06/01/2012 Newsnight


Kirsty Wark asks the NHS medical director why he won't recommend the removal of contaminated breast implants. Has Labour u-turned on cuts? And the Wall Street movie Margin Call.

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Germany joins France in recommending the removal those


breast implants, why is the NHS still refusing to do the same?


The least five countries have decided to recommend removal,


Britain finds itself in a minority in refusing to follow suit. Our


science editor is here. The Department of Health is fudging


its position, it won't recommend removal, but now wants to see them


taken out if the patient really wants it.


The NHS Medical Director will be here to explain himself.


Has Labour u-turned on the cuts they have, up until now, condemned.


While these two keep quiet, it it is left to the Shadow Defence


Secretary, to declare that spending plans must be credible, no populist.


Ed Balls's point man, Chris Leslie, is here to clarify.


Also tonight. Music is about to stop, and we are going to be left


holding the biggest bag of odour ous excrement ever assembled in the


history of capitalism. Inside a Wall Street bank the night


before the great crash of 2008, we speak to the director of Margin


Call. I didn't want to make charicatures


of these people. I wanted to actually try to represent the


decision-making process. The Government tried to quell the


outcry against the breast implant scandal. The German authorities did


the opposite to Britain, Germany now says in the light of new


evidence, it is joining, France, Israel, Venezuela and the Czech


Republic, in recommending that women with these kind of implants


should have them removed. Today's report by the NHS Medical Director,


Sir Bruce Keogh, admits the data in the UK is wanting, seriously


underreported he describes as information about the French


implants. What of the 40,000 or so women with PIP implants to do. In a


moment we will hear from Sir Bruce, but first this.


We are at the end of the week when politicians across the globe had


had hoped to have reassured the hundreds of thousands of women who


have had breast implants from French company, PIP. But


Governments differ markedly in their response and decidinging who


will pay. -- deciding who will pay?


Germans will remove the PIP implants, alongside Germany, Israel,


Venezuela, in deciding to do that. I'm not sure how the health service


works in ermgr, I understand there may be an assurance scheme that


agree to do that, as in Israel. German authorities say they are


changing their risk assessment due to the rising number of notices


from doctors, trade organisations and hospitals in recent days. They


go on to say that these notices, silicone from such implants,


increasingly and over time can leak. The fact that so many Governments


have have such different public positions raises the question about


if they are sharing safety data as they might.


It seems the quality of safety data from British clinics poor. Members


of a panel intervened to advise the Government, and concedes the


picture on rupture rates is uncertain, and the nature of the


gel in the implants is unclear, as is the picture of how toxic the gel


is. The group says it has no evidence to suggest it is dangerous.


The expert group has made clear there is no link to Cannes, there


are no specific safety concerns that require these implants to be


removed. If women are understandably worried, we in the


NHS are going to make it very clear they can get access to advice,


scans, and to the removal of the implant, if necessary. We expect


the private sector to offer the same service to the women whose


implants they provide. Many plastic surgeries, both here in the UK, and


internationally, are sticking to their position, that these implants


should be reof moved. The Government seems to be relying --


removed, the Government seems to be relying on the private clinics to


follow aed model it set out for NHS -- follow a model it set out for


the NHS clinics. There are a number coming out that they are going to


pay for, obviously the patients to be seen and any scans they might


need. If there is a clinical reason for the implant to come out then


they will pay for it. There are others who have done much larger


amounts, and there is a concern there about the financial


arrangements. There is a plan ined today's report


for continued monitoring, -- plan in today's report for continued


monitoring and surveillance. A lot hangs on private clinics doing the


right thing. So long as the independent sector play ball the


way that the Government have told them to, then I think the women out


there can be assured they will be looked after. It very clearly


states that. The Government expects the private providers to look after


their patients, as the Government are looking after their patients.


The focus may now shift to the medicines and healthcare products


regulatory agency, the MHRA, and how well it is overseeing this


sector. Today the new head Europe's drug watchdog said there is an


acute need to tighten regulations on medical devices. We need to take


into consideration that this implant came in from a French of


manufacturer, and was given a quality mark by the regulator in


this country, and that needs to be taken into consideration. There


needs to be some accountable for what happened. That the Protestant


vieders did not purchase -- the providers did notp purchase these


implants thinking they were substandard ones. What seems to be


driving the Government is a determination to see the private


clinics to cover the cost for having opted for these cheap French


implants, but by gentle persuasion, whether they succeed remains to be


seen. Earlier I asked the author of


today's report, Sir Bruce Keogh, why the UK was at odds with other


countries in had its advice on implant removal. What we have done


is conduct a review that has looked at two things. First of all, the


hard evidence around safety of these implants, and the second


aspect was how to offer compassionate treatment to women


who will be undoubtedly worried. In terms of the hard evidence that we


have on safety, we know there isn't an increased Canneser risk we are


uncertain about whether -- cancer risk. We are uncertain about


whether there is an elevated risk, there is no evidence to suggest one


way or another, we are looking at that. The hard scientific evidence


as to whether or not this gel is more irritant suggests that it


probably isn't. Having said that, we know it is more liquid, finally


we have looked at what are the risks of redoing the surgery. So we


have come to the view that when you add all of those up, we don't have


hard evidence that it is unsafe, which is of course not the same as


evidence of safety. You don't have evidence of safety, why not operate


on the precautionary principle. The reason I say that, is because


Germany, as it were, hard bd up its advice over evidence taken -


hardened up its advice over evidence taken from hospitals. They


have changed their advice and saying as a precautionary principle


women should have them refd moved. Surely you should be trying to do


the best for women. Naturally I will invited Germans to share their


information with me. Should that not have happened up until now, the


Germans, the Israelis, the Venezuelans and the Czech Republic?


Yes, mew early indications is their evidence is -- my early indications


their evidence is no harder than our's. Talk about two things there,


first of all, what the Germans are saying is the evidence of


degradation of these implants over time is significant. So, therefore,


for a start, would it not be better to recommend women who have had


them implanted for more than three years, they should be having them


removed? We have considered that. Bear in mind that all breast


implants degrade, and at continue years, about one in ten them will


have failed any way. What we are doing, I think we are offering


something that is a much better solution. It it is easy to offer


the solution that everybody should just have them out. What we're


doing...Is It, do it then? In the NHS we are doing something better.


What we are doing is we are going to inform all patients who have had


a PIP implant. We are going to write to them and offer them an


opportunity of an informed consultation, with either their GP


or a specialist breast surgeon. And on the basis that, we are offering


them some personalised decision making which will take into account


emerging evidence, and take into account their personal


circumstances and wishes, and if they want the implants out,


following that, we will take them out and we will replace them.


be clear, we are talking with with implants put in on the NHS, we are


not talking about private, of which that is the vast majority? Let me


be clear, it is the expectation of this expert group that the NHS, we


think, hax set a gold standard of - - has set a gold standard of duty


of care. We expect the private sector to step up to the plate and


offer the same level. The gold standard should exist across


private and NHS? Clearly it should. You by your own admission. Can I


read a disturbing part of the report which says, "we believe


underreporting seriously affects the validity of PIP data and some


comparative data about similar implants", on that very basis, and


some ruptures, as many as two or three do not show in clinical


symptom, and can only be shown by removal. You have made a decision


baseded on information which you yourself say is -- based on


information which you yourself say is underreported seriously. That is


no reassurance for women, you don't have the data? The extent of


underreporting is haveous. We have asked for data from those


organisations that implant the breast implants. They are showing


the PIP implant, that the risk of rupture on this data is five-hold


less than other data. We are -- five-fold less than other data. We


are discarding that data. We are looking at compassionate treatment


for worried women. We are expecting the private sector to step up to


the plate and offer these consultations and personalised


decision making with women in the same way that the NHS is. They will


have to pay to have them removed? We don't expect the private sector


to charge people to have them reof moved. And, where women feel they


have been failed by the private sector, because either the


organisation has gone out of business, or the surgeries have


retired, or, for some reason or another, the organisation which put


in their implant take as rekals trant approach to this, then the


NHS will step into the breach to help.


Here is a confession, I am the shad he dough Defence Secretary and I


accept -- Shadow Defence Secretary, and I accept �5 billion of defence


cuts. He rejects shadow and temporary populisim, can we expect


a long line of Labour front benchers to come out and support


George Osborne's Plan A, in an attempt to try to I a chief what


the Shadow Defence Secretary called genuine credibility. And there is


no suggestion that Ed Milliband is in denial about the plans.


In the first days of 2012, Labour has seemed a little bit like a ship


without a destination. Its compass wonky, its crew, uppity.


There seems to be no strategy, no narrative and little energy. Old


faces from the Brown era seem stuck in defending Labour's record in all


the wrong ways. We didn't spend too much money, we will cut less fast


and less far, but we can't tell you how. Thus spaik Lord Glasman, Ed


Milliband's hand-picked shipmate. Cue an outbreak of dismay in the


Labour ranks. There is a sense drift, there is no clear direction


set upon the party and we are 18 months into Ed Milliband's


leadership. A lot of people like him, and think he's the right man


with the right value, but they worry where he's going and taking


the party, it is not clear.Ed one had shadow minister did try to


make -- today one shadow minister did try to make things clear. He


accepted the defence cuts in an attempt to gain, as he put it,


genuine credibility. They started to map out the he detail of how


Labour would go about restoring the UK and fiscal deficit to some sort


of balance. And this is hard for Labour, because there are a lot


things in there that challenge the Labour Party's core instincts. What


they have done is start to get into the specifics, this is a different


environment to one in which the opposition may have face in 2008.


People want to hear are you credible in what you are going to


do. Originally Ed Milliband wanted economic policy to be about the new,


a new more caring kind of capitalism, and new things Labour


could deliver to its voting base. What he did not want it to be about


was fistle Calpol sis. He didn't originally - fiscal policy, but it


has become about fiscal policy. Ed Balls has two problems, he was


closely associate with the fiscal policy that went wrong, and he's


the strong advocate of a centre stand today. Centre ground.


chart sums up the shifting terrain for Labour. This was Alistair


Darling's deficit reduction plan, to more than half the deficit over


four years. Not fast enough, said the coalition in June 2010, they


would cut �40 billion more and get the deficit down to just 2% of GDP.


Six weeks ago that plan was scrapped. The coalition's new


borrowing targets are now higher than those Alistair Darling lost


the election on. In every remaining year of the parliament. It should


have been a propoganda coup for Labour, but it wasn't. I think the


Labour message isn't getting through for two reasons, one, they


are up against a press which is 80% right-wing, backing the Tory talk


about cuts, which doesn't want it to hear about growth and invest


anything the economy. Secondly, the Labour Party is not united, the


leader hasn't come down strongly enough on the side of growth,


investment and job creation over deficit reduction, cuts, cuts, cuts.


That is the problem, it leaves Balls relatively isolate. That is


byer Tsar, because Ed Balls has been vindicate by the facts and the


data. Labour's five-point plan for recovery includes only one fiscal


policy move, proposing a cut of VAT of �12 billion a year. That leaves


Shadow Cabinet ministers having to write a fiscal policy in detail,


department by department. If November left the coalition's


deficit plan in ruins, it left Labour without one full stop,


because Darling's old plan is history now. That leaves Ed Balls


reliant on the single argument that austerity is hurting, but not


working. And Labour's all too well aware that many people do not yet


accept that argument. People are anxious, you see, when


people are anxious they get scared. They cling to what seems most solid


and stable. Whether it is right or not. It is debatable. Therefore,


they have stuck with the coalition on economic policy, because they


see that as the safest option, whether it is or not. Tonight the


Labour leader, in an interview with the Guardian, warned his supporters


that the era of tax and transfer social democracy was over. New


schools, he said, new hospitals, tax credit, that is not going to be


available to the next Labour Government. Labour's economic


skpwrouorny, may, in truth, -- journey, may, in truth, have hardly


started. I'm joined by Chris Leslie. The latest poll of polls, Labour is


trailing the Tories, despite the economic crisis. A former adviser


say you lack environment. The Shadow Defence Secretary is saying


you can't sustain popularity without genuine credibility. Do you


accept you have a credibility problem? Credibility ultimately


depends on whether it will work or not. The credibility of the


Government's economic plan will depend on whether it works or not.


Let me just fin urb. I think he's talking about your credibility?


important thing for bus credibility is whether we can demonstrate that


-- for us about credibility is whether we can demonstrate a


healthy economy. A healthy economy leads to healthy public finances.


We have always acknowledged some cuts would beness radio. These are


going to be very difficult choices -- would be necessary, these are


going to be very difficult choices. We want a fair and balanced


approach to the cuts that would be necessary. They are taking a very


dogmatic approach, too far and too fast. You haven't actually got a


credible plan, at the moment you have a situation where Ed Balls


believes you have to spend your way out of of the recession, and yet


you have certificate and series of ministers being told they have -- a


series of ministers being told they have to line up and make a series


of cuts. You don't really actually v you don't have a deficit


reduction plan at all now? We do. What is it, is it still Alistair


Darling's? If I can get a word in edgeway, depends on the strength of


the economy. If you end up cutting so far in such a way that you strip


away the economic growth that we have, that you end up piling more


expenditure on welfare, unemployment benefit. What you will


do is worsen the economy and the deficit. See borrowing going up. In


terms of cred bltd, that, I think, will be the central -- credibility,


that, I think will be the central debate over the coming years. We


have a credible plan. Even before the election you talked p the


Alistair Darling plan, we accept some cuts are necessary this


Government can't even match the pace of the Alistair Darling plan.


As your research showed. couldn't make any propoganda out of


it either. You say, you have a deficit reduction plan, you have


one, but of course it will depend what happens with the economy. What


is the deficit reduction plan today, you don't have one, do you?


Murphy has outlined the cuts we think would be acceptable. He


talked about �5 billion in certain defence elements in the next five


years. Policing is a good example. The Government want to cut 20%, the


independent inspectorate say that would be very harmful. We have said


12% of police cuts is a level of reduction that is would be


sustainable, without hurting the frontline. There are differences


between us and the Government. much, just give us a figure then, a


straight forward figure, how much are you going to cut the deficit


by? We have said, and I think it is important to acknowledge we want to


cut the df sit, but not the pace the Government wanted -- deficit,


but not the pace the Government want. Roughly half over the four-


year period, that is the Alistair Darling plan. The problem is the


economy and the Government finances are not static but dynamic. When we


get to the next election we will have an opportunity to write a


manifesto and set out more details. By then the credibility might be


less than the poll of polls said today. As straight forward question,


is the deficit plan to reduce the deficit by a half by the end of the


parliament, what is it? That is the plan put before the public. There


are and today? Bear in mind that the public, we were rejected from


office, we lost the last general election, the public wanted to give


the benefit of the doubt to the Government. The key thing about


credibility, if they are not succeeding in delivering on the


expectations and the promises they made, the Government's credibility


will be shot to pieces. That is the alternative we have. That is the


challenge we have. If we can prove that actually building the economy


rather than stripping it out and cutting it into shreds will be


harmful, we have an opportunity to do that. Tomorrow morning's


Guardian, Ed Milliband talks p about the Tony Crossland era being


over, the proceeds of tax and growth going on schools and


hospitals and tax credits is gone. It will not be there. It will never


happen again. What is the point haeb? We are always going to --


Labour? We will always believe in improving public services. There is


no option to do this any more? difference is this, we believe in


investing in public service, but in a fair and balance way. We will


have to make some tough choice, but this is a Government not thinking


through properly, the implication for the economy for public services


of the cuts agenda they are pursuing. Not just too far and too


fast, but failing to tackle the very deficit that theyp promised


they would sort out. In a cop of words, how would you characterise


the first week -- in a couple of words, how would you characterise


the first week for Ed Milliband? The media will characterise it in a


different way, he has shown strong leadership on Rupert Murdoch.


was last year? On rewriting the rules of capitalism, he has a


strong agenda, and this is a crucial year for us. The prevailing


orthodoxy in real life and in the movies is that bankers are bad,


sometimes mad, and definitely dangerous. But a new film paipbts a


more complex picture of Wall Street in 2008, when the caefpl hit like a


freight train. Now some of the best actors in town, Stanley Tucci,


Jeremy Irons and Demi Moore, have waved their usual fees to appear in


Margin Call. A low of-budget film about an investment bank in the


middle of huge lay of-offs and discovers huge discrepencies on the


books. JS Chandor, the son of an investment banker wrote and


directeded the film, I spoke him earlier todayment I should warn you


there is some strong language that follows. Hello. I need you guys to


come back up here. Just trust me, I need you guys back here, now.


a minute, what am I looking at. This figure here? Is that figure


right. So, what you are telling me is, that the music is about to stop,


and we are going to be left holding the biggest bag of oderous


excrement ever assembled in the history of capitalism. You don't


moralise about the people who are there, do you, you kind of let them


tell their own story? In the US the films come out a month or two ago,


in the US on the left people have been a little upset that I wasn't


quite citle kal enough, that -- critical enough, that I wasn't


demonising these people. I think their actions speak for themselves,


I didn't want charicatures of these people, I wanted to actually try to


look at the decision making process. One of the most affecting scenes is


the opening scene,s almost like a zombie movey, people are getting up


are from desks, putting their boxes down, going to the lift, evacuating


the buildings. A friend of mine who works in the city, called me from a


Citibank trading floor. He said get down here, you should see what is


about top happen. A team had HR, human resources people, came in and


set up camp in every room, and your phone would ring. I am obviously


sorry that we are here today, but these are extraordinary times, as


you very well must know. Look I run risk management, I don'tle really


see how that is a natural place to start cutting jobs. We understand


this is in no way personal, the majority of this floor is going


today. The hiring and firing situation may shed more light on


how we got to where we were than the technicalties of what the


trading was going on. Studying the way friction ratios underlines use


under reduces gravity loads. So you are a rocket scientist. I was.


Interesting. How did you end up here? It is all just numbers,


changing what you are adding up, and to speak freely, the m money


here is more attractive. There certainly is a disconnect between


this new generation of brilliant qants, the mostcateded people on


the plan the. And you know, a fundamental guy who came up through,


most educated people on the planet, and who a fundamental Kay who came


up there you the ranks. Of the two banks one or two went under, and


the issue was the CEO not comprehending what is going on.


Speak as you like to a young child or golden retrieve, it wasn't


brains that got me here, I can assure you of that. In visiting the


floors, you ran into MIT rocket scientists. And I think one of the


things, the film, although it is structured as a thriller, and


hopefully keeps the audiences on the edge their seat. At its core it


is also a tragedy. Because it is really lost potential, making money


from money, instead of making money from making things. Is that the


best use for our best and brightest. I know my answer for that.


Ironically you are a product of the boom years in investment banking,


your father worked for Merrill Lynch for more than 30 years. That


was a big influence on you? father was not a trader like the


characters in the film. Mid-level banker for many years. We also


lived in communities of bankers. So how that influenceded me was that I


learned what these people cared about. Presumably you don't think


youred dad was a bad guy? Sometimes! I'm kidding. He is


certainly not out to save the world, so he made selfish choices to take


care of had his family n way. Anyone that goes into that -- In a


way. Anyone going into that industry make as choice when they


enter it. They are making choices a teacher is not. My father is not an


evil or a charicature, he is a person who went to work every day,


and you know, at times was investing money for a teachers'


union, so he felt that banking could serve a purpose.


I just don't know how we locked this up quite so much. When did you


start feeling so sorry for yourself, it is unbearable. What, so you


think we might have put a few people out of business today, it is


all for nougt, but you have been doing that every day for almost 40


years, Sam. If this is all for nougt, then so is everything out


there. It is just money, it is made up. Pieces of paper with pictures


on it so we don't have to kill each other just to get something to eat.


It is not wrong. It is certainly no different today than it has ever


been. It seems to me that you are saying this will happen again, we


will go there again, is the film a warning? I guess the answer would


be, being left to their own devices, of course this will happen again.


So the point is to expect Jeremy Irons character to make massive


changes of his own way doing business is a fool's errand. We


need toen gauge, and the banking sis -- to engage, and the banking


system is there for us, not the system is there for us, not the


other way around. The papers now. Alert over dangers of cosmetic


That's all from Newsnight tonight. Bob Holness died today at the age


of 83. He will be remembered as the presenter of BlockBusters, the


children's programme. A P please, bob. Yes, if that's how you feel.


A new contestant to play the game. Join us, we look forward to your


company. Goodbye.


Here is the host of BlockBusters, Bob Holness.


Hello there. If p you have been affect by the recent storms. You


will be pleased to know this week's weather will be run of the mill.


Bright and breezy sums it up for much of the UK on Saturday. A few


showers, but they will be fleeting, and they won't amount to much. Some


getting into parts of north-east England in the Pennines. Many


places will stay dry and avoid the showersen tierl. A lot sunshine


across -- showers entire, a lot of sunshine across East Anglia, a bit


of a broz, a layer or two if you are -- a breeze, a layer or two if


you are out and about. Across Devon and Cornwall the odd scud of rain.


Showers possible. Dry, bright and breezy afternoon in the offing.


That is the case for Northern Ireland. A bit more cloud in the


west, and for Scotland as well. That cloud will be thicker and


producing sharp showers across the northern half Scotland. Dryer and


brighter further south and east. That is the picture as we end the


day. It stays dry into nightimement increasingly cloudy from the west.


An unsettled scene across northern and western parts of Europe.


Western fronts will bring further outbreaks of rain. A God dop lol,


recently. Further south into the Mediterranean, showers across the


Kirsty Wark asks the NHS medical director why he won't recommend the removal of contaminated breast implants.

Has Labour u-turned on cuts?

And the Wall Street movie Margin Call.

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