28/02/2012 Newsnight


28/02/2012

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Here we go again. First it was breasts, now implants routinely

:00:09.:00:15.

used by the NHS for hip replacements, may be leaking metal

:00:15.:00:21.

fragments into their hosts. 49,000 British patients with all-

:00:21.:00:26.

metal hip replacements will have to be monitored for life, with a view

:00:26.:00:32.

to taking them out again. I'm glad we got there in time, metal debris,

:00:32.:00:36.

front wall of the pelvis has been eaten away. I will be asking the

:00:36.:00:39.

regulator, who is supposed to keep us safe, how on earth this could

:00:39.:00:42.

have happened. He's the pizza millionaire who

:00:42.:00:46.

claimed he could deliver the White House for the Republican party, and

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found, he couldn't. Becoming President was Plan A, and before

:00:54.:01:02.

you get discouraged, today I want to describe Plan B. We will ask

:01:02.:01:07.

Herman Cain what Plan B is. Britain's biggest cake shop chain

:01:07.:01:10.

is the latest to query the ingredients of the Government's

:01:10.:01:15.

work experience scheme. Also tonight:

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In the City they call Barclays Bank the bald eagle, now the Treasury

:01:20.:01:25.

has decided to clawback the money from a perfectly legal tax dodge.

:01:25.:01:35.
:01:35.:01:36.

What other retrospective laws might they try out?

:01:36.:01:41.

We have given lots of people a new lease of life, seeming to free them

:01:41.:01:46.

from infirmity and pain. Tonight the regulator is saying anyone with

:01:46.:01:50.

an all-metal hip joint should undergo tests every year for as

:01:51.:01:54.

long as they have it inside them. Following an investigation by this

:01:54.:01:57.

programme and the British Medical Journal, which has uncovered

:01:57.:02:00.

serious side-effects in some people, and raises profound questions about

:02:01.:02:07.

whether this sort of surgery is properly regulated.

:02:07.:02:14.

Replacing a hip is about as physical as it gets for a surgeon.

:02:14.:02:20.

But as tough as the operation is, around 70,000 people a year have

:02:20.:02:24.

hip replacements. For most people this is life changing.

:02:24.:02:30.

Taking away years of pain and disability, but for some, there can

:02:30.:02:34.

be a down side. Surgeries are concerned that some

:02:34.:02:38.

metal hips are wearing down faster than they should. There are fears

:02:38.:02:42.

that metal debris from the joint is poisoning patients. Around 2,000

:02:42.:02:47.

patients a year are having to have their metal hips replaced.

:02:48.:02:54.

The UK regulator, the MHRA, announced that 49,000 patients,

:02:54.:02:59.

with all-metal, total hip replacements, like this one, with a

:02:59.:03:02.

large diameter, will have to have annual checks because of safety

:03:02.:03:06.

fears. Particles of metal debris have destroyed tissue around the

:03:06.:03:11.

joipbts in thousands of patients, we understand on Thursday, research

:03:11.:03:16.

will be presented looking at the risks of bladder cancer in these

:03:16.:03:19.

patients. No clinical trials were done before these hips were put in.

:03:19.:03:23.

One campaigning group is calling it a large, uncontrolled experiment,

:03:23.:03:27.

involving millions of patients around the world. Following on from

:03:27.:03:34.

the breast implants scandal, experts say the whole system, for

:03:34.:03:37.

regulating devices, is not protecting the public. Maureen

:03:38.:03:41.

laughed walking in the Yorkshire Dales near her home in Richmond. It

:03:41.:03:46.

was a surprise when the surgeon told her she needed to have two hip

:03:46.:03:49.

replacements. When I went to the hospital I was told I would get

:03:49.:03:54.

this new kind of hip joint, a state-of-the-art joint, it was

:03:54.:03:59.

metal and would last almost probably my lifetime. Maureen had

:03:59.:04:05.

two Pinnacle hips put in, they are mind by US giant, Johnson & Johnson.

:04:05.:04:09.

They were fitted in 2005, they have already failed. I have swelling in

:04:09.:04:14.

my lower abdomen, I had an ultra sound, and they said they are fluid,

:04:14.:04:19.

but obviously they shouldn't be there. They do concern me, lumps in

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my body, you don't want them. Nagel is Maureen's surgeon, he's

:04:24.:04:29.

about to replace one of her failed implants. There is nearly no other

:04:29.:04:34.

explanation, apart from the implant is wearing out abnormally. I'm glad

:04:34.:04:41.

we have got here in time. Metal debris everywhere. The front wall

:04:41.:04:46.

of the pel is -- pelvis has just been eaten away. But it really is

:04:46.:04:50.

quite significant the damage. is scooping out a mixture of

:04:50.:04:56.

rotting flesh and cobalt and chromium metal debris from around

:04:56.:05:00.

Maureen's hip joint. Surgeries are worried about the levels of these

:05:00.:05:05.

metals in patients' blood, because of the possible long-term damage to

:05:05.:05:12.

health. We are seeing patients of 10, 20, 50-times normal levels, the

:05:12.:05:18.

highest level is to nearly 300. Tony has removed the head of

:05:18.:05:22.

Maureen's hip implant, and it is clearly damaged. That is where the

:05:22.:05:25.

wear starts, and it goes right down to the floor. That is the wornout

:05:25.:05:31.

part, it goes right the way round. This is mechanical wear, that is

:05:31.:05:35.

the problems you get with mechanical. Maureen's hip has now

:05:35.:05:38.

been sent to experts at Newcastle University, this is one of several

:05:38.:05:42.

centres around the country trying to figure out what is going wrong,

:05:42.:05:49.

let's see what they find. Maureen's hip joint is put on to a scanner

:05:49.:05:54.

which maps the damage. Mechanical engineers then analyse how much

:05:54.:05:58.

metal has worn away. We can see damage from the head, we can also

:05:58.:06:05.

see damage from the metal cup. So whether we have metal surfaces in

:06:05.:06:08.

contact, potentially that can generate metal wear that will go

:06:08.:06:14.

inside the patient. Tom Joyce is an engineer, who has analysed hundreds

:06:14.:06:20.

of tip joints. There is evidence that these large metal-on-metal

:06:20.:06:23.

hips are failing at a rate we wouldn't expect. We are trying to

:06:23.:06:27.

get the bottom of that and explain what is happening. Surgeries

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decided to use metal-on-metal hips, because old versions, made of

:06:33.:06:36.

plastic, were wearing down in active people. They thought metal

:06:36.:06:42.

would be a more durable option. Some times of metal hips work well

:06:42.:06:46.

in young, active men. How have these failing metal hips been

:06:46.:06:51.

allowed to get on to the market? The scandal of PIP's breast

:06:51.:06:55.

implants, expose the failure of regulators to protect patients and

:06:55.:07:02.

cause a public outcry. The same failure of regulation has led to

:07:02.:07:06.

thousands of patients needing their hips replaced. It is a long, costly

:07:06.:07:11.

process to get drugs on to the markets. They have to be tested in

:07:11.:07:14.

test-tubes, animals and large clinical trials by people, before

:07:14.:07:17.

they are used on you and me. You would think it is the same for

:07:17.:07:21.

artificial breast and hip implant, but it is not. Doctors are

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concerned there is not enough regulation to stop harmful devices

:07:25.:07:29.

being put into hates. Carl Henegan has studied the way medal devices

:07:29.:07:35.

are regulated in Europe. We realise with drugs like thalidomide we

:07:35.:07:39.

can't carry on with the current system, it is catastrophic. The

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data can be eight to ten years of development and drug trial, then

:07:43.:07:47.

you have to have on going trials for safety and efficacy. With

:07:47.:07:52.

devices it couldn't be more different. My estimate is you could

:07:52.:07:56.

get a device through with a two to three day literature review, and no

:07:56.:07:59.

clinical data requirements at the current time. You are telling me

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you could get a hip to market with two to three days work looking at

:08:04.:08:09.

the literature? Yes, and 7 0hips have gone through the system in the

:08:09.:08:14.

US, only three have clinical data, that is in the world. If you want a

:08:14.:08:17.

new drug on to the market in Europe, you have to go to a central

:08:17.:08:21.

regulator to get approval. But for a new, artificial hip or breast

:08:21.:08:24.

implant, the manufacturers can choose who they want to approve it.

:08:24.:08:29.

They can go to any of dozens of companies who are all competing for

:08:29.:08:37.

their business. DePuy use the British standards institution,

:08:37.:08:42.

which is better known for giving Kite Marks to such things as

:08:42.:08:46.

toasters and baby buggies. DePuy wouldn't tell us what tests they

:08:46.:08:50.

had done on artificial hips because of client confidentiality. They

:08:50.:09:00.
:09:00.:09:01.

Governments around the world have been very lapse in checking the

:09:01.:09:07.

implants. An e-mail from a senior manager at DePuy and says it is a

:09:07.:09:11.

"fun fact" that in South Africa you could implant a tent rod if you

:09:11.:09:16.

wanted to. It is astonishing that DePuy could tweak the design

:09:16.:09:20.

without testing how it works with patients. The head became bigger

:09:20.:09:25.

and the stem shorter. The head of the MHRA has known since 2006 that

:09:25.:09:31.

there were concerns about the hips. The data tells us since 2006 that

:09:31.:09:37.

there were metal lines being -- increases in the replacements.

:09:37.:09:45.

There was enough data to make the certain in 2006. As early as 2005,

:09:45.:09:49.

internal DePuy documents show they were aware of the damage that could

:09:49.:09:54.

be done to patients for metal-on- metal implants. They are being sued

:09:54.:10:00.

by patients who have had to of the hips replaced. They have put

:10:00.:10:03.

millions aside to cover potential costs.

:10:03.:10:07.

Tony Nagel is an expert witness in the legal case against DePuy.

:10:07.:10:11.

Originally he was paid by the company to train surgeries in the

:10:11.:10:17.

use of their implants. Now his hospital trust has recalled call

:10:17.:10:21.

patients with metal-on-metal hips. We have brought back all the

:10:21.:10:26.

patients with Pinnacle caps, nearly 1 though, tested, screened them and

:10:26.:10:31.

scanned them, we know exactly what is happening. We have out of 970

:10:31.:10:37.

patients, 75 failures related to metal debris, that is high. DePuy

:10:37.:10:41.

told Newsnight and the BMJ, that patient safety is their top

:10:41.:10:46.

priority, and clinical data showed the Pinnacle was safe. Tony Nagel

:10:46.:10:56.
:10:56.:10:56.

first told the company about damage to tissue in Pinnacle in 2008?

:10:56.:11:06.
:11:06.:11:10.

But the metal-on-metal Pinnacle is still on sale. The UK regulator,

:11:10.:11:17.

the MHRA appointed a committee to decide the fate of metal-on-metal

:11:17.:11:22.

hips, it included representatives of the manufacturer. The committee

:11:22.:11:26.

decided there was no need to stop the metal-on-metal hips, and

:11:26.:11:30.

patients should be told about the risks. No I a lert was issued to

:11:30.:11:37.

patients or surgeries. Today the MARA said all patients with large

:11:37.:11:41.

diameter metal-on metal hips would receive checks because of the

:11:41.:11:48.

evidence about them. Tony has fitted Maureen with a new hip, made

:11:49.:11:54.

of ceramic and plastic. How are you feeling? Fantastic. The operation

:11:54.:12:01.

went well, there was quite a lot of damage there, but we got there in

:12:01.:12:05.

time before there was damage beyond repair. I'm glad it's out.

:12:05.:12:10.

operation cost the NHS �12,000, if it is widespread it will cost the

:12:10.:12:13.

cash-trapped health service tens of millions.

:12:13.:12:17.

Our science editor is here. How worried should people be? According

:12:17.:12:22.

to the regulator, the MHRA, there are some 49,000 people out there,

:12:22.:12:26.

who have this larger diameter metal-on-metal type hip implant.

:12:27.:12:30.

They have said today that these people should have annual checks

:12:30.:12:33.

because of the safety concerns over the device. They are saying people

:12:33.:12:36.

should go to their GP if they are worried, find out what type and

:12:36.:12:40.

size of implant they have had, to see if they might require blood

:12:40.:12:44.

tests or perhaps an MRI scan, to look for any possible problems, to

:12:44.:12:49.

see if there is sign of leakage of these small metal particles. There

:12:49.:12:53.

are parallels, there seems to be, to a layman, parallels with the

:12:53.:12:58.

whole PIP breast implant thing? Common sense would tell us, in both

:12:58.:13:04.

cases the current system has failed patients. The MHRA's own website

:13:04.:13:08.

says it is responsible for ensuring that medicines and medical devices

:13:08.:13:14.

work and are acceptably safe. Yet, in both instances, it has seen

:13:14.:13:19.

reports for many years and outside pressure, and then the regulator

:13:19.:13:25.

acts. It is raising broader questions about how medical devices

:13:25.:13:29.

are regulated here and across Europe. The question is whether or

:13:29.:13:32.

not there needs to be safety tests before the devices are implants,

:13:32.:13:36.

and better safety evidence. So we are not relying on reporting by

:13:36.:13:40.

patients and healthcare professionals, but a more rigorous

:13:40.:13:45.

set-up. There is concern over the kite mark system. The notified

:13:45.:13:49.

bodies which have a contractual relationship with the makers, the

:13:49.:13:53.

certify a device does what the manufacturer says. They don't

:13:53.:13:58.

release data routinely, they can claim client confidentiality, over

:13:58.:14:02.

any data they hold. Some argue they might have a vested interest in

:14:03.:14:06.

aproving a contract, hoping for follow-on business from

:14:06.:14:09.

manufacturers, for approval for further products. All of this is

:14:09.:14:13.

increasing calls for perhaps a central European body to replace

:14:13.:14:20.

the 70 or 80 notified bodies, and the ace sem ought to look more --

:14:20.:14:25.

the system ought to look more like the system for aproving drugs, but

:14:25.:14:30.

the system for clinical trials is much less rigorous, and then there

:14:30.:14:34.

is the cost to the NHS of picking up things when they go wrong.

:14:34.:14:38.

us is the chief executive of the MHRA, the regulator of medicines

:14:38.:14:43.

and medical devices. How many clinical trials were

:14:43.:14:52.

conducted on this hip joint before it was implanted in 40,000 people?

:14:52.:14:55.

Standardised medal trials were not required. There were no clinical

:14:55.:15:00.

trials? There are clinical studies required before a joint is approved

:15:00.:15:06.

by the notified body, or it receives the Kite Mark. The nature

:15:06.:15:09.

of the study depends on the nature of the device. Do you want to

:15:09.:15:12.

apologise to all of the people for whom the operation has gone wrong?

:15:12.:15:17.

I think the agency has acted with great thoroughness in recent years.

:15:17.:15:21.

We have a situation in the UK where we are essentially concerned about

:15:21.:15:26.

the patterns of wear of these joints which, have been widely used.

:15:26.:15:31.

There are 500,000 metal-on-metal joints implanted worldwide. We were

:15:31.:15:35.

the first agency to put out a safety notice. That safety notice,

:15:35.:15:40.

for example, the advice that you gave today about people having an

:15:40.:15:44.

annual check-up, what was the new information on which that advice

:15:44.:15:49.

was based? The UK is fortunate in having the world's biggest national

:15:49.:15:53.

joint registry, which contains over a million operations of knee and

:15:53.:15:56.

hip replacements. When did you discover there was a problem?

:15:56.:16:00.

problem has emerged over the last couple of years. When the first

:16:00.:16:03.

five years of experience. You were warned six years ago, weren't you?

:16:03.:16:10.

No. If you look at the data from the National Joint Registry between

:16:10.:16:14.

2003-2008. Metal-on-metal joints were no more likely to fair than

:16:14.:16:19.

alternative manufacture. It is only in the last couple of years that

:16:19.:16:23.

the wear patterns and failure rates have diverged as they have done.

:16:23.:16:27.

it not true that there were meetings held in 2006, in which

:16:27.:16:32.

these dangers were discussed? meetings concerned the significance

:16:32.:16:36.

of the metal irons that were released, as you have heard. That

:16:36.:16:40.

the extent to which metal irons are released varies greatly from joint

:16:40.:16:44.

to joint. In some patients the levels are high, in some patients

:16:44.:16:48.

they are very low. Indeed and the patients in whom it is higher are

:16:48.:16:52.

the ones we are worried about? is precisely why we gave out advice,

:16:52.:16:56.

two years ago now, that patients with this type of advice, should

:16:56.:17:00.

have the metal irons measured in their blood, if the levels are

:17:00.:17:07.

raised, they have further investigations with images --

:17:07.:17:11.

Imaging. What has happened between that advice and today when you are

:17:11.:17:15.

advising an annual check-up? were advising all that for patients,

:17:15.:17:19.

what we have done now, with further information from the Joint Registry,

:17:19.:17:25.

this is longer experience with the joints, is we can focus the

:17:25.:17:30.

monitoring on those who need it most, the ones that have the larger

:17:30.:17:35.

head metal-on-metal device. These joints were put into people without

:17:35.:17:39.

any clinical tests, you already conceive. Were you made aware of

:17:39.:17:44.

the fact that the design of the joint had changed? You asked me

:17:44.:17:49.

were there clinical trials, I said clinical studies, but not

:17:49.:17:55.

randomised, controlled trials, of the type you might expect with the

:17:55.:17:58.

pharmaceutical industry. We are talking about the rate of wear,

:17:58.:18:02.

which can only be observed over many years, in use, over large

:18:02.:18:07.

groups of patients. There were no such tests? It would be difficult

:18:07.:18:11.

to devise randomised trials. can do it with drugs, can't you?

:18:11.:18:14.

The way that drugs give rise to problems are fundamentally

:18:15.:18:20.

different from the way that medical devises do. These people were being

:18:20.:18:26.

used as Guinea pigs? I dispute that phrase. You don't like it?

:18:26.:18:31.

cannot test the wear patterns of human joint replacements on any

:18:31.:18:34.

animal species. No you can test them on humans, which is what has

:18:34.:18:40.

happened? What we have done, and it is an essential part of all medical

:18:40.:18:43.

devise regulation, is to ensure there is -- device regulation, is

:18:43.:18:47.

to ensure there is good follow-up long-term analysis. Were you told

:18:47.:18:51.

of the change in the design? change of the design would be a

:18:51.:18:56.

matter for the notified body. that you? No. That is somebody else

:18:56.:19:01.

is it? We are the notified -- we are the competent authority, the

:19:01.:19:05.

notified body would assess the procedures. You are not aware of

:19:05.:19:09.

the changes in design? We are aware of the changes of the design, it is

:19:09.:19:17.

up to us to assess each change of design. Three of the committee who

:19:17.:19:22.

did check the design were on the payroll of the manufacturers?

:19:22.:19:26.

committee who have helped with the guidelines we are talking about

:19:26.:19:29.

today, was composed of representatives from the British

:19:29.:19:33.

orthopaedic organisation and the Hip Society, they were not

:19:33.:19:36.

manufacturer representatives, they were experts in the field. They

:19:36.:19:40.

worked with data from the National Joint Registry, which is

:19:40.:19:44.

independent, to devise the best help for patients now. When the

:19:44.:19:49.

Americans decided that these joints should not be implanted in women of

:19:49.:19:56.

childbearing age, why didn't you do the same? The evidence on that is

:19:56.:20:00.

extremely equivocal. Did you think they were being hysterical or

:20:00.:20:05.

something? The metal-on-metal joint replacements are the most widely

:20:05.:20:10.

used in the United States. The data on the effects of the metal irons,

:20:10.:20:15.

to the extent they get into blood, and secondly on the women of

:20:15.:20:19.

childbearing age, do not allow people to make firm conclusions.

:20:19.:20:23.

You tried to stop pregnant women from eating certain kinds of cheese,

:20:23.:20:27.

I suggest you that having a foreign body implanted inside your own body,

:20:27.:20:31.

with the possible, catastrophic consequences that we know about,

:20:31.:20:34.

would have been on the precautionary principle, a sensible

:20:34.:20:38.

thing to do? What we are seeking to do, by monitoring, is to detect

:20:39.:20:43.

those patients that do generate a raised level of cobalt and chromium

:20:43.:20:46.

in the blood. Those patients will go on to have further investigation

:20:46.:20:50.

with a view to removing the joint if it is necessary. We are intent

:20:50.:20:54.

on protecting patients from the effect of raised metal irons in

:20:54.:20:58.

blood. This monitoring is with a view to the NHS then paying to have

:20:58.:21:01.

the things taken out of people, is it? The purpose of the monitoring

:21:01.:21:06.

is to make sure that in that minority of patients, in whom there

:21:06.:21:10.

is accelerated wear, the detection of that wear early ensures the

:21:10.:21:14.

joint can be replaced at a time when it is most satisfactorily done.

:21:14.:21:18.

What is the costs of removing one? I honestly haven't examined the

:21:18.:21:24.

costs. We are talking about many thousands of pounds. We are, it is

:21:24.:21:28.

hugely expensive? Hip joints wear out, it is a general phenomenon of

:21:28.:21:32.

all hip joints f you look at the types of joints developed, most

:21:32.:21:37.

have been driven by the attempt to reduce the rate that they wear out.

:21:37.:21:41.

They don't all wear out while poisoning the patient, do they?

:21:41.:21:44.

point you are raising about poisoning the patient, is exactly

:21:44.:21:49.

the reason we are setting in place this monitoring arrangement for

:21:49.:21:58.

patients with this particular type of hip. This time tomorrow night we

:21:58.:22:01.

will hear from the Health Secretary, as we devote the whole programme to

:22:02.:22:05.

the controversy surrounding the Government's health bill. The

:22:05.:22:08.

latest stage of the steeplechase to become the Republican candidate

:22:08.:22:11.

tole cha eing Barack Obama this year is taking place in Michigan.

:22:11.:22:16.

Each of the four men left in the race say they will stay the course

:22:16.:22:20.

until the party convention in the summer. In the meantime they have

:22:20.:22:23.

all amplely demonstrated that no- one is meaner to a politician, than

:22:23.:22:28.

one who claims to be on the same side. In a moment I will talk to

:22:28.:22:34.

the man who thought he could turn his experience in running a pizza

:22:34.:22:38.

parlour empire to running the United States, but has had to bow

:22:38.:22:45.

out of the race. Herman Cain was the early Republican pace setter,

:22:45.:22:51.

who inspired the bumper sticker "the pizza man always delivers".

:22:51.:22:56.

And deliver, in many ways, Herman Cain did.

:22:56.:23:02.

After announcing his presidential cadidacy in May last year, he

:23:02.:23:07.

quickly earned the accolade of most covered candidate in the race. His

:23:07.:23:10.

unorthodox tendencies had everything the media could ask for.

:23:11.:23:17.

Whacky, viral ads. We can take this country back.

:23:17.:23:27.
:23:27.:23:32.

Foreign policy stumbles. When they asked me who is the President of U-

:23:32.:23:35.

bek-ebek-beck-stan I will say I don't know, do you.

:23:35.:23:43.

There was even singing. But he was propelled from businessman to the

:23:43.:23:48.

frontline. His proposed 9-9-9 tax plan, along with debate

:23:48.:23:52.

performances confirmed him as the Republican front runner, he briefly

:23:52.:23:57.

led President Obama in the polls. A stellar record had made his name.

:23:57.:24:01.

Herman Cain grabbed the opportunity to turn around two floundering

:24:01.:24:06.

businesses. First, transforming the fortunes of 400 Burger King stores

:24:06.:24:11.

in Philadelphia, from the least, to the most profitable in the company.

:24:11.:24:17.

Before saving Godfather's Pizza from bankruptcy. Initial low Cain

:24:17.:24:21.

managed to dismiss those who criticised his lack of political

:24:21.:24:26.

experience, he, he said, was part of the solution, and professional

:24:26.:24:31.

politicians, part of the problem. But ultimately, uncomfortable

:24:31.:24:38.

allegations of sexual harassment tightened the noose around his name.

:24:38.:24:46.

The charges and accusations are absolutely rejected. They simply

:24:46.:24:51.

didn't happen. Finally, in December last year, off the back of sliding

:24:51.:24:56.

poll results, in spite of his numerous public denials of

:24:56.:24:59.

wrongdoing, Cain announced he was suspending his run for the

:24:59.:25:07.

presidency. With a lot of prayer, and soul searching, I am suspending

:25:07.:25:15.

my presidential campaign. The Godfather of common sense fell

:25:15.:25:20.

foul of what Thomas Jeff son dubbed the painful and thankless office,

:25:20.:25:23.

before even assuming the office himself. Leaving others to fight it

:25:23.:25:33.

out for the White House. In his first interview as the former

:25:33.:25:39.

candidate for the Republican party presidential campaign, Herman Cain.

:25:39.:25:45.

Did you enjoy your runnout for the presidency? I did enjoy it, the

:25:45.:25:48.

best part was the feedback and response of the people, and

:25:48.:25:52.

secondly, their response to the bold solutions that I presented as

:25:52.:25:57.

part of my campaign. But I did enjoy it. You sounded pretty bitter

:25:57.:26:05.

when you quit? I wasn't bitter, I was angry, because the false

:26:05.:26:09.

accusations could not be proved, and how do you prove you didn't do

:26:09.:26:12.

something, or that you weren't somewhere that someone said. The

:26:12.:26:16.

bottom line was, it was my word against someone else, and they had

:26:16.:26:20.

absolutely no proof. That was the part that angered me. I might add,

:26:20.:26:24.

that I was going to stay in the race. But because of the coverage

:26:24.:26:28.

of the false accusations on the part of the media, it was causing

:26:28.:26:34.

undue pain on my wife and my family. And I made a decision, family first,

:26:34.:26:38.

rather than stay in, and allow them to continue to present these

:26:38.:26:43.

accusations as if they were true, when in fact they were not. Why do

:26:43.:26:53.
:26:53.:26:53.

you think you couldn't cut it in that race? On the contrary, I did

:26:53.:26:58.

believe I could cut it in that race. I did believe my appeal to the

:26:58.:27:01.

American people was number one. I proposed common sense solutions to

:27:01.:27:06.

our problems. Secondly, I didn't speak in political speak, I had

:27:06.:27:10.

specific solutions. I cut it in the race, that wasn't the issue, the

:27:10.:27:16.

issue was the constant spinning and respinning of unfounded allegations

:27:16.:27:20.

that became a distraction, not only to me and my campaign, but it

:27:20.:27:25.

became very painful to my family. I wasn't going to put them through

:27:25.:27:29.

that. What did you make of things like, you know, your boast that you

:27:29.:27:33.

couldn't name the President of Uzbekistan, that was a pretty silly

:27:33.:27:38.

thing to do, wasn't it? I don't think it was silly, I think it is

:27:38.:27:43.

silly to ask a candidate to know the head of every small country in

:27:43.:27:47.

the world, without some reference. I was driving home a point, that is,

:27:47.:27:51.

you don't have to be an international expert, in order to

:27:51.:27:54.

be able to make the appropriate decisions, once you have the right

:27:54.:27:57.

information, once you have the right intelligence information, and

:27:57.:28:02.

once you have an opportunity to analyse the situation. It is

:28:02.:28:07.

impossible, Jeremy, to answer thousands of hypothetical questions

:28:07.:28:11.

about hundreds of countries without knowing exact low what it is that

:28:11.:28:14.

you are supposed to talk -- exactly what it is you are supposed to talk

:28:14.:28:21.

about. I called those questions, "goch cha questions", I wasn't

:28:21.:28:24.

going to worry about answering those questions. An American

:28:24.:28:28.

President has to know that sort of stuff doesn't he? You don't have to

:28:28.:28:32.

know the head of every state in the world, before you become President.

:28:32.:28:42.

That was my point. Yes you would need to know it if it was a

:28:42.:28:46.

relationship you were going to cultivate or analyse. But to pick a

:28:46.:28:49.

random country and expect a candidate to know off the top of

:28:49.:28:55.

his head is unrealistic. The thing is, the American people agreed with

:28:55.:28:59.

me. When you say the American people agreed with you, you made a

:28:59.:29:02.

distinction in one of your comments about how there was a political

:29:02.:29:07.

class in the country, a media class, and then there was "the people",

:29:07.:29:16.

can youamify that? Sure, the politic -- political establishment

:29:16.:29:19.

has a certain tendency as far as candidates they want to support.

:29:19.:29:24.

Secondly, the political class, just about everybody currently holding

:29:24.:29:29.

office in Washington DC, including the President, they make decisions

:29:29.:29:37.

and proposals to sustain the status quo. The media class cover politics

:29:37.:29:42.

and everything else. They also sometimes are very biased in their

:29:42.:29:48.

coverage of stories. They do, what I call, fly-spec everything you say

:29:48.:29:53.

as a candidate, especially if you get the lead in some of the primary

:29:53.:29:59.

results. Then the people are every day normal people, trying to take

:29:59.:30:04.

care of their family, save for the kids education, they have a job and

:30:04.:30:07.

working hard. They see in the United States Washington is broken,

:30:07.:30:10.

it doesn't solve things, it continues to move problems down the

:30:10.:30:15.

road, and secondly, we have a serious financial challenge that

:30:15.:30:20.

right now they are not adequate low addressing. It sounds as if your

:30:20.:30:25.

system is pretty broke? It is broke, that is the word I use when

:30:25.:30:31.

decribing it to someone. When you have got a $16 trillion national

:30:31.:30:36.

debt, and over $5 trillion occurring in the last three years,

:30:36.:30:40.

we have a serious problem. We have a serious problem because we have

:30:40.:30:44.

to borrow from other countries to service the debt. If you look at

:30:44.:30:49.

the fact we are now spending $10 billion a day in order to be able

:30:49.:30:53.

to just service the debt, we are broke, and we have a serious

:30:53.:31:01.

financial issue. The Employment Minister has his work cut out these

:31:01.:31:05.

days, trying desperately to restore some credibility to the

:31:05.:31:08.

Government's work experience scheme. One company after another has

:31:08.:31:11.

pulled out of the scheme, embarrassed by accusations that

:31:11.:31:19.

unpaid work is being forced on to them with the threat of withdrawal

:31:19.:31:29.

of benefits. The head of the chain greings invited us Gregg invited us

:31:29.:31:34.

to look at how it works there. Look at the rather thing, expanding

:31:34.:31:41.

business, creating jobs, no wonder the Government took comfort when

:31:41.:31:46.

Gregg's bakery signed up to its work experience scheme. In these

:31:46.:31:50.

unassuming offices in Newcastle, support can no longer be taken for

:31:50.:31:54.

granted, posing a threat to a big part of the national welfare-to-

:31:54.:31:57.

work programme. They have told us they have frozen the offer of

:31:57.:32:01.

unpaid work placements, they may go further. There shouldn't be a

:32:01.:32:04.

question about whether companies should be offering work experience

:32:04.:32:08.

opportunities to the young unemployed, but inevitably, when

:32:08.:32:12.

there is criticism, as a company you have to review the scheme and

:32:12.:32:15.

decide if you still believe it is right for the company to offer

:32:15.:32:18.

those opportunities to the young. We still believe very much in the

:32:18.:32:21.

scheme, but there is one part of it the Government needs to review.

:32:21.:32:25.

That is the part that if, having taken up a placement, somebody

:32:25.:32:29.

decides they don't want to complete the placement, we don't feel they

:32:29.:32:34.

should lose their benefits. Atticus tomorrow mer care, the usual

:32:34.:32:39.

concerns about -- at customer care, the usual concerns about sandwich

:32:39.:32:44.

deals, they have been overcome by customer complaints about the

:32:44.:32:49.

scheme. It has put Matthew Nelson in a difficult position, he's in

:32:49.:32:54.

the office that is handling the calls, despite being on a work

:32:54.:32:59.

placement himself. It is his first sniff of a job opportunity since he

:32:59.:33:02.

graduated from Newcastle University last summer. I'm getting the most

:33:02.:33:06.

out of this, because I'm getting the experience, the company isn't

:33:06.:33:09.

getting that much, other than the work I'm doing, they are not

:33:09.:33:11.

getting enticements from the Government or anything like that,

:33:11.:33:17.

or financial support, just for me to be coming here. Well just me

:33:17.:33:21.

getting the experience is really helpful in my development, and

:33:21.:33:24.

personal development. You think you are getting the most out of it?

:33:24.:33:31.

Definitely, yes. Since last June, Gregg's has offered more than 40

:33:31.:33:34.

placements, 14 have led to permanent jobs. The scheme is

:33:34.:33:39.

voluntary, but if, after a week, a jobseeker pulls out, they risk

:33:39.:33:44.

losing benefits. It is this threat that means future placements with

:33:44.:33:51.

Gregg's, between 50-100 per yor, are all now at risk. -- a year, are

:33:51.:33:55.

now all at risk. The company says it is very sad. Gregg's is very

:33:55.:34:00.

positive about the scheme it says is helping young people, they are

:34:00.:34:06.

waviering, -- wavering. The tide of public opinion is pushing a

:34:06.:34:11.

Government policy dangerously close to the rocks. Other companies have

:34:11.:34:18.

already jumped ship. While others, like Matalan, Argos, and now Greggs,

:34:18.:34:22.

are taking to the lifeboats. For 19-year-old Daniel Kelly, the

:34:22.:34:26.

scheme rescued him from unemployment. He has been taken on

:34:26.:34:30.

permanently by Greggs, in the payroll team. When I signed up for

:34:30.:34:34.

a wage, I signed up primarily for the experience, that is all I

:34:34.:34:38.

wanted from it. You don't think people in your position are being

:34:38.:34:42.

exploited? I think we have people currently on it, I'm working with

:34:42.:34:46.

someone on the scheme, they love it, they don't think it is exploiting

:34:46.:34:49.

people. It gives awe bit of purpose. It is something to wake up and do

:34:49.:34:54.

in the morning. This is a recent edition to the chain, it might be

:34:54.:34:58.

because the firm is growing that existing staff have no problem with

:34:58.:35:03.

the idea of unpaid placements. think most people when they are

:35:03.:35:06.

working here would see it from the positive and see them as another

:35:06.:35:10.

member of staff, that is finding a different path into the company,

:35:10.:35:14.

rather than anything negative. scheme, run through the Jobcentre,

:35:14.:35:20.

first attracted big business, but now risks losing it under the tide

:35:20.:35:27.

of bad PR. Greggs tells us the threat of job seekers losing

:35:27.:35:30.

benefits was never explained. wasn't clear enough at the

:35:30.:35:34.

beginning. Even now it is not clear just how many people have actually

:35:34.:35:42.

been penalise Ford not completing their placement. So I think --

:35:42.:35:45.

penalised for not completing their placement. It was always going to

:35:45.:35:48.

be an issue that affects a very small number of people, and it

:35:48.:35:51.

wasn't briefed very clearly as a big part of the scheme. It was

:35:51.:35:54.

always intended to be for one or two individuals, if indeed it was

:35:54.:35:58.

required at all. But that should have been much clearer and up front

:35:58.:36:02.

with employers, at the very beginning. Tomorrow, the minister,

:36:02.:36:06.

Chris Grayling, will meet employers like Greggs, to keep their support

:36:06.:36:11.

he may have to sacrifice a central principle of the welfare-to-work

:36:11.:36:15.

programme, that the unemployed must fully engage with it, or face

:36:15.:36:22.

sanction. The Treasury has found �500 million

:36:22.:36:28.

down the back of the sofa, well, it has stopped banks not paying �500

:36:28.:36:32.

million in taxes. Barclays says it is perfectly happy to pay tax, it

:36:32.:36:35.

had been planning to dodge. They hadn't done anything illegal, but

:36:35.:36:40.

trying to avoid paying taxes when banks have had to be bailed out by

:36:40.:36:45.

the taxpayer, at enormous cost, is about as popular as a flat lent man

:36:45.:36:49.

in a lift. What were these schemes? There were

:36:49.:36:54.

two schemes Barclays was use to go minimise tax bills. It was claiming

:36:54.:36:57.

tax credits on a flow of income that hadn't been taxed in the first

:36:57.:37:03.

place. The second one I will refer to a graph involving corporate

:37:03.:37:09.

bonds, IOUs. This is when a company sells bonds in itself to the market

:37:09.:37:14.

t promises to pay the market a certain amount of money by a

:37:14.:37:18.

certain date, we will call that A, in terms of the source of money,

:37:18.:37:23.

last December Barclays decided to buy some of those bonds back from

:37:23.:37:28.

the market, which garn earned an amount of money called B, so B

:37:28.:37:33.

minus A is a profit, under the old loophole not subject to corporation

:37:33.:37:37.

tax, so they didn't mention anything to it. Of that lop hole,

:37:37.:37:41.

it was closed yesterday, -- loophole, it was closed yesterday,

:37:41.:37:46.

it was backdated to December last year. It applies retrospectively.

:37:46.:37:51.

But I thought financial legislation wasn't supposed to apply

:37:51.:37:54.

retrospectively? Normal low that is the case. The key thing is the --

:37:54.:38:00.

normally that is the case. The key thing is the retrospective part of

:38:00.:38:04.

it. There are groups out there saying doing it for that group, why

:38:04.:38:10.

not for our group. One tax consultant said you only lose your

:38:10.:38:16.

virginity once, so serious is the precedent. Overseas companies might

:38:16.:38:19.

think they will invest in Britain because of the stable tax regime,

:38:19.:38:26.

but nas not necessarily the -- that is not necessarily the case now.

:38:26.:38:31.

The Treasury wants to yield �500 million, Barclays are in the

:38:32.:38:36.

picture for �300 million, �200 million is unnamed. Will it be

:38:36.:38:42.

named? We hope so, we think the Conservative chairman of the all-

:38:42.:38:45.

party Parliamentary Committee on taxation, he will write to the

:38:45.:38:48.

Chancellor, asking him, the Chancellor, to name these companies,

:38:48.:38:53.

if the Chancellor can't, because they are on going cases, so he

:38:53.:38:56.

can't, he says why don't you put it in the parliamentary record, in the

:38:57.:39:00.

library, then we will get a look at the names, when the loopholes are

:39:00.:39:05.

closed and the tax cases are closed too. That may take a year. David

:39:05.:39:09.

Gauke, the Treasury minister, with responsibility for the tax system

:39:09.:39:15.

is here. �300 million of it is Barclays,

:39:16.:39:19.

�200 million is company else's liability, is that right? I think

:39:19.:39:27.

what I should say, on the numbers, is that as far as this particular

:39:27.:39:31.

scheme, the debt buyback scheme is concerned, if a bank or other

:39:31.:39:37.

entity is engaged in it, they should notify HMRC, under the

:39:37.:39:42.

disclosure of tax avoidance set of rules, and nobody else has. Are you

:39:42.:39:47.

getting back �300 million or �500 million? There is an amount, which

:39:47.:39:51.

we think is, if you like, the retrospective element, that has

:39:51.:39:55.

already happened, which is coming from the one entity, for example,

:39:55.:39:58.

Barclays, they have declared themselves it is them. The rest of

:39:58.:40:01.

the calculation. I know it is complicated, but let me make this

:40:01.:40:05.

point. The rest of the calculation is about behavioral r ral change,

:40:05.:40:10.

and that may be -- behavioural change, and that may be some

:40:10.:40:13.

entities or those who have already taken advantage of it. I'm being

:40:13.:40:19.

slow, I expect, but the figure is �300 million, that is what Barclays

:40:19.:40:28.

say they think they are on the hook for, the other �200 million is the

:40:28.:40:32.

speculative thing? It is the estimate HMRC have made. These are

:40:32.:40:40.

preliminary estimates, and they will have to be run past the budget

:40:40.:40:44.

of -- office of budget responsibility. With future bank

:40:44.:40:49.

activity, so. Why can't you tell us who you might think might owe the

:40:49.:40:53.

money? There is only one entity at the moment we are aware of, that is

:40:53.:40:57.

doing this. The only bank you know about doing this was Barclays, and

:40:57.:41:04.

bark close say the extent of their liability is �300 million not �500

:41:04.:41:08.

million. That is what they say. believe Barclays are on the hook

:41:08.:41:15.

for the full �500 million. We think the �300 million is up to now, and

:41:15.:41:21.

the �200 million is the future. We can get hung up on the two figures.

:41:21.:41:26.

It is a lot of money? It is, this was a very aggressive scheme and we

:41:26.:41:32.

have closed it down. This question of retrospective legislation, it

:41:32.:41:36.

has been a principle of financial legislation in this country, has

:41:36.:41:40.

had not, that it isn't retrospective. If you are going to

:41:40.:41:44.

do it in this case, why don't you just declare that the rate of

:41:44.:41:48.

income tax last yor, shouldn't have been what it is, it should -- last

:41:48.:41:53.

year, shouldn't have been what it is, it should have been 7 %, you

:41:53.:41:58.

can do anything? There is a concern about how retrospective legislation

:41:58.:42:01.

is used, if you misuse it creates uncertainty. I would be the first

:42:01.:42:04.

to argue that point. There are particular circumstances that apply

:42:04.:42:08.

in this case. There are always particular circumstances, look at

:42:08.:42:12.

the Vodaphone deal, and the Goldman Sachs deal, any of those? If you

:42:12.:42:17.

look at this particular case, what you have got here is that you have

:42:17.:42:20.

got a taxpayer, that has signed a Code of Practise, saying it will

:42:20.:42:25.

not engage in aggressive tax avoidance activity. You have also a

:42:25.:42:29.

particular area, Joe described it very well, the debt boyback

:42:29.:42:34.

arrangements. Actually the previous -- buyback arrangements. The

:42:34.:42:38.

previous Government in 2009 made statements and legislated in 2010,

:42:38.:42:41.

to try to prevent abuse of that, and try to close a loophole. This

:42:42.:42:45.

was an area, if you like, where there was a very clear sign, keep

:42:45.:42:50.

off the grass, I think everybody knew that this was an area where

:42:50.:42:55.

there had been a loophole, it was closed and, and nonetheless, one

:42:55.:42:59.

taxpayer went back into this area, in a way that was very aggressive,

:43:00.:43:03.

very contrived, and clearly against what the spirit of the law was.

:43:03.:43:08.

won't be doing this against Vodaphone and Goldman Sachs or

:43:08.:43:12.

anybody else on other arrangements? We would only use retrospective

:43:12.:43:16.

legislation in exceptional circumstances, where there was a

:43:16.:43:21.

very stkroing case, where it is very -- strong case, where it is

:43:21.:43:25.

very artificial and contrived. might do it again? Nobody will Raul

:43:25.:43:30.

it out. You have already said it is undesirable? It should only be used

:43:31.:43:35.

in very exceptional cases. Treasury's enthusiasm for

:43:35.:43:40.

maximising the tax makers motivated by the need to close a huge hole in

:43:40.:43:43.

the public finances f that goal will be met the economy will have

:43:43.:43:47.

to start growing. Today the cabinet met to look at the progress being

:43:47.:43:51.

made to promote growth ahead of next month's budget. Our political

:43:51.:43:55.

editor is here. What did they discuss? It was a review of the

:43:55.:43:58.

growth review. A year ago they said we need measures to get this

:43:58.:44:02.

economy going again, and three weeks away from the budget, they

:44:02.:44:06.

had to say where have we got to, in the words of one Downing Street

:44:06.:44:10.

person it is shaking the tree on existing measures, can we get more

:44:10.:44:15.

out of them. What was most striking is it was what we call, blue-on-

:44:15.:44:23.

blue, and yellow-on-yellow, across the benches sniping. It was a line

:44:23.:44:27.

that William Hague pushed, but today the Prime Minister pushed it,

:44:27.:44:30.

and it is this, at the moment some of the big infrastructure projects

:44:31.:44:37.

and the big things making a difference to UK Plc, appear to be

:44:37.:44:41.

blocked by EU rulings. Things people have been talking to me

:44:42.:44:44.

about, the Porton Down in Cornwall, if it got off the ground it would

:44:44.:44:49.

be big. In other parts of the country they don't talk it as

:44:49.:44:53.

gospel and sometimes they ignore them. The Prime Minister and the

:44:54.:44:58.

Environment Secretary, who has to lock at things like the EU Habitats

:44:58.:45:01.

Directive, says if there is a balance of risk and you might get

:45:01.:45:07.

something from it, go for it. It is extraordinary for the Prime

:45:07.:45:12.

Minister to say let's not err on the side of caution. Anybody else?

:45:12.:45:16.

Ken Clark, the Justice Secretary, weighed in on business, he made an

:45:16.:45:19.

intervention saying we are not doing enough for small businesses,

:45:19.:45:23.

which we know. Banks aren't lending to them, he said, there is too much

:45:23.:45:30.

red tape, how it was relayed to me is this is a guy, former Chancellor

:45:30.:45:35.

from pre-1997, who had there not been a coalition, he would have

:45:35.:45:40.

been the Business Secretary. It was interpreted as a shot across Vince

:45:40.:45:45.

Cable's Boug h, and some would say he's a Chancellor not that keen on

:45:45.:45:49.

business. The Chancellor wanted to know what was happening to another

:45:49.:45:53.

controversial piece of legislation, another things causing problems is

:45:53.:45:57.

how they are reforming planing. They think if they can unclutter

:45:57.:46:02.

the planing system they can get growth going. He wants to know from

:46:02.:46:05.

the community secretary if he will go forward on this. The National

:46:05.:46:09.

Trust hate it, we need the Government response. Pickwick said

:46:10.:46:13.

they will come forward with something -- Pickles said they

:46:13.:46:17.

would come forward with something. This time last night, the City of

:46:17.:46:21.

London police were readying themselves for removing the Occupy

:46:21.:46:24.

London Protest from outside St Paul's in London.

:46:24.:46:29.

There ain't no more # You have taken everything

:46:29.:46:37.

# My belief in mother earth # Can you ignore

:46:37.:46:47.
:46:47.:46:52.

# My faith in everything # Away away

:46:52.:46:58.

# And don't say neighbour Manage you will try

:46:58.:47:08.
:47:08.:47:10.

# Come up and see me Tuesday was a very cloudy but

:47:10.:47:13.

exceptionally mild day, particularly across the north and

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east. Keeping the cloudy mild conditions on into Wednesday, most

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of us will start off with rather grey and overcast skies, things

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will tend to brighten up into the afternoon. The north-east of

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England will be favoured, seeing some decent breaks in the cloud.

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Where we get these temperatures will lift to 14 degroos, that will

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feel pleasant in the sunshine. We could see limited brighter spells,

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the best of the breaks in the cloud are likely further west. A much

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sunnier day for South-West England, Wales, the West Midlands and on

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towards Greater Manchester, sunny spells reaching 11-13. In Northern

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Ireland a similar day to yesterday, rather cloudy but a few brighter

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spells. Western Scotland keeps the blanket of cloud, with a few spots

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of rain over the western hills. East of the Grampians sunshine into

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Aberdeenshire, it won't be as toastie as it was on Tuesday.

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Staying rather cloudy for most of us, particularly into the morning.

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Things turning a little bit brighter, in the London area,

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temperatures cooling off a touch as we go into Thursday. That is not

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just for London, it is a trend as we go on through the latter stages

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of this week, across much of the country. For Thursday a good dole

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