19/01/2012 Dragon's Eye

Lesley Griffiths and Andrew Lansley have fallen out over breast

implants. This is Dragon's Eye. Good Evening. The Health Minister

says she's had to make decisions over how to deal with PIP breast

implants in Wales without all the evidence. Lesley Griffiths is

claiming the UK Government didn't share information, including an

official report, quickly enough as the health crisis unfolded. That's

denied by her Westminster counterpart, Andrew Lansley, who

argues that the Welsh Government's policy of replacing the implants

risks letting the private companies who performed the original surgery

off the hook. Here's Brian Meechan. It's a health crisis that couldn't

have been planned for and as a result, it seems politicians and

the medical profession have been scrambling to keep up with events.

I'm not sure we have been caught on the hop, but it's rapidly

increasing and as we know with the internet information spreads

quickly. Concern can spread quickly, perhaps a bit faster sometimes than

the reassurance. The advice in the UK is that there is no need for all

the low-grade silicone PIP breast implants to be removed, only those

that are causing problems. A different approach emerged between

London and Cardiff. The Welsh NHS would remove them and replace,

whilst in England they would only be replaced in exceptional

circumstances. It's been confusing and even minister worrying for

women than it had to be. That's because we saw the Government

position changing both in the UK and in Wales quite significantly.

Clearly, the regulatory system has failed and the information

providing to Government has not been reliable. It was a clash at

First Minister's Questions. Also to replace those implants quite

frankly is absolutely an appalling decision, which taxpayers clearly

do not support. I think he'll find it rather different. Are you

seriously saying you would be happy to see the implants removed, but

nothing put in place to replace them? Are you seriously saying

that? If you do, you have very little understanding of human

nature and you have little understanding of sympathy for

others. The UK Government says the private medical practises that put

the implants in should be responsible for the removal and

replacement. Welsh ministers agree, but critics say their decision has

made it less likely that that will now happen. I have to say to the

Shadow secretary, if he commends what the Welsh Government has done,

he - perhaps he were to do so, to commend it, they have to recognise

it runs the risk of letting the private providers off the hook.

Effectively it gives them a get out of jail free card to the private

clinics who have a duty of care to the patients who they have put

implants in. I think it's quite wrong of taxpayers to pick up the

bill. The dispute seems to have highlighted divisions between

London and Cardiff over their response to the PIP scandal.

think it speaks to an underlying tension between London and Cardiff,

on health policy. Theoretically the matters are devolved, but it's not

as cut and dried in real issues and there's a deGrecian of conned sen

shun from London to Cardiff. Welsh Government is clear it has no

idea how many women in Wales have the implants nor how much each

procedure will cost to replace them and critics say they should have

found that out before signing off a blank cheque. The Welsh Government

has made this uncosted commitment at a time when the finances are

already broken. They are at breaking point and we know local

health wards will be over budget by the end of the financial year and

to make another commitment of taxpayers' money towards this sort

of project is completely barmy. It's a flaw in the whole system in

Britain that we don't have a proper registry, as we do with orthopaedic

implants, to know exactly who has got them and how many have got them.

Ultimately, I have to say, as someone looking after these women,

I don't really mind. It's a sense of compassion for the women. They

have paid into the NHS. There is a need for them to have their

implants removing and in that respect the Welsh government is

doing no more than it should legally do with women who have got

something inside them that shouldn't be there. Gl there have

also been concerns expressed by GPs. Only yesterday the Royal College of

Surgeons in England, along with my own association and others produced

some very specific guidance which is really helpful and that's

available for GPs and patients on the various websites. As I say, the

Welsh Government will produce shortly even more detail. The NHS

budget is being cut in real terms and the Health Service coming under

pressure to deliver more for less. While wards are being closed and

provisions cut back, some critics say is now the time for the NHS to

be clearing up a private sector mess? There are fears that the

waiting lists for plastic surgery in Wales will be tested unless more

resources are made available to deal with this. We have been

assured by the Welsh Government and the minister and by Special

Commission, who are handling this on behalf of the Welsh Government,

that they will do what is necessary to make sure that this doesn't

impact on our current waiting lists. To be honest, our lists are already

long and we are working closely with the health boards in Wales to

try to get them where they should be and if we were asked to do this

work on top, that would be a problem. In a year when extra

funding was being ploughed into the NHS the decision to replace poor-

quality breast implants may have been less controversial. It's

perhaps a symptom of the current economic times that it's become so

now. Brian has been talking to the health minister. We've been told by

plastic surgeons that we have no idea of the number of women

involved here. It could be 20, or it could be 2,000. We have no idea

the cost of each procedure. Isn't this really an uncosted proposal?

We don't know how much the procedure is going to cost, but

there is a figure obviously for removing the implants and then to

replace them is not a great difference. Probably just in the

hundreds. There is that element. We don't know the numbers and getting

a firm number is one of the priorities and officials are trying

to find them out quickly. However, we know that they have not been

used by NHS in Wales, these implants and they haven't been used

by private providers in Wales, so we do know that and we think the

number will be relatively low. problem you have is that you are

relying on private companies to give you information. They haven't

been forthcoming so far, so there could be lots of women who don't

have PIP, who are going to have to be tested anyway? Officials are

ringing around private providers and we have been getting the

numbers, so I think they have been telling us this. This isn't letting

the providers off the hook. I think we are putting pressure on the

private providers to make sure they recognise their duty of care. That

is one thing that we are very keen to get over. This is not a blank

cheque. We are not taking that away. We do expect private providers to

step up to the plate and really fulfil their duty of care to women.

If they get a phone call from a woman in Wales they know it's

already been underwritten by the Welsh Government. They are going to

shrug their shoulders and carry on? There are legal aspects and duty of

care and we are putting pressure on them. It's ultimately private

companies, who have made a mess of this. It's their problem. Surely

you should be putting pressure on them to fix it, rather than letting

them off the hook? It's their responsibility and we expect them

to do it. What we have said is for any woman who is concerned and

can't get in touch with her provider for a variety of reasons,

they are not in practice, for example, we are saying they should

see the surgeon and if they can't, then they should have an assessment

by the GP. The evidence at the moment is still that they are not

necessarily having to have these implants removed. Until we know

that, we'll take the steps forward when we need to. One of the things

that you have talked about is a clinical need. What do you mean by

that specifically? Is it a physical need or is there an element of

mental need about it, because obviously the fact this is in the

news so much it becomes a sort of mental health issue potentially?

could potentially and I'm concerned that so many women have this fear

and I don't think that is too strong a word. That is the message

I've had. We are wanting to say and get this out very clearly, at the

moment there is to clinical evidence to say that women who have

had PIP implants need them removing. However, if they are concerned they

should see their surgeon or GP. Many of the GPs have said that they

have not been getting the guidance that they need from the Welsh

Government. Do you accept that there's been short comings in that

area? We had to - the initial start of this process was coming from the

Department of Health and unfortunately we weren't party to a

lot of information coming. My officials were having great

difficulty getting information from the Department of Health in the

first instance about eleven days ago. We couldn't get to see the

independent report, so we have had to take decisions perhaps that we

would have preferred to have taken much more firmly, but we had to

take decisions because we needed things to be taken swiftly. The

guidance is out there. My officials are working hard and if any woman

is concerned make an appointment to see the surgeon or the GP, and

we'll support you all the way. you saying that the Department of

Health has not been sharing information with the Welsh

Government? A week last Friday there was a definite lack of

sharing of information. I have written to the Secretary of State

because obviously I think the regulation of these implants and

perhaps other surgical devices needs to be much closely inspected

and regulated and I think there is a concern here about this. You may

be aware, we have a surgical materials testing lab in Bridgend,

and we are the only country in the UK to have this and I have written

to the Secretary of State asking him and the other devolved

administration health ministers to see if they would like to use it,

because we are leading the way in this. At a time when NHS budgets

are being squeezed and we are seeing closures of wards, why is

this a priority? It's not going to be an urgent treatment. If a woman

is found to need the breast implant removed and replaced I don't think

from the evidence I've been given it will be urgent. They will go on

a list and the process will be followed through. Are you not

concerned that this sets a precedent whereby very poor

practice on part of private companies and NHS are having to

pick up the tab? No, I don't think so. Well, a Department of Health

spokesperson has told this programme - "The allegations are

simply untrue" and that the Chief Medical Officer had shared "all

available information". They go on to say that "The Welsh Government

did not inform us prior to their announcement on PIP implants."

Setting up a Commission can mean one of two things - a Government

wants to do something or a Government doesn't want to do

something. This week the UK Government announced it was setting

up a Commission to look at whether Welsh, Scottish and Northern Irish

MPs should be prevented from voting on matters affecting England only.

Pressure has been growing on the UK Government to address concerns that

English voters being sidelined in post devolution Britain. The

Commission consists of a panel of experts and will report in May 2013.

Our Parliamentary Correspondent, David Cornock, reports. It was

launched with a minimum of fuss. Not even a ministerial photo call

or interview, but the Commission on the couldn't quepbss of devolution

for the House of Commons could have a big impact on the way this place

is run -- consequences. It's a Westminster-focused commission. It

will look at issues of Parliamentary and legislative

practice and procedure. It's going to find it quite hard to look at

wider issues of how England is governed, although there is

increasing evidence that the English are getting really quite

anxious about the wider issues and they need to be addressed somehow.

That evidence appears to be growing. One of the things we wanted to look

at was English attitudes to the West Lothian question and we asked

English people whether they think that Scottish MPs should be barred

from voting on English matters and 79% of people said they should.

Political parties used to target Worcester woman, the floating voter

in middle England. This Worcester woman has been trying to change the

law to answer the question. It's something in the coalition

programme for Government to set up a commission to look into these

issues and I think as an MP who represents an English constituency,

a lot of my constituents say to me that they are concerned that

English-only legislation is voted through potentially by MPs who

don't represent England. Here's one of those MPs who doesn't represent

England. Paul Murphy represents a Welsh seat, but has sat in the UK

One of his predecessors, the Conservative John Redwood, says

England feels hard done by and needs a stronger voice in the union.

He wants English votes on English issue, but there is another

question posed by this week's announcement, why now? With Alex

Salmond pushing for an independent Scotland, and David Cameron trying

to keep it together, why risk it? The timing is unfortunate. The

inevitable conclusion of the commission will be that Scottish

MPs are not allowed to vote on English-only legislation or are

restricted in voting, and that, arguably, weakens the United

Kingdom Parliament and therefore weakens the United Kingdom.

Alex Salmond's high-profile campaigning is helping fuel English

resentment? I wouldn't say resentment, but I find English

people saying you have Welsh people in the Cabinet and Scottish people

in the Cabinet. Who is representing us? You have your Assembly, they

say. The Scots have their Parliament. Where's ours? There is

a build-up. We know there are several English-based parties now

who are looking at a Parliament for England. Which could be one answer

to the West Lothian question. Already three answer to the West

Lothian question - one is reduce the number of MPs from Scotland and

Northern Ireland, Wales from Westminster which mean that is

continue to vote on all business, but they have less influence

because there are fewer of them. The second is what is called an

English Parliament. That would mean creating a separate distinct

institution to represent England. The third answer which has been

constituent policy at the recent elections is English votes for

English laws. That's a vote Harriet Harman hopes

will be delivered. The Speaker can certify certain pieces of

legislation that are England only and through the standing orders, as

they're called, we can decide situation where the majority of

English MPs is also required. conceivable you could also have a

Labour UK Government that didn't have the majority of seats within

England. That would create questions about how you implement

English votes for English laws. one said it would be easy. Perhaps

the West Lothian question is rath really an English question.

Whatever the academic answer are to all of this, the political reality

is such if we start weakening the role of Welsh Members of Parliament

together, reducing their numbers, that is actually playing into the

hands of the people who want to see the breakup of this country.

Conservative-led coalition won't like that solution, so will the

commission achieve anything? ever, it's the Government feeling

they have to appear to be doing something to answer a question that

was first asked by in the 1970s and has been asked ever since. It needs

panel of experts because it's a very tricky question, and it

probably doesn't have a tidy answer, but if anyone is going to have a

way of coming up with squaring the circle, it's this body of expert

opinion. If Westminster does become more of an English Parliament, that

could throw up new questions. If Welsh MPs are banned from voting on

English issues, then could an MP with an English seat still be

appointed Secretary of State for Wales? The question perhaps for

another commission. David Cornock reporting on the

commission looking at voting rights of MPs from the devolved nations.

The body will begin its review against a background of shifting

currents across the UK. Here in Wales, the Silk Commission is

looking at the way Wales is funded, and the Scottish Government is

preparing to publish its plans for an independence referendum. Its

First Minister, Alex Salmond, has already had a war of words with

David Cameron over that. BBC Scotland's Political Editor Brian

Taylor gave me the latest. It's important to talk about the process

and the rules determining a referendum. Some people may think

it's rather arcane, but it matters that we get the rules and the

regulations correct for the referendum. We are, after all,

dealing with the future of the union that's lasted 300 years. It

might be a reasonable idea to get it right, so where we are at the

present moment is we have a dispute between the Scottish and UK

governments on absolute fundamental issues with regard to the

referendum. We have a dispute on timing. The UK Government want it

eerily. The Scottish Government says 2014. We have a dispute on

legality. The UK Government says Scotland can't hold a referendum

unless it gets further powers. Alex Salmond says no. We can order a

consultation. We have a dispute above all about the question or

questions to be asked. Alex Salmond wants the flexibility to ask a

second question on devolution maxed. Rather than Holyrood independence -

it must be a yes or no on independence. We hear lat of

discussion about devo-Max as a possible option. What does Alex

Salmond mean? Alex Salmond says it's up to others

- perhaps civic Scotland, perhaps the intellectuals who might be

tempted to come up with this in detail, but of course the

Government in February 2010 publishes a draft bill. They define

it as being full control of all tax revenues and spending in Scotland

with the exception of defence, Foreign Affairs, currency and the

currency itself. They say it's up to others to

define what they mean. Broadly, it's full control on spending.

see a full consultation paper. What can we see there? Alex Salmond will

state the details on his thinking of the referendum. We have only had

a consultation paper from the UK Government. We'll have this

consultation paper from the Scottish Government on the

questions, the timing - just these issues that divide. Really, what we

have here are the two governments seeking to assert their control of

the referendum, their influence over the referendum. Alex Salmond

has gone from a situation where he was telling the Prime Minister to

butt out of the debate to a situation where he is open to

negotiation and discussion as long as he says the primacy of the

question - the primacy of the referendum is recognised as being

in Scotland's hands, which means - the Scottish Parliament's hands

which means the Scottish government's hands. It's early days

to be taking about opinion polling and voter intentions. What with

they telling us these days? Most polls tend to suggest a lead for

union over independence. If they ask the extra question on devo-max

or enhanced powers that seems to be the more popular. You're right. It

is far, far too early to say the referendum details haven't been

fixed, let alone the date or the campaign. Thank you very much.

Plaid Cymru's been undergoing a period of soul searching since its

disappointing performance in the Assembly elections last May. Its

leadership contest will be concluded in March, and this week

the party published a review examining where it's been going

wrong and making recommendations about how it can get back on track.

The review was lead by Eurfyl ap Gwilym, Plaid's Chief Economic

Adviser. One of the themes emerging from the review is the need for

clarity in agreeing and communicating policy. I asked him

Mr ap Gwilym whether the number of recommendations - 95 in total -

jeopardised that goal. That's a good question. What we did

as part of this exercise - we came up with 95 detailed recommendations

- we got five principle recommendations. The other thing to

bear in mind - this report now goes to the party at large. It is to be

the basis for a lot of debate within the party, then from within

that debate, it's a matter for the party to decide if they accept this

recommendation or reject it. Following on from that is to bring

in an implementation plan and implement it over several years, so

this is a part of the process, not the final end product. Would it be

fair, then, to describe the long list of recommendations as a menu

rather than a plan? You pick the ones you like? I wouldn't say that

we believe the recommendations have validity and should be accepted by

the pardy, but ultimately it's a matter for the party whether they

accept them or not. As we worked our way through, this sounds

paradoxIcal, but clearly Plyd Cymru hasn't been doing well in electoral

terms. In my business experience if I have ever gone into a company

which is having difficulties in terms of being successful, if you

went and looked at the mechanisms of that company, you would find

they all are working perfectly well, you have a problem. Paradoxically,

in Plyd Cymru, lots of things we can improve on. That's why we have

come up with so many recommendations. Lots about

structure, but some are very basic - this in particular surprised me -

in the case of official spokespersons it should be a

precondition they develop a sound understanding of their own brief.

It does beg the question of what sort of candidates the party has

been picking up until this point if you have to say something that

basic, is that right? Quite right. I am very critical of some we have

seen, weak performances by some of our people on some subjects. Do you

want to name names? No. They all know who they are. I mentioned they

all need to pull up their socks, get a lot smarter, or they

shouldn't be candidates or spokespeople. Do you think that is

the sort of message they'll be willing to accept and other party

members will be? I think the party membership will, and I hope most of

our senior people will as well. We have not been doing well enough.

It's as clear as that. And we have to up our game. This is why this is

quite a hard-hitting report. Indeed. Are you talking about exceptions

here in terms of underperformance, or would you say that then a

general problem of underperformance among the party's elected

representatives? I wouldn't say a general problem, but I think it's

patchy. Somewhere I use the term "varied quality". Therefore, we

need to get those that aren't performing as well to perform as

well as some of our good performers. You talk about the changing

perception of the party. You say Plyd Cymru is regarded as a party

of Welsh speakers and talk about the need to change that. Other than

the suggestion that the party should change its English name, you

don't offer any guidance how to achieve that? We do in part. If you

look at the report, a very basic thing - in quite large areas of

Wales, we conduct a lot of our - in Welsh only. We are saying we must

train our people to do simultaneous translation and get that as the

norm. A lot of countries, including Europe, are multilingual. People

are used to working in one language, but clearly, where we have meetings,

it's very difficult unless you're a Welsh speaker that naturally is

going to make us appear to be not only for Welsh speakers, but

discourage non-Welsh speakers from joining us. Can I ask about

independence. You have a call for clarity. Are you saying

independence should be the banner behind which Plyd Cymru marches?

Our constitutional aim - and unique to Plyd Cymru is we want

independence for Wales within the European Union. Until last year we

didn't actually have that spelt out in our stution. That's caused us --

constitution. That's caused us some difficulties. While we have been

reluctant... But the party is still divided on that issue. Look at your

five leadership candidates... have four. Forgive me. That's all

right, but let's just check this. Another thing we say - several

years ago, as a member, we had an internal meeting on our policy, and

the committee didn't publish that report. If we want unity around

policies, you have to first of all afford the membership the

opportunity to debate them, hammer them out, and then when you have

done that then it's reasonable to call your membership right now.

This is the policy we have agreed as a party collectively. Now

support it. I am grateful for joining us. Thank you very much.

If you have any suggestions as to who that mystery fifth candidate I

invented might be, answer on a postcard. Maybe our Welsh affairs

correspondent Vaughan sawn can help out.

What are you hearing... Nominations haven't stopped. There could be a

fifth. Maybe many members wish there were. It seems from the early

stains of this contest - and it's quite a long contest - the

candidates who -- the candidate who has gone up like a rocket is Leanne

Wood. She seems to attract more attention Somme would have expected.

Another of the candidates suggests that the race could be very close

between the two women candidates - Ellen Jones and Leanne Wood, with

the two male candidates lagging a little bit at the moment, but an

awful lot of undecided's out there. Remember, this is one of those

alternative vote candidates where people go one, two, three, four,

and an awful lot will depend on the second and third preferences and

who gets knocked out in the early stages. Remind us when it will be

resolved. We're going to go through weeks and weeks of this, and when

you get an announcement, you're then going to have the whole

question of how that person will lead because one of the things that

comes up in that report that Eurfyl ap Gwilym was talking about is the

need for a leadership team. That to me suggests there may be a lack of

confidence in the four candidates that they feel whichever one wins

there are weaknesses there and they need people around them, perhaps

the thought was that Jones had a little bit too much power over the