Shadow Health Secretary

On Sunday 09 August Sophie Raworth interviewed Andrew Lansley MP, Shadow Health Secretary

Please note 'The Andrew Marr Show' must be credited if any part of this transcript is used.

Andrew Lansley MP: "'absolutely' no Tory plans to raise VAT to 20%".

SOPHIE RAWORTH:

Andrew Lansley MP, Shadow Health Secretary

Now would you like to have access to your own medical records?

This weekend, the Conservatives are pledging that every patient would have their own user name and password, giving us instant access to all kinds of information about our health and treatment.

And you wouldn't just be able to read your notes. You could also add extra information to them - whatever you thought the doctor should see.

Health spending has proved particularly controversial for the Tories.

They've pledged to "maintain current Labour spending plans", but acknowledged that this will mean "reducing other budgets significantly".

Well the Shadow Health Secretary Andrew Lansley is here this morning. Good morning.

ANDREW LANSLEY:

Good morning.

SOPHIE RAWORTH:

So we're all going to be able to access our own medical records then if you win the next election?

ANDREW LANSLEY:

Well one of the vital things is that people do have greater control over their own healthcare, and access to your medical record I think is a key part of that. Because if we're going to ask people to take more responsibility for their health, which I think is an important part of improving our overall health outcome, and controlling health expenditure in the longer term, then we need people to be engaged with it.

SOPHIE RAWORTH:

But I'm not quite sure what I would do with my medical records. What would I need to access them for?

ANDREW LANSLEY:

Well if you are chronically ill - and let's remember one in four people in this country, by and large, are likely to have some form of chronic illness - so actually that business of being aware of what's happening to you, what are the main symptoms you should be looking out for. There's lots of people for whom it is important that they monitor their blood pressure or they monitor their cholesterol level or they are aware …

SOPHIE RAWORTH:

(over) So it's kind of keeping an online diary almost?

ANDREW LANSLEY:

It's a bit like that. But then, of course, people, when they actually - particularly for children, for example, parents and children - they want to have access to medical records as well, to be able to make sure that they're looking at what is happening to them. And how many people have been to hospital and had a consultation and thought they understood what was going to happen to them, what was the information, and then came home and they were talking to their family and they were asking them questions about it and said, "Well actually maybe I don't quite completely understand"?

So, actually, then, if you can access your medical record, you can look at this. And, if necessary, you can even put questions into it, so that you're prompted and your GP or your hospital consultant or somebody is prompted to say, well these are these are the questions I have and what are the answers to those?

SOPHIE RAWORTH:

Will you be delivering this through the NHS centralised IT system that the government's spent billions on developing?

ANDREW LANSLEY:

Well it's very important that we achieve better IT in the health service. I mean it is an enormous task to deliver good quality healthcare …

SOPHIE RAWORTH:

(over) So is that how we'd get it?

ANDREW LANSLEY:

… and IT can help. But quite clearly the government went about it entirely the wrong way, this centralised top down system.

SOPHIE RAWORTH:

(over) So are you starting from basics again? Are you going to get … Will you get rid of that system?

ANDREW LANSLEY:

Tomorrow, tomorrow … Stephen O'Brien on my health team and I commissioned an independent review and these ideas, including the idea that we should have greater personal control of health records, are in the independent review that is going to be published tomorrow …

SOPHIE RAWORTH:

(over) So we're not sure yet whether or not you're going to crack it.

ANDREW LANSLEY:

(over) … and we are going to respond to that. But I can tell you that it is going to be focused now on moving away from this top-down centralized, single NHS system into one which is decentralised, which is led by users, where people in the NHS at the frontline feel that it is responding to their needs.

SOPHIE RAWORTH:

I mean how can I be sure that my health records are going to be safe in whatever provider service you use to store them?

ANDREW LANSLEY:

Well because you're going to have greater ownership of them. And the way in which health records are going to be held in the NHS will be more geared towards the frontline system. We're going to build it around what you would expect. At the moment, for example, you're registered with a local practice. They generate most of your medical data and are responsible for it.

But the way the government has designed this new system, their attitude is it's all owned by the government and it's all held on these central servers and that's not good enough. Actually at the moment the risk is much greater in this new system that people all over the country who have access to the necessary passwords and NHS smart cards would have access to data, and it would be very difficult to monitor who is accessing data and why.

SOPHIE RAWORTH:

You've said you're going to … You've pledged that you're going to protect the NHS from cuts and you're going to match the government spending. I mean how are you going to afford all this? Is it the 20% VAT that is in The Telegraph today?

ANDREW LANSLEY:

Well, Sophie, first can I say you say "match the government spending". Yes we've said we'll match the government spending this year and next year, but when we look beyond next year we don't know what the government spending plans are. David Cameron and George Osborne and I, we've been very clear about our priority, and our priority is for the NHS not to be cut back. But actually it's not about protecting existing NHS spending.

It's about recognising the reality that we have outcomes for health in this country that are not yet as good as elsewhere in Europe, for example, and they need to be better, and we need the resources to make them better. And we've got year by year an ageing population. And age is the principal determinant of health need, so it would be completely unrealistic for us to say we could cut back. So the point is that beyond 2011, we don't know what Labour's plans are.

They actually … The NHS Chief Executive at the moment is asking the NHS to take £20 billion out of NHS expenditure in those three years. Our view is that yes we should make savings; we should get more for less from existing resources; we should focus the NHS on payment by results, which hasn't happened.

SOPHIE RAWORTH:

(over) But let me just …

ANDREW LANSLEY:

But then we should use that money to pay for improvements for additional health gain and for responding to an ageing population.

SOPHIE RAWORTH:

Okay, but just where's the money going to come from? Is it a VAT increase, as the papers say?

ANDREW LANSLEY:

(over) No, no, because the point is we've been …

SOPHIE RAWORTH:

(over) Or I mean are you going to be able to, are you going to be able to guarantee that the NHS will get some sort of real terms increase, year on year? Can you say that for sure?

ANDREW LANSLEY:

We've pledged to real terms increases for the NHS year on year.

SOPHIE RAWORTH:

To when?

ANDREW LANSLEY:

Now the point is …

SOPHIE RAWORTH:

Till when?

ANDREW LANSLEY:

Can I just make the point about the VAT story because, as far as I can see, the Daily Telegraph actually has a story that the Labour party, the Labour government have contemplated a 20% VAT cut. I know that we have no such plan and we've had no such senior level discussions that they refer to.

But in any case, the point is we've been very clear about the need for public spending to be controlled and the priorities that we will have within public spending, including for the NHS. We've been very clear about that because we don't want to be in a position where we have to have big tax increases …

SOPHIE RAWORTH:

(over) Right, okay.

ANDREW LANSLEY:

… the effect of which is to stifle the recovery.

SOPHIE RAWORTH:

But quite simply, are we looking at VAT at 20%?

ANDREW LANSLEY:

As far as I'm aware, we have no … we have absolutely no such plan and I know there have been no such senior level discussions as referred to. And the Telegraph story, as far as I can see, the only thing they actually have evidence of is a Labour government looking at raising VAT to 20%, not of a Conservative Opposition looking at it.

SOPHIE RAWORTH:

Let me talk to you about swine flu. Are you happy with the plans some say that are being rushed out to get a vaccination programme in place?

ANDREW LANSLEY:

Do you know it's very interesting. We do need to have over these next few weeks - notwithstanding it's August, notwithstanding the government might all be out of the country - we actually have to have a serious discussion about what it is we want to achieve with the vaccine and when is it going to be available. Because, actually the response to a flu is normally vaccination. You know we had the seasonal flu vaccine and we'll have that again this autumn, and that tends to be focused on the elderly. But here, of course, we have a new strain of flu, which appears to be particularly impacting upon young people and young adults. So the question is should we have a vaccine, and we have it available, should we be looking at making it available early in a programme to vaccinate schoolchildren because you know we have …

SOPHIE RAWORTH:

And do you think we should? I mean should we …

ANDREW LANSLEY:

(over) Well I think there's a place for it.

SOPHIE RAWORTH:

… when the children go back in September, should there be a mass vaccination programme to make sure that children are protected?

ANDREW LANSLEY:

Well two points really. Firstly, there is a timing issue. When is the vaccine going to be available? It may not be available before the schools come back.

SOPHIE RAWORTH:

But it may be available before the results of these trials which are being carried out now in Leicester …

ANDREW LANSLEY:

(over) That really comes down to the licensing issue, which is in the hands of the European Medicines Agency, and really it's down to them. I don't think we should …

SOPHIE RAWORTH:

(over) But would you be comfortable with a mass vaccination programme launched in the autumn?

ANDREW LANSLEY:

Well let's say two things. Firstly, I would not be comfortable with a vaccination programme using an unlicensed vaccine.

SOPHIE RAWORTH:

Okay.

ANDREW LANSLEY:

Once it is licensed, I think I would be very keen for us to focus on schools and schoolchildren because they appear to be the mechanism by which the transmission is taking place.

SOPHIE RAWORTH:

Andrew Lansley, thank you very much for joining us.

ANDREW LANSLEY:

Thank you.

INTERVIEW ENDS

Please note "The Andrew Marr Show" must be credited if any part of this transcript is used.

NB: This transcript was typed from a recording and not copied from an original script.

Because of the possibility of mis-hearing and the difficulty, in some cases, of identifying individual speakers, the BBC cannot vouch for its accuracy

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