15/12/2011 Hearts and Minds

Look hello and welcome to the programme. Coming up this week, the

Health Minister on his new blueprint for the NHS. Can it

really be delivered? The Europe debate, why Northern Ireland still

divides on classics sectarian lines. And is that a legislative

instrument and your pocket, or are you just pleased to see me? Do we

want beauty and brains in our politicians?

Good evening. It would be fair to say the general response to this

week's Compton review of the NHS has been favourable, with even the

unions going for a broadly let's wait and see approach and that is

the nub of the debate. It is all very well to promise abrade new

world of home and individual centred care, but these are

scarcely new concepts, so why should we be confident that vision

will be developed -- will be delivered this time question might

the Health Minister is with me. We heard people were abusing the NHS,

people were smoking, drinking and eating themselves to illness. Isn't

that another way of saying that the whole service would be fine if it

was not for all the sick people? The Health Service has a budget and

the budget we has dashed the we have is of sufficient to meet the

needs of people. What I was pointing out yesterday was it was

not sufficient to meet abuse. Currently, GPs will tell you around

one third of their visits are a necessary. A&E Louis will tell you

about a third of visits are unnecessary and the ambulance

service says 20% of their calls should not happen and we have a

considerable number of people who end up being treated because they

have self-inflicted damage on themselves. Excessive eating,

excessive drinking, excessive smoking, or a combination. Is your

logic not to treat those people eventually? The logical extension

of the argument is to better educate people as to the

consequences they make in their lifestyle choices they make. Do

people want to have good health on into their older years? Or do they

want to be living with COPD, with diabetes, and perhaps Lou -- Louisa

Lim? Those are messages people are not as well aware of as they need

to be. Prevention is at the heart of the new strategy and yet the

report itself tells us there are 340,000 people over the age of 16,

who smoke. This is after decades of anti-smoking publicity and severe

tax hikes. So while you might like to say people are going to have to

look after themselves a bit better, it is really not going to happen,

is it? I do not accept it is not going to happen. We are down to 24%,

which is a reduction. 340,000 this people smoking, never mind obesity.

In countries like New Zealand it is down to 13 or 14%, so there is more

work that can be done. What scares me is in the 11-16-year-old, around

10% are currently smoking so we are in it -- bringing in a ban on

vending machines giving up cigarettes because a lot of people

acquire facilities -- a quiet cigarette set those facilities.

There is more that can be done and sometimes we will get challenged

for doing that and say we are a nanny state, but we do need to make

a change. One in two people who smoke die as a consequence. John

Compton is talking about a fat task -- fat tax on crisps. Denmark did

that. Is it something you would back? I am not sure we have the

legislative ability to do that. It is something we should investigate

further. We are looking at a minimum price for alcohol.

Ultimately I think that government across the UK will be challenged on

all these issues because if people are going to continue to eat food

which is a really bad for them, getting to the point where they are

obese, and those are consequences that we have diabetes, stroke and

heart attack on a regular basis. The danger is you end up penalising

the people who can least afford to be penalised, the people who were

less well-off in society? It may incentivised people to eat foods

perhaps that are still low-cost but are much healthier for them. We

would encourage people to going back to some of the more

traditional ways of life, where a good pot of stew or a good pot of

soup was made in the household which is very nutritious at low

cost. You are dreaming. Well, some people may say we are dreaming but

we need to challenge and we can't continue to go on as we are

currently doing and expect that the health service will sustain it and

indeed our bodies will sustain it because they don't. It is terribly

long term, isn't it? You are talking about this review, having a

new system in five years, to bring our figures down in terms of

obesity and abuse of alcohol and abuse of smoking, that is maybe a

couple of generations, isn't it? Those are long-term things but we

need to look at long-term measures on short-term measures, so what is

proposed in the review is short term, we have relaunched the scheme

for connected health, where we will monitor people in their own homes

and that will reach about 20,000 people over the next six years. We

will get significant results out of that. We will reduce mortality,

morbidity and hospital appointments as a result. Money is at the centre

of all office. The health service budget is something like �4.5

billion and you are talking about moving �83 million from hospitals

to community care and getting another �70 million from the

Assembly to pay for retraining, which is again a central plank of

this whole project. Those are tiny drops in the ocean, aren't they?

Well, �83 million is not a tiny drop in the ocean. It is out of

four under -- out of 4,500 million. I am sure the hospitals will think

it is a significant sum. We are going to challenge the care that is

provided. We believe that more care can be provided at the primary

sector, at the community sector. We can make better use of multi-

disciplinary teams and ensure we get better outcomes avoiding

hospital admissions. But in their response to the draft budget

earlier this year the Health and Social Care Board said it was

already worried about money restricting access to community-

care, reducing the grants available to the voluntary sector and

generally reducing service levels, so that is before you even start to

reform anything? Well, that is one of the issues we will have to look

at. We have the budget that we have. Health came out of it not as badly

as some departments in terms of the amount that came to Northern

Ireland. Certainly we would like more money. Our budget is growing

by 8% over four years. We require 4% each year-end inflation on top

of that. If we don't do something then a lot of the cataclysmic

things that were going to be announced last year and suggested

last year would happen but if we can take accidents we can ensure we

can get good outcomes on that. Given the financial restrictions

this is the time to be thinking about replanning and reforming, in

a way you are caught between the devil and the deep blue sea, aren't

you? We cannot afford not to do it. The health service is an

unsustainable model, where we would be continuing to demand more and

more money, to actually deliver a second Test -- a second-rate health

care. We need to deliver better health care was better outcomes in

a particular envelope. It is achievable and it is what we are

going to do and this report will help us to do it. To those people

who say one of the major reasons for putting care into the home is

so you can rely more on unpaid family support, what do you say to

that? We will be putting packages together to allow families to have

the right support for their loved one to stay at home, but families

do play a crucial role in office. They have done for years. I trust

that families will still want to support their elderly relatives.

you think it is realistic? It sounds like going back to the days

of the goods part of Irish stew, society is different now, you can't

rely on the family network. can't rely on the state to do

everything for us. People do have responsibilities. We all have

responsibilities to our own families and we need to show that

but at the same time we cannot leave families about their hanging.

We have to provide them with support, put the right care

packages in place and what this document is proposing is giving

people more control over their care packages. They have ownership. The

families and carers get involved in the planning process. This is not

something that we are wanting to offload work on to families and

carers. It is bringing families and carers into the system. Do you

think you need to stay at the health helm general elections and

Assembly elections, not withstanding to see is this true

for the next five years? No, I don't, I have started the course of

work and with the support of my family I would do it. If someone

else was put into the position they would carry on the work I have

started. Minister, thank you very It's not only the Coalition that's

split over Europe, Stormont is too! With wearying predictability, local

politicians are divided over David Cameron's performance at the

weekend. In a Stormont debate on Monday the unionists came together

to congratulate him on his bulldog stance, while the SDLP described

his use of the veto as regrettable and condemned him for not

consulting them before he went to Brussels. Then on Tuesday, the DUP

tabled a House of Commons motion commending the Prime Minister for

his bullish, pro-British defence of the nation's interests, a motion

which, predictably, the SDLP opposed. You see that's the great

thing about Ulster politics, you can put it on a plane and take it

anywhere! Where you take your broken arm in future is less

certain now that there's a fifty- fifty chance that your local A&E

department will have been closed! John Compton's long awaited review

of the Health Service which came out on Tuesday, indicated that the

number of hospitals providing A&E services in the Province is likely

to be halved from ten to five. In Belfast it's likely to be at the

Royal, and it looks as if both Daisy Hill and the Causeway are in

for the chop, although understandably that's not an

expression which hospitals like to use. This reduction in emergency

provision is intended, among other things, to streamline A&E services

and cut waiting times. Presumably in much the same way that closing

two lanes of a motorway in the rush hour eases congestion! The only

plausible explanation for this wacko logic is that John must have

employed consultants. In an attempt to justify the closures the report

pointed out that elsewhere in the UK, a population the size of

Northern Ireland would be served by just four hospitals. It didn't

point out, of course, that elsewhere in the UK a population

the size of Northern Ireland would be served by just one Health Board!

It's the familiar story of a ballooning bureaucracy and slashed

front-end services. Slashing car insurance here is a matter of some

urgency according to a report out on Wednesday by the Office of Fair

Trading. They report that Northern Ireland motorists are considerably

disadvantaged, which is OFT speak for "being ripped off"! It appears

that we are paying on average 11% more for insurance than the rest of

the UK. In fact, in rural areas some motorists are paying up to 70%

more than their counterparts in Great Britain. The cite a number of

factors for the disparity in premiums, but apparently one of our

problems is that we adopt the same approach to car insurance that have

The thoughts of Lindsay Allen. Beauty is of course in the eye of

the beholder, but you might be wanting to call well-known high-

street spectacle cellar for the veteran MP, who has claimed that

the current Parliament is the most beautiful in years. Julia Paul puts

that theory to the test. A sow, you are in London, you want to

experience a bit of the high life. But on your glad rags, rub

shoulders with the beautiful people. Apparently this is now the place to

It is the most beautiful of parliaments in my 25 years here.

For me, if he sets the bar that low, I am quite happy! There is this PUP

view that politics is show business but ugly people. Politicians insist

that politics is just about politics, nonsense.

Well on a day like this it seems that the star of Westminster is

this building itself. There is no doubt that the make-up of the House

of Commons has changed. At 76, with six terms of office under his belt,

Paul Flynn is what we call a veteran MP. The number of MPs who

were staggeringly beautiful, not just good-looking, these are women

and men too, mostly they are Burnett goddesses on our side and

blonde goddesses on the conservative side. If you look and

see these women, it is the most beautiful of Parliament in my 25

years. No one seems to have noticed. He has written a book for

backbenchers, how to be an MP. wanted everyone to know about this

wonderful, amazing, staggering place and I wanted to pass on that

enthusiasm. It is a very peculiar job to have, to be an MP, and

they're all kinds of marvellous opportunities. You are mixing with

some of the brightest and some of the strangest people of my

generation, any generation, and it is an incredible place to be.

does it feel to be a part of the most beautiful Parliament? Well, I

did not have the experience of sitting through the previous

parliament so I can't really comment. I have to say that for me,

if he sets the bar that low, I am quite a bit. Beauty is in the eye

of the beholder and all of these things are subjective. It is not

about how the place looks, it is about what it does and the

substance of the matter. Looks do matter because they are part of the

personality, the presentation of a politician and that helps to get

the public involved, gets them to watch the television, gets them

interested in politics. Is it more about delivery, presentation,

authority, but it is about good looks? It is to do with general cop

on and the ability to engage to the review of the Listener. Does

classic good looks matter in that? I don't think it does but someone

like Zac Goldsmith, a Tory MP, he is gorgeous Klimesova ladies say

and they are more likely to listen to what we're saying. Something as

serious as politics should not be about looks, surely, it should be

Robin Cook said that he was too ugly to be the Prime Minister, and

he was right. People vote before the glamour people the one that

they like. Tony Blair, who was a much more superficial character,

was acceptable, he was a fine actor. We've got problems now with the way

that the present Leader of the Labour Party looks weird. Hague is

bald and he was unelectable as a Prime Minister. Now, we may well

regret this, but this is the reality of modern life.

everyone agrees. I'm reminded of a statue of Oliver Cromwell, he said,

"Paint me warts-and-all" and he was a man of substance - not very

attractive. It is what Parliament does that makes it great, not how

it looks. Parliament should be a reflection of the people. You see

people with disabilities, you see people with different nationalities.

If people is going to work, it needs to reflect all of the people

and it needs to feel like you wouldn't feel out of place if you

were there. Some claim that attractive people are inevitably

more successful. If we have this Parliament which is full of such

attractive MPs, do you think it will be a more effective

Parliament? I think there's a huge amount of talent here. Generally,

the people who are good-looking are comfortable in their skin and they

don't fret about the way they look and their appearance and shape. So,

they concentrate on other things. There is an advantage in saying

that beautiful people often are the most effective as far as

parliamentarians are concerned. Politicians are fully aware of this.

This is the reason they spend so much money on image and on general

presentation that they make to the public. They are sales people and

sales people will always bare the looks and the sound in mind as much

as the message -- bear the looks and the sound in mind as much as

the message. Sorry, just glaming up! I am hoping I will be mistaken

for an MP! -- glammin up! Julia Paul on the brains and beauty

at Westminster. Whether you think David Cameron's tactics in Europe

last week were catastrophic or masterful, Europhiles and

Eurosceptics can agree that exercising the veto on reforms for

the Eurozone has left Britain more isolated than at any time since it

joined the Common Market. In this tiny corner of Europe, reaction was

predictable, with Nationalists horrified, and Unionists jumping

for joy. But what are the repercussions for us in Northern

Ireland? Already, Angela Merkel is talking about Britain being an

important partner in Europe, so it has been a storm in a teacup?

warn people were exaggerating their jubilation and they were

exaggerating the indignation on the other. An actual deal wasn't

concluded in Brussels. Negotiations have to continue. That is the

mistake David Cameron made. He took himself out of detailed

negotiations that still have to take place. The package, I don't

believe, is strong enough to solve the problems in the eurozone. I

think there are other countries that feel that. They would be

possibleallys for David Cameron in the continuing negotiations. In

trying to get a strengthened outcome for the eurozone, he could

try to get the safeguards he is talking about for the sterling zone.

I don't agree with him. He has some of his priorities wrong. He is

obsessing on the interests of the city rather than the wider sterling

zone economy. The fact is, there are negotiations taking place.

There's a lot of politics between now and March. He took himself out

of it. Isn't it the problem, Nigel Dodds, Britain doesn't have a seat

for these negotiations and that is something Margaret Thatcher never

allowed to happen? I think something very important happened.

That was the first time a British Prime Minister was prepared to

stand up to some of the bullying and so on and the pressure that

comes on from diplomats and all the rest of it. I think in the

specifics of this particular instance, whatever about the

implications of this in the long run, it is very significant in the

long run. In this case, the negotiations may continue and all

the dire predictions about being isolated and if the negotiations

are going to go on, what was that all about? But the fact is, what

are the negotiations going to be about? David Cameron said they are

not going to be about wearing this treaty into the EU institutional

arrangements. That is fairly important. So I think that the

clear reaction across the country is whether you are a Labour,

Conservative, Lib Dem, or neither of any of those, the clear reaction

is one of overwhelming support. At long last a British Prime Minister

has stood up to Europe and said, "Enough is enough." It was over

nothing of any importance? At this point? I don't agree. I think the

importance of this is that the eurozone crisis is as Mark has said

absolutely critical. The leaders of the European countries were intent

on institutional and treaty change for the future rather than getting

to grips with what needs to be done to rescue the euro. People have

said very clearly that they haven't gone far enough. Instead, they were

back to their usual routine of trying to institutionalise changes

to the Treaties. That was the wrong approach. David Cameron was right

to say no, the UK will not agree to that. It was very clear that there

is support for that. We certainly support him as was demonstrated in

the House of Commons the other day when our motion was passed by a

clear majority. The problem with what David Cameron did at Brussels

was he turned turtle on what he said was his priority. He and

George Osborne have been saying for months that there needed to be big

firepower to protect the eurozone. When the eurozone was finally

making moves to try to provide the cover that is needed, they moved in

to say no, you can't actual I will have that, you can't do that within

the existing treaty, even though he had previously said the answer

could be found within the existing treaty. He then said there is no

new treaty and said what you have to do is create a new agreement, a

new framework outside of all that. The problem with that is, if you

have a completely novel unconventional collection of 26

countries and David Cameron saying, "You can't meet inside European

Commission buildings" - he is like that judge on Strictly Come Dancing

- "That is an illegal lift!" He was saying, "You can't use EU lawyers,

EU translaters in these negotiations." The markets are

going to say if this isn't using the EU institutions, what certainty

is there, what reliability is there in this? He has made it much harder

to get an outcome that solves the eurozone problem and then also

helps to solve the problem that is hurting the sterling zone as well.

The more difficulty that the eurozone is in, the more difficulty

the sterling zone is in. That affects jobs, services, families

and our budget. As Northern Ireland is the only place that has a land

border with the eurozone, it is of major significance to us, isn't it?

Yes. What lies fundamentally at the root of this debate is this: The

people of the United Kingdom and a lot of people on both sides of the

House of Commons, even though some of them may not see it openly,

believe now that the time has come for a fundamental realignment of

the relationship between the United Kingdom and the European Union.

That is what lies at the heart of this. People have said, "We are fed

up with the issue of continual diktat from Brussels" and they want

the sovereignty of the United Kingdom returned. The little

Europeanists who want to concentrate the attention on

creating a federal Europe against the wishes of the United Kingdom

and people from the rest of Europe, even the Germans are saying that

they are not happy... Is this not central to this whole thing, that

European political unity is, some would say, an inevitable result of

economic unity and that therefore it is all pushing towards that

ultimate goal? You have the bizarre situation where it is people like

David Cameron and George Osborne who have been calling for tighter

fiscal union within the eurozone. Yes. Now, the fact is, we have a

situation where there is a serious economic problem. There's plenty of

time for all the political arguments about between Euro-

sceptics and euro enthusiasts. There is a serious situation that

is affecting every economy in Europe now and the wider world. It

needs to be addressed and addressed urgently and effectively. With

regards... Get on with it then, Mark! There won't be a new treaty

at 27, even though he told the House of Commons he wanted a treaty

at 27. He has said you have to create some new inter-governmental

agreement at 26. That in itself is potentially... All of the problem

could be solved if the Germans and the French could agree what

everybody says needs to be done - the Americans and everybody else -

you have to have an underwriting of the European debt by Europe as a

whole. What does that mean? The Germans need to underwrite it.

Until they do that, you don't need all this institutional nonsense.

That is what needs to happen. is why Merkel will not be able to

sell this deal - she will have to say this isn't an EU deal. This is

a strange deal at 26. It is an EU deal but it is not an EU deal. It

is not very convincing. It will be open to lots of legal arguments.

David Cameron has said he would be in to blow the whistle on anything

that appeared to be... All of this... All of this technical

jargon, what matters is this: If the Germans and French agreed to

underwrite the debt through the European Central Bank, or through

eurobonds, the crisis would be over. That can't happen because the

German people won't why it? That's the fact. The question is, how does

the eurozone continue to exist? If they want take the actions, those

who created the euro, to underwrite it, that is a matter for them. It

will impact on us. That is the unfortunate part about this

politically-driven issue. You are right, Mark, to say that the euro

was a political project. That is why I'm glad our party said it was

wrong to join the euro. Where would we be now if we had followed the

advice of the Labour Party? David Cameron could turn out to be

something... He was right in the decision that he took. If it all

collapses, David Cameron will be seen to have taken the right

decision, won't he? People might well say that. The problem is, he

has created the situation where it is more likely to collapse. He has

made it more difficult to make sure there is a strong answer to the

eurozone crisis and something credible that can be shown tomorrow.

A very quick question: A junior minister has said the Republic

shouldn't be worried about reverting to clinging on to the

UK's coat tails when it comes to Europe. Is that right? I think the

Republic have to make sure they work well with all partners. The UK

has a very good partner for the Republic. The Republic is a good

ally. The problem is, David Cameron has created a situation where he

hasn't got the benefit of that good practical access with the Republic.

All right. We must leave it there. Thank you both very much.

And that's where we must leave it, not just for this week but for this

year, as Hearts and Minds joins the politicians, not literally of

course, for the Christmas break. I wish you all a happy and peaceful

holiday season, and we look forward to seeing you all in 2012. Where

are the years going? Goodbye. did you get your licence? Some

carry-on this week. Republicans got excited when they saw the headlines.

It was only David Cameron in Europe. Britain is still going to pay for

us. I think we should reduce corporation tax. It will stimulate

growth, attract investment. David Attenborough got in trouble for

faking some of Frozen Planet. That is typical of the BBC. Remember,