Transcript of interview between Andrew Marr and Jeremy Hunt,7/2/16.

Transcript of interview between Andrew Marr and Jeremy Hunt,
broadcast on the Marr Show, BBC1, 7/2/16.

Text approximately captured by Speechlogger and Voicemeeter and then corrected by hand. I think it's fairly accurate. Please use as you think fit.

The interview can be viewed on BBC iPlayer (starts at 36 minutes) here: 

http://www.bbc.co.uk/iplayer/episode/b070rt5r/the-andrew-marr-show-07022016

AM: And I just happen to have the Health Secretary Jeremy
Hunt with me, welcome Mr Hunt.

JH: Good morning, Andrew.

AM: Now Jamie  just
said that he thinks you might be in favour of a tax on sugary drinks. Are you?

JH: Well it's a bit terrifying not to answer affirmatively
if he's going to get more ninja.

AM: He'll get more ninja if you don't say yes.

JH: And obviously it's Sunday morning and people are tucking
into their bacon and eggs, chocolate croissant or whatever I don't want to be
too much of a killjoy but he is right we have got to do something about this. And
I've got a one year old daughter and on current trends by the time she reaches
adulthood a third of the population will be clinically obese. 1 in 10 will have
type 2 diabetes. It is a national emergency. We have to have to do something.

AM: You have to do something radical and big which is why all
this process, this discussion of a sugar tax is so important, because that
would be a big, big symbolic thing as big as the ban on smoking it would have a
big change on real people's behaviour.

JH: Well I actually agree with what he said in the earlier
part of the interview.

AM: So what's the argument against it you if you're not in
favour of it, or are you in favour of it?

JH: I am in favour of what he said. It has to be a game
changing moment, a robust strategy. The issue here is that we do what it takes
to make sure that children consume less sugar because we have got this terrible
problem we are at the most obese nation in the EU and it's getting worse.

AM: Well we agree with all that but what is it?

JH: Well we will be announcing in due course, we're working
out the details. David Cameron has said if it isn't a sugar tax it needs to be
something that is equally robust but he hasn't taken a sugar tax off the table.
We have got parents up and down the country who want to know that they're going
to be given the support they need to make sure their children eat healthily and
I think the other thing that Jamie is being very sensible in saying is that partly
it's what the food manufacturers do and that's why you have discussion about
taxes on drinks. It's also what the retailers do, it's what schools do it's
what parents do and that's why we need a strategy that brings everyone
together. And if we do  this, I think
it's just a final point to make, in this country we have a very good record on
public health. Recently the number of teenagers smoking has fallen to below 5%
and this is huge progress. If we make up our minds we can do this and I think
we will.

AM: Put in a sugar tax and you'll be able to do it.

JH: That's one of the options but there are many other others
as well.

AM: Alright well let's move to the junior doctors' strike. There
is a central poisonous misrepresentation which I think has made this a  particularly bitter dispute which is your assertion the 11,000 extra deaths at
the weekend are connected with poor staffing by junior doctors in hospitals. That
drives them absolutely insensate with anger and it's not true.

JH: Well the truth is that a junior doctors are right to say
as we deal with the higher mortality rates at weekends it isn't just about
junior doctors it's about being able to get diagnostic tests back at weekends it's
about consultant cover. But if you look at, we have had I think now 8 studies
in the last 5 years, and they all say that staffing levels at weekends are one
of the issues that needs to be seriously inve...

AM: One of the issues but not... And Sir Bruce Keogh, who
did the report, has said that it would rash and misleading to suggest that
these deaths are avoidable by changing staffing.

JH: He actually said that it would be rash and misleading to
say that you could avoid every single one of those deaths but he is also very
clear that staffing levels matter and I think one of the unfortunate
misunderstandings, junior doctors work incredibly hard, they are some of the
hardest working people who do some of the most weekends and nights and we need
to support them to do their jobs better. I think when we deliver a 7-day NHS
and this in the end is about making the NHS the safest, the most high quality
system in the world. The first thing I had to deal with as health secretary was
the tragedy of Mid Staffs and I've learnt from that that when you have these
studies that say you've got these problems you can't duck them. You have to
deal with them.

AM: I mean you have connected those excessive deaths to the
whole question of rostering and junior doctors and that is what people think is
misleading. Because it's a much more complicated situation than that. Many of
those deaths are caused by the fact that people go into hospital at weekends
are already iller and therefore much more likely to die. And Sir Bruce Keogh
and many other have said that you can't connect the number of deaths to rostering
questions and yet you have.

JH: Well that's not true if you look at their studies, let
me just tell you, if you look at the studies and we've had studies that came
out by Fremantle last September we have a study that came out by Professor
Ailen (?) just before Christmas, they all say, the royal colleges say, that you
have got to look at staffing levels we have 3 times less medical cover at
weekends. Now we're never going to have the same levels because there are lots
of things, and I think this is another misunderstanding, there are lots of
things that we don't do at weekends hip operations, knee operations and so on but
for urgent and emergency care... If I give you one example, which actually a
relates to senior doctor presence, the clinical standars, and this is all about
making sure we meet the clinical standards, they say that if you're admittted
to hospital you should be seen by a senior doctor within 14 hours. That
currently only happens in one in eight of our hospitals. Now if we want to
promise, if we want that to happen across seven days a week, if we want to
promise every NHS patient as I do that they are going to get the same high
quality care every day of the week then we have to look at these issues.

AM: I definitely want to return to that but just to stay on
this central question of misrepresenting the position of junior doctors, I can
quote you two things you said: There are 11,000 excess deaths because we do not
staff our for hospitals properly at weekends, and you said that excessive
overtime rates give hospitals a disincentive to roster as many doctors as they
need at weekends and that leads to 11,000 excessive deaths. Again, Bruce Keogh
who wrote, who did the research who says it is not possible to ascertain the
extent to which which of these is 11000 deaths may be preventable, to assume
they are avoidable would be rash and misleading. So when the editor the BMJ
accuses you of misrepresenting that report she was right.

JH: She was wrong and if you look at Bruce Keogh said there
he didn't say that what I said was wrong, he said it's wrong to say that you
could avoid every single one of those deaths but he also confirms that staffing
levels are one of the issues that needs to be investigated among many other
issues. Look, in the end, it's intuitively very sensible thing to observe that
if you don't have enough senior doctors when people are admitted to hospital at
weekends, if you're not able to check for example the most vulnerable patients
twice a day which is what the clinical standards say, then your risk of a death
that could be avoided is higher and I came into this job wanting to make sure
that we offer the highest standards of care for every single patient and I
think the the sad thing about this is that you know we're going to have a
strike on Wednesday and actually what I want to do is what every single doctor
wants to do. The want to give the highest standard of care to their patients
and what we should be doing is sitting round the table discussing how to do
this? Rather than withdrawing care from patients which can only harm them.

AM: You have said again and again the phrase "senior
doctors". Why go into head to head confrontation with the junior doctors
who are the very people who are actually staffing hospitals at the weekends and
who are not responsible for the 11,000, can we agree that they are not
responsible for 11,000 deaths in hospitals over the weekend?

JH:  I think there are
a number of things that are leading, there a number of things, if you look at
the study, I think you know you're saying to me that we need to be very careful
with our words. And if you look at the studies they all say there are a number
of factors that need to be investigated including staffing but if you just look
at this contract, and I think there's been a lot of misunderstandings, but look
at the crucial issue of pay, because I think this is something that worries people,
we are be absolutely clear that we don't want to cut junior doctors' pay in
fact for the majority of them it will go up.

AM: Sorry, just on pay, you said something that I don't understand
at all you have said that this is revenue neutral, you've used that phrase,
it's not the cost any money at all and you've said that 75% of junior doctors
are going to be paid better, have more money coming in, and the rest won't be
worse off. That is mathematically impossible.

JH: Well in the short term, as we transition to the new
contract, it will actually cost us more as we protect the pay of people as they
move, but when we move through to the new contract in four years' time the
total amount going into the junior doctors' paypacket will be higher not lower.

AM: So it's not revenue neutral.

JH: In the end, if you're going to ask more doctors to work
at weekends...

AM: So you're going to have to pay more money.

JH: You're going to have to pay more but ter in order to be
able to afford that, do that in a way that's affordable for the NHS, we do need
to reduce, this is a very important point, we need to reduce the premiums that
we pay at weekends, make up for it with an increase in base pay, but even after
these changes that we're making junior doctors will get a higher premium for
working at weekends than the nurses working in the same hospital, than the
ambulance drivers who take people to hospital, than the porters, than the
cleaners.  It's a good deal for junior doctors
but most importantly it will make care safer for patients because what we need
to do is to make sure that our hospitals are properly staffed at weekends.

AM: Is it such a good deal? Why do you have to protect their
pay for three years?

JH: Well because what we're actually doing in this change is
we're giving more rewards to people who work the nights and the more frequent
weekends and I want to make sure, the transition is very complex business, that
there are absolutely no losers. What we'll end up with is a contract that is
better for patients but also better for doctors. Now if you're a junior doctor
the moment and you go to work at the weekend, you will find in an A&E
department we have half as many consultants on a Sunday as we do in the week so
it's a very stressful experience. Now what I want to do is for a junior doctor to
know when they go to work, whichever day of the week, they're going to get the
support they need to be able to give the best care to patients. And this is obviously
very challenging the BMA is a very formidable union and health secretaries, you
look at the battles that Ken Clarke had, that Nye Bevan had, you know health
secretaries have these battles but what history judges is in the end have you
done the right thing for patients.

AM: Well that's it. Let me come back to that because again
and again you've used the phrase senior doctors and the Keogh report makes it
very clear that if you're going to get better care at the weekends you need not
the junior doctors simply but you need the consultants, I know this is a
cliche, sorry consultants, off the golf course and back into hospitals, and you
need the people doing the bloods and the MRIs and the nurses and the people
running the pharmacy and all of them so where is going to be the great battle
to get them doing 7-day working as well?

JH: Well they are an absolutely vital part of it and we're
having negotiations with the BMA on those and they have been a bit more
constructive and those negotiations are ongoing so I hope we'll do that. But if
you look at what Sir Bruce Keogh, what the royal colleges, what Sir David
Dalton who runs Salford Royal which is one of the hospitals which has
successfully introduced 7-day care they, say that you need senior decision
makers, that could be a junior doctor towards the end of their training, junior
doctors are actually in training for very many years, but you need experienced
doctors, that'll be consultants that'll be junior doctors with experience...

AM: So you're going to make consultants come in on Sunday
and Saturday as well?

JH:  We have said that
we will have to remove the opt out that consultants - that junior doctors don't
have but that consultants currently have - which means that they are able not
to work at all at weekends. And, you know, the goal here, and I think this is important
because I feel what happened with this junior doctors debate is that we've lost
some of the big picture. This is actually a year of opportunity for the NHS. In
the spending round the last autumn this government gave the NHS the sixth biggest
increase in its budget ever. We've just had a really tough period. We have an
opportunity now to actually turn the NHS into the safest highest quality healthcare
organisation in the world and that's what I'm absolutely determined to do.

AM: And yet somehow you have absolutely outraged junior
doctors in all of this. Let me read you a few things they have said to us. We
have been talking to some. Rachel Clark who is a doctor has said: Mr Hunt has made
me feel demoralized insulted and cheap. He implies we are the problem when I
give my life to the NHS. It's so grim on the frontline now I sometimes work 14
or 15 hours straight without a second even to eat. I have never felt so
despairing or so close to quitting medicine. Andy King a registrar from Oxford:
With so many patients to see I'm absolutely petrified. I'm too exhausted to
look after them safely. If we are stretched even more thinly over 7 days I'm
certain patients are going to die. This is what they're saying. One final one. Jane
Jenyon from Hereford: The profession is at absolute breaking point. I see
doctors in tears because they are so despairing about what the future holds.
Jeremy Hunt has done this, he's driving away a whole generation of doctors.
Those are the voices of doctors right now, that's what they feel.

JH: Yes, and it's incredibly disappointing that the totally
irresponsible way that the BMA has behaved in refusing to sit down and talk
about how we can improve patient care and spreading misinformation that those
doctors, for example...

AM: That seems to be their personal experience of daily
life, not what the BMA is telling them.

JH: The one thing I would agree with them and the BMA is
that quite outside the contract we need to do a number of things to improve the
morale of junior doctors. And I think there's a lot we can do with respect to
the training. But what I would say is you know one of the reasons for that
anger, and there is anger, that is because they were told by the BMA that their
pay was going to be cut. It isn't. They were told that they were going to be
asked to work longer hours. They aren't. We're actually bringing down the hours
they work. And if you're told by your union that the Health Secretary wants to
do these awful things of course you feel devalued. Now the way to restore morale
in a profession is to sit round the table, discuss what is the right thing to
do for doctors and for patients and also to look at the bigger picture which is
record resources going into the NHS. As I said, the sixth biggest increase in
funding in one year in the history of nearly 70 years of the NHS. More doctors
and nurses than ever. A total commitment by the government to making the NHS
the highest quality safest healthcare anywhere in the world and, you know,
there are always battles along the way but I think what history will ask is,
did the Health Secretary, did the Government that's committed in it's manifesto
to seven day services, did they do the right thing for patients to make care
safer and better. And if they did in the end I think doctors too will say, you
know there was a big argument over it, but it was the right thing for the NHS.

AM: Just on the 8 billion you mentioned, the King's Fund
says that that will not fund this seven day thing, most of it's already been
spent. So you're going to need more money. Two things on that. One, are you
really sure in your heart of hearts that your language on this has been adroit?

JH: Well, I think my language has been extremely careful
because I've always wanted to make sure that people understand how hard junior
doctors are working. What I can't control, as you know very well, we have a
free press and often my words are distorted by the BMA which, you know, is in a
one of the cleverest trade unions in the book. Because they know that in any
argument between doctors and politicians the public are going to side with the
doctors but in the end, look at the big picture here. The NHS it come up...

AM: I'm sorry, they are still absolutely furious with you.
98% of these highly educated, hard-working people have voted to strike. It
can't be everybody else's fault but yours, surely.

JH: No. Look, I take responsibility for everything that
happens in the NHS but you know what I also have to take responsibility for is
the care that we give to patients, that's the most important thing for any
health secretary and I think the big picture here is record resources going to the
NHS. Record numbers of doctors and nurses...

AM: Sorry, record numbers of doctors doing their 2 years'
basic training and then going off to find a job somewhere else. 50% now leave to
do something else, they don't go into the NHS because they are so horrified and
demoralised before they even start.

JH: Andrew I think it's really important that you don't make
a snap judgement about what's happening to doctors in the heat of a very
difficult industrial relation dispute we have 11,000 more doctors than 5 years
ago. This is a moment for the NHS to pull together and in end doing the right
thing for patients is the way that will help the NHS go from strength to
strength.

AM: Last question I promise on this, have you got more give
them when you meet them next?

JH: Our door is open. I've said that the single issue we are
still at loggerheads on is this question of unsocial hours on Saturdays. I've
said my door is open, we're happy to do that, the BMA are saying they don't
want to talk about that. What I say is you know rather than cancelling more operations
come and talk.

AM: Now you're announcing today four billion pounds to make
the NHS paperless. Why is that so important?

JH: Well let's go back to those junior doctors that you were
talking about. One of things they find incredibly frustrating they spend so
much time filling out paperwork, bureaucracy. We know that proper investment in
IT, it's not without its pitfalls, but proper investment in IT can save time
for doctors and nurses and they can spend more time with patients and this is a
much needed investment to allow that to happen.

AM: You came in after the NHS was in some kind of crisis to smooth
feathers, to calm things down. And people regard you now as toxic. Isn't this
going to be a very damaging thing for somebody who is still talked about in the
senior ranks of the Conservative Party as a future leader of the Conservative
Party?

JH: Look at the history of the NHS. The person who founded
the NHS, Nye Bevan, was describe three years after the end of the second world
war by the BMA as the medical fuhrer. That's how much they hated him. Look at Ken
Clarke who when he was Health Secretary they put up posters of him all over the
country saying what do you call a man who ignores medical advice and there was Ken
smoking his cigars.  This is part of what
happens when your health secretary but you know in the end when the dust
settles, you've got to do the right thing for patients.

AM: Jeremy Hunt thanks very much for talking to us this
morning and now over to Christian for the news headlines.