Martyn Lewis, BBC
Prime Minister, the Health Service first:
Top doctors are worried, the Government has agreed to meet them next month. Last week, a sudden cash injection of an extra £100 million.
Despite all you have said about the National Health Service, is there a whiff of panic in the air?
Prime Minister
No, I do not think there is any panic at all.
Had you been interviewing me eight years ago and I said then: “Look! Whatever is being spent now, we will spend two-and-a-half times as much in eight years' time; there will be more nurses, more doctors!” you would have thought it impossible and I was promising things that could not be fulfilled—but they have.
But nevertheless, there have been some hospitals in difficulties and, therefore, a particular injection of money has been made to get them through this year.
There is a bigger injection next year, which was always planned, and in the meantime, we shall be looking very carefully at how different hospitals are performing because one can learn so much from another. [end p1]
Martyn Lewis, BBC
You are also going to be looking at other ways of raising money for the Health Service and your Health Minister, Tony Newton, has said the Government is considering hotel-type charges for patients in NHS hospitals.
Did you not specifically rule these out before the election?
Prime Minister
They could not possibly come in during the lifetime of this Parliament, because I remember very vividly being on the platform at a press conference at Conservative Central Office during the election campaign and Norman Fowler sitting beside me, and I confirmed what he said, that we would rule it out during the lifetime of this Parliament.
Martyn Lewis, BBC
But Mr. Newton says they are looking at it!
Prime Minister
But you know, our thoughts are going well beyond the lifetime of this Parliament.
We have, in fact, introduced one or two extra charges which we think people can well afford, but right now what we are doing is increasing the amount of money that is going to the Health Service and we are looking at how effectively it is being spent. [end p2]
You will find all sorts of strange things. For example, in some hospitals, beds are vacant for three days between operations in general surgery; in others, only one day are beds empty.
You will find that in some hospitals the surgeons have learned to have what they call a “short immediate notice waiting list” , that is to say, if some people have to cancel, people can be called in at short notice, and they have cut down the waiting list by that means.
We are looking at all the more effective means of making the best use of the money and it is our duty to do so. So at the moment we are not talking about extra charges beyond those which we have introduced.
Martyn Lewis, BBC
Are you also looking at ways of obtaining that money? Are you tempted, for example, to try and fund the NHS wholly by private insurance schemes?
Prime Minister
No, we are not attempting to do that at all.
As I indicated, no government has ever managed to put more resources into the Health Service than this one—a great deal more resources: more doctors, more nurses. But you know, the treatments and the new research, they are just outrunning some of the resources available, so obviously we are having to try to see [end p3] whether we can get better value for the money that is being put in. It is very considerable.
Martyn Lewis, BBC
And other ways of raising money as well?
Prime Minister
We are always prepared to look at new ideas, but at the moment, we find we have got more information—more management information—than we have ever had before.
We are interested that some hospitals are not in any difficulty and, I might tell you, some of those are a little bit concerned that the ones that did get into difficulty have got more money and they are just wondering if they have been treated correctly, if they had managed to spin out their budget and husband their resources, so we are looking at effective management; we are looking at the new figures which we can now get on computers; we are looking to see how the people's money can be better spent.
Martyn Lewis, BBC
Is it part of that new effective management to look at the nurses as well, because 30,000 of them a year are leaving the profession simply because there is not enough money? Why should not a nurse get as much as a policeman at a similar stage of training?
Is there not a case for giving the nurses a giant hike up the pay league table once and for all? [end p4]
Prime Minister
There were rather a lot of questions involved in that!
First, it is 30,000 nurses leaving a year out of about 480,000 nurses and bearing in mind that they are young, attractive, a lot of them go to get married or have children, that is not an unduly large amount, plus those who are also retiring and, of course, we have a lot more nurses in the Health Service now than we had when we came to power—64,000.
We are looking at their pay to see how extra skills are dealt with. At the moment, those who are on geriatric wards get extra pay but not those who are on paediatric work, so we are looking at the whole structure through a review body which we set up.
When that review body has demanded the pay of nurses be increased, we have in fact given that increase. For every £5 that a nursing sister got when we came into power, she now gets £12. You will say: “Yes, but there has been inflation!” Quite right, but when you take that into account, for every £5 she got, she is now in real terms getting £7, so the pay has gone up, but we are just a little bit concerned that the extra skills they get—they have to take midwifery, they have to take special children's courses, some have to take special geriatric courses—are not necessarily being deal with properly, so we referred that to the review body. [end p5]
Martyn Lewis, BBC
Prime Minister, Neil Kinnock said last week that a government that would rather have more tax cuts than health treatment is not doing everything in its power to improve health care in this country.
Are you not tempted to give some of the money that would go in tax cuts back into the Health Service?
Prime Minister
No, look! What matters is that the economy grows. The economy has grown. It is because it has grown that whereas some £8 billion was being spent on the Health Service when we came in, some £22 billion will be spent next year and that is a lot extra, together with tax cuts, but if you are to get the growth, people have got to have the incentive. The earnings belong to them.
Government takes what it must take to run the country well, including the Health Service, but the policy we have run of having tax cuts and giving incentives has led to the economic growth which has enabled us to give far more to the Health Service than any previous government, so it is that policy that has worked both ways: a higher standard of living and a very much higher standard of health care.
Martyn Lewis, BBC
Prime Minister, moving on to the security services: the Government, as we have heard, was defeated today over “Spycatcher” [end p6] in the High Court. You have said you will appeal against that. The latest case against the BBC goes on.
Now, I do not want to go over all the arguments again, but can I ask you if you think that the new Official Secrets Act the Government is contemplating should ban all reporting of the security services?
Prime Minister
There are a lot of questions there. Can I make two points which I think will answer the question you are putting to me, although you know I can say very little about that case because it is before the Court.
I thought the judge today gave an account for profits against the profits earned from the “Sunday Times” . Now, if that is not correct, perhaps you will say so.
Martyn Lewis, BBC
He did in part do that, but…
Prime Minister
That is very important and very very significant, very important and will help words missing? [end p7]
Martyn Lewis, BBC
Can I also put to you what he said?
He said: “I found myself unable to escape the reflection that the absolute protection of the security services that Sir Robert Armstrong (your Cabinet Secretary) was contending for could not be achieved this side of the Iron Curtain.” How do you react to that?
Prime Minister
I am not going to comment on his precise wording of his judgement because it will make an interim appeal…that fact must be argued in Court. I was merely saying that from what I saw on television you did not report that an account for profits against the earnings from the serialisation in the newspapers had been awarded, which is very important.
The second point I want to make is this:
The country has to have security and intelligence services. It is vital for our security. Our duty as a government is to see that those people who work in those services do not divulge their secrets, because if they did—either for personal notoriety, prestige or for money—there would soon be no secret nor intelligence services and that would undermine the security of the country. That duty is vital. It is vital to your security, it is vital to the security of most people, and I think most people understand the importance of that and therefore, we shall in fact continue to take that to the highest possible Court of Appeal because of the importance of the principle. [end p8]
We shall have a new Official Secrets Act. We have had a try at amending the existing one—we did in our first year of power—it did not get through Parliament. We are looking at that and we shall come forward with a new one and I hope that the next one will get through.
Martyn Lewis, BBC
Prime Minister, can I ask you very quickly one final question?
On 3 January, you become the longest-serving Prime Minister this century since Asquith. Are you tempted to consider retirement so that your successor can be in place for the next General Election?
Prime Minister
Not yet, not yet. I would like to carry on for some time longer and when it comes, then I hope it will not be yet.
Martyn Lewis, BBC
Prime Minister, thank you very much indeed!
Prime Minister
Thank you!