0:00:39 > 0:00:41Hello and welcome to the Daily Politics,
0:00:41 > 0:00:44where MPs are getting ready to begin a marathon series of debates
0:00:44 > 0:00:47over Brexit that could last until Christmas.
0:00:47 > 0:00:52The EU Withdrawal Bill is intended to copy EU rules into British law,
0:00:52 > 0:00:54but the government's opponents,
0:00:54 > 0:01:00including a number of Conservative rebels,
0:01:00 > 0:01:01are threatening guerilla warfare in the Commons
0:01:01 > 0:01:02with hundreds of amendments.
0:01:02 > 0:01:04We'll bring you up to speed.
0:01:04 > 0:01:06The chancellor Philip Hammond is still beavering away
0:01:06 > 0:01:08on next week's Budget, so will he welcome some
0:01:08 > 0:01:11friendly advice from backbencher Jacob Rees Mogg?
0:01:11 > 0:01:15We'll speak to him about his alternative Budget for Brexit.
0:01:15 > 0:01:19It's been claimed that vital NHS operations and treatments
0:01:19 > 0:01:22are increasingly being rationed in England but is there a good case
0:01:22 > 0:01:27for restricting treatment for smokers or the overweight?
0:01:29 > 0:01:34And there's plenty for Theresa May's cabinet to chew over when they meet
0:01:34 > 0:01:36this morning amid reports that they're not exactly
0:01:36 > 0:01:40getting along swimmingly.
0:01:40 > 0:01:42We'll ask a member of John Major's cabinet for some
0:01:42 > 0:01:48tips on restoring harmony.
0:01:48 > 0:01:51All that in the next hour on another busy day here at Westminster,
0:01:51 > 0:01:58and with us for the whole of the programme today,
0:01:58 > 0:02:00it's the former head of the Royal College
0:02:00 > 0:02:01of GPs Clare Gerada.
0:02:01 > 0:02:04She is still a GP and she also campaigned with the Liberal
0:02:04 > 0:02:05Democrats at the last election.
0:02:05 > 0:02:06Welcome to the show.
0:02:06 > 0:02:09First today, the monthly inflation figures for the UK have been
0:02:09 > 0:02:11released this morning, that's the consumer price index
0:02:11 > 0:02:14which measures the rate of increase in the prices of goods and services.
0:02:14 > 0:02:17And according to the Office for National Statistics it has
0:02:17 > 0:02:20remained at its five-year high of 3%, which means there is no let
0:02:20 > 0:02:22up in the cost of living squeeze hitting UK households,
0:02:22 > 0:02:24although the rate has not risen higher as predicted
0:02:24 > 0:02:31by some economists.
0:02:31 > 0:02:34Well let's talk now to our economics editor Kamal Ahmed
0:02:34 > 0:02:39who can tell us what that means.
0:02:39 > 0:02:41Has it peaked, inflation? Well, certainly, there seems to be some
0:02:41 > 0:02:47evidence that the foot has come off the inflation accelerates a full.
0:02:47 > 0:02:51First of all, the sterling effect, so, the decline in the value of
0:02:51 > 0:02:54sterling after the referendum meant that the goods and services we
0:02:54 > 0:03:01imported into the UK became more expensive, that pushed up inflation.
0:03:01 > 0:03:03Inflation is a comparative number, compared with what is happening this
0:03:03 > 0:03:09time a year ago, that inflation effect starts to fall out of the
0:03:09 > 0:03:15data, Stirling, although it is low, is staying at the same low rate.
0:03:15 > 0:03:20That inflation effect seems to dissipate a bit. Well prices are not
0:03:20 > 0:03:24rising as fast as they were this time last year. The big question, as
0:03:24 > 0:03:29you suggest, does it mean we have hit a peak? We are seeing the top of
0:03:29 > 0:03:33the upward curve, certainly, the Bank of England believes the peak
0:03:33 > 0:03:38will be reached by the end of the year. There are still some in
0:03:38 > 0:03:42inflationary pressures, food prices are the highest they have been since
0:03:42 > 0:03:462013, unrest in the Middle East, global growth, increasing demand,
0:03:46 > 0:03:53has meant oil prices are starting to push up again. Although, yes, for
0:03:53 > 0:03:57the moment, inflation has eased, whether or not... It is not the
0:03:57 > 0:04:00peak, it will increase a little bit more. The overall trajectory is
0:04:00 > 0:04:07starting to come down.Let's pick up on two of those things, food prices,
0:04:07 > 0:04:11your supermarket shop is still more expensive than it has been in recent
0:04:11 > 0:04:16times and wages are still not keeping pace with prices.Average
0:04:16 > 0:04:22household income increases are around 2.2%. If you look at food
0:04:22 > 0:04:26inflation, running at 4.2%. Exactly as you say, that squeeze on living
0:04:26 > 0:04:32standards continues, food is the largest proportion of our weekly
0:04:32 > 0:04:36expenditure, and certainly for poorer households, it is more
0:04:36 > 0:04:39significant than for richer households, the issue you are
0:04:39 > 0:04:45starting to see is this big increase in input inflation into the food
0:04:45 > 0:04:48system, into supermarkets, they have suddenly had to pay a lot more for
0:04:48 > 0:04:53the food imported from the European continent, in particular and
0:04:53 > 0:04:57elsewhere, because of the weakness of sterling. Those prices are
0:04:57 > 0:05:01starting to be pushed through the system, coming out the other end, in
0:05:01 > 0:05:05food inflation. That means it is tougher, when looking at the
0:05:05 > 0:05:10Christmas spend on food. Again, because of the sterling effect,
0:05:10 > 0:05:15those effects may start dissipating over time. But, that fuel price
0:05:15 > 0:05:19increase, some suggestions that fuel prices will start rising again by
0:05:19 > 0:05:24the end of the year, that will push up the inflation numbers.Just
0:05:24 > 0:05:27briefly, what about reaction from the Bank of England, we saw interest
0:05:27 > 0:05:32rates double from a very low bar, but I have seen this strange phrase,
0:05:32 > 0:05:35the Bank of England will stretch out the horizon over which it plans to
0:05:35 > 0:05:39rein in inflation. Does that mean it will not take further action for the
0:05:39 > 0:05:44moment?For the foreseeable future that is absolutely correct, many
0:05:44 > 0:05:47economists say there will not be another interest rate rise until the
0:05:47 > 0:05:54end of next year, and the interest rate rise, that very small number,
0:05:54 > 0:05:580.25%, once again. The Bank of England is not just concerned with
0:05:58 > 0:06:03inflation, where the pressure seems to be coming off slightly, but also
0:06:03 > 0:06:07concerned with economic growth, and the real problems are in economic
0:06:07 > 0:06:12growth, not in inflation. This will encourage those dovish members of
0:06:12 > 0:06:17the monetary policy committee, to say, we need to hold off any further
0:06:17 > 0:06:22interest rate rises, and weaken the hand of the Hawks who think there
0:06:22 > 0:06:26should be more interest rate rises to control inflation. Today's
0:06:26 > 0:06:32figure, I think, means any interest rate rise, when it comes, is a long
0:06:32 > 0:06:36way off and will be very small.
0:06:36 > 0:06:39In the public sector, when you look at the NHS, talk about busting the
0:06:39 > 0:06:451% pay freeze, which would be welcomed, but with inflation at 3%,
0:06:45 > 0:06:49it is not as much of a rise, in real terms, it is still a cut all stop it
0:06:49 > 0:06:56is still a cut but more importantly. -- it is still a cut.-- it is still
0:06:56 > 0:07:00a cut but more importantly, medicines I prescribed are from
0:07:00 > 0:07:05overseas, China, America, I wonder how much we see the health inflation
0:07:05 > 0:07:08impact if we do not have sensible trade deals post "Brexit", I know
0:07:08 > 0:07:13that we will be discussing it later on in the show but for me, the big
0:07:13 > 0:07:17one is the health inflation costs and what that means. That will feed
0:07:17 > 0:07:22into the overall economy, because we have medicines, we take them for
0:07:22 > 0:07:25granted but they are very expensive and if they are going to cost more
0:07:25 > 0:07:30because we do not get proper deals, then inflation will rise more. I'm
0:07:30 > 0:07:34not an economist, just a simple punter, but I see and read the
0:07:34 > 0:07:38newspapers and think, we are in a very precarious position.We will
0:07:38 > 0:07:43return to this when we talk about Brexit in more detail.
0:07:43 > 0:07:44Now it's time for our daily quiz.
0:07:44 > 0:07:46The question for today is which political relative
0:07:46 > 0:07:49is heading to the jungle for the new series of ITV's
0:07:49 > 0:07:51I'm A Celebrity, Get Me Out Of Here?
0:07:51 > 0:07:54A) Samantha Cameron, wife of David. b) Philip May, husband of Theresa.
0:07:54 > 0:07:55c) Piers Corbyn, brother of Jeremy.
0:07:55 > 0:07:57or d) Stanley Johnson, father of Boris.
0:07:57 > 0:07:58At the end of the show Clare will give us the correct answer.
0:08:07 > 0:08:10Let's turn to the story that's going to dominate
0:08:10 > 0:08:12here at Westminster for the next few days,
0:08:12 > 0:08:15and frankly for the following months and years,
0:08:15 > 0:08:17as MPs brace themselves for up to eight hours of debate
0:08:17 > 0:08:20on the EU Withdrawal Bill in the Commons today.
0:08:20 > 0:08:22It's a crucial piece of the Brexit legislation
0:08:22 > 0:08:25designed to copy across EU rules into domestic UK law
0:08:25 > 0:08:27to ensure a smooth transition on the day after we leave.
0:08:27 > 0:08:30And it looks like storm clouds could be gathering over Parliament
0:08:30 > 0:08:35as MPs begin to thrash out the details of the bill.
0:08:35 > 0:08:37Labour and a number of Conservative rebels
0:08:37 > 0:08:39have already expressed anger at Theresa May's announcement
0:08:39 > 0:08:42that the date we actually leave the EU will be put into the bill
0:08:42 > 0:08:46and fixed at the 29th March 2019.
0:08:46 > 0:08:49Mrs May wrote in the Telegraph that her government would not
0:08:49 > 0:08:53tolerate attempts from any quarter to use amendments to the bill
0:08:53 > 0:09:02to slow down or stop our departure from the EU.
0:09:02 > 0:09:04However, nearly 400 amendments have been tabled
0:09:04 > 0:09:06and although only a number will be voted on,
0:09:06 > 0:09:08they could cause real problems
0:09:08 > 0:09:12for a government with a slim majority in the Commons.
0:09:14 > 0:09:16The amendments include calls to curb the so-called "Henry VIII powers"
0:09:16 > 0:09:19that would allow ministers to change laws without much Parliamentary
0:09:19 > 0:09:22scrutiny and a demand that we don't actually leave the European Union
0:09:22 > 0:09:25until a new treaty establishing a future relationship between the UK
0:09:25 > 0:09:31and EU has been agreed by MPs.
0:09:36 > 0:09:41Jeremy Corbyn wants to keep the European Court of Justice's
0:09:41 > 0:09:47oversight over us during any transition period
0:09:47 > 0:09:49and Remain-supporting Conservatives could join with Labour
0:09:49 > 0:09:52and rebel on the issue of giving parliament a so-called
0:09:52 > 0:09:55"meaningful vote" once the deal has been done.
0:09:55 > 0:09:57Yesterday Brexit secretary David Davis
0:09:57 > 0:09:58appeared to give ground on that issue,
0:09:58 > 0:10:01promising a final parliamentary vote.
0:10:01 > 0:10:04I can now confirm that once we have reached an agreement,
0:10:04 > 0:10:06we will bring forward a specific piece of primary legislation
0:10:06 > 0:10:10to implement that agreement.
0:10:10 > 0:10:14This will be known as the Withdrawal Agreement and Implementation Bill.
0:10:14 > 0:10:16This confirms that the major policy set out in the withdrawal agreement
0:10:16 > 0:10:19will be directly implemented into UK law by primary legislation,
0:10:19 > 0:10:23not by secondary legislation in the Withdrawal Bill.
0:10:23 > 0:10:25This also means that Parliament will be given time to debate,
0:10:25 > 0:10:28scrutinise and vote on the final agreement we strike
0:10:28 > 0:10:29with the European Union.
0:10:29 > 0:10:38This agreement will only hold if Parliament approves.
0:10:38 > 0:10:42That was David Davis speaking yesterday,
0:10:42 > 0:10:45but was that concession enough for Conservatives
0:10:45 > 0:10:47who might be thinking about voting against the government?
0:10:47 > 0:10:50Well, Dominic Grieve is a Tory MP who has tabled 19 amendments
0:10:50 > 0:10:52to the bill and has signed more.
0:10:52 > 0:10:54He's in central lobby of the Houses of Parliament.
0:10:54 > 0:10:57The government is promising to enshrine the "Brexit" deal in
0:10:57 > 0:11:00primary legislation which means MPs will be able to make amendments to
0:11:00 > 0:11:05the deal, does that give Parliament a meaningful vote that you will
0:11:05 > 0:11:08support?It is a very significant change and I greatly welcome it,
0:11:08 > 0:11:14that said, it remains the case that the Secretary of State, in
0:11:14 > 0:11:20explaining it, also highlighted that he thought the powers to do this by
0:11:20 > 0:11:26statutory incident could not be removed. Feels like it might be
0:11:26 > 0:11:30necessary to use them and can only have debate on the statute after we
0:11:30 > 0:11:35have actually left. That is clearly a very unsatisfactory state of
0:11:35 > 0:11:39affairs, the government may have a point on this but we will need to
0:11:39 > 0:11:43explore it during the course of the passage of the legislation and see
0:11:43 > 0:11:48how we can try to make sure that in virtue all circumstances Parliament
0:11:48 > 0:11:51will have two reacts to the statue, which in my view will have to be
0:11:51 > 0:11:55necessary in order to leave the EU. At this stage, we are not saying you
0:11:55 > 0:12:00will vote against the government or push ahead with an amendment for
0:12:00 > 0:12:05this so-called meaningful vote?No, yes, I should say, that is exact
0:12:05 > 0:12:10what I am saying, the amendments table, series amendment, the
0:12:10 > 0:12:14government has come back with an important concession, at the same
0:12:14 > 0:12:19time, that concession has been qualified, and we need to look at
0:12:19 > 0:12:23the terms of the qualification. This is part of the process of what
0:12:23 > 0:12:29looking at a committee is all about. I keep what optimism that we will
0:12:29 > 0:12:32resolve many of the issues on which I have taken amendments by
0:12:32 > 0:12:37consenting between the government and myself. -- consensus.Looking at
0:12:37 > 0:12:41Conservative colleagues who were at a meeting with the Chief Whip
0:12:41 > 0:12:44yesterday, and there was some anger expressed at that time, were you at
0:12:44 > 0:12:48that meeting?I was present at the meeting with the Chief Whip
0:12:48 > 0:12:56yesterday, yes.How bad was the feeling between yourself and the
0:12:56 > 0:12:59whip?I will not discuss the meeting but there was considerable anger
0:12:59 > 0:13:03among sections of the Conservative MPs, the government having tabled
0:13:03 > 0:13:07the amendment, accompanied by a sort of pronouncement that there would be
0:13:07 > 0:13:12fixed on the face of the bill a date of exit, March 2019 I could not
0:13:12 > 0:13:15understand why they were doing this and it made no sense to me at all
0:13:15 > 0:13:19except as a placatory offering to those of my colleagues who really
0:13:19 > 0:13:24want to take us out of the EU without any deal at all. I
0:13:24 > 0:13:27subsequently discovered this morning that the government tabled another
0:13:27 > 0:13:30amendment, which they did not talk about on Friday, which, if passed by
0:13:30 > 0:13:37the house, entirely negates the effect of their first Amendment. I
0:13:37 > 0:13:42have to say, this is all a bit regrettable, I think the government
0:13:42 > 0:13:45should be treating Parliament as grown-ups and we should not have
0:13:45 > 0:13:49games going on which are likely to make people irritated.Why do you
0:13:49 > 0:13:55think they are playing games, they obviously want to have people like
0:13:55 > 0:13:59yourself on site for this important piece of Brexit legislation, you say
0:13:59 > 0:14:02there was a lot of anger expressed at the time but what is essentially
0:14:02 > 0:14:07wrong with having an end state on the face of the bill?And end date
0:14:07 > 0:14:13on the face of the bill, which is obligatory, is a crazy thing to do.
0:14:13 > 0:14:17We do not know exactly how the negotiations will and, it could lead
0:14:17 > 0:14:22to a situation where we leave the EU in chaos, whereas just by extending
0:14:22 > 0:14:27the period of membership by one week, for example, we would have
0:14:27 > 0:14:31been able to get the deal the government is seeking. It is a
0:14:31 > 0:14:34completely pointless amendment and should never have been introduced to
0:14:34 > 0:14:36the statute books. What the Prime Minister said that we will not
0:14:36 > 0:14:43tolerate attempts from any quarter to allow amendments to block the
0:14:43 > 0:14:48democratic will of the people.She's talking about you.I don't know if
0:14:48 > 0:14:52she's talking about me or not, my task as a parliamentarian is to
0:14:52 > 0:14:56listen to the consequences of the referendum, I have always said this,
0:14:56 > 0:14:59and I have been consistent in not trying to obstruct Brexit taking
0:14:59 > 0:15:03place but that is not removed my responsibility as a parliamentarian
0:15:03 > 0:15:08to scrutinise legislation and ensure that every stage, people, the public
0:15:08 > 0:15:12generally, understand what we are doing and the consequences of what
0:15:12 > 0:15:15we are doing, and that is what I intend to do as this legislation
0:15:15 > 0:15:21goes through. I'm confident that as we go through this, we will end up
0:15:21 > 0:15:24with better legislation at the end. Are you prepared to vote against the
0:15:24 > 0:15:27government if you don't think this legislation is fit for purpose in
0:15:27 > 0:15:28your mind?
0:15:34 > 0:15:39I said at second reading if the legislation was not improved, it was
0:15:39 > 0:15:44questionable as to whether it was fit for purpose. We believe that as
0:15:44 > 0:15:47a hypothetical question.It sounds as if you are prepared to vote
0:15:47 > 0:15:51against the government. Are you prepared to consider what will
0:15:51 > 0:15:55happen if you vote against the government, it could lead to a vote
0:15:55 > 0:15:59of no-confidence the government could fall? You have taken that into
0:15:59 > 0:16:04account?I have taken everything into account, but if the legislation
0:16:04 > 0:16:08is not fit for purpose, it will not deliver what the public want, a
0:16:08 > 0:16:14smooth Brexit.Are you prepared to bring the government down for that?
0:16:14 > 0:16:18That is an entirely hypothetical question. I am a supporter of the
0:16:18 > 0:16:23government and my task is to ensure the government succeeds.Would you
0:16:23 > 0:16:28join forces with Labour on a number of these amendments to improve the
0:16:28 > 0:16:33bill?The question is not a question of joining forces, as a
0:16:33 > 0:16:36parliamentarian I express a view on the floor of the house as to what I
0:16:36 > 0:16:40think could improve the bill. If there are other members across the
0:16:40 > 0:16:45house to share my views, they were expressed that as well.If you do
0:16:45 > 0:16:50vote with Labour colleagues, are you a collaborator as your Tory
0:16:50 > 0:16:55colleague Bill Cash suggests?All I will say to Bill Cash is that he has
0:16:55 > 0:16:58probably rebelled against the Conservative government more often
0:16:58 > 0:17:01than any single other colleague on the Conservative benches in the
0:17:01 > 0:17:09course of his career. I think with one exception over HS2, I do not
0:17:09 > 0:17:13think I have ever rebelled against the government after 20 years in
0:17:13 > 0:17:19Parliament.Was it helpful that will cash did that?I was not around, but
0:17:19 > 0:17:26he thought it was the right thing to do with his conscience and decided
0:17:26 > 0:17:30to support the government at the time despite disagreeing with them.
0:17:30 > 0:17:36So a deal is agreed on mice the 29th at 3pm in the afternoon and it comes
0:17:36 > 0:17:41to Parliament and you do not like the deal. What we do because it will
0:17:41 > 0:17:46be eight hours before the EU leaves the EU?We will make an assessment
0:17:46 > 0:17:51of the situation as it stands at the time. The only option open to
0:17:51 > 0:17:55Parliament is either to accept the deal or reject the deal and face a
0:17:55 > 0:17:59chaotic exit without any agreement to move into any transitional
0:17:59 > 0:18:05arrangement. That is a problem for Parliament and indeed the public
0:18:05 > 0:18:09which they will have to face up to at the end of this risky and complex
0:18:09 > 0:18:13process.If you reject it at that point, there will be no time to go
0:18:13 > 0:18:19back to the EU to undo the bill? That is right unless the EU is
0:18:19 > 0:18:24prepared to re-negotiate.Which of course it is not at the moment.
0:18:24 > 0:18:26Which of course it is not at the moment.
0:18:26 > 0:18:28Well, to discuss this further we're joined by former Conservative
0:18:28 > 0:18:30cabinet minister Theresa Villiers, who campaigned for Brexit,
0:18:30 > 0:18:33and by Labour's Chris Leslie who is a member of the pro-EU
0:18:33 > 0:18:34campaign group Open Britain.
0:18:34 > 0:18:39Welcome to both of you. Chris Leslie, are you pleased that David
0:18:39 > 0:18:44Davis has now promised a meaningful vote to Parliament?He has tried to
0:18:44 > 0:18:49polish it up as though it is a meaningful vote, but within the
0:18:49 > 0:18:56space of 15 minutes all of those impressions quickly fell away and I
0:18:56 > 0:18:59think most parliamentarians, including Dominic and others, are
0:18:59 > 0:19:04now saying, hang on a minute, what is the point of offering an act of
0:19:04 > 0:19:08Parliament, a bill that will become an act of Parliament, after the
0:19:08 > 0:19:13withdrawal agreement has been signed and sealed by ministers? The whole
0:19:13 > 0:19:16point of parliamentary democracy is you can shape events, you can steer
0:19:16 > 0:19:22what happens. If you have that Bill before the withdrawal agreement is
0:19:22 > 0:19:27signed, so it is a draft withdrawal agreement, that would be a
0:19:27 > 0:19:32significant concession.Otherwise it is a sham. When do you want it to
0:19:32 > 0:19:37be? Surely the same situation will stand if it is a month or two months
0:19:37 > 0:19:41before we leave the EU? There still will not be time to redo the bill
0:19:41 > 0:19:46before we go back to Brussels. Because this is the most important
0:19:46 > 0:19:50change in a generation we should not box ourselves into an artificial
0:19:50 > 0:19:57timetable. We have to get it right. When a draft, is from the European
0:19:57 > 0:20:01Commission, from ministers of the Crown, Parliament can look at it and
0:20:01 > 0:20:07decide if it is good enough. Does it protect businesses and jobs? Is it
0:20:07 > 0:20:13making sure that European medicines can flow, that we can have tariff
0:20:13 > 0:20:17free trade? Or is it going to really harm this country significantly? I
0:20:17 > 0:20:21think we have got to be serious and growing up about it and deal with
0:20:21 > 0:20:27that before the withdrawal treaty is signed.Explain to our viewers why
0:20:27 > 0:20:32does offer from David Davis is a game changer?It is a very important
0:20:32 > 0:20:36compromise the government has made, signalling it wants to work across
0:20:36 > 0:20:41parties with people with different views on these matters. It will give
0:20:41 > 0:20:45Parliament the opportunity to scrutinise in detail the withdrawal
0:20:45 > 0:20:49agreement. I think it is a sensible move and it does demonstrate that
0:20:49 > 0:20:53the government wants to work across parties to make a success and
0:20:53 > 0:20:57deliver a smooth exit from the European Union.Or it is worried
0:20:57 > 0:21:01about defeat because there could be enough Conservative rebels that they
0:21:01 > 0:21:05might actually lose the vote. You say there will be time and it will
0:21:05 > 0:21:10be meaningful, but if the deal goes to the wire, we are talking about
0:21:10 > 0:21:13the last moment which David Davis has discussed, the vote could happen
0:21:13 > 0:21:19afterwards, could it not?Everyone wants to get an agreement before the
0:21:19 > 0:21:24deadline. But we have to bear in mind that he meaningful vote took
0:21:24 > 0:21:30place in the referendum and when MPs decided to invoke Article 50. Once
0:21:30 > 0:21:35we did that, the question is we get another vote on the deal, but if we
0:21:35 > 0:21:39reject that deal we leave under Article 50 without an agreement.
0:21:39 > 0:21:42There were lots of things not on the ballot paper and that were not part
0:21:42 > 0:21:49of the vote in Article 50, for example the market, the customs
0:21:49 > 0:21:59union, should we be a member of all these various agencies? The aviation
0:21:59 > 0:22:06situation, the fishery system. If Parliament cannot deal with all of
0:22:06 > 0:22:09these, what on earth is the point of having Parliament there at all?
0:22:09 > 0:22:13Because you want to stuff it, you want to thwart the decision that was
0:22:13 > 0:22:18taken at the time of the referendum and enacted by Article 50 which the
0:22:18 > 0:22:25Labour Party voted for.There is no static, democratic snapshot. The
0:22:25 > 0:22:31situation is evolving all the time. Yes, I am personally very sceptical
0:22:31 > 0:22:35about Brexit, but in the House of Commons there may be a consensus
0:22:35 > 0:22:39which says maybe we need to stay in the single market, maybe we want a
0:22:39 > 0:22:44proper transition more than the deep deal that the government are doing.
0:22:44 > 0:22:48How can Parliament secure that if the deal is already done and dusted?
0:22:48 > 0:22:53That is the point. You campaign so hard to give Parliament sovereignty
0:22:53 > 0:22:57in this case, but it will not have any meaning. You just said yourself
0:22:57 > 0:23:02in terms of the deal it could well be a take it or leave it.That is
0:23:02 > 0:23:09the way Article 50 works.So it is a sham. This offer from David Davis is
0:23:09 > 0:23:16not a meaningful vote.Once you invoke Article 50, you say you are
0:23:16 > 0:23:19leaving the European Union and that is what will take place on March the
0:23:19 > 0:23:2420 night.We know the Prime Minister has probably had some legal advice
0:23:24 > 0:23:29because she is refusing to say if she has had legal advice and the
0:23:29 > 0:23:33government policy is that we leave on March the 20 night in 2019, but
0:23:33 > 0:23:37the government is backed into a corner, the clock has ticked down,
0:23:37 > 0:23:41we have not got a good deal and Parliament might have to revoke
0:23:41 > 0:23:46Article 50. It is far better if we get into a situation where
0:23:46 > 0:23:51Parliament is taken along and not treated as an afterthought.That is
0:23:51 > 0:23:57revealing. At the heart of it you want to use amendments to overturn
0:23:57 > 0:24:04it, to block it from going along?I want to ensure prosperity and jobs
0:24:04 > 0:24:07for this country rather than take an ideological view that somehow going
0:24:07 > 0:24:13over a cliff edge into a hard Brexit is great for Britain.We all want to
0:24:13 > 0:24:16ensure jobs and prosperity and the way to do that is by working
0:24:16 > 0:24:21together across parties to deliver a successful end result.If that is
0:24:21 > 0:24:25the case, let's do it in Parliament before the treaty is signed, surely
0:24:25 > 0:24:30that is the most grown-up and sensitive way to do it.Let's talk
0:24:30 > 0:24:33about working cross party because your amendments do not have Tory
0:24:33 > 0:24:38support apart from MPs like Dominic Grieve, so they will not go
0:24:38 > 0:24:46anywhere, will they?We are joined up with Ken Clarke and in the
0:24:46 > 0:24:50Florence speech, where Theresa May said she wanted a transitional
0:24:50 > 0:24:55arrangement, we want to put that into the bill.And how much support
0:24:55 > 0:25:01has Theresa May got from other MPs? Those votes will come on days six
0:25:01 > 0:25:05and seven and eight, so we are only at the foothills of this particular
0:25:05 > 0:25:10bill's committee states so far.But you need remain Tories on side
0:25:10 > 0:25:16otherwise your amendments do not go anywhere.True.How much talking is
0:25:16 > 0:25:21going on?Lots of discussion is going on across all parties. I have
0:25:21 > 0:25:24a very strong opinion about the dangers of Brexit and others are
0:25:24 > 0:25:28saying they want Brexit do happen in a gentle way with the transition. I
0:25:28 > 0:25:32will get the best possible outcome I can do and work with colleagues to
0:25:32 > 0:25:37do that. But if we stick to ideological, party political
0:25:37 > 0:25:42tramlines, we will not do much right for the public.Is that what Bill
0:25:42 > 0:25:49Cash is doing when he describes them as Tory collaborators when they join
0:25:49 > 0:25:53the Labour Party?I urge my colleagues not to vote against the
0:25:53 > 0:25:57government, but I recognise they have strong views on these issues.
0:25:57 > 0:26:01As Dominic Grieve said we need to work to scrutinise this bill
0:26:01 > 0:26:05carefully and make sure nothing goes through which would jeopardise
0:26:05 > 0:26:09implementation of the result of the referendum.Would they be
0:26:09 > 0:26:13collaborators if they joined forces with the turncoat Labour Party?I
0:26:13 > 0:26:17would not describe them like that, but I would urge them not to do
0:26:17 > 0:26:20anything which would undermine respect for the 17.5 million votes
0:26:20 > 0:26:25in this country.Why was it important for Theresa May to put the
0:26:25 > 0:26:29date in the bill? Does it not tied the government's and by having a
0:26:29 > 0:26:36hard buffer their in March?The country has made its decision. MPs
0:26:36 > 0:26:40ratify that when they invoked Article 50, that means we are
0:26:40 > 0:26:44leaving on the 29th of March. It makes sense to include that date in
0:26:44 > 0:26:49the bill.It is the stupidity of boxing ourselves into a poor
0:26:49 > 0:26:54negotiating hand so that the other side of the negotiating table can
0:26:54 > 0:26:58wait for the clock to come down and we get more and more desperate for a
0:26:58 > 0:27:02deal as time goes by. There was nothing on the ballot paper about
0:27:02 > 0:27:09the 29th of March, 2019. All of this should be for Parliament to decide.
0:27:09 > 0:27:17Do not be so rigid, getting the best deal is what we want.I can agree on
0:27:17 > 0:27:20the need for an implementation period. Right across the House of
0:27:20 > 0:27:28Commons we agree on that. That will enable us to prepare for Brexit.
0:27:28 > 0:27:32Which is why some of the amendments today are really crucial. Do not
0:27:32 > 0:27:36forget the Prime Minister herself said in the Florence speech that win
0:27:36 > 0:27:41might need the ECJ to continue in order to get existing institutions
0:27:41 > 0:27:45in the transition. The bill as it stands stops all of that and throws
0:27:45 > 0:27:50it out on exit today, so the bill is not consistent with the
0:27:50 > 0:27:54implementation position that even the Prime Minister has talked about.
0:27:54 > 0:28:00How likely is no deal scenario now? We have got this hard buffer of a
0:28:00 > 0:28:04date which the government would like to put on the bill and the clock is
0:28:04 > 0:28:10ticking. Do you think no deal is now the more likely option?No, I remain
0:28:10 > 0:28:14optimistic we will get a deal. One question is the mechanics of the
0:28:14 > 0:28:18exit deal and the second is the trade agreement. Delivering the
0:28:18 > 0:28:22trade agreement will be more difficult in the time available, but
0:28:22 > 0:28:26it is in the interests of both sides that we do that and I remain
0:28:26 > 0:28:31optimistic we can do both.As a doctor and working in the NHS, how
0:28:31 > 0:28:39important is it for you to get that deal?You want to remain. I sit here
0:28:39 > 0:28:43aghast and known as the majority of the public do I suspect. If I was
0:28:43 > 0:28:47offering you a major operation and told you nothing about it until your
0:28:47 > 0:28:52guts were spilling out and you are on the table and told you nothing
0:28:52 > 0:28:55about the side-effects and what it would cost and what it would mean
0:28:55 > 0:29:00further down the line and then you have little choice, you would strike
0:29:00 > 0:29:05me off and refer me to the General Medical Council. There are real
0:29:05 > 0:29:08people frightened about this, real people leaving this country and real
0:29:08 > 0:29:14people suffering and yet we are playing party politics. For me in
0:29:14 > 0:29:17the NHS, the NHS relies on overseas people not just for service
0:29:17 > 0:29:27delivery, but for innovation and yet we are entering this process, if I
0:29:27 > 0:29:34can finish, I understand people who want to leave because they were told
0:29:34 > 0:29:39more lives than a used car salesman. Did the other side not tell lies?
0:29:39 > 0:29:48They did not tell lies. Project fear was considered lies. It was not, but
0:29:48 > 0:29:54they were too arrogant and two expert to say it does not work.Let
0:29:54 > 0:29:58Theresa Villiers comeback in terms of reassuring people. You talk about
0:29:58 > 0:30:02the majority of people. There is no evidence to say the majority of
0:30:02 > 0:30:07people are worried. The polls are shifting. We do not have that
0:30:07 > 0:30:10evidence. Reassure her if she thinks people are literally terrified about
0:30:10 > 0:30:15what is happening.This is a period of uncertainty and one of the
0:30:15 > 0:30:20reasons we need this withdrawal bill to go through is to ensure we have
0:30:20 > 0:30:25as much certainty as possible for businesses and individuals. I take
0:30:25 > 0:30:29issue with you in terms of the reasons why people voted to leave.
0:30:29 > 0:30:34It is legitimate to say that we should take back control of making
0:30:34 > 0:30:38our own laws in our own Parliament. That is why people voted to leave
0:30:38 > 0:30:45the European Union.We will have to leave it there. Briefly, this
0:30:45 > 0:30:48statutory instrument Dominic Grieve topped the back that he says is in
0:30:48 > 0:30:52the bill which would allow the government to extend the data beyond
0:30:52 > 0:30:56the 29th of March, does that worry you? does that worry you?I have not
0:30:56 > 0:31:00seen the details, I think it was only...That is the detail, that
0:31:00 > 0:31:06they can extend the date by using a statutory instrument, it could go
0:31:06 > 0:31:09further into the future, are you worried?It would be good to have an
0:31:09 > 0:31:13exit date, if there is flexibility that the government also puts
0:31:13 > 0:31:17forward, I will certainly consider that carefully, it is not worry me,
0:31:17 > 0:31:20from what you have told me about it.
0:31:28 > 0:31:32Chance of Philip Hammond is not short of advice, including from some
0:31:32 > 0:31:37within his own party, believe supporting MP Jake Jacob Reece Mark
0:31:37 > 0:31:45has today been delivering his own budget for Brexit.
0:31:45 > 0:31:48The leave supporting MP Jacob Rees Mogg has this morning
0:31:48 > 0:31:49been delivering his own "budget for Brexit".
0:31:49 > 0:31:52He predicts there will be a £135 billion windfall
0:31:52 > 0:31:54to the Treasury between 2020-2025 as the financial benefits
0:31:54 > 0:31:55from leaving the EU are felt.
0:31:55 > 0:31:58We'll speak to him in a moment, but first let's have
0:31:58 > 0:31:59a listen to the speech.
0:31:59 > 0:32:01The key to economic success and the ability to pay for public services
0:32:01 > 0:32:05is our ability to exercise economic freedom and simultaneously minimise
0:32:05 > 0:32:09protectionism. The results of these ideas will be an intensification of
0:32:09 > 0:32:13competition in the UK economy which will improve the UK's productive
0:32:13 > 0:32:20performance. I confidently believe therefore that over the medium-term,
0:32:20 > 0:32:23the fiscal prospects are much better, than those that will be
0:32:23 > 0:32:29revealed to you by the Obie's short-term projections. It does it
0:32:29 > 0:32:33reputable, but on the basis of full assumptions, supplied to it by the
0:32:33 > 0:32:42Treasury.I apologise for the picture quality, we were hoping to
0:32:42 > 0:32:46speak with him directly, but I think there are technical issues which
0:32:46 > 0:32:51prevent us from doing so, so instead...
0:32:51 > 0:32:54We like to introduce you to new words on this show,
0:32:54 > 0:32:56think of us as a political version of Ccountdown, but
0:32:56 > 0:32:58without dictionary corner or the loyal fanbase.
0:32:58 > 0:33:00Some recently coined terms include "fake news", "gig economy",
0:33:00 > 0:33:01or how about "gender fluid"?
0:33:01 > 0:33:03Well, the philosopher Roger Scruton has brought
0:33:03 > 0:33:11one to our attention, it's "oikophobes".
0:33:11 > 0:33:13Oikophobes, he says, "define their goals and ideals
0:33:13 > 0:33:15against some cherished form of membership against anything that
0:33:15 > 0:33:25makes a claim, however justified, on their loyalty".
0:33:25 > 0:33:27Well, Roger Scruton talks about "oikohphobia" in his new book,
0:33:27 > 0:33:30it's called Where We Are, The State of Britain Now,
0:33:30 > 0:33:36and he joins us now.
0:33:36 > 0:33:42You refer to this term oikohphobia but is a deep cynicism needed to
0:33:42 > 0:33:46make institutions work for everyone? Certain measure of cynicism is
0:33:46 > 0:33:51always a good thing, but a deep in a system, which bases its self
0:33:51 > 0:33:54entirely on mediation, that is not a very helpful thing to the thing that
0:33:54 > 0:33:56it repudiates.
0:33:56 > 0:34:01We all of us in my view have a need to belong, we all define belonging
0:34:01 > 0:34:05in slightly different ways but there are certain fundamental things that
0:34:05 > 0:34:10we must share. A place, which is ours, whether or not we agree about
0:34:10 > 0:34:15how it should be governed, this is the place we are talking about, a
0:34:15 > 0:34:19system of law, political process which is ours. In defining that
0:34:19 > 0:34:24term, I was really trying to come to terms with the growing current of
0:34:24 > 0:34:29rejection that runs especially through the intellectual world, in
0:34:29 > 0:34:32which people try to define themselves not in terms of where
0:34:32 > 0:34:37they belong but in terms of what they would not belong to if they
0:34:37 > 0:34:46were not rejecting it!Where do you fit in, in this, are you an
0:34:46 > 0:34:51oikohphobeyou are fundamentally correct, we all have a fundamental
0:34:51 > 0:34:55need to belong to a group. All have groups, there is a great move at the
0:34:55 > 0:35:00moment not to belong to something, we have not to belong to a gender at
0:35:00 > 0:35:04the moment, and the confusion that is causing.What about the belief of
0:35:04 > 0:35:10being part of the country, the land. Absolutely, as a foreigner, I feel I
0:35:10 > 0:35:14belong to this country, this country is very dear to me, gave me and my
0:35:14 > 0:35:20family a home and work and gave me my future and I belong to the United
0:35:20 > 0:35:23Kingdom, does not mean that when I go abroad to where I actually come
0:35:23 > 0:35:28from I do not feel some loyalty, but I belong here. The rejection of
0:35:28 > 0:35:32belonging is a perverse and pervasive part of our society, as
0:35:32 > 0:35:38you say.You talk about it being part of the intellectual is...What
0:35:38 > 0:35:42do you mean? My colleagues in universities on the whole, as George
0:35:42 > 0:35:47Orwell pointed out a long time ago, they cannot utter words like
0:35:47 > 0:35:52England, Britain and so on without a certain smear. It is always, we are
0:35:52 > 0:35:56not to be identified like that, that is what our grandparents fought for,
0:35:56 > 0:36:02but we are in the business of establishing our identity completely
0:36:02 > 0:36:07apart from all the ordinary forms of loyalty.Do you agree with that?
0:36:07 > 0:36:13Universities were criticised for negativity towards Brexit, is that a
0:36:13 > 0:36:19form of elitism that should be discouraged?Not at all,
0:36:19 > 0:36:23universities were critical of Brexit because of what people do to
0:36:23 > 0:36:25innovation and academic and universities that is part of it, I
0:36:25 > 0:36:30den think it is part of not belonging to Britain. If one were to
0:36:30 > 0:36:36ask. -- I don't think. I'm European, that is why I feel strongly about
0:36:36 > 0:36:41Brexit. I was born on one continent and I live in another, we are all
0:36:41 > 0:36:46from all over the place, very few of us are one bit, if we check DNA. I
0:36:46 > 0:36:50belong here, my loyalties, we have just celebrated Remembrance Day, I
0:36:50 > 0:36:54was not born there, it is not part of my culture in many ways but I
0:36:54 > 0:36:57feel it through me.Do you sympathise with Roger's point that
0:36:57 > 0:37:05there is a smear about Englishness and England.Yes, if you went to
0:37:05 > 0:37:09Scotland, Ireland...Absolutely, yes, absolutely, again, interesting
0:37:09 > 0:37:14point, by being in favour of Scottish nationalism, someone can
0:37:14 > 0:37:19use that to enhance his rejection of England, that is one of the reasons
0:37:19 > 0:37:22why we do not find a great intellectual movement to smear
0:37:22 > 0:37:29Scottish nationalism. While we do find a great movement to smear
0:37:29 > 0:37:33Englishness.Do you see the support of the the EU, the remain
0:37:33 > 0:37:37credentials Claire inhabits, do you see that as being disloyal?No, of
0:37:37 > 0:37:47course not, not in itself, best to say. It is quite possible to be a
0:37:47 > 0:37:51committed citizen of one country and also have wider loyalty to other
0:37:51 > 0:37:57things. I am very much a British patriot, also, an English patriot,
0:37:57 > 0:38:05and I am also European. But I also think that in the end, one's basic
0:38:05 > 0:38:08political identity is wrapped up with the people who govern you.
0:38:08 > 0:38:14Where are we governed from, by whom? That is why I am in favour of Brexit
0:38:14 > 0:38:18because I am in favour of national sovereignty. But it does not stop me
0:38:18 > 0:38:23being European or thinking that I have a wider loyalty to the
0:38:23 > 0:38:26continent and the civilisation that has established.I agree with you
0:38:26 > 0:38:29with most of what you said except for the last bit.I know that you
0:38:29 > 0:38:34wouldn't.Quirkiness, that the English do not promote themselves, I
0:38:34 > 0:38:41love that, the English bemoan themselves.You criticise-- you
0:38:41 > 0:38:44criticise Jeremy Corbyn as being a radical oikohphobe but you seem to
0:38:44 > 0:38:48agree with him on globalisation, for instance, one of the issues you
0:38:48 > 0:38:54highlight is damaging the nation. Yes, that is true, but he would join
0:38:54 > 0:38:58in this fundamentally anti-English sentiment, I think.Why would he do
0:38:58 > 0:39:03that?He believes that ours is a class society, which has to be
0:39:03 > 0:39:08turned upside down, we have two repudiates all kinds of institutions
0:39:08 > 0:39:14and ways of doing things for the sake of a more egalitarian border,
0:39:14 > 0:39:17which is not defined.If institutions are not working for
0:39:17 > 0:39:21large portions of society, as Jeremy Corbyn and Theresa May have said,
0:39:21 > 0:39:26isn't it right that they are challenged?Up to a point, yes, but
0:39:26 > 0:39:30it depends upon which institutions, not the political process under the
0:39:30 > 0:39:34common law, that we have inherited about which Jeremy Corbyn has almost
0:39:34 > 0:39:38nothing to say.Do you think it is right to challenge in the tuition is
0:39:38 > 0:39:42to lead to a more egalitarian society?Who could possibly disagree
0:39:42 > 0:39:48with that, of course I do, but what institutions? The NHS is the most
0:39:48 > 0:39:53egalitarian in the juice and we have in this country, it is classless. --
0:39:53 > 0:39:58institution. If we put more money into education we would then have...
0:39:58 > 0:40:03I disagree, if we put less money into it, it would get much better.
0:40:03 > 0:40:09Tell that to the teachers.Yes, I know, but at the moment, two
0:40:09 > 0:40:13bureaucrats for every teacher in the state education system, that money
0:40:13 > 0:40:17is being squandered partly because people are not taking seriously the
0:40:17 > 0:40:21crucial encounter, that between the teacher and the pupil.I disagree,
0:40:21 > 0:40:25when you have schools having to ask parents for substitute Harry on
0:40:25 > 0:40:30teaching, when teachers are taking in equipment in order to teach, and
0:40:30 > 0:40:35where you know that bureaucracy is management, you need to run an
0:40:35 > 0:40:39organisation, you cannot run it on a wing and a prayer.I don't see why
0:40:39 > 0:40:44not, you see, if we privatise the entire educational system, people
0:40:44 > 0:40:47all over the country would be taking these initiatives and running things
0:40:47 > 0:40:52on a wing and a prayer. I have believed that all my life.Before
0:40:52 > 0:40:56you go, talking about the European Union, you are in favour of leaving
0:40:56 > 0:41:00it, do you access that it could lead to worse consequences, of
0:41:00 > 0:41:04globalisation, bargain bucket economy, race to the bottom in
0:41:04 > 0:41:09regulation, a Singapore style economy, very successful however in
0:41:09 > 0:41:16Singapore but which may not work here?Anything might happen, none of
0:41:16 > 0:41:20us are a profits, and I am even less of a profit than Jeremy Corbyn
0:41:20 > 0:41:25because I have no power, he can influence things. But it has ever
0:41:25 > 0:41:31been so, all political decisions are made largely in a void. And all you
0:41:31 > 0:41:34have to rely upon is your own sense of the past and obligations and
0:41:34 > 0:41:37loyalties. -- none of us are prophets. That is what should take
0:41:37 > 0:41:41us forward.Thank you very much.
0:41:46 > 0:41:49Is it right for patients to be prevented from having
0:41:49 > 0:41:51certain types of treatment
0:41:51 > 0:41:53unless they quit smoking or lose weight?
0:41:53 > 0:41:56Well, health trusts argue this is often the best way to improve
0:41:56 > 0:42:00results of non-emergency operations, but critics claim it's also a way
0:42:00 > 0:42:03of dealing with the pressure on NHS budgets in England and Wales
0:42:03 > 0:42:04by rationing care.
0:42:04 > 0:42:05Emma Vardy's been to Hertfordshire
0:42:05 > 0:42:08where some new rules have caused controversy.
0:42:08 > 0:42:10Here, some NHS patients are given an ultimatum.
0:42:10 > 0:42:14Under new rules, some smokers will only be referred
0:42:14 > 0:42:16for certain operations ifthey quit smoking.
0:42:16 > 0:42:18Those who are obese may be restricted from having non-urgent
0:42:18 > 0:42:25surgery until they lose weight.
0:42:25 > 0:42:27Clinical commissioning groups, these are the GP-led organisations
0:42:27 > 0:42:30that plan local care,
0:42:30 > 0:42:33they are facing tough decisions this year about how
0:42:33 > 0:42:38to balance their budgets.
0:42:38 > 0:42:40The Hertfordshire case is not a one-off, the majority
0:42:40 > 0:42:42of CCGs are having to consider different ways
0:42:42 > 0:42:45to restrict access to patient care in order to balance budgets.
0:42:45 > 0:42:48I think we can expect to see more and more of these cases of CCGs
0:42:48 > 0:42:51taking tough decisions about how to meet financial targets.
0:42:51 > 0:42:54The NHS is under huge financial pressure
0:42:54 > 0:42:58because the demand for care is going up much faster than funding.
0:42:58 > 0:43:00It means like Hertfordshire,
0:43:00 > 0:43:01many areas are taking more stringent decisions,
0:43:01 > 0:43:06but is that fair?
0:43:06 > 0:43:09I don't think it should be a blank "we cannot treat
0:43:09 > 0:43:10you because you smoke."
0:43:10 > 0:43:14I think they should have to say, you need this, but we want to see
0:43:14 > 0:43:16that you are stopping smoking in the meantime.
0:43:16 > 0:43:19Never smoked in my life, and I do feel that it should be
0:43:19 > 0:43:21considered absolutely, yes.
0:43:21 > 0:43:31I believe,
0:43:34 > 0:43:37if you've been paying into a national health all your life...
0:43:37 > 0:43:38Then you should get the treatment.
0:43:38 > 0:43:40The Royal College of surgeons has become increasingly concerned
0:43:40 > 0:43:42about the rationing of surgery in the NHS.
0:43:42 > 0:43:45It commissioned a report which last year showed that now nearly one
0:43:45 > 0:43:47third of clinical commissioning groups in England and one health
0:43:47 > 0:43:50board in Wales now have policies which require patients either
0:43:50 > 0:43:51to lose weight or stop smoking
0:43:51 > 0:43:54before they can be referred for routine surgery.
0:43:54 > 0:43:57It fears some patients are becoming soft targets for NHS savings.
0:43:57 > 0:43:59The Royal College of GPs is also worried, saying trying
0:43:59 > 0:44:04to force patients to change will not always work.
0:44:04 > 0:44:07Everybodyknows smoking is bad for us, drinking excessively is bad
0:44:07 > 0:44:10for we also all know that eating too much red meat is bad for us
0:44:10 > 0:44:12and living sedentary lifestyles.
0:44:12 > 0:44:14But it doesn't mean that we all live by those rules,
0:44:14 > 0:44:16and so there is a difference between encouraging people
0:44:16 > 0:44:19to make the right choices, making it easy to live good,
0:44:19 > 0:44:21healthy lifestyles, but then also enforcing rules upon them
0:44:21 > 0:44:24that they were not expecting and in a situation where
0:44:24 > 0:44:25they haven't got much control.
0:44:25 > 0:44:26That is tough.
0:44:26 > 0:44:29Hertfordshire clinical commissioning group says its policies
0:44:29 > 0:44:31are not about saving money, but to improve patient safety
0:44:31 > 0:44:32during nonurgent surgery.
0:44:32 > 0:44:34Some argue that these strategies
0:44:34 > 0:44:37are destroying the fundamental principles of our NHS.
0:44:42 > 0:44:44We're joined now by Alastair Dickson.
0:44:44 > 0:44:51He's a GP and former clinical health adviser to Parliament.
0:44:51 > 0:44:59Welcome to the programme. Just before I come to you, the CCT in
0:44:59 > 0:45:02Hertfordshire says it is not about saving money and it is not about
0:45:02 > 0:45:09rationing. If the surgery outweighs the outcome, the patient will have
0:45:09 > 0:45:20the surgery.You have to separate obesity and smoking. Smoking is a
0:45:20 > 0:45:26childhood disease. I was a smoker. I used to pick up my Father's dog ends
0:45:26 > 0:45:31when I was an eight-year-old and it took me 40 years to finally stop.
0:45:31 > 0:45:37Restricting smokers and where it is very dubious whether the risk
0:45:37 > 0:45:42outweighs the benefits I think is wrong.If someone is asked to give
0:45:42 > 0:45:46up smoking and they give up smoking and it will impact positively the
0:45:46 > 0:45:52outcome, is that not the right thing to do?Fantastic. But as an ex
0:45:52 > 0:45:56smoker myself it took me the best part of 40 years to give up smoking.
0:45:56 > 0:46:04If it was that simple, we would have all stopped a long time ago.
0:46:04 > 0:46:07Alistair, Hertfordshire says that before being referred to surgery you
0:46:07 > 0:46:11will be referred to Weight Watchers and slimming world. Is that a good
0:46:11 > 0:46:16use of NHS money?It is in the most clinically appropriate
0:46:16 > 0:46:20circumstances. We all know that as the film showed we should do things
0:46:20 > 0:46:25to build up our own health and look after ourselves. That should be in
0:46:25 > 0:46:29the overall promotion anyway. If you are talking about everybody and not
0:46:29 > 0:46:35targeting, then one cannot question it. But if you are looking at
0:46:35 > 0:46:39someone who is struggling and they are getting problems with arthritis
0:46:39 > 0:46:44in the knees and their hips, we know from guidelines that this should be
0:46:44 > 0:46:50part of a package of care. It should not be just thrown in at the end.
0:46:50 > 0:46:55What we should be doing is working proactively to do this. When we are
0:46:55 > 0:47:00looking at surgery we should be saying, look, it is important for
0:47:00 > 0:47:05you to lose weight. We know you will have a better chance with your knees
0:47:05 > 0:47:08particularly of actually having a safe and fulfilling operation with
0:47:08 > 0:47:13good outcomes afterwards with minimising failure if you can get
0:47:13 > 0:47:19your weight down.Hips it is not so obvious for. Is there not also an
0:47:19 > 0:47:24aspect of saving money. If you can defer these operators, it will
0:47:24 > 0:47:28improve the outcome, but it saves money and it is a form of rationing.
0:47:28 > 0:47:32Everything is a form of rationing if looked at in the right manner. But I
0:47:32 > 0:47:37agree, it could be a way of saving money, but I am not interested in
0:47:37 > 0:47:43saving money, I am interested in patient outcomes. If we look at the
0:47:43 > 0:47:46triage for primary care developed in the North East and other parts of
0:47:46 > 0:47:52the UK, we have shown that 80% or more of people who were referred for
0:47:52 > 0:47:56surgery did not need surgery and benefited from things which were
0:47:56 > 0:48:01better, including weight loss. When you asked them, they said they did
0:48:01 > 0:48:05not want surgery.Alistair is right around obesity and we have a
0:48:05 > 0:48:10population disaster going on and we need to tackle it at individual and
0:48:10 > 0:48:13population level.That could result in a lot of people being denied
0:48:13 > 0:48:20treatment.What Alistair is saying is right. Your risk of dying if you
0:48:20 > 0:48:26have a BMI of 37-42 is quite high, therefore a routine operation you
0:48:26 > 0:48:29are better off postponing it and going to evidence -based treatment
0:48:29 > 0:48:36and going to Weight Watchers, absolutely 100%. My issue is with
0:48:36 > 0:48:42smokers. Where do you end with lifestyle? If I go skiing in
0:48:42 > 0:48:46January, should I be denied treatment because it is a dangerous
0:48:46 > 0:48:51activity. All of these things become insidiously put in. You are a GP and
0:48:51 > 0:49:17I trust you to make the right decision, but as time goes on and
0:49:53 > 0:49:57Is it more important than you can show that they have low carbon
0:49:57 > 0:50:03monoxide in their blood, on the day of the operation, when it does
0:50:03 > 0:50:08require you to reduce significantly the amount of cigarettes you are
0:50:08 > 0:50:13taking in 448 hours before the operation.Doctors make decisions on
0:50:13 > 0:50:19whether to refer people to surgery every day. Doctors make those
0:50:19 > 0:50:25decisions.-- for 48 hours.Doctors have been making assessments about
0:50:25 > 0:50:31weight and lifestyle forever.Up we now have referral management.
0:50:31 > 0:50:36Doctors make that decision. There is an additional barrier, that will
0:50:36 > 0:50:40increasingly be managers who then decide, whether or not that person
0:50:40 > 0:50:45will go on to the operation.I disagree, actually, we are looking
0:50:45 > 0:50:47at the need for specialist teams.
0:50:58 > 0:51:03I as a GP will be referring you to surgery, but often you need a
0:51:03 > 0:51:06specialist team.Will there be a case of deserving and non-deserving
0:51:06 > 0:51:12patients.There has to be a clinical need for patience and they will be
0:51:12 > 0:51:16patients who are winners and losers in the system. The Oregon experiment
0:51:16 > 0:51:22clearly showed that in the 1990s. There will be deserving and
0:51:22 > 0:51:24non-deserving and whilst I think there are some rationing decisions
0:51:24 > 0:51:30that have to be made on clinical grounds, it is wrong to make these
0:51:30 > 0:51:33decisions purely on lifestyle.
0:51:33 > 0:51:35The cabinet has been meeting this morning for the first
0:51:35 > 0:51:38time in a few weeks, and rather a lot has happened
0:51:38 > 0:51:39since they last got together.
0:51:39 > 0:51:41Not only have two cabinet ministers,
0:51:41 > 0:51:43Michael Fallon and Priti Patel, been forced to leave,
0:51:43 > 0:51:46but there have been fresh signs that not everyone left behind is exactly
0:51:46 > 0:51:52singing from the same hymn sheet.
0:51:52 > 0:51:53Oh, to be a fly on the wall.
0:51:53 > 0:51:56So are the tensions in cabinet any worse than this lot?
0:51:56 > 0:51:59# I stay out too late...
0:51:59 > 0:52:00Sir Geoffrey Howe has announced his resignation
0:52:00 > 0:52:03from the government.
0:52:03 > 0:52:05How do you feel this evening?
0:52:05 > 0:52:09Fine, how are you?
0:52:09 > 0:52:16# But I can't make him stay, at least that's what people say.
0:52:16 > 0:52:19If he wished to change his Chancellor, it was surely right that
0:52:19 > 0:52:21I should leave the Cabinet.
0:52:21 > 0:52:23# Can't stop, won't stop moving, it's like
0:52:23 > 0:52:31# I've got this music in my mind saying it's going to be all right.
0:52:31 > 0:52:33Here, Gordon.
0:52:33 > 0:52:37It is not often the Chancellor gets something.
0:52:37 > 0:52:39At least I don't have to worry about her
0:52:39 > 0:52:42running off with the bloke next door.
0:52:42 > 0:52:47# Shake it all, shake it all...
0:52:47 > 0:52:50The whole point is we had a great agreement and the cabinet works very
0:52:50 > 0:52:54well together.
0:52:54 > 0:52:57If you think there is a time to go, there is a time to go
0:52:57 > 0:52:58and I want a break.
0:52:58 > 0:53:01Is the coalition still working?
0:53:01 > 0:53:06# Shake it all, shake it all #.
0:53:06 > 0:53:09Well, to discuss how to restore cabinet unity we're joined now
0:53:09 > 0:53:11by Jonny Gifford, he's a specialist in mediation from the
0:53:11 > 0:53:13Chartered Institute of Professional Development.
0:53:13 > 0:53:15And by someone who sat in John Major's cabinet,
0:53:15 > 0:53:22which wasn't always exactly united, the former minister David Mellor.
0:53:22 > 0:53:28Welcome to both of you. David Mellor, none of us are in the
0:53:28 > 0:53:31Cabinet and none of us were dead this morning when they met and they
0:53:31 > 0:53:35are divided on a number of issues, but that is not unusual. How would
0:53:35 > 0:53:40you assess the state of Theresa May's government?I think appalling.
0:53:40 > 0:53:46I have been in politics for 50 years and have been actively involved in
0:53:46 > 0:53:50it for most of that time and have never been so depressed about the
0:53:50 > 0:53:56state of it. There is grandeur when candidates get angry with people in
0:53:56 > 0:54:04cabinets.These people are pygmies. But the fallout is the same. If we
0:54:04 > 0:54:07look back at previous governments, you mentioned Margaret thatcher and
0:54:07 > 0:54:16Michael Heseltine, there were sleaze allegations against politicians and
0:54:16 > 0:54:21back to basics was ridiculed.Is it really any worse? It is worse today
0:54:21 > 0:54:27because lots of good work was being done by John Major. He had two good
0:54:27 > 0:54:31chancellors. Norman Lamont was unfortunate with the ERM and the
0:54:31 > 0:54:35exchange rate mechanism and was brought down by it. Ken Clarke was
0:54:35 > 0:54:38an excellent Chancellor and the British economy was handed over in
0:54:38 > 0:54:43good shape to Tony Blair. I think there was a great deal of common
0:54:43 > 0:54:49effort. Whereas this lot cannot help but squabble. They are not big
0:54:49 > 0:54:53beasts and there is no discipline. Under Mrs Thatcher if you went out
0:54:53 > 0:54:57and said what you thought about things, Bernard Ingham would descend
0:54:57 > 0:55:01on you like a tonne of bricks. Even if you thought she was wrong, you
0:55:01 > 0:55:06had to keep your opinion to yourself as I had to do on a number of
0:55:06 > 0:55:11occasions. But this is anarchy, anything goes. The cat does not have
0:55:11 > 0:55:15to be away before the mice connect to play, the cat can be around and
0:55:15 > 0:55:19the mice are not afraid of it. Imagine you were given the case that
0:55:19 > 0:55:25David Miller says exists at the top of government, what would you do?It
0:55:25 > 0:55:30is not an uncommon phenomenon.I am sorry to hear that.From our own
0:55:30 > 0:55:34work we can see that one in four of UK employees would identify that
0:55:34 > 0:55:38they have had some kind of interpersonal conflict given a 12
0:55:38 > 0:55:42month period and that can involve any sort of behaviours ranging from
0:55:42 > 0:55:47lack of respect due to refusing to work together or verbal abuse,
0:55:47 > 0:55:52shouting, right through to threats of actual physical abuse which are
0:55:52 > 0:55:58much rare but which can still happen in one in 100 UK workplaces.Have
0:55:58 > 0:56:03you had Boris Johnson and Philip Hammond call you up?Not personally.
0:56:03 > 0:56:09How would you bring them together? David talked about working together,
0:56:09 > 0:56:13lack of unity. I think one of the common things in any kind of
0:56:13 > 0:56:19conflict is recognising that there are interests that prevail over
0:56:19 > 0:56:23positions, so getting people to think about what do they actually
0:56:23 > 0:56:27want from a scenario rather than why I can't work with that person, why I
0:56:27 > 0:56:32cannot trust that person. And then getting them to recognise there are
0:56:32 > 0:56:36certain parameters within which we have got to work. There are some
0:56:36 > 0:56:41givens in any workplace relationship that is going wrong.What you have
0:56:41 > 0:56:47to remember, David, is she is looking after Brexit and Brexit is
0:56:47 > 0:56:51an enormous task, is it not that that is making it difficult?It is
0:56:51 > 0:57:05part of it. It is the classic hospital pass. It is appalling.
0:57:05 > 0:57:09Think of our previous Prime Minister David Cameron chill axing with lots
0:57:09 > 0:57:17of money telling people not to be Prime Minister whilst the chaos
0:57:17 > 0:57:21continues. But it is the breakdown of discipline that is the problem.
0:57:21 > 0:57:25Is she up to dealing with the discipline?I do not think she can.
0:57:25 > 0:57:31Look at that lot, there are 30 of them around the table. I was looking
0:57:31 > 0:57:39at the photo. In the good old days, permit me to say that, it was not
0:57:39 > 0:57:43like that, only secretaries of State sat in the Cabinet. Now you get
0:57:43 > 0:57:48ministers of state, and all manners of odds and bits sitting at the
0:57:48 > 0:57:52table and of course they will squabble. But they will not squabble
0:57:52 > 0:57:56with any grandiloquence. When you get people like Boris, he is
0:57:56 > 0:58:01untameable unless you sack him. Can she sack him? I do not think so. She
0:58:01 > 0:58:07was going to sack Philip Hammond if she won a majority at the election.
0:58:07 > 0:58:12And she did not win a majority and that hampers her ability to impose
0:58:12 > 0:58:16discipline.It makes it impossible for her. The trouble is that Theresa
0:58:16 > 0:58:22May became Prime Minister but she was not one of the above and there
0:58:22 > 0:58:28were no real qualities she had to be Prime Minister. Those of the above
0:58:28 > 0:58:31are even less qualified now than they were.I am not sure she will be
0:58:31 > 0:58:34calling you in to help bring the two sites together.
0:58:34 > 0:58:35sites together.
0:58:35 > 0:58:38There's just time before we go to find out the answer to our quiz.
0:58:38 > 0:58:40The question for today was which political relative
0:58:40 > 0:58:43is headed to the jungle for the new series of ITV's
0:58:43 > 0:58:45I'm A Celebrity, Get Me Out Of Here?
0:58:45 > 0:58:46Was it a) Samantha Cameron.
0:58:46 > 0:58:47b) Philip May.
0:58:47 > 0:58:48c) Piers Corbyn.
0:58:48 > 0:58:49or d) Stanley Johnson.
0:58:49 > 0:58:51So Clare what's the correct answer?
0:58:51 > 0:58:57I would imagine it is Stanley Johnson.And you are right, it is
0:58:57 > 0:59:01Boris's father who is heading to the jungle and I can imagine he will I
0:59:01 > 0:59:02get there.
0:59:02 > 0:59:04jungle and I can imagine he will I get there.
0:59:04 > 0:59:05That's all for today.
0:59:05 > 0:59:07Thanks to our guests.