............................................................................... ON THE RECORD RECORDED FROM TRANSMISSION: BBC-1 DATE: 21.11.93 ............................................................................... JOHN HUMPHRYS: But first, back to basics. John Major's latest rallying cry. He wants us to return to basic values and he's spelled out some of them - low inflation, better education, respect for the law - and, perhaps above all, a greater acceptance of personal responsibility and family values. Is that the context in which we should see the latest leak of government thinking? Gordon Brown has given the Observer a document which discloses that seven teams of top civil servants have drawn up plans that would effectively demolish whole chunks of the welfare state. Well with me is the Health Secretary, Virginia Bottomley. Mrs Bottomley, perhaps this is one way of getting back to basic values is it, to reduce the dependence of people upon the Welfare State, upon Government? VIRGINIA BOTTOMLEY MP: Well we always want to encourage independence and nothing does that better than having an economy where jobs are growing, we're seeing unemployment falling and the one thing people want on benefit is to find jobs, we're being singularly successful there, one of only two European countries that are seeing unemployment falling. But evidently the Government has to look at every area of expenditure to examine how savings can be made, how we can target our resources better, whether it's health, education and of course at Social Security it's important to examine all the heads of expenditure. I thought the Labour Party agreed with that, they've got their commission on Social Justice which is doing precisely the same, saying if you're spending eighty billion pounds, thirteen pounds a head for everybody in work, certainly we need to look at options. There's all the difference in the world though between a scare story and a leaked document examining options and saying this is what the Government is going to do. And as ever, the Labour Party only get publicity when they produce a leaked document, they don't have policies of their own. HUMPHRYS: But why is it a scarce story if the document's real and exists, and indeed it does exist, I have a copy of it here? BOTTOMLEY: The point is that they always start talking in an alarmist fashion about what they predict the Government is going to do, we have it on virtually every head, I have it time and again in the area of health. The Government has a duty to examine the way in which we spend money, particularly a Budget of eighty billion pounds but we also have a very firm duty to protect the Welfare State, to provide for the weakest, for the frailest, to make sure people in need get the help they need. We've been very successful in that and we will continue to do so. HUMPHRYS: So you have a duty, and I quote from the document "to examine the scope for greater use of private provision for unemployment, sickness, invalidity and retirement." BOTTOMLEY: We certainly believe in encouraging independence, we've seen an enormous growth in recent years in private pensions, so that more people in their older years are independent and the living standards of older people has been rising dramatically, that's important when you have a doubling of the population over seventy-five. HUMPHRYS: So when we talk about encouraging, we're talking about what, offering tax incentives for instance, to enable people to take out private insurance of one sort or another? BOTTOMLEY: I'm not going to say anymore about a leaked document, those are responsibilities that Peter Lilley has. Think what are the options that we can take forward... HUMPHRYS: Some of them are your responsibilities. I mean we're talking about health figures... BOTTOMLEY: People should look at what we've done. As far as the Health Service is concerned we're committed to real terms increases in spending. This year alone an extra thousand million pounds going into the National Health Service, a Health Service that serves the nation well and one which we're seeing is delivering results. As we know more patients treated than before the reforms, people living longer, having much better treatment and waiting times coming down. HUMPHRYS: But you want to encourage people to take greater responsibility for their own health? BOTTOMLEY: I'm committed to a National Health Service available to all on the basis of clinical need and not on ability to pay. I want people to take a bit more responsibility for their health in terms of some of the health promotion messages. If I can encourage people to eat a bit more healthily, to drink a bit less, to smoke not at all, certainly there will be very substantial savings on the National Health Service budget which I can then put into some of the pioneering new treatments I want to go forward faster with. HUMPHRYS: But if they are unfortunate enough or silly enough to drink a lot or smoke a lot and get terribly fat and end up in hospital, you want to encourage them to consider taking out private insurance so that they pay for themselves or their insurance scheme pays for themselves rather than the state. That's what this is all about is it? BOTTOMLEY: Nonsense. It's not remotely about that. HUMPHRYS: Is it nonsense? BOTTOMLEY: The National Health Service will continue to provide for all on the basis of their clinical need. HUMPHRYS: But you're looking at all options you said. BOTTOMLEY: As far as the National Health Service is concerned we'll continue to provide for all on the basis of their clinical needs... HUMPHRYS: I didn't suggest you weren't. BOTTOMLEY: I have no vendetta the private sector, many people use private health insurance for a number of reasons but what we know is we have a National Health Service providing ever higher standard of care and that will continue to be the case. I hope, however, they will take the messages of a healthy lifestyle since that leads to very substantial savings on my budget which I could put into other more useful things. HUMPHRYS: But it's interesting that you are so vehement about this and you say "nonsense" at even the suggestion that there might be some sort of tax incentives or some sort of change. I mean in this programme a few weeks ago, Michael Portillo was quite open on this whole area, he talked for instance about hospital charges within the NHS. BOTTOMLEY: Year on year, we'll continue to review the role, for example, that charges play. HUMPHRYS: Right, so it isn't nonsense is it? BOTTOMLEY: We've had charges in the National Health Service as long as you've had National Health Service. The legislation was passed by a Labour Government, they introduced some of the first charges, there's nothing new about a number of charges in the NHS. HUMPHRYS: So why "nonsense"? BOTTOMLEY: The consideration year on year is what's the role of charges and what contribution can they make to the further hospital programme, to improving immunisation, to improving health services generally..but the basic principles are absolutely unchallengeable, our National Health Service, really the envy of the world, will continue as it is, available to all on the basis of clinical need and not on their ability to pay. HUMPHRYS: But that does not preclude... BOTTOMLEY: And the success of what the Health Service is achieving can be seen year on year as we see increasing life expectancy, more treatment, falling waiting times. HUMPHRYS: That does not preclude though, examining the scope - and I quote again from the document and you said it was "nonsense" a minute ago and then you suggested in your subsequent comments, I think, that maybe some of it might be the case - to examine the scope for greater use of private provision for, for instance, sickness. Now why is that nonsense, bearing in mind what you've just said? BOTTOMLEY: Because the National Health Service and the principles on which it's established and which the Government has stewardship for it will continue as they are. What I've made clear is that we'll continue year on year to decide which charges should be taken forward in whatever way. At the moment we have precious few charges, free to go to the GP, free to go to hospital, only one item in six carries a prescription charge. I haven't found a health service anywhere in the world that has fewer charges. We've made the position clear on that, year on year we make an announcement about how that would develop. HUMPHRYS: And year on year... BOTTOMLEY: And there are no plans to somehow discourage people from using the NHS by promoting the private option, albeit many people will decide to have private health insurance, we have a very low base at the moment, but that is not part of an agenda to direct them in that way. Our efforts and all our very determined efforts are to make sure that the hundred million pounds we spend a day on the NHS are used well and clamping down on the drudge budget, clamping down on unnecessary bureaucrats, unnecessary grey suits, dare I say, is all a way of getting.. HUMPHRYS: You better tell John Redwood that and not me. BOTTOMLEY: Indeed, a good expression and it describes very well exactly what we're doing. What we've set these reforms in hand to do is to get better efficiency, to get every hospital delivering as well as the best. HUMPHRYS: I understand that. BOTTOMLEY: And a lot more scope for improvement. HUMPHRYS: I understand that and I'm not talking about those particular reforms. But you said year on year we look at new ways, basically of saving money if I can paraphrase, or being more efficient. Now one of the ways is quite clearly here to examine the scope for greater provision for private insurance. Now, if you're telling me that that is nonsense, should you not go to this committee that's sitting in Whitehall and say "look, don't even look at it, we're not even considering it, it's nonsense." BOTTOMLEY: You're confusing, I think, two budgets. The Social Security budget is eighty billion pounds... HUMPHRYS: Well I not trying to think of it in terms of specific budgets, I'm trying to think of the Government's overall philosophy which is what these documents are all about. BOTTOMLEY: The Labour Party have set up a commission on social justice to try and help solve some and tackle some of these problems... HUMPHRYS: And I'm not talking about the Labour Party either.. BOTTOMLEY: Any country in the world, with a rising elderly population, where the proportion of people who are of retirement age, compared to those in work, is changing fast, will be looking at their Social Security budgets to say how can we continue to target resources to update our benefits, to make sure that a benefit that started for one purpose isn't now being used in a different way. That's fundamental for eighty billion pounds, thirteen pounds a head for everybody in work. That is separate from the work of the Health Service continuing year on year to look for efficiencies, for looking...a way of taking forward their priorities. HUMPHRYS: So you are considering the case then, in that case. If you separate out the Health Service, and perhaps I can come back to you in a second, but you are then, you accept that you should consider the case for - and I quote again from the document: "withholding, reducing, or otherwise limiting the non-contributory, non-means-tested benefits received by people with incomes or capital above specified limits". In other words, if you are getting child care, child benefits rather, and you don't need the money, then you should take another look at it because that's sensible. BOTTOMLEY: Well, I hope that every department of Government - and this is precisely what is happening - is looking at ways in which they're spending the money that the taxpayer gives them. HUMPHRYS: So you've no quarrel with these documents? BOTTOMLEY: And there's all the difference between examining the options and taking the decision that that is the policy that is going to be applied. It would be irresponsible spending eighty billion pounds of the taxpayers' money, not to continue to look year on year whether for example a benefit that's started to help the most vulnerable and most in need, has become distorted and is now not necessary for those who are most vulnerable. Remembering that it is very often the low income person in work, paying taxes, who is paying very substantial sums in terms of benefit for others. That individual wants to be quite sure that the budget is being scrutinised and, of course, remembering that our job in a welfare state is to help provide for the most vulnerable. That is precisely right. Combining that, though, with a recognition of individual responsibility and the sharing responsibility for times of need. HUMPHRYS: So, notwithstanding manifesto commitments, you are looking at the whole picture. You are saying: "Things may change fundamentally in the next year, or two years, or three years." BOTTOMLEY: I'm saying no such thing. I'm saying that every ... HUMPHRYS: But you've accepted that the committees are discussing these things that you will in turn, if I may just finish the point, that these committees are sitting - you've not disputed that - that these are some of the headings under which they're operating and that you, the policy makers, will be looking at those recommendations and taking them seriously at the very least. BOTTOMLEY: This is old news. Six months ago we set up committees with all the big spending departments saying: "How are we spending our money? Are we spending it sensibly? Does Sir Humphrey always know best? Should we rigorously examine - not just in the last few months of a spending round, but in a longer term - how we are best using the money the taxpayer gives us?" There are many low income earners paying taxes who want to be sure that the money is being spent carefully and responsibly, and I certainly regard myself as responsible for thirty five billion pounds of the taxpayers money to look constantly as to how I can target it, because it's by targetting the money that you can do more and go further. HUMPHRYS: Right. So the emphasis is on targetting. Let's look at some other basic values. Acceptance of personal responsibility and family obligation. And let me - because I think people become a bit confused about returning to basic values and nobody's quite sure what it means, what the whole concept means, so let me pluck out one little thing. How do you, for instance, stop teenage girls getting pregnant? What does the Government do to legislate that into existence? BOTTOMLEY: Let me speak more broadly. HUMPHRYS: Well, I'd like you to deal with this specifically... BOTTOMLEY: I will come onto that if I can try, a difficult enough area, and they're all difficult areas. But the whole theme of 'back to basics' is about saying that there are some core themes that we share in our society - the responsibility of family, of parents, of communities. They are matters that actually concern our constituents. The importance of education, the importance of law and order. HUMPHRYS: Nobody would dispute any of that, I don't think. BOTTOMLEY: They may not impress the 'chattering classes' also, but if you knock on the doors in the streets of this country, people are concerned about truancy and that's why the truancy is so important; they are very worried about law and order and that's why Michael Howard's work
is so very important... HUMPHRYS: So what do you do, specifically? BOTTOMLEY: And so, also, in terms of younger people having babies that is a matter of concern. HUMPHRYS: So how do you tackle it? BOTTOMLEY: You tackle it above all by reminding parents of the need that children need to know the facts. HUMPHRYS: Do you think they don't know? BOTTOMLEY: I'm pleased to say it's one of the target areas set out in the health of the nation where we are seeing improvements this year. The figures are beginning to turn round. It's important that in schools that sex education is available, sensitively and well-handled. HUMPHRYS: Right. Now will you legislate, for instance - as the Dutch authorities have done, will you legislate to make it - sex education of a particular kind - compulsory and perhaps legislate for free condoms? BOTTOMLEY: I think that the right way forward is for sex education to be taken forward by schools in discussion with governors and with parents and working with the local health authority. But, of course, it's a sensitive and a difficult area but it's an area where facts are necessary, albeit in the context of the concerns of the family that it should be within a cultural context that recognises family life. HUMPHRYS: So will you then, bearing all that in mind, say: "Because we are so concerned to return to family - to these basic - values, we will actually legislate to make some of that happen. We will bring it about"? Because at the moment all you're saying is: "We will exhort people", and that's not going to be enough, is it? BOTTOMLEY: John Patten has already said that sex education will be taught in all schools... HUMPHRYS: Free condoms? BOTTOMLEY: ...albeit - I don't think that is something that will take place in our schools as things are - albeit the parents would have the right to take their children away if they so wished. But these are, of course, all matters concerning families and concerning education, are very sensitive. What we're saying though in the whole 'back to basics' theme is "don't let us forget the role of the family". Look at truancy, if one in five children are not going to school the families do have a responsibility. I spent ten years as a juvenile court magistrate; ten years working in the Inner City in a Child Guidance Unit and I know some of the difficulties that families get into, but what the family needs to do is to feel what's the contribution that they can make? For example, making sure the child goes to school. Keeping an eye on those wayward youngsters, all getting into terrible difficulties. And families welcome this year's programme that says: "We want common sense values in our schools, we want children taught the 'three Rs', we want our children able to spell, to add up in a sensible way, and we really do want a reinforced programme to crack down on law and order. HUMPHRYS: Virginia Bottomley, thank you very much. ....oooOooo....