News - Foundation Hospitals ‘watered down’?
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Jeremy Vine: I’m joined now by Douglas Alexander, the Minister charged with implementing reform of the public services. Six years on, do you think you’ve gone as far down the road as you expected to go. Douglas Alexander: Well I think we’ve made some real progress. I mean we started with one single challenge in the National Health Service, which was that the capacity of the service wasn’t great enough; so for example, we have 10,000 more doctors, we have 50,000 more nurses, so of course we’ve got a long way to go. I share people’s impatience to make sure that the service improves. Jeremy Vine: But would you have expected …… (both together) Douglas Alexander: ….. we have made some real progress. Jeremy Vine: Would you have expected to have got further by now. Douglas Alexander: After 18 years of under funding, we knew that the situation was going to be pretty bad, and that’s why we took some very tough measures at the beginning, to make sure that the finances could flow, not for one year, but actually right through the parliament, and that’s why we’re determined now to make sure that we build on the progress, to have the kind of corporate estate finance finance hill in insurance irwin mcgraw principle real series service that was talked about in your film. Jeremy Vine: But we’ve got this rather strange situation where as was pointed out in Gloria’s film, 40% more money has gone in, 40%, but the output is only up 14%. Now, maybe you can do nothing about that. Douglas Alexander: Well, as the woman from the King’s Fund said during your film, that doesn’t actually recognise the fact for example, we’ve got the largest hospital building programme ever since 1997, 40 new hospitals being built across the country. Just to give your viewers a sense of scale, I mean the National Health Service has about 1.3m staff across the country, a tremendous army for good, I would argue. They deal with a million patients every 36 hours, so it’s a tremendously large service I believe to (both together) Jeremy Vine: But you’re putting the money in and not getting the results, that’s proportion to the amount of money. Douglas Alexander: Well for example if you look at the number of doctors, as I say, 10,000 extra doctors, those don’t just emerge, they have to be trained, it takes about three years to train a nurse, at least five years to train a doctor; so of course resources are key, but other hand we need to make sure we’re building for the long term, and that’s why we’re building all of those extra centres as well. Jeremy Vine: Where is your reform programme now on the NHS because in November 2001, Gordon Brown insisted, we can see these words on the screen, in an interview with The Sun he said, ‘There will not be one penny more until we get the changes to enable us to make the reforms and carry out the modernisation the health service needs’. Now the money has gone in before the reforms have been put in place hasn’t it.
Douglas Alexander: Yes, but that’s exactly why … (overlaps) Jeremy Vine: You promised that wouldn’t happen. Douglas Alexander: …. for example why we have new targets which have been set. Now targets are important and they featured in your film, but actually they’re just a means to an end, they’re to make sure that we have that patient centred service, and that we get value for money. Jeremy Vine: (overlaps) ….. very misleading as well. Douglas Alexander: Well, in what sense. Jeremy Vine: Well because the targets can be fiddled.
Douglas Alexander: Yes, but that’s exactly why we have an inspections regime to make sure that they’re not. Jeremy Vine: Okay. But going back to the Gordon Brown point, you promised you would not put money in until reforms are in place (interjection) … to-day we’re seeing foundation hospitals reform go through the House of Commons. But the money is coming in already. Douglas Alexander: You’ll have to wait till next week. Look at the reforms we’ve seen, we’ve seen for example NHS Direct, literally a service that is now the envy of the world, which simply didn’t exist prior to 1997. We’re also seeing new diagnostic and treatment centres, we see a whole range of new services. Jeremy Vine: But the reforms that you want for the NHS are not completely in place yet are they. Douglas Alexander: Well the process is not completed, but on the other hand it has started and it would be disingenuous to suggest otherwise. Jeremy Vine: Do you worry that the whole foundation hospitals plan that you put forward has been so diluted that even its opponents now support it. Douglas Alexander: Well if you look at who some of the opponents are, the Conservative Party has historically had a very different view of the National Health Service. (overlaps)… Jeremy Vine: …. one of your MPs. Douglas Alexander: If the National Health Service fails, that proves the virtue of their politics, that somehow suggest the private sector is inherently better to the public sector. What foundation hospitals represent is the next stage forward for the National Health Service, whereby within the National Health Service, you can have a degree of local autonomy and direct control by local communities, that provides the quality of services that people are looking for.
Jeremy Vine: Come on Mr Alexander, it’s been very very watered down hasn’t it, to the extent where Stephen Pound, one of your MP s who’s against it says, We’ve now had five stages of dilution, so a lot of us are a lot more happy. Douglas Alexander: Well there’s been a debate, it would be daft to pretend otherwise. That’s exactly what Stephen …. (overlaps) Jeremy Vine: Well it’s been watered down. Douglas Alexander: But I believe what we’ve got is the right balance between on one hand national standards of treatment which I think people have a right to expect, not just in one community but in every community of this country, with a recognition that where there are hospitals who have outstanding levels of management and clinical services, it’s perfectly right that in years to come, they’re able to enjoy higher degrees of autonomy, while support and assistance has been given right across the service.
Jeremy Vine: But what’s happened to the promised ability to borrow money. Douglas Alexander: Well that’s, I mean, the point I started this interview by making, was that actually we’ve massively increased resource to the National Health Service. Jeremy Vine: Well why haven’t they got that any more. Douglas Alexander: Well that’s because they’re getting extra resource through the public sector. Jeremy Vine: We were told they were going to get that. Douglas Alexander: Well there was discussion as to what was the best way (overlaps) … Jeremy Vine: You’ve watered it down. You’ve watered it down. Douglas Alexander: But I’ve never seen the tests of the National Health Service as whether borrowing is on or off balance sheet. The real test for me, and I think actually for your viewers Jeremy, is what quality of health service they actually enjoy in the 21st Century, and there’s a huge choice to be made here for the British public. Do we believe that we should have a National Health Service where treatment is provided free at the point of need, or do we accept a Conservative vision which says that the quality of treatment that you receive is actually determined by the size of your wallet (interjection) That’s not a future I want for myself or my child. Jeremy Vine: Why do you think that in this poll to-day, 36% of people are expecting the National Health Service to get worse. Douglas Alexander: Well I think people are impatient for change, of course they are. (interjection) I think one of the challenges we face particularly in the National Health Service is that people’s expectations of services, in part because of their experience of some of the private sector, improves year on year. And that’s why, for those of us who are committed to see a national health service providing treatment free at the point of need, we have a huge job to do, and we’re continuing to take forward that work. (overlaps) Jeremy Vine: I’m sorry Mr Alexander, I don’t understand how that explains why a third of the people in this country might be expecting the health service to get worse under your government. Douglas Alexander: Well partly because there’s a media agenda amongst certain sections of the newspapers who are determined to suggest we’ve got a third world health service. I actually think in the years to come, say over the next five to ten years, with the innovations taking place for example in genetics, that people will come to see the NHS as a quintessentially modern idea, the best insurance policy the British people could ever have. I don’t want to have to be reliant on the small print of an insurance policy to determine whether I get treatment in ten or 20 years, and that’s why the programme that this government is taking forward for the health service is so important. Jeremy Vine: Looking more broadly at the public services in general, I know you’re responsible for reform in all of them, do you worry that the government is not taking on the so called ‘vested interests’ effectively. Douglas Alexander: No, I think, of course there’s, as I say a huge number of people involved in providing public services across the country and 1.3 million people for example in the NHS; so of course there are going to be areas of disagreement but if you’ve heard the announcement this morning by John Reid the Health Secretary for example, that he’s looking forward to a discussion with the consultants, they represent 30,000 employees out of that staff of 1.3 million, and literally (injection), and literally everybody else has already signed up to the agenda for change programme. So in that sense I think there are grounds for more optimism, that working together with the staff, not just of the National Health Service, but with teachers and staff and schools right across the country, we can advance the idea that in the years to come, the public services can be as valued as they’ve been in the past. Jeremy Vine: Your consultants example explains it precisely doesn’t it, because they, they have managed to stop or complain successfully about these new contracts and they’re going to have a discussion about it, and it’s very difficult for you to get reform past public sector workers who don’t like it. Douglas Alexander: Well I’m not averse to discussion and neither is John Reid, the Health Secretary, that’s why he said he believes the settlement on the table offered to the consultants is a generous one, but on the other hand, he’s listening and learning from a wide range of voices within the National Health Service, appropriate to a Minister who has just taken over that brief, and he’s looking forward to meeting the consultants on that basis. Jeremy Vine: All right. Finally, on the subject of this row between the government and the BBC. Do you think that since Alastair Campbell has become the story, it is time for him to go. Douglas Alexander: Well Andrew Gilligan made Alastair Campbell the story a month ago with specific allegations which suggested two things. First of all that Number 10, as distinct from the Intelligence Services, had actually inserted a specific allegation about forty five minutes, in to a dossier, and then exaggerated it. Now, on the basis of a single, business liability insurance source, the BBC then broadcast that, indeed it broadcast it for a month. I therefore think it’s very important that the Foreign Affairs Committee of the House of Commons looks in to this matter, and it’s doing so at the moment …. (overlaps) Jeremy Vine: But you don’t think Mr Campbell should resign. Douglas Alexander: …. to the bottom. No, I certainly do not. Jeremy Vine: Cos the claim that Saddam Hussein had weapons of mass destruction at forty five minutes readiness was in your dossier, on one source as well wasn’t it. Douglas Alexander: Yeah, but this is a very fundamental distinction. That was a dossier that was compiled by the Intelligence Services, it was then put to the Join Intelligence Committee, who in turn passed it on to Downing Street; so the idea that somehow there is an equation between a single unattributed source speaking to a journalist in a hotel, with the considered view not just of the joint intelligence committee, but also … (?) the word of the Prime Minister, the Foreign Secretary, the Intelligence and Security Co-ordinator and the Chairman of the Joint Intelligence Committee, I think begs some pretty fundamental questions.
Jeremy Vine: But some embarrassment at the other dossier, parts of it were lifted from a student dissertation, you can acknowledge that. Douglas Alexander: Of course, and Alastair Campbell …. Jeremy Vine: Considerably banking career career finance in insurance opportunity opportunity…. Douglas Alexander: Well, Alastair Campbell was quite candid in conceding that that was an error when he was in front of the Foreign Affairs Committee. Jeremy Vine: Douglas Alexander, thank you very much indeed for joining us. Let us know what you think
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