12/06/2011 The Politics Show North West

And in the North West, the Archbishop of Canterbury described

it as stale, but can the Big Society breathe new life into our

communities? And case notes from history, how

treatment pioneered in the the North West has helped shape the NHS

Apology for the loss of subtitles for 2221 seconds

Welcome to the Politics Show in the north-west, I am Annabel Tiffin.

Coming up, the Big Society, is it the biggest thing since sliced

bread or simply a stale and crusty idea? I have a genuine worry that

the more disadvantaged communities will not have a combination of

knowledge, the capacity or the weather thought, if you like, and

the volunteer time. And medical history, how our region

helped pioneer the treatment The big guns have come out in the

war of words over the Big Society this week. Lining up on opposite

sides, the Prime Minister and the Archbishop of Canterbury. David

Cameron says his policies will empower local people, but the

archbishop described the Big Society as they will, so which is

it? Elaine Bentley reports. -- From cities to rural villages, from

the affluent to the poor, it includes us all, but is the Big

Society power to the people or a political pipe dream? That great

project in your community, go and lead it. That waste in government,

go and find it. The school in your neighbourhood, go and demanded. The

neighbourhood group, joined up. The business you dreamt of, start up.

When we say we are all in this together, it is not a cry for help,

it is a call to arms. This week PSNI House of Lords have been

debating the backbone of the Big Society, the House of Lords. --

peers in the House of Lords. Outside of the debating chamber,

will this work? Where better to find out than the 10 Avenue in

Preston? We have removed everything the council provides, rubbish

collection bat they are taking the bins, not our rubbish. Residents

have been part and a unique social experiment. Or council services

were removed and the community took charge. -- Paul. We developed our

own bureaucracies. We spent hours discussing pain from Mobil and how

to get rid of abandoned cars. -- paint removal. Councils, whether

you like them or not, they are a professional organisation, and they

can just pull the procedure off a wall and know what they're doing

straight away. We had to research everything. It took us ages to sort

Regeneration, social housing and planning applications are also

getting a makeover. Regional planning will be swept away, and

communities will have the power to grant planning permission if a

local majority are in favour. principle, we think it is a good

idea, it is a good Bill because it brings local authorities and

communities together. In particular, first of all, I think the idea is

that local-authority should work with local communities. The first

part, I think, is around the limitations of the Bill and the

fact that it is complex. The second concern that we have is around the

amount of resources that are going to be available to local

communities, and we have a genuine worry, perhaps for more

disadvantaged communities, they will not have a combination of the

knowledge, the capacity or the wherewithal and the volunteer time.

The Big Society is, for the most part, a vision, but some are

already living the dream. The shocking goals with Anders pub and

Salford were threatened with closure until locals left him. --

this shop in Gawsworth and this pub in Salford were threatened with

closure until locals stepped in. needed to have a proper business

plan, get to grips with profit and loss, and it was a time-consuming

process. But having said that, we were successful, and I would

encourage anybody else he was thinking of setting up a community

shop. I would say, go for it. not so sure about this idea of the

Big Society. We feel like a very small society, a local community,

and it is something that we want, something that is very peculiar to

us. I cannot think you could take our model and immediately apply it

somewhere else. -- I do not think. So far we have only scratched the

surface of the big community, but there needs to be a vast array of

legislation. You worry that something with such a broad scope

could end up having very wide and unintended consequences, and so

therefore you do worry that such a broad belt might actually lose some

focus for may have some effects that are not foreseen at the moment.

-- Bill. There is still a long way to go before the Localism Bill

becomes law, but there remains big questions over the Big Society.

I am joined in the studio by two of the region's envy Conservative MP

for Weaver veil, and Kate Grant is the Labour MP for Stretford and

Urmston. We should talk straightaway about what the

Archbishop of Canterbury said this week. I happen to disagree with

what he said, but he is perfectly entitled to... He said the Big

Society was stale. He is entitled to his opinion, but the Big Society

has been around for one time. It has been put at the core of

political debate. He is entitled to his opinion, but I do not agree

with it. You do not think he was reflecting what the public think?

The issue I have that people like the Archbishop is, he will put

something out into the media, and where are his colleagues to sit in

studios like this and debate it? He has thrown a rock into the pool

that we are all left talking about. I would rather be talking with

representatives from the church and people like himself. Are you glad

he brought this to the top of the agenda and people are talking about

it? I think people have been at best puzzled about what the Big

Society is meant to be. It is not new. People have been volunteering

and doing work in their communities for decades. What I am worried

about, and perhaps what the Archbishop of Canterbury is getting

out, is that people are being potentially expected to provide a

lot more services in their community to replace the loss of

public services. And at the same time, they are not really getting

all the support they need to make sure they can make those community

organisations work in the way that they want. Gone, Graham. That is

fair comment. The fact is that too many communities have relied on a

local authority or government to provide those services, and it is a

balance. When we are short on cash, when councils are short on cash,

are there areas were the local people could take control? There

are community centres and libraries where local people who know the

area better, known to local needs, could do it, rather than always

relying on the local authority. I accept there are some things which

will always be provided by the local authority. This is an

opportunity for people to take control of their street. As you

said, it is a way of saving money. Well, we cannot afford... The

nation cannot afford to provide all of the things that we are currently

providing false start is it right to expect local people to pick up

where local authorities were once I think it is right depending on

the individual situation for that community. I notice John Knight was

speaking quite eloquently there. I used to cross swords with him when

he was at the planning authority at Macclesfield Borough Council, where

I served for 10 years, and I fundamentally disagreed with the

way that the top down Dick that came from central government,

telling local councillors what they could not do in their communities.

I suppose the concern is when everybody is equipped to take on

his role. I do not think people necessarily have the time. They may

not have the capacity. People move on. If you need to be there for the

long term, you may lose the people who were energetic in getting

particular activities started up. I do not think you can just say that

libraries or community centres can be left to communities. Think are

the people who did have the time in the past, often married women,

often rather older women perhaps. Many of those women have family

commitments, they are looking at the grandchildren to help their

daughter work. That they are working themselves. I do not think

we are in a position where people are able to sustain community

services, and we need to have the council's underwriting the minimum

standards that people and especially the mart bonnet of

people need to be able to access. - - the most vulnerable people. They

are not giving them the money, and Graham is right. Some of this is

because local councils have less money to spend. We know from the

chief executive of the voluntary organisations body that the funding

for the voluntary sector is being substantially squeeze over the next

two or three years. He has taught us something like �3 billion coming

out of the budget for community and voluntary organisations. We are

asking them to take on more but to it with less at a time when people

have many other pressures are now lives. We want to support community

engagement, and there are great things going on in my constituency,

but it is not a substitute for public services. I was going to say,

Graham Evans, recently MPs have not exactly given it their seal of

approval. A committee said it was not being supportable implemented

across the board, so why is it not being embraced, the Localism Bill

in particular? I believe it is being embraced, but it varies from

one community to another. For example, in my constituency, I have

local residents who have taken over a community centre and to a

fantastic job for their estates. But the next estate as a community

centre run by the local authority, and it is quite interesting to see

the differences. Those people who take ownership for their community

operate in a slightly different way, and the local authority community

centre operates in a different way. I see both sides of the argument.

This is very much the beginning. What we are saying to the nation is

that we cannot carry on the way we have been going on, spending money

on local services. Wherever possible, if we can allow the local

community to take ownership, we should welcome that. Thank you both

very much. The north-west has been at the forefront of many moments of

medical history, the first test- tube baby, revolutionary cancer

treatments and even the birth of the NHS. Today we start a series of

reports looking at how the region has been instrumental in shaping

the health treatment that we received today. Gill Dummigan

starts by looking at the pioneering work on hip replacement carried out

Will it turn round and go back, Mrs Percival, please? A 1962, is

certain courts John Charnley went on television to show his

remarkable new invention. -- A surgeon called John Charnley.

patients were severely disabled with arthritis, and now they have

artificial hip joints. Julie Bickerton was a young woman. In the

mid-60s, she was 23, just starting married life, then one night her

world changed. We had been dancing in the evening, went to bed about

midnight, woke up at about 3 o'clock in absolutely excruciating

pain. I could not move. Julie had rheumatoid arthritis. In a

wheelchair, she went to see Professor Charlie, who agreed to

replace both of her hips. -- Charlie. You get out of bed the

next morning, they stand of, and I remember the sensation that my legs

were this long. But there was no pain. Let me try to explain what we

have done. We have put into the socket of the hip joint a plastic

socket or cock like there's -- cock like this and replaced the head of

the thigh bone with this deal device. Charlie got the inspiration

for his design from the world of engineering. -- Charnley. He opened

up a workshop to develop them. of the components were made in his

garden shed. He had a lay that he made at home. -- laved. According

to his son, Wednesday night was called socket night, and on

Wednesday he actually made the sockets at home in his shed.

Charnley's next task was to reduce the high rates of infection from

the operation. He collaborated with a company which made air filters

for the brewing industry. This was put up on Tuesday and taken down in

the evening. The air would come in under pressure through this filter,

and it would be pushed downwards and outwards. It is called a

laminar flow. And this really reduced the level of infection.

did, it reduced infection from 10% down to 1%. Around 75,000 hip

operations are carried out in England and Wales every year now,

many of them here in the hospital where it was invented, but there

are fears that an active surgery like this could be vulnerable when

the cuts come. -- collectives surgery. In one or two areas, hip

and knee replacement have been questioned as a procedure of

limited value, and this is not only denying patients to a very

successful procedure, a very cost- effective procedure, but eventually

delaying surgery in these patients could actually create more

financial demands in the future. is now 41 years since Julie's first

contact with the Charnley hip. He must be very grateful to the man

who did this. I certainly am, it has changed my life. I have had a

life. Absolutely pioneering work there, but as we heard from the

surgeon at the end, this is an expensive operation. Is this an

area, Kate Green, where savings can be made? It is not an emergency

operation. It is a very good value for money operation. It means, as

the surgeon was saying, that if you treat people early and keep them a

mobile and enable them to be active, you're not piling up other medical

problems for them down the line. We know that older people,

particularly, as long as they remain active, they are more

healthy generally, and that keeps the costs down to the NHS. The pain

that people are in while they are waiting for these operations is

actually excruciating, and we should not be expecting anybody to

be living with that level of pain when we have got the means to do

something about it. I think these are real priority operations for

the NHS, and I would say anybody who has a family member who has

been through one would say exactly the same. There is evidence that

the number of operations are going down. And because of the costs cuts

that these hospitals have to make savings, this is where they are

choosing to make them. I do not accept that. The issue in my

constituency is the Orthopaedic Hospital at Halton which was

recently closed because it was a five-year contract. �125 million

over five years. The local PCT tried to maximise that demand. So a

private company was given a contract for five years, 125

million, but it fell short by �8 million. But private company was

given �8 million for not doing anything, no operations. That �8

million could be used to put money back into the NHS and spent on

other things. When you look at the contracts that are drawn up...

Whether it is right or wrong, it is happening and hospitals are

choosing to delay these so-called collective operations to save money.

They can save money by having contracts with providers that do

the job on time. They do a fantastic job. It is done very

efficiently and cost-effectively, but unless you have contracts that

are cost-effective and professionally written, you will

lose money. So where can savings be made? The Government itself is

imposing a very substantial programme of savings on the NHS. At

the same time it is asking it to go through massive organisational

change. I think there are too many tensions in the NHS at the moment.

�20 billion of efficiency savings, the reorganisations of our

hospitals, PCTs being abolished, GPs taking over commissioning, the

introduction of more competition. All of that is asking the NHS to

swallow too much, too quickly, and if we were to take a more measured

approach to continuing to improve and reform the health service, I

think we would be able to maintain the level of operations and

treatments that people need, make sure we have good quality local

health services for local people, and get good value for money.

Graham Evans, waiting times, there seems to be some argument amongst

your own party about waiting times. In fact, Andrew Lansley wanted to

end the 18 weak cap, but David Cameron has insisted that it be

reinstated. Where are we at? Oh my understanding is that waiting times

will stay at the current level and indeed be reduced. You think that

is right, Andrew Lansley said it was not. It will, in terms of

having hip replacements and knee replacements, it is vitally

important that they are done as soon as possible. The technology is

there to do them within 24 hours effectively. On the specific issue,

there is no reason why it cannot be done as quickly as possible, and by

others will stop Labour brought in that waiting-list cat. Do you think

they should still be there? Before 1997, patients were waiting 24

months even for a first appointment with a consultant, and that was

plainly an acceptable. -- not acceptable. But patience and

clinicians, at my own hospital in Trafford General, have told me how

much they value the target. It is a way of managing the hospital

effectively, and I am absolutely clear that we should be keeping

them, and I'm glad the Prime Minister has had a change of heart.

But they are at a three-year high at the moment. OK, well, clearly we

need to get us down. But if I can just say, it is vitally important

that we do make those changes now, because we have an ageing

population. The cost of medication, the new technologies mean that we

all live longer, we are all growing older, and we have to make these

reforms to the NHS so that we are in the best position to be able to

cope with the demand. I'm just interested, briefly, as to how we

bring waiting times down and how you carry on doing all these

surgeries with hospitals having to save money. As I alluded to before,

if you give a contract to a private provider, you need to make sure

that you do get it done cost- effectively. A lot of the contracts

that were put under the previous Labour government were five-year

contracts and they were given money for not performing the operations.

It costs �250 million for operations that did not happen.