13/10/2011 Question Time


13/10/2011

From London, David Dimbleby is joined by Andrew Lansley, Ken Livingstone, Sarah Sands, Dr Phil Hammond and Mark Littlewood from the Institute of Economic Affairs.


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Transcript


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We're in the Queen Mary University of London. Welcome to Question Time.

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And with me on our panel tonight, the Health Secretary, Andrew

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Lansley, the former Mayor of London, Ken Livingstone, who is hoping to

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win that post back. Dr Phil Hammond, a GP, a stand-up comedian and who

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writes for Private Eye. Mark Littlewood, director a free market

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think-tank and the deputy editor of the Evening Standard, Sarah Sands.

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APPLAUSE Our first question from Peter

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Mammato, please. Is it appropriate for the Defence

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Secretary to bring a friend to work?

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Andrew Lansley? I hope all have friends at work and friends who

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visit us at work. The purpose of your question is to say, where are

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the boundaries? Liam himself, I saw him at the House of Commons and say

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to the Commons he had made mistakes and apologised for those because he

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allowed the distinction between his private life and his public

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responsibilities to be blurred. He accepted that and apologised for it.

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Ynd that there are investigations being con-- beyond that there are

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investigations being conducted. I will not judge anything beyond that.

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Do you think, as one of his friends said today, it would turn the Prime

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Minister into John Major if he bowed to pressure and got rid of

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Fox? No, I don't think there is any comparison. I don't know what that

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is supposed to imply. From my point of view, I work with Liam, I have

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known him for a long time. I think he's been an excellent Defence

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Secretary. He's had a terrible legacy from Labour. He had to go

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through a tough process of dealing those and doing a strategic

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security and Defence Review. I think he's given leadership and

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support to the armed services in Afghanistan and libyafplt over this

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year-and-a-half they have -- Libya. Over this year-and-a-half they have

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performed magnificently. I think if you look from the public interest

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point of view, is he a good Defence Secretary? Absolutely, I think he

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is. You would like him to stay? I think Liam Fox has got every

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right to bring someone in to give him advice. The root is you appoint

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them as a special adviser. They are paid about �60,000 a year. I think,

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given the track record of civil servants in the Ministry of Defence

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and senior military officials who have almost bankrupted one

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Government after another with dire advice I am pleased to see a sharp

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mind brought in from the outside. Why was it not made a legitimate

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appointment. As it hasn't been, I think we need to know what rules

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the finances around here. What was he earning and who was he getting

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the money from. If they answer that the issue will go away. You had

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special advisers, paid a lot more. �120 how thousand. Brought in, they

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ran everything. They had to go.... They ran everything, not you?

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no. It is different. The American model of politics is what Tony

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Blair brought to London. The advisers were running the system.

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We didn't have all those civil servant types. I found it easier to

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get things done. I would like to see a lot more clearing out of

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senior civil servants and people brought in to make sure Governments

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can get their policies through an often resistant Civil Service. They

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should say, who was paying what and was there any undue influence?

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Until he does say that.... What would you call "Undue influence?"

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commercial interest? If a commercial firm was paying that

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adviser and that adviser was influencing the contract that is a

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huge problem. We need to be told and the issue can go away. I can't

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understand why it's being allowed to drag on and on and more

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speculation around it all. Sarah Sands? Well he is becoming less a

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friend by the day. By yesterday he was an imagine farry friend. He was

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described as a Walter Mitty figure. By the end of the week he may have

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no relationship at all with Mr Fox. I think it is Dr Fox. Obviously, it

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looks odd to have best man on a business card, so adviser was the

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option. I mean, you say... You mean, According to Ken if you want

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someone in because you cannot trust your civil servants he seemed to

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get a good deal. Mr Werritty didn't seem to make much money out of this

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at all, or he was sponsored. Whether he can survive I think is

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an interesting question. We did see all the cavalry brought out in the

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House of Commons to protect him. It has slightly become a press verses

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the Government, which I think is what Dr Fox is now playing on. Or

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his friends, more friends telling Cameron, the Prime Minister, that

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he would be looking weak to dismiss. The man there? Isn't this half of

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the problem that it has become acceptable by Ken and Andrew and

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Government generally in a democracy that it is OK to bring in your

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buddys and pay them �120,000 as special advisers? It is ridiculous!

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I think that is an excellent point. Actually Cameron did promise to

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sort out lobbyingch he said it was the next big -- lobbying was the

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next big problem. This chap seems to lobby and he's not in the box.

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We are playing the next Where's Wally? It's called where's Werritty.

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You don't go on 44 trips for no reason. You could have won him in a

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raffle. He could be doing something unusual. We won't know until the

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tests are back! With all these things you have to investigate them

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independently. My experience of health service investigations f you

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do them house and do them in secret you don't get to the truth of the

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matter. You need someone independent, putting out the

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answers in the public domain. don't count the Cabinet Secretary

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as somebody like that? No. You need somebody with the appearance of

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being independent. APPLAUSE

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Yes? I want to ask Mr Lansley, you say Liam Fox has apologised N this

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situation it is a clear miss judgment. Is an apology enough?

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you make mistakes it is good to apologise. That is what he did at

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the first opportunity. Can you apologise for anything that you

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have done wrong? If you make a mistake would you not apologise.

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Nobody knows what you're doing with that! I see the point you're making.

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Actually, you know, he, not only did he apologise, but he had taken

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the step of instigating an investigation, which the Prime

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Minister said, I would like the Cabinet Secretary to do it. That is

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fine. I'm surprised Ken says it is dragging on. It's only been about

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six days. I mean are we not capable of realising if you're going to

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have a welter of accusations, allegations against people, which

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include, much of which may not prove to be true, it's better

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actually to have a proper investigation and not to prejudge

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it. So long as the... As long as the NHS reforms take! My brother's

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in the Armed Forces. I don't think a sorry, a simple sorry for

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somebody who just follows the Ministry of Defence around is

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correct. What about the security of the country where he was following

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him around - the information he was partial to? It's just wrong. My

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brother, he serves in Afghanistan. He had two terms there. He's

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serving now and you can't get a word out of him for where he's been,

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where he's going. He takes it serious and serves Queen and

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Country. You can't just, "Oh, let me take my friend around." He has

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duty to this country. There are failings there for recognising what

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his duties are. APPLAUSE

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The original question was this, wasn't it: Is it OK to have friends

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visiting you at the office? No it is OK for the Defence Secretary to

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bring a friend to work? I wish our politicians listened a lot more to

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experts and their friends rather than following what the civil

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servants advise them. In Liam Fox's case it is straightforward. Look,

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on the face of it looks like odd behaviour. I don't know many people

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who take their best man with them on 18 trips to Dubai. It looks odd

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behaviour. Something which looks like odd behaviour is not a firing

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offence for the Secretary of State for defence. There are two things

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we need to discover. I think the Cabinet Secretary will get to the

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bottom. Was there any impropriety? If there was a suggestion that

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defence contracts were being skiched up, that is a firing --

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stitched up, that is a firing offence. Was security breached? If

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yes, Fox has to go. But for God's sake n a mature democracy, let's

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take a few days, at least, to sort this out. These are serious charges.

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We only need the patience of a few more days to get to the bottom of

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them. Does Liam Fox's own statement, on Sunday, answer one of those

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points, when he said, I do accept that given Mr Werritty's defence-

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related business interests my frequent contacts may have given an

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impression of wrong doing? Because the code covers the impression of...

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He says Werritty has defence- related business interests.

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don't know what they are. Is there real impropriety here? If it turns

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out he is a Walter Mitty character, that is odd, but relatively

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harmless. If it turns out worse than that, then he has to leave the

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Cabinet. Do you not think that the British taxpayer is sick and tired

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of seeing their money get wasted? APPLAUSE. It's not taxpayers' money.

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We don't think he's paid by the taxpayer. He seems to be able to

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travel around the world on little money. We don't know how he's

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funded this, he probably can sort out the economy by the money he

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makes by doing relatively little. Who is funding all this?

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Echoing the previous comments from the middle of the audience, Liam

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Fox is a public servant, and you know, if this was the head of an

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NHS Trust, who may have a friend, a best man who may be the head of a

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pharmaceutical company, or something like that, if they were

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allowed confidential meetings there would be an outcry and his position

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would be in question. So, there's no question that Fox has given this

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guy too much access. OK, let's go on. Chandrika Chopra?

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How wise it is to persist with the NHS reforms when health

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professionals oppose them so strongly? All right, Andrew

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Lansley? But not the whole sorry, but jaust the answer to that

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question, if you would -- just the answer to that question, if you

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would. The premise is that health professions are against this. Take

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one central principal here, which is that doctors and nurses should

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take greater responsibility for designing services on behalf of

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their patients. Actually, across the NHS that is supported. The

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Royal College of General Practitioners and the BMA and the

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Royal College of Nursing have supported that principal. The

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principal of the legislation that there should be greater democratic

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credibility. People by and large support that. Now, I know there are

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a lot of things people say they don't like. Half the time they are

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saying there are things in the bill which are not there that they don't

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like. Things they imagine the bill is introducing competition to the

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NHS. Actually it does not change the scope of competition at all. If

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you construct a different argument and base it on a miss

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representation of what is in the bill, it is easy then to get people

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to say, I am against the bill. We've had a lot of miss reputation.

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We've had a lot of occasions when frankly from my point of view we've

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had to explain. There have been occasions when people wanted

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reassurance. We went to enormous lengths to make certain when we

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were listening to people and pausing the bill, to take the NHS

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Future Forum, a team of experts and professionals from across the

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service, go out across the country, hundreds of meetings, thousands of

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contributions, to arrive at a place where the forum told us what the

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professionals across the service, as well as the patients and the

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:14:56.:15:08.

public needed. We accepted every This depends on trust. APPLAUSE

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difficulty with this is it is 353 pages - it is impossible to

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understand it. It is unreadable. What did you say? It is wonk. This

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is unreadable. There is no narrative. You would think if you

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would read that you would hear words like transparency, openness,

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accountability. They are not in there. How many times does the word

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"competition" appears? 86. Co- operation? Nought. Integration.

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appears. There is a duty... Collaboration? There is a duty in

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the legislation for integration of services. 86 competitions, four co-

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operations, no integration, no collaboration. The point is the

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reason... There is no reason to argue about it. Andrew, I let you

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speak. Let me speak, please. What is your impression about the

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reaction of the NHS professionals? Does it matter? Yes, it does.

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the professionals always against reform? It is not just the

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professionals, it is probably the vast majority of patients. Nobody

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has managed to read this thing. The thing they... You clearly have. You

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have done a word count on it! thing that worries people most is

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this element of competition. The NHS needs to rediscover its

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humanity. If you look at Mid-Staffs, there is a real problem. If you

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look at competition - and Labour did this - the competition cherry

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picked the easy cases. In the NHS20% of patients take up 80% of

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resources. I can see patients here, you are fairly fit, I will cherry

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pick you. You have five or six diseases, you are a bit expensive,

:17:17.:17:27.
:17:27.:17:29.

I'm not interested in you. The only way to focus the NHS is to

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integrate it. Although Andrew will say there has been a change in here

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- it has never happened yet. What they want is collaboration and keep

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as many patients out of hospital as they can. It doesn't change...

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says it, but will it do it? You are not trusting the doctors and nurses

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themselves. We designed the service around the needs of patients. We

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give the doctors and nurses the ability to commission the services

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that they need for their patients. Then we make certain that it is

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democratically accountable... right. There are five people around

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- hang on. We have five people on this panel and a lot of hands up.

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Mark Littlewood? We need a bit of a reality check. I know the National

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Health Service is thought of very fondly by a majority of people. It

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saved my live seven years ago. Let's not kid ourselves. Let's not

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fall for a myth. Let's not believe it is the envy of the world - it

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isn't any more. Better health provision is being given in much of

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Europe, many other OECD countries and we have a substantial financial

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problem. NHS spending has trebled in the last 30 years. Life

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expectancy amongst the poorest elements of society has not

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improved as much as life expectancy of the richest elements of society.

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So it is not even helping the people at the lower end. We need a

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reality check. The NHS model, if it is the envy of the world, has been

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copied by no-one. It isn't the envy of the world. I would like to say I

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welcome Andrew Lansley trying to tackle some of these problems about

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efficiency. I would like to see something which gives patients

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control and power, you, the guys in the audience, not the doctors, or

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the Commissioners - patients. One of the problems we have got is that

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it is not responsive enough to patients who need care. There are a

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lot we can learn from other systems in the world that produce better

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results at much lower costs. APPLAUSE The person there in the

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fourth row? I think you are completely wrong. The NHS...

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APPLAUSE When the NHS was established in 1948, whatever it

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was, all the OECD countries followed suit. There was Japan,

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Australia and Canada, they all used the same system. Everything you

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have just said is wrong. It has one of the highest rates of

:20:19.:20:23.

satisfaction in Europe. It has one of the greatest levels of outcomes

:20:23.:20:32.

that there are and it has a lower percentage of GDP use than any

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other countries. Let's be careful. Please not just... Are you saying

:20:40.:20:47.

they have better healthcare policies? Yes. Your chance of

:20:47.:20:54.

survival if you are diagnosed with cancer in the US... You are

:20:54.:20:59.

completely wrong. Let's not fall for this nonsense that the only two

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available healthcare systems on the planet are the National Health

:21:03.:21:07.

Service or the USA. I don't think the USA is a good system at all. We

:21:07.:21:13.

can learn a lot from Singapore. They don't spend as much. It is not

:21:13.:21:18.

just what we have got or America. We can do better than that. The

:21:18.:21:21.

European systems use insurance models, a more market-based

:21:21.:21:27.

approach. Which have lower satisfaction rates and longer

:21:27.:21:31.

waiting times. We really think we are the only people who have

:21:31.:21:38.

cracked this? It is nonsense. woman in green? Ultimately, this is

:21:38.:21:44.

a time sensitive issue. There are people's lives at stake. How would

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the panel answer the Shadow Health Minister's point that while we are

:21:48.:21:52.

having these protracted debates, it is stopping us from fixing the NHS

:21:52.:21:56.

we have got now. We are not making those reforms because we are having

:21:56.:22:02.

this debate. He says drop the bill and we will help you reform NHS

:22:02.:22:06.

commissioning, the new - Andy Burnham. Ken Livingstone?

:22:06.:22:11.

simple reality is that we, according to the Commonwealth

:22:11.:22:14.

Institute, have the most cost- effective healthcare in the world.

:22:14.:22:19.

We spent 8% of our wealth on the NHS. In America it is 16%. France

:22:19.:22:24.

and Germany, it is 10%. I think what the reason the Government is

:22:24.:22:28.

doing this is it can't go to the American system in one big step,

:22:28.:22:31.

they couldn't get it through. It is starting to push down the road of

:22:32.:22:35.

more and more privatisation, more and more profit and when you are

:22:35.:22:38.

adding profit to the cost of an operation, there will be less

:22:38.:22:42.

operations done at the end of the day. When you think that this

:22:42.:22:45.

Government promised not just that there would be no top-down

:22:45.:22:50.

reorganisation of the NHS, they promised, Cameron promised to

:22:50.:22:55.

increase spending on the NHS in real terms and a moratorium on

:22:55.:22:59.

hospital closures. I have never seen such a deliberate pattern of

:22:59.:23:09.
:23:09.:23:12.

lies in an election... APPLAUSE Ken, Labour's line was to say it is

:23:12.:23:16.

irresponsible to increase NHS spending? Not just Labour's line,

:23:17.:23:21.

Andy Burnham's view. That is Labour. Exactly. Sorry, I don't get your

:23:21.:23:26.

point. And he is still their Shadow Health Secretary. He has been

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reappointed in circumstances where he was telling us that we ought to

:23:30.:23:34.

be cutting the NHS budget and we are not. We are increasing the NHS

:23:34.:23:39.

budget by �12.5 billion. I don't know where you have been around all

:23:39.:23:45.

my life. I'm not here simply to parrot the Labour Party line. I am

:23:45.:23:49.

broadly in agreement with the vast majority of Labour's policies. I

:23:49.:23:53.

was profoundly unhappy with the partial privatisation measures Tony

:23:53.:23:58.

Blair's Government introduced which has helped land us in this mess. It

:23:58.:24:03.

should all be free at the point of delivery. There should be no profit

:24:03.:24:13.

motive at all. It will be. The man there? If you keep your remarks

:24:13.:24:19.

brief, I would be grateful. Yes? was wondering when 60 senior

:24:19.:24:22.

medical officials have sent off a letter describing the health

:24:22.:24:27.

reforms as "unpopular and undemocratic" surely it would be

:24:27.:24:33.

reprehensible to follow through with them? APPLAUSE Sarah Sands?

:24:33.:24:38.

Talking earlier about the issue of trust and the public trust doctors,

:24:38.:24:41.

they don't trust politicians. It doesn't mean the doctors are always

:24:41.:24:47.

going to be right. I think there is a problem and we have seen from the

:24:47.:24:51.

protests outside that people feel very strongly about this. The

:24:51.:24:54.

National Health Service is the religion of the British people. The

:24:54.:25:00.

trouble is then you say anything must happen to it and any

:25:00.:25:04.

efficiencies are a back door privatisation. It means we can

:25:04.:25:08.

never talk about it in a rational way. That does worry me. Very

:25:08.:25:13.

important, I want old people treated with dignity, I want

:25:13.:25:18.

children treated in medical emergencies. We have had feelings

:25:18.:25:24.

of a powerless in the face of a monolithic bureaucracy. If you can

:25:24.:25:33.

find a better way of ordering paper for the National Health Service and

:25:33.:25:38.

do it a bit cheaper, I think the fact we can't look at it because

:25:38.:25:44.

this is an attack on the NHS and I know your motives are impure, that

:25:44.:25:52.

puts us in a difficult position. APPLAUSE OK. There are still many

:25:52.:25:56.

people with their hands up. You have a clipboard in front of you. I

:25:56.:26:04.

beg you to speak briefly if you would? A few pressing points.

:26:04.:26:11.

you mean you will speak briefly? Absolutely. 80 to 100 billion will

:26:11.:26:21.
:26:21.:26:22.

be handed to United Health America. It has been called the derevolution

:26:22.:26:25.

of the National Health Service. Let's talk about the 120 billion

:26:25.:26:30.

uncollected through tax avoidance. Let's talk about the 1% of tax

:26:30.:26:35.

breaks that the richest, the ten billion... All right. You are now

:26:35.:26:40.

reading it. Dr Hammond? Do you want to answer his point? I think it is

:26:40.:26:44.

an interesting point. If you involve private providers they are

:26:44.:26:49.

there to make a profit motive. I have no objection to them coming in

:26:49.:26:54.

on occasion if the NHS can't deliver. Every single model are

:26:54.:26:57.

moving towards integrated care. It is patients who fall between the

:26:57.:27:02.

bits of the NHS, particularly the elderly. You must do everything you

:27:02.:27:07.

can to keep them in their homes. The NHS are a bit like the French

:27:07.:27:10.

rugby team. While we have had headless management, some really

:27:10.:27:16.

good things have been happening on the ground. There have been falls

:27:16.:27:20.

in emergency admission. There is a wonderful organisation in North

:27:20.:27:24.

West London where they are working, they are sorting out their chronic

:27:24.:27:29.

diseases and stopping people going into hospital. All of this has been

:27:29.:27:35.

done without the Health Bill going through. The bit of legislation -

:27:35.:27:39.

you can't win over the hearts and minds. If people don't believe in

:27:39.:27:43.

competition, it will never work. Integration is the way forward.

:27:43.:27:48.

me reassure you. It is whether they trust you. Of course. I am looking

:27:48.:27:53.

for trust, particularly because I have spent now nearly eight years

:27:53.:27:56.

as Shadow Health Secretary. My responsibility in all that time has

:27:56.:28:01.

been to arrive at a place where people do believe the NHS will

:28:01.:28:08.

improve continuously under a Conservative administration. My

:28:08.:28:13.

commitment - and I made it to the Conservative Party - was that while

:28:13.:28:19.

I am Secretary of State the NHS will not be privatised, it will not

:28:19.:28:26.

be fragmented. The reason why there are general practitioners is

:28:26.:28:30.

because they are getting the opportunity as doctors and nurses

:28:30.:28:34.

to design services themselves. is happening now. If it is

:28:34.:28:40.

happening now, why? We have arrived at a point where the Primary Care

:28:40.:28:43.

Trusts and the Strategic Health Authorities know that they are

:28:43.:28:47.

going to be abolished when the Bill goes through. There is an argument

:28:47.:28:51.

that has been put that you needn't have brought up this Bill. You have

:28:51.:28:56.

had eight years to think about it. You could simply have built on what

:28:56.:29:00.

Labour was already doing and... That is the point about legislation.

:29:00.:29:05.

Difficult though it is to go through that process... You need it.

:29:05.:29:11.

You do. You can't abolish Primary Care Trusts without doing it. In

:29:11.:29:14.

the year before the election, Labour increased the management

:29:14.:29:24.
:29:24.:29:24.

costs in the NHS by �350 million. All right. We reduced it by �329

:29:24.:29:28.

million. All right. No. Wait, please. This is a programme. I know

:29:28.:29:32.

there are a lot of important points and you have made many. I must stop

:29:32.:29:36.

you. We have to hear what the audience say as well. The woman in

:29:36.:29:44.

the striped shirt? There seems to be a myth that the NHS reforms are

:29:44.:29:48.

a future act but as someone that works in the NHS the impact is

:29:48.:29:52.

already being felt and the lack of confidence is having an impact now.

:29:52.:30:02.
:30:02.:30:14.

How dare the Government have their hands on our public service before

:30:14.:30:19.

going after the money at the top. Close the loopholes. Don't even

:30:19.:30:23.

think about abolishing the 50% tax rate. Let's get the money back from

:30:23.:30:28.

the top and then we can work down. Hands off our public service - all

:30:28.:30:38.

of it! The man at the top right there.

:30:38.:30:43.

was mentioned earlier, when we arrived today we were met by a

:30:43.:30:47.

lively demonstration against the Health Secretary's proposals. They

:30:47.:30:54.

even burst into our pre-Question Time coffee and cakes. This shows

:30:54.:30:58.

how passionate they are to protect their's and our National Health

:30:58.:31:04.

Service. Are they right? They are. Is there any vested interest?

:31:04.:31:08.

Everybody in the world has some vested interest. They don't trust

:31:08.:31:13.

the meddling of bureaucrats and politicians. We've heard a lot of

:31:13.:31:16.

complaints here. Anybody coming to the support of what the Government

:31:16.:31:21.

is trying to to? I think there is actually a misconception about the

:31:21.:31:25.

NHS being perfect, considering the fact that on the policy of life

:31:25.:31:30.

index, published this year, the UK had a massive dip in its health

:31:31.:31:34.

care section. Whereas other countries, such as France, scored

:31:34.:31:41.

near perfect in that area. I don't necessarily think we can get

:31:41.:31:43.

benefits from the system being implemented now, the privatisation

:31:43.:31:47.

of it. We can learn from other countries, such as France, in this

:31:47.:31:52.

area and improve the NHS rather than keep it as it is. The person

:31:52.:31:58.

there? How do you make sure that you micromanage this reform,

:31:58.:32:03.

especially at the GP, primary care level, to make sure the

:32:03.:32:08.

consequences don't actually happen? The intention may be good. How do

:32:08.:32:12.

you make sure that the unintended consequences don't happen. What

:32:13.:32:16.

kind? Abuses, I mean at the moment, GP power. You give them so much

:32:17.:32:21.

money. Who is going to make sure that the money is well spent? The

:32:21.:32:27.

GPs don't clog up time and claim money which can happen at the

:32:27.:32:31.

moment. Rip off their clients? have to have somebody making the

:32:31.:32:35.

decision about how and where the money is spent. Shall we buy this

:32:35.:32:38.

service from this company or that from that company? Somebody has to

:32:38.:32:43.

make the decisions. I prefer Andrew Lansley's view that those decisions

:32:43.:32:47.

are better made by medical professionals than bureaucrats.

:32:47.:32:50.

They won't necessarily get everything right, all of the time.

:32:50.:32:54.

They won't. Errors will be made. The question is whether you put in

:32:54.:32:58.

place a system more likely to produce better results. The thing

:32:58.:33:03.

people like about the NHS is the equal access to all. That, I think

:33:03.:33:10.

everybody is agreed with. It won't be the question of if you are rich

:33:10.:33:15.

you get good care and if you are poor you get none. How you deliver

:33:15.:33:21.

it, to deliver it in the most efficient way possible. You don't

:33:21.:33:25.

micro-manage it. I don't want Andrew Lansley doing that. I want

:33:25.:33:29.

to work it myself with medical advice on the ground. It won't be

:33:29.:33:35.

perfect, but that is a better system than the creeping

:33:35.:33:39.

bureaucracys. If you have comment on this at home and you are

:33:39.:33:44.

on this at home and you are tweeting, you can join our debate D.

:33:44.:33:54.
:33:54.:34:04.

Is it acceptable for MPs to tweet while in a parliamentary debate?

:34:04.:34:13.

They decided that tweeting was allowed. The procedures are often

:34:13.:34:18.

so tedious I would sit out of line and I notice a lot of

:34:18.:34:22.

correspondents do it. Should they tweet? From the point of view of

:34:22.:34:26.

the journalists the more that tweet the better. It is all stories for

:34:26.:34:30.

us. Are you in favour of your colleagues tweeting? I think I

:34:30.:34:34.

wouldn't do it myself. If you're in the House of Commons, you're there

:34:34.:34:37.

in order to participate in the debate. I think it is a good idea

:34:37.:34:41.

to concentrate in the debate if you are in there for that purpose. The

:34:41.:34:46.

truth of the matter is people do it everywhere now. I suspect they will

:34:46.:34:51.

in the House of Commons. That is the way the world is going. You can

:34:51.:34:58.

use any hand-held electric device, providing it is silent and used in

:34:58.:35:03.

a way that does not impair decorum. You can take papers into the House

:35:03.:35:07.

of Commons with you. I suppose that technically means we are getting to

:35:07.:35:13.

a place where people could be providing prompts on iPad screens

:35:13.:35:18.

or something. Instead of being whispered to.

:35:19.:35:23.

If anybody can reduce this to 146 characters I will give them a

:35:23.:35:33.

medal! 146 characters. I would say this,

:35:33.:35:37.

the House of Commons is a stuffy old place. Its ability to connect

:35:37.:35:42.

with the public in any meaningful way is zero. The protocols are

:35:42.:35:46.

absurd. It is stuck in the past in a lot of procedures. You don't have

:35:46.:35:51.

to rip that up to embrace some modern ways of MPs communicating,

:35:51.:35:54.

not just to journalists but to their constituents. We will be

:35:54.:35:58.

living in a very, very old fashioned democracy if we start to

:35:58.:36:01.

say that MPs cannot use mobile devices to say what they are

:36:01.:36:07.

thinking. You be the judge about whether they are concentrating in

:36:07.:36:10.

the debate or whether they are passing comment on to you as the

:36:10.:36:17.

constituent. A brief comment. Are we in fear of

:36:17.:36:19.

allowing our MPs to become celebrities almost rather than

:36:19.:36:25.

catering for society? Trying to trend. The person up

:36:25.:36:30.

there on the far left. If they are tweeting it shows they are awake in

:36:30.:36:35.

the chamber for a change! APPLAUSE

:36:35.:36:40.

And you, Sir? Maybe it will allow them to communicate with their

:36:40.:36:47.

unofficial advisers. OK! Let's go on. Anita Chin, please.

:36:48.:36:51.

Should we be encouraging the nation's youth to follow their

:36:51.:36:55.

Irish counter parts and emigrate around the globe to look for work?

:36:55.:36:59.

This is in the light of the figures that nearly one million young

:36:59.:37:04.

people are unemployed. Should we encourage them to follow the Irish

:37:04.:37:08.

example? Sarah Sands? I think it is a global market now. It is

:37:08.:37:13.

something that probably they have to think about. I am surprised and

:37:13.:37:20.

so impressed just by the ingenuity and resilience of the young

:37:20.:37:23.

graduates now. We have seen in universities themselves they are

:37:24.:37:27.

starting to look abroad. We have to look at job creation. It is the

:37:27.:37:32.

most important thing. Given the state we're in, that has

:37:32.:37:37.

to come from the private sector. So, how we do that - we have to

:37:38.:37:43.

look at it in a hard-headed way of where the jobs are. That may mean

:37:43.:37:46.

going abroad. I have known relatives of mine who have gone to

:37:46.:37:49.

be doctors abroad because there were opportunities or where the

:37:49.:37:55.

skills market is. I was talking to someone from Cisco technology firm

:37:56.:37:59.

who said there are tonnes of jobs but they don't have the people

:37:59.:38:03.

trained for it. In Britain? technology. There are jobs. There

:38:03.:38:07.

are thousands of jobs in technology. They were so wareed about the --

:38:07.:38:10.

worried about the lack of skills that I are talking about setting up

:38:10.:38:13.

their own academies to educate people from the start. I think

:38:13.:38:18.

people will have to think much more creatively about jobs in this tough

:38:18.:38:24.

environment. Well, I mean there may be some young people, very talented,

:38:24.:38:28.

who speak fluently a foreign language with go and work in China

:38:28.:38:32.

or Brazil. The majority of our young people don't have a fluent

:38:32.:38:36.

second language. We have a duty to provide a range of jobs for kids

:38:36.:38:40.

coming through our education system, whether they are the 45% who have

:38:40.:38:43.

been to university or the ones who have not. That means rebuilding and

:38:43.:38:48.

reviving our economy. We should be seeing something like a cut in VAT.

:38:48.:38:52.

We should be encouraging with tax breaks, firms to hire and take on

:38:52.:38:57.

more people. We should be looking at, say areas where there are huge

:38:57.:39:00.

housing problem. Here in London and other parts of Britain. Putting

:39:00.:39:04.

people back to work. Building the homes people need. There is a vast

:39:04.:39:08.

amount we need to do. You will not be able to while the Government is

:39:08.:39:12.

cutting its own spending. At a time like this, in an economic downturn

:39:12.:39:17.

the state should be helping to gear up the economy, put people back to

:39:17.:39:21.

work so they are coming off benefit and paying tax. That is how you pay

:39:21.:39:31.

back the debt. Some of what Ken said I agree with.

:39:31.:39:35.

Which bit? The Government can do things to actually help young

:39:35.:39:39.

people get back to work. Mainly it's getting out of the way. We

:39:39.:39:44.

live in a country now in which the tax code, the rule book for tax is

:39:44.:39:50.

about 14,000 pages long. This is Fife or six times as long as the

:39:50.:39:54.

complete works of Sheikh. What about cutting tax?

:39:54.:39:59.

-- of cutting Shakespeare. What about cutting the tax? I would

:39:59.:40:05.

slash tax. And VAT? I think VAT is probably too high. You may even

:40:05.:40:08.

raise more money by cutting it. think you can get growth back in

:40:08.:40:12.

the economy for the one million or so unemployed youth? It doesn't

:40:12.:40:16.

happen overnight. If you had a serious plan to deregulate now and

:40:16.:40:20.

start to reduce tax now, you could see the results in the next year or

:40:20.:40:24.

so. The coalition doesn't have that plan. And Osborne's plan is wrong n

:40:24.:40:32.

other words? Osborne is right to get spending under control. That is

:40:32.:40:37.

a... The Government's plan for growth seems to be to pray that it

:40:37.:40:45.

happens. There's very, very small steps in some areas of labour

:40:45.:40:50.

market reform. I would like to see de-regulation, that helps small and

:40:50.:40:54.

medium-sized enterprises who tend to pick up those who are not as

:40:54.:40:57.

well qualified. This war on red tape to get Government out of the

:40:57.:41:05.

way would do an enormous amount to help these young people find work.

:41:05.:41:10.

If I may, I would like to go back to the question. I think, yes,

:41:10.:41:14.

we're in a global market, but actually our young people are our

:41:14.:41:18.

future. I want them to see their future here with us. Actually when

:41:18.:41:22.

I look around the world, I and when I think about, for example, the

:41:22.:41:26.

pressures in terms of immigration to this country in order to do jobs

:41:26.:41:30.

here, I think actually we are a good place to come and work. Lots

:41:30.:41:34.

of people believe we're a good place to come and work. Yes, we

:41:34.:41:38.

have tough times. They are extremely difficult. We have a

:41:38.:41:42.

legacy and an international set of economic circumstances which make

:41:42.:41:47.

it incredibly difficult. We have got to have growth and growth is

:41:47.:41:51.

not going to come through abandoning the reduction of the

:41:51.:41:54.

deficit, because actually the entire.... He agrees with you on

:41:54.:41:59.

that. He says there are things you are not doing like cutting VAT.

:41:59.:42:04.

are doing things. We are cutting tax for people on low incomes so

:42:04.:42:07.

they will have more money in their pockets. We are putting for

:42:07.:42:14.

business, we're taking corporation tax to the.... About de-regulation?

:42:14.:42:18.

We have been, net we have reduced regulation since the election. That

:42:18.:42:25.

is turning a tide, because there has been a tide of new regulation.

:42:25.:42:30.

We were promised a bonfire, not a trim.

:42:30.:42:33.

How does a bonfire of regulation help when the banks are not lending

:42:33.:42:37.

to small businesses and everybody is crying out for money they cannot

:42:37.:42:46.

get hold of? APPLAUSE It helps enormously. I will tell

:42:47.:42:51.

you why it helps. By rowing back on red tape you don't get a boom in

:42:52.:42:55.

the economy, you don't convert microbusinesses into massive

:42:55.:42:58.

multinational companies. The amount of time and effort that small

:42:58.:43:02.

businesses have to go through to comply with the rules, let's say

:43:02.:43:07.

you have your bank loan sorted, just to comply with the rules is so

:43:07.:43:12.

intensive that you are making the businesses.... George Osborne, at

:43:12.:43:17.

the budget, put forward a moratorium until 2015 on impact on

:43:17.:43:20.

the small businesses. That is where the jobs are coming

:43:20.:43:24.

from. The question is whether young people are right to travel. Not to

:43:25.:43:28.

travel? To emigrate. I think, yes, they are. They are

:43:28.:43:34.

not going on holiday. Going abroad to get a job. It was said, life

:43:34.:43:37.

without work goes rotten. It is true. We talked about inequality in

:43:37.:43:42.

this country. They have got wider under Labour. If you have no house,

:43:43.:43:50.

no future to life you are unlikely to go to Waitrose for the oily fish

:43:50.:43:54.

and sun dried tomatoes and all the stuff that will keep you healthy.

:43:54.:43:58.

The knock-on effect for the health service when people become anxious,

:43:58.:44:02.

depressed T number of NHS managers you have made profoundly anxious

:44:02.:44:06.

because you announced you would get rid of their jobs at the time we

:44:06.:44:11.

are trying to make savings. If you put job insecurity into people's

:44:11.:44:21.
:44:21.:44:21.

mind it profoundly affects their mental health. The answer to Anita

:44:21.:44:24.

Chin's question? If they are competing, yes, I think they should

:44:25.:44:31.

go abroad to get a job. I will go to other members of the audience.

:44:31.:44:35.

Isn't it a shame that our youth have to go abroad to get jobs when

:44:35.:44:42.

investment should be in this country making sure that they get

:44:42.:44:46.

the right, investment to get jobs here? Isn't it a shame they have to

:44:46.:44:55.

go abroad? Do you think people should go

:44:55.:45:04.

abroad, like the Irish? It is rhetorical. The global market is

:45:04.:45:07.

shrinking. Skills are needed around the world. Many of us in this room

:45:07.:45:10.

have parents who have come from abroad. Why shouldn't our children

:45:10.:45:14.

go abroad again to make a living for themselves if it's not possible

:45:14.:45:17.

here. There are many people who come here to do exactly that.

:45:17.:45:26.

The Government pumped in �75 billion recently. What seems to be

:45:26.:45:33.

happening is that it is stagnating in the banks. What is the

:45:33.:45:36.

Government doing with that money that's going into the economy? What

:45:37.:45:42.

are they doing to create jobs? will the �75 billion do? That's

:45:42.:45:47.

right, in order to create jobs. Does anyone know? It will increase

:45:47.:45:51.

inflation, a year or two down the road. A large amount of it will go

:45:51.:45:55.

abroad. Instead of spending �75 billion printing money, I would

:45:55.:45:59.

rather see them spend �20 billion putting people back to work on

:45:59.:46:07.

works programmes, building houses. APPLAUSE The woman in the striped

:46:07.:46:12.

shirt? Surely it would be better to encourage British unemployed people

:46:12.:46:16.

or young people graduating to take jobs in this country rather than

:46:16.:46:25.

allowing EU migrants to take them? APPLAUSE A quick point - the NHS

:46:25.:46:29.

would only exist because of workers from overseas. They have propped up

:46:29.:46:37.

the NHS for over 60 years and we should be grateful. APPLAUSE Andrew

:46:37.:46:43.

Lansley, would you answer that woman's point? Make your point

:46:43.:46:47.

again. Surely we should have the right people in this country to run

:46:47.:46:53.

our NHS? What do you mean by that? Not having people come from abroad?

:46:53.:46:58.

Yes. We should have the right skills here. 500,000 nurses I think

:46:58.:47:04.

are from abroad. The NHS has depended over a generation from

:47:05.:47:09.

people coming to work in the NHS... Why can't you train people in this

:47:09.:47:13.

country to do it? We are training people to do it. You have 300,000

:47:13.:47:18.

people in the NHS who have come from abroad? In years past, we

:47:18.:47:23.

weren't training enough doctors, dentists or nurses. We are training

:47:23.:47:28.

more. We are ensuring that we can meet our needs. If you are a medic,

:47:28.:47:32.

a doctor, with the levels of skill we are talking about you are

:47:32.:47:42.

working in an international - I know I was at... Dubai?!

:47:42.:47:46.

LAUGHTER I was at one of our leading Children's Hospitals and I

:47:46.:47:51.

was talking to somebody who was describing his career to me. He had

:47:51.:47:56.

worked in California, Cairo and he was working in Britain. He was a

:47:56.:48:01.

very, a leading paediatric surgeon. That is what you have got to expect.

:48:01.:48:04.

My point is when you look at people from around the world wanting to

:48:04.:48:10.

work in this country, yes, they do want to work here. So we shouldn't

:48:10.:48:13.

be so pessimistic about ourselves. If other people around the world

:48:13.:48:17.

with skills want to be here, we should realise that we are a good

:48:17.:48:24.

place for people with skills to be here. The man on the gangway there?

:48:24.:48:29.

Part of the issue that is being discussed here is there's youth

:48:29.:48:34.

that feel disengaged with the workplace at the moment. Sarah

:48:34.:48:40.

Sands makes this point of Cisco who are going to the lengths of putting

:48:40.:48:44.

in place a training programme for the youth. The problem exists that

:48:44.:48:49.

we need to have qualifications on the same level, academic and

:48:49.:48:52.

vocational. Instead of these companies going to the lengths of

:48:52.:48:56.

saying we might have to put in place our own work programme. It

:48:56.:49:02.

should be encouraged by the Government to do that. APPLAUSE

:49:02.:49:08.

Yes? You talk all about these apprenticeships, so many hundreds

:49:08.:49:16.

out there. Where are they? Three people in my family can't get an

:49:16.:49:19.

apprenticeship. Where are they? What were you saying about your

:49:19.:49:23.

family? I have three people in my family trying to get

:49:23.:49:28.

apprenticeships. Not one of them can get one. Explain a bit more.

:49:28.:49:36.

They get kicked from pillar to post. What apprenticeships are they

:49:36.:49:41.

looking for? Motor and two in electrical. They go to companies

:49:41.:49:46.

and say have you got any apprenticeship posts open? They are

:49:46.:49:50.

given a phone number for a body to go to. They get kicked from pillar

:49:50.:49:54.

to post. We are pushing as a Government forward... You are not

:49:54.:50:01.

pushing hard enough! Then we will do more. APPLAUSE We have increased

:50:01.:50:07.

the number of apprenticeships... Why can't they get one? When Phil

:50:08.:50:11.

talks about the problems of people not being in work and the

:50:11.:50:15.

implications that has, the largest part of that is people on

:50:15.:50:17.

incapacity benefit, that is where the work programme is tremendously

:50:17.:50:22.

important. In the course of this Parliament we will see 2.5 million

:50:22.:50:25.

people go through the work programme. It could have the impact

:50:25.:50:30.

of increasing employment by up to 300,000. One more point, the man

:50:30.:50:34.

with the beard? I work in the higher education sector. I teach in

:50:34.:50:39.

it. Let me tell you with the abolition of EMA and the trebling

:50:39.:50:44.

of tuition fees combined with university cutbacks, I tell you

:50:44.:50:48.

young people are terrified about what is going to happen to them,

:50:48.:50:58.
:50:58.:50:58.

even more so... APPLAUSE Even more so when I graduated in 2006, before

:50:58.:51:02.

the crash, when the market was flooded with graduates which was

:51:02.:51:06.

largely caused by Labour's ridiculous 50% target of everyone

:51:06.:51:10.

going through higher education which isn't workable. Some people

:51:10.:51:14.

simply are not suited to higher education. That is not saying they

:51:14.:51:21.

are stupid. We need to get these skills back into the country.

:51:21.:51:31.
:51:31.:51:35.

APPLAUSE We will leave it there. We will go on to a final question from

:51:35.:51:40.

Jon Fawbert. Will overregulating the press put democracy itself in

:51:40.:51:45.

peril as Paul Dacre asserted yesterday? This is the conversation

:51:45.:51:49.

going on at the Leveson Inquiry in the press in the light of the phone

:51:49.:51:57.

hacking and what you can do to regulate. Paul Dacre of the Daily

:51:57.:52:00.

Mail was against the regulations that were being proposed. Ken

:52:00.:52:04.

Livingstone, what do you make of what he said? I don't want to see

:52:04.:52:09.

any stit regulation of the media in that sense. -- any state regulation

:52:09.:52:15.

of the media in that sense. I don't like the idea that someone like

:52:15.:52:25.
:52:25.:52:25.

Rupert Murdoch can decide what we read and what we see. Or Paul Dacre,

:52:25.:52:31.

so a real free press would be one that wasn't owned by multi-

:52:31.:52:37.

billionaires. APPLAUSE So what Dacre says is British's

:52:37.:52:40.

commercially viable free press is the only really free media? It is

:52:40.:52:45.

in hock to the people who own it. What chance have I got of getting

:52:45.:52:49.

the Daily Mail, or the Daily Telegraph, or the Times endorsing

:52:50.:52:54.

me for Mayor next year because their owners won't let them? What

:52:54.:53:00.

will the London Evening Standard do, Sarah Sands? We will do what's best

:53:00.:53:05.

for London. We are open-minded. am relaxed immediately(!) You will

:53:05.:53:08.

have the Guardian behind you. The important thick is it is a

:53:08.:53:13.

competitive and it is a vibrant press. -- important thing is it is

:53:13.:53:17.

a competitive and it is a vibrant press. We are an industry that is

:53:17.:53:22.

on our knees at the moment. Everyone agrees that the News of

:53:22.:53:27.

the World behaved horribly. I went last week to a police station to

:53:27.:53:34.

look at a notebook that had all my numbers on, the number of my

:53:34.:53:39.

numbers on, the number of my husband. It's a horrible feeling. I

:53:39.:53:43.

think there is a danger that this is going to be used because there

:53:43.:53:49.

are a lot of other interests in a muzzled press. Powerful people

:53:49.:53:54.

would like to control the press. I don't think Paul Dacre was

:53:54.:53:57.

exaggerating when he said what you end up with is Zimbabwe. You may

:53:57.:54:03.

not love the press. It can be boisterous and vulgar and sometimes

:54:03.:54:08.

unfair. I take all that. I still believe it is better there than not

:54:08.:54:15.

there. It has to self-regulate. What have you done? They are

:54:16.:54:24.

getting desperate. Phil Hammond? would be wary if regulations

:54:24.:54:34.
:54:34.:54:36.

stifled good journalism. It is the closest thing, the Private Eye, we

:54:36.:54:45.

have to a free press. It's patients and parents raising concerns who

:54:45.:54:48.

then get journalists on their side who hold these institutions to

:54:49.:54:53.

account. So really good investigative journalism is vital.

:54:53.:55:00.

You have to invest in it. It is the one thing that holds people to

:55:00.:55:06.

account. The man up there? APPLAUSE Could the panel please address the

:55:06.:55:10.

myth that we have of free press? British libel laws are some of the

:55:10.:55:16.

worst in the world. You need only publish something in Heathrow for

:55:16.:55:21.

someone to come here and sue you about it? I agree they are

:55:21.:55:24.

restrictive. You need a good lawyer! I have been writing for

:55:24.:55:31.

Private Eye for almost 20 years now. I broke the Bristol heart scandal.

:55:31.:55:34.

I thought my career was on the line. Nothing happened. I guess because

:55:34.:55:38.

the story was true. If you get your story true, you have an editor who

:55:38.:55:43.

backs you up, generally, you are protected. Private Eye has never

:55:43.:55:52.

won a libel action. They have... Never lost! They always lose.

:55:52.:56:00.

are they still going? Who is funding it?! I agree with much of

:56:00.:56:03.

what has been said. A free press is extremely important. You have to

:56:04.:56:08.

bear in mind that that will mean there are a lot of press vehicles,

:56:08.:56:11.

media outlets that you don't personally like because there will

:56:11.:56:18.

be a diversity of choice. The BBC has a colossally bigger share of

:56:18.:56:23.

the TV market than Ru purt Murdoch could ever dream of. Thank God.

:56:23.:56:29.

Let's have choice. I hope that Ken wouldn't be worried about Fox News

:56:29.:56:34.

existing in the United Kingdom. It adds to the spread of choice.

:56:34.:56:39.

you think the Government is gunning for the press? We have got into an

:56:39.:56:42.

unfortunate situation which is where you want the press and

:56:42.:56:47.

politicians to be daggers drawn, it has now got to a dangerously

:56:47.:56:50.

hostile relationship. The press are crucial at holding people to

:56:50.:56:55.

account. We can be quite confident about it now. The internet, blog

:56:55.:57:00.

sites, we have a plethora of people who by putting down ten quid and

:57:00.:57:06.

buying a URL, they can become their own investigative journalists. That

:57:06.:57:14.

is a very exciting time. OK. OK. Andrew Lansley, let me put a quote

:57:14.:57:20.

from Paul Dacre to you. "Am I alone in detecting the rank smells of

:57:20.:57:24.

hypocrisy and revenge in the political classes current moral

:57:24.:57:28.

indignation over a British press that dared to expose their greed

:57:28.:57:33.

and corruption." I don't think that is justified. It wasn't politicians

:57:33.:57:37.

who encouraged the News of the World to go out phone hacking,

:57:37.:57:44.

trying to get into people's... expenses. It was all before then.

:57:44.:57:50.

You are getting your own back. indignation is not just amongst

:57:50.:57:54.

politicians. There is public indignation. There is a sense that

:57:54.:57:57.

newspapers, the press seriously overreach themselves. I don't think

:57:57.:58:01.

it was about getting the story right. If it was, there wouldn't

:58:01.:58:05.

have been any problem. It was going into people's private lives and

:58:05.:58:11.

often making things up. Is there a move for licensing the press in the

:58:11.:58:15.

way that... What I think everybody is looking for is to move to a

:58:15.:58:20.

place where the press are not simply able to be judges and

:58:20.:58:26.

prosecutors and juries, that there has to be independence and

:58:26.:58:29.

standards have to be pursued independently. There is a place for

:58:29.:58:34.

regulation. Mark makes the point about getting a range of voices in

:58:34.:58:37.

the media. That is why several years ago, when I was a backbencher

:58:38.:58:41.

with David Putnam, we worked together on putting the public

:58:41.:58:47.

interest test into media mergers which is the test that was applied

:58:47.:58:51.

when the News International were trying to take over BSkyB because

:58:51.:58:55.

regulation for competition and for choice and for plurality has its

:58:55.:59:00.

place. We can't go any further. Our hour is up. We have to stop

:59:00.:59:03.

Question Time. We will be in Glasgow next week and Winchester

:59:03.:59:10.

the week after that. If you want to come to either of those programmes,

:59:10.:59:13.

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