29/02/2012 Newsnight


Jeremy Paxman challenges the health secretary over the government's contentious NHS reform plans. Plus, James Murdoch quits News International.

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It affects all of us, and we will all have to live with the


consequences of the most contentious piece of legislation of


the entire Cameron Government. Tonight, the plan to reform the


National Health Service. The legislation is far bigger than


the law which created an institution all parties profess to


love and protect. Does the system have to stay the same forever and


ever? The Health Secretary tells us,


there is nothing wrong with the reforms, it is all about


perceptions. You could say blame me as a communicator, but if people


are literally distorting and misrepresenting what the bill does,


I just literally have to fight back against that.


These people have to make the health service work, they will be


putting their anxieties and hopes directly to the Health Minister,


who thinks the whole reform is solely about making the system work


better for patients. And one sunrises as another departs.


How long before News Corporation gets out of British newspapers for


good, as James Murdoch quits. Another day, another pile of


argument about the Government's attempts to reform the healthcare


system, Labour claim tonight that the Government was trying to rush


its now very knocked about bill through parliament, by the time of


the budget next month. Rubbish said the Government. The plan described


by a senior NHS boss, as so big you can see it from space, has had a


very checkered history. Promoted by the Liberal Democrats, and amended


by them. Introduced into parliament in January last year, then


suspended for a while, now approaching final votes. It is not


what the Government had hoped for. Away from Whitehall and Westminster,


to Worthing. A beach on the south coast. The Government's health


reforms look set to make it on to dry land, what exactly do they


change, how and when? What we have here is a charity that


is part of, in effect, the NHS. asked the Health Secretary to take


us to somewhere that exsemplified the reforms they are trying to get


going, he has brought us to Action For Deafness. This charity is being


billed as the best provider of help for those who are hard of hearing.


It isn't strictly the NHS, as it stands it is asked by the health


service to cater for patients' needs. Lansley's bill is supposed


to give help to give suppliers like this, who want the best for their


patients, the work. In 60 seconds, Josie clearly isn't fully aware of


what is going on, explain it? we are setting out to do, it comes


down to, firstly, making sure that you as a patient, everything that


happens to you, you should get really good information, and


wherever possible you should have some choice about the service that


is provided to you, including where it is provided from. Secondly, you


are registered with a GPs' surgery, your GP locally, and doctors and


nurses around locally in Worthing, they should be in a position where


they are able to design the services that you need locally, and


use the NHS resources to make sure those services are here for you.


Days ago Nick Clegg urged his party to take pride in the fact that they


had saved the NHS from privatisation. It strikes a bit of


fear with privatisation. Because, just explain to me what is it? From


my point of view, we are not going to do privatisation, explain to me


what it is you think privatisation means as a problem? It will just go


out to various people, are those people going to care like the


National Health Service cares now. I have had a lot of dealings with


the National Health Service regarding my father, he died a


couple of years ago, to try to bring all those bits and pieces


together was one long fight, but we got there in the end. Because we


all worked together. If it is going to be put out to privatisation, is


it all going to work. The sort of thing I have been saying, actually


it is going to be NHS care, like this is NHS. It doesn't have a big


sign saying it, but this is NHS care. The political peril of this


bill is clear, while the Health Secretary is down south, at Prime


Minister's Questions, Labour's leader goes on the attack for yet


another week. Let me refresh his memory as to who opposes his bill.


There is no good the Deputy Prime Minister smirking, I don't know


whether he opposes or supports the bill, which day of the week. Oh he


supports it, oh, he supports it, Mr Speaker. What you are saying is the


critics don't really understand the bill? I have to say, there are a


lot of things that I have seen said about the bill that appear to


suggest they haven't even bothered to read it. That includes coalition


partners, doesn't it? No. Of course it does? To be fair, Shirley


Williams, actually, that is the point. We have spent some


considerable time working with Shirley and others in the Lords, to


get to a point where, yes, we are going to make some amendments, but


they are amendments that give us, and them, a sense of actually,


finally putting precise reassurance in. Health Minister Mr Bef van cuts


the turf. Lansley's predecessors include the founding fathers of the


NHS. Is it up there with Beveridge these reforms? I wouldn't say.


they are going to last for a long time? The character is very


different. If you go back to 1950, Bevan said there is the tension


between the centralised funding system and decentralised


administration. And actually, over the years, the fact that the centre


has provided all the money, has meant the centre has had all the


control. Andrew Lansley was so trusted by the Prime Minister, that


years out of forming Government, he was the only one of David Cameron's


team to be promised he would make the grade, and go from Shadow


Health Secretary to the Government job. The idea was no major reform


change, reorganisation, steady as she goes, the public was to trust


the Conservatives on the NHS. But now, because of these reforms, it


is almost certain the NHS will be a battleground at the next legs, that


was never part of their plan. -- next election, that was never


part of their plan. It is one thing to get a bill through parliament


against opposition, many have done it. But verdicts on policy come


later, in the real world of people's experience. The challenge


for this Government is, while they may will it to work, it is probably,


very soon, out of their hands. As you heard there, the Health


Secretary was at a centre for the hard of hearing in Worthing earlier


today, by happy chance, it is also the town where Oscar Wilde wrote


the Importance of Being Ernest. Did you anticipate the sort of trouble


that you have run into on this bill? Yes, I always knew there


would be, there is always noise, the NHS matters, so people make a


lot of passionate remarks about it. You could go back, 2003, do you


remember, it is only less than a decade ago, Alan Milburn put


forward foundation Trusts, over 100 members of his own parliament


rebelled against him, The Royal College of Nursing came out against


it, others said it would be the end of the NHS. You are the person who


said in 2006 you would build consensus on the need for change?


You failed? On the need for change, absolutely we have, and on the


principles of the bill. If you look at it, not only amongst


organisations, but last year, when the Future Forum went to thousands


of NHS staff, at hundreds of meetings across the country, they


established there was a consensus on the principles. Would the bill


have been any different if you had not been in coalition? If it had


just been a Conservative Government, we would have started now the a


different place. The bill is better as a result of the coalition coming


together to shape it. Actually, I think, the central point, from the


Liberal Democrats' point of view, has been democratic, local,


democratic accountability. Local Government, in the new health and


well being boards, bringing together health, social care,


public health, into a combined forum, where local voices, and


local views can be added to professional views from the health


service. Actually it is stronger, as a consequence of being a


coalition bill. If you can't take cabinet colleagues with you, on a


profoundly important piece? We have taken cabinet colleagues with us.


They sign off on one thing and then they try to amend it? I'm sorry, we,


as a Government, as a coalition Government together, designed the


legislation. As a coalition together, Nick Clegg, David Cameron


and I, we want to improve the bill, we want to respond to people's


concerns, we did that last year. I think we did that very successfully.


Are you also going to maintain that this rigmarole we have been through,


the legislation being introduce, paused for consultation, and


amendments introduced many of which you accept, that was all


anticipated too was it? No, I thought when we published the White


Paper, which we did in 2010, and we had 6,000 consultation responses,


that actually most of the concerns would be there. It turned out it


didn't happen that way. That, it wasn't until the bill was in the


Commons, that many people said, we're worried about this and that.


Actually it was important to pause the bill, to listen, and to respond.


We did that. I think, actually, what that demonstrated was the


support, in principle, for the bill, across the service. It gave us a


lot of recommendations, and we were able to accept them. Which is why,


actually, I think, across the NHS, there is an understanding among


many staff that this is actually, in a sense, the bill they helped


shape. Doesn't it also demonstrate that however well you may be on top


of your brief, you are a hopeless communicator? No, I don't think


that at all. You didn't take people with you? Then that didn't happen


to any a second on health legislation at any time in the past.


Patricia Hewitt stood up in front of the Royal College of Nursing and


they booed her. Ken Clark, a fabulous communicator, he tried


reform in the early 1990s, and the BMA said it was the end of the


world as we know it, they put up posters with a picture of Ken Clark


asking what do you call a man who doesn't take medical advice. There


is no way of undertaking major reform, important reform, and


imagining that you are going not to be misrepresented, distorted or the


subject of argument, not going to be the subject of genuine concerns,


and genuine issues, that you have to genuinely respond to. I think we


have pretty much reached the stage where quite a lot of the


disinformation out there is a problem too. People are saying


things that are literally not true. The list of organisations,


organisations that ought to know about the NHS, as well as you know


about the NHS, the Faculty of Public Health, BMA, nurse, midwives


and all the rest of it? The Family Doctor Association, and the


representatives of Trusts and Hospitals. Are you saying they are


ignorant, have they fallen for propaganda? They are engaged in


various campaigns for various purposes. When you actually get to


it, take The Royal College of Nursing, for example. When do you


think they opposed the bill? January, up until that point they


had been literally with us. They said they supported the bill. What


changed? They fell victim to some piece of propaganda or something?


You tell me. Maybe they read the bill? I tried to find out what


change caused them to change their minds. What is your theory? I think


they were angry with the Government because there was a continuation of


pay restraint and the pensions issues, frankly, I find it...These


Organisations if they are against the bill, they have a right to be?


How can it be we introduce the bill in January 2011, for a year The


Royal College of Nursing work with us, say they support the bill. The


general secretary sits in my office on more than one occasion, saying


they support the bill. We make the amendments they looked for in the


course of the discussions we had with them last year, and suddenly


they say they are against it, well, because actually, other things were


going on. Can you guarantee, finally, that if this bill goes


through, and it is now much improved, you claim, that it will


be the last reform of the NHS, that you can foresee for the next ten


years? Yeah. I think it is a major piece of legislation. Why? Because


we are dealing with issues that haven't been dealt with in the past.


The reason we need the legislation is to effect a transfer of


responsibility and power, to local authorities and local health


organisations. It doesn't deal with the fundamental problem, that the


NHS, for not much longer, can be afforded? It does very much help


with that. What it does is it puts the decision making responsibility,


increasingly, in the hands of people who can use resources better.


Rationing is inconceivable, in your view? Proirt setting is necessary,


and should be done by -- priority setting is necessary and should be


done by the doctors and nurses with the care of the patients. That is


rationing? It is not, that is depriving people access to services,


getting people the right care, at the right time, in the right place,


is what it's about. Thank you. With us is the Shadow Health Secretary,


Andy Burnham. Apart from taking �20 billion out, what is your policy on


the NHS? We had a successful NHS when this Government came in,


judged by the Commonwealth fund to be one of, if not the best


healthcare system in the world. What they have done in the 18


months in power, is take the self- confident NHS, destablise it, and


demoralise it, and turn it into an organisation fearful for the if you


are tue. We will be the judge of what -- Future. We will be the


judge of what they turned it into, what is your policy? We have a


planned National Health Service that for 60 years delivered care.


You haven't a policy other than what exists? I have a policy, a


National Health Service that is planned and provides care to a


whole population, not legislation for a market in healthcare, that


basically, breaks all of that apart. No change? No, and one of the


arguments I would make, one of the problems with this bill, it is a


distraction from the real reform the NHS needs. It needs service


reform, not back office structural reform. It needs reform? It needs


more care in the patients' homes in the community, changes to service


on the ground. The whole debate about the structures of the NHS s a


massive distraction to the change of services we need on the ground.


In policy terms, what are you advocating? I have just explained,


we need service change. You have asserted people need more care in


their homes? In the ageing society, we need to bring together health


and social care. It was an argument I made as Health Secretary.


would you do that? We needed to reform the social care system to


provide more prevention in people's homes, better integration with the


health service. This bill is a recipe for fragmentation, and a


move away from the integrated care we need to see. I'm interested in


what you want to do. Is it just coincidence, that when you are in


Government, Tony Blair boasts about the scars on his back, that come,


he said, from taking on vests interests in the public sector, and


that when you are in opposition, you basic clo dance to the vested


interests -- basically dance to the vests interests tune? I don't agree


with that. The it is not opportunism, what they did was make


a catastrophic mistake, by combining the biggest-ever


financial challenge in the NHS, with the biggest-ever top-down


reorganisation. They would do well now, at this late stage, to give


the NHS the stability it needs to face the financial challenge. That


is what I will be doing now. I will be giving the NHS the ability to


focus on changing services, make them more sustainable so, they can


face the future. Will there be any detail in what you will do, should


you be elected? I was part of Government that took the NHS, that


was on its knees in 1997, and turned it into one of the best


healthcare systems in the world. needs changing? It needs service


change. I have always argued for that. We made some difficult change


to skefrss in Government. We made changes to stroke services in


London, maternity services in Greater Manchester. These are the


difficult changes the NHS needs. That is the nettle all politicians


need to grasp. If we are in the position where we are always using


the NHS as a political football we will never get there. That is what


the bill should focus on, this bill is a massive distraction from it.


With us now is the Minister of State for Health Simon Burns, and


an ensemble of healthcare professionals, between them they


represent thousands of nurses, doctors and patients across England,


and listen to those who have been patients of the NHS. Some agree


with Government reforms, others are sceptical. Let's start with this


accusation about The Royal College of Nursing. Did you sit in Andrew


Lansley's office and tell him you believed in the bill? Sat in Andrew


Lansley's office many times, telling him we had severe anxieties


and concerns about this bill, but we were committed to try to work


with it, and we worked with it for a year, and we didn't get anywhere,


we made the decision that we would now withdraw our support, because


while there was a lot of listening, there wasn't much action. So you


did tell him you supported the bill in one sense, but when it came to


it you decided you couldn't? thought it was the responsible


thing to do, with the elected Government of the day, to try to


work with this, to see if we could change it, and we didn't succeed.


This is a very, very significant difference of emphasis, what is


your recollection? I was at some of the meetings, not all, my


recollection is similar to Andrew Lansley's. We did listen, we have


made changes that responded to what The Royal College of Nurse iting


was asking for. For example, they wanted a nurse on all -- The Royal


College of Nursing was asking for. They wanted a nurse on all the


clinical boards, following the Future Forum review, we have sed


that, and that is now happening. We have accepted that and that is


now happening. Is your recollection about the British Medical


Association in any sense similar? With all reforms there will be


people who are for it, within an organisation, and people who aren't.


What we found with the responses to the consultation document, that the


BMA were supportive of some things, but less happy with others. When


the Future Forum reported its recommendations, which we accepted


last June, they warmly welcomed that, because they were taking on


board ideas to improve and strengthen the bill. So Dr Hamish


Meldrum, did you also initially support the bill? No. You have


never supported it? Never supported the bill. When the White Paper came


out, the headlines, which are about better clinical involvement, better


patient engagment quality, of course you support that, when you


read beneath the headlines, no, we didn't support it. We engaged in


the consultation process, three months after the bill came out, we


had a special representative meeting, asking for the bill to be


withdrawn. So to say we have supported the bill, I'm sorry, is a


travesty of the truth. You also opposed the setting up of the NHS?


No we didn't, that is another long and oft repeated myth. The doctors


and the BMA proposed, don't look so surprised. Did he not say, I will


get their agreement, by stuffing their mouths with gold? That is


about the contractual arrangements within the NHS. Exactly? It wasn't


about the NHS itself, doctors didn't want to be state employees


and actually not to...You Don't like change, that is your problem?


That is not true, I have been a GP for over 30 years, I have seen


massive change. It has been evolutionary change not structural.


I have seen nine structural organisations that have made the


NHS worse in many respects, they have been hugely distracting and


costly, and taking the eye off the real things. Do you think those


with a vested interest in the National Health Service are really


adaptable? I would hope they have the best interests of improving the


NHS. I want you to talk about your experience rather than your hopes?


In my experience I have found they have been prepared to engage, but


they have come to conclusions that are not in the interests of moving


the NHS to move forward. What is disappoint beg the BMA is they have


-- disappointing about the BMA, is they have been for the bill, but


they voted for one of the core parts of the bill, clinical


commissioning groups. Dr Alessi you are a GP, you support the bill?


am a GP. You are singing from an entire different hymn sheet from


the BMA? I am looking it on the basis of consultation with patients.


I can think of the way things will change in the future. Things won't


happen quick low, change won't happen rapidly. We will -- quickly,


change won't happen rapidly. We will come to the bit soon where we


will manage the interfaces, and we will have more control over what


happens to patients than we have at the moment, that is what all this


about. You think it gives you freedom? I think the change has


been palpable, the discussions I'm having now with my colleagues in


hospital is completely different to what it used to be before. They


have been liberated as well. They are able to speak to me, before


they just, it just didn't work. doctors' trades unions angry?


fact it is happening before the bill has passed, shows you don't


need a bill to make that happen. That is the whole point. You can't


say it is due to the bill, the bill isn't in law yet, these things are


and were happening. The fact that doctors want to do the best for


their patients, Assam, who sat on a platform with -- as Sam, who sat on


a platform with Andrew Lansley a year ago. He said just because we


want to do the best four patients, doesn't mean we support this bill


and we don't. You are a GP, you also think there


is a lot to be said for the reforms? I do, I think while I have


some mixed views about the bill, there are some parts I'm not


supportive of actually, there is no doubt in my mind, as a GP involved


in commissioning, it has made a huge difference to the influence


that I have been able to exert. the changes have already been


implemented, why do you need another piece of legislation?


have been trying to change things for better for about 15 years. Up


until this legislation, which attracted everybody's attention, I


haven't been able to get the traction I needed to effect change.


You have got the traction, you are making the changes, as Dr Alessi


has been saying? Absolutely, it is because of the bill, the scope,


scale and sheer audacity, has hit the radar of absolutely everybody,


and people have started to behave, I agrie, as if it is in lepblgs --


I agree, as if it is in legislation, but before this happened under the


previous administration it was not possible. The clear indication is


you didn't need to do much of this? We do, that is a false myth, put


around, sadly, mostly by politicians. The reason we have to


have the legislation is because they are moving in pathfinder form


at the moment. But there is nothing in law to make the clinical


commissioning groups accountable, so you need legislation, and also,


you have got to abolish the PCTs and the SHAs, you cannot do that


without primary legislation. That is why it needs the legislation to


actually make it work. Angela Coulter, you speak for a number of


organisations, I understand in your judgment can it deliver better


patient care? There are 160 organisations representing patients


and carers, and they are, on the whole, very unhappy about the bill.


They have done a lot of lobbying, and are very pleased that the


Government has listened in some cases, and the bill includes more


power for patients, more involvement in decisions about


their care, and so on. But, it is a real distraction from the major


issue, which faces our health system and everybody else's, which


is people with long-term conditions who want joined-up care. The


problem is, that this bill seems to represent, or certainly the concern


of our members is, is it will make care more disjointed, not more


joined up. It is not just a distraction, it is a positive


impediment? Nobody really knows, because the bill is incredibly


complex. There is a real fear. feel similar? It is one of the


major concerns, this emphasis on competition, what we should be


doing is getting the component parts to work with each other, to


collaberate with each other, the Hackneyed, joined up thinking, this


bill will stop that happening. is, I'm afraid. Factually incorrect.


The whole ethos of the bill is putting patients at the centre of


care, and...Built Around the idea of competition? Competition has


always been in the NHS and will continue to be. Competition, based


on quality, can be a force for good. Let me give you a brief example.


Two NHS hospitals within five miles of each other, one of them has a


reputation, through surgeries, for hip replacements, they have short


waiting times for it. There may be other peripheral things, their MRS


A-levels are very low, their mixed sex ward accommodation is very low,


and the hospital five miles away, an NHS one, has a poor record,


clinically, on hip replacements, longer waiting times, with patients


empowered with choice, you will see, probably, many more patients going


to the hospital that is performing better, that will be a spur for the


less performing one, to ask why. That is open it to patients now, we


don't need the bill for that. is a good thing. You can already do


this? You can already do that, if you can find the information about


the quality of the hospitals you can choose to go to the best. We


didn't need a bill for that. have some experience of how


competition works, Kresimir Zubak? I find the debate of -- Stephen


Bubb? I find the debate of are we for the bill origins frustrating.


The majority of people in hospital beds are over 65, long-term


conditions, taking 70% of the health budget, and there are


charities and social enterprises, who want to do more to provide


those services. We want competition to enable that to happen.


You, presumably, you are heavily involved in charities that would


like to do more? I run a social enterprise. I presume you welcome


this, don't you? It is not case of welcome or not welcome. We are


where we are, the fact of the matter is the competition issue is


largely irrelevant, we have had competition in the NHS for a long


time, the question is management of the markets. What worries me is


noft-for-profit organisations, social enterprises, aren't in a


place where they can compete with some of the highly capitalised


private sector organisations. Just giving you an example, if you look


at the provision of community health services in Surrey, that


contract, which was worth �90 million a year, went to a private


sector organisation, when, actually, the best performer, in terms of


delivering community healthcare services was a social enterprise.


But it simply could not compete. I raised this matter with the Prime


Minister. You can't just talk about competition without saying


something about how you manage the market. Just one other thing, it is


the case that where you have limited resource, and we do have


limited resources, unfettered competition can waste those


resources. There are lots of issues about the market and how we manage


the market. Your experience, Ali Parsa, of letting different kinds


of disciplines get to work, is actually rather different, isn't


it? Absolutely. Just explain what you do? We are, I guess, now


Europe's largest partnership of doctors, nurses, healthcare


professionals, who think we should be able to run hospitals, exactly


in the same way that GPs can run GP practices, they are a partnership


of people who have come together and contracted back to the


Government to deliver to them the services the Government want. Why


can we not do that in hospitals. Where we were given the opportunity


to do it, for instance, in Bath, from scratch, without any


Government grant or support, we built a building that won the award


for the best building, globally, we brought people who design luxury


hotels to design the building, and Michelin-starred chef to cook every


day. It can be done. Makes you want to be ill? When you are ill you are


welcome. It can be done. Why do you oppose it? You don't need a bill to


do that, as demonstrated. That is a fair point? To take the Simon's


point, the hospital that is poor needs to be sorted out, patients


still have to go there, you need to sort out bad, inequality of service,


competition won't help that. Actually this bill is costing �3


billion. No it is not. It is taking a huge amount of people's minds off


the care of patients. What do you mean it is costing, the


implementation of the bill? implementation. Can we put it right.


The cost of it, as the impact assessment shows is up to �1.3


billion, a one-off cost, as a result of that, between now and


2015, the savings will be �4.5 billion, to reinvest in the health


service. For the rest of the decade �1.5 billion, per an number, all to


be reinvested in the -- peran number, all to be reinvested in the


health service. You are changing the subject now? This is the risk


of this legislation. You asked about money, he told you about


money, now you are talking about the risk register? I think if you


put clinicians in the driving seat of reorganising healthcare, we


understand the product of healthcare in a way professional


managers don't always. I'm abs lout low certain that my colleagues, and


-- absolutely certain that my colleagues, and a lot of young


doctors are coming forward with solutions for improving services


for patients. The NHS is not perfect, there are areas where we


can do better, and we know where they are. We don't need a lot of


data, we speak to patients on daily basis, we understand what needs to


be fixed. We are the best placed people, clinicians working in


partnership with hospitals and colleagues to do this best. We have


to remind ourselves this is the NHS and social care bill, it is not


just about clinicians deciding what populations want. What it should be


about is commissions and populations deciding how they


provide an integrated health and social care system. Hang on, let me


finish, which is about commissioning. And so far, just a


point I'm making, I'm not saying I disagree with any of you, I'm


making the point that we have talked about the NHS as though it


is about hospitals and clinical interventions, the NHS and social


care bill. We're not going to save �20 billion unless we integrate


health and social care. Are all of these a conspiracy against the


public, the NHS should be about patients? That is my point, it is


the NHS and social care bill. also about citizens. It is the


citizens in charge. It is care, well co-ordinates and meets their


need. Absolutely. That is the challenge. This shake-up of the NHS


is putting organisation against organisation, it is dividing


professionals, it is actually not helping. It is going to take about


four years before the commissioning groups really learn how to do it.


It will take some time to settle in. All major change takes time? A lot


of people will be ill and need better co-ordinated care. You look


at countries according to the OACD, have the best healthcare quality in


the world, France, Germany, Switzerland. And the UK. They are a


co-operation between the private sector, public sector, private


sector in Germany runs more hospitals, more healthcare


provisions than the public sector does T does it in a regulated


market, in which people can't "cherrypick", in which people need


to focus on the patients. That is what we need to focus on. The


British public is not concerned on whether the service is provided by


public sector, private sector, the Government, it is concerned about


whether it is fair, it is accessible, it is free at the point


of delivery. We should focus on making sure that happens, and when


that happens, when that happens everything will be fine. By the way,


for those who think that the private sector, or the social


enterprises just take the cherry, let me say it here and now, please,


give us all your potatoes, keep the Cheries, we love to have what you


don't want. France and Germany spend 2% more of GDP on healthcare.


The British healthcare system is the most cost effective service in


the world. But not the best. haven't had much of a shout. Can we


have an opportunity perhaps, now we are in this state where we are


starting to have a dialogue with our local authorities. This is


starting now. Let's give us the oxygen we need to make it happen.


We need the space, the time to make this happen. I wonder if you feel,


as a practising GP, that, in a sense, this is rather missing a


point. We can have the organisational changes, but there


is a real crisis in this country about how on earth we carry on


paying for healthcare, giving the increasing demand? Unless we change


what we are doing, we will get into difficulty. I believe only by laifg


the dialogues at this level and in- - having these dialogues and at


this level and intensity can we find our way out of where we are at


the moment. A lot of this debate is often dominated by a professional


view. There is nothing wrong with that, but the citizen view doesn't


often get in. To give you an example of this, we want more


choice in the NHS. The NHS institution guarantees choice, but


doesn't deliver it. If at the end of your life you want to die at


home or in a hospice, you are often denied that choice. The majority of


people who want to die in a hospice or at home, they die in a hospital


bed. There are charities out there, hospices that would love to provide


that care, they are not commissioned, and the system needs


to be opened up, so that those organisations can be commissioned


and provide that choice to people. That's what people want. That will


happen under your bill, will it? is already happening. It is already


happening. It isn't, because the majority of people at the end of


their life are dying in a hospital bed, they wish to die in a hospice


or home. Let's support charities that provide that for them.


going to have to stop you, I'm afraid, we have to get on to


something else. Thank you very much. Now, it's perhaps one of the least


surprising bits of corporate news this year, James Murdoch, the man


whose father gave him a media empire, is quitting ASBOS of News


of the World. He hopes there by to step out -- quitting as boss of the


News of the World. He hopes to step out and set up somewhere Aspel a


television executive. Whether that will be -- Where as a television


executive. Whether that will be enough, we will see.


On a week where one Murdoch Sun went, another rose.


James Murdoch was nowhere near his father's corporation when the


hacking went on at News of the World, why do many believe it was


he have table he would step down. Some say he was in charge when he


tried to limit the damage. Some say he either tried to cover up how far


hacking went, in that case he had to go, or on the other hand, he had


no idea what was going on in the company, in which case, he had to


go. There has been criminal wrongdoing on a large scale in this


company for many years. Now the police investigation is beginning


to unearth those networks and Leveson is beginning to show the


methods deployed by some of the journalists working for the company.


Not all of them. And yes, I think the day of judgment is coming for


James and Rupert Murdoch. Until very recently, News International


maintained hacking was the work of one rogue journalist, the royal


editor of the News of the World, Clive Goodman. But the company had


information that the practice was far more widespread. Just this week


the Leveson Inquiry into practices, saw an internal e-mail showing 110


victims could have been involved. James Murdoch agreed a huge pay-off


to one of the victims, �700,000 to gord dond Taylor, then of the


professional Football Association. If he had read the paperwork that


accompanied the pay-off, he would have known many more victims were


involved. Although he was sent e- mails, he maintains he didn't read


them. You embarked on a sustained cover-up, the accusation against


you, because you know how widespread it was and you didn't


want it to come out? There was a particular settlement I authorised,


and I have said was made with information that was incomplete.


James Murdoch has been dogged by this question ever since. Did you


see, or were you made aware of the "for Neville" e-mail, the


transcript of the apt voicemail message? No, I was not aware of


that at the time. But Mr Murdoch has been contradicted by two of his


former executives. Although he quits as chief of News of the World,


he remains CEO of News Corporation based in New York. Many there say


he's no longer credible. Does it worry you that his explains in all


of this was, sorry, I didn't read my e-mail? That is at best, that is


if nothing else, if he is found incompetent to read his e-mails,


that doesn't make him fit to be chief executive of any company we


are investing in. You can't have people like this. 100 years ago it


would be a cluby person on the board, they have to be high-


performing individuals. How do we read the departure, is it evidence,


as some believe, a victory for News Corporation shareholders, who don't


like the messy, low tech, newspaper business, and particularly the


reputational damage it is doing to their interests. Or is it evidence


that Rupert Murdoch has decided to take personal charge of the


operation here in Britain. Just like he did in the old days.


It was, afterall, Rupert, not James Murdoch, who launched the Sun on


Sunday this week. However, the big news of the week, that you wouldn't


necessarily have read about in the Sun, was the revelation at the


Leveson Inquiry, that the Sun was running a network of corrupt public


officials, including the police, spending tens of thousands of


pounds on bribes. There also appears to be a culture at the Sun


of illegal payments, and systems have been create today facilitate


these payments, while hiding the identity of the officials receiving


the money. Some believe this is a game changer, opening News


Corporation in America, to poosable, federal investigation under the


Foreign and Corrupt Practices Act. Some believe it is all about


isolating and limiting this damage. Joining us now from New York, the


former editor of the Sunday Times and Times, Sir Harold Evans, whose


book about working for Murdoch, is about to be reissued, including the


events of last year. Did he jump or was he pushed, James Murdoch?


think we shouldn't spent too much time on James Murdoch, actually, he


was a very able executive of Sky. I think he's blundered awfully, I'm


not absolutely convinced he orchestrated the cover-up. That may


have been the work of sloppyness and negligence of him. I'm not sure


he did. I think more important, other than the faith of James


Murdoch, is the faith of the Murdoch empire given the very


serious charges of bribery, not just by one journalist, buying a


cop a drink. But by a whole series of systematic payments. I think,


myself, don't forget Rupert Murdoch and I parted, not on the best of


terms, he pushed me out of the Times, you have to bear in mind I'm


some what prejudiced. I'm also prejudiced for decent reporting,


honesty, and not invading people's minds. What is running through the


whole thing from beginning to end is the rotten smell of corruption.


It has been there for years, and only encouraged by slack and


corrupt politicians who wanted favours from him. It is really an


indictment, not just of James Murdoch, which is actually small


fry in many ways, but the whole Murdoch corporation, of the cosines


between slack politicians, and Rupert, who knew how to manipulate


them. It raises the question of how the owners of these properties here


will regard their investment? a terrific investment in terms of


cashflow. You have to look at the News Corporation businesses, they


are extremely well run, highly profitable, and the question is how


big is a shareholder's soul. If he cares about integrity in the news,


he will care a lot. On the other hand, if the Murdoch corporation


faces a prosecution under the corrupt practices act in the United


States, that is very serious trouble. Because it was that the


Murdoch corporation would have to lose, if they were indicted and


convicted, they would have to lose control of very valuable


investments, that depend on Government licenses, cable


television and the like. That is the really serious issue here. Also


bear in mind the other serious issue is the terrible blow that


these activities have done to the reputation of journalism generally.


Just leaving that to one side, the question of the reputation of


journalism as a whole, the future of the Murdoch empire, Rupert


Murdoch, a man who, whatever his failings, believed in newspapers.


James Murdoch, a man who doesn't believe so much in newspapers, but


clearly blofs in other forms of media. Why -- believes in other


forms of media. Why Hong on to newspapers here? It is a good


question. A little bit of my heart goes out to him, I'm a romantic


newspaper man myself. But the rest of my heart, and most of my head


said, I would rather he had nothing to do with newspapers, he does not


bring enough to them, apart from money. He doesn't thing integrity


to them. In some sense, as I say, I'm personally slightly torn about


it. I think it would be a good idea if he devested himself from the


newspapers, it would be good for the shareholders, and in the end,


for journalism. The smell now is so intense, I don't think it can be


eradicated by any more apologies, revelations keep coming out and


coming out. The public, I think, is sick to death of it.


Thank you very much for joining us. Tomorrow morning's front pages,


James Murdoch is on most of them. There he is on the front page of


the Guardian. Also he's on the front page of the Independent and


the Financial Times. On the front page of the Telegraph


is a picture of Davey Jones of the That's all from Newsnight tonight.


A man in a chip shop in Worthing gave me a free gherkin today. There


will be all manner of pickles and preserves on tomorrow night,


preserves on tomorrow night, overseen by Mr Gavin Esler.


Good evening, a cooler start to tomorrow than the last few days.


Misty and foggy towards the south. Most brightening up through the day.


Sunny spells developing in plane areas. Holding on to a lot of cloud


across southern areas. To the east of the Pennines, to the Midlands


and the south, the morning cloud and mist, it clears, the cloud


breaks, sunny spells developing. It will be a mild day under light


winds. Temperatures peaking at around 14.15. Sunny spells in the


south west and through many parts of Wales.


On the west we could see one or two showery bursts of rain. In the


south-east of Northern Ireland, holding on to bright, if not


sunnier weather. After a wet start across the Highlands in Northern


Ireland, brighter and dryer, some of the patchy rain pushing into


other parts of Scotland with a drop in temperature. That rain fizzling


out. Cloud on Friday, with temperatures dropping a degree or


so down. Across England and Wales a lot more cloud for the end of the


week. Again, temperatures down a notch. Still above average for the


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