Sarah Wollaston MP: If our relationship with the EU cannot be loosened then, with regret, I would vote to leave

Dr Sarah Wollaston is Conservative MP for Totnes, Brixham and the South Ham. Follow Sarah on Twitter.

When David Cameron delivers his long awaited EU speech on Friday it must be more than just an exercise in managing expectations.

It is an opportunity to set out how both sides could benefit from a more constructive partnership with our Eurozone neighbours. He must also clarify how and why that relationship needs to change for us to stay. Unless there is a clear intent to seek consent in a referendum, it will of course be pointless to expect a genuine negotiation.

Eurosceptics are used to being dismissed as ‘mad’, ‘swivel-eyed’, ‘right wing’ or ‘dangerously irresponsible’ by those who fear a public vote on Europe, but it is time for the sneering to stop.

Like many of my constituents I am centre right and perfectly capable of recognising the benefits of the EU. We are tired of the stereotypes as are those from the left who share a deep unease at the federalist quicksand. The refusal of Eurosceptics to be dismissed out of hand means that those comfortable with the status quo can no longer assume that sceptics will be safely outmanoeuvred.  Instead of applying insulting labels to those who seek a reappraisal of our place in Europe they should focus on how Europe could better serve all of its people.

The EU's democratic deficit and waste are causing misery in countries like Greece. If a single currency such as the Euro is set up to fail then the right course of action is not to ignore the problem but to either abandon it or adopt the fiscal union which they know to be required. We cannot be part of that and so a renegotiation is inevitable and has nothing to do with British blackmail.

This is the time for Cameron to set out the Conservative position for those negotiations. We may not achieve everything we demand and no one doubts the complexity of the task when in coalition with a Party which would gleefully accept even greater European integration.

The Fresh Start project lists proposals for a looser and more constructive relationship; one which emphasises and seeks to enhance trade. The EU is the world’s largest economy and trading bloc. It accounts for around 40% of the UK’s total exports of goods and services and is still the most important market for UK business. The point is that we are equally important to the EU.

I hope our place will remain in a reformed Europe, not least because our access to the single market supports our place as one of the most favoured destinations for foreign direct investments. But there is a cost; the over regulation of UK businesses also undermines our efforts to compete with other growing economies.

Despite the trade benefits, does anyone seriously feel that if the current state of our relationship with Europe had been put to the British people in 1975 we would have had the same result? Is it all worth the loss of sovereignty, the loss of control over immigration and the expensive but remote European institutions? Would voters have approved the vast subsidies to large landowners within the unreformed CAP or the devastation of fish stocks via the CFP had they realised what that would cost?

The extent to which the EU now controls so many aspects of our daily lives is a cause of deep unease. In the NHS the working time directive has adversely impacted on medical training and continuity and we are still unable to adequately test whether healthcare workers from the EU can speak English. Sensible health measures to prevent the sale of ultra cheap alcohol will be held up for years in the European Courts whilst liver deaths continue to rise because Parliament is impotent to set our own controls without lengthy legal challenges.  It is not just our own civil service which can paralyse Government.

Renegotiation is an opportunity to end the cycle of negativity that characterises our relations within the EU. It is not about wanting to cherry pick the parts that will bring greatest self interest whilst gaining a competitive edge over other member States. It is about establishing the principle that Britain does not want to join a federal union and should not be disadvantaged by the block votes of those which do.

There is room for European Nations to have flexibility as was established by the 2001 Laeken Declaration, which allowed for the EU to adjust the division of competencies and restore tasks to member States. Wouldn't it be better for our European partners to welcome Britain's enthusiasm to pilot changes which might benefit all member States?

It would be in everyone’s best interests for the British to fall back in love with the EU and for us to be a constructive partner, but that can only happen if we review the terms and commit to asking the question at a referendum. If our relationship cannot be loosened then, with regret, I would vote to leave.

Of course there are more important things to worry about like the cost of living and fuel prices but these are intimately linked with our European obligations and not always for the better. It is time to set out how these could be improved by a looser relationship with the EU based on trade rather than conformity.

If the US wishes to help us to stay then they would do better to persuade the EU to take that seriously than lecture us not to ask the question.