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Wednesday, 23 May, 2001, 12:54 GMT 13:54 UK
Nick Harvey quizzed

To watch coverage of the forum, select the link below:

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Nick Harvey is the Liberal Democrats' health spokesman. He has held a campaigning role for the party alongside several policy roles.

He answered your questions in a live forum on Wednesday 23 May.

Highlights of interview:

News Online Host:

Two opposing views, let me put them to you. The first one from Bob. If we do have European tax harmonisation we might finally have to pay enough tax to support our beleaguered public services, and we might be able to afford a health system like that of Germany's, a social system like Holland or Sweden and a decently publicly-owned transport network. Then there's Steve Mortimer from Basingstoke, who said that if a tax were to be placed on public transport and books then people would simply stop buying them and start importing things using the web.

Nick Harvey:

Yes, that's an interesting point. I mean, Bob, the first person with the question, I mean, we could choose to levy taxes at a level to do all those sorts of things for ourselves. We don't need Europe to tell us to do that. And I'm very much against tax harmonisation. If we go into the single currency it's very important that the different countries within the single currency have got control over their own tax affairs. Because they'll need to levy different taxes at different points in the economic cycle, if we're all compelled to have one interest rate. If you look at America, there's a single currency there across all 50 states, but actually tax competition between the states of America. It's an essential internal dynamic of the American economy. And it would be an essential dynamic of the European economy within a single currency as well. So if that is what lies ahead, it's very important we have tax competition and not tax harmonisation.

News Online Host:

Well, to be fair as well, the European Commission have said today that that's not what they're planning anyway, isn't it? Let's move on to health. And, the first one here about your policy on health, from Neil Perry in Warwick. Your promises on waiting times and recruitment are surely not deliverable in the course of one parliament. Labour had more modest ambitions and have struggled to deliver on them. Why should yours be any more plausible?

Nick Harvey:

Let's separate those two points out. He's talking about waiting times and recruitment. Commitments on recruitment are entirely deliverable. I don't think anyone would seriously dispute that. There are plenty of people applying to nurse training, for trainee doctors, to be therapists, as well, there's no shortage of people coming forward. The problem is the lack of places. And certainly we have talked to the providers of these trainings, the deans, the faculties, who would all very much welcome this commitment to increase the numbers. I mean, if I'm blunt, I think it is a fairly modest pledge that we're making here. But I'm absolutely confident that it can be delivered. On waiting times, we have quite deliberately avoided making specific commitments and specific targets. Our proposition to the voters is, under the Liberal Democrats there will be more doctors, more nurses, more beds than there would be under either Labour or the Conservatives. And I am not going to try and run the whole NHS from a Whitehall office, I will leave it to clinicians to make the decisions because I am confident that the waiting times will be shorter under the Liberal Democrats than they would be under either of the other parties because the capacity of the NHS would grow.

News Online Host:

Isn't this though a problem for you, in that a lot of your commitments do seem to be, let's say, more extravagant than the other parties? They seem to be very careful to promise actually very little.

Nick Harvey:

The other parties are promising very little, particularly the Conservatives, whose manifesto contains no commitment to have a single extra doctor or a single extra nurse in the NHS. And how they think we could improve standards without doing that, it's very hard to see. The Labour party set out its stall on health last year when they published the national plan. Much of which they have repeated in their manifesto, with a few new ideas on top. Now we agree with the general direction of travel of the national plan for the NHS. Our concern is that they are simply not going far enough, fast enough. So what we are suggesting in our manifesto is that they need to just be somewhat more ambitious on these recruitment targets and I don't think there's any reason to doubt that the numbers we are talking about can be achieved.

News Online Host:

OK, well, another question about your policies. Philip Howard, from Guildford, he's wondering how you as a party can claim to be more health conscious than the others because you proclaim, he says, the legalisation of cannabis. He supports all your other policies except for this one. In fact he would rather see tobacco banned.

Nick Harvey:

We don't proclaim the legalisation of cannabis as one of our policies. What we do say is that drug abuse is a very serious issue and that it's important that we have an adult debate about this. Not simply about issues of legalisation but how we deal with it, the treatments that we give, how we try and police the whole drug problem. And that royal commission that we propose looks at all of these issues would also look, as he's getting into there, at issues of alcohol and tobacco. But you know 30 times as many die as a result of something related to alcohol, and 100 times as many people die through smoking as die of drug abuse. So it is important to look at these issues together. All we've said is that if a royal commission, bringing together the evidence of judges, doctors, police officers, and everybody involved in the relevant issues, were to say that we should revisit the issues of criminalisation, we would have an open mind to that. And so I think he's wide of the mark in saying that we've already arrived at a foregone conclusion about legalising cannabis.

News Online Host:

Now, another question about, let's say individual freedom here. MMR, the vaccine that children have to have, all lumped together now, measles, mumps, and rubella. A question here from Terry Vance in London, will the Liberal Democrats let parents choose which vaccinations their children should have and not force them to have the combined MMR?

Nick Harvey:

Yes, we would allow them to have them done separately. But we would be looking for a commitment from parents that they were going to do all three. We respect the fact that some parents have misgivings about the combined vaccine, and we're prepared to let them exercise freedom of choice over that but we don't want to see a dropping off of the levels of immunisation and so we would be looking for a commitment from parents that they would follow through with all three courses. But that in fact in total would mean six jabs, and many parents would prefer to deal with it in the single jab. But we would, we would keep an eye on it, having allowed that, and monitor closely to make sure that levels of immunisation didn't drop. In fact, we think they might go up because those who don't put their children under MMR would be prepared to go and do them separately.

News Online Host:

Now some countries, Australia is one, actually make it compulsory. You simply don't have any option, you can't send your child to a nursery, you can't do all sorts of other things unless you can provide the form saying that they've had their jabs. Is that something that you'd consider? Or is that too illiberal?

Nick Harvey:

No. I think it is too illiberal, unless we got to a situation where there were really public health considerations because levels of immunisation were falling drastically. There's no sign of that at the moment and I can't envisage circumstances in which that would come about.

News Online Host:

OK, now a couple of questions on NHS reform. James Ades from London says most people would agree that the NHS has been starved of funds. But aren't the problems even more fundamental than that? What do you plan to do in the introduction of wholesale root and branch changes to the system? Would you, for example, abolish GP fund holding?

Nick Harvey:

Well, GP fund holding has gone. The government has just reorganised primary care into primary care groups and primary care trusts. It's been a fairly massive upheaval and it came hot on the heels of fairly massive upheaval in primary care that the previous Conservative government put in when it brought in the GP fund holding. Now tempting though it would be to whip out a Liberal Democrat blueprint on how primary care should be organised, frankly it's the last thing that primary care in this country could stand, another complete root and branch form of upheaval. So although we don't necessarily think that the primary care trust route is perfect in every last respect, we do feel and we hear what GPs say on this, that a period of calm to allow these reforms to bed in and see how effective they are is absolutely vital. So in that respect, no, we don't plan root and branch reform of primary care.

News Online Host:

OK, now another question on NHS reform from Vicky Bolton in Winchester, who quite likes the Monster Raving Loony party's idea of cutting hospital bureaucracy by using forms that are only one A4 side long. Do you think that, to coin a phrase, the NHS is drowning in a sea of red tape?

Nick Harvey:

I think it is. I think there's far too much paperwork and bureaucracy. A lot of it coming down from the top where governments set these rather arbitrary targets for bluntly political reasons because they want to achieve some particular political goal over a particular timescale and this actually ends up with doctors and nurses and people who should be spending their time treating patients having to do far more paperwork than is frankly very healthy. It would be a laudable aim, I think, to try and make every from one side of A4 but whether people with very complicated conditions could really get all their medical particulars down on one side of A4, I don't know, but it would certainly be a goal worth striving for.

News Online Host:

Now what about junior doctors? Chris Barry in Surbiton says, what would you do about the ridiculous hours that junior doctors have to work?

Nick Harvey:

I mean this is a very serious problem. It always strikes me as rather an irony that we have the 48-hour week from Europe and if you sort of stuff peas into a tin in a factory it's absolutely essential that you don't work more than 48 hours, but exemptions are granted for train drivers, aeroplane pilots and people performing complex surgery. It is actually wrong that this is the case. So we are very much in support of getting that down to 48 hours. Now the European Commission and the British government and the courts have now agreed a timescale for this. Frankly, it is too long, and it is too leisurely. But what can you do about it? You've got to have far more doctors in the system in order to bring these hours down and you can't do that just overnight. So we will have to recruit more and more doctors from abroad until such time as the additional training places in Britain, which we are talking about in our manifesto, have had time to deliver a qualified doctor.

News Online Host:

Right now. Another question from Tony, its about pharmaceuticals, which is a key part, really of your policy, and about reforms, and he says, won't your intended pharmaceuticals agency just drive drugs companies, which are a valuable part of the UK economy away from this country?

Nick Harvey:

It's an interesting point that he raises. There's no real reason why it should. They are still going to want to sell their drugs in the UK market. It's a very sizeable market. So what is the point of uprooting with all the costs that that involves, going off to another country, setting up new factories over there and then paying the transportation costs to ship the pharmaceuticals back to the UK to sell in the UK market? There's really no reason why it should drive the pharmaceutical industry offshore. And I would be very sorry indeed if I thought that the only reason the pharmaceutical industry chose to base itself in a substantial way in the UK was because the NHS pays too much for its drugs. And the NHS does pay too much for drugs. We pay far more for the same pharmaceuticals than they do in America or they do on continental Europe and I have pharmaceutical companies who say to me, it's a terrible scandal that there are so-called parallel imports that people are bringing in drugs in from France at a lower price and not buying them here. Well, my answer to the pharmaceutical companies is quite simple, if you bring your prices in the UK down to what they are in France nobody will be going over there to make parallel imports.

News Online Host:

I mean, will the savings really be that significant? I mean, you're talking about really renegotiating the NHS's relationship, aren't you, with the pharmaceutical industry?

Nick Harvey:

That is exactly what we are talking about doing. At the moment the NHS pharmaceutical budget goes up about 10 per cent each year. Way ahead of inflation that currently runs at two and a half, three per cent, so it's a huge year on year growth. Now when New Zealand decided that this was getting out of hand there, they also had 10 per cent year on year growth, they put in place an agency along the lines that we are talking about, and that agency has succeeded in bringing New Zealand's year on year growth down from 10 per cent to three per cent. Now we're not proposing to be quite as draconian as that. We are suggesting trying to bring the year on year growth down from 10 per cent to seven per cent, and over a period of time that does begin to make considerable savings and our commitment is that those savings will be used to end the post code lottery, where people in one part of the country don't get access to drugs that people in another part of the country do. But also to make sure that British patients have access to the most modern drugs. In many conditions, we're still treating people with horribly out of date drugs compared with what is available elsewhere on the world market. Nothing could be a better example of than that mental health, where we're still treating mental health patients frankly with 1950s drugs. Many of them get very negative reactions to those drugs and don't like taking them. There are modern drugs available for helping people with mental health problems, particularly in America which don't have any of these side effects, and which patients in America are very happy to use and have a much better take-up level. So it's impossible to say exactly how successful this will be, but it is bound to save some money and that money can be used to make sure that the best pharmaceuticals are available to all.

News Online Host:

Now, another question about professions really, but one that's often overlooked, the role of social workers, and George Howard from London says politicians like to wax lyrical about the contribution of nurses and doctors, and policemen, and so on. Do you value the social work profession? And if so, what would you do about recruitment, long working hours and poor pay?

Nick Harvey:

Yes, I mean, social workers do have all of those problems. He is absolutely right. There are recruitment problems and there are certainly pay problems and in London and the south east it's a very competitive salary rate to bring in. We do want to get more money into the social services, firstly because we want better social services, but secondly, an inadequate social care network contributes to the problem of bed-blocking. If we could only get a better social care network going, some people would never need to come into hospital in the first place, others would be able to get out of hospital a lot quicker and the other thing that we would avoid is re-admissions, when people are put out of hospital too quickly but because there isn't an adequate social care network there, they have to end up being re-admitted and coming back in. Now Liberal Democrats are committed to free personal care for the elderly and disabled who have to have long-term care. At the moment that is means-tested. This would be a huge injection of funds into social care. Now I admit it's targeted at that particular group. But the additional money that that would put in to the social work field would, I think, take a lot of pressure off social services departments and actually enable them to perform all their duties rather better and on a better resourced basis than at present. And as time allowed and the economy grew, we would seek to get really significant increases into social services departments budgets.

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