On the Politics Show, Sunday 21 January 2006, Jon Sopel interviewed The Environment Minister, Ben Bradshaw and Shadow Health Secretary, Andrew Lansley.
The Environment Minister, Ben Bradshaw has told the Politics Show that he would oppose any watering down of new anti-discrimination laws.
Mr Bradshaw's comments came in response to reports that the Communities Secretary, Ruth Kelly- herself a Catholic- is fighting to allow Catholic adoption agencies to turn away gay couples. Mr Bradshaw told Jon Sopel:
"I'd be very surprised if the government was thinking of bowing to pressure from conservative Catholics". He went on "I think this is an issue of equality, it's exactly the same as saying you can't have a child for adoption because you're black, or because you're a woman or because you're disabled."
On the possibility of variable charging for rubbish collection, Ben Bradshaw said: "Well we haven't decided yet but we're looking very closely at those options because we think if you look at the experience in the Netherlands, in Denmark, Germany and in other countries most of these countries do give people an incentive to recycle either through a charge on the general waste or through a council tax rebate on recycling.
"And that does two things, it gets recycling up it gets waste down and that the saves the council tax payer money in the long run... I think there are very strong arguments for it, I am yes [in favour].
On incineration, Mr Bradshaw added: "...we are going to have to increase it a bit... because the one thing that everybody agrees with on this, even our own Green politicians, is that landfill is the worst because of its impact on climate change - a major contribution to green house gases. Now we incinerate very little in this country compared with most other northern European countries we landfill much much more, those figures need to get reversed."
Shadow Health Secretary Andrew Lansley told the Politics Show why the Conservative Party wants to overhaul central targets for the NHS, set new objectives to measure how well patients are treated and give doctors greater responsibility for their own budgets and priorities.
He told Jon Sopel that the government's targets - on waiting times, for instance - were too narrow: "The NHS should be measuring the overall outcome. And for cancer patients, for example, five-year survival rates is the way to do it. Narrowing in on how long people wait for specific treatments is actually distorting the whole process."
He added: "One size fits all targets isn't the right way forward. We need local targets which are set by doctors and hospitals and those local targets wouldn't try to say, we must have an eighteen week target for every operation, everywhere in the country."
On his plans for giving GPs more control over their budgets and services for patients, Mr. Lansley said: "We need them [GPs] to take serious and senior responsibilities and putting together the clinical decisions about what's right for patients, with the budgetary consequences and setting those sorts of local priorities, that's the sort of thing GPs should be doing."
INTERVIEW WITH: Ben Bradshaw MP, Environment Minister
BBC1 POLITICS SHOW January 21st 2007
JON SOPEL: I'm joined now by the Minister responsible for waste, Ben Bradshaw. Ben I felt we should have really had an inset of you during that film because every time the Dutch policy was coming on you were cheering and saying, yeah right on, why haven't we got Dutch policy then.
BEN BRADSHAW: Well because we started from a long way behind we relied much more heavily on landfill in the first place. As your report showed the Dutch ran out of land fill earlier, they changed from landfill more because they'd run out than for environmental reasons, so we're behind the Dutch but we're catching up. We've quadrupled recycling since Labour came to power in 1997, we still have very low levels of energy from waste to incineration, we still have about 60% land fill. We need to get where the Dutch figures are and we hope to do so.
JON SOPEL: Ok, lets start at the beginning, do we simply need to throw away less?
BEN BRADSHAW: Yes, we need to throw away less and actually in the last three years as a country for the first time ever, we've reduced the overall amount of municipal waste that we have produced; we've broken the link if you like between economic growth and waste growth, but one of the things we're considering very carefully is part of our new waste strategy to be published in March is whether we need a minimisation target, as well as a recycling target.
JON SOPEL: Well let's use another horrible word, incentivise, how do you incentivise that how do you make people throw less away.
BEN BRADSHAW: Well it's partly through the targets we've already got on local authorities, it's partly through the landfill tax, we tax landfill, that tax is going up every year so local authorities and businesses have to pay to throw stuff into landfill. We have something called the landfill allowance trading scheme which is a bit complicated, it's a bit like the carbon emissions trading schemes so local authorities can trade land fill allowances if you like and we're looking very carefully at the continental experience of householder incentives.
JON SOPEL: Well let's cut to that immediately, are you going to put a set of scales essentially in our wheely bin so that you know how much we're throwing away and you charge accordingly.
BEN BRADSHAW: Well we haven't decided yet but we're looking very closely at those options, cos we think if you look at the experience in the Netherlands, in Denmark, Germany? in other countries most of these countries do give people an incentive to recycle either through a charge on the general waste or through a council tax rebate on recycling. And that does two things, it gets recycling up, it gets waste down and that the saves the council tax payer money in the long run.
JON SOPEL: Are you in favour of that.
BEN BRADSHAW: I think there are very strong arguments for it, I am, yes, the Secretary of State David Milliband has already expressed his support for it but there are a number of problems that we have to try to iron out. People are concerned about fly tipping, people are concerned about the possible impact on large less well off families who tend to produce more waste than others; so there are a number of things we have to be very careful about before we make a decision one way or another.
JON SOPEL: Cos it could be a poll tax in a wheely bin.
BEN BRADSHAW: Not necessarily. The sort of figures you're talking about on the continent, [you're] really talking about £50 difference in a year it's not like the poll tax, it's been very popular where it's been implemented in other countries and the Conservative run Local Government Association here wants us to do it.
JON SOPEL: I know in Bournemouth I think they have put some kind of microchip inside bins, there's been a citizens revolt, people ripping them out.
BEN BRADSHAW: There has among some people but the reason that some local authorities have done that is not in preparation for...
JON SOPEL: One third have apparently.
BEN BRADSHAW: ... recycling rebates. The reason that some local authorities have done it is because they can more easily measure the amount of waste that they're producing and accurate data is very important if we're going to avoid these land fill finds in 2010, 2013 and 2020.
JON SOPEL: So outside the house where it's been converted into I don't know, seven flats or whatever where at the moment there is one huge wheely bin, you're going to have seven individual wheely bins so you can measure individually each single person's waste produce.
BEN BRADSHAW: Not necessarily and even in the Netherlands which has very sound waste policies, in blocks of flats they don't do as much recycling as they do in individual houses. One of the reasons in this country that recycling levels tend to be higher in the suburbs and in rural areas is, it's easier to collect the recyclable materials from the single house holders than it is from - so you have to take account and that's one of the reasons we have different systems in different parts of the country here, which may be confusing to householders but it reflects the different kind of housing stock.
JON SOPEL: Yeah and so let's talk about recycling in some detail now. If it is so important that you get recycling right why is it left to local authorities to decide, you set some broad parameters but it's up to them. If it's so important, let central government tell the authorities what to do.
BEN BRADSHAW: Well there are targets, there's a statutory requirement on all local authorities to provide a curb side collection for two recyclables by 2010 most are in fact ahead of that, we've seen a huge expansion in curbside collection by local authorities but the reason we allow some discretion for local authorities is the one I gave earlier, because local authorities differ; some are very urban, some are very rural. It might make more sense in a rural area to collect garden waste for example, not such good sense in Tower Hamlets.
JON SOPEL: But even in your own constituency back yard not your literal backyard, but in your own constituency back yard you get different councils where the amount that they're recycling varies enormously from one council to another next neighboring.
BEN BRADSHAW: It does, some of our local authorities are doing as well as the Dutch, they're up to 50%. Some are down in low teen figures. The reason that there are different systems though Jon, is because different technologies have been, have grown up piece by piece in different local authorities.
Some local authorities have invested in these huge recycling centres, where big machines separate out the glass the plastic the paper; others haven't, they've invested in the curbside collection and that's where the separation happens in the street.
JON SOPEL: But don't you think there should be a standard. We heard in Paola's film there, the Dutch minister saying we just didn't suddenly wake up to this you know there's been political pressure being put on this, and for example where I live we put out our newspapers and bottles and cans but if we put any cardboard in, the cardboard's rejected.
If you go to a neighboring borough the cardboard may be collected. Shouldn't there just be certain standards where everything that you think is recyclable should be recyclable.
BEN BRADSHAW: Well there are certain standards but actually in the Netherlands too which I have also visited along with a number of other countries, different local authorities have different recycling systems that reflect the different characteristics of those local authorities. What's important is that we get, what's much more important is that we get our recycling up - we have done that very successfully in the last eight years, we will continue to do so as long as we get the policies right.
JON SOPEL: So then you've got the recycling in place, what happens then, because there's less in rubbish bins, some councils decide well we don't need to collect on a weekly basis, we'll collect every two weeks. Consequence rat population going up.
BEN BRADSHAW: Well there isn't actually any evidence to show that that is the case and it certainly doesn't need to be the case, you're right some local authorities have introduced alternate weekly collections, it's not really accurate to call them fortnightly collections so they collect recyclables one week non recyclables the next, but it's very interesting- if you look at those local authorities, they also tend to have very high recycling rates so it does seem to have acted as an incentive to people to take recycling more seriously.
No reason why the rat population has to increase as long as the biodegradable stuff is sealed properly, handled properly both by the householder and by the local authority.
JON SOPEL: Now I have to say when we started looking into this I didn't know this body existed but the National Pest Technicians Association, which I guess are the body that count rats, say that the population is soaring because of recycling mania.
BEN BRADSHAW: No I don't think that's fair at all, I mean the rat population is, it has grown but it's much more to do with people throwing food away from fast food outlets away from the availability of food and from the warmer weather.
JON SOPEL: Right, let's go onto incineration now, we saw in the Netherlands there a third of waste is burnt, here it's only 8%.
BEN BRADSHAW: It's about 10% now.
JON SOPEL: Ok, so are you going to bring it up to a third.
BEN BRADSHAW: No but we are going to have to increase it a bit and it was very interesting to see the green politician in the Netherlands welcoming energy from waste because the one thing that everybody agrees with on this, even our own Green politicians, is that landfill is the worst because of its impact on climate change - a major contribution to green house gases. Now we incinerate very little in this country compared with most other northern European countries we landfill much much more, those figures need to get reversed.
JON SOPEL: Yes but so isn't part of the problem, some people say that you're intentions are good, it's just that you don't want to stand up to the Green lobby particularly, you've always said that you know in this country you know that incineration is bad, but the new generation of incinerators are completely different in terms of the harmful waste they put into the atmosphere.
BEN BRADSHAW: You're right, I mean there are very strict emission controls.
JON SOPEL: We're right that you haven't stood up to the Green lobby?
BEN BRADSHAW: No, you're right about what you said about emissions from energy from waste plants, there are strict EU rules, it's not just Dutch legislation, we are bound by those as well. I don't think anyone who's listened to anything I've said about incineration or energy from waste over recent months can accuse me of not standing up to our Green lobby. I have, I have confronted them with the evidence, I think they're wrong on incineration, and I've told them that, both publicly and privately.
JON SOPEL: Okay, so what's your target for what should be incinerated and by when.
BEN BRADSHAW: Well, at the moment we think we'll probably need to burn about 25% of our waste stream by 2020, that's less than we thought back in 2000, because we're doing so much better on recycling and of course it's far less than the Dutch incinerate, the Germans, the Swedes and the Danes.
JON SOPEL: I just want to ask you about one other issue that's in the papers this morning. It's been reported by one newspaper that Ruth Kelly is engaged in some kind of internal battle so that Catholic Adoption agencies should be allowed to opt out if you like, to turn away Gay couples from adopting. Would you support that.
BEN BRADSHAW: Well, I'd be very surprised if the Government was thinking of bowing to pressure from conservative Catholics. This Labour Party has an excellent record on equality. We've got rid of most of the discriminatory laws against lesbian and gay people and I'll be surprised if that was the case.
JON SOPEL: So you would oppose that.
BEN BRADSHAW: Well yes I would. I think this is an issue of equality. It's exactly the same as saying you can't have a child for adoption because you're black or because you're a woman or because you're disabled. If our policy is the interests of the child are what really matters, then you can't then add certain conditions on to that.
JON SOPEL: But just to add to that. If Ruth Kelly went ahead with that would you find it a resigning issue.
BEN BRADSHAW: Well, I mean these decisions are made collectively and I've been assured that no decision has been made and I'm sure that the government will reach the right decision.
JON SOPEL: Okay, Ben Bradshaw, thank you very much for being with us.
BEN BRADSHAW: Thank you.
END OF INTERVIEW WITH BEN BRADSHAW
INTERVIEW WITH Andrew Lansley, MP, Shadow Health Secretary
BBC1 POLITICS SHOW January 21st 2007
JON SOPEL: The Shadow Health Secretary, Andrew Lansley joins us now and welcome to the Politics Show to you.
ANDREW LANSLEY: Thank you Jon.
JON SOPEL: Why get rid of government targets.
ANDREW LANSLEY: Because they've actually distorted the way in which the NHS works. I mean I'm sure that if you were asking doctors, what has been the impact of these targets, they'd say well, in the early stages, it actually helped the NHS to know that you could measure performance and you could achieve specific results, but we've reached the point now particularly with waiting time targets that the effect of it is to distort the judgments that doctors should be making and the NHS should be making about which patients should be treated first and how quickly they should be treated. We've reached the absurd situation, where now, the waiting time targets are being turned in to a minimum wait, so you've got local NHS bodies, telling the hospitals they can't treat patients before say twenty weeks, because they can't afford to pay for it and because the waiting time target says they should be seen at twenty weeks.
JON SOPEL: But aren't they a very clear way, forget doctors, aren't they a very clear way for us to know how long we're going to wait, if we've got something wrong with us, if we need a hip replacement or a knee joint, whatever, that that tells us, well we know what's in store for us.
ANDREW LANSLEY: Yes, and the, and where we need to move to is a structure. Let's take something like you need a hip replacement and you go to your doctor and your doctor says okay, let's go and see where you best go and you can look to your local hospital and actually, they should be publishing how quickly they can see you and it shouldn't be eighteen or twenty weeks and maybe it should be considerably less than that.
But that will be, as it were like a local contract and those local targets are more important than the national ones. One size fits all targets isn't the right way forward. We need local targets which are set by doctors and hospitals and those local targets wouldn't try to say, we must have an eighteen week target for every operation, everywhere in the country.
If you went to Europe, if you went to the continent of Europe and said, that every patient should wait eighteen weeks for treatment, they'd think you were mad. Many patients should be seen considerably sooner than that and we should be making that difference between different kinds of patients, according to how severe their illness is.
JON SOPEL: But haven't things like, I don't know, the National Cancer Targets, they've achieved results.
ANDREW LANSLEY: Oh well, cancer is quite interesting you see because the waiting time target on cancer for example, is a waiting time to first treatment and if you look for example, at patients who have breast cancer, quite often they have surgery first and radiotherapy thereafter and the waiting time for surgery went down, because it's the first treatment, the waiting time for radiotherapy went up.
Now what we should do where cancer is concerned, yes we should target outcomes and the outcomes for cancer are things like five year survival rates and in too many instances, our five year survival rates, from cancers, are below the European average, and in relation to some things, way below the American average and that's what we should be focusing on.
JON SOPEL: So you would set a national target for that.
ANDREW LANSLEY: We should relate to outcomes, these are targets, these are objectives for the overall...
JON SOPEL: Why don't you call them targets. People like the idea of targets.
ANDREW LANSLEY: Because target says you narrow in on a specific part of the whole patient pathway. What we're saying is, the NHS should be measuring the overall outcome and for cancer patients for example, five year survival rates is the way to do it. Narrowing in on how long people wait for specific treatments is actually distorting the whole process.
JON SOPEL: It sounds like you want to replace something that is rather specific and quantitative, with something that is much more impressionistic about how you feel your treatment is overall, are much more wooly.
ANDREW LANSLEY: Well actually five year survival rates is quantitative, you can measure it, the point however is that what it measures is the overall service that is provided. Rather than trying to use waiting times as one part of the overall service that is provided and behave as if that measured everything and the same is true where GPs are concerned. You know, at the moment, the Government has this enormous structure of tick box for different processes and they treat outcomes as if it were just processes and of course, outcomes is something different, it's a much wider holistic thing.
JON SOPEL: Okay, let's talk about the way you want GPs to operate because at the moment different groups of GPs come together, different surgeries come together and they buy services from hospitals. Now you want to give that power back to individual, an individual group of GPs, ie one surgery to have the buying power, fund holding by any other name.
ANDREW LANSLEY: Well, I think the way you describe it is not how it works. In theory, GPs should be able to get together and have contracts with local hospitals. In fact it's bodies called the Primary Care Trusts who do this, not the GPs. And although once upon a time, if you go back ten years, the intention was that these local groups would in effect be groups of GPs working together, (interjection) ? they turned in to part of the Department of Health.
JON SOPEL: Doesn't that create a two tier system where you've got the GP fund holders or whatever you want to call them, the groups of GPS who take that buying power, who have suddenly got a awful lot of muscle, those that don't, haven't and that was what was wrong with the old system.
ANDREW LANSLEY: There was a problem with fund holding, precisely that. This idea that some did and some didn't. So, we are going to be clear, we do need every GP to take this responsibility. I mean we've had this debate this week about how much GPs are paid.
They are well paid, they are senior public service professionals. We need them to take serious and senior responsibilities and putting together the clinical decisions about what's right for patients, with the budgetary consequences and setting those sorts of local priorities, that's the sort of thing GPs should be doing.
They are senior professionals who are best placed to work out what is in the best interests of their patients. They should bring those things together.
JON SOPEL: Okay, Andrew Lansley, thanks very much indeed.
ANDREW LANSLEY: Thank you.
END OF INTERVIEW WITH ANDREW LANSLEY
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The Politics Show Sunday 21 January 2007 at 12:00 GMT on BBC One.
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