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JOHN HUMPHRYS: Alan Milburn let's pick
up that point that he made at the end there about beds. This is an enormous
problem isn't it. We have far fewer beds per head of population than our
continental cousins, Germany has twice as many as us for instance. We should
have as many beds as them should we not?
ALAN MILBURN: We should certainly have
more beds in the health care system that is absolutely true. While I don't
know quite what the German figures are but what I do know is that over
the last ten, twenty years, the number of acute beds in hospitals has fallen
enormously. I think we have lost about forty thousand hospital beds during
the last twenty or so years and my view about this is that, look if we
are going to deal with the demands that an ageing population brings and
there are more and more old people and we've seen some of that this winter
with a lot of very elderly people in hospital prone to respiratory illness
and flu and so on. And that is the sort of situation that the NHS is going
to have to deal with, not just for one winter but for others. And if we
are going to do the sort of activity rates that we want to do in the National
Health Service now, as we expand the Health Service, then we will need
to see more beds in the system. And my view about hospital beds is that
the trend rate of decline that we've seen with the number of beds falling
simply can't keep pace either with an ageing population or indeed with
the increased activity that we want to do. So we want to expand the number
of beds but we have also got to make sure that we get the right beds in
the right places and it isn't just a question of getting more beds into
hospitals, it's also a question of making sure that we get beds in the
appropriate place. For example, we know now from this National Beds Enquiry
which we just published, that there are around twenty per cent of hospital
beds are inappropriately occupied, often by elderly people, they've come
into hospital, they've been properly treated and they are ready to leave.
They can't leave because they are not ready to go home and they need a
step down, they need an intermediate level if you like to build a bridge
between hospital and home and that is what we are going to do. We are going
to have more beds in the home care system, more active rehabilitation,
more recovery services, precisely in order to get people back on their
feet again.
HUMPHRYS: So how many more do you
think we need?
MILBURN: Well the National Beds
Enquiry said that over the course of next three or four years, we might
need up to four thousand more beds in the whole care system. Now there
are some choices to be made about where those beds are best provided. My
own view about this is that what you need to do is certainly need to expand
some beds in the acute sector in hospitals, we know and your report has
just pointed to, for example, the problems that we had with critical care
beds and we need to expand the numbers there. But when we talk about beds,
by and large we are not just talking about pieces of wood and iron...
HUMPHRYS: ...you're talking about
people..
MILBURN: ...exactly. Christine
Hancock from the Royal College of Nursing got this absolutely right when
she said look, you know the issue here is not just trying to get beds,
it's trying to get trained staff. I can buy beds in any high street but
I can't get is trained nursing staff and trained doctors, I certainly can't
get them overnight. But thankfully there is some good news there because
we are expanding the numbers both of doctors and nurses. I think we are
beginning to turn the corner on nursing shortages in the National Health
Service. We've now got about four and a half thousand more nurses in place
now in the NHS than we had a year ago and we've launched this very big
recruitment campaign that I hope will get more nurses and physiotherapists
and scientists into the Health Service.
HUMPHRYS: So you accept the logic
that says it's all very well to talk about efficiency but there is such
a thing as being too efficient in the sense that if you are operating at
a hundred per cent capacity as some of the hospitals...one of the hospitals
we saw in that film were, you have no slack so eighty five per cent is
the maximum bed occupancy that you should be able to tolerate. You accept
that theory, that principle.
MILBURN: I think it is true to
say that we need more capacity in the National Health Service and that's
what modernisation is all about. It's both about expanding the services
but changing the services too. So yes, we need more beds, yes we need more
doctors and we need more nurses and we are getting more of those. But we
need to change the whole of the way the Health Care system works. So as
I say, for example we need to see a new emphasis, particularly with an
older population on this form of active rehabilitation and recovery that
we haven't had in the past. It simply hasn't been there and it's not surprising
that when I went to St. Thomas's Hospital in London with the Prime Minister
on Tuesday and we talked to consultants in Accident and Emergency there
about whether they had enough beds in A&E they said well yes and no. Well
what do they mean by that? - they mean yes they do have enough beds providing
further down the hospital system, further down the care system, there are
enough beds there and if I go and talk to staff, as I do in acute wards
in hospitals, they will say if we could use these beds more appropriately
and ensure that we could get people discharged at the right time into the
community, into step down facilities, into rehabilitation and recovery,
then sure we can make better use of the facility that we've got. So it's
both a question of expanding the capacity and changing the way facilities
are delivered.
HUMPHRYS: Since you acknowledge
that capacity has to expand, it is odd isn't it that the newer hospitals
have fewer beds than those that they are replacing. We were looking at
the figures just yesterday, two thousand five hundred beds were lost, you
acknowledge yourself that many beds have been lost in the last few years,
two thousand five hundred beds were lost in the first eleven new hospital
schemes, that's over the last five years. So this is rather odd isn't it,
that we are building smaller hospitals with fewer beds to replace larger
hospitals with more beds, when we need more not fewer beds.
MILBURN: Well I'm not sure where
those figures come from because I can tell you what the real figures are
because we actually build the hospitals...
HUMPHRYS: ..comes from the King's
Fund, pretty reputable..
MILBURN: ..it is very reputable,
indeed, it's a very good organisation but you know I can tell you what
the real figures look like. We've got this enormous hospital building programme
under way now, actually the biggest hospital building programme that the
National Health Service has ever seen with thirty-seven new hospitals either
being built or in the pipeline. When I as Minister of State, prior to becoming
Secretary of State announced the first wave of these new hospitals, the
fifteen, actually the numbers there showed that the number being built
through the private finance initiative route and the number of beds available
through the PFI route were broadly the same as if it had been built with
exchequer capital. But I think what we have got to start moving away from
you know, is this idea that the whole problem can be solved by expanding
the number of hospital beds..
HUMPHRYS: ..but you have acknowledged
that that is absolutely crucial in the first five minutes of the interview...
MILBURN: But what I am saying is
that what really counts is the number of beds in the whole care system.
You have got to get the right number of beds, but you've also got to get
them in the right places too. So sure, of course we need more critical
care beds in hospitals, sure if we are going to be...
HUMPHRYS: ...three times as many?
MILBURN: ...we need a lot more
critical care beds in hospitals and that means that we have got to have
more critical care staff. It means that we need more consultants, it means
that we need more nurses too. But I tell you what will happen, if we expand
the number of hospital beds without expanding the number of beds at an
intermediate level, in cottage hospitals and community hospitals and in
step down facilities, precisely to give older people the sort of rehabilitation
and recovery that they require, the whole system will become snarled up.
HUMPHRYS: ...you better stop shutting
cottage hospitals for a start.
MILBURN: Well what we have got
to do is give cottage hospitals a new lease of life and what I want to
see for example is to turn them into more active institutions that do what
old people, like people of our generation want. What they want is to live
an independent a life as possible, that all too often John, what happens
is an old person comes into hospital, they have their treatment in care,
and they end up being discharged into a residential home or a nursing home.
And they are literally banged up there for life. Now residential and nursing
care is of course appropriate for some people but not for all. And I want
to provide a choice for people, but that means that we have got to reform
the system, modernise the care structure to make sure that we are starting
to manage the health system as if it is one system rather than a series
of competing, free standing health institutions.
HUMPHRYS: Let's look then at heart
disease. Again, you're not going to argue with this, we have the worst
record in Europe, and you're going to do something about it. What are
you going to do, we hear about a heart Tzar for instance?
MILBURN: Well, tomorrow in fact
we'll be launching what amounts to a national crusade against heart disease,.
This is a blue-print that has been draw up by Sir George Alberti and some
of the leading clinicians in the land to tackle Britain's biggest killer.
Around a hundred thousand people a year have died from coronary heart
disease, many of those deaths are preventable, and we will try to prevent
them by better prevention and earlier intervention, because that can make
a real difference. What this blue-print does is look at the sort of services
that are required in every aspect of the care system, not just in hospitals
where of course we need to see faster access to surgery, a point illustrated
in your film, but we also need better prevention too, and what the blue-print
will be laying out is a whole series of measures to speed up intervention
and to put a new emphasis on prevention as well.
HUMPHRYS: Surgical intervention
if necessary. So it's reported that you will have a three-month target
for a by-pass operation, is that right - three-months waiting list for
that?
MILBURN: Well, you'll have to wait
and see what is published tomorrow, but what I will say is this, that we
need to get the waiting times for heart surgery down. It frankly isn't
acceptable that people have to wait in some cases for eighteen months for
heart surgery at the moment. But I can only get the waiting lists down
as I build the capacity up, and the truth is right now that we've inherited
an NHS that is under-doctored, where we have a shortage of nurses, and
where we have a shortage of trained staff too. Indeed when we got into
office the number of nurse training places had been cut. As a consequence
we are having to turn this round and build up the capacity of the NHS,
so for example I think at the moment we only around one-hundred-and-seventy
heart surgeons in the National Health Service, and that simply isn't enough,
so I'm going to build up the capacity, but it takes time to get there,
it simply takes time to train nurses and to train doctors.
HUMPHRYS: Well, that's fine except
that what Professor Alberti of whom you speak approvingly says, is that
they're there, they're waiting, but they cannot afford - the hospital
trust cannot afford to create the consultancy posts because there isn't
enough money.
MILBURN: Well, we are creating
the consultancy posts
HUMPHRYS: Because there isn't enough money.
MILBURN: Actually we are creating
the consultancy posts and one of the very first.....
HUMPHRYS He says only half of the
ones that are needed..
MILBURN: Well, one of the very
first things that I did when I became Secretary of State, is I said: 'Look,
there are two key priorities for us aside from mental health which is a
very important set of services, and that is improving heart disease services
and improving cancer services. Why, because they are the two diseases
that are killing most people off in this country.'
HUMPHRYS: And why haven't you appointed
twice as many as Professor Alberti said you could have done?
MILBURN: And what I said at the
time is that I was going to create and extra four hundred consultant posts.
That is what we are going to do. An extra three-hundred and thirty cardiologists,
and an extra eighty cardio-thoracic surgeons , Now the extra eighty cardio-thoracic
surgeons, heart surgeons, will be in effect a fifty per cent increase on
what we have, but you've got to train them, and it takes time. They don't
grow on trees.
HUMPHRYS: With the best will in
the world, that isn't the point. The point is that they are there, they're
waiting, they're registrars, senior registrars or whatever. Professor
Alberti himself the source on these matters says they are there but there
is not the money to create the consultancy posts.
MILBURN: But that isn't true.
HUMPHRYS: Well......
MILBURN: That simply isn't true
John.
HUMPHRYS: ....on that film.
MILBURN: With the greatest respect
it simply isn't true, and what I've said is I want to see more doctors
in training and indeed we have put more doctors into training. We have
created.....
HUMPHRYS: Will you able to provide
the money to allow them to become consultants?
MILBURN: Hold on. Hold on. We've
created an extra one thousand medical places in universities, one of the
first things that the Government did when we came into office, and at the
same time as they people go through training, and remember it takes five,
six or seven years to fully train a doctor before they can become a consultant,
as they come through we will create the consultant posts, and that is a
commitment that I've given, for example for cardiology and for heart surgery,
because we need more of them.
HUMPHRYS: You've obviously not
satisfied Professor Alberti on that one. What about the other. He says
that you need to double the number of heart operations being carried out
at the moment. Do you accept that?
MILBURN: I certainly think that
we need to dramatically expand the number of heart operations. Well, I
think you'll have to wait 'till tomorrow to see what the National Service
framework says, but there is no doubt whatsoever in my view that you've
got to do two things: One, you've got to increase the number of heart
operations that take place, and secondly you've got to bring down the waiting
times that it takes to get treated. People are waiting far too long to
be treated at the moment, and we've got to change that, but as I say you
can only bring down the waiting times as you build up the capacity and
that means getting more doctors and nurses into the system. But the other
thing that we've got to do aside from expanding the services is to reform
the services too, to modernise them, so for example tomorrow I will be
announcing that we are going to establish so new fast track chest pain
clinics. So if you go along to you GP with suspected angina in the future
you will have a guarantee of being seen by a hospital specialist within
two weeks, rather than having to wait two months or longer to be seen.
Why - because if you've got angina it must be pretty worrying for you,
it must be one of the worst times in your life from a patient's point of
view. Secondly the sooner we can get you seen the sooner we can get you
treated and put you on the road to recovery. Now that is what I mean by
modernisation, the expansion and reform in the way that services are provided.
HUMPHRYS: That would be terrific
if I popped along to the clinic and they said: yes, you've got a problem,
you need an operation. You need it now, very, very soon indeed. But then
you see the problem is, Professor Alberti and his colleagues say, : Well,
I'm sorry, we'd love to be able to do it, but we can't, we haven't got
the surgeons to do it, we haven't got the money to appoint the surgeons
to do it. So how soon are these things going to happen? It's all very
well there being as many modernised clinics as you like, but it's ......
start the operating.
MILBURN: Well, they're going to
start happening from April this year.
HUMPHRYS: Yeah, fine.
MILBURN: So we're going to start
rolling them out....
HUMPHRYS: Clinics are no good without
the ....
MILBURN: Yes, of course.
HUMPHRYS: ..... people who can
operate on you if the clinic says you need an operation
MILBURN: That is absolutely true,
but remember a lot of people with angina and suspected heart disease, a
lot of people need various forms of treatment and it isn't just heart operations
that they need, they need better drugs, sometimes they need simple things
like exercise and better diet, and these fast track chest pain clinics
will be in a position to provide that sort of advice. So it's a change
for the system, but it's an expansion to the system as well.
HUMPHRYS: Can I offer you a part
solution here, that does not come from me, but from people who know much
more about these things than me, and that is this, that you have too many
priorities in the Health Service as we speak, and your biggest priority
right from the very beginning, the thing that helped you to win the election
was pledging to cut waiting lists. Now that's all very well, to say people
don't like waiting lists, of course they don't, none of us likes to be
on a waiting list, but the problem with it is that it does distort priorities.
Now you say , you go along to your chest clinic and you can have an operation
more quickly. You could have it a darn sight more quickly if people who
run hospital trusts and authorities weren't so obsessed because you have
told them they must be obsessed with cutting the waiting lists. And they
say: well, we can cut the lists a darn sight more quickly if we do half
a dozen varicose veins operations than if we do a triple heart by-pass,
so get rid of that waiting list pledge for a start.
MILBURN: Well I believe in one
thing in politics and that is that if you make promises you should keep
to them.
HUMPHRYS: But if you've made a
mistake, you should get rid of it (both speaking at once)
MILBURN: It isn't a mistake John
and I'll tell you why. As you cut waiting lists so you cut waiting times
and that is what people care about.
HUMPHRYS: Not if you've got to
wait even longer to see a consultant......
MILBURN: Well I tell you that is
the case because when we came into office as everybody knows waiting lists
were going like that, they peaked and they're coming down and since they
have been coming down......
HUMPHRYS: Waiting time to see a
consultant hasn't come down........
MILBURN: ..... and since they're
been coming down the time that you wait as an inpatient for an operation
has fallen as well and it's pretty much common sense isn't it? If you
go along to the supermarket which queue do you choose to wait in? You
choose the shortest queue, of course you do because there's an intimate
link between the size of the list and the length of time that you wait.
Now it is important that we get the waiting lists down not just because
we said we would, although it is important that we keep our promises, but
also because it is the right thing to do and when I, tomorrow, announce
that there is going to be a shorter waiting time to get access to cardiac
care in the national health service, people I hope will say that that is
the right thing to do because the emphasis is (both speaking at once).....
the emphasis is on clinical need which is the criticism that you're making.
I want to see the emphasis to be on clinical need, it should always be
on clinical need and it's exactly the same with cancer if I may say so.
What we've done there is again the right thing. Of course we're investing
in extra cancer services, modernising the equipment, getting more doctors
and more nurses in, but what we're also providing is a new and modern way
to get access to care so that if you go along to your GP and you have suspected
cancer and you need an urgent referral from your GP, rather than having
to wait for months on end now by the end of this year, by the end of the
year 2000, you will be seen within a fortnight by a hospital specialist.
HUMPHRYS: Alright. Excellent.
Every body will say that's terrific but are you saying to me this morning
that if that means that the person who comes along with the varicose veins
problem therefore, as a result of that, has to wait longer and common sense
says that if we have X number of patients, we have X number of surgeons,
if the priority for those surgeons becomes that particular thing those
patients, some of them, are going to have to wait longer. Are you happy
with that and if you saw....... Lets me finish the question because it's
a hugely important one, if you saw that the number of patients waiting
for less urgent operations was increasing, was increasing, so that your
actual target was not met but that the number of patients with the truly
serious conditions, cancer or heart problems was decreasing would you be
happy with that and would you be prepared to go into the next election
saying - 'All right, we didn't quite do what we intended to do with that
promise but look what we have achieved.'
MILBURN: Well it all depends on
the capacity because the people...........
HUMPHRYS: ..... of course it does..............
MILBURN: Well I know but this is
the important thing you see because it's back to this issue that George
Alberti quite rightly raised in your film about the number of heart surgeons
that we have. We've only got a hundred and seventy heart surgeons. We
need to expand the number of them and frankly the people who operate on
varicose veins aren't the same people who are operating on hearts and therefore
what you've got to do is expand the number of staff who are able to undertake
these clinical procedures. That is precisely what we're doing. Now if
people want to criticise us for expanding the number of staff, that's fine,
but if people also want to criticise us for saying 'look, it's too slow'
well look, I accept that, okay and I accept that it is extremely frustrating
for people to have to be told to wait but with the best will in the world
what I can't do John, is conjure, trained cardiologists and trained cardiothoracic
surgeons. Well I just can't.
HUMPHRYS: Well he says that they're
their already and it's just a matter of cash which would help them. This
is the problem isn't it. It is, in the end, you say it's about training
but what the doctors tend to say is, and people like Stephen Thornton........
yeah, of course that's part of it but it's also about money and if they
had the money they could turn those registrars, senior registrars into
consultants because they are there waiting they simply don't have the money
to fund the consultancy posts. So given all of these pressures - let me
quote what Stephen Thornton, Chairman of the NHS Confederation said, 'There
is precious little money left to invest in, what you describe as being
absolutely vital - 'modernisation'. You've got to have a short term cash
injection have you not?
MILBURN: Well we've put extra money
into the National Health Service for the next financial year, I listen
very carefully......
HUMPHRYS: But it's eaten up the
extra money you put it. It's eaten up in higher wages, working time directive
costs, higher pension coverage - it's gone. It's already gone.
MILBURN: That's what Stephen says
but I don't think it is quite right actually......
HUMPHRYS: Oh - somebody else who's
got it wrong?
MILBURN: What we've done is we've
increased the amount of money that is going out into the National Health
Service to the health authorities from the First of April they will get
six point eight per cent on top of what they're getting this year. Now
look, I recognise of course that there are very real pressures out there,
there are, and things like the working time directive and the fact that
we've had a big increase in the price of generic drugs nobody denies that
those pressures are there but they're taken account of in the amount of
money that we've put out into the service.
HUMPHRYS: But it's not as high
as you said. It's not actually six and a half it's actually four and a
half per cent in real terms.......
MILBURN: In real terms.......
HUMPHRYS: ..... but it's four and
a half per cent in cash terms. Let's talk in real terms..........
MILBURN: It's six point eight per
cent........
HUMPHRYS: Well let's talk in real
terms (both speaking at once) It's normally ten per cent. Professor Alberti
says it should be ten per cent.
MILBURN: ...... and that is a real
increase, that is an increase on what is going on in the current financial
year and listen, all sorts of clinicians and all sorts of doctors and managers
have very different views about how much the National Health Service needs.
At the time that we did this first comprehensive spending review that
has given the NHS the biggest cash injection it has ever seen - well let
me finish this point - the argument about this was that what the NHS needed
was a real terms increase of three per cent per annum. That is what it's
had for the last twenty-five or thirty years and many reputable organisations
and individuals argued for around three per cent. We haven't given it
three per cent. We've given it fifty per cent more than that. Around
five per cent in real terms.
Now if we can continue to
manage the economy well we can continue to get those sorts of increases
into the NHS and yes, over time, we will expand the National Health Service,
the number of staff in the NHS, but we'll change it too because it isn't
just a question of getting more money into the system it's using that money
to lever in real practical changes. Let me give you a good example of
that - just to finish this point because I think all too often, particularly
over the last few months the debate has been all about money for very understandable
reasons but there's another side to the money coin and the other side is
modernisation.
We are modernising Accident
and Emergency Departments. We've put in I think an extra one hundred and
fifty million pounds to modernise A+E's because they're needed to create
more space, to make sure that people have shorter waits. But it isn't
just a question of getting the three quarters of hospital A+E's that need
investment modernised, new buildings so that they look better and feel
better and there's more space, we're also modernising the way that those
A+E's work and that means crucially, getting nurses to the front end of
the hospital so that they're in a position to treat the patient first,
to triage them. That means making better use of nurse skills rather than
just assuming that nursing is just one discipline, medicine is another.
What we've got to do to
modernise the NHS is to break down these demarcations between staff because
if we do that the consequence is that patients will get faster and better
care. Now that is what we're doing and people like George Alberti want
to see an expansion in doctor numbers but what they also recognise is that
the traditional division of labour between medicine and nursing is something
that has to come to and end and it does.
HUMPHRYS: Alright, but what the
King's Fund says, you
heard Julia Neuberger there, if you don't get more cash now, we are...on
top of what you've already talked about, we are going to see another crisis
in the NHS this coming winter and you know the kind of damage that does
to you.
MILBURN: Well don't forget that
at the time of the
pre-Budget report in November, Gordon Brown held out the prospect of more
money for the National Health Service. What he said then and I think this
is a very very good idea indeed, is that in future rather than simply increasing
taxes on tobacco and putting that into the general government kitty, in
future if there are real terms increases in tobacco taxation, then that
money will be ear-marked for the National Health Service and he talked
then about increases which could amount to some three hundred million pounds.
Now, we will wait and see what is in the budget which is in a few weeks'
time.
HUMPHRYS: But you are going to
ask him for the money over and above that, for more money over and above
that, bearing in mind the Prime Minister's pledge a few weeks' ago.
MILBURN: What the Prime Minister
talked about was an increase from the comprehensive Spending Review, from
the next spending review..
HUMPHRYS: Which of course is not
going to be anything like enough to take us to that happy state where we
are going to be in line with our colleagues in Europe...
MILBURN: Oh yes it is...
HUMPHRYS: No, what every single
health economist who has done the sums - independent health economists
- who has done the sums on this says it's absolute nonsense. Those figures
that the Prime Minister used were simply wrong and we can go into the figures
in some detail if you like. Do you know what's interesting about this discussion
we are having, that all these outside experts, the King's Fund and Professor
Alberti and heaven knows who else, the IFS - Institute for Financial Studies...
MILBURN: Fiscal studies...
HUMPHRYS: Fiscal thank you.. they
are all wrong, it's only the Department of Health that's right.
MILBURN: No, no, it isn't only
the Department of Health but actually I am very happy to go through the
figures if you like and you know what Tony Blair said was absolutely right.
Providing we can manage the economy well, providing we do that and continue
to get stability and growth in the way that Gordon Brown has managed.
Then, if we continue what we have been doing over the last couple of years,
over this year and the next year and the following year, yes we will get
real terms increases, not at three per cent which is what has been happening
in the past, but at five per cent and the consequence of that is that we
will get up to the EU average...
HUMPHRYS: ...it would have to be
five point five per cent to get to the EU average everbody says..
MILBURN: ..it will take time, it
will take time to get there but there is absolutely no reason providing
we continue to manage the economy well that we shouldn't do that.
HUMPHRYS: It will cost not five
per cent. It will cost an extra five and a half per cent according to
all these other people that I have been quoting because the European average
is eight point six per cent and that's taking the lowest, that's an OECD
figure, you believe in the OECD, you always say look the OECD thinks we
are doing well when they say that, when they say other things you don't
believe them.
MILBURN: There are a lot of figures
being bandied around. I read an article in I think this week's British
Medical Journal saying it wasn't five and a half per cent, it was eight
and a half per cent...
HUMPHRYS: ...that's confusing two
figures, we're talking on one hand about how much...(both speaking at once)
MILBURN: ..that was about the EU
average and it was about what the Prime Minister said on the Frost programme.
The point is this, that we can expand the National Health Service and we
will expand the National Health Service and we will do so providing we
continue to manage the economy well.
HUMPHRYS: Well you see there's
a provision there, you are not guaranteeing...
MILBURN: There's a provision to
everything John...let me explain what I mean by that, with the greatest
of respect about this, you don't know whether if there was a recession
tomorrow you are going to be sitting here in this TV studio interviewing
me because the BBC revenues may take a downturn and...
HUMPHRYS: I do know that Gordon
Brown for instance is going to give away two and a half billion pounds
because he is going to cut a penny off income tax. Now if you were serious
about the putting extra money into the NHS, he could do that. He could
say you can have that instead. Politically unpopular with some, very popular
with others and you believe this is the priority, so you can't have it
both ways.
MILBURN: But there is the nub of
the argument you see. Here is the nub of the argument, why is it do you
think, that we are now in the position rather than giving the NHS what
it has had over twenty five or thirty years when the Conservatives were
largely in power and gave...
HUMPHRYS: ..gave about the same
over the last twenty-five years...
MILBURN: ..no that isn't the true.
It isn't true. We are putting in an average of around five per cent in
real terms. The average previously was around three per cent in real terms.
Why is it that we can do this? - we can do it because we are managing the
economy well, because we are doing the right things, taking the difficult
decisions and I am sure... sure in our first two years it was difficult.
It was difficult precisely because we had to turn the economy round and
we had to get rid of the structural deficit that we inherited. But because
we have done that, we are now in a position, providing we can make the
economy continue to grow, to give the NHS the sort of increases that it
needs.
HUMPHRYS: Alan Milburn, thanks
very much indeed for joining us this morning. And that's it for this week.
Until the same time next week, good afternoon.
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