You Ask The Questions: Andrew Lansley, shadow health secretary

Can the public trust the Tories on the NHS? Should politicians admit fallibility? And do you like singing 'Land of Hope and Glory'?
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The Independent Online

Are you embarrassed to have been responsible for destroying David Cameron's fightback on hospital closures? And did he give you a bollocking?

CLIVE HAMES, Manchester

No, to both. David Cameron's fightback on health will continue. The fact is that even though Gordon Brown has said the NHS is his priority, he hasn't acted upon those words. The campaign is the right one and it is a necessary one, if we are going to maintain access to local hospital services. There was a lot of nonsense talked about the list of hospital closures. There was one error - putting Altrincham in place of Trafford - which was immediately corrected. I had asked for that change last week, and it hadn't been made. Such things happen. We got proof that this campaign is the right one when it was announced on Friday that Greater Manchester will lose some maternity and A&E units. I am still waiting for a government minister to explain what clinical evidence there is to support these cuts.

Are you still exhausted? And do you think more politicians should admit their fallibility?

JUSTIN O'BRIEN, Cardiff

I never said I was exhausted and I'm not. I do say that I am fallible - we all are.

Was the last Conservative government wrong to offer tax relief on private health insurance?

SEAN DODD, Bristol

Yes, because any public money available to support health care should be used to improve access to quality health care for everyone.

Why do you think the Tories are so far behind in the polls?

JANE SIMPSON, Harpenden

We're not far behind and it is the predictable consequence of a focus on the transfer to Gordon Brown. As soon as people remember that Gordon Brown was at the heart of Labour for the past 10 years and that nothing fundamental has changed, we'll be leading again. Gordon Brown is to blame for the targets and the top-down centralised bureacracy that hinder NHS professionals from doing their job properly.

Why don't you just admit that the NHS can never operate efficiently and break it up?

OLIVER BREWSTER, Guildford

I don't accept it. We have never had a NHS which is well-resourced and responsive to patient choice, primary care commissioning, with combined clinical and budget responsibilities and required to be competitive. That will realise major productivity gains. Cutting bureaucracy will help a lot too. And we must strengthen our whole public health efforts, or demand will be unsustainable. I have set out in a consultation paper what needs to happen in public health. At the moment the Government is taking money from public health budgets to get the meet NHS deficits. This is wrong, which is why in my consultation I say that regional directors for public health must run their own budgets without interference.

What was the last time you went to the doctor and what did he warn you to do less/more of?

JAMES BROOKS, Ipswich

Wednesday and he didn't.

What's wrong with wanting to use the doctor you want when you want? Isn't that taking pressure off the NHS?

HELEN PHILLIPS, London SE17

Nothing wrong with it. It is something everyone should be able to achieve through the NHS. The reason there have been all these stories about people being unable to get a doctor out of hours is because the Government badly negotiated a contract with GPs, so they need to rectify that and soon.

My local GP is a one-man band and I like that arrangement. Will you promise not to force him into a multi-GP office?

STEPHEN MORRISON, Lancaster

Yes. Single-handed GPs need to network so they have access to diagnostics and are part of proper clinical governance. I don't agree with forcing GPs into big poly-clinics. GPs are local, by definition, and the public need a choice of styles of GP. The new Labour minister Ara Darzi is looking at this area in his review at the moment and I have been concerned with the direction he is taking, he seems to be saying poly-clinics are the way forward. I don't agree.

The average GP earns a six-figure salary, five times the average wage -and works less. Do you think they are overpaid?

JASON KEANE, Sheffield

No, GPs work hard. They are very senior professionals. I do believe, though, that they have to take the responsibility which goes with their seniority and pay, by managing budgets and commissioning, including out-of-hours care, on behalf of their patients. In our NHS Bill which was published just before recess we showed how this could be delivered.

Could you conceive of a hospital being allowed to go bust?

DENISE FIELD, Lincoln

They do now; and are regularly bailed out. The important thing is that if a hospital goes bust, and the managers or lenders to that hospital lose out, the services to the public are protected, if necessary under new management.

What's a fair wage for a qualified nurse?

PHILIPPA MORTON, Southampton

It depends on the seniority and skills of the nurse. Agenda for Change was supposed to establish that with greater confidence, but hasn't lived up to expectations. Nurses' pay more generally is based on independent pay review body recommendations but Gordon Brown this year overrode those - without providing his evidence to justify doing so. If any nurses are reading this, then you should know that we are holding seminars up and down the country to ask the views of nurses. You can find out where and when on www.nursesvoice.org. It is not just pay that nurses are bothered about, they are fed up with all the bureaucracy.

Do you think that the general public is ready to trust the Conservative Party again on the NHS?

ALISTAIR GRAHAM, Reading

Yes. David Cameron and I have been clear about our commitment to the values of the NHS. Labour have let the NHS down and now appear set on undermining it. Recently, in Hospital Doctor magazine, 44 per cent of doctors said they intended to vote Conservative, compared to 7 per cent for Labour. If those working in the NHS now trust the Conservatives so can the public.

Why didn't you do better in the Southall by-election?

MARTIN BLAKE, London, NW6

We increased our share of the vote but I wish we had done better. I went round Ealing Hospital with Tony Lit, I thought he was a really good candidate.

Immigration, Europe, crime, the family - why is David Cameron lurching to the right and repeating the mistakes of his failed predecessors?

T IBHERE, Ealing

David isn't lurching anywhere. Being committed to the family isn't right-wing, it's just right. Effective border controls is just good policy - which Gordon Brown now wants to copy. And is it right-wing to want a referendum on the EU constitutional treaty? Hardly, since now the trade unions apparently want it as well. And in the area of health we are the party saying the NHS should be free at the point of use based on need and not ability to pay, not Labour.

You've had lots of leaders recently, and they all flopped; isn't there a message there that it's the party not the leader that's been your problem?

TIM MURPHY, Cranbrook

David Cameron is changing the Conservative Party. People know this and they support the direction he is going in. If imitation is flattery so is Gordon Brown. David is a born leader. Over time, leaders do define their parties.

Do you actually enjoy singing ''Land of Hope and Glory''?

FRANK TAYLOR, London N19

Yes, but I prefer "Rock of Ages".

I read somewhere that you once had a stroke. Was it frightening - and has it affected your life since?

PAMELA BOOTHROYD via email

Yes, I had a stroke in 1992. It was only frightening for a short while. I am very lucky it only affected my fine balance - making skiing harder. But it has made me determined to improve stroke care and for strokes to be treated as an emergency. I am a member of the all-party group on strokes.

As an Essex man, what is it like being surrounded by Cameron's Old Etonians?

STEVE MARSH, Highgate, London

I have known David Cameron for 17 years. I know that he judges people for what they can achieve, not where they came from.

Have you ever used private medicine? If so, when was the last time?

CARL THORPE, Milton Keynes

No, other than private dentistry.

Should Mr Cameron have taken such a long holiday?

DAVID REECE, London SW18

Two weeks is not a long holiday.

Have you ever taken drugs and, if so, which?

KEVIN HOPKINS, Clapham

I have never taken an illegal drug.

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