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DERMOT MURNAGHAN: Well now, the government’s Health and Social Care Bill must be one of the most controversial pieces of legislation in recent times. It’s been opposed by patients groups, some health professionals and politicians from it seems many sides. Well this week the Bill finally became law but how can the government expect it to be executed successfully with so much ill feeling surrounding it? Well joining me now is the Health Secretary, Andrew Lansley, a very good morning to you Mr Lansley.

ANDREW LANSLEY: Good morning.

DERMOT MURNAGHAN: We will obviously discuss that at length in a moment or two but just first a reflection on the last couple of weeks for your party. It seems you’ve pre-budget squandered quite a healthy poll lead, turned it into quite a deficit and in between times had pastygate, grannytaxgate, donorgate and jerrycangate.

ANDREW LANSLEY: Well I think from my point of view not only in the last two weeks have we successfully passed the Health and Social Care Bill into law, which we’ll talk about in a moment, but also when you look at something like George’s budget, actually I think people have got to realise we inherited the largest deficit of any of the OECD countries, we’re in a position where contrary to many other countries the markets are demonstrating they have confidence in this coalition government and our ability to bring down that deficit, but in the context of the budget what that meant of course was that if people are going to have their income tax reduced – and remember we are taking two million people in total as a consequence of increasing personal tax allowances, out of tax altogether, large numbers of people, hundreds of thousands of people seeing their income tax reduced – it’s not possible to do that without there being compensating changes elsewhere so it was a budget therefore that really did impact, it benefited people and it benefited growth and today, it’s the 1st April, it’s the start of a new financial year and of course there is a reduction in Corporation Tax. We do have to pay our way in the world, we have to succeed in international markets.

DERMOT MURNAGHAN: There is this overriding perception at the moment that in particular the Conservatives are out of touch with the general public and the misses in the budget, the things that you missed presumably while you had a look at it in Cabinet, while it was being formed, symbolise that. The pasty tax, we know you don’t really eat a lot of pasties. The granny tax, the Chancellor regarded it as a simplification and then on other things going round, the petrol dispute, you drive around in Ministerial cars, you don’t use petrol, you’re out of touch.

ANDREW LANSLEY: Come on, none of that is true. First thing is, yes of course we knew and when George presented the budget to Cabinet it was very clear what the consequences were in terms of the age allowance but that equally it wasn’t taking any money away from anybody, it wasn’t increasing that allowance and it was at the same time increasing the personal tax allowance for often what are very hard pressed families. So to suggest we’re out of touch is missing the point because actually it is often precisely those families who are benefiting on relatively low incomes who are paying income tax, who are now not going to be paying income tax, who are perhaps some of the hardest pressed in the country. At the same time, yes, when you talk about a fuel strike, yes of course a fuel strike if it happens is a bad thing and you have to prepare for it and frankly from our point of view it seems to me that all the evidence shows that you get damned if do prepare and you get damned if you don’t.

DERMOT MURNAGHAN: Well was your colleague Mr Maude right, you should prepare, you should stock up? Is the government advice explicit now, don’t go out and fill up those containers?

ANDREW LANSLEY: The government advice is very clear. The union have not called a strike yet but when they do, if they do within 28 days there’s seven days’ notice. What we don’t want at that point for there to be a panic so of course it is important for people to prepare. We have got to build resilience in the system and that’s what we are doing, building resilience in the system.

DERMOT MURNAGHAN: In spite of the dangers, that seems to be saying that the jerry can advise stands in spite of the obvious dangers that we saw to horrific effect in York, you’re the Health Secretary, it’s a health risk.

ANDREW LANSLEY: Of course there’s a health risk if there were a strike and I don’t want there to be a strike and I do think tomorrow when the trade union and the employers get together at ACAS they ought to come to an agreement because I don't think it is in anybody’s interests for there to be a strike, it’s not just a health risk, it’s a risk to the economy and that’s the last thing that we need at this time but I think actually the advice is very clear – there is no need for anybody to panic, there is no need to be queuing at petrol stations. I think where we are already is at a place where there is more resilience in the system, I know from my point of view with the ambulance service and the emergency services we are building resilience, making sure that we have fuel supplies available.

DERMOT MURNAGHAN: There are a couple of suggestions in the papers today, some Cabinet sources so-called, who say that Mr Maude overstepped the mark there, that this was beyond the agreed line in COBRA, the emergency committee and that he shouldn’t have said that. Do you think he should have said it?

ANDREW LANSLEY: I’ve been on the receiving end of this kind of reporting and I think it is all nonsense frankly. It was nonsense when they said Cabinet Ministers were saying, you know, the Health Bill was a disaster and I had to go and I think it’s nonsense when they say this about Francis Maude. We all of us, look, we have a difficult job to do. Sometimes of course it gets so difficult that people say well wouldn’t it be easier just to go, point the finger and blame. I don’t see my colleagues doing that, they don’t do it in private. As Cabinet Ministers they have an opportunity to say their piece, we all say our piece, we reach sometimes difficult decisions and then we just support each other and get on with it.

DERMOT MURNAGHAN: Okay, the Health Bill, you mentioned it there. How do you feel now it’s on the statute … ?

ANDREW LANSLEY: Do you know Dermot, can I just say, you said at the beginning it has been opposed by patient groups. Yes, of course there’s been opposition but there’s been support too.

DERMOT MURNAGHAN: By some patient groups.

ANDREW LANSLEY: There has been supportive patient groups, there has been supportive health professionals, supportive …

DERMOT MURNAGHAN: I am going to put that very point to you right now. Fairly unloved, unloved by sections of the Liberal Democrat party, we saw two spring conferences, some in your own party muttering about it, as you mentioned there they were muttering about your position. Unloved by many of the Royal Colleges who came out against it, many of whom will have to implement it.

ANDREW LANSLEY: Not all, by any means.

DERMOT MURNAGHAN: I mean, do you love it because it doesn’t presumably bear much resemblance to what you designed, that you carefully crafted in opposition?

ANDREW LANSLEY: I’ll say two things about the Act, as it now is. All the way through there was clear evidence of support for the principles that we were pursuing including, if you remember in the middle of last year, well about this time, we launched a listening exercise where we paused the Bill, had a listening exercise, hundreds of meetings with thousands of NHS staff right across the country, conducted independently by senior health and care professionals themselves.

DERMOT MURNAGHAN: But you didn’t do that out of the goodness of your own heart, you did that because of the weight of opposition, because your Liberal Democrat colleagues didn’t like it.

ANDREW LANSLEY: Of course, because they and others had concerns and we wanted to make sure that we had listened which is why there were amendment and, you know, sometimes it is important to stop, listen, reflect and make changes and we did make changes because actually this legislation is about giving the NHS a stable structure for the future and dealing with some of the issues that have been around for a very long time because most of what’s in it isn’t new, I didn’t invent the idea of doctors and nurses taking ownership of commissioning, the Labour government used to have practice based commissioning, it just effectively died because it didn’t have statutory backing. I didn’t invent the idea of patient choice, it just never got extended to a place where patients were really able to exercise choice. These things are now going to happen and there is generally support in the NHS for doing this. They want patients to share in decision making, to have better information, they want to lead the design of local services.

DERMOT MURNAGHAN: Indeed, but with that in mind, that’s what you set down to design, you had the blueprint in opposition, developed in government and then came the raft of amendments. Do they still protect that core ethos?

ANDREW LANSLEY: Yes, they protect the principles and indeed many of my colleagues, I mean the process we went through with the Lords I thought was really a very positive and constructive one. Of course there were votes in the Lords but the Labour party didn’t win any votes in the Lords during the passage of the Bill. There were 32 votes and the government, we only lost on two of them and they were issues that we have been able to either accept the change or to seek a different change that has had the same effect. So that’s pretty good. If you go back to 2003 and Alan Milburn and John Hutton I think was the Minister at the time, they had ten defeats on their Health Bill in the Lords at that time, they had 130 Labour MPs rebel against them so health legislation is never easy.

DERMOT MURNAGHAN: It’s never easy, okay, we saw the bruising and …

ANDREW LANSLEY: But the point is, at the end does it deliver for patients? That’s the point and this will deliver for patients. Why? Because firstly it will mean that patients get much more information and choice, it means patients get a stronger voice through Health Watch, it means we get a stronger voice for local communities through democratic accountability, we strengthen public health by having locally led, local government led and NHS working together and we start a new year with the professionals …

DERMOT MURNAGHAN: But the point of that, Mr Lansley, is many, many … many of the professionals who are going to have to implement that new structure and those new programmes opposed it tooth and nail while it was in its incubation. Do you really expect them to become enthusiastic participants?

ANDREW LANSLEY: But Dermot, you have to bear in mind for example, during the legislation there were front page headlines for the fact that one clinical commissioning group had said they didn’t support the Bill and they pretty much ignored the fact that 75 wrote a letter to the Times saying that they supported it.

DERMOT MURNAGHAN: The Royal College of GPs, the Royal College of Physicians, you know the list of Royal Colleges who came out against it.

ANDREW LANSLEY: They didn’t oppose the Bill and the Royal College of Surgeons didn’t oppose the Bill, so the two major Royal Colleges and the Royal College of GPs, I have a lot of dealings with them and have done for years. They actually want and support the concept of GPs and their colleagues taking responsibility for designing services and here we are, the start of the new financial year, this year about 240 clinical commissioning groups all over England will be taking delegated responsibility for budgets, in total some nearly £40 billion of budgets, they will be designing services for patients. If you asked the public do you think that the doctors and nurses who look after you, especially the GP practices who have a view of the health of your local population, should they be able to design the services that provide care to you locally? The answer is yes and we’re seeing the evidence already of that, we’re seeing more patients being looked at in the community, fewer hospital emergency admissions and of course emergency admissions are bad for patients and they are bad for hospitals as well.

DERMOT MURNAGHAN: Well, there are arguments about waiting times but can we just join this up …

ANDREW LANSLEY: The number of people waiting over six months and over a year is at the lowest ever level.

DERMOT MURNAGHAN: But waiting in accident and emergency, I don’t want to …

ANDREW LANSLEY: That isn’t any worse than it was, it’s getting better.

DERMOT MURNAGHAN: Just as we conclude the interview, we started with this issue of the Conservatives appearing out of touch, the re-toxifying as some commentators have said of the Conservative brand, do you feel on this Health Bill, the bruising battle that has ensued here and all the work you did in Opposition to detoxify the Conservatives when it came to the National Health Service, the idea of no top down reorganisation and that you would keep up the level of funding for the National Health Service, that that has all been undone, that you have expended all that political capital and indeed a great amount of your personal capital?

ANDREW LANSLEY: No, no I don’t at all because the purpose of what we did was not about politics, it was about supporting the NHS and since the election that is what we’ve done. We’ve given the NHS real terms increases in resources, this year for example, the financial year starting today, there will be about a £3 billion increase in cash for the NHS compared to last year, so that will enable the NHS to continue to improve services. We have backed the NHS, I think the Health and Social Care Bill is about backing the NHS. Of course there are noises about we don’t like competition but the Bill is absolutely clear, competition is on quality and it is not an end in itself. There is nothing in the Bill that promotes privatisation of the NHS, that was always just a Labour party and a trade union accusation and there is nothing in the legislation that permits extra charging. So it is the fundamental values of the NHS maintained, modernising for the 21^st century in the legislation allows the NHS staff to achieve that better so it gives … I mean I think in a sense we’ll have used that political capital to make the changes that will sustain the NHS’s future.

DERMOT MURNAGHAN: Indeed and I mentioned your personal capital and efforts, I mean the Bill is clearly as you have demonstrated here this morning, something you are still clearly very proud of but is your mission done on the NHS now? Do you regard this as your major work, you’re spent on this and looking for a new challenge? Would you move on in a reshuffle?

ANDREW LANSLEY: No, in the Department of Health of course from our point of view we have I think three main challenges. The first is to ensure that the implementation of the legislation succeeds, that we continue to improve quality of services for patients which are improving now and will need to improve in the future, introducing things like the 111 telephone system all over the country so that people can get easy access to the NHS, giving tele help at home for three million people. There is also, very quickly, we have to improve public health, so for example we announced the alcohol strategy recently, there’s a lot of major risks to the public’s health we need to deal with and we need to reform social care.

DERMOT MURNAGHAN: So if the Prime Minister came to you in the reshuffle whenever it comes and said Andrew, I’d like you to move on and face new challenges, you’d say no, Prime Minister, I want to stay in the health department?

ANDREW LANSLEY: Well office in government is at the invitation and behest of the Prime Minister so if the Prime Minister says something, you say thank you Prime Minister and that’s it but that’s not the issue. The issue from my point of view is are the priorities that I set out the ones we’re still pursuing? Yes, to increase patient choice, to empower doctors and nurses in the NHS much more, to improve the public health, to reform social care and to strengthen the long term health of the nation. All those priorities are still there, jobs still have to be done on all of those.

DERMOT MURNAGHAN: Secretary of State thank you very much indeed, Andrew Lansley there.

ANDREW LANSLEY: Thank you.