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JOHN HUMPHRYS: Good afternoon. How
will Sinn Fein respond to the latest ultimatum from the Ulster Unionists.
I'll be asking Martin McGuinness. There's a new man in charge of the
NHS this week and I'll be asking him how he's going to make it better.
And more problems for the government over the dome. That's after the
news read by George Alagiah.
NEWS
HUMPHRYS: Two months to go before
they close the dome... but the government's problems aren't over yet.
MARSHALL ANDREWS: "Ministers need to take responsibility
and resign. And there needs to be a full public inquiry."
HUMPHRYS: And you may think that YOU
will decide on the next government... but if you're not one of the few
being targeted by the political parties, perhaps you'd better think again.
OONA KING: "I think it's a scandal,
honestly that in a democracy so many of our votes effectively don't count."
HUMPHRYS: I'll also be talking to
Nigel Crisp, who takes over as the Chief Executive of the NHS on Wednesday.
Can he deliver the improvements that we all want.
JOHN HUMPHRYS: But first, Northern
Ireland. The First Minister, David Trimble, managed, just, to win the
support of his Ulster Unionist Party yesterday but at a price. He's placated
his hardliners by refusing to allow Sinn Fein to attend meetings of the
North South ministerial bodies that were set up as part of the Good Friday
Agreement and he won't let them back in again until the IRA starts putting
its weapons beyond use. So how is Sinn Fein going to respond to that.
Well the party's activists are meeting near Dundalk in the Republic and
Martin McGuinness, who's the Education Minister in Northern Ireland joins
us form there now.
Good afternoon Mr McGuinness.
MARTIN MCGUINNESS: Good afternoon John.
HUMPHRYS: Now one of your ministers
is actually supposed to be going to a North South meeting this week, what's
going to happen?
MCGUINNESS: Well we hope that that meeting
will take place, we hope that people will sit back and reflect on the enormity
of what the Ulster Unionist Party have decided in the course of the last
twenty-four hours. Clearly David Trimble and the leadership of his party
have now effectively stepped outside the Agreement. David Trimble is in
danger of being in contravention, in breach of his ministerial pledge,
the code of conduct agreed at the Executive. And I think people should
recognise that this is a recipe for disaster. This is a clear declaration
of his intent to bring about the destruction of the Good Friday Agreement
and I think he needs to reflect on that and he needs to consider that he's
making a very very serious blunder.
HUMPHRYS: Well he's not going to
change his mind is he because he said just this morning, just a few hours
ago that he's taken legal advice, he's perfectly entitled to do it and
this is what he intends to do. And clearly he couldn't back down in the
face of his own party now. So what are you going to do, are you going send
that minister there, is she going to go there. Are you going to take legal
advice, I mean are you going to try and defy it or what?
MCGUINNESS: Well I think the first thing
that must be done is that there should actually be now an urgent meeting
of the Executive. I think that people need to be reminded that all of us
sat around the Executive table last Thursday, Seamus Mallon was there,
Bairbre de Brun and myself were there and David Trimble and other representatives
of his party and there was no discussion whatsoever about what was to come
on Saturday. So clearly there now needs to be because of this refusal to
consult with the rest of us, there needs to be a meeting of the Executive
and that needs to happen urgently.
HUMPHRYS: But are you planning,
in the absence of something like that and some backing down on the part
of Mr Trimble which as I say is entirely unlikely, are you planning to
try to attend these meetings, to try to take part in them anyway.
MCGUINNESS: Well I think it is absolutely
vital and essential that the institutions that were set up as a result
of the Good Friday Agreement continue to work and continue to work effectively
so there is a clear responsibility on David Trimble and all of the other
pro-Agreement parties within the institutions to ensure that those institutions
are working and are working well. One of the big difficulties that we
face at this time as a result of the events of the last twenty-four hours,
you know it has always been very very clear that people like Ian Paisley
and Jeffrey Donaldson lead the no wing of Unionism. What is now in question
for many Nationalists is a source of huge confusion for them and that is
whether or not David Trimble is now leading the don't know wing of Unionism.
HUMPHRYS: Now, you didn't answer
the question though. Are you going to try to go to the meeting, or your
colleagues.
MCGUINNESS: Well I think what we need to
do first of all is have the meeting of the Executive and certainly the
Sinn Fein ministers intend to fulfil their responsibilities under the terms
of the agreement and we will be endeavouring to go to that meeting yes.
HUMPHRYS: Now, you describe what
Mr Trimble's done as the enormity of it, isn't the real enormity of this
that the IRA has simply refused to make the very clear commitment, to meet
the very clear commitment that it made in May and I quote from that, from
what they said, to initiate a process which will completely and verifiably
put IRA arms beyond use. They have not done that, they have broken a very
clear commitment.
MCGUINNESS: Well I think you need to be
reminded that the two international inspectors, Cyril Rampahosa and Martti
Ahtisaari, two eminent statesmen from the international community have
made it quite clear that they believe that the IRA have fulfilled their
commitments and I think clearly there is a responsibility to ensure that
all of the participants to the different agreements that have been made
right throughout this process, fulfil the responsibilities that they have
made and of course agreements were made earlier this year at Hillsborough.
Now it's very important to point out that the IRA didn't make any agreements
with the leadership of the Ulster Unionist Party. Agreements were made
between Sinn Fein and the British government and indeed between the IRA
and the British government. The dificulty...
HUMPHRYS: ...you chucked them out...
MCGUINNESS: ..well the British government
have not fulfilled and honoured the commitments that they made at that
time and there was a very clear commitment by the British government that
they would fully implement the Patten proposals because we do need a policing
service. We need a new beginning to policing in the North and as we speak
at this moment the Nationalist community and that includes the SDLP and
the leadership of the Catholic Church and ordinary Nationalists on the
ground are in uproar at the refusal of Peter Mandelson to implement fully
the Patten proposals. People are also very concerned about the situation
in South Armagh and other parts of the North where clearly the British
have dishonoured their commitment to demilitarise. All of these matters
essentially means that there is a responsibility, particularly on the British
Prime Minister and on our ourselves and others to ensure that all of the
commitments that are made are honoured. As far as I am concerned, it's
about duty and responsibility on everybody, that includes the IRA and the
British government to live up to the commitments that they have made. But
our difficulty, John, within this process, clearly, is that we have seen
a situation where the leadership of the Ulster Unionist Party and people
within the British establishment have attempted to effectively emasculate
the Good Friday Agreement and of course the Unionists will continue to
behave in the way that they are behaving, if the British government allow
them to get away with it and that is why the performance of Peter Mandelson
in particular is so disappointing.
HUMPHRYS: Well, let me remind you
what the British government has done as far as demilitarisation is concerned.
They've pulled out three-thousand-five hundred troops since the ceasefire
from Northern Ireland, troop levels are at their lowest that they have
been since the troubles began, the early release programme of prisoners
has been completed. What has the IRA done? The IRA has made one phone
call, one call, to the commission, the international commission, and they've
opened up a few arms dumps for an inspection. Well, that is not the beginning
of the process that they had promised, is it?
MCGUINNESS: Well I think anybody that knows
the individual circumstances that have existed here in the North of Ireland
of many years, whether it be thirty years, or three-hundred years, will
understand the huge significance of what the IRA has done. The fact is
that the IRA have opened up their arms dumps, and have allowed international
inspectors to inspect them, they have now re-inspected those dumps and
they have told the world quite clearly that they are satisfied that the
IRA have not moved those weapons and that those weapons have remained silent.
So I think, you know, let's, let's give credit where credit is due. The
IRA have made a huge contribution to the search for peace in Ireland, the
IRA have been in ceasefire for years and we clearly now need to see from
everybody, and I do think there is a responsibility on everybody, and that
includes the British government, and it includes the IRA, to honour the
commitments that they made. As far as I am concerned, the IRA have been
honouring their commitments, as far as I am concerned, the British government
have not yet honoured the very clear commitments that they have given on
very, very important issues within this process.
HUMPHRYS: So the IRA has done everything
it's supposed to do and you, Sinn Fein, are not honouring your commitment
therefore to put pressure on them to do more. I mean, that is your commitment,
isn't it. To put pressure on them to do more, to use your influence, what
you seem to be saying is they've done everything that is required of them,
which will come as a great surprise to many people.
MCGUINNESS: Our commitment John, is to
work to ensure that the peace process is a success. And I think anybody
that has watched this conflict resolution process over the course of recent
years, knows that for over ten years the Sinn Fein leadership have been
out front in trying to develop a creditable peace process. Our big difficulty
is that the British government and the leadership of Unionism have found
it very, very difficult to come to terms with the type of changes that
have to take place. You see, the reality is that I represent people who
are no longer going to be treated like second-class citizens in their own
country. I am not going to be treated as a second-class minister by the
leader of the Ulster Unionist Party, or indeed by Peter Mandelson, or anybody
else. And I think that the sooner people get to grips with the reality
of why we are in difficulties within this process, the better. And why
are we with...in great difficulty within this process? We're in great
difficulty within this process because there are those, those within the
British establishment who have yet to come terms with the needs of equality
and justice and human rights and we're in difficulty within this process
because Unionism, and I make a clear distinction between the political
leadership of Unionism and Unionist grass roots, who are very much for
this process. The political leadership of Unionism have yet to come to
terms with the reality that there is a community within the North, the
nationalist community, many of them are Catholics who are no longer going
to be treated as second-class citizens in their own country.
HUMPHRYS: So when David Trimble
says there if there is no progress made there should be a formal review,
another formal review of the whole Agreement by the British government
and everybody else. What do you say to him?
MCGUINNESS: Well, what I say is that there
needs to be an implementation of the Agreement and the Unionist political
leadership, who have opposed for example, the Patten proposals, who have
opposed demilitarisation, who have opposed the release of prisoners and
have opposed many other aspects of the Agreement, need to sit down and
reflect on where all of this has taken us. We have people out there within
the political leadership of Unionism, who are very, very determined to
drive the Good Friday Agreement and the peace process to destruction.
What I want to see is decisive leadership from those people who have told
us for the last number of yeas that they are prepared to move forward and
bring about the essential change that needs to be brought about. I want
to see those people effectively reflecting on what has happened over the
course of the recent while and taking the vital decision that we must press
on with the implementation of the Agreement, because the great tragedy
about all of this, John, is this, is that I know there are many, many tens
of thousands of good, decent Unionists, Protestant people in the North,
who want to work with me, and who know that I want to work them to build
a new future for all of us. The difficulty is that the rejectionists within
Unionism, led by Paisley and Donaldson, have now effectively turned David
Trimble, to use Donaldson's words, on to their ground. Now these people
are full of people who are not really concerned about the issue of decommissioning
at all, these are people who are opposed to equality, these are people
who are opposed, not just to having Sinn Fein in a power-sharing government,
they're also opposed to the SDLP, because they believe in majority rule,
they want to keep the RUC to themselves, they want the British Army on
the streets, and all they are offering up to the rest of us, is a diet
of misery for the next thirty years.
HUMPHRYS: Martin McGuinness, thank
you very much indeed.
HUMPHRYS: Two months from tomorrow
they will close the doors at the Dome, no more visitors for what must be
the most ill-fated, most controversial tourist attraction this country
has ever seen. Tony Blair promised us that it would be a symbol of all
that is best in Britain - a lasting legacy. Well, we'll certainly remember
it but perhaps not for the reasons the government had hoped. They'd probably
prefer we forget all about it indeed, but as Paul Wilenius reports, there
is more embarrassment yet to come.
PETER MANDELSON: If the Millennium Dome is a success,
it will never be forgotten. If it is a failure, we will never be forgiven.
PAUL WILENIUS: Former Dome Minister Peter
Mandelson may be needing some forgiveness. The cost of the Millennium Dome
has almost reached a staggering �1 billion pounds. But for Tony Blair's
government there is also a high political price to pay. Ministers will
soon be criticised by official inquiries into the project and then they'll
face embarrassing votes in the Commons and the Lords over the cash used
to keep it going.
Thousands turned up for
their amazing day at the Dome last week. But ministers' dreams that 12
million people would pack into the great exhibition have turned into a
nightmare.
ACTUALITY
Blood curdling financial
losses are the result of an unexpected drop in visitor numbers to only
six million. Now many people want to find out what went wrong.
PETER AINSWORTH MP: There's very serious trouble
ahead on the Dome as gradually, bit by bit, and inch by inch the truth
comes out about this project. At the moment there's a great deal of ignorance
about what actually really went wrong and who was responsible, and over
the next few months we will be seeing how this huge national project came
to be the national disgrace, that it is today,
WILENIUS: Ministers will learn
in two weeks the contents of the key report from the National Audit Office
on the Dome , which is run by NMEC, the New Millenium Experience Company.
It's expected to be a brutal reminder of the Dome disaster and will put
the everyone involved a black mark. Ministers could not have foreseen
the incompetence that's dogged the project. But the shock waves from the
report could well reach the very centre of government.
BOB MARSHALL-ANDREWS MP: The impact of the National Audit Report
cannot be overstated. It is going to be a devastating criticism of NMEC
but that in truth is a devastating criticism of the Government. Now, the
problem here, of course, was the way in which it was set up - is this a
Government body or is it not a Government body? And everybody understands
the principle that in truth this is Government. And Government money at
the end of the day will be put at risk.
DIANA ORGAN MP: I do have concerns that I think
it will show that management was lax, that there weren't the financial
controls in place, and that there was almost a disregard for the amount
of money that was being spent. It was like we've turned on the tap and
it might not stop and it doesn't really have to be accountable. So I think
that may come out but we'll have to wait and see for that and I suspect
that the Select Committee will have to revisit another inquiry on the Dome
in the light of this.
WILENIUS: Over estimating the numbers
of people who would turn up to the Dome was the biggest single financial
problem. But the new Dome Chairman feels mistakes were made in the panic
to get it open on time.
DAVID JAMES: The closer it got to the opening
day there must have been tremendous pressures mounting on everybody concerned
and I'm sure that at that time a great many things occurred which took
short cuts, short corners which we're still having to sort out today. The
contracts to which you refer are one thing, the incompleteness of the asset
register, which has already been well publicised is obviously another very
big factor.
WILENIUS: But was lofty ambition
also a factor? In the post election euphoria, the project was given the
go ahead by Tony Blair, even though in the past the public have often given
grand schemes a large raspberry. It was hoped it would define New Labour's
success. But as there was little real control over the fast moving project,
senior Labour figures feel it may have been too ambitious for the Blair
government.
DOUG HENDERSON MP: I think people got carried away,
I think that is what actually happened, kind of they look back and said
there was the great Victorian exhibitions, there was the big exhibitions
in the 1930s after the Coronation, what can we do this time for the millennium,
let's build a big Dome and then let's try and think of something to put
inside it. They didn't need this large structure costing a colossal amount
of money, these, that could have been done in a better way more cheaply.
WILENIUS: Even though the government
will face criticisms over its handling of the project, it could choose
to ignore them. But there's a much more serious problem, Ministers need
the approval of Parliament to extend the life of the Millennium Commission
beyond New Year's Eve. That's because they need more lottery money to
compensate for the extra cash given to the Dome. So as time runs out
for the Dome, these votes will give its critics the opportunity to unleash
fresh attacks on Ministers. There may even be a rebellion in the Commons
over the measure.
Fifty Labour MP s are
backing a Commons motion tomorrow calling for a full debate on the move
to give more lottery money to the Millennium Commission.
MARSHALL-ANDREWS: I think that the public and members
of Parliament have had enough of the take it or leave it, it's going to
cost more money not to put more money in than otherwise - that argument
which is plainly spurious. The argument is used in order to lever more
money out of the Millennium Commission. Because the Government knows full
well that if the Millennium Commission doesn't give this money and ultimately
the Dome then falls - which it should do, as a commercial venture - then
the Government is going to be left with the bill and then, you will have
accountability. And that I am afraid is what the Government is worried
about.
WILENIUS: Here children at the
Dome try their hand at voting. But it's not only the vote in the Commons,
but also the one in the Lords that's causing a lot of worry. There are
now demands for the sacking of Dome Minister Lord Falconer as the price
the government has to pay, to get it through.
AINSWORTH I don't think the House of Lords
will be remotely impressed to see Lord Falconer, of all people, coming
back with a begging bowl for the Dome. He's the man who said there wasn't
a problem at all. He's the man who eventually had to put up his hand and
say there was. He's now the man who says he's going to stay there and
see the project through to the end. Many people find it astonishing that
he's still in position. He is the minister responsible for an enormous
financial disaster. And if the Government wants to get more money through
Parliament, in any way related to the Dome, I cannot imagine a worse person
to put that question, than Lord Falconer.
WILENIUS: It'll take more than
this one million pounds featured in the Dome Money Zone to fill the financial
black hole left by the project. No one yet knows exactly how big that
hole will be. So Labour MPs are reluctant to write out a blank cheque for
the Dome.
ORGAN: My view about extending
the life of the Millennium Commission to just fund the Dome would be that
I wouldn't support that. But of course I have concerns about wanting to
extend the Millennium Commission because there are many other projects
which are fantastic, that are being carried out in the regions that maybe
jeopardised if we don't. What I don't want to find is that we're being
duped in to believing that those would be in jeopardy if we don't extend
the Millennium Commission and that to discover that the finances being
funnelled away to support the Dome,
WILENIUS: The aim is to wrap up
the exhibition without needing more money. But the ever growing cost doesn't
include the high price of getting the site ready for a buyer, which could
increase the burden already placed on the public.
JAMES: It does not cover and has
never been intended to cover the decommissioning of the Dome itself in
full, or whatever strategy is going to come for the future of the Dome,
because that depends on what is needed by whoever buys it and it's quite
possible they will want to buy it in its present form or that they will
want modified decommissioning or whatever else, and so we would expect
that the costs for a very substantial programme of decommissioning would
be covered significantly out of any proceeds of the sale or out of the
proceeds of however the area was developed or the proceeds that came from
that.
HENDERSON: I think the government have
to really cut losses now. Nobody believes that there will be no future
demands for further money. We've already had four additional demands this
year, the last in September, which brought the total increase in public
funds to a hundred and seventy-nine million. A lot of people believe they
will come back for more and I think it is important for the government
to make sure that the book is closed now, that there is no begging bowl,
that they have got to sort it out.
WILENIUS: As the time for fun in
the Play Zone ebbs away, Ministers are looking for a way out. There are
calls for a public inquiry, the sort of political interaction the government
may wish to avoid. But to head off open displays of discontent in the run
up to the next election, the government may have to own up to its mistakes.
Confront the fact, that it got it wrong, to accept that the only way to
put things right could be to flatten the Dome.
AINSWORTH: If it is the case, as we hear
that clearing the site, getting rid of the Dome, would realise an additional
three hundred million pounds, we want to know that. That should be information
available to Parliament before anybody comes along and says, we need to
extend the life of the Millennium Commission, incidentally taking money
out of education and health projects, in order to pay off the Dome's problems.
We need to know if it is conceivable, that by clearing the site, an additional
three hundred million pounds could be raised, then that is information
that is absolutely relevant to any vote which may be taken on extending
the life of the Millennium Commission.
WILENIUS: Are you worried that
you may not be able to sustain it - the Dome?
JAMES: There has to be a possibility
that unless a buyer comes along and is prepared to see a constructive purpose
to the future of the Dome which fits into their plan then the Dome will
have to be considered either first in the first instance for alternative
usage in some leisure, sports or maybe some business park context, but
alternatively beyond there then comes the value of the land and the development
of the development of the peninsula, the whole Greenwich peninsula which
is a vast area, as I say. It's the biggest undeveloped area in the whole
of London.
WILENIUS: The Dome was supposed
to be an amazing triumph for the New Labour government. But even Cabinet
Ministers are openly admitting it has been a disaster. Now Tony Blair can
only hope that it is a distant memory for voters when they go to the polls
next year.
HENDERSON: It doesn't help our electoral
cause at the next election. I think people are very realistic and the
Dome is not the most important issue in politics in this country today.
But I think people will want the government to come clean on it, where
there are mistakes admit the mistakes
MARSHALL-ANDREWS: I think that the electoral consequences
of a failure to take responsibility of this will be dire. And the way
in which you do it, I'm afraid, is that ministers need to take responsibility
and resign. And there needs to be a full public inquiry. Now in those
circumstances the electoral, or the political consequences, will be minimal
because the Government will be perceived to have acted in the way that
governments should. Everybody makes mistakes. The most important thing
is to acknowledge them to the public and then to put them right.
WILENIUS: Tony Blair, Peter Mandelson
and Lord Falconer all put their trust in the Dome. They hoped it would
be a symbol of the future for a New Labour government and a new Britain.
But its financial failure means that even though millions have liked it,
critics will use it to attack the government's record and image. Bold and
glossy on the outside, but ultimately empty inside. So as long as the Dome's
there they'll find it hard to shake off this impression, even when the
lights finally go out, on New Year's Eve.
HUMPHRYS: Paul Wilenius reporting
there and we did ask the Dome Minister, Lord Falconer if he wanted to respond
to that film but he didn't.
JOHN HUMPHRYS: From Wednesday the National
Health Service will have a new boss. His name is Nigel Crisp and he will
not only run the NHS, but he'll be the most senior civil servant in the
whole department of health. Quite a job. Particularly since the NHS has
become probably the biggest problem facing the government. Mr Crisp is
with me. Good afternoon to you.
NIGEL CRISP: Good afternoon.
HUMPHRYS: I suppose I should start
by saying Good Luck! But let's clear up this two jobs thing first of all.
Because here you are, a civil servant responsible for the whole Department
of Health, but you're also running the NHS. Now, in the past we've seen
a certain amount of tension quite properly between the chap who runs the
NHS and the person who runs the department of Health because the NHS man
constantly says to him a lot, we need more money for - we want this, we
want that, you give us this, you give us that. You can't do that can you,
so there is a bit of a conflict here for you.
CRISP: Well, actually I think it's
easier than it's been for my predecessors, because for the first time we're
bringing health and social care together, and if you think about the Health
Service and about improving the Health Service we can't do that unless
we work very effectively across the whole range of government departments
and local authorities. And that's the advantage we get from bringing these
two jobs together.
HUMPHRYS: But you can't as it were
make demands on the permanent secretary because, or on his boss in a sense
because you are the permanent secretary and we want you, we who use the
NHS, want you to make those demands.
CRISP: Well, let's be clear, the
main part of my job responsibility is the modernisation of the NHS, and
that's what I will really be thinking about, and I will certainly be making
demands on behalf of the NHS both externally in terms of funding but also
internally about how we need to change to meet the challenges of this.
HUMPHRYS: There are massive expectations
resting on you aren't there. You're not going to be able to deliver on
those expectations, certainly in time for the next election are you?
CRISP: Well, we've got big expectations
and rightly we've got big expectations. We've had a very large increase
in money, and we've got a very good national plan, an NHS plan which brings
together a whole lot of new ways of doing things, and we're going to see
improvements. Many of those improvements will take some time, but already
you can see some things happening, already we know that if somebody has
got suspected breast cancer then they will be seen by a specialist within
two weeks, we need to roll that out for other cancers, that'll take some
time. So what we aim to do is to not only make some long term big changes
in the NHS but make sure that we see those happening month by month, year
by year.
HUMPHRYS: You have a crisis coming.
I say that because winter is coming and there's always a crisis in winter.
The BMA says that hospital beds are already running at full capacity.
There are bound to be problems aren't there?
CRISP: I've no doubt there'll be
problems, but when I think about this winter, and this is the part that
I've really spent a lot of time thinking about at the moment as you can
imagine, is we've got more capacity than last year, we've got more beds
in the system, we've got more nurses. In London alone there are two thousand
more nurses on the wards than there were this time last year. We're also
better prepared, better links with the voluntary sector, better links with
social care. But even with all of that we will undoubtedly have bits of
the Health Service come under real pressure for whatever reason.
HUMPHRYS: So, people are going
to have to wait, whatever happens to people who get sick as a result of
winter, people are going to have to wait for what might otherwise have
been routine operations for instance?
CRISP: Well, one of the things
we will do, is we'll switch some of our capacity, so some of our capacity,
some of our beds and so on, we'll be using for emergency care rather than
for elected care.
HUMPHRYS: Exactly, so people who
would have been in there for the emergency care.....
CRISP: Well, this happens every
winter to an extent. What we're doing this year is being a bit more systematic
and a bit more planned about it.
HUMPHRYS: .... As well.
CRISP: But that doesn't mean to
say that we will break any of our pledges around waiting lists. We will
still be determined to make sure that we hit our targets on waiting lists
over this period, and indeed the planning during the year has taken account
of the fact that we will do more planned work in the summer and more emergency
work in the winter, which is only sensible.
HUMPHRYS: But you're still having
to get a quart into a pint pot.
CRISP: We need more capacity.
I mean the NHS plan is a very honest plan, it says we've got real problems.
I think I'm the first chief executive of the NHS who's coming in saying
we need more beds, and this is a serious commitment that we're making about
this. We do need to see more capacity, we're gradually getting more capacity
as I've already said.
HUMPHRYS: But we've been building
smaller hospitals as a result of the PFI and all that.
CRISP: Well, let me give you the
example of University College hospital in London which was approved over
the summer, and it's part of my current responsibility in London. There
we looked at the plans and we sent them back and said we need more beds,
so at UCL... (INTERRUPTION). Well, it's the first one in a train, and
what we're now expecting is that when any new hospital is being built whether
it's through PFI or through some other route we will only be approving
it provided we see there are adequate beds across the whole system.
HUMPHRYS: So as far as the coming
winter is concerned you will not, will you, be going to the Chancellor,
and we've got his autumn statement coming up of course this week, and saying:
I need more money?
CRISP: We've already got a lot
more money in the system. We could always use more money in the system.
We will have pressures, but I think the key, the most important thing
for us to do is how we deal with those pressures, so if we do get a crisis
in a particular hospital how do we respond, how does the whole NHS and
social care network in that area respond to it, how do we make sure that
we deal with the problem as soon as possible?
HUMPHRYS: One of the problems,
one of the problems you've got right now, today, is this thing with flu
jabs. You want people to go and get them, especially the elderly people
to go and get their flu jabs, you're running this terribly expensive newspaper
advertisement campaign with Henry Cooper flexing his muscles and all that
sort of thing, and yet the jabs aren't there, the vaccines aren't there
for doctors, at least one in five doctors do not have the vaccines. It
seems bonkers to go spending a fortune on an advertising campaign and not
having the injections there for people to have.
CRISP: It's a very successful campaign,
and in the early...
HUMPHRYS: What, without the vaccines?
CRISP: .. we've already seen a
large proportion of the people that we want vaccinated, vaccinated. We
need abut eight million doses of vaccine to cover the people we think need
vaccinating. We've got eight-and-a-half million out there in doctors' surgeries,
we've got another two-and-a-half million to come. Some of that, we're
having a difficulty with one of the suppliers, but what we are finding
is that in a few places, and I don't think it's as much as one in five
we've actually had some difficulties with delivery of the vaccine.
HUMPHRYS: Well, but, but from your
own figures, one in five of the vaccines are not there. And I talk to
doctors, my own GP, who says, look, I can't do it because I haven't got
any vaccine.
CRISP: Well, the evidence that
I've seen, and again, I have looked at London, em, is that we do have the
vaccines out there, we do have eight-and-a-half million, we don't necessarily
always them exactly in the right place, but we will get them in the right
place, we will ensure that we do have the vaccine available to people,
and that we can build on the success of what is a successful campaign.
HUMPHRYS: Well, wouldn't it have
been more sensible to hold the campaign off, until you knew that all the
vaccines were in place, so that everybody who goes along for the GP, and
who qualifies to have one of these jabs, can have one.
CRISP: There is a time lag in producing
vaccines and what we've had, is, as I said, we've got eight-and-a-half
million vaccines out there, we need another two-and-a-half million, and
we've got a problem with about one-and-a-half million of that which is
coming from a particular supplier, who has had difficulties in production.
HUMPHRYS: You talked about getting
extra beds during the winter crisis. Now one of the ways obviously to
get better, extra beds, is to go to the private sector. There seems to
be no ideological opposition now to, because the government, because the
government seems to have conceded that, let's use the private sector, have
you actually said to local authorities, to NHS Trusts, and all the rest
of it, now look, if you have a problem, get an arrangement in place.
Sort it out, work out the contracts or whatever, you've done it, is it
all formalised so that during this winter we will not see the situation
where you have people who can't get a hospital bed and there are hospital,
private hospitals with empty beds coming out of their eyes.
CRISP: What we've actually done,
is we've asked every Health and Social Services Community, so the Local
Health Authority area, to come up with a really comprehensive plan for
winter...
HUMPHRYS: ...asked or told?...
CRISP: ...we've told them to do
that. And we got them back to us at the end of September and we are working
those through with them. Now in most of those cases, they are actually
looking at what extra capacity they can get from elsewhere. I mean, the
job for hospital managers as you'll appreciate, is to try and get the best
deal for their patients in whatever way, and it is sensible and practical
for us to use the private sector, um, where that will take a bit of pressure
off the system, take a bit of pressure off staff, make sure that we can
get some urgent cases in, which might otherwise not come in if we got an
awful lot of er, er, emergency work coming in. But, let me just give
you, give you an example. I looked at one of these plans last week for
an area of London and they have already decided that they are going buy
forty extra operations from their local private hospital for orthopaedics.
Now, that's forty operations, ones which they were worried might not get
done otherwise, but that's in the context, forty operations in four months,
that's in the context of in London us admitting two-and-a-half-thousand
people every day.
HUMPHRYS: Quite
CRISP: So, it's a helpful contingency.
And we are asking, as I say, Health Service managers, to look at every
way of trying to make sure that we keep up the level of our service and
that we reduce the pressure on staff over winter.
HUMPHRYS: In other words, we can
be satisfied that during this coming, this, this coming winter, there will
be no private hospital beds sitting there with people who would otherwise
have gone into NHS, can't get into the NHS, wondering, why can't I go into
a private one, there will be no empty private hospital beds, in effect.
CRISP: No, clearly I can't go that
far and the reason...
HUMPHRYS: Why not?
CRISP: ...the reason for that is
two-fold. Firstly, it needs to be local decisions by local people about
what's needed. And those need to be based on two things. Firstly quality.
BOTH SPEAKING TOGETHER
CRISP: Well, we have to make sure
that they are up to the standard. And that's the first point. And the
second thing, is that it's also got to be good value for money for the
public purse. And we cannot be in the position of saying that we will
use every private sector bed in the country. We need to make sure that
as our managers are looking for contingency plans, that they negotiate
sensible and reasonable deals locally, that can only be done locally.
HUMPHRYS: Mmm. But I mean, if
somebody desperately needs a bed, and it's going to cost another fifty
quid to put somebody in 'x' private clinic, you're not going to say, you
can't go, are you.
CRISP: Well, if somebody desperately
needs a bed, then it is the responsibility of the local health care system
to find a means....
HUMPHRYS: ....at whatever cost?...
CRISP: ...a bed, and we've had
examples of that in the past, as I'm, I'm sure you, you well know, where
we have used the private sector, if that is the only way. But what we
are actually saying here, is that not just when people desperately need
beds, but when we want to try and make sure that we're maintaining the
service, let's think about what capacity is available locally, if it's
the right quality, if it's also the right price, because I'm not going
to give any blank cheques to the private sector around this, then let's
make sure that we use that as part of the whole range of things that we
are doing to try and make sure we run this Health Service effectively over
the winter.
HUMPHRYS: This is going to be a
big test for you, isn't it? Perhaps the big test for you. If we have
another winter crisis in let us say, two years from now, you will have
failed, won't you.?
CRISP: Well, you can never guarantee
what might happen, and never precisely predict the future. I think I,
and the managers in the system need to be tested on two things. First
one is, how well have we prepared? Have we done all the things that it
is reasonable and sensible to do? Have we done the contingency planning,
and then secondly, when something goes wrong, and things go wrong, how
well do we respond? How quickly do we respond? Those are things we need
to do. And you know how well the NHS responds to a crisis.
HUMPHRYS: Well, sometimes well,
sometimes deplorably, but there we are. And one of the reasons why it
can't respond perhaps the way it ought to is a shortage of staff, nurses
and doctors. Now you talk about extra beds, and you talk about bigger hospitals,
and all of that is fine, but not if you cannot staff them with nurses,
and we are told, by the Royal College of Nursing, that there are twenty-thousand
vacancies at the moment, let alone having to staff new and bigger hospitals.
CRISP: Yes, you're quite right
that staffing is the real constraint on the growth in capacity.
HUMPHRYS: Well how are you going
to sort that?
CRISP: We are already seeing an
increase in the number of people in post. There are two figures here,
there's the numbers in post and the number of vacancies. We in London
have increased the numbers of posts in London, we have also increased the
numbers of nurses in staff, er, nurses in post. And we need to see that
continuing. And there's a lot of ways of trying to do that. I mean, one
of them is about making sure that the working environment is good, making
sure that people have opportunities, another one is about training more
people, bringing more people back into nursing....
HUMPHRYS: ...And pay.
CRISP: ...and pay is clearly an
important issue.
HUMPHRYS: Christine Hancock of
the Royal College of Nursing says a substantial pay rise for every nurse
would kick start recruitment, motivate nurses to return and encourage others
to stay. Do you agree with that?
CRISP: I think pay is very important.
I think this government has a good record around increasing pay, it's got
a commitment to its staff, it recognises the importance of nurses, pay
is part of the overall package that we need to have in place to provide
housing for people. I mean the issues in London are very much around housing
and things like that.
HUMPHRYS: So there will be, in
the words of Christine Hancock, a substantial - that's the word she uses
- a substantial pay rise for every nurse.
CRISP: No, again you are actually
asking me something that I can't make a commitment on or a comment on at
this stage.
HUMPRHYS: But it's crucial, you've
acknowledged that.
CRISP: It will be one of the issues
that I will be looking at when I start taking up the post...
HUMPHRYS: But you cannot do what
you want to do without those nurses.
CRISP: You are absolutely right,
the nurses are the constraint and the really - nurses and other staff -
are the constraint to development and that's why we have seen and are seeing
a lot of work on housing. We have got many more places for nurses in London
to accommodate...
HUMPHRYS: But let's stick with
pay for the moment because that is absolutely crucial and if you cannot
make that commitment, then you cannot do your job.
CRISP: You have already heard from
this government in the past very considerable commitment to nurses and
to paying nurses appropriately..
HUMPHRYS: It's words, it's words,
it's action that they want..
CRISP: Well let's see, as I say
this isn't an issue that I have yet picked up as I haven't yet started
the job. But it's not the only issue and it's not the only issue that
nurses tell us about.
HUMPHRYS: Another issue is this,
you talk about the jobs that they do, hugely important. When senior posts
become vacant, we are told again by the Royal College, the grading is reduced.
So in other words, a new nurse comes in to take a job that her predecessor
had at a certain grade, that grade is cut, so she has to take actually
rather less money than she would have otherwise got and that's happening
all over the place. There are nine thousand fewer jobs for senior ward
sisters alone. Are you going to stop that?
CRISP: One of the things that we
have done is seen an increase in grading for some nurses so we have got
nurse consultants now, which we haven't had in the past and which I think
the RCN approves of and supports. I haven't actually seen the figures you
are talking about, I mean clearly we do need to make sure that we are paying
nurses appropriately, grading them appropriately and that particularly
when we are asking them to take on extra responsibility and one of the
things again about the NHS plan is to say that the staff within the NHS
need often to think about doing different things. You will see nurses
extending their roles, taking on wider skills and we do need to pay them
appropriately to do that.
HUMPRHYS: Alright...
CRISP: ..so I'll certainly look
at the figures from Christine..
HUMPHRYS: Final thought then, on
modernisation. A lot of people believe that consultants stand in the way
of modernisation and one of the things that the government has said it
wants to do, as part of the national plan, is to say to consultants that
after you have trained you have got to work for seven years in the NHS
without going private. They are saying no we are not going to go along
with that. Will you stand up to them?
CRISP: We will certainly enter
into discussions with them...
HUMPHRYS: ..that's not what I asked
you - are you going to stand up to them?
CRISP: I'm sure that we will stand
up to them in the right place and at the right time. Doctors are very
important to the NHS as you obviously know, it's.. and we're bringing them
into all kinds of management roles in different ways, the example I gave
you earlier of cancer, that is being driven by a leading cancer specialist.
We need doctors within the systems taking authority and taking important
roles. We also need to recognise that we pay for the training of doctors
and the development of doctors and that actually in an NHS that is under
as much pressure as we've just talked about, we need to make sure that
we retain those doctors within it.
HUMPHRYS: So the answer to the
question whether you will stand up to them in one word is yes.
CRISP: Indeed.
HUMPHRYS: Mr Crisp, thank you very
much indeed.
HUMPHRYS: Democracy's a lovely
notion. We all get a vote so we all get to choose who runs the government.
That's the theory, but there's a problem, some votes are worth a lot more
than others, it's really only the swing voters who determine the outcome
of the election and as Polly Billington reports, the parties are focussing
on them more than ever before.
POLLY BILLINGTON: Those that say Middle England
is a place only to be found in the minds of politicians should come to
Welwyn Garden City. Labour and the Tories are making ever more sophisticated
efforts to identify the few hundred thousand people in similar marginal
seats who are open to persuasion about which way to vote at the next election.
FRASER KEMP MP: If we don't win the marginal
seats then we have a serious problem and you know there are that number
of seats within the electoral map of Britain which make a very substantial
difference, decide the outcome of the next general election. So I think
all political parties are going to view them very, very carefully.
BILLINGTON: Elections aren't about the
whole country - the result is actually in the hands of only a few voters
in only some constituencies. Targeting them has become a crucial part of
every main party's electoral strategy. Welwyn Hatfield was a target seat
for Labour last time, identified as winnable by them even though the Tories
- wrongly - believed they could hold it without putting in any extra national
effort. It's in seats like this that next time both Labour and the Tories
will directing much of their national resources.
Tory foot-soldiers are already doing battle in Welwyn Hatfield. To have
a majority in the House of Commons the Conservatives need to win this and
a hundred-and-sixty-four more seats. That's a lot of targets. It's unlikely
they can direct an equal amount of effort into all of them.
CERI EVANS: I doubt - and I'll be very
surprised - if they choose to target a hundred-and-sixty seats. I would
think they'll focus much more ruthlessly than that and put their efforts
into those seats.
BILLINGTON: Labour has also taken on a
mammoth task - to defend all those seats it won last time. Privately they
concede some seats will probably fall. Their troops are likely to be carefully
deployed where the party's got most chance of holding on. But publicly
they claim they have a hundred and eighty so-called strategic seats.
KEMP: We're going to be going out
to fight and win in those 180 seats, we've got one big advantage that we
didn't have in 1997 and that is that we've got sitting Labour MPs in those
seats, Labour MPs who've been working hard, communicate with the electorate,
and making sure that they get Labour's national message across, and that's
a tremendous advantage that we've never had in the past.
PETER KELLNER: What any party strategist
would love to have is a really reliable crystal ball which will tell them
which of the ten, twenty, thirty seats which at the end of an election
campaign will be the knife-edge seats and to pour all their resources in
to that small number of seats to try and wring out the last possible vote.
The trouble is when you make your dispositions before the election campaign
starts at the beginning, you can't be sure which are gonna be the knife-edge
seats.
BILLINGTON: Once you've chosen your seat
you must identify the voters, like Tony Willis, that will make the difference
between victory and defeat. Targeting has always happened; this time all
the parties are being more sophisticated in their approach. More than ever
before, they'll be focussing their efforts on the people who changed their
mind last time.
TONY WILLIS: A number of things changed
my mind and made me vote Labour in the Nineties. One was the sense of
government arrogance and a very long time in power.
BILLINGTON: Call centres like this one
are crucial to finding all the Tony Willises in the country. Labour had
a national call centre last time - now the Tories have just established
their own called Geneva; they want to have sixty volunteers calling twelve
hours a day reaching as many floating voters as possible.
EVANS: Not everybody in politics
likes the simplicity of this - it is a marketing decision. And it is a
targeting, marketing decision. And you have to concentrate your fire power
in a narrower, perhaps more concentrated field than simply spreading it
about.
BILLINGTON: Both main parties are going
to ensure the literature that floating voters get is targeted to their
priorities. If the messages are personalised addressing your own main concerns,
the parties reckon you're more likely to pay attention.
EVANS: To receive something through
the mail that directly addresses your concerns, your issues and plays into
your values, has a huge impact. You think, well there's somebody who knows
what I'm thinking and is inside my head and understand what's important
to me and my family. So, it can have a huge impact.
BILLINGTON: National telemarketing and
direct mail isn't a hit with everyone; the Liberal Democrats believe it
can be counterproductive as well as being beyond their financial means.
LORD RENNARD: Liberal Democrats won't use
a national call centre. If you are a floating voter perhaps in a marginal
seat, you might be receiving calls from a national headquarters of the
Conservative or Labour parties, irritating you, as they phone you up from
London and tell you how you must vote. Liberal Democrats prefer to do things
the local way.
BILLINGTON: It's not just listening though
- it's also about responding to the information gleaned by the call centres
and the direct mailshots. The national message will be tailored to the
concerns of those voters who will count.
KEMP: One aspect of the direct
mailing is to ensure that you get feedback and people are invited to give
their views and feedback into the party machine and feedback into the candidates
what their concerns are and you clearly listen very carefully as to what
electors are saying.
BILLINGTON: Tony Willis will be snowed
under by such mailshots in the next few months. He voted Labour last time
despite being a loyal Tory during the Eighties, and he still hasn't yet
decided how he'll vote next time. So his phoneline and his doormat will
be battlegrounds between the two main parties.
WILLIS: I think it's probably likely
to reinforce my prejudices one way or the other, and I suspect that I'll
form my main views from Press, from talking to people, from TV coverage
and general background. You can get a high irritation factor from some
of the standard literature.
BILLINGTON: Despite his scepticism Tony
Willis is favoured with so much attention. Other voters' concerns can get
sidelined. Some people argue that the demographic profile of floating voters
isn't as diverse as the rest of the electorate. Middle England's worries
can overshadow everyone else's, leaving issues that are important in safer
seats out of the game altogether.
OONA KING: What actually concerns
me is that my party to an extent has to concentrate on issues that come
up there, but for example may not be the issues that come up in a city
seat which is a safe Labour seat. And therefore what is the point in the
Labour Party concentrating its efforts in that area, I think it is wrong,
I think the whole system is wrong, it is equally wrong for Tories in areas
where it is a safe Tory seat. It is wrong for anyone who isn't that tiny
percentage of key voters who may swing their vote in a marginal seat.
EVANS: I don't personally have
a concern that floating voters can disproportionately affect the messaging,
and therefore the result, and therefore the kind of country we live in
- because, I think we're in the middle of a trend where increasingly people
of a limiting number of demographic backgrounds are sharing, values - we've
talked about health and education, law and order, transport and so on.
BILLINGTON: Unlike the Tories, Labour are
worried about getting their core voters to the polls and so have launched
Operation Turnout. They believe their traditional support isn't disillusioned
so much as complacent about Labour getting back in. It's the biggest threat
to them winning next time. The party will try to scare them about the chances
of the Tories winning to get their natural supporters out to vote.
KEMP: We have to ensure that we
enthuse people, but at the same time as getting our message across, we've
got to constantly remind people, particularly our core voters of what the
real dangers of letting the Tories back in would be and I think that has
to form part of the message that we get across.
BILLINGTON; But the big political messages
will be coming through Tony Willis' letterbox on a regular basis. The parties
reckon localising big issues like health and education is the way to sway
the least tribal of voters. It's the way our electoral system works. Votes
in safe seats count for much less than votes in marginal ones.
KEMP: I think there is recognition
amongst Labour voters that they realise they cannot have a Labour government
by simply returning rock solid Labour members of parliament in safe seats
and what they've got to do is go out and win middle England.
KING: I think it is a scandal,
honestly that in a democracy so many of our votes effectively don't count,
that is why we have got to change the system. I mean in 1997 if just a
hundred-and-sixty-eight-thousand voters, Labour voters in ninety of the
key seats had changed their vote, then Labour wouldn't have had a majority.
Now that is just half a per cent of the electorate. What about the rest
of us, what about the other ninety-nine point five per cent.
BILLINGTON: As the election looms closer
all the main parties will be stepping up their efforts to identify who
they need to speak to, in which seats, and what they need to talk about.
But do key seat strategies work? Literally, right next to door to Welwyn
Hatfield is St Albans, also a Labour win last time. Now despite not being
a target seat and therefore not having national resources directed at it,
Labour achieved a bigger swing here in St Albans, than they did in Welwyn
Hatfield.
KELLNER; The 1997 election campaign
was not only dazzling and dramatic and record breaking in all sorts of
ways, it went a long way to puncturing the myth of the key seats strategy
of fighting elections. In all sorts of places around Britain you'd have
one seat where Labour and the Tories had put in masses of effort because
they thought that they were marginal seats, only to discover on the night
that Labour won them by a mile, only to find next door there was a seat
that neither party had particularly targeted which turned in to a knife-edge
contest.
KEMP: The benefit of hindsight
is great in politics, and you can never be sure until after the event,
what would have happened, you know, had you done 'x' or 'y', I think what
you've got to do, is work on the assumption that elections are always going
to be fairly tough, are always going to be hard fought, and just to try
and ensure that you can win a majority in parliament.
BILLINGTON: Pushing the right buttons to
enthuse floating voters won't win a majority on its own. But political
parties believe in the strategy enough to intensify their approach ready
for the next election; even though it's an approach that can mean others
voters' concerns are left out in the cold.
HUMPHRYS: Polly Billington
reporting there. And that's it for this week. Next week I shall be talking
to Mo Mowlam. Until then, and by the way if you're on the Internet, don't
forget our website address. Good afternoon.
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