Press Office

Aired: Sunday, 28 May, 2006 10:00
Sunday Live with Tim Marshall

Marshall:        It’s not that bad, I have talked to a lot of people who say the health service is pretty good, they say that waiting lists are down.  You keep telling us it is in crisis but on the ground people are saying its ok.

 

Lansley:          Well I hope that one of the things Andy and I will agree about is that there is a great deal of very good work being done in the health service and there’s more than a million NHS staff who are doing level best to provide good quality care.  In many cases they’re succeeding and the reality of what people experience is very often very good care from staff in the NHS.  The problem is that that is being done in spite of the government, not because of the government.  The problems that the NHS is experiencing are management problems from the top, now, you said about people leaving the NHS?  Well, Aidan Halligan, who was Deputy Chief Medical Officer, said that basically the service is rudderless, there’s a void of leadership.  Andrew Foster who was Director of Human Resources for the NHS said there’s a big gap between hard working frontline staff on the one hand and what he described as systemic dysfunctionality on the other.  It is not only the Home Office which is a dysfunctional department, the health department at the centre is not helping the NHS to deliver.

 

Marshall:        Andy Burnham, new health minister, you can perhaps say that that is just politicking by one of your opposite numbers but it is much harder to take on board the fact that people have resigned and have said it is rudderless and say that your management structures that you have got  and your big ideas simply aren’t working.

 

Burnham:        Well, I do reject what Andrew says.  To say that it is the government – it is not down to the government.  This is the government that has put record amounts of investment into our National Health Service and that good patient care that Andrew rightly talked about is down, in large part, to that major, major investment.  There has been a clear direction from the very beginning since Labour took office about the way in which we wanted to see our NHS develop.  We wanted lower waiting lists, shorter waiting times, better quality health facilities, buildings, hospitals, more doctors, more nurses and that is what we have done.  Yes, the NHS faces a difficult year, of course it does, but the direction has always been extremely clear from this government.

 

Marshall:        But why are such senior people resigning and using such heavy language, such as saying it is rudderless, I mean, these are the people at the coalface.  Like I say, you can take on the political argument of your opposite number but how would you take on the argument from the people who are actually in the health service and are saying that what you are doing isn’t working?

 

Burnham:        There will always be differences of opinions about the way in which healthcare should go and people will have different views about the extent to which reform should take place, the extent to which money should follow the patient but we are very clear about the kind of health service we want to create and it is actually now the kind of health service that is unfolding before us.  We want to see patients having full choice of where they’re treated, not the old like or lump it and get what you’re given NHS where patients are just told when and where they are going to be treated.  We want to see a health service reformed and that is what is happening.  Now, there may be differences of opinion along the way but we have a very clear vision about where we are taking our National Health Service and let’s remember it was my party that created and it is my party which is reforming it in the way we are.

 

Lansley:          Well, if Andy stops trying to live in the 1940’s let’s get into the 21st century and actually in the NHS I know he’s recently been appointed a minister in the department of health but the reality is that we all, on my side as well as his, we want to see money follow the patient, we want to see choice for patients but it is not being handled well.  The payment by result system;  the government were supposed to be introducing a tariff, they announced it in February, they then had to withdraw it because there were fundamental errors in it, they then re-announced it just ten days before the start of the financial year.  Now, if you want to know one of the reasons why we’re seeing all these job losses it is because of the way in which the government has managed the process of allocating money across the country.  The John Radcliffe hospital will tell you actually they’re not getting the resources that they think they ought to get for the number of patients they are having to treat and the disease in Oxfordshire.

 

Marshall:        Your boss, David Cameron, said a month a go that you can spend less money and you can have more doctors and nurses.  How?

 

Lansley:          He didn’t quite say it in those terms actually but what you have to have are resources that are allocated across the country according to the level of disease, not just government assumptions about what the overall requirement is in different parts of the country.  The government has been manipulating, it has been shifting money across the country and that is causing places like Oxfordshire to lose out.  But also they just didn’t organise the system for allocating money properly and there are hospitals literally in the weeks after this new tariff was announced by the Department of Health who have announced job losses.  There are 60 hospitals now, 60 who have announced in the last two months 14,000 job losses.  Now, Andy and I can agree about the necessity of health service frontline staff delivering quality care but that is not going to carry on if we have the NHS which the resources of which are not being well managed by the government and they have got 14,000 staff or 14,000 posts that are being lost in hospitals across the country.

 

Burnham:        I’d like to come back to that if I could.  There are three myths that the opponents to the National Health Service in the Conservative Party are continuing to put around.  Firstly that there are widespread redundancies in the NHS -

 

Lansley:          - There are no opponents to the National Health Service, Andy, I am in support of the National Health Service and you know it.

 

Burnham:        - They say there are widespread redundancies but that is not the case.  Some trusts are looking at freezing numbers of posts but there are very few compulsory redundancies taking place in the health service.   The second thing they try and claim is that this is happening everywhere, all over the country, but it isn’t at all, it is in a very small number of NHS trusts – about 7% of trusts.  They also try and claim that this is directly now reading to cut backs and services on the ground and that patient care has been sacrificed but that is completely wrong -  

Lansley:          - It’s not wrong.  I can show, I can take you to places, I can show you where services have been cut back.

 

Marshall:        - The Healthcare Commission on Friday issued its report that said nine out of ten patients rated their care as excellent, very good or good.  The health service is performing extremely well but in some parts of the country there are difficult decisions on the ground and trusts are doing what is needed to be done to get their books into balance but that is the right thing to do, they have got to go through that process. 

Lansley:          Well hang on a minute.  Literally in the month just gone hospitals in this country will be carrying forward a deficit of 1.1 billion pounds, rather than money going to the frontline in the year ahead, Andy you know this is true, there is going to be about one and half billion pounds which is going to get taken out of frontline care to pay off these deficits.  There are wards being closed, there are over 100 beds that are being shut in main hospitals, this year I suspect we will see more than 1,000 beds lost in hospitals.  14,000 posts lost – not all redundancies but if you’re a nurse trying to find a post and you have just been in training and those posts have been abolished then you don’t find a job that’s why the Royal College of Nursing said a few weeks a go that 50% of nurses coming out of training aren’t going to find jobs.  Now, if we are trying to develop the National Health Service, and Heaven only knows there’s still more that we need to do, we can’t do it in circumstances where the mismanagement is such that jobs are being lost, that people can’t find posts when they leave training, that the services is hospitals are being cut back.

 

Burnham:        If you don’t mind me saying this is completely rich coming from a Conservative Party that stood at the last election with their patients passport which would have siphoned millions of pounds out of the NHS and who said they would take more than half a million pounds out of NHS bureaucracy, now that would have seen major job losses all around the country -

 

Lansley:          - Well cutting bureaucracy would be quite useful wouldn’t it Andy?

 

Burnham:        - There is no huge crisis as Andrew tries to claim, the NHS is performing extremely well on the ground all over our country-

 

Lansley:          - So, after ‘the best year ever’ we arrived at, ‘there is no crisis’?  Try telling NHS staff -

 

Burnham:        - Waits are shorter than they have ever been, yes there are some difficult decisions being taken in some trusts where they have to balance the books but the public would say to you Andrew, and to me, the NHS is not a bottomless pit, it has to be properly managed, it has to at the end of the day balance it’s books, there is not a blank and those trusts are taking those decisions.

 

Lansley:          Of course it has to be properly managed but that is the whole point!  The senior staff in the NHS are leaving, the Chief Executive had to resign because of a financial mess, his deputy has effectively been sidelined, the Deputy Chief Medical Officer has left saying the service is rudderless, the Head of Personnel for the whole of the NHS has left saying there is systemic dysfunctionality.  I am afraid it isn’t about whether or not the staff at the frontline are delivering, they’re doing their best, it is about whether the people at the centre, like ministers, are actually running a service that is efficient.  And you talk about well, we don’t need to cut bureaucracy - we certainly do.  There have been 106,000 extra administrators in the NHS since 1997, even last year there were only 5,500 nurses recruited but there were 11,000 administrators.  Frankly Andy, that’s what it comes down to.

 

Marshall:        Andrew Lansley if I could jump in there.  I am a little hard at understanding on this issue because at the beginning you said yes things do seem to be going pretty well, waiting lists are down this that and the other although not down to the Labour party so I don’t quite understand why it is all going so horribly wrong.

 

Burnham:        Well said.

 

Lansley:          Because the finances are going wrong, that’s what is happening.  The last three years we have seen progressive problems; two years a go there were small deficits, last year the deficits were 250 million, the year just gone now it’ll 620 million net deficit, we’re running into this financial year and they’re going to have to find one and a half billion pounds in order to deal with it.  Now, the money is not being spent at the frontline in the way that it should.

 

Burnham:        Can I just say Tim that you nit the nail squarely on the head with your question there.  All the good things, according to Andrew in the NHS and there are plenty of them, are nothing to do with us the government at all but all the bad things, well, they’re all absolutely our fault.  It’s all an agenda which suits him and the Conservative Party at this particular point in time, they want to talk down the NHS, they want to talk up this sense of crisis but the facts on the ground don’t bear that out.  The people who are being treated in hospitals up and down the country, who are going to good primary care facilities rebuilt in my community here where I am now, well, they know the reality on the ground, they know this government has put the money in and that’s what they see and why they won’t buy all this wild talk about it all falling apart.