:00:36. > :00:39.And in the North West, the Archbishop of Canterbury described
:00:39. > :00:41.it as stale, but can the Big Society breathe new life into our
:00:41. > :00:44.communities? And case notes from history, how
:00:44. > :00:54.treatment pioneered in the the North West has helped shape the NHS
:00:54. > :00:55.
:00:55. > :37:56.Apology for the loss of subtitles for 2221 seconds
:37:56. > :37:59.Welcome to the Politics Show in the north-west, I am Annabel Tiffin.
:38:00. > :38:05.Coming up, the Big Society, is it the biggest thing since sliced
:38:05. > :38:09.bread or simply a stale and crusty idea? I have a genuine worry that
:38:09. > :38:13.the more disadvantaged communities will not have a combination of
:38:13. > :38:18.knowledge, the capacity or the weather thought, if you like, and
:38:18. > :38:28.the volunteer time. And medical history, how our region
:38:28. > :38:28.
:38:28. > :38:32.helped pioneer the treatment The big guns have come out in the
:38:32. > :38:35.war of words over the Big Society this week. Lining up on opposite
:38:35. > :38:39.sides, the Prime Minister and the Archbishop of Canterbury. David
:38:39. > :38:42.Cameron says his policies will empower local people, but the
:38:42. > :38:52.archbishop described the Big Society as they will, so which is
:38:52. > :38:53.
:38:53. > :38:58.it? Elaine Bentley reports. -- From cities to rural villages, from
:38:58. > :39:03.the affluent to the poor, it includes us all, but is the Big
:39:03. > :39:08.Society power to the people or a political pipe dream? That great
:39:08. > :39:13.project in your community, go and lead it. That waste in government,
:39:13. > :39:17.go and find it. The school in your neighbourhood, go and demanded. The
:39:17. > :39:21.neighbourhood group, joined up. The business you dreamt of, start up.
:39:21. > :39:26.When we say we are all in this together, it is not a cry for help,
:39:26. > :39:30.it is a call to arms. This week PSNI House of Lords have been
:39:30. > :39:35.debating the backbone of the Big Society, the House of Lords. --
:39:35. > :39:39.peers in the House of Lords. Outside of the debating chamber,
:39:39. > :39:44.will this work? Where better to find out than the 10 Avenue in
:39:44. > :39:49.Preston? We have removed everything the council provides, rubbish
:39:49. > :39:53.collection bat they are taking the bins, not our rubbish. Residents
:39:53. > :40:00.have been part and a unique social experiment. Or council services
:40:00. > :40:06.were removed and the community took charge. -- Paul. We developed our
:40:06. > :40:13.own bureaucracies. We spent hours discussing pain from Mobil and how
:40:13. > :40:18.to get rid of abandoned cars. -- paint removal. Councils, whether
:40:18. > :40:21.you like them or not, they are a professional organisation, and they
:40:21. > :40:26.can just pull the procedure off a wall and know what they're doing
:40:26. > :40:33.straight away. We had to research everything. It took us ages to sort
:40:33. > :40:37.Regeneration, social housing and planning applications are also
:40:37. > :40:39.getting a makeover. Regional planning will be swept away, and
:40:39. > :40:44.communities will have the power to grant planning permission if a
:40:44. > :40:48.local majority are in favour. principle, we think it is a good
:40:48. > :40:53.idea, it is a good Bill because it brings local authorities and
:40:53. > :40:58.communities together. In particular, first of all, I think the idea is
:40:58. > :41:03.that local-authority should work with local communities. The first
:41:03. > :41:07.part, I think, is around the limitations of the Bill and the
:41:07. > :41:10.fact that it is complex. The second concern that we have is around the
:41:10. > :41:15.amount of resources that are going to be available to local
:41:15. > :41:17.communities, and we have a genuine worry, perhaps for more
:41:17. > :41:23.disadvantaged communities, they will not have a combination of the
:41:23. > :41:27.knowledge, the capacity or the wherewithal and the volunteer time.
:41:27. > :41:31.The Big Society is, for the most part, a vision, but some are
:41:31. > :41:35.already living the dream. The shocking goals with Anders pub and
:41:35. > :41:39.Salford were threatened with closure until locals left him. --
:41:39. > :41:44.this shop in Gawsworth and this pub in Salford were threatened with
:41:44. > :41:48.closure until locals stepped in. needed to have a proper business
:41:48. > :41:53.plan, get to grips with profit and loss, and it was a time-consuming
:41:53. > :41:56.process. But having said that, we were successful, and I would
:41:56. > :42:02.encourage anybody else he was thinking of setting up a community
:42:02. > :42:07.shop. I would say, go for it. not so sure about this idea of the
:42:07. > :42:11.Big Society. We feel like a very small society, a local community,
:42:11. > :42:15.and it is something that we want, something that is very peculiar to
:42:15. > :42:20.us. I cannot think you could take our model and immediately apply it
:42:20. > :42:26.somewhere else. -- I do not think. So far we have only scratched the
:42:26. > :42:30.surface of the big community, but there needs to be a vast array of
:42:30. > :42:35.legislation. You worry that something with such a broad scope
:42:35. > :42:39.could end up having very wide and unintended consequences, and so
:42:39. > :42:43.therefore you do worry that such a broad belt might actually lose some
:42:43. > :42:47.focus for may have some effects that are not foreseen at the moment.
:42:47. > :42:52.-- Bill. There is still a long way to go before the Localism Bill
:42:52. > :42:58.becomes law, but there remains big questions over the Big Society.
:42:58. > :43:03.I am joined in the studio by two of the region's envy Conservative MP
:43:04. > :43:06.for Weaver veil, and Kate Grant is the Labour MP for Stretford and
:43:06. > :43:16.Urmston. We should talk straightaway about what the
:43:16. > :43:20.Archbishop of Canterbury said this week. I happen to disagree with
:43:20. > :43:24.what he said, but he is perfectly entitled to... He said the Big
:43:24. > :43:28.Society was stale. He is entitled to his opinion, but the Big Society
:43:28. > :43:31.has been around for one time. It has been put at the core of
:43:31. > :43:36.political debate. He is entitled to his opinion, but I do not agree
:43:36. > :43:39.with it. You do not think he was reflecting what the public think?
:43:40. > :43:43.The issue I have that people like the Archbishop is, he will put
:43:43. > :43:47.something out into the media, and where are his colleagues to sit in
:43:47. > :43:51.studios like this and debate it? He has thrown a rock into the pool
:43:51. > :43:55.that we are all left talking about. I would rather be talking with
:43:55. > :43:58.representatives from the church and people like himself. Are you glad
:43:58. > :44:03.he brought this to the top of the agenda and people are talking about
:44:03. > :44:07.it? I think people have been at best puzzled about what the Big
:44:07. > :44:11.Society is meant to be. It is not new. People have been volunteering
:44:11. > :44:14.and doing work in their communities for decades. What I am worried
:44:14. > :44:17.about, and perhaps what the Archbishop of Canterbury is getting
:44:17. > :44:21.out, is that people are being potentially expected to provide a
:44:21. > :44:25.lot more services in their community to replace the loss of
:44:25. > :44:28.public services. And at the same time, they are not really getting
:44:28. > :44:34.all the support they need to make sure they can make those community
:44:34. > :44:38.organisations work in the way that they want. Gone, Graham. That is
:44:38. > :44:42.fair comment. The fact is that too many communities have relied on a
:44:42. > :44:46.local authority or government to provide those services, and it is a
:44:46. > :44:51.balance. When we are short on cash, when councils are short on cash,
:44:51. > :44:54.are there areas were the local people could take control? There
:44:54. > :44:59.are community centres and libraries where local people who know the
:44:59. > :45:02.area better, known to local needs, could do it, rather than always
:45:02. > :45:05.relying on the local authority. I accept there are some things which
:45:05. > :45:09.will always be provided by the local authority. This is an
:45:10. > :45:14.opportunity for people to take control of their street. As you
:45:15. > :45:18.said, it is a way of saving money. Well, we cannot afford... The
:45:18. > :45:24.nation cannot afford to provide all of the things that we are currently
:45:24. > :45:31.providing false start is it right to expect local people to pick up
:45:31. > :45:34.where local authorities were once I think it is right depending on
:45:35. > :45:38.the individual situation for that community. I notice John Knight was
:45:38. > :45:42.speaking quite eloquently there. I used to cross swords with him when
:45:42. > :45:46.he was at the planning authority at Macclesfield Borough Council, where
:45:46. > :45:48.I served for 10 years, and I fundamentally disagreed with the
:45:48. > :45:53.way that the top down Dick that came from central government,
:45:54. > :45:57.telling local councillors what they could not do in their communities.
:45:57. > :46:01.I suppose the concern is when everybody is equipped to take on
:46:01. > :46:07.his role. I do not think people necessarily have the time. They may
:46:07. > :46:10.not have the capacity. People move on. If you need to be there for the
:46:10. > :46:15.long term, you may lose the people who were energetic in getting
:46:15. > :46:18.particular activities started up. I do not think you can just say that
:46:18. > :46:22.libraries or community centres can be left to communities. Think are
:46:22. > :46:26.the people who did have the time in the past, often married women,
:46:26. > :46:29.often rather older women perhaps. Many of those women have family
:46:29. > :46:33.commitments, they are looking at the grandchildren to help their
:46:33. > :46:38.daughter work. That they are working themselves. I do not think
:46:38. > :46:43.we are in a position where people are able to sustain community
:46:43. > :46:46.services, and we need to have the council's underwriting the minimum
:46:46. > :46:55.standards that people and especially the mart bonnet of
:46:55. > :46:58.people need to be able to access. - - the most vulnerable people. They
:46:58. > :47:02.are not giving them the money, and Graham is right. Some of this is
:47:02. > :47:07.because local councils have less money to spend. We know from the
:47:07. > :47:11.chief executive of the voluntary organisations body that the funding
:47:11. > :47:15.for the voluntary sector is being substantially squeeze over the next
:47:15. > :47:19.two or three years. He has taught us something like �3 billion coming
:47:19. > :47:23.out of the budget for community and voluntary organisations. We are
:47:23. > :47:26.asking them to take on more but to it with less at a time when people
:47:26. > :47:30.have many other pressures are now lives. We want to support community
:47:30. > :47:35.engagement, and there are great things going on in my constituency,
:47:36. > :47:40.but it is not a substitute for public services. I was going to say,
:47:40. > :47:43.Graham Evans, recently MPs have not exactly given it their seal of
:47:43. > :47:47.approval. A committee said it was not being supportable implemented
:47:47. > :47:52.across the board, so why is it not being embraced, the Localism Bill
:47:52. > :47:56.in particular? I believe it is being embraced, but it varies from
:47:56. > :48:00.one community to another. For example, in my constituency, I have
:48:00. > :48:04.local residents who have taken over a community centre and to a
:48:04. > :48:07.fantastic job for their estates. But the next estate as a community
:48:07. > :48:11.centre run by the local authority, and it is quite interesting to see
:48:11. > :48:14.the differences. Those people who take ownership for their community
:48:14. > :48:18.operate in a slightly different way, and the local authority community
:48:18. > :48:23.centre operates in a different way. I see both sides of the argument.
:48:23. > :48:26.This is very much the beginning. What we are saying to the nation is
:48:26. > :48:31.that we cannot carry on the way we have been going on, spending money
:48:31. > :48:34.on local services. Wherever possible, if we can allow the local
:48:34. > :48:39.community to take ownership, we should welcome that. Thank you both
:48:39. > :48:43.very much. The north-west has been at the forefront of many moments of
:48:43. > :48:46.medical history, the first test- tube baby, revolutionary cancer
:48:46. > :48:50.treatments and even the birth of the NHS. Today we start a series of
:48:50. > :48:52.reports looking at how the region has been instrumental in shaping
:48:52. > :48:56.the health treatment that we received today. Gill Dummigan
:48:56. > :49:06.starts by looking at the pioneering work on hip replacement carried out
:49:06. > :49:08.
:49:08. > :49:11.Will it turn round and go back, Mrs Percival, please? A 1962, is
:49:11. > :49:15.certain courts John Charnley went on television to show his
:49:15. > :49:18.remarkable new invention. -- A surgeon called John Charnley.
:49:18. > :49:23.patients were severely disabled with arthritis, and now they have
:49:23. > :49:28.artificial hip joints. Julie Bickerton was a young woman. In the
:49:28. > :49:33.mid-60s, she was 23, just starting married life, then one night her
:49:33. > :49:38.world changed. We had been dancing in the evening, went to bed about
:49:38. > :49:42.midnight, woke up at about 3 o'clock in absolutely excruciating
:49:42. > :49:46.pain. I could not move. Julie had rheumatoid arthritis. In a
:49:46. > :49:51.wheelchair, she went to see Professor Charlie, who agreed to
:49:51. > :49:55.replace both of her hips. -- Charlie. You get out of bed the
:49:55. > :50:00.next morning, they stand of, and I remember the sensation that my legs
:50:00. > :50:07.were this long. But there was no pain. Let me try to explain what we
:50:07. > :50:13.have done. We have put into the socket of the hip joint a plastic
:50:13. > :50:16.socket or cock like there's -- cock like this and replaced the head of
:50:17. > :50:23.the thigh bone with this deal device. Charlie got the inspiration
:50:23. > :50:27.for his design from the world of engineering. -- Charnley. He opened
:50:27. > :50:35.up a workshop to develop them. of the components were made in his
:50:35. > :50:39.garden shed. He had a lay that he made at home. -- laved. According
:50:39. > :50:44.to his son, Wednesday night was called socket night, and on
:50:44. > :50:47.Wednesday he actually made the sockets at home in his shed.
:50:47. > :50:52.Charnley's next task was to reduce the high rates of infection from
:50:52. > :50:58.the operation. He collaborated with a company which made air filters
:50:58. > :51:03.for the brewing industry. This was put up on Tuesday and taken down in
:51:03. > :51:08.the evening. The air would come in under pressure through this filter,
:51:08. > :51:13.and it would be pushed downwards and outwards. It is called a
:51:13. > :51:19.laminar flow. And this really reduced the level of infection.
:51:20. > :51:23.did, it reduced infection from 10% down to 1%. Around 75,000 hip
:51:23. > :51:27.operations are carried out in England and Wales every year now,
:51:27. > :51:30.many of them here in the hospital where it was invented, but there
:51:30. > :51:36.are fears that an active surgery like this could be vulnerable when
:51:36. > :51:39.the cuts come. -- collectives surgery. In one or two areas, hip
:51:39. > :51:43.and knee replacement have been questioned as a procedure of
:51:43. > :51:47.limited value, and this is not only denying patients to a very
:51:47. > :51:52.successful procedure, a very cost- effective procedure, but eventually
:51:52. > :51:59.delaying surgery in these patients could actually create more
:51:59. > :52:02.financial demands in the future. is now 41 years since Julie's first
:52:02. > :52:07.contact with the Charnley hip. He must be very grateful to the man
:52:07. > :52:13.who did this. I certainly am, it has changed my life. I have had a
:52:13. > :52:18.life. Absolutely pioneering work there, but as we heard from the
:52:18. > :52:23.surgeon at the end, this is an expensive operation. Is this an
:52:23. > :52:27.area, Kate Green, where savings can be made? It is not an emergency
:52:27. > :52:32.operation. It is a very good value for money operation. It means, as
:52:32. > :52:36.the surgeon was saying, that if you treat people early and keep them a
:52:36. > :52:39.mobile and enable them to be active, you're not piling up other medical
:52:39. > :52:42.problems for them down the line. We know that older people,
:52:42. > :52:46.particularly, as long as they remain active, they are more
:52:47. > :52:50.healthy generally, and that keeps the costs down to the NHS. The pain
:52:50. > :52:54.that people are in while they are waiting for these operations is
:52:54. > :52:57.actually excruciating, and we should not be expecting anybody to
:52:57. > :53:00.be living with that level of pain when we have got the means to do
:53:00. > :53:04.something about it. I think these are real priority operations for
:53:04. > :53:08.the NHS, and I would say anybody who has a family member who has
:53:08. > :53:13.been through one would say exactly the same. There is evidence that
:53:13. > :53:16.the number of operations are going down. And because of the costs cuts
:53:16. > :53:22.that these hospitals have to make savings, this is where they are
:53:22. > :53:25.choosing to make them. I do not accept that. The issue in my
:53:25. > :53:31.constituency is the Orthopaedic Hospital at Halton which was
:53:31. > :53:36.recently closed because it was a five-year contract. �125 million
:53:36. > :53:40.over five years. The local PCT tried to maximise that demand. So a
:53:40. > :53:45.private company was given a contract for five years, 125
:53:45. > :53:49.million, but it fell short by �8 million. But private company was
:53:49. > :53:52.given �8 million for not doing anything, no operations. That �8
:53:52. > :53:56.million could be used to put money back into the NHS and spent on
:53:56. > :54:00.other things. When you look at the contracts that are drawn up...
:54:00. > :54:05.Whether it is right or wrong, it is happening and hospitals are
:54:05. > :54:10.choosing to delay these so-called collective operations to save money.
:54:10. > :54:14.They can save money by having contracts with providers that do
:54:14. > :54:18.the job on time. They do a fantastic job. It is done very
:54:18. > :54:20.efficiently and cost-effectively, but unless you have contracts that
:54:20. > :54:26.are cost-effective and professionally written, you will
:54:26. > :54:29.lose money. So where can savings be made? The Government itself is
:54:29. > :54:33.imposing a very substantial programme of savings on the NHS. At
:54:33. > :54:39.the same time it is asking it to go through massive organisational
:54:39. > :54:42.change. I think there are too many tensions in the NHS at the moment.
:54:42. > :54:47.�20 billion of efficiency savings, the reorganisations of our
:54:47. > :54:51.hospitals, PCTs being abolished, GPs taking over commissioning, the
:54:51. > :54:55.introduction of more competition. All of that is asking the NHS to
:54:55. > :54:59.swallow too much, too quickly, and if we were to take a more measured
:54:59. > :55:02.approach to continuing to improve and reform the health service, I
:55:02. > :55:05.think we would be able to maintain the level of operations and
:55:05. > :55:09.treatments that people need, make sure we have good quality local
:55:09. > :55:13.health services for local people, and get good value for money.
:55:13. > :55:20.Graham Evans, waiting times, there seems to be some argument amongst
:55:20. > :55:24.your own party about waiting times. In fact, Andrew Lansley wanted to
:55:24. > :55:28.end the 18 weak cap, but David Cameron has insisted that it be
:55:28. > :55:34.reinstated. Where are we at? Oh my understanding is that waiting times
:55:34. > :55:38.will stay at the current level and indeed be reduced. You think that
:55:38. > :55:41.is right, Andrew Lansley said it was not. It will, in terms of
:55:41. > :55:44.having hip replacements and knee replacements, it is vitally
:55:44. > :55:49.important that they are done as soon as possible. The technology is
:55:49. > :55:54.there to do them within 24 hours effectively. On the specific issue,
:55:55. > :56:00.there is no reason why it cannot be done as quickly as possible, and by
:56:00. > :56:09.others will stop Labour brought in that waiting-list cat. Do you think
:56:09. > :56:12.they should still be there? Before 1997, patients were waiting 24
:56:12. > :56:19.months even for a first appointment with a consultant, and that was
:56:19. > :56:22.plainly an acceptable. -- not acceptable. But patience and
:56:22. > :56:27.clinicians, at my own hospital in Trafford General, have told me how
:56:27. > :56:29.much they value the target. It is a way of managing the hospital
:56:29. > :56:33.effectively, and I am absolutely clear that we should be keeping
:56:33. > :56:37.them, and I'm glad the Prime Minister has had a change of heart.
:56:37. > :56:41.But they are at a three-year high at the moment. OK, well, clearly we
:56:41. > :56:45.need to get us down. But if I can just say, it is vitally important
:56:45. > :56:49.that we do make those changes now, because we have an ageing
:56:49. > :56:52.population. The cost of medication, the new technologies mean that we
:56:52. > :56:57.all live longer, we are all growing older, and we have to make these
:56:57. > :57:01.reforms to the NHS so that we are in the best position to be able to
:57:02. > :57:06.cope with the demand. I'm just interested, briefly, as to how we
:57:06. > :57:10.bring waiting times down and how you carry on doing all these
:57:10. > :57:14.surgeries with hospitals having to save money. As I alluded to before,
:57:14. > :57:18.if you give a contract to a private provider, you need to make sure
:57:18. > :57:22.that you do get it done cost- effectively. A lot of the contracts
:57:22. > :57:26.that were put under the previous Labour government were five-year
:57:26. > :57:31.contracts and they were given money for not performing the operations.
:57:31. > :57:35.It costs �250 million for operations that did not happen.