On the Politics Show, Sunday 08 October 2006, Jon Sopel interviewed Patricia Hewitt and David Willetts.
Health Secretary Patricia Hewitt acknowledged for the first time that reconfiguration of NHS services would "almost certainly" lead to fewer hospitals with a full range of services.
She argued that she was concerned most with "saving lives rather than simply saving buildings".
Also on the programme, Shadow Education Secretary David Willetts underlined the importance of bringing Muslim schools into the state sector, arguing that introducing a quota system for pupils of other faiths might discourage them from joining the sector.
PATRICIA HEWITT MP HEALTH SECRETARY
'They won't be the same as they were, 10, 20, 30 years ago
JON SOPEL: And I'm joined now by the Secretary of State for Health, Patricia Hewitt. Patricia Hewitt, welcome to the Politics Show.
PATRICIA HEWITT: Thank you.
JON SOPEL: Do you agree with Doctor Sikora in that film, that District General Hospitals are essentially antiquated and inefficient.
PATRICIA HEWITT: No. Er, DGHs you know were invented er, in the early 1960s, indeed when Enoch Powell was Health Minister; they've been changing a great deal over the last ten or fifteen years. They're not going to disappear, but they are going to go on changing, simply because modern medicine is changing and as indeed your film showed, it's now possible to do so much more in the community that previously you could only do in an acute hospital, but also, with medicine becoming increasingly complex and specialised, there are some cases for which you are much safer in a specialist centre.
JON SOPEL: But you, you've said yourself that the structures that were right in the 1960s when the model for the District General Hospital was defined, aren't right today. Why shouldn't they disappear.
PATRICIA HEWITT: No. You will still need local hospitals, but they won't be the same as they were er, ten, twenty, thirty years ago, for exactly the reasons - you know, I was in Bedford er, not just last week, but a couple of weeks ago, going out with community matrons. And I was visiting for instance, an elderly gentleman with very serious chronic heart disease.
Before the community matron started looking after him in his own home, he'd been in hospital, in Bedford Hospital, five or six times in the course of just six months, as an emergency patient. Since she started looking after him, he's hardly needed to go to hospital. Scale that up as they've done in Dudley in the West Midlands, and actually what you have is a much smaller district hospital in Dudley, they've gone down from nine hundred beds to just over six hundred, hugely controversial, but they are giving people much better health care, and that's what matters here.
JON SOPEL: I just want to be quite specific. In your vision, we will have a smaller number numerically, of hospitals that are offering all services; so you know, including A&E maternity and paediatric services.
PATRICIA HEWITT: We will have a different range of hospitals and the - what I want to stress here John is that we're not sitting in London, trying to work out what the right solution is in different places. It's got to be done locally, it's got to be done in London, it's got to be done up in Yorkshire, in Cumbria, in Bedfordshire and Hertfordshire. The local NHS, the local doctors and other front line staff, sitting down, with each other and with the local public, to work out, what is the best and the safest way of providing health care to the people of their area.
JON SOPEL: So is that a 'yes' to my question.
PATRICIA HEWITT: It means that these decisions get made locally; so I'm not going to sit here and tell you exactly how many hospitals of different kinds there are going to be. What I can tell you is that if in every area we will get the right organisation of services...
JON SOPEL: I just want to...
PATRICIA HEWITT: ...more in the community.
JON SOPEL: I just want to tie this down quite specifically. Are you saying that in your vision, and in all likelihood, and I know there are strategic health authorities that will draw up individual plans, but you are the Health Secretary, under your scheme, will there be a smaller number of hospitals with a full range of services, ie including A&E, Maternity, Paediatrics.
PATRICIA HEWITT: Almost certainly. If you take the example of Huddersfield, I think that's one of the places where there are some protests, and where there's been a really intense debate over several months, the doctors were very clear that in order to give safer care to mothers and their babies, they needed to centralise the, er, the consultant led labour ward, on just one site.
JON SOPEL: (overlaps) Okay and how many...
PATRICIA HEWITT: Let me just make the point. So what they will have is one instead of two consultant led maternity units. But they will have a new midwife led unit, to support all those women who actually would much rather give birth either at home or in a midwife led unit. That's not fewer hospitals, but it is different and actually better hospitals.
JON SOPEL: But, but I'm being quite specific in the question I'm asking. It is the hospitals that are offering all services and you say, almost certainly there will be fewer, how many fewer would you estimate.
PATRICIA HEWITT: It's a great mistake to assume that all district general hospitals are offering all services at the moment. And I'm not refusing to answer your question, but I'm saying that as modern medicine changes - take King's College for instance. That hospital, almost uniquely in the country is now offering round the clock surgeries, specialist surgery for people with serious heart attacks. In most hospitals, if you have that kind of heart attack, you will get the drug treatment very quickly, but the surgery, the angioplasty, you'll have to wait days for. What I think will happen in the next few years, following the King's College Hospital example, is we will have a limited number of specialist regional centres that will treat people who need that particular kind of treatment.
JON SOPEL: And could you quantify it...
PATRICIA HEWITT: That is an improvement, it's not a cut.
JON SOPEL: Okay. Could you quantify, how many you will estimate will change in what they're offering because I think most people would say, well I think of a hospital as somewhere that's got an A&E department and emergency surgery.
PATRICIA HEWITT: But hospitals do far more than that.
JON SOPEL: I know but I'm just, but that's the sharp end of a hospital. That's what people think actually, if I have an accident, that's where I'm going to go because I know that I've got my district general hospital. How many fewer.
PATRICIA HEWITT: Well, what we will see and what's already happening is some hospitals will offer emergency surgery, others will only do the planned care, and that is much better, because actually when you have a hospital that is doing for instance, planned hip replacements along with er, emergency surgery, you end up with cancellations for the planned care. (interjection) So you separate them. Now, that...
JON SOPEL: I just want to talk about the politics because we don't have a lot of time. I mean what would your advice be to a Labour MP in a marginal constituency, support your proposals and risk losing his seat.
PATRICIA HEWITT: I work with colleagues all across the country, and what I have done in my own constituency and what I would advice every member of parliament to do is campaign for the best care that you can possibly get for your constituents and of course that's likely to mean changes in hospital services because frankly, if we can look after elderly people with chronic heart disease, in their own homes, taking the hospitals to them, keeping them out of emergency admissions, that is far better for the patients. It may well mean fewer beds and fewer staff in the... (overlaps) ...
JON SOPEL: But in the course of doing, in the course of making the film that we've just shown, I mean, we were told that Labour MPs are being given the nod and the wink, you've got carte blanche to campaign against any changes to your district general hospital, if you're in a marginal seat and you think it's going to cost you votes.
PATRICIA HEWITT: Well, what I would say to - I'm simply not aware of that. What I say consistently to my parliamentary colleagues is campaign for the best care for your patients because what matters here and the maternity example up in Calder Vale and Huddersfield is a very good example.
JON SOPEL: But then why...
PATRICIA HEWITT: What matters here...
JON SOPEL: ...so popular and so sensible...
PATRICIA HEWITT: What matters here is saving lives.
JON SOPEL: Of course.
PATRICIA HEWITT: Rather than simply saving buildings. And if we all concentrate on that and we get the doctors, the nurses, the other staff and the public discussing it, then I think we'll come to the best decisions.
JON SOPEL: Right, and I'm sure if I was to ask you about the Health Service in general, you'd say we'd never treated more patients, we've got more doctor nurses than ever before. We've cut waiting lists. If everything is so great, why has Labour lost its lead on its ability to handle the Health Service, for the first time since that polling question has ever been asked.
PATRICIA HEWITT: Change is very difficult and at the moment there is a lot of change going on and there are some hospitals that have over-spent and that are having to make some very very difficult decisions, which are particularly difficult for their staff. So of course that is hard for everybody and the other thing is as any pollster will tell you, attitudes towards government policy on the health service are much more dictated by how people feel about the government as a whole. And we haven't been having a good time recently and we all recognise that. That also has an effect I'm afraid.
JON SOPEL: Do you take any responsibility as the person who has had to go out there and sell the policy and we all remember the pictures of you before the Royal College of Nursing, getting booed and hissed, I mean you do seem to have aggravated people.
PATRICIA HEWITT: I go round the country. I spend a great deal of time in private meetings, particularly with staff, particularly in hospitals where they are having to make difficult decisions, reducing the number of jobs. Very occasionally, not as often as the headlines would suggest, even looking at redundancies and all the time I am saying to staff, we will do everything we can an ensure that redundancies of course are the last resort, that where staff jobs are changed, they get proper support to do that. But we are asking the staff to actually come forward with proposals for getting the best possible care that uses modern medicine in the best way.
JON SOPEL: We've only got a few seconds left, I want to ask you a final question about the whole row that has been provoked by Jack Straw's comments about women wearing the veil and the fact that he thinks it would be better if they didn't. Where do you stand.
PATRICIA HEWITT: Well, there's one point that is constantly overlooked in all of this: the great majority of British Muslims are hard working, law abiding people, bringing up their children well, contributing in the health service and right across our society and I just want to preface the discussion with that, because it is a point that is constantly overlooked. As far as the full veil goes that conceals everything except the eye, I have to say I've always in the past seen that as a symbol of women's oppression but my mind was changed on this when a young woman came to see me in my own constituency surgery, quite some years ago now, and the full veil, let me say is very rare in my own part of Leicester - she was fully veiled. I assumed she'd probably only recently arrived in Leicester, in fact, she'd been born there, she'd made the decision not her parents or anybody else that she wanted as part of her statement of her faith, to wear the full veil. I would not ask her to take that off or to change a decision that she has made as an adult woman.
JON SOPEL: Okay. Patricia Hewitt, thank you very much indeed for being with us. Thank you.
PATRICIA HEWITT: Thank you.
END OF INTERVIEW WITH PATRICIA HEWITT
INTERVIEW WITH: DAVID WILLETTS MP
'We do want each faith group to be thinking about how they can make sure that their schools are indeed part of the wider community'
JON SOPEL: I'm delighted to be joined by David Willetts, the Shadow Education Secretary. I'll come to Ken Baker's amendment in a minute. Why have faith schools at all, funded by the State.
DAVID WILLETTS: There are six thousand faith schools. Every since we've had state education in this country our main faith groups have been allowed, indeed encouraged to run schools; they have a distinctive ethos and all the evidence is that parents like them, they're very popular with parents and some of them achieve high levels of ethic mix and social mix.
JON SOPEL: Do you think they encourage integration.
DAVID WILLETTS: I think they can do; they needn't but they can do and some of them are really trying hard. I think this Anglican initiative is very welcome, I think it's a great idea as David said in his speech. But also, as the Anglicans themselves have said, it doesn't follow that it's one fixed model that every other faith group should follow. But we do want each faith group to be thinking about how they can make sure that their schools are indeed part of the wider community.
JON SOPEL: When you talk about their popularity, Guardian Poll, August last year, 'Schools should be for everyone regardless of religion and the government should not be funding faith schools of any kind'. 64% of the population agreed to that.
DAVID WILLETTS: Yeah. But if you then look at what parents, real parents want, parents do want faith schools and I don't think in a feel society, you could possibly want to change the status and the freedoms enjoyed by 6,000 faith schools in this country. Our churches play a massive role in education, and it's a good thing that they do.
JON SOPEL: Right. Now let's talk about Lord Baker's amendment and that would give statutory force to the C of E idea that 25% are from other faiths. Why not extend it to other faiths, schools of other faiths.
DAVID WILLETTS: Well I have as Ken knows, some problems with his amendment. I think, I understand what he's trying to achieve but first of all, I just am wary of more legislation in this area. It seems to me that the Anglican initiative was an admirable one because it was an initiative that they took themselves and one of the reasons that David Cameron welcomed it was because it's a great example of what we've been talking about in our Party Conference, social responsibility .. organisation running schools, taking its own decision. I don't want to tell Church groups exactly how they should run their schools.
JON SOPEL: But why if it's right for a Church of England school, shouldn't it be extended to Catholics, Jews, Muslim schools.
DAVID WILLETTS: I certainly think that the other faith groups do need to tackle this issue in some way; it needed be tackled in the same way as the Anglicans. I'm having a meeting tomorrow with the Catholic educationalists and I know that they are proposing changes in the way in which Catholic schools are inspected so that there's a much clearer measure of how they're performing, integrating their schools in the community. And of course Catholic schools already do very well on ethnic mix and social mix, often better than secular schools in the same area. So different faith groups should tackle this issue in different ways that suit them best.
JON SOPEL: So just to be clear, you suggest that Tories should vote against this amendment or you'll leave it as a free vote.
DAVID WILLETTS: Exactly how this is handled in the Lords will be a matter for my colleagues in the Lords but I think it's, I don't believe...
JON SOPEL: What would you recommend.
DAVID WILLETTS: We will not be backing Ken Baker's amendment. It could be something therefore on which we abstain. Given the personal issues of conscience it could well be something for a free vote.
JON SOPEL: David Cameron's speech, welcoming the CofE decision, saying, I believe the time has come for other faith groups to show similar responsibility. But why back peddle, why, I mean I can't understand why - you say you've got some objections. What objections.
DAVID WILLETTS: Look, as I said, the objections to Ken's particular proposal are that it's national legislation on something which is really for voluntary action and because it prescribes one particular model - it's... Anglicans have followed, others may not follow. But I do think you're right Jon, there is a massive issue here and obviously it particularly arises with the Muslim schools and this is where there is an enormous potential to make a great contribution to the great integration of Muslims in to the community because there are many independent Muslim schools that wish to join the maintained sector and the crucial negotiation that is now underway, is the terms on which Muslim schools join the maintained sector and if we can get those terms right that they do reach out to the wider community, then there is enormous potential to make that a contribution.
JON SOPEL: But isn't this just an area, and talking about, you know, in a wider context this issue - where the new look Conservative Party sounds like it's saying great things and when it comes to making a decision, you're left saying, well where is the beef, you're not backing a specific proposal, you're just making more warm words about, well we need to all get on better as different communities.
DAVID WILLETTS: The whole point of social responsibility which we've been talking about in our Party Conference, is precisely that there are large areas of social life where the initiative should be with individual groups, it should not be a matter of national legislation.
JON SOPEL: This is tough proposal where I suspect you'd get a lot of support if you were to take it.
DAVID WILLETTS: I don't think there would be. I think that this, that the idea of a requirement on all faith schools to do this, would be deeply opposed by the Catholic ..
DAVID WILLETTS: . deeply opposed by Catholic Churches, for reasons that I fully understand, and would probably mean that the Muslim schools gave up all attempts to join the maintained sector. I think that it would be better if we had more Muslim schools in the maintained sector and we have to work very carefully to get them in on the best possible terms for everyone.
JON SOPEL: Okay. David Willetts, thanks very much for being with us here on the Politics Show.
END OF INTERVIEW WITH DAVID WILLETTS
Please note BBC Politics Show must be credited if any part of these transcripts are used.
NB:These transcripts were typed from a recording and not copied from original scripts.
Because of the possibility of mis-hearing and the difficulty, in some cases, of identifying individual speakers, the BBC cannot vouch for their accuracy.
Let us know what you think.
The Politics Show Sunday 08 October 2006 at 12:00 BST on BBC One.
You can reach the programme by e-mail at the usual address or you can use the form below to e-mail the Politics Show.
You will be returned to the Politics Show website after submitting the form.
Disclaimer: The BBC may edit your comments and cannot guarantee that all emails will be published.