:00:11. > :00:16.That something Nazi Germany would have done and did do. I think it's a
:00:17. > :00:17.disgrace that information that was false and fake and never happened
:00:18. > :00:21.got released to the public. That's right, you heard
:00:22. > :00:23.America's President-elect compare He thinks intelligence
:00:24. > :00:26.agencies spread salacious No, I'm not going to
:00:27. > :00:39.give you a question. Fter an electrifying
:00:40. > :00:45.hour-long press conference, what more have we learned of Trump,
:00:46. > :00:58.the truth, and his relations We've all seen humanitarian crises
:00:59. > :01:00.around the world. To use that description of a national Health
:01:01. > :01:02.Service was irresponsible and overblown.
:01:03. > :01:06.The government tries to paper over growing concern about the NHS.
:01:07. > :01:11.Like, I've already made the decision I want to be a girl.
:01:12. > :01:16.But I haven't made the decision if I want to do the surgeries.
:01:17. > :01:19.Is it right that primary school age children should be permitted gender
:01:20. > :01:34.Donald Trump has suggested that US intelligence agencies may be behind
:01:35. > :01:38.claims that Russia has gathered compromising information on him,
:01:39. > :01:41.and rubbished the news agencies that chose to publish the salacious
:01:42. > :01:46.sexual allegations about him from leaked and unverified documents.
:01:47. > :01:49.Speaking at his first press conference since July,
:01:50. > :01:51.the President-elect reminded reporters just how different
:01:52. > :01:57.In an explosive and combative exchange, Trump attacked
:01:58. > :02:00.both CNN and Buzzfeed - which he described as
:02:01. > :02:05.And he compared the actions of the CIA - who had shared
:02:06. > :02:08.the intelligence with him - to Nazi Germany.
:02:09. > :02:11.The documents appear to claim Russia had secretly filmed him,
:02:12. > :02:17.Donald Trump - and his surrogates - spelled out why none of the facts
:02:18. > :02:21.Our Diplomatic Editor, Mark Urban, has pieced together
:02:22. > :02:38.With his first press Conference in six months, Donald Trump was bound
:02:39. > :02:43.to have been under close scrutiny. So last night's allegations couldn't
:02:44. > :02:47.have been better timed, and indeed does make indeed the leaks finally
:02:48. > :02:53.pushed into publicly blaming Russia for hacking rivals. As far as
:02:54. > :02:58.hacking, I think it was Russia. But I think we also get hacked by other
:02:59. > :03:06.countries and other people. And I can say that when we lost 22 million
:03:07. > :03:09.names and everything else that was hacked recently, they didn't make a
:03:10. > :03:14.big deal out of that. That was something that was extraordinary,
:03:15. > :03:19.that was probably China. We have much hacking going on. But if that
:03:20. > :03:24.seemed to put the President-elect on the same page as his intelligence
:03:25. > :03:33.chiefs, think again. That nonsense that was released by the maybe the
:03:34. > :03:36.intelligence agencies, who knows? May be the intelligence agencies,
:03:37. > :03:41.which would be a tremendous blot on their record, if they in fact did
:03:42. > :03:44.that. A tremendous plot. Because a thing like that should have never
:03:45. > :03:51.been written. It should never have been had and it should never have
:03:52. > :03:55.been released. The allegations published last night have been known
:03:56. > :04:00.to some reporters for months. But it was the fact that intelligence
:04:01. > :04:05.agencies decided to brief Trump on these claims and votes for the
:04:06. > :04:11.credibility of their author, a former MI6 officer, that gave them
:04:12. > :04:15.traction. These were based on memos compiled by a former British
:04:16. > :04:20.intelligence operative, whose past work US intelligence officials
:04:21. > :04:26.consider credible. When that had aired, the reports ended up online.
:04:27. > :04:29.The documents, marked confidential and sensitive source, argue the
:04:30. > :04:35.Russian government had been backing Trump for at least five years. One
:04:36. > :04:40.makes salacious claims about his alleged use of prostitutes, and that
:04:41. > :04:46.the FSB had either arranged or moderate them. The latest memo
:04:47. > :04:51.details a meeting in Moscow between Carter Page and senior Russian
:04:52. > :04:54.officials. One source suggests the Russians have compromising material
:04:55. > :05:01.on both Trump and Hillary Clinton. A Kremlin spokesman is alleged to have
:05:02. > :05:06.led the campaign to help Trump and damage his opponent. He today issued
:05:07. > :05:12.his own denial. There were also alleged meetings between Trump
:05:13. > :05:20.lawyer Michael Cohen and Kremlin officials. One suggests he met
:05:21. > :05:25.Kremlin officials in 2016. Michael Cohen says he has never been to
:05:26. > :05:30.Moscow. CNN reported may have been a different Michael Cohen. The memos
:05:31. > :05:35.claim deniable payments were made to hackers who had worked for the
:05:36. > :05:40.Kremlin and against Clinton's campaign. The fact that Buzzfeed and
:05:41. > :05:45.CNN made the decision to run with this unsubstantiated claim is a sad
:05:46. > :05:51.and pathetic attempt to get press. The report is not an intelligence
:05:52. > :05:54.report, plain and simple. People need to look very carefully at a
:05:55. > :06:00.range of information in front of them. And, go to their own
:06:01. > :06:11.conclusions as they sift through a variety of different facts. -- and
:06:12. > :06:15.come to the wrong conclusions. I will say that I listened to him very
:06:16. > :06:20.closely and listened to be denied and what he did not. And the point
:06:21. > :06:24.about the number of different contacts that people in his campaign
:06:25. > :06:29.had with the Russians, which he was asked about repeatedly, he did not
:06:30. > :06:37.comment on that point. Today's confirmation hearings for Trump's
:06:38. > :06:43.Pickford Secretary of State spent much time on Russia and Putin. I
:06:44. > :06:46.have not had any class -- on classified briefings because I have
:06:47. > :06:51.not received my clearance. I did read the report released on January
:06:52. > :07:00.six. That report is clearly trouble. It indicates all of the actions you
:07:01. > :07:04.describe are undertaken. The tycoon's Kremlin ties are the chosen
:07:05. > :07:07.battle ground. This was a press
:07:08. > :07:09.conference like no other. The bulk of it was spent
:07:10. > :07:14.on dispelling what Donald Trump But in between, we got
:07:15. > :07:17.plenty of real news. The Mexican wall will be built
:07:18. > :07:19.with almost immediate effect, Obamacare would be replaced
:07:20. > :07:23.with a new healthcare system, a border tax would be enacted
:07:24. > :07:26.on those companies who move production abroad,
:07:27. > :07:28.and the President-elect would be isolating himself
:07:29. > :07:31.from all his business interests and handing the company
:07:32. > :07:33.over to his sons to run. As a press conference,
:07:34. > :07:39.this was unwieldy, confused and exhausting, but as a piece
:07:40. > :07:42.of television, it The man who in just
:07:43. > :07:49.ten days will be sworn in as the leader of the free world
:07:50. > :07:52.began by dismissing the lurid allegations of sexual behaviour
:07:53. > :07:55.in a Russian hotel room and commended those who chose not
:07:56. > :08:00.to report them. I want to thank a lot of the news
:08:01. > :08:03.organisations here today. Trump pulled back
:08:04. > :08:04.to questions of his If Putin likes Donald
:08:05. > :08:09.Trump - guess what, folks - that's called
:08:10. > :08:12.an asset, not a liability. Trump then explains why
:08:13. > :08:14.those extraordinary I was in Russia years
:08:15. > :08:23.ago with the Miss Universe contest,
:08:24. > :08:24.which did very well. And I told many people,
:08:25. > :08:32.be careful, because you don't want to see
:08:33. > :08:34.yourself on television. Trump lashes out at both
:08:35. > :08:40.the US intelligence highly personal fight with the news
:08:41. > :08:45.organisations who did choose to Since you are attacking
:08:46. > :08:50.us, can you give us a She's asking a question,
:08:51. > :09:06.don't be rude. No, I'm not going to
:09:07. > :09:13.give you a question. I think it was disgraceful,
:09:14. > :09:19.disgraceful, that the intelligence agencies
:09:20. > :09:20.allowed any information that turned out to be
:09:21. > :09:28.so I think it's a disgrace,
:09:29. > :09:32.and I say that, and I say And that's something Nazi Germany
:09:33. > :09:36.would have done, and did do.
:09:37. > :09:37.I think it's a disgrace. As far as Buzzfeed,
:09:38. > :09:39.which is a failing pile of garbage, writing it,
:09:40. > :09:43.I think they're going to suffer the He picks up parts of the story
:09:44. > :09:51.he claims are demonstrably false. Michael Cohen of the Trump
:09:52. > :09:53.organisation was in Prague. It turned out to be
:09:54. > :09:56.a different Michael Cohen. It may well be that
:09:57. > :09:59.none of the leaks are true, but the story in some ways
:10:00. > :10:02.has already moved on. A man about to enter
:10:03. > :10:04.the highest office in the land who distrusts
:10:05. > :10:07.the very agencies tasked
:10:08. > :10:09.with keeping America safe. No note to end on, so he falls
:10:10. > :10:12.back on a role he does These papers are all just
:10:13. > :10:19.a piece of the many, many companies that
:10:20. > :10:22.are being put into trust
:10:23. > :10:26.to be run by my two sons. I hope that the end of eight years
:10:27. > :10:29.I'll come back and I'll Otherwise, if they do a bad job,
:10:30. > :10:33.I'll say, you're fired. Well, within the last hour,
:10:34. > :10:43.the BBC has named Christopher Steele as the author of the series of memos
:10:44. > :10:46.regarding Donald Trump which has He is a former member
:10:47. > :10:50.of the Secret Intelligence Service, MI6, and has been a director
:10:51. > :10:54.of Orbis, which describes itself as a leading corporate
:10:55. > :10:56.intelligence company. He has not yet responded
:10:57. > :10:59.to a request for comment. Glen Greenwald - best known
:11:00. > :11:01.for his role in the publication of the National Security Agnecy
:11:02. > :11:16.leaks - joins us now from Rio. You heard Buzzfeed, the publication
:11:17. > :11:20.that went ahead with publication today, being described as a failing
:11:21. > :11:27.pile of garbage. Would you have published? I think the question
:11:28. > :11:32.about whether to publish was a very easy one before yesterday, which was
:11:33. > :11:36.the decision that every news organisation that had this document
:11:37. > :11:41.made, which was not to publish, because nobody could verify this
:11:42. > :11:45.information. Once the intelligence agencies called CNN to tell the
:11:46. > :11:49.world that the FBI and CIA had briefed the President-elect on this
:11:50. > :11:54.material, and that Russia allegedly had dirt on Trump, I actually think
:11:55. > :11:57.Buzzfeed did an important journalistic service by ending the
:11:58. > :12:01.speculation about what that was and letting everybody see what a
:12:02. > :12:06.farcical document this actually was on which this is based. You call it
:12:07. > :12:11.a farcical document, Donald Trump called it fake news. You basically
:12:12. > :12:16.with him on that? I don't know if it is fake or real. I say it is
:12:17. > :12:20.farcical because when it was disclosed it was not only anonymous,
:12:21. > :12:26.now a person has been identified, it was somebody paid by Democratic
:12:27. > :12:30.operatives to pick up dirt on Hillary Clinton. There is no
:12:31. > :12:34.evidence. It is all based on what anonymous people allegedly told him.
:12:35. > :12:39.It is impossible to evaluate whether or might not these claims are true,
:12:40. > :12:43.which is why no journalist or organisation was willing to publish
:12:44. > :12:48.despite efforts to get them to do so. It was taken seriously by the
:12:49. > :12:55.CIA, doesn't that elevated above gossip? Right, so the CIA is an
:12:56. > :12:59.agency that has repeatedly got caught lying in the past. It is
:13:00. > :13:02.designed to disseminate propaganda and they are currently in open
:13:03. > :13:06.warfare with the person elected president of the United States.
:13:07. > :13:10.There were behind the Hillary Clinton campaign. Once the CIA
:13:11. > :13:14.briefs the president and President-elect on this document, it
:13:15. > :13:19.becomes newsworthy. But the mere fact the CIA tried to enshrine this
:13:20. > :13:23.document in a cloud of authenticity or credibility, doesn't for me as a
:13:24. > :13:29.journalist convince me. I want to see evidence first to believe
:13:30. > :13:33.claims. You are calling the CIA partisan. You basically suggesting a
:13:34. > :13:39.Donald Trump ignores everything the CAA tells him, that is no great loss
:13:40. > :13:45.to America? No, I didn't say anything even a multi-like that. You
:13:46. > :13:50.suggested the CAA was partisan and pitted against the President-elect?
:13:51. > :13:55.That is absolutely true. The former head of the CIA, Michael Morrell,
:13:56. > :13:59.went to the New York Times and endorsed Hillary Clinton. General
:14:00. > :14:04.Hayden went to the Washington Post and did the same. They both accused
:14:05. > :14:09.Trump of being a recruit of Vladimir Putin. Whatever they tell him now,
:14:10. > :14:14.in that case, he would have to take with a pinch of salt because he
:14:15. > :14:20.would see them as a partisan organisation? Is that what you are
:14:21. > :14:23.suggesting? I would say that any rational human being with minimal
:14:24. > :14:27.history of the United States and the CIA would take everything that the
:14:28. > :14:33.CAA says with a huge grain of salt. I would call it a dose of rational
:14:34. > :14:38.scepticism, given how many times in the past that agency has lied and
:14:39. > :14:40.been in error. The Iraq war was started because that agency said
:14:41. > :14:44.that Saddam Hussein had weapons of mass destruction and was in alliance
:14:45. > :14:50.with Al-Qaeda. Something that was tragically untrue. So of course
:14:51. > :14:54.people would treat those claims sceptically. But intelligence is not
:14:55. > :14:58.the same as fact. It's Omeley comes to you with a terrorist threat, it
:14:59. > :15:02.is what they understand might be about to happen. If they came to you
:15:03. > :15:03.with fact, it would be too late. That is what the CIA is doing, isn't
:15:04. > :15:15.it? For the CIA calls to be public is
:15:16. > :15:19.not pack can anybody's mind not even the CIA say it is fact. As own
:15:20. > :15:23.report demonstrated, one of the only claims that could be verified, that
:15:24. > :15:27.Trump's lawyer travel to Prague to meet with Russian officials, came
:15:28. > :15:36.pretty close to being affirmatively disproven, given that Michael: Was
:15:37. > :15:41.not in Prague. It is not a fact. It is a falsehood, as the CIA so often
:15:42. > :15:44.disseminates. But it may not always come down to fight with
:15:45. > :15:52.intelligence. Are not right to try to alert the incoming president that
:15:53. > :15:56.this may be going on? Surely that is an intelligence agency doing its
:15:57. > :16:00.job, isn't it? I don't think anybody has a problem with the fact the CIA
:16:01. > :16:08.told Donald Trump this happened. I think the problem is they called the
:16:09. > :16:13.source credible, then somebody went to CNN in a coordinated way,
:16:14. > :16:17.multiple officials, to tell CNN that this was briefed to the president
:16:18. > :16:20.and the President-elect, knowing they would report it and the
:16:21. > :16:25.document would surface. You can take the line that the CIA was trying to
:16:26. > :16:28.do its job, but it is obvious there is open conflict between the
:16:29. > :16:33.intelligence community and the elected president and this was a way
:16:34. > :16:37.of undermining his credibility. We don't know where those leaks came
:16:38. > :16:41.from, although he has pointed the finger at the intelligence agencies.
:16:42. > :16:45.Let me ask you to clarify one thing, because it seemed as if the first
:16:46. > :16:48.time today we had Donald Trump concede that the hacking of the
:16:49. > :16:54.Democratic e-mails over the probably did come from Russia. Would that
:16:55. > :17:07.change how you view Wikileaks and awayday leaked -- and the way they
:17:08. > :17:13.leaked? I don't regard Donald Trump as a paragon of truth that we are
:17:14. > :17:17.duty bound to agree with. I want to see evidence before I believe Russia
:17:18. > :17:22.did it. Second, every media organisation, when they get
:17:23. > :17:29.material, ask two questions: Is it authentic, and is it in the public
:17:30. > :17:34.interest? It does not matter what the provenance of the documents was
:17:35. > :17:38.from a journalistic perspective, it depends on whether they were in the
:17:39. > :17:42.public interest, and they clearly were. It resulted in five Democratic
:17:43. > :17:46.officials being removed. Wikileaks did the right thing in reporting on
:17:47. > :17:48.those materials. Labour has accused the Prime
:17:49. > :17:51.Minister of being in denial over In the Commons today,
:17:52. > :17:53.Jeremy Corbyn pointed to the increasing number of patients
:17:54. > :17:57.waiting more than four hours in A, and the number of hospitals now
:17:58. > :17:59.overstretched, and called for extra investment in health
:18:00. > :18:01.and social care, calling it a humanitarian crisis -
:18:02. > :18:03.the phrase first used Theresa May rejected the phrase,
:18:04. > :18:22.but admitted the pressure exists. It is winter, the NHS's hardest time
:18:23. > :18:26.of the year, and while it is not actually snowing in Westminster, it
:18:27. > :18:31.feels positively arctic in the English health service. Today, its
:18:32. > :18:35.chief executive, who already has a pretty frosty relationship with
:18:36. > :18:39.Downing Street, kicked off a fairly public campaign for more NHS
:18:40. > :18:43.funding. The Government is repeatedly telling us, and I have
:18:44. > :18:47.had letters recently from the Secretary of State, that the NHS is
:18:48. > :18:53.getting more money than it asks for, so what is your view? I have said it
:18:54. > :18:59.previously to a select committee in October that, like probably every
:19:00. > :19:04.part of the public servers, we got less than we ask for in that
:19:05. > :19:09.process, and so I think it would be stretching it to say that the NHS
:19:10. > :19:17.has got more than it has asked for. So how bad are things? Is it just
:19:18. > :19:20.January? No, it isn't. Here are the 2014 figures for the share of
:19:21. > :19:27.patients at A dealt with within four hours. You can see how cold
:19:28. > :19:34.weather ways on the service. It is well below its 95% target at the end
:19:35. > :19:41.of the year. He was 2015 and 2016. Now, let's look at the July. You can
:19:42. > :19:44.see that, yes, winter matters, but performance has declined each year,
:19:45. > :19:49.and each year, there was matching deterioration in the financial
:19:50. > :19:55.position of the hospitals. The hospital sector is struggling on all
:19:56. > :19:58.fronts. Hospitals started the financial year with an underlying
:19:59. > :20:03.deficit of almost ?4 billion, which meant they were spending ?4 billion
:20:04. > :20:07.more than their funding. In the summer, the Government introduced a
:20:08. > :20:11.so-called reset, of measures to address this, including targets for
:20:12. > :20:17.hospitals to gradually reduce those deficits, and some extra money over
:20:18. > :20:22.the next three years, though that has to be taken from elsewhere in
:20:23. > :20:29.the NHS. There is also a restriction on hospitals hiring locum staff. As
:20:30. > :20:35.part of the reset, hospitals were supposed to increase performance.
:20:36. > :20:40.Here is the average of the plans set out, starting from July. You can see
:20:41. > :20:45.they were supposed to gradually moved back to that elusive 95%
:20:46. > :20:50.target, but here is what happened. The hospitals started off behind and
:20:51. > :20:52.fell further back. The BBC has obtained leaked data suggesting
:20:53. > :21:02.recent performances in this region of the graph down here. The reset
:21:03. > :21:08.utterly failed. Some of the causes of this winter's problems in health
:21:09. > :21:12.care are very long. Full example -- for example, the country's ageing
:21:13. > :21:16.and every year technology means that we can treat new diseases, which
:21:17. > :21:20.means there is rising demand for health care every year. It is a type
:21:21. > :21:24.that comes in and never goes out. But some of the problems have more
:21:25. > :21:31.medium-term causes. For example, what's going on in social care. If
:21:32. > :21:36.you go back to 2010, we now have 400,000 fewer people receiving
:21:37. > :21:39.social care, so a 25% care in the number of people getting support,
:21:40. > :21:44.which means you have large numbers of people in hospital ready to be
:21:45. > :21:49.discharged, medically fit for discharge, but we cannot get them
:21:50. > :21:54.into social care facilities. Act hospitals mean bad care, high costs
:21:55. > :21:58.and long waiting times, which is why Simon Stephens supports more money
:21:59. > :22:02.for local authority social care. The hospitals themselves have another
:22:03. > :22:10.problem: They have taken up particularly big part of the NHS's
:22:11. > :22:18.funding string. They wanted to drive more productivity in hospitals by
:22:19. > :22:22.reducing the amount the given per patient. This meant that by 2015,
:22:23. > :22:26.the hospital was paid the equivalent of ?850 to treat a patient they
:22:27. > :22:32.would have been paid ?1000 to treat five years earlier. The hospitals
:22:33. > :22:39.aren't coping on those lower prices. It's really not just another winter.
:22:40. > :22:41.Hospital bosses now talk about the new law of longer waiting times and
:22:42. > :22:42.was hospital performance. Does the NHS need
:22:43. > :22:45.comprehensive reform? I'm joined in the studio now by
:22:46. > :22:48.former Health Minister, Dan Poulter. By the former President
:22:49. > :22:50.of the Royal College And by Ali Parsa, who is the founder
:22:51. > :23:08.of the Digital Healthcare There was this dismissal of it being
:23:09. > :23:11.a crisis, or at least not on the scale the British Red Cross
:23:12. > :23:16.suggested. When the Prime Minister talked at PMQs about beans -- the
:23:17. > :23:21.small number of incidents, there was a collective groan at someone who
:23:22. > :23:27.had clearly underestimated the problem so badly, ban. When we think
:23:28. > :23:31.of a humanitarian crisis, she rightly said, we think of Syria and
:23:32. > :23:36.Iraq, but it is the case that there is a big problem in the NHS, and we
:23:37. > :23:39.have seen tragic examples in Worcester and elsewhere this week,
:23:40. > :23:44.where people's lives have been lost because of the pressures on A You
:23:45. > :23:52.are clear, there is a big problem in the NHS, not a small number of
:23:53. > :23:57.incidents will stop -- a small number of incidents. It is worse
:23:58. > :24:03.than I have seen things in the decade or so but I have been working
:24:04. > :24:09.as a doctor. The result of pressure on front line services, we can see
:24:10. > :24:15.that, if you like, the shop window of the NHS, A, is under pressure,
:24:16. > :24:22.both in terms of difficulties in discharging patients, reductions in
:24:23. > :24:25.money to local councils for social care, but I think we really need to
:24:26. > :24:29.start a fund general practice and community care to make sure we can
:24:30. > :24:32.prevent some of those admissions. When we talk about increases in the
:24:33. > :24:36.budget over the last few years, almost all has gone to the acute
:24:37. > :24:41.sector, to hospitals, many of them in debt, and a lot of that money has
:24:42. > :24:44.sometimes been taken from mental health budgets at the expense of
:24:45. > :24:49.primary care, and that needs to change. This talk of a humanitarian
:24:50. > :24:54.crisis, do you think it has been unhelpful in the debate because it
:24:55. > :24:59.makes it sound rather political? I wouldn't use the term, but I think
:25:00. > :25:04.it is a human crisis for those elderly people waiting for hours on
:25:05. > :25:08.trolleys, for those children with mental health problems having to
:25:09. > :25:15.travel hundreds of miles to find a hospital bed, and for my profession,
:25:16. > :25:20.who are trying to deliver and unable to deliver. So it is certainly a
:25:21. > :25:23.human crisis, and I believe that what Dan has just said is absolutely
:25:24. > :25:30.correct. It is sometimes easy to say that we need more money. We have an
:25:31. > :25:36.incredibly cheap health service. We eke out so much care from our health
:25:37. > :25:41.service. We have one of the most efficient services in the world. It
:25:42. > :25:45.is a precious gift to the people of this country, and if we lose it, we
:25:46. > :25:50.will all be more the worse off for it. Ali, do you think it comes down
:25:51. > :25:56.to money, is it really that obvious? I don't know whether it all comes
:25:57. > :26:07.down to money or not, but I do know that money is not the only solution.
:26:08. > :26:12.We have to deploy better technology. One of my children got sick at the
:26:13. > :26:18.weekend, and I had the option of taking the child to A, on a bus or
:26:19. > :26:24.whatever, adding to the overcrowded this, spending hours and putting a
:26:25. > :26:27.burden on doctors, or I picked up my phone, made an appointment in
:26:28. > :26:33.seconds, so a doctor within minutes, my prescription was sent... When you
:26:34. > :26:39.say you picked up your phone, argue talking about a private clinic? --
:26:40. > :26:50.are you talking about a private clinic? With my private company,
:26:51. > :26:53.Babylon, all of that went away within minutes. I pay a subscription
:26:54. > :27:04.every month, which is a fraction of the price it costs. That is a
:27:05. > :27:09.fraction of what we pay each year. If we push people towards this as an
:27:10. > :27:12.alternative to A There is no doubt that investing in technology
:27:13. > :27:17.is an important part of improving the delivery of care. It is not just
:27:18. > :27:27.the application, it is the extra payments. I believe in a health
:27:28. > :27:31.service free at the point of care, and free in terms of need. I think
:27:32. > :27:33.it should be funded from general taxation. There is a sensible
:27:34. > :27:37.discussion we need to have about whether the level of money you put
:27:38. > :27:45.into the health service and the level of taxation should perhaps be
:27:46. > :27:52.increased to pay for and maintain a health service we all care about. Do
:27:53. > :27:56.you think we need more taxation? It used to be the case that national
:27:57. > :28:00.insurance was strongly linked to health contributions. It's now a tax
:28:01. > :28:06.that just goes to the Treasury. If we can re-establish some link
:28:07. > :28:09.between hypothecated health and care Pack, it is something I would be
:28:10. > :28:18.open to discussing. I think there is a good case. I am not a politician
:28:19. > :28:21.but I agree. The public probably don't mind paying more tax if they
:28:22. > :28:28.are sure it is going to the health service. The over 65s don't pay
:28:29. > :28:33.national insurance. There are ways that the public can start to look at
:28:34. > :28:39.how we can fund the health service. If you lose the service, or even the
:28:40. > :28:43.idea of the service, it's something that you regret and you never get
:28:44. > :28:51.back. Do you think, in a sense, that is inhibiting the NHS from trying
:28:52. > :28:59.new, more radical ideas? Never so much iconography about the NHS, it
:29:00. > :29:02.doesn't dare disturb itself much. In that respect, I think you're right.
:29:03. > :29:09.We provide the same service in Rwanda. In 15 weeks since we
:29:10. > :29:14.launched, we signed up 2.5% of the population of row under. We
:29:15. > :29:19.delivered 70,000 consultations over the phone to the people of one of
:29:20. > :29:25.the poorest, most economic way challenged countries in the world.
:29:26. > :29:32.We have to be careful about this. This is not whether they should be
:29:33. > :29:35.private or public. In Essex, we have the same arrangement with the NHS
:29:36. > :29:40.where we do this for the National Health Service. What are some of the
:29:41. > :29:44.other solutions you are looking at? If you see yourself as a pioneer,
:29:45. > :29:51.it's not just about an application on your phone will stop where else
:29:52. > :29:57.are the solutions? Ten years ago, it would have cost $1 million, ?1
:29:58. > :30:05.million, to do diagnostics on you. Today, I can do that for ?10,000, a
:30:06. > :30:07.99% reduction of the cost in diagnostics, and I can throw in your
:30:08. > :30:12.gene sequencing. What is happening with technology and its effect on
:30:13. > :30:16.health care is significant. We need to embrace it, as well as keeping
:30:17. > :30:23.our old system. It is not one against the other.
:30:24. > :30:34.If we were self prescribing more, is that a danger? It can be a danger.
:30:35. > :30:41.The Pats -- has to be used in a Safeway. But certainly supporting
:30:42. > :30:48.terrorism is important. 1.I would make is that in the NHS our systems
:30:49. > :30:57.are just beginning to talk to each other. We need to improve the
:30:58. > :31:03.delivery of front-line patient care. Most health care organisations spend
:31:04. > :31:08.only a small fraction. Please don't fall into the trap of assuming that
:31:09. > :31:12.all innovation is in the private sector and not the public sector. In
:31:13. > :31:16.my practice, we have developed an online digital offering for patients
:31:17. > :31:24.currently offered to 2.5 million patients across England. It will
:31:25. > :31:28.offer people pre-care. It will tell the GP what they think is wrong with
:31:29. > :31:34.them. We can do electronic prescribing. I think it is 2 billion
:31:35. > :31:39.prescriptions described digitally. We self prescribe pharmacists. Let's
:31:40. > :31:45.not look at one sector and save the NHS is a Luddite and a dinosaur. The
:31:46. > :31:50.NHS is an innovative institution. The problem is people working in the
:31:51. > :31:55.NHS are exhausted. To innovate, to experiment, requires energy and
:31:56. > :31:59.Headspace. Do we have to get used to living with crisis? Demand will
:32:00. > :32:04.always outstrip income. There will never be a time when there is a
:32:05. > :32:12.surplus of money to spend on health, right, because of how the population
:32:13. > :32:18.has changed? We have had an unprecedented period of a squeeze on
:32:19. > :32:24.finances. Demand has increased. People with increasingly complex
:32:25. > :32:28.care needs. But funding is going up by 1% a year. That is not a
:32:29. > :32:33.sustainable long-term solution. We spend a lower amount compared to
:32:34. > :32:41.other countries by OECD calculations. When we saw a
:32:42. > :32:44.transformation in what we could do with the health service was when
:32:45. > :32:49.Tony Blair put the money in and made an investment. We need a similar
:32:50. > :32:54.investment now. You are the Tory minister talking about the need for
:32:55. > :32:58.a Tony Blair, Gordon Brown government splurge? I care about the
:32:59. > :33:04.health service. I care about patients. That made a difference.
:33:05. > :33:08.With Gordon Brown, Tony Blair or Theresa May, we need to make a
:33:09. > :33:14.difference. If that isn't done, do you have to look at the services
:33:15. > :33:20.that can no longer be offered? . I think you're right. We need to send
:33:21. > :33:26.some of the practices we have into general practice. If we re-source
:33:27. > :33:29.them better, we will keep patients out of hospital and we will
:33:30. > :33:33.hopefully be able to write this crisis. Fundamentally we get what we
:33:34. > :33:35.pay for if we don't put more money in. We can't pay for anything. Thank
:33:36. > :33:36.you. Around the world there has been
:33:37. > :33:39.a significant increase in the number of children being referred
:33:40. > :33:41.to gender clinics. Increasingly, parents with children
:33:42. > :33:43.who say they've been born in the wrong gender,
:33:44. > :33:45.are adopting a gender affirmative approach
:33:46. > :33:47.and supporting their children Tomorrow night, a documentary airs
:33:48. > :33:53.on BBC Two which looks at the choices children
:33:54. > :33:55.and their parents Around the world, the transgender
:33:56. > :34:01.community is on the march. Not all boys have a penis,
:34:02. > :34:14.and not all girls have a vagina. Parents are facing
:34:15. > :34:16.an explosion in the number of children saying they were
:34:17. > :34:18.born in the wrong body. I never actually fitted
:34:19. > :34:38.in with being a boy. I don't like the games,
:34:39. > :34:45.the hairstyles, the clothes. And I always thought
:34:46. > :34:47.from the beginning There's nothing wrong
:34:48. > :34:54.with being a boy. It's just that I don't
:34:55. > :34:57.enjoy being a boy. She's just at an age now
:34:58. > :35:03.where sexuality is starting to develop, so boy crushes and things
:35:04. > :35:07.like that are just starting to come I'm pretty sure I'm going to have
:35:08. > :35:12.to get surgeries and all that It might be rough, cos
:35:13. > :35:26.everybody has a rough life. At this point, we have
:35:27. > :35:33.to start considering puberty blockers, things like that, so we've
:35:34. > :35:38.been researching that like crazy and speaking to doctors and different
:35:39. > :35:41.things to try to make those decisions for her because she's
:35:42. > :35:45.too young to make them. Like, I've already made
:35:46. > :35:51.the decision I want to be a girl, but I haven't made
:35:52. > :35:54.the decision if I want to do the And you can see the whole
:35:55. > :36:02.of that documentary - Transgender Kids: Who Knows Best -
:36:03. > :36:19.tomorrow night on BBC Joining me now is Sian say, it's
:36:20. > :36:27.transgender journalist in Bristol. At what point do you think children
:36:28. > :36:35.are able to makes up their own minds on this? I think the whole point
:36:36. > :36:39.about this kind of treatment or realisation is there is a lot of
:36:40. > :36:42.nonsense in the media at the moment about transgender children and about
:36:43. > :36:48.the kind of treatments they go through. Something like puberty
:36:49. > :36:57.blockers, which was just discussed, Aaron fact allowing children space
:36:58. > :37:03.and time by delaying puberty. They experience such stress out of their
:37:04. > :37:06.gender role. It gives them the time before puberty takes over and
:37:07. > :37:11.essentially takes a lot of decisions out of their hands that have to be
:37:12. > :37:18.reversed painfully later. Let me bring in Ray Blanchard, who is
:37:19. > :37:23.joining us from Toronto. Ray spent many years researching factors that
:37:24. > :37:28.determine sexual orientation. Do you think if you can take out that
:37:29. > :37:32.messy, oak-wood, complicated stage of childhood puberty because a small
:37:33. > :37:38.child knows best, wouldn't you choose to do that? -- awkward. There
:37:39. > :37:43.are some facts that have to be introduced. Every follow-up study
:37:44. > :37:48.has shown that the majority of children with gender identity issues
:37:49. > :37:53.do not enter up transsexual. The majority and up with normal gender
:37:54. > :37:56.identity. Secondly, we have no diagnostic procedure and methods
:37:57. > :38:02.that can reliably distinguish which children are going to go on a sexual
:38:03. > :38:07.trajectory and which are going to end up with normal gender identity.
:38:08. > :38:12.Thirdly, I think people who are not enthusiastic about it in young
:38:13. > :38:17.children take the decision that the first line of approach Tonetti
:38:18. > :38:22.should be helping the child accept his or her sex. If they can't do
:38:23. > :38:28.that by puberty, it is reasonable to consider puberty blockers. I am OK
:38:29. > :38:33.with puberty blockers. Only after a screening period. We heard about a
:38:34. > :38:37.doctor who was fired in Canada for not being gender affirmative and
:38:38. > :38:42.off. In other words, for asking children to pause before making that
:38:43. > :38:45.kind of gender choice. Surely it's right for the medical profession to
:38:46. > :38:50.try and stop that in the first instance because it's irreversible?
:38:51. > :38:57.One thing I want to say is actually the doctor in question wasn't fired
:38:58. > :39:01.purely because of his ideology about children and gender. He was also
:39:02. > :39:08.fired because of a review by his peers which actually found that his
:39:09. > :39:16.methodology was faulty. But also that his practice as a clinician
:39:17. > :39:23.was... That is categorically untrue. He was asking very lured sexual
:39:24. > :39:30.questions. I have to say we have to be a little bit wary... We have
:39:31. > :39:34.heard from Ray that is categorically untrue. I don't want to go further
:39:35. > :39:38.down those allegations because he is not here to defend himself. Let us
:39:39. > :39:42.look at the wider question, that this is something that can't be
:39:43. > :39:46.reversed for a child. Isn't it eminently sensible in such a young
:39:47. > :39:51.science of clinical practitioners to Paul's? While unfortunately, the
:39:52. > :39:55.problem is that when that pause occurs it sounds very nice and
:39:56. > :40:00.reasonable and rational. But these are real people at the heart of it.
:40:01. > :40:03.And unfortunately, one statistic that genuinely is true in this
:40:04. > :40:09.country is that 48% of trans-teenagers before they hit 18,
:40:10. > :40:17.attempt suicide. When you call for this very reasonable pause, parents
:40:18. > :40:31.and teachers increasingly know and the majority of clinicians know...
:40:32. > :40:36.The objective data shows gestures in gender children are the same as
:40:37. > :40:42.those in other psychiatric populations of children and
:40:43. > :40:48.adolescents. There is no data about the rate of completed suicides is
:40:49. > :40:51.hiring gender this form to children than in adolescence. Isn't the
:40:52. > :40:55.question that parents do not want to feel they are guilty of having
:40:56. > :41:00.failed to listen to their child's concerns when they could have done
:41:01. > :41:05.something meaningful about his? Yes, I agree. Some parents are being
:41:06. > :41:11.emotionally blackmailed by false information about threats of suicide
:41:12. > :41:15.by these children into thinking that if they make any attempts to help
:41:16. > :41:23.their kid that they are putting their child at risk of suicide. It
:41:24. > :41:26.is just pure manipulation. It is manipulation and emotionally
:41:27. > :41:30.blackmailing? Who is manipulating? Where is this coming from? I'm
:41:31. > :41:38.transgender myself. I work with transgender children. No one's
:41:39. > :41:41.parents was looking for this. Most parents of transgender children have
:41:42. > :41:45.had to go through a long process. It's not like your GP pushes it.
:41:46. > :41:50.It's quite difficult to access health care in this country. Schools
:41:51. > :41:55.aren't very aware of it. This idea that there is some kind of pressure,
:41:56. > :42:03.or some trans-mob that walks into a home and says, it's time for
:42:04. > :42:13.surgery... We have run out of time. Ray, last word to you,... Do you
:42:14. > :42:18.think it's just because essentially this is a new science and people
:42:19. > :42:22.have not caught up with where it transgender issues are, even those
:42:23. > :42:28.who work within it? I think the problem is that the media coverage,
:42:29. > :42:34.I'm not talking about the BBC, the media coverage has been so water
:42:35. > :42:38.well mainly one-sided in terms of cheerleading for gender transition,
:42:39. > :42:40.it has not covered other aspects of the question. -- overwhelmingly
:42:41. > :42:45.one-sided. Thank you both.