On the Politics Show, Sunday 29 June 2008, Jon Sopel interviewed Andrew Lansley MP and Nick Gibb MP
Andrew Lansley MP
JON SOPEL: Well let's speak now to Andrew Lansley, who speaks on health matters for the Conservative Party, the Shadow Health Secretary.
Thank you very much for joining us and I'm sure you're delighted to hear that prescription code lottery is to end.
ANDREW LANSLEY: Well I hope patients will get faster access to the drugs that they need because when you look at comparisons between this country and other countries it's I think frankly, scandalous.
I mean we have some of the best cancer research in the world in this country, but we have amongst the slowest uptake of new cancer drugs and we have one of the poorest five year survival rates for cancer and these things are not unrelated so it's not just about a post code lottery inside the United Kingdom, it's about the comparisons that one has to make between the kind of outcomes we're achieving in this country and the outcomes we're achieving in other countries.
JON SOPEL: We'll come on to that wider issue in a moment, but just on the narrow point of the speeding up of the delivery of drugs, making sure that they're not just rejected on financial ground alone, would you, as the Conservative spokesman say yeah, that's good news.
ANDREW LANSLEY: Well it's not gone far enough. I mean strictly speaking, what Alan has told you today is already true. Technically speaking, ministers have told the NHS that they should not say that a drug is not available on cost grounds alone while they're waiting for a NICE appraisal and if a NICE appraisal says a drug should be available, then legally, it is always the case after a three month delay, it should be available. (interjection) ... you've heard, it's a statutory right. I mean it's already there in the statute. So, I'm afraid Alan is I'm afraid telling you something that isn't an improvement.
It should be different - I'm afraid Alan doesn't appear to understand the way the licensing process works. The medicines health care regulatory agency, not only establish that a drug is safe, they establish that it's clinically effective and of good quality. At that point, drugs should be available in the NHS. The issue of course is, well how do we control costs for the NHS, because just last year for example, it cost the NHS four hundred million pounds, for the new drugs that were available and if we went down this path, it would be more.
And what really needs to happen of course, is that the NICE, what NICE should be doing is arriving at an evaluation that says, this is the value of this drug, these are the clinical benefits of this drug and that should help to drive the price of the drug. So that actually, the pharmaceutical industry should get the benefit of new drugs being available through the NHS, but also be aware that they should be paid according to the clinical value of the drug. And the government missed that opportunity.
JON SOPEL: Okay a lot of people watching, listening very closely to what you are saying. How would a Conservative led government, A Cameron government, Andrew Lansley, Health Secretary be different from what people are getting at the moment.
ANDREW LANSLEY: Well it would be different for patients first because they would genuinely have more control over their healthcare. Not only choice of general practitioner, choice of primary care, choice in secondary care. The government has talked about it but they haven't delivered it and that exercise of choice makes an enormous difference, in holding the whole of the NHS to account.
For people working in the NHS, it will be enormously different because they are fed up, sick and tired of the bureaucracy and the control and the distortion of clinical priorities that goes with targets and so if we can say look, we get rid of all that bureaucracy and all that waste, but we will hold you to account, to patients who exercise choice, and for the outcomes that you achieve.
JON SOPEL: Don't think though that it has been a significant achievement, the reduction of waiting times.
ANDREW LANSLEY: Well the reduction of waiting times, long waiting times was always going to happen and the previous Conservative government had started that process. The average waiting time has hardly reduced at all. From the median waiting time - has actually gone up from 41 days to 49 days.
The issue of course is, how do you bring waiting times down. Answer- if you have increasing capacity in the National Health Service, which we do, because resources are rising and if patients are exercising choice, patients will treat waiting times as one of the measures that they will use to determine where they go, but not the only one Jon, because waiting time isn't the only issue. Things like infection rates and access and outcomes, these are also the things that patients should have a right to know, before they decide where they're going to be treated.
JON SOPEL: You talk about greater patient choice, over their GPs and all the rest of it. If you have choice, you have to have surplus so that people - and isn't surplus in the National Health Service incredibly wasteful.
ANDREW LANSLEY: Well, you have to have an over-supply but not a, not a large over-supply but you do have to have over-supply in order to make competition effective, of course you do. But actually, we have potential over-supply, we've had - in the secondary care section, we've potentially got the capacity to do this. Something like cataracts for example at the moment, we have over-supply. In something like hip replacements we probably do have over-supply at the moment.
Now the fact is, you can therefore bring waiting times down. Nobody disputes any of that. But what is the most effective mechanism in life for trying to allocate resources effectively, answer - market mechanisms. Now, the NHS is not a free market and never will be a free market, shouldn't be. Because actually, it's governed by our principles that everybody has access according to need. But we should of course, the NHS should be very competitive about getting those resources, used effectively, by holding public and private and independent charitable sector providers to account.
JON SOPEL: Andrew Lansley, thank you very much for being with us.
ANDREW LANSLEY: Thank you.
END OF INTERVIEW
Interview with Nick Gibb, MP, Shadow Schools Minister
Nick Gibb, MP, Shadow Schools Minister
JON SOPEL: Nick Gibb is the Shadow Schools Minister and I suppose the easy joke is you've been looking at a Swedish model, but let's not do that. One of the reasons we saw there that the schools were so successful was that they were able to make a profit. Why not support that.
NICK GIBB: Well it's not necessary. We have a long tradition in this country, different from Sweden of philanthropic and charitable bodies, providing education and schools in this country. There are scores of bodies: the churches, united learning trust, the livery companies and new bodies such as ARK that are very keen to establish more schools in this country.
JON SOPEL: You've said you want to widen the choice to the widest possible extent to the different ways that schools can be provided. Why not say, we'll have the profit motive. I thought the Conservative Party believed in the profit motive.
NICK GIBB: Yes, but it's not necessary. The trouble with allowing companies to make a profit from providing schools is that it take money out of the education system, significant sums of money out. We want to make sure that all that money is retained within it and if it were necessary, fine but it's not necessary, there are - as I say, there are scores of organizations that really do want to provide education without profit and if you were to look at the Swedish system, only about 7% of pupils now, even now attend independent schools. Only half of those are private companies, and of those private companies, very few have even paid dividends to their shareholders so they're not actually making a profit from this, even in Sweden.
JON SOPEL: Is it that you have a principled objective to profit in schools.
NICK GIBB: No of course not, schools are going to buy stationery, they're going to buy desks and furniture from private companies, but we don't think it's necessary to have private companies adding a mark-up to teachers' salaries which is the predominant expense within schools, in order to make the system work. We believe it will work without incurring that expense for the tax payer.
JON SOPEL: Lord Blackwell seemed to be suggesting it was a political judgment that you were making, ie you just don't want the political flack and the row that might ensue if you said it, even though it probably is a very good idea.
NICK GIBB: No, it's about value for money for the tax payer and we just don't think it's necessary to pay shareholders money when this system will work with the philanthropic and charitable bodies that already exist and are keen to establish more schools.
JON SOPEL: Okay, well if the cost of educating a pupil, I don't know, is five thousand pounds per annum, which I think is roughly the figure and there was a private school that was costing eight thousand pounds a year, why not say to a parent, well look, use your five thousand pounds from the state system, pay the extra three thousand and your child can go privately.
NICK GIBB: Because David Cameron made it very clear, that we're not in the business of helping a few middle class parents escape the state system. Our priority is to raise standards in the 93% of schools that are state run so that every local school is a good school. That is our priority. It's a big job, but it's what we're going to focus on.
JON SOPEL: And one of the things that's been coming our recently - the figures for social mobility, which show that social mobility has decreased and there are an awful lot of Conservatives who say, well you know what, the way to increase that is to go back to grammar schools, which were the greatest way that saw people being able to escape from the sort of social background that they were in to move upward.
NICK GIBB: And those grammar schools are very good, there are a hundred and sixty four of them, they're very effective schools and they're going to be very safe under a Conservative government. But we want to concentrate on the two and a half thousand to three thousand comprehensive schools and to try to establish, in those schools the grammar school ethos that exists in grammar schools, try to replicate that in those comprehensive schools. I visit schools every week and I've seen some very high quality comprehensives in very deprived parts of Britain that can achieve just that and what they do is they set their children by ability so that children are taught in similar ability group, whereas in a lot of comprehensives under this government, only about 40 % of lessons are set. So that's a key priority, getting behavioral standards raised in our comprehensive schools, strict school uniform, a rigorous academic education, then you'll see the grammar school type of education existing in the comprehensive ...(interjection)
JON SOPEL: If you're so keen on the grammar style education, expand grammar schools.
NICK GIBB: No, why aren't you telling me to expand secondary moderns. Nobody who advocates grammar schools simultaneous advocates secondary moderns. They provided a very poor quality of education. Why do you need two separate buildings to provide high quality education across the ability range. We believe very strongly that you can create the grammar school ethos in every comprehensive school in this country and that's our aim - behavior, rigour, strict school uniform, extra curricula activities, competitive sports and that's how you created a grammar school ethos in our comprehensive schools.
JON SOPEL: Nick Gibb we must leave it there. Thank you ever so much for joining us on the Politics Show.
END OF INTERVIEW WITH NICK GIBB
END OF INTERVIEW
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The Politics Show Sunday 13 July 2008 at 1200BST on BBC One.
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