it's great to have you on the program uh today um you I've been looking forward to speaking to you what do you make of the report I think it's a really well-written report I think he's done an excellent job on making a diagnosis what he's not done anything about of course is treatment so actually the problem and he makes an excuse that saying that he was not this was not part of his remit whether it was or not I mean he certainly poses some things which can give you an inkling of what you might do uh but there are no solutions that he really poses which you could see in the report which is fair enough I mean but it means something really important it means that we've got to do something actually about what the report is saying uh and that means further investigation of the issue about the solutions and I think that's a really interesting question which people haven't really talked about and you got to look at the solutions as a whole not individual bits of it I think you see this as the thing because I feel like look the report is obviously very helpful but you probably don't need a report to tell us the HS is in a really bad way right you just have to try and get a doct pointment will go to your local hospital or or whatever it is um the difficult thing like say is a solution what do you think needs to actually happen I think we need to have a much more honest discussion and I was a bit disappointed at Stephen kinck actually I just heard on on on the program it seemed to me that you know to talk about you know the labor party is the one that's really always been in favor of the NHS and from the beginning of its Inception and all this sort of thing you know I've been a labor member for a very long time this is not a it's not a political issue and it shouldn't be a political it shouldn't be a political issue too important it's got to be by the decision of a much broader community and I think a real discussion would mean actually a proper look at the whole thing in a political way as far as possible and one solution of course is first of all to decide how much money we're spending on the Health Service and actually in a way we don't know because one of the things the report doesn't tell us is what the actual treatments are costing individually and that would be really interesting but you know for example you a hip surgeon so do be so much in one place and different in another place and the question really is why is that and what is needed part of that is NHS England but it's more complicated than that and then I think once you've got the whole thing in picture then got to decide how you fund that amount of money one solution obviously I'm afraid to say although the lab Proby won't want me to say this but I you know much as I'm you know hugely supportive of K sta I think we have to ask ourselves whether or not we need to consider how much we can afford to spend and where the shortfall will come in forms of some find of extra funding which might be obviously an insurance scheme which is done in some countries or some other hypothecated tax or where we accept people have to pay a bit when there was a big crisis back in the year 2000 I I got myself into trouble with Tony Blair you're about to do the same I can see aren't you you're bracing yourself you're like I'm going to get the call after he was no he was great because he really listened and he you know and he put a huge amount of money in which solved the problem for a while but you know inevitably this is going to happen again and again because the price of healthcare is going to continue to rise the technology we're talking about in this report is going to get more and more expensive out of proportion to the actual amount of money we're putting in it's bound to so you've got what patients expect but the expectations are always going to be below the Align which is the cost going up so that's one of the problems we have to really think and this is a very good time to do it because you've suddenly got a government with a massive majority therefore you know it's not going to be unseated if it's sensible it doesn't need to be too nervous to actually say well let's really be radical and one possibility might be really to say how do you accomplish getting that sort for made made available I mean look there'll be some people listening to this thinking you know that kind of hearts beating as soon as you start talking about insurance about paying for parts of the NHS people get worried they get worried that they do people will not be able to access Healthcare if they haven't got the money right well in the year 2000 what of course I suggested to Tony was that what we might do is to bring Private Practice into the NHS hospitals actually that private surgeons could only work in the NHS we didn't have many clinics in that that time it was turned out to be a really good idea because the people who then built private clinics made a massive fortune and now of course this nearly all foreign money we've missed that opportunity we could probably do something like that still in education but that's another time come that but I think here um I'm not saying we should necessarily have a hypothecary through tax or insurance but I think it's something we need to be discussing very very carefully and seeing where it slows down and I think you know one of the problems is that you know it's a funny thing about humans They Don't Really value what they don't pay for actually that's a big problem a lot of people don't value their Health Service they say they do you know when there's a crisis for example during the pandemic but maybe we have to accept that you know we have to find some way of paying for some of the cost of the Health Service you know in a in a way which is not impossible and how we could means to us that if necessary I mean after all looks as if we might be doing it with with winter fuel payments dare I say that yeah um but I mean on a much bigger scale um there are some clear issues here there are three really big issues one clearly is mental health which is massively important where in fact there's a huge shortfall of ability to do it secondly I think there's there's obviously as as Dary rightly points out one of the issues is the issue of um o of primary care and of course what was just being spoken about by Mr hdan of course was the issue of investment in the infrastructure and you know that's really important you can't get away with crumbling hospitals you know there were some hospitals in there one in particular I'm thinking of where the passageway through through the hospital from one side to the other is like going into one of those tunnels in Gaza it's and that's not acceptable and you know patients perhaps are going through that as well fact they are on troles sometimes so you you know it I think we have to really understand that we have to do something right quite urgently about the structure um I could talk about this for for a long time because because it's a really really important issue um do you think the NHS is trying to do too much like too trying to do too much you know whether it's you know Dentistry or whether it's fertility treatment or whether it's is this just too big I think I'm sure W streeting is finding that at the moment and I know that you know previous secretaries of state and have said that in the past um but you know at the background of course you've got another issue as well which we haven't really talked about which is social care and that has to be solved and clearly that's got to be funded and you can't leave it as it is the other problem is this may I bang on or do you want me to stop we haven't got load of time but I one of the isues is preventative medicine you know it it's true of course we've got people dying younger than they need to but of course the longer you people keep people alive the more multi morbidity they have the more more extra diseases they get therefore the more cost the Health Service You could argue that preventative medicine is perhaps not such a good way of saving money in the long term I mean perhaps if everybody smoked it would make the Health Service cheaper not more expensive well there you go I mean this is the thing isn't it because we all die of something right that's we all die of something I mean I me I know I'm being a bit flippant but nonetheless there's a serious thought there which I think we have to think about if we get healthier it may also be more costly effectively yeah thank you very much indeed a lot to ponder uh that was very very interesting thank you