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Prime Minister Tony Blair
Prime Minister Tony Blair
BBC BREAKFAST WITH FROST INTERVIEW: PRIME MINISTER TONY BLAIR APRIL 21st, 2002

Please note "BBC Breakfast with Frost" must be credited if any part of this transcript is used

DAVID FROST: Now last Wednesday Gordon Brown delivered a budget which was widely perceived as not only a turning point for the government but something of a gamble for New Labour. It all centred on health and the morning after budget day. The Chancellor and the PM went about the task of winning over voters. The two crucial issues, can voters be persuaded that they should fork out more for better services, and just as important, can Gordon Brown and Tony Blair overcome the scepticism of the Tories and many commentators about how effective the extra cash will be. The Chancellor may deliver millions to hospitals and to GPs up and down the country but how soon will we see a measurable improvement in health care? We welcome the Prime Minister now to talk about that and other topics. Top of the morning.

TONY BLAIR: Good morning David.

DAVID FROST: Since - I was going to go straight into the budget and later on talk about Israel but Chris was talking very persuasively there, is there anything we can do about the situation in Israel?

TONY BLAIR: I think what we've got to do is to make every effort with our other European partners, with the United States, with the Arab world, to relaunch a political process, because that in the end is the only thing that is going to work in this situation.

DAVID FROST: And do you think the actions of Mr Sharon in his alleged war on terrorism have made the international war on terrorism that much more difficult?

TONY BLAIR: Well I think what they have done is obviously drive a big wedge between sections of the Arab world and the West. However, I think most people accept that provided we can get a proper political process relaunched in the Middle East, and that is the vital pre-requisite of peace there. We're never going to manage the situation through military or security measures alone, there has to be a political process and I think if one does come together then I think those divisions, that have obviously been apparent in the last few months, can be healed.

DAVID FROST: I was a bit surprised by that description of Mr Sharon as, quote, a man of peace, by the president. I never, I never thought of that phrase, had you?

TONY BLAIR: Well I think, the thing we should never forget in this situation, we have made it clear our view of Israel factions and the need for them to withdraw, we support very strongly the UN mission that will go in there in order to find out what exactly what has happened in Jenin, because everyone has been shocked and appalled by the pictures that have come back from there. But we shouldn't forget, either, the problems that Israel faces when its citizens are being targeted by terrorist suicide bomb attacks and are also dying in very large number. So there is bloodshed being shed on both sides, innocent people are dying and the reason that is happening is because if there isn't a political process the extremes move into the vacuum that's created and as we've learnt from our own political process in Northern Ireland, if you have a political process, yes there are huge difficulties and obstacles along the way, but at least people have something to aim for whereas if there's no political process, if there's no basis for discussion and negotiation and resolution of difficulties through politics, then of course the people of violence move into the vacuum that's created.

DAVID FROST: Well now let's turn to domestic matters which have been dominating the agenda this week, Prime Minister. The interesting response in all these opinion polls, as you've probably seen, 76 per cent approval, including 54 per cent of Tory voters, in one of the polls. Forty-seven per cent of people said they'd be worse off but 72 per cent of those approve of the overall package. In fact the high figure's 68 per cent here, 58 per cent approve the Budget basically, but only 20 per cent - and this is the ticking time bomb I suppose - only 20 per cent think what you're doing will work. And the Sunday Times has a poll that says 58 per cent of people say that what was done ran counter to the party's manifesto pledges. And, again, they say only 18 per cent say there'll be an improvement. So some of those figures are higher than you would have thought and others not. Just, just starting with the thing about misled, I mean one debate is obviously income tax, well, this is, this is the same thing, this is a tax on income, income tax.

TONY BLAIR: Well of course -

DAVID FROST: There's only a - there's only a narrow, you know, it's one of those in the foreseeable future type get outs, isn't it?

TONY BLAIR: Well I understand that's what people say, however, of course, it isn't the same as the standard or top rate of income tax, which is where we made our commitments, because it doesn't apply to pensioners, it doesn't apply to savings. But if we're talking about promises, it's worth just sitting back for a moment and looking at the -

DAVID FROST: But it is a tax on income though.

TONY BLAIR: Well all things come out of people's income but the election campaign, as you remember, people were constantly pressing us to give assurances on national insurance and we said look we're not writing the budget now.

DAVID FROST: Well now that's an important point, Prime Minister, because a lot of people say, you said that you, when, when did you realise the only way you could sort out the NHS was with vast new taxes and so on. And you said in one thing it was when you got the Wanless Report Part I last November or whatever, but lots of other peoples like the -

TONY BLAIR: And of course the budget figures because we don't -

DAVID FROST: Yes, true. But lots of people said that once there was the review of July 2000 the IFS and every one else was saying they can only do this by raising taxes and in fact the IFS went back to our conversation back in January 2000 when you raised the thing of equalling the European Union's thing, and said after that we could see they could only do it by raising taxes. So what they are saying is you must have really known, in your heart of hearts, at the time of the last election, that you were going to raise taxes.

TONY BLAIR: What we knew was obviously the health service would need more money, what we couldn't be sure of are exactly what the economic circumstances would be, or the precise amount of money - which is why we commissioned Mr Wanless to do his report and it was commissioned before the election, completed afterwards. But I want to make a slightly bigger point if I might. You know when people talk about the promises that we've made, five years ago I came to power and after I came to office I think we inherited a difficult economic situation, we sorted that economic situation, then we got the investment into our public services. But when I look at the promises that were made, I promised that we would sort out the economy - we have. We've got the lowest inflation, the lowest mortgage rates for decades. I promised that we would reduce unemployment - when we came to office there were 350,000 young people long term unemployed, there are now four and a half thousand. I said education would be the number one priority - we got the money in, we had the best primary school results we've ever had in this country, now we're sorting our secondary schools. And we promised - and I repeated that promise here in this programme some years ago - that we would get extra investment and reform into the National Health Service. We've done that. And over these next few years -

DAVID FROST: On the other hand -

TONY BLAIR: - to get the changes in that we require -

DAVID FROST: On the other hand people say they never said "and the only way we're going to improve the health service is by raising taxes."

TONY BLAIR: But of course -

DAVID FROST: Never said that.

TONY BLAIR: But that is not the only way that we're going to improve the health service. When we, in July 2000, we came up with the National Health Service plan, that coincided with the first significant sums of money that we got into the National Health Service and those sums of money actually have yielded benefits over the past 18 months and, although this isn't often the perception in parts of the media, actually if you talk to people within the health service today - and I think the BBC's National Health Service day showed this very, very clearly - they will say to you "yes there are real signs of improvement now." Virtually all the main indicators in the health service - not all of them but virtually all of them - are now moving in the right direction from where we were a few years ago. There's still a long way to go, tremendous challenges, but the investment and reform we've already put in has yielded certain benefits and now we've got to carry that through for the next stages.

DAVID FROST: But can you honestly tell us, with hand on heart or whatever that, can you guarantee that the NHS has the outstanding management that would be needed to spend a vast sum of money like this, speedily, fruitfully and wisely. They don't, do they?

TONY BLAIR: Without the reform it would not be wise to put these sums of money in. But there is huge reform going into the health service. Reform of the way the GPs work, reform of the hospital system, reform of the doctors and the consultants and the nurses and the way that they work, reform of the systems within the health service, and every single pound of money we put into the health service is going to be independently inspected and audited by an independent body.

DAVID FROST: But these things take time, don't they? It will be 2004 before that will be operating - I read.

TONY BLAIR: Well we already have, of course, the Audit Commission that do an excellent job for the health service, and we have the Commission for Health Improvement that isn't fully independent from government that has already been auditing and inspecting hospitals. So there's massive reform going into the system. I mean, by 2004, for example, 75 per cent of the money that we spend on the health service will be devolved down to the new primary care trusts within which the GPs, the family doctors, will work. The hospital payment system is all being changed, patients are going to be given choice. By 2005, all the patients inside the National Health Service system that have operations will have them through booked appointments, not the old waiting list system...

DAVID FROST: And you've said by 2005 three month waiting time for an outpatient appointment and six month maximum wait for a hospital operation.

TONY BLAIR: With an average wait of seven weeks.

DAVID FROST: Yes. But so those, you've pinned those to the mast.

TONY BLAIR: Yes, absolutely.

DAVID FROST: If those are not done by the next election you'll expect to feel the wrath.

TONY BLAIR: Well - I mean I've said -

DAVID FROST: Feel the wrath.

TONY BLAIR: Look, I've said to people throughout, I will be judged on this - just as we were judged on our promises last time. And that's why I went back and said look at the big picture of what this government's done. I mean when we came to office five years ago, would people have really said that a Labour government, with all the history of Labour governments, would end up proving the most effective economic managers this country's probably had in terms of our economy's since then ...

DAVID FROST: No, they're a bit, they're a bit worried that the old redistribution of wealth may be taking over again.

TONY BLAIR: Yes but let's just look at that for a moment.

DAVID FROST: This tax and spend ...

TONY BLAIR: Yes, this idea, is this a reversion to old tax and spend. It's nonsense ...

DAVID FROST: It's certainly tax and it's certainly spend.

TONY BLAIR: But it's reform coming with it and it's on the basis of a solid economic foundation. And the reason why you've even got a majority of Conservative voters supporting this is that people know that if you want a decent health care system you have to pay for it. You see, the other fascinating thing about this debate is that everybody now accepts that we have to spend more on our health care system. Everyone through from the Conservative Party, business, everybody. Now, you get it in one of three ways. You can either get it through the National Health Service, funded out of general taxation, or you can go for the French, German systems of social insurance - which results in employers paying, for example in France, 60 pounds per week per employee - or you can do it through the American system. But the trouble with the American system is it's very expensive - premiums have just gone up 13 per cent in the last year. There was an interesting article in one of the American papers the other day saying that they thought that premiums would go up something near the region of 25 per cent over the next few years. You know, there is no cheap way or free way of doing this. But I happen to think the National Health Service is the most efficient and fairest way of doing it -

DAVID FROST: So it's not -

TONY BLAIR: - and we need to get that extra money in, combined with the changes.

DAVID FROST: So, as someone said, it's not tax and spend but it's tax and spend with strings attached.

TONY BLAIR: Well it's reform, it's invest and reform is how I would describe it. And that's what we've done in schools, for example, I mean, you know, people say to us sometimes oh public services, have they really improved. The answer to that is if you look at education, which we said would be our number one priority, there's no doubt that education is better. You go to any constituency in the country and you can see the investment ...

DAVID FROST: But it's not your number one priority any more.

TONY BLAIR: Of course education remains absolutely key for the government because it's the economic future of the country. But it's important ...

DAVID FROST: But it, it's education, education, educations, it's now health, health, health, health. Four healths, three educations.

TONY BLAIR: No, the education remains absolutely fundamental.

DAVID FROST: Now you've laid out the plan for five years, you've laid out the tax plan for three years. That, after all the history of this stuff with national insurance at the last election, worries people very much. Will there be more vast rises in the fourth and fifth years to finance the NHS?

TONY BLAIR: The actual plans, that Gordon announced, in fact cover all five years, so it takes us up and through that. So the improvements that we're looking for, for the health service, which is by 2008 we want to get the maximum waiting time down to three months, from six months -

DAVID FROST: Oh I know, but people are worried there may be more taxes in the last two years -

TONY BLAIR: Those are all funded - I mean, again, I'm not going to sit down and write the budget - but those are all funded. I'll just say this on tax, as well, because, you know, of course, no one ever likes paying tax, even after these changes, the tax burden, under this government, will be lower than in many of the Thatcher years, lower than the European average, lower than any of our major comparable European competitors.

DAVID FROST: But you're not going to write the budget here, and so on, I thought you might say something like that, but can you just reassure people that you're not going to use the NI loophole again in this parliament?

TONY BLAIR: Well, as I say, I can't write the budget - I mean I'm just going to say what I've always said on these things - I can't go and write the budget, what I can say is the changes that we made in the health service are funded by what we did yesterday - yesterday, sorry, on Wednesday.

DAVID FROST: ... on, no further rise, they said here today - that was not true in the Observer, here, we've got the Observer here, where you were quoted as saying, as you probably saw this morning, that no further rise on tax.

TONY BLAIR: I'm quoted as saying many things that I never quite say but no - I mean obviously I can't write the budget, what I probably said, if this is what they're referring to on television interviews, is that the money that we found for the health service is funded by the national insurance rise. But, that said, of course you can't sit down and write the budget.

DAVID FROST: People are also concerned about what else you'll need money for, obviously transport and things like that, and that, unfortunately -

TONY BLAIR: Those plans are of course funded by, mind you.

DAVID FROST: - and also child poverty is going to - if you're going to hit your figures, that's one, one of the figures you haven't hit, obviously, it should have been 1.2 million by now out of poverty and it's only 500,000.

TONY BLAIR: Well there's some dispute about that, actually, because it depends how you measure it. What is beyond doubt is that after years in which child poverty increased, child poverty is now falling and one of the budget measures that Gordon did was effectively a tax cut for middle and lower income families with children. So I think it's roundabout half of those families with children, even after these national insurance changes, will actually be better off not worse off.

DAVID FROST: And will you, in terms of the NHS changes, will you act on the new, the new head of the commission, who's going to be independently chosen and so on, if he comes up with a failing hospital or something, will you then sack the people responsible?

TONY BLAIR: Well we already -

DAVID FROST: Close the hospital.

TONY BLAIR: I mean - we already have - I mean look, this really starts back, in fact back on the programme you and I talked about this issue back in January 2000, and I said then that I wanted to get health service spending up to the European Union average, which we will now do, in fact we'll exceed it, but I also said we had to get proper reform into the health service. We then began a process of six months of discussion with people inside the health service - that resulted in the July 2000 National Health Service plan. That plan gives us, already, the powers, in circumstances where hospitals are failing. We can change the management, we can if necessary contract out parts of the management. So, and we also have now, for the first time, already people can see whether hospitals are three star, two star, you know, one star, zero star. So, you know, we have a system of inspection that already allows us to make judgements about whether hospitals are coming up to scratch or not. But I have to say to you, I have enormous faith with the National Health Service staff. They're, you know, I've, I've probably, in these last couple of years, spent more time talking, discussing, sitting down with National Health Service staff than any prime minister before me and I can tell you they are highly dedicated, very able, committed people and a lot of them have been working flat out in this system, starved of the proper investment, and are desperate for the changes we're trying to introduce.

DAVID FROST: And John Chisholm of the BMA said last, that last year a total of new GPs recruited was 18, when the target was 500. That's what he said this week, John Chisholm. Now, if we can't find 500 how are we going to find 15,000 more, as your, and the numbers of nurses as well, when we could only find 18 when the target was 500?

TONY BLAIR: Well on nurses, of course, we've had, we've actually exceeded our target. I mean there have been something like, I think, 25, 30,000 extra nurses.

DAVID FROST: But where are these, apparently a lot of these doctors, you plan to come from overseas.

TONY BLAIR: Some, short term, we will have to get in from overseas because it takes seven years to train a doctor, it can take up to 15 years to train a consultant, so we're not able to get all these people in, home-grown as it were. But of course we're now expanding the medical training places, we're now offering far better incentives for people to come into the profession, I hope we are also able to give people a better chance to be retained also as doctors too. I believe we will be able to attract certain doctors back into the profession too. So I think there are lots of things that we can do there, we're working very hard with the BMA and others to achieve it, and I would just point out to you that where we made a particular focus on cancer and cardiac consultants we've increased those numbers something like, I think, 25 per cent in the last year or two years and we'll increase them by another 25 per cent in the next few years.

DAVID FROST: And in terms of going ahead with your plans and so on, the other thing that people say is that you are, you are planning, in order to speed things up, for greater private involvement in the NHS.

TONY BLAIR: Well, we use the private sector where it helps. So, for example, if there's spare capacity inside the private sector, I don't think that people think it's inconsistent with the National Health Service to say the health service itself will purchase that spare capacity. If we need to attract people in to run some of these dedicated units working around elective surgery, let's do it. If there's spare capacity elsewhere in Europe that we can use, let's use it. Because this is a long term programme of change. I mean we've had, what, three decades of underinvestment in the National Health Service. We've got now to put it right, over time. It does take time. The health service plan was a ten year plan from July 2000 and you know we've got to make sure that we make whatever provision we can from whatever quarter we can to get the service better.

DAVID FROST: If you have to take on the unions, are you prepared to do so?

TONY BLAIR: I think in the past few years, I've shown where I have a disagreement with the unions and I believe the national interest requires us to do something they don't want, then I'm perfectly prepared to take people on. But I don't go into it with the attitude that I'm spoiling for a fight with anybody. I think that you will see from the comments made by Unison, which is one of the main unions inside the health service, that they support the reform agenda. Now, true it is that some of the trade unions are very reluctant to have anything to do with the private sector, and that's in some ways for understandable reasons, they feel their members haven't been properly protected when they've been transferred to the private sector, but, you know, the reform programme is there, it's been set out very clearly, we were elected on a programme of invest and reform in the public services and we've got to carry it through, but I'm convinced myself that we will be able to carry this through with people inside the National Health Service basically backing us.

DAVID FROST: How much of a risk is this? Everybody's had headlines to that effect, that it's a huge gamble. It's a rather untypical gamble it may be said, because you're making the gamble but it's with our money - that's unusual for a gamble. But how much of a gamble, how much of a risk, how much danger are you in? Because the danger obviously comes from, not the 76 per cent who welcome it, but if the 20 per cent will become 76 per cent if it doesn't work.

TONY BLAIR: Well it's a challenge isn't it, it's a big thing. I mean it's as big as industrial restructuring was in the 1980s for the Thatcher government, to put our public services on a proper footing. And it requires very difficult choices and to say to people "I'm sorry, if we want a better National Health Service system, we have to pay for it," and then to take on the challenge of reforming the system itself, when it's a huge enterprise, employs a million people, treats a million people every 36 hours, yes it's a very big challenge but there's no point in being in politics unless you take the big challenges on.

DAVID FROST: And if it were to fail?

TONY BLAIR: Well if it fails, of course, you know, I will carry the can - I've said that. But I believe that it won't and I think that you can see already, by what we've done on the economy, on unemployment, on primary schools, now on secondary schools, that we have a track record of setting objectives that we can secure. And yes it is a very, very big challenge to make this crucial investment in the National Health Service and to reform it, fundamentally, but I'm convinced that we can do both and succeed.

DAVID FROST: And was this - do you admit this was a redistributive budget?

TONY BLAIR: No I -

DAVID FROST: In the classic webbed sense of the word ...

TONY BLAIR: No I don't. Because whether - I think a lot of nonsense has been talked about this. For me, New Labour has always been about modern social democracy. We are a centre left political party who believes in certain values - social justice, community, opportunity for all, but we're realising those in today's world. This budget was also about enterprise, and supporting small businesses. It was also about supporting families, and many families will gain overall from the budget. And it was also about making sure we got investment in our national health service. But I think you will find that the vast bulk of so-called Middle England support investment in our national health service because it's the best security, an insurance policy, they can have against illness.

DAVID FROST: Iraq. How close is action on Iraq? You've been saying it's not very close but I mean is it close?

TONY BLAIR: We have not taken any decisions on Iraq at all. You know, we've identified weapons of mass destruction as a crucial issue - and it is, Saddam Hussein is a threat, the world would be better off without Saddam Hussein in power but we have taken no decisions and we will not take decisions 'til we've looked at all the options and in the meantime the claim to Saddam Hussein is get the weapons' inspectors back in there, that's what the United Nations has told you to do, you're in breach of those resolutions, fulfil your obligations under them.

DAVID FROST: Gordon Brown says you're too gung-ho, apparently, on Iraq. Has he ever said that to you face to face?

TONY BLAIR: No, and I can assure you Gordon and I know each other well enough that if he thought that that's what he'd say.

DAVID FROST: But obviously the Cabinet, there's real debate, there's real difference in the Cabinet.

TONY BLAIR: I don't think there is, to be honest. I think, you know, I would divide -

DAVID FROST: But you don't look at it quite the same way as Gordon, not quite ...

TONY BLAIR: Well I would look at in this way. I think there are people who are against taking action in respect of Saddam Hussein no matter what - and Tam Dalyell is like that. But there is another group of people who are asking perfectly sensible questions. They're asking is it sensible to do this at the same time as the Middle East is in problems; have we worked out the right military options; what is the role of the United Nations - these are perfectly sensible questions and that's why I say to you all we have decided, at this juncture, is that weapons of mass destruction have to be dealt with, it is a serious issue, how we deal with it, however, is an open question.

DAVID FROST: Your dossier - the disappearing dossier on Iraq, some said it was stopped because it was two or three years out of date, that was the last time we had any decent intelligence from Iraq, and someone else said to the FT it was insufficient to convince critics within the Labour Party that the full scale offensive against Iraq was justified. Is that why it was pulled?

TONY BLAIR: No and it wasn't pulled. I mean we just, we will publish it at the appropriate time and when that's going to be I simply don't know. But both of those things are absolutely wrong. The evidence of Saddam Hussein on weapons of mass destruction is vast.

DAVID FROST: What do you think - we talked about incontrovertible evidence a couple of interviews ago when we were talking about Afghanistan and so on - what is our incontrovertible evidence about when he could have a nuclear capacity, or capability? The Germans say three years.

TONY BLAIR: What we can't be sure of is the truth, what we know is that he's trying to acquire that capability. And what we also know from our experience of September 11 is that it's sensible to try to deal with these threats before they become fully operational rather than after.

DAVID FROST: In terms of the, the, increasingly interesting, there's been a sea change not only in budgets in the past week but the attitude to state funding of parties. Now people see no difference in the polls between your problems with contributors and the Tory problem with contributors and so on. Isn't this the moment to decide on state funding for parties?

TONY BLAIR: Look it's a terrible problem this for any government looking at a situation where, I mean we've introduced rules on openness and transparency for political funding. I mean you said the Conservatives had problems with their contributors - actually no one knew who their contributors were, their problems were to do with their MPs. For 20 years we had not the faintest knowledge who funded the Conservative Party, from where they got their money, from which country they got their money or what was the relationship between any contributor and government. We have thrown open all the rules, made it totally transparent, everyone knows where we get our money from and yet, I'm afraid all it's done is simply make anyone who gives money a target for being ripped to shreds in parts of the press so, you know, it's a very difficult issue but I've always said about state funding, it can't be done unless there's a consensus behind it.

DAVID FROST: And is there a consensus behind it?

TONY BLAIR: I don't think so.

DAVID FROST: Would you be in favour of it?

TONY BLAIR: Well I would certainly look at it if others, if there was a clear, clear evidence that others were prepared to accept it too, because I think you'd have to have all the political parties. But I always say to people, there is no such evidence that anyone's going to be in favour of it and I think for the public too -

DAVID FROST: The problem is ...

TONY BLAIR: They will prove reluctant to fund political parties which is why I say to people, in that case, if we're not going to fund it through the state - and as I say I think it's unlikely you'll ever get agreement to do that - then people, you know, we need the maturity in our political system for people to understand that in those circumstances people who donate to political parties are actually helping support those political parties. You know when I came, became leader of the Labour Party, I mean all this seems very odd now, but when I became leader of the Labour Party we got 90 per cent of our money off the trade unions - and that was a huge point of criticism.

DAVID FROST: We'll just go to the news quickly and then we'll come rushing back.

[NEWS]

DAVID FROST: Thank you very much indeed, Sian, and well we're virtually at the end of our time and you're coming up for your fifth anniversary in power. Has it been easier than you expected? More difficult, or what?

TONY BLAIR: I think it's been about what you expect, which is very exciting, very challenging and a privilege.

DAVID FROST: Just what you expected. You're not getting tired?

TONY BLAIR: No I'm fine.

DAVID FROST: Do you wake, do you wake up every day with the same zeal?

TONY BLAIR: Absolutely, because I mean the job's not done. You know, we were talking about the health service earlier, we're not through that, we're not done. And, you know, we've got big challenges ahead in the next few years.

DAVID FROST: ... you're just starting. Are you going to stay 'til you get it right?

TONY BLAIR: Well I mean I, you, you obviously set yourself certain objectives and the government set itself certain objectives and we want to fulfil them, of course we do.

DAVID FROST: Prime Minister, thank you very much indeed.

TONY BLAIR: Thank you.

DAVID FROST: Thank you for joining us this morning, too.

ENDS


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