Politics live blog - Monday 17 January
Rolling coverage of all the day's political developments as they happen
10.49am: David Cameron is delivering his public service reform speech at 11am. I'll post a proper summary once I've had the chance to read the whole thing. But, in the meantime, it's worth pointing the fact that the extracts sent out to journalists last night contain an apparent inconsistency.
Cameron insists that he has been planning his reforms for a long time.
These changes have to be carefully worked through. And that's exactly what we have done through our years of preparation in opposition and we will continue to do so every day in government.
But he also says that one of the good things about the coalition is that it has forced ministers to look at policies in a new way.
Politics should be no different from the rest of life, where rational people find a way of overcoming their disagreements ... Indeed, I've found that instead of arguing about tribal dividing lines or sticking to long cherished shibboleths, what we do is have a proper discussion about what really works ... And as you can see with radical policies from the universal credit in welfare, to free schools in education or strengthening our universities, the policies that result can be more wide-ranging and more effective than when you're working on your own.
10.41am: Here are a couple of assessments of David Cameron's perfomance on the Today programme earlier.
From Tim Montgomerie at ConservativeHome
It was a confident and persuasive performance from Mr Cameron although he was on shaky ground trying to explain away the pre-election promise not to reorganise the health service. Few would accept that the Lansley reforms are anything other than a radical change to the way that the NHS is structured. Necessary, perhaps, but certainly a big reorganisation.
From Paul Waugh at PoliticsHome
In his haste to get out the "don't settle for second best" message, the PM blurted out that people shouldn't have to settle for "second rate" healthcare.
Yes, that's right: "second rate".
He immediately corrected himself, acutely aware of the toxic nature of any outspoken criticism of doctors, nurses and others in the NHS. I suspect that correction won't stop Labour from hammering him hard, accusing him of insulting millions of hard-working public servants.
9.48am: Here are some of the quotes from the Cameron interview. I've taken them from PoliticsHome.
Cameron on why Britain should not put up with a "second best" NHS
These reforms are right. We obviously have to introduce them in the steady way that we're doing. You have to test your policies. But as I keep saying we should aim for excellence, we shouldn't put up with second best, we should recognise that doing nothing is an option which I think actually, could end in tears.
On why doing nothing on the NHS would be a mistake
First of all we're getting close now to spending the European average on health, so it's not a spending problem. But we are a long way from having the best outcomes in Europe. Our outcomes in terms of how long you survive from cancer, what are your chances of surviving if you have a heart attack, are worse than many countries in Europe. The second reason is that costs in the NHS inexorably go up as new drugs come on stream, new treatments arrive, as the population gets older and I don't think there is an option of just quietly standing still staying where we are and putting a bit more money into the NHS.
On why he promised no "top-down reorganisation" of the NHS
What I was objecting to that happened a lot over the last decade was the reorganisations where you took parts of the NHS like Primary Care! Trusts and you renamed them Primary Health Authorities. What we are going to be delivering is an NHS that really depends on the decisions that we all make as patients and that our GPs make about where we're treated and how we're treated.
On why the reforms are evolutionary.
There's nothing in these reforms that hasn't been tried in some way in the NHS... it is evolutionary, it goes with the grain of the best things that have happened in the National Health Service in recent years. It's not being introduced in one great big bang.
On bankers' bonuses
We're having, really detailed discussions with Barclays with the other major clearing banks to try and get a settlement on this whole issue. And let me tell you what I want. I want the bonus pools to be lower, I want the taxes that the banks pay to be higher and vitally I want the lending that they do to business, particularly small business in our economy to increase.
On the fuel duty stabiliser proposal
I want us to examine this idea. We have a budget coming up in less than eight weeks time.
On Andy Coulson
Obviously when he was editor of the News of the World bad things happened at the newspaper and when he found out about those things he resigned, and that was the right thing to do. I almost think there's a danger at the moment that he's effectively been punished twice for the same offence. I judge his work by what he has done for [me] ... I gave him a second chance.
8.53am: I hope Cameron's public sector reform speech later today is a bit more coherent. In that interview, on the subject of the NHS, he and Humphrys were rambling all over the place. I felt the interview improved as they moved on to other subjects. Here are the main points.
Cameron rejected claims that he was imposing sudden change on the NHS. "There's nothing in these reforms that hasn't been tried in some way in the NHS," he said. The changes were "evolutionary". There was also "a lot of enthusiasm" amongst doctors for! what wa s happening, he claimed.
He refused to deny reports that Andy Coulson offered to resign as his communications chief. Cameron said that "bad things" happened when Coulson was editor of the News of the World. But he did not think it was right for Coulson to be punished twice. As communications chief, Coulson had done a good job, Cameron said.
He insisted that the government has not given up trying to stop banks trying to pay large bonuses. When it was put to him that big bonuses would be paid, he said this was not "a done deal". The government is trying to reach a settlement with the banks, and wants to announce details in the next few weeks.
He hinted that there could be measures in the budget to address rising fuel costs. But he acknowledged that there were difficulties with the fuel price stabiliser idea that is being examined by the Treasury.
8.32am: Humphrys asks if it is true that Andy Coulson offered to resign.
Cameron says "bad things" happened when Coulson was editor of the News of the World. He believes in giving people a second chance. He is concerned about the idea of Coulson being punished twice for the same thing.
Cameron won't discuss private conversations.
In other words, he is refusing to deny claims that Andy Coulson offered to resign.
Cameron says that Coulson has done a good job as his communications chief. He says there have not been complaints about him in this role. "He has worked for me for many years. I think he does a very good job."
The interview ends. Evan Davis moves on to another item. He says that this is meant to be the gloomiest day of the year. Humphrys asks Cameron, who is still in the studio, if he feels gloomy. Cameron says that he actually feels "chirpy".
8.30am: Humphrys asks about fuel costs.
Cameron says that he recognises that fuel costs are "extremely painful".
Q: Will there be a fuel price stabliser?
Cameron says he wants the governm! ent to e xamine the idea. There will be a budget in March.
I do want to see some method of sharing the burden between the taxpayer [and the government]
8.29am: Humphrys asks about the bankers. Why did he not ask Bob Diamond, the Barclays chief executive, to cut his bonus.
Cameron says the government has been having extensive talks with Barclays about this issue.
Q: Why don't you just insist they cut their bonuses?
Cameron says there is a difference between the state-owned banks and the other banks.
Q: But we know they are going to pay huge bonuses.
Cameron says that this "isn't a done deal". A settlement will be announced within a few weeks. The state-owned banks will be "back-markers" when it comes to paying bonuses.
A balance has to be struck. The state-owned banks need "effective leadership".
Overall, Cameron says he wants a settlement with lower bonus pools and high tax payments to the Treasury.
Q: But you're prime minister. Can't you insist on this?
Cameron says people have contracts.
8.25am: Q: But you must be worried about the pace of change. You asked Oliver Letwin to review the plans.
Cameron says Andrew Lansley has "a huge knowledge and love and understanding of the NHS". The reforms are right.
We should aim for excellence and we should not put up with second best.
8.23am: Cameron says his changes are "evolutionary". The changes are not being introduced "in one great big big bang".
The reforms will cost 1.4bn. But they will save 1.7bn within two years, he says.
Q: People like the NHS. Satisfaction with the NHS is greater than ever.
Cameron says the biggest rate of satisfaction is often with one's GP. People know their GP. They do not know who runs the local primary care trust. These changes will give more power to GPs.
Q: Why does it have to be done now?
Cameron says it is right to start change now. He has looked back at previous governments. They waited too long before starting to r! eform pu blic services.
Also, these changes will be introduced in a "gradual" way.
There is not a "quiet life" option.
With NHS costs rising, and drug costs rising, the NHS cannot be left as it is, he says.
This is about having "a healthier nation", Cameron says.
Q: But the NHS has been getting better over the last 10 years.
Cameron says there are many good things that have happened in the NHS. But health inequalities are worse than at any time since Victorian times.
Q: But, under these reforms, we won't have a national health service. Services will differ locally. We'll be back to the postcode lottery.
Cameron says there are huge variations now.
One of the problems with the public services is that the better off are able to opt out. The poorest cannot. Empowering GPs will help people in the poorest areas.
Cameron says he will give people "a much greater choice" over GPs. "We are giving people a route out of poor service."
Cameron says he is not surprised that the trade unions are opposed to his plans.
Q: Do you accept that this is high risk?
Cameron says all change involves risk. "I don't accept that doing nothing is an option."
8.16am: John Humphrys is interviewing Cameron. He suggests the NHS will be the defining issue of the next election (which is a fairly bold assumption). Yet Cameron's plans have come in for a great deal of criticism.
Q: Who wants a huge reorganisation of the NHS?
Cameron says he "cherishes" the NHS. He wants it to be as successful in the future as it has been in the past. But there are two reasons why he wants to reform it.
NHS spending is now almost at the EU average. But outcomes are not as good as elsewhere in Europe. That should change.
Also, health costs are going up. Cameron says he wants to to make the service more efficient.
Q: But you said that there would be no top-down reorganisation?
Cameron says previous reforms involved "rebadging" of NHS bureaucracy. Came! ron says his reforms are different. He is stripping away bureaucracy.
Q: But people did not ask for this.
Cameron says increasingly doctors are asking for these changes. "There is a lot of enthusiasm for what we are doing."
There is nothing in the reforms that has not been tried somewhere in the NHS, he says. For example, GPs commissioning services, or local government having a greater role.
7.58am: David Cameron is going on the offensive today. With his NHS reform bill being published on Wednesday, and his plans coming under increasingly fierce attack from the medical profession (as the Guardian reports this morning), the prime minister is trying to persuade the public that he is not being reckless. He is making a big speech on the subject this morning. And at 8.10am he will be on the Today programme.
Here's a list of some of the items on the diary for today.
9.45am: Nick Clegg gives a speech at the launch of a Demos report on parenting.
10.30am: Lord Taylor of Warwick, the former Tory peer, is due to go on trial accused of fiddling his expenses.
11am: Cameron delivers his speech on NHS reform.
As usual, I'll be covering all the breaking political news, as well as looking at the papers and bringing you the best politics from the web.
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