DAVID GROSSMAN:            The Conservatives long journey 
to the next election is beginning with a little trip. Dr Liam Fox the Shadow 
Health Secretary is today visiting Germany, a country with hospitals so 
efficient the only trolleys in the corridors are moving and enquiries about 
waiting lists meet with blank incomprehension. In this happy land of medical 
plenty the Tories are looking for a Health policy.

DANIEL FINKELSTEIN:            The Conservative Party's looking 
all around Europe at solutions that other countries are using successfully 
to blend private finance with public finance.

ANDREW LANSLEY MP:            The NHS is not being sustained 
at the moment at an adequate standard, in a sense the issue is not should 
the NHS change or not? It must change.

GROSSMAN:                    If the NHS was ever the 
envy of the world they certainly seem to have overcome their jealousy in 
places like Berlin. The Conservatives think that the way they deliver healthcare 
here, particularly the mixture of public and private provision could have 
important lessons for the UK, and for their chances of assembling a set 
of policies on public services that the electorate will take to.

It's not hard to see why the Tories are looking to Europe for clues on 
how to improve the NHS. In the treatment of many diseases patients are 
significantly better off than they are in the UK. With prostate cancer 
for example, sixty-seven point six per cent of patients in Germany survive 
at least five years after diagnosis. In France the rate is only slightly 
less at sixty-one point seven per cent.  But within the UK England has 
the worst survival rate, way down at forty-four point three per cent.  
With Leukemia too, five year survival rates in Germany are thirty-nine 
per cent, in France forty-four point nine per cent with England lagging 
well behind at twenty-seven point nine per cent.

RUTH LEA:                    I think the first thing 
if you look at different types of cancers then the survival rates tend 
to be much poorer and poorer in this country than they do on the Continent, 
but I think where you really see the difference is in things like waiting 
times and waiting lists. If you talk to doctors in Germany or in France 
they just don't understand the concept of a waiting time, here we understand 
it only too well and I think that's where the biggest problems are.

GROSSMAN:                    The Think Tank Civitas 
hosts a seminar on Health. Until recently the German system was a bit like 
German cuisine,  largely ignored overseas.  It's recipe with a greater 
role for the private sector is  essentially unchanged since Bismarck's 
day, but is now very definitely in vogue. The message from Professor Friedrich 
Breyer of the University of Konstanz is that it's a system based on choice 
and autonomy, with the state, companies and individuals all contributing 
to achieve  results that can leave the NHS standing.  

PROFESSOR FRIEDRICH BREYER:    I wouldn't call the NHS the envy of 
the world, because the way patients are treated in this system is more 
favourable in most European countries.  We have free choice of physicians, 
we have practically no waiting lists. 

GROSSMAN:                    Undoubtedly, one reason 
why they're able to achieve significantly better results on the Continent 
is that their health systems are far better funded. The proportion of the 
country's earnings spent on publicly funded healthcare in Germany is seven-point-nine 
per cent, in France it's seven-point-three per cent, whereas in Britain 
it's just five-point-six per cent.  The funding gap doesn't end there - 
when you add the amount of private money spent in each country the total 
in Germany becomes ten-point-six per cent, in France nine-point-six per 
cent and in Britain just six-point-seven per cent.

LEA:                        I think it's absolutely 
vital that you get more money into a healthcare system, clearly we do pay 
less as a percentage of GDP than they do  on the Continent, certainly in 
France and Germany, and I think the biggest shortfall here is actually 
on the private sector rather than the public sector, although we fall down 
on the public sector as well.  I think the key thing is, yes we can see 
that Gordon Brown's going to put more taxpayer funded money in, but with 
changes to healthcare, you've got demographic changes, you've got technology 
changes, you've got changing expectations, at the end of the day I think 
people will have to be incentivised to spend more of their own money on 
healthcare if we're really going to get up to the standards of the Continent.

LANSLEY;                    I'm sure it will be the 
case in the long run that publicly funded healthcare is part of a mix and 
people who are able to make a contribution do make a contribution to it, 
probably primarily through employer-funded health insurance packages.

GROSSMAN:                    Dr Liam Fox makes a house 
call.  Inside Berlin GP Dr Roland Krasser's surgery it's modern and well-equipped. 
 In Britain The Prime Minister has this week re-committed Labour to pushing 
NHS spending up the EU average within four years. But any new money it 
seems must come from general taxation.  That could leave the Tories clear 
to propose more private finance.

Coming to Europe and looking for ideas about how to reorganise the NHS 
is one thing. Taking those ideas back to the UK and trying to convince 
a sceptical British public is another matter altogether. Some Conservatives 
fear that however attractive the idea of putting more private sector involvement 
in the Health Service might be to them it's just the sort of policy that 
could terrify an already hostile British electorate.

FINKELSTEIN:                I think that the problem of 
involving private finance, involving private organisations in the National 
Health Service, in having some measure of mix between public and private 
insurance, has not, is not the scary concept that it was five years ago, 
partly because the Labour Party has talked so much about these things. 
Nevertheless, behind all those things lie severe dangers that people will 
worry that something they value, free NHS at the point of use, might be 
being endangered, so the Party's got to come up with radical interesting 
ideas that can make a real difference while at the same time reassuring 
people that it won't change the things that they value the most and that's 
a very difficult combination, it's not impossible but it's difficult.

GROSSMAN:                    Andrew Lansley and Liam 
Fox struggle to lift Tory gloom during the last election campaign. Then 
their message on Health concentrated on Labour's failings, definitely not 
proposing radical Tory solutions. 

LANSLEY:                    I think the world has 
moved on, I think the experience of the last four years has said to the 
British public that Labour didn't have the answers that they thought they 
did in 1997 and I think the public now are more open-minded about the changes 
that are going to be needed in the future in order to provide healthcare, 
and I think that may therefore give the Conservative Party a considerable 
opportunity.

GROSSMAN:                    But are voters really 
any more receptive to new ideas now? On the Record commissioned some research 
to see how such policies might go down with voters. We asked: If the Conservatives 
proposed that a higher proportion of healthcare be paid for by private 
insurance, would you approve?  Thirty-one per cent did, whilst fifty-seven 
per cent disapproved. We also asked: If the Tories proposed that some treatments 
currently provided for free by the NHS should in future be paid for privately 
by patients, only nineteen per cent thought it was a good idea whilst seventy-two 
per cent didn't like the idea.  Finally, and perhaps more encouragingly 
for the Tories when we asked if the Conservatives proposed making private 
hospitals play a bigger part within the NHS, fifty-three per cent approved 
whilst thirty-six pr cent disapproved of the idea.

FINKELSTEIN:                The Conservative Party knows 
that radical solutions are necessary, it doesn't believe that the current 
system could be managed as it is, but on the other hand, if you propose 
radical alternatives you immediately run into the problem that people may 
distrust those solutions and particularly if they're advanced by a Conservative 
Party they don't traditionally associate with caring about the NHS, so 
it's a big opportunity, but it's also a big problem.

GROSSMAN:                    It's back to the airport 
for the Tory health team for the flight home. Having lots of ideas from 
abroad will certainly help - they're off to Stockholm tonight to give the 
Swedish system a check up. The real test though is turning all these air 
 miles into a workable prescription for the NHS and getting UK voters to 
swallow it.