:01:22. > :01:24.And in the North West: Restructuring the NHS - how a 19th-
:01:24. > :01:34.century humanitarian movement is helping one hospital through a 21st
:01:34. > :01:34.
:01:34. > :44:01.Apology for the loss of subtitles for 2547 seconds
:44:01. > :44:05.I'm Arif Ansari. Coming up. Restructuring the NHS. The 19th
:44:05. > :44:10.century organisation helping one hospital through a twentieth-
:44:10. > :44:18.century cash crisis. I don't think what I am doing is morally right. I
:44:18. > :44:23.think the country should provide this service like the way through.
:44:23. > :44:29.This week I am joined by the Liberal Democrat MP for Hazel Grove,
:44:29. > :44:35.Andrew Stonnall, and by the new Labour MP for Manchester Central,
:44:35. > :44:41.Lucy Powell. How has it been enjoining the Commons? What is life
:44:41. > :44:46.like. I am just trying to get used to the place. I am sure Andrew and
:44:46. > :44:54.others would have some advice, how you can make an impact and what you
:44:54. > :45:01.can do as an MP. I was there when you got elected. Politics is not
:45:01. > :45:06.new to you, so does it feel quite different being an MP? In it is
:45:06. > :45:10.different being down in Parliament. I am used to representing my
:45:10. > :45:17.constituents and being a representative for Manchester, not
:45:17. > :45:22.the cut and thrust of the houses of parliament. But I have had a couple
:45:22. > :45:29.of Prime Minister's Questions so far. Andrew, what is your advice as
:45:29. > :45:33.somebody with a lot of experience in Parliament? Concentrate on the
:45:33. > :45:37.constituency, they are the people who sent you there and the people
:45:37. > :45:41.who will decide whether you have done a good job. What happens in
:45:41. > :45:48.Parliament is good and valuable, but the people who give you the job
:45:48. > :45:54.or a back in the constituency. it been difficult for do not -- no
:45:55. > :45:59.longer being a minister? It gives you more space to get on it to
:45:59. > :46:05.helping constituents get what they need and what they want.
:46:05. > :46:08.Having skived off for their Christmas we are back in time to
:46:08. > :46:12.discuss the battle between the workers and the Sherpas. This week
:46:12. > :46:17.the Government won the Commons vote to limit the increase in most
:46:17. > :46:21.benefits to 1% for the next three years. Chris Rider has been to one
:46:21. > :46:26.benefits hotspot where there are warnings of a possible impact.
:46:26. > :46:30.Care be is one of the most deprived areas in the country with high
:46:30. > :46:34.levels of unemployment and many claiming benefits. The credit union
:46:34. > :46:44.here is worried that this 1% cap which in effect is a cut will make
:46:44. > :46:50.matters worse. People are being asked to pay quite a great deal
:46:50. > :46:54.towards solving the credit crisis. Last year the average weekly wage
:46:54. > :47:00.increased to �470. The number of people claiming jobseeker's
:47:00. > :47:05.allowance was down slightly, at just under 200,000. There was a 55%
:47:05. > :47:10.rise in the number claiming for more than one year. The Government
:47:10. > :47:14.has this view that people have chosen to live on benefits. In fact
:47:14. > :47:19.it is not like that. A better approach would be for them to deal
:47:19. > :47:25.with the barriers to people getting into employment. In the town centre,
:47:25. > :47:33.some shoppers were critical of the Government's stance. Food prices
:47:33. > :47:41.are going up. Electricity and gas. We do not get a lot of money, so
:47:41. > :47:47.what we do get we have to budget with. Ba do not see why people on
:47:47. > :47:51.benefits should have more than 1%, when at the public and private
:47:51. > :47:55.sector are capped. This is a political argument about fairness.
:47:55. > :47:59.Labour accuses the Government of targeting the most vulnerable
:47:59. > :48:04.people in society. The Government says benefits should not be
:48:04. > :48:12.increasing more than wages. Will the Secretary of State admit that
:48:12. > :48:18.under these plans, Child poverty will go up at? I was approached by
:48:18. > :48:23.a member of Manchester Constabulary, who said how can you justice by --
:48:23. > :48:30.justify putting benefits up by 5.2% last year, when I have had a pay
:48:30. > :48:33.freeze and a risk my life every day? I think benefits for those
:48:33. > :48:41.people we really need to protect, that is why I have not supported it
:48:41. > :48:45.tonight. We are seeing the language from
:48:45. > :48:50.Chancellor Osborne of the shirker and the skiver. I think that is
:48:50. > :48:56.appalling. That sort of hate thy neighbour thing but they are trying
:48:56. > :49:01.to generate, I think that is evil. Some very strong language there at
:49:01. > :49:07.the end. Did you support this decision with enthusiasm or
:49:07. > :49:12.reluctantly? I think it is part of a much bigger package which sees as
:49:12. > :49:17.clamping down on bankers plu's bonuses and on the rich, as well as
:49:17. > :49:20.making sure that does in the middle get their tax rebates as well. If
:49:20. > :49:25.we lived in a perfect world we would not need to make these
:49:25. > :49:30.reductions, but we live in a world where the country's finances are in
:49:30. > :49:35.disarray, and where it is vital to get that straightened out. In the
:49:35. > :49:39.discussions which led to the benefit reform package, the Liberal
:49:39. > :49:43.Democrats were clear but we wanted to see protection for the disabled
:49:43. > :49:49.and those groups who are most vulnerable, but it's into a swipe
:49:49. > :49:58.that those who are of working age should bear some of the cost on
:49:58. > :50:03.this occasion. A what is the answer to that, Lucy? So 68% of people
:50:03. > :50:09.being affected by this small increase or freezing of the
:50:09. > :50:14.benefits are people in work, auditing maternity pay, so we feel
:50:14. > :50:19.they are the wrong people to penalise. They are not people
:50:19. > :50:24.sitting at home with the curtains shut. The people in work by getting
:50:24. > :50:32.the income tax rebate. This April they will be getting a �600,000
:50:32. > :50:36.rebate. The point that John is making, one of your fellow MPs, is
:50:36. > :50:42.that the benefits you have given people would be income tax rebate
:50:42. > :50:47.are being taken away by these changes to benefits? The maximum
:50:47. > :50:52.change to welfare benefits, of course people are getting a cash
:50:52. > :50:59.rise but it is limited to 1%. What they lose is the difference between
:50:59. > :51:04.that and inflation. The IFS says that will be �165 per year. The tax
:51:04. > :51:08.rebate is �600 per year, so people will be getting much more in the
:51:08. > :51:15.tax rebate and they are losing in the welfare benefit if they are in
:51:15. > :51:19.work. I raised the case this week, if somebody works part-time in a
:51:19. > :51:27.supermarket, she does not earn enough to get the benefit of the
:51:27. > :51:31.tax rebate. She earns less than �600 -- �60,000 per year. What the
:51:31. > :51:37.Government are not telling you is that they have already lowered the
:51:37. > :51:43.rate of benefit increase, because they changed the link from RPI to
:51:43. > :51:47.CPI. People have already taken a hit on that. There are other
:51:47. > :51:54.changes taking -- coming all ready with the universal credit coming in
:51:54. > :52:03.April. Constituent of mine who earns less than �600 per year it
:52:03. > :52:07.will be over �100 per week but worse off. A even if we bought the
:52:07. > :52:13.fairness argument by side, in terms of popularity this is a popular
:52:13. > :52:18.move by the Government, isn't it? To be few present it in those terms,
:52:18. > :52:28.and you are not being clear with people about the measures they are
:52:28. > :52:31.hitting people with, and at the same time we have seen the Liberal
:52:31. > :52:37.Democrats and the Tories give a tax break to some of the wealthiest in
:52:37. > :52:43.society by reducing the highest rate of income tax from 50p to 45p.
:52:43. > :52:49.Does that -- does Labour except that when they are -- were in
:52:49. > :52:54.Government they should have done more to reform the benefit system?
:52:54. > :53:01.The tax credit system in that some sense is subsidising low pay, which
:53:01. > :53:04.is why I support a living wage. We should be putting pressure on the
:53:04. > :53:09.private sector through different means to pay people a higher wage,
:53:09. > :53:13.so that they do not need their salaries being subsidised by the
:53:13. > :53:20.taxpayer. We should live in a world where but does not need happen.
:53:20. > :53:24.Andrew, is there a danger that if people who are working see their
:53:24. > :53:30.salaries go down, suddenly the support for this move will
:53:30. > :53:34.disappear? I do not think so. It is about making sure we have a fair
:53:34. > :53:38.system which always make sure that work pays and make sure the most
:53:38. > :53:45.vulnerable in society are protected. That is a difficult calculation,
:53:45. > :53:48.but I believe we have got it right. This year the NHS will continue to
:53:48. > :53:53.struggle to make savings at hospitals and trusts across the
:53:53. > :53:57.region. Blackpool Victoria Hospital is one of the busiest in at the
:53:57. > :54:02.North West with 80,000 visits a year to A&E alone. Stuart Pollitt
:54:02. > :54:09.has been looking at one scheme helping them to save money.
:54:09. > :54:15.1915. The Red Cross helps build a hospital in Blackpool. Almost one
:54:15. > :54:19.century later, the charity is still involved in the town's hospital.
:54:19. > :54:25.Today it is helping recovering pensioners like Joan, rather than
:54:25. > :54:29.wind its soldiers. A hospital pays the Red Cross to take patients home
:54:29. > :54:35.and help them settle in. They spend fewer nights on the ward, better
:54:35. > :54:40.for patients and the trust's bank balance. It gives you peace of mind
:54:40. > :54:49.that that patient is going home with an amazing team of people who
:54:49. > :54:54.will do anything. Before, you what sort of just left
:54:54. > :55:00.inside. These people are on the spot for you. The have formed
:55:00. > :55:05.friendships. A have. They have become like friends, and it makes
:55:05. > :55:11.me feel good because all my family are spread across the world.
:55:11. > :55:20.For former RAF officer Ian is one of a Das -- dozens of volunteers
:55:20. > :55:23.who help out. A I get a lot out of it. It is extremely well wrought --
:55:23. > :55:28.it is extremely rewarding, but should the NHS should not be relied
:55:28. > :55:31.on somebody like you? A day don't think what I am doing is morally
:55:31. > :55:36.right. I think the country should provide
:55:36. > :55:44.the sort of service like the way through. Are recognise also that
:55:44. > :55:50.the Government -- country does not have lots of money, whatever the
:55:50. > :55:56.relative benefits of this scheme for people like Joan, at it only
:55:56. > :56:02.saves �200 per ounce steered -- �200,000 per year, which in turn is
:56:02. > :56:08.a fraction of the �20 billion the NHS must find in inefficiencies
:56:08. > :56:14.services by 2015. We have to save money. We have to
:56:14. > :56:20.look at innovative ideas of being able to manage. I think it is
:56:20. > :56:25.different -- difficult for everybody.
:56:25. > :56:31.Give it is really busy. The amount of patients coming into hospital is
:56:31. > :56:36.increasing. Cost is an issue. We have to do things most effectively,
:56:36. > :56:45.which improves quality. It gives us more facilities to do other things
:56:45. > :56:50.with. The Red Cross is usually associated
:56:50. > :56:55.with appeals like this, but increasingly they help is needed
:56:55. > :56:59.closer to home. There is a crisis in the health and social care
:56:59. > :57:05.sector, and it is important that we get involved in solving the
:57:05. > :57:10.problems that we are facing. I think the Red Cross is the big
:57:10. > :57:13.society in some ways, as art volunteer organisations across the
:57:13. > :57:18.country. J owner is certainly grateful for
:57:18. > :57:24.their involvement -- Joan is great for.
:57:24. > :57:29.By find that they are really wonderful. More precious than gold.
:57:29. > :57:39.But latest report from the Audit Office says the NHS megabits
:57:39. > :57:40.
:57:40. > :57:42.efficiency targets, but finding the money must be like finding the
:57:42. > :57:49.Blackpool Tower on a misty day like this.
:57:49. > :57:53.You know it is out there, but you do not know where.
:57:53. > :57:57.Let us turn to Professor John Appleby from The King's Fund, he is
:57:57. > :58:03.a leading campaigner on health reform.
:58:03. > :58:07.Brady explained this to me. The Government always says that they
:58:07. > :58:14.protected the health budget, so why is there so much financial pressure
:58:14. > :58:19.on the NHS? The Government have given the NHS more money, the
:58:19. > :58:23.trouble is it is just about enough to cover rising prices, so in real
:58:24. > :58:28.terms it is flat and has been for the last two years. It is likely to
:58:28. > :58:35.be just about enough to cover inflation for next year as well.
:58:35. > :58:38.The NHS needs more money, because there are growing health needs. The
:58:38. > :58:44.image as find it -- finds itself in a position of having to close the
:58:44. > :58:49.gap between funding and what is needed. That is the �20 billion,
:58:49. > :58:55.the value of the productivity gain the NHS needs to make.
:58:55. > :59:02.We saw a but blackball hospital, which is saving �200,000 in that
:59:02. > :59:08.scheme, but has to save �50 million by 2015. How on a do hospitals like
:59:08. > :59:12.that go about doing that? We do a survey of the finance
:59:12. > :59:17.directors of hospitals and other NHS organisations every three or
:59:17. > :59:21.four months, and our latest survey suggests that about two-thirds are
:59:21. > :59:25.pretty pessimistic about the finances in their local area. One
:59:25. > :59:34.of the tactics the Government uses to put pressure on hospitals to be
:59:34. > :59:39.more productive is to reduce the actual prices that hospitals can
:59:39. > :59:44.charge local primary care trusts for their services.
:59:44. > :59:50.Andrew, what is your answer up, bearing in mind Bear will not be
:59:50. > :59:55.extra money available. We are putting extra money into the health
:59:55. > :00:00.service, the problem is that there is a growing demand. As I ask a
:00:00. > :00:07.question in Parliament this week on exactly that. Stepping Hill
:00:07. > :00:11.hospital has had an 11% increase on A&E admissions in one year. The
:00:11. > :00:18.question asked was about what can we do on the alcohol strategy to
:00:18. > :00:23.make sure that fewer people go to A&E with alcohol-related problems.
:00:23. > :00:27.To you see the answer as having fewer people going to hospital?
:00:27. > :00:35.what we are doing about public health is making sure it is more
:00:35. > :00:41.closely integrated with social care, is very important. Hospitals
:00:41. > :00:45.themselves and the NHS as a whole still have work to do. I meet -- I
:00:45. > :00:51.discussed with a pharmaceutical services be questions about drugs
:00:51. > :00:56.supply and drug costs. The fact is that there is an almost limitless
:00:56. > :01:01.amount you can spend on the health service if money was no object.
:01:01. > :01:08.but have massively increased the NHS budget, get it is still under
:01:08. > :01:12.pressure. By Ben any solutions here? By this Government had said
:01:12. > :01:18.they would not do a top down reorganisation of the NHS, and they
:01:18. > :01:24.have done that. The second think which Andrew are
:01:24. > :01:27.needed to is the pressure on adults social care at the moment. It is
:01:27. > :01:32.local councils that are principally responsible for providing those
:01:32. > :01:35.services. We are seeing huge cuts to the budgets of local authorities
:01:35. > :01:40.here in the North West, meaning that many of those services are
:01:40. > :01:45.being cut. My husband is a A&E doctor and he sees the pressure
:01:45. > :01:50.every day of all the people who really should not be bed blocking,
:01:50. > :01:56.if you like, in many of our hospitals.
:01:56. > :02:00.Do you accept the point that you see is making? Social care is a
:02:00. > :02:08.pressure point for many authorities, so we are going to be restructuring
:02:08. > :02:18.the way that is financed. I am no longer in a position to blurt out
:02:18. > :02:19.
:02:19. > :02:24.bought that answer will be, but you will hear it in a month or two.
:02:24. > :02:30.Lucy and I could have a interesting discussion about local Government
:02:30. > :02:34.finance in the North West. The reality is an authority like
:02:34. > :02:38.Manchester has �110 million sitting in the bank, and is slashing
:02:38. > :02:45.services left right and centre. I don't believe that is a successful
:02:45. > :02:49.-- sensible use of resources. Lucy Powell mentioned the NHS
:02:49. > :02:53.reorganisation, has that made things better or worse?
:02:53. > :02:57.We will have to wait and see. That is clearly one of the huge
:02:58. > :03:03.pressures on the NHS, there is funding, the productivity challenge.
:03:03. > :03:10.The fact we have frozen pay for NHS employees for the last two years
:03:10. > :03:15.has helped. But that is not sustainable in the longer term. You
:03:15. > :03:19.also have a major reorganisation, something like 18% of managers have
:03:19. > :03:24.gone from the service. We have reorganisation of change is not
:03:24. > :03:29.just locally but at national level. Day is a huge danger that people
:03:29. > :03:34.take their eye off the ball here. The NHS has done quite well over
:03:34. > :03:40.the last couple of years, if you look at waiting times, hospital
:03:40. > :03:46.infection and so on. The NHS seems to beat staying within the targets
:03:46. > :03:50.it has been said. The big fear is that this is the first couple of
:03:50. > :03:58.years of a four-year spending review which is extremely tight. We
:03:58. > :04:05.do not expect real time increases over they end --, I think the worry
:04:05. > :04:10.is that... Professor John Appleby, thank you
:04:10. > :04:14.very much. It is time for the rest of the week
:04:14. > :04:17.News, Ian Haslam with 60 Seconds. Right on track - Network Rail
:04:17. > :04:19.announced the biggest investment in our railways since Victorian times
:04:19. > :04:25.- �1 billion over five years for new tracks, electrification, and
:04:25. > :04:28.longer trains. Sign of the times - Oldham Council
:04:28. > :04:38.says it can't afford school crossing patrols. Local businesses
:04:38. > :04:39.
:04:39. > :04:42.are considering stepping in to fund them.
:04:42. > :04:45.A Liverpool music promoter was fined for racially abusing the
:04:45. > :04:47.Wavertree MP Luciana Berger. Philip Hayes, who founded The Picket,
:04:47. > :04:50.swore at the MP and said he hated Jews.
:04:50. > :04:53.A campaign's under way to prevent maternity services being withdrawn
:04:53. > :04:56.at Furness General in Cumbria. Pregnant women could face a trip to
:04:56. > :04:59.Lancaster or Whitehaven. And there's no such thing as a free
:04:59. > :05:09.But in Blackpool 12,000 primary school pupils are bing offered a
:05:09. > :05:15.
:05:15. > :05:25.The council is spending �700,000, and says no child should start the
:05:25. > :05:29.
:05:29. > :05:33.We have heard quite a lot about rail investment, and we have been
:05:33. > :05:39.told about the northern hub getting the go ahead before, but do you
:05:39. > :05:45.welcome that? I would also welcome something the Government was doing
:05:45. > :05:50.in the interests of my region, even though they are not my party.
:05:50. > :05:54.much of a difference will it make? Its is part of a beget strategy to
:05:55. > :05:58.bring more jobs and investment to the region. Transport
:05:58. > :06:02.infrastructure is a critical part of getting people to the jobs there
:06:02. > :06:08.are in the region, so it is very important.
:06:08. > :06:15.One sort of changes do you want to see, Andrew? -- what sort of
:06:15. > :06:21.changes do you want to see? I think this sooner we get to see whether
:06:21. > :06:24.high-speed strategy is, the better. It will only be of use to ask when
:06:24. > :06:29.it gets to Manchester. I want to see longer and more frequent
:06:29. > :06:35.commuter trains on my route, so that my constituents do not have to