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tv   Prime Ministers Questions from the British House of Commons  CSPAN  February 24, 2016 7:17am-8:01am EST

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are cnn saving excellence closer and closer. >> obviously the issue of education is involved in web number possibility for the government, but i would urge them to focus a good education depends not only on the finance which is fair because of the way of the formula works and the decisions were taken about funding hhs in england also requires high standards and the publication of the tables of people can see how children are doing and crucially requires structure of her friends from the pre-schools, academies introducing diversity, competition and getting organizations passionate about education to provide state education. we want all the best organizations providing the best education for children. >> mr. speaker, may begin by associating the party with the comment to the prime minister and leader of the labour party in relations to the tragedy and
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our thoughts about those affected. for the prime minister congratulate the government and his own colleagues who do not financial arrangements for the next phase of scottish devolution. the treasury position with 7 billion pounds of public finance got been at the beginning of this week reduced to 3 billion pounds yesterday morning to point out what she tells them agree to it or not i'm no worse off? >> let me agree with the right honorable gentleman. this is an excellent deal for scotland, but also an excellent deal for the united kingdom. for those of us who want to keep united kingdom together, what we have demonstrated as you can have full and devolution with a powerhouse parliament, a fair physical settlement inside the united kingdom and and that is something to be celebrated. now we will move the situation
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with the scottish government and parliament will have to start talking about policies and decisions rather than processes. happy the negotiations went to baghdad and i'm happy laura smith responsible for so much work it out a statement saying this delivers smith and the principles in full. no more grievance, no more fussing about process. no more arguments about the arrangements. now it's time to get on and govern. [shouting] >> we are indebted to scotland's finance security note that human field from scotland. prime minister is right that all parties will have to layer their plan with the may election. could you answer this question? is it true this time the lesser day, his party, the conservative party is planning attacks cuts for higher earners in scotland? >> you will be with davidson is
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the only proper opposition figure setting out the plans. if you are buried in scotland about having a one-party state and the lack of accountability, if you think the labour party lost its way, there's only one choice. i think there are opportunities to sharpen incentives. there are opportunities to attract businesses and people in the scotland. as she does, whatever she decides she will have my full unequivocal support. [shouting] >> i believe industry council, 96% of the 1100 residents are more satisfied with my counsel services. with my great honorable friend join me in the conservative
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leader perry richardson to counsel a colleague and all the office of employee district council are continuing to deliver to the residence. [shouting] >> i'm happy to join my honorable friend in doing that. he does make an important point that we have to make difficult as spending decisions not only in the last five years, the satisfaction actually when not. this proves the larger point, which is you can reduce spending levels, find efficiencies and provide better services at the same time. >> mike tichy went to someone turn due to depression but is no longer down for espn cannot think gse due to his job and
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could not leave his highly skilled job as a sheriff due to the threat of punitive sanctions. will the prime minister look at his case specifically, but also the wider richer people with mental health issues unable to work? >> i'm very happy to look at the individual case. the way our system should work is clear that if you are unable to work, but without good work on the sugar 12 employment on the work-related activity group and get that out. if you're unable to work, get a higher amount of money. it's not been tested, not time limited. people who have difficulties also have the new personal independent payment system which can address some of those. a generous and compassionate country with the benefit system to port those who cannot work on making sure those who can work are encouraged to do so. >> thank you, mr. speaker.
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the unemployment constituency has qualified 62%. however, even more work toward full employment. that is why on march the 18th had been halted between the job fair, bring together employers to find out the many ways you can get employment or indict the prime minister and see for him of -- [inaudible] >> i'm sure i'll be doing a lot of touring country in the weeks to come. perhaps a visit to era watch as well. we have not had much lower unemployment rate. just about 5% is one of the lowest in europe. even at that rate, a lot more to do to match the jobs created, to the people that want to work in
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job fairs and apprenticeships are absolutely essential. this is full employment. >> thank you, mr. speaker. the prime minister on the seventh of january, we debated the issue of women's state pension and the fact women are discriminated by the increase. the house debated the 1580 i. for government to mitigate the effects of this. why has the government not respected the parliament? >> first of all, i argue strongly where not discriminating against women. we are making sure there is an equal page of retirement and two women have been discriminated against in the pension system in the past, the single-payer pension means many more will be retired with a full pension. as they do so, the triple lock
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of nine pensions will go up by wages, prices are 2.5%, whichever is highest. that is a pensioner poverty is a record low and pensioners that they can live in security and dignity in our country. >> mr. speaker, behind much of the south east and many embassies i lost the landscape regeneration alliance that brings together community groups. can i invite my right honorable friend and the minister to this gem on our doorstep to see for themselves what it could and indeed should be? >> i'm very happy to put us for the coming months. we remember battle he fought back stitching me. i sat at the coastal command assigned with a dedicated mr. the government to help coastal communities and i will make sure officials meet with
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this new alliance and make sure they both got the coastal community team and what they can do to help. >> mr. speaker, for two years, they campaign against the development of a luxury breaker. they rejected the plans, but then i can ever do is called in the decision overturned the wishes of the community with disrespect for local democracy. the prime minister of vocalist and finally admit only believes in the devolution across not the devolution of actual power in the community. [shouting] >> we have a long and system for local planning, but also being able to: session that operated all that time. if anything, our local planning system is putting more power in the hands of local people because once they've completed
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their local plan, it is much easier to say yes to developments within the plant had no to development outside it. i've tried to have a child suffering from acute to help difficulties css. colleagues from across the chamber are all too familiar with such visits. i welcome the prime minister's recent commitment to reform mental health division for young people. i asked him to consider reviewing the provision of a mental state treatment and after he continues to be the champion for these vulnerable and brave children. >> i think my honorable friend for his question. he is read to children and young people's mental health is a priority for this government. we can all agree across this house this is not an area with adequate attention or adequate investment for many years. i would have a particularly the problems of psychosis, sometimes
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caused by drug use. i would also raise the huge problem of eating disorders where we see a rapid increase in the number of people suffering. we've gone a long way in increasing the number of talking therapies. something like 740,000 more people are accessing therapy is when the government came to office. we recognize more to be done and we are investing 1.4 billion systemwide transformation across children and nonetheless in mental health. >> richard are close. >> thank you, mr. speaker. last week, the apg crucial new evidence was uncovered. i am utterly convinced over 2000 constituents in half a billion people in the u.k. has scottish power. given this a scandal of huge proportions, with the prime minister agree to meet with me to discuss how we can ensure that these ordinary hard-working people receive cash backs
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promised? >> i'm glad the honorable gentleman has raised this because it's been raised on previous occasions by abbott, and another cross party group has sent some useful work. my understanding is that any alleged wrongdoing should be fully investigated. they can impose fines if they find companies have reached license and i'm happy to arrange for a meeting between him and other members of the group with the relevant ministers in the department of energy climate change to get this fixed. does my right honorable friend agree with me that with a nato summit with that said of the national security threat, we are right and this is our 2% of gdp towards defense? are we shocked the failure the party opposite to do likewise?
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>> i think my honorable friend makes an important point, which we do face an insecure and unstable world with what putin has done in the ukraine, particularly what we see in syria. 2% spending on defense and making sure we review is the right answer. they have got an answer. they are not going to spend 2%. they are not to renew submarines, but they come up with a really brilliant cancer. they are bringing back as their spokesman and spin doctor, damien arrived. this is the leader's opposition. we can win in 2020 but only for spend the next five years building a movement in putting forward the new politics. honest, kinder and more kerry and. six months old, and damon mcbride is back. [shouting]
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>> the colleagues are calling for more. there will be more. >> thank you, mr. speaker. last week i visited palestine along with several honorable friend where we visited the home and family who lived in the old city of east jerusalem since 1953. however, settlers are now trying to force 60 years under our many other cases. does the prime minister agree with me that illegal settlements and construction are a roadblock that handle peaceful negotiations and what is this doing to help the injured
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palestinian bias and land? >> to question the general bull raises import. i am well-known as being rendered is what i have to say the first time i visited and had a proper tour around that wonderful city and saw what is happening with the settlement of these servers on, it is genuinely shocking. but the government has consistently done saying we are supporters of israel, but we do not support illegal settlements. we do not support what is happening in east jerusalem and it's very important the capital city has maintained the way it was in the past. >> thank you, mr. speaker. one of my constituents is fighting to defend drawback to the u.k. after being taken to the poland by the mother
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illegally at the hague treaty. for the prime minister outlined that interventions the government can make to du and polish authority with regard to the information. the object of children >> my honorable friend is right to raise a case like this. sadly there are far too many in our country. the standard answer is the return decision and governments can't interfere in the processes of another justice system. we do have a cot at the ministry of justice. they been in comp didn't touch processing paperwork. they are chasing the counterparts in poland and i will make sure the foreign secretary is aware of this case and does everything he can to help her and help her constituents. >> oil and gas has
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300 billion pounds treasury. the scotch government treats oil and gas are calling for reduction to support the industry in its hour of need. yet in that of the so-called rock shelters of the u.k., what we see are the sloppy shoulders of the prime minister repeatedly dodging. will he commit the fact oil and gas industry? >> what i was say to the honorable gentleman is first of all the budget last year we reduce the burden of gas and oil and taxpayers something we were able to do because of the broad shoulders of the u.k. that is just determined what has happened since that time. oil and gas revenues are down 94%. if there were broad shoulders of the united kingdom government that this was it ignorantly fiscally independent goblins, there'd be a massive black hole in your budget. you would be cutting welfare. you would be cutting the name,
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putting up taxes to my facing a financial catastrophe. [shouting] >> thank you, mr. speaker. every week to women are killed in england and wales by current or former partners. the perpetrator is the problem. the question is not why doesn't she leave, but why doesn't she stop. the commissioner is piloting the program which aims to change behavior of offenders. in advance of its new strategy to tackle violence against women and girls, with the prime minister join me in congratulating and tackling domestic projects? >> my honorable friend is absolutely right to resist. the crime of domestic violence we've got better tackling but there's still so much more to do. katie boren who i know does an excellent job is a good example
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of the sort of thing crime commissioners with a higher profile and authorities can give israel the time. i would urge others to do exactly that. we need to make sure we are policing and is properly and change the culture. police and crime commissioners can help lead the way. >> mr. speaker, the prime minister knows for a fresh start agreement in november to help legacy cases. while the prime minister considered a kind of hinted by the secretary of state to help the police service of northern ireland face increasing pressures and runtime policing and will he take the opportunity to reaffirm that there'll be no rebranding of the past in northern ireland to legitimize terrorism or to promote the pernicious narrative bikini equivalent security forces on terrorism? >> what i was dead is a fresh
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start agreement with the good agreement to an important part is dealing with legacy cases and make sure they were dealt with more quickly. to me it's always been about trying to heal the hurt that the legacy cases rather than trying to write narratives. i look at what he says about resources because we need to make sure the policing of arthur nylund continues to be properly resourced because they still face a terrorist threat today. >> the united kingdom and they says the referendum published by the european commission for democracy through law. defends equality of opportunity must be guaranteed for supporters and opponents of the proposal being voted on and equality must be ensured in terms of public subsidies and other forms of backing. yesterday, jeremy hayward sent a letter around the department preventing ministers from having tax is two briefings and the
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prime minister check that the latter with the guidelines? >> i'm very happy with the letter sent out for this reason, that the government has a position on this issue. the government's position is we will be better off in a reformed european union. ministers are able to depart from the position and campaign in a personal capacity. that is a very important statement. it is right in terms of how we go about it, but it does not mean the government is neutral. the government has a policy for which people can depart. for the funding of the referendum campaign, we now have clear laws in place and rules in place in the electoral commission to make sure both campaigns are funded properly. i think that is good for our democracy. [shouting] >> order.
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>> luo that the british house of commons as members move onto other business.
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>> metadata is literally the outside of the envelope for electronic communication. and as you said 10 american law enforcement traditionally has been able to look at the outside of the envelope. the supreme court decided that the fact of who you called, when or how long also was essentially the outside of the envelope. ♪ >> the issue i'm most concerned about in this election is really national security. i'm looking for a leader that understands national security completely, supports military and make sure the border is the fact day.
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we need to have commonsense methods to achieve this. we don't need to exclude anybody or hurt anybody. we need to establish guideline procedures to make it happen in an appropriate fashion. >> we are here today at the trump rally. i've been to marco rubio, ted cruz and jeb bush. this is the fourth one most important to me. we continue to spin out of control. the second most important issue is immigration. you can't have anybody coming into jeopardizing national security. thank you. >> a senate hearing, pentagon officials talk about how to improve the health care system. we'll hear from the secretary of defense for health affairs of the surgeons general or the military branches. senator lindsey graham shares this two-hour hearing.
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[inaudible conversations] >> admitted will come to order. we meet this afternoon to discuss military health care system reform and learn how we can redesign it to finance health care system that has become unsustainable and does not work as well as it should for servicemen and women and their families. we are fortunate to have two panels of distinguished witnesses joining us today. the first family have, executive director and executive charge for mid-atlantic medical group. dr. mark friedrich, or for the insurance design and professor in the department of internal medicine helps manage policy at the university of michigan. mr. david mcintyre, president and ceo of the west health care
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alliance. mr. john whitley, ceo at the institute for defense analysis. we have the honorable assistant secretary of defense for health affairs, vice admiral richard and outpatient days, lieutenant general of the air force. weissman drove at the navy pier but in a general blast surgeon general of the army. senator mccain has made this a priority to find a way to reform health care. we made a good effort and i think some breakthroughs in terms of retirement reform and now it is health care served because it's such a big part of the budget. last year the military modernization commission gave us an important report on the system complete with numerous recommend nation. without the commission scraper, we could not have reformed military retirement system and the conference we did. but we have more work to do. the mission will also make
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recommendations to assure service members receive the best possible combat casualty care to access, choice and health care for all beneficiaries and family members with special medical needs. in fiscal year 2016, we begin the journey to accomplish military health system reforms requiring dod to establish an published standards to be more transparent in important areas of health care quality, patient safety and beneficiary satisfaction by requiring them to publish measures on public sites mandating a program that allows beneficiaries to get urgent care without need at a time consuming unnecessary preauthorization treatment and requiring unity to implement a pilot program in a based reimbursement whereby health care providers improve health care economic outcomes, patient satisfaction and the experience of care. although the commission
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published its report over one year ago, we have seen little progress made by dod to fix the many problems and without we get frequent reports of the difficulties military families face every day. here are two examples. an expectant mother with a high risk pregnancy most of their husband to new duty station during the 28th week of her pregnancy. before being assigned to an obstetrician at the new duty station, she had to see a primary care manager and get a pregnant the testbed despite the fact her medical records verified her high-risk status. after going through all of this, and she still couldn't get an appointment with the military obstetrician until the 36th week. a spouse of her retiree injured or risk in december and she's scheduled walter reid for undervaluation. at the appointment of providers spent more time berating the patient for being overweight and examining her risk.
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a risk x-ray was done but the provider dismissed as a carpal tunnel syndrome. no follow-up appointment was given. one month later the patient received a letter from the radiology department at walter reid advising her she had a broken wrist. the patient now has a cast on her arm. in my view the statue view the status to provide timely quality health care are symptoms of the many bills within the health care system. clearly there are problems -- they are centers of excellence in the system, but these centers are not large enough in frequent enough. in my view, we've seen the military health care and design over decades to deliver peace and health care in a way that is being passed by time and modernization in the air. on the battlefront, many soldiers alive today would've died in other words because of the quality of military health
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care. that has to be acknowledged. to those on the front line, you've done amazing things that the purpose of this committee is to learn about how we can make things better, to listen to the private sector works very simply take a 20th century --
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i appreciate the military has put in place a demonstration program to help military families. however, i am where they propose changes to reimbursement rates for providers major rail the program. in your remarks would appreciate a decision on your recommendation regarding
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families with special needs children. finally, we have to make sure military health care providers maintain skills and experience they need to provide world-class health care to service members wounded on the battlefield and we have to assure those who have served our country bravely is able to meet their physical and mental health care needs. service members deserve the highest quality of care. i think our witnesses for the time and effort they put into this important issue. >> senator mccain. >> good afternoon, members. thank you for the invitation to be here. i am dr. bernadette loftus come in charge of 1300 positions of the mid-atlantic medical group at kaiser permanente. the largest private integrated health care delivery system in the united states providing services to 10 million members in eight states on the district of columbia.
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high-performing health system is recognized by the commonwealth club in the national committee for quality assurance. and 2015, only to systems in the entire u.s. received a five out of five rating for both commercial and medicare packages and they were the mid-atlantic states and kaiser permanente of california. in fact, no plan received lower than a 4.5 out of five rating and 2015, a level that 10% of plants achieve nationwide. we believe detainee next-line now comes understanding where that was a measure arm and so opportunities are continuously identified. we strategically exploit the full benefits of our electronic medical record creating systems of care to make it easy to do the right thing and hard to do them wrong. this is a company that clear expectations around behavioral norms and performance for staff.
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a reliable achievement of better results starts with knowledge of current results. we measure all aspects of care at all levels. which is a trickster measurement better evidence-based, nationally recognized and reasonably comparable across geographies and populations. this minimizes distracting argument that my patients are so unique you can't hold me accountable for any particular outcome. we do believe we can really assess performance across diverse populations using the injured measures. we assiduously measure access to care because obviously without access, quality suffers. we went from two decades of studying correlations between patient satisfaction and the object of speed to accessing days that patients having the tires and are then doctors may feel is strictly medically necessary. because of this we base our
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access standard solely on members expectations. our best levels of patient satisfaction with routine specialty care correlate with the speed to access significantly less from date of referral. we measure and record access to care due to expectations or position managers is that the supply of appointments will be managed dynamically on a daily basis to adjust to the ebb and flow of demand the science affects one access is just that, science. although it is a relatively simple one from the supply of available appointment must always succeed historical demand in order to ensure greater access. had there managers are thoroughly trained on the content management that must be brought to bear to maintain access. i achievement of quality requires the same degree of performance measurement, analytics and reporting. specific to quality management, we produce monthly variation reports which graphically
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display variation in performance and quality metrics on multiple levels. the sun blinded report allow us to identify the high and low performers in similarly situated back since a great effort for dialogue around improvement. data trends. the spurs not only dialogue, but a little competition as well, which in turn is more rapid improvement. primary care physicians can on a daily basis check their own performance on quality measures against those in their department. we do not however the prevention of quality achievement to our primary care physicians. it is our cultural expectations at every position regardless of specialty addresses the prevention and chronic disease needs of every patient she sees. this means dermatologists an orthopedic surgeon rs response to bill for ensuring each
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diabetic is measured timely for the woman gets her to answer those patient's primary care physician. we continually collect and analyze data about a patient's health status and other findings and use that to create extensive registry that in turn inform software so every visit to every patient for our treatment measure. everyone job. again, thank you for today's syndication. i hope those provided will solve to the changes of the tri-care program and would be honored to provide assistance and serve as population in any way we can.
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good afternoon. thank you and that chairman mccain, chairman graham, and members of the subcommittee. i'm the primary care physician and professor at the university of michigan. mr. chairman, i applaud you for holding this hearing on defense health care with him because access to quality care in containing costs are among the most pressing issues for the military personnel and national well-being. yet moving from a volume driven to value-based delivery system requires a change in how we deliver care and how we engage consumers to seek care. reforming care delivery and payment policies are important as you just heard. however, less attention is paid to how we can alter consumer behavior. today i propose clinically driven consumer incentives in the creation that promote smarter decision-making can assist us in achieving our clinical and financial goals. the most common approach is that payers to impact consumers in the united states is cost
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shifting. with the notable exceptions, most help plants including tri-care implement cautionary in a way and the beneficiaries are charged the same for every doctor visit, every diagnostic tests and every prescription drug. people frequently ask me if tri-care members copayments are too high, too low or just right. the answer of course is that depends. ask depends. asked if tri-care members to pay more for all services despite clear differences in clinical volume resulted decrease in both nonessential and essential care, which in certain clinical circumstance lead to adverse health outcomes and higher overall costs. i see this approach is penny wise and pound foolish. doesn't make sense to you, mr. chairman, that much i care patient paid the same out-of-pocket costs for essential as it touches a cardiologist after a heart attack or a therapist for opioid addiction or autism?
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they pay for the same for drugs that are life-saving for cancer, diabetes and depression and drugs that make tone of fungus go away for hair grow back. realizing tri-care members of bail themselves to too little high-value care and too much low value care endorse martyr clinically to what scott sharon is a potential solution. one that encourages members to use more services than more services that make them healthier and discourages them away from the services that do not. we refer to these lands as value-based insurance design. they simply sat cautionary to encourage the use of high-value services and providers and discourage the use of low value care. for the record, if poor high cautionary levels, but only for those services that do not make tri-care members help here. the fundamental idea of buy more of the good stuff and less of the bad stuff has made one of
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the very few health care reform ideas with a multi-stakeholder and bipartisan political support led by the dirt, implemented by hundreds of private and public employers, several states and most recently the medicare program. it is common sense and barriers to high-value services are reduced and access to low value services are discouraged. we obtain more help for ever dollar. therefore i recommend incorporating the tri-care plan in the following ways. first, the tri-care plan should vary for services in accordance to provide them such as high-performing was the location of care based on quality as well as cost. second, track your plan should implement programs that combine reductions in high-value services, but also that the resources are low value care. as a think about fiscal
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sustainability, it is important to point out that immediate and substantial savings are accumulated from identification and elimination. last, tri-care plan should very posh and a son of her mission such as clinical risk that is, special needs in disease diagnosis. the successful practice of precision medicine requires decision benefit design. f. scott sharon becomes a necessity for tri-care is fiscal sustainability, and encouraged us to take a common approach of setting member copayments based on whether he clinical service makes the tri-care member help you instead of the status quo which is basic contributions exclusively on what they caused. if such an approach encourages utilization of high-value care of and discourages low value services, the tri-care plans can improve health and consumer responsibility and reduce costs. i am honored to support the men and women of the u.s. military and

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