
Yet McDonald remains bullish about Ipsa's recommendations and feels "a real sense of loss" that he cannot see the reforms through. A final decision about MPs' pay and their pensions package is due after the 2015 general election.
"But the board has said very clearly that we've done a really extensive piece of work here, lasting 18 months, and for all the noise that 'the time isn't right', I don't think anybody has really been able to take issue with our underlying analysis." McDonald's four years at Ipsa have undoubtedly been demanding and stressful. Until now he has been determined not to let his illnesses get in the way, using innovations such as voice recognition software to help him type. "But if I've had three bad nights in a row, with a couple of hours' sleep, by the fourth day I'm finding it really hard to concentrate." Other than this, he has few physical symptoms. The Parkinson's is only visible to an outsider's eye in the form of a slight tremor in his left hand - it has been a gradual deterioration since McDonald first became aware of it as he was reading the New York Times seven years ago. When he reached to turn the page, he couldn't feel the edge of the paper between his fingers. His immediate concern when his GP referred him to a neurologist was that "I wouldn't live to see my daughter grow up". His daughter, whom he does not wish to name, is now 17.
"Having to explain both Parkinson's and prostate cancer to a teenager is tough," McDonald says, his voice tightening. "It's been very tough for her." His wife, too, has found it "unquestionably" difficult.
There is no certainty about McDonald's prognosis, only that the prostate cancer is terminal. Perhaps the strangest part of it all is that he feels quite well.
"It's as though you're playing some bizarre video game," McDonald explains. "The doctor appears with this printout of blood test results going back to 2010 and that's the only manifestation of the cancer. There's no physical discomfort. That disjunction between what I know and what I feel is odd and it's not at all straightforward." Recently, he was walking in the countryside in beautiful sunshine "and I was asking myself: how can there be such a mismatch between the glory of the moment and the knowledge that it's coming to an end?" McDonald has tried to carry on as normal. He has become a passionate advocate for talking openly about illness and disability in the workplace. When he was first diagnosed with Parkinson's, he was chief executive of Government Skills, the skills council for central government. He wanted to be open with his team, but two of his colleagues advised him not to - "because you will be labelled as a disabled civil servant and it will limit your career chances thereafter".
McDonald was "really shocked and I - maybe in a bloody-minded way - decided I wanted to go ahead because if I didn't, I felt I was making it more difficult for the next person".
He went on to chair several taskforces on disability in the civil service. At Ipsa, he instigated a series of lunchtime talks where employees - himself included - could talk openly about disability or illness.
"It has helped me to understand intuitively that a diverse workforce is more likely to be an effective workforce," he says. "I understood that intellectually before, but now I recognise much more immediately that if people come to the table with a diversity of experience, they are more likely to make better decisions." The broader desire is that this will lead to a more informed dialogue in society as a whole. We don't like to talk about cancer, he says, because it is still seen as "a battle. People have 'brave victories' over it or 'plucky defeats' . . . so [the vocabulary] is all about combat," he says. "Lying behind that is the prevailing notion that, if you get cancer, you're doomed." Parkinson's, by contrast, is viewed much more passively, as an illness people "suffer from" before "retreating from life". McDonald recalls reading a recent book review of a thriller written by Martin Cruz Smith which stated that the author had just "admitted" to having Parkinson's. "The use of that verb stares out at you as being extraordinary," he says.
It is difficult, when listening to McDonald speak with such clarity and eloquence, to remember how ill he really is. Throughout our hour-long conversation, his voice never falters. The only sign of emotion comes when he breaks eye contact briefly and looks out of the window.
Doesn't it ever strike him as monstrously unfair to be diagnosed with not one but two such serious illnesses in the last six years? "I don't see it in those terms, oddly enough. The full extent of my profound insight on this is 'stuff happens'. I don't feel angry about it. I'm a Catholic and people have asked: has this made me question my faith? And it hasn't. My concept of God has never been one where God is intervening, arranging things in our daily lives like some puppeteer. You have to deal with the cards you've been dealt." Has he cried? "Oh, I've cried plenty of times. I . . ." He pauses. "The prospect of not being able to do things that I want to do. I find that very difficult." When he leaves Ipsa, McDonald wants to write a book about his experiences and will give a public lecture entitled Let's Talk About Cancer for Marie Curie Cancer Care in June. "Enticing title," he says drily.
But he also wants to indulge in the things he most loves doing - such as freshwater swimming. Three times a year, he aims to take a different friend to explore a particular lake or river. The only stipulation is that the location must have some personal resonance for either party. So far, McDonald's trips have taken him from the Pirin mountains in Bulgaria (he wore a wetsuit) to the River Stour in Dorset.
"I want to do more of that," he says, as we walk out of the offices into the chilly January breeze. "I want to see more of family and friends for as long as my health allows." It is a simple wish, all the more poignant for its modest ambition.
Age 51 Family Married, one daughter.
Lives Muswell Hill, north London.
Education Emerson Park school, Essex; St John's College, Oxford, MA, modern history; Bristol University, PhD on control of public expenditure.
Career 2009-present: chief executive, Ipsa; 2006-09: chief executive, Government Skills; 2006-07: senior adviser, Phillips review of party funding; 2001-05: constitution director and other roles, Department for Constitutional Affairs; 2000-01: acting chief executive, Office of the Public Guardian; 1986-2000: head of records management, board member and other roles, National Archives.
Interests History, walking, swimming in freshwater lakes, travel, sport.
Captions: Andrew McDonald at the Independent Parliamentary Standards Authority offices in London last week. 'I want to see more of family and friends for as long as my health allows,' he says. Photograph by Andy Hall for the Observer (c) 2014 Guardian Newspapers Limited.
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