we are fighting also for our own health. so when i talk about pharmaceutical industry this is

very funny thing because actually i went to school to make money out of pharmaceuticals. that was my training, to use all the scientific knowledge and use my business knowledge to make money out of medicines. it is very interesting when one listens in many of the debates that the claim generally from the pharmaceutical industry gets fired up by this crisis we have only 13% of the u.s. spending is due to drugs. actually, that is true but not quite because the issue is that every single intervention, every visit one doctor to doctor represents a prescription of medicine. so even if one focus on prevention which i think it is an important thing. we have to work on prevention all the time. we also need to realize that some things are not preventible

and even though we want to avoid to develop a certain disease things just happen. so even prevention, which is extremely important, it has its limitations and as i will develop a little bit on this pharmaceuticals, most likely any visit at doctor will represent a prescription of a drug. second, we live in a very consumer oriented society. we've become very unfortunately pharma codependent. we have to go to the point that people are having a lot of problems because antibiotics, for instance, they are in the water, residue from pharmaceuticals are in the water. because of our unfortunately our mentality and i want this here and i want this now. new medicine came, i want it. new treatment came, i want it. the scientists discovered this,

i want it. so that mentality, even though i think that is the right attitude to have but we have to pay for it. so as we want better medicines and want safer medicines, we want other things we also have to invest and there are people who are going to be there to make money out of this. so science and the whole pharmaceutical and medical sectors have become a business. i think that people should look into that because obviously they are part of the economy. so all of these issues about having better technologies, having better diagnosis, they actually represents costs. to have accesses something better very to invest. to invest we have to put in money. to recover the money and we have to increases prices and this has a very, very negative impact economically to the country. finally when we talk about prevention, people say, well what you do healthy, we should

do exercise, we should just prevent. fine. this is correct. we should stop smoking. do other things and to take care of our own health but even within prevention we need medicines. the reason why we don't have polio in the western world and the reason why some of the smallpox was eradicated and reducing hepatitis and awe the infectious diseases because there have been vaccines for them. so even within prevention plans we need medicines and that is a reality because if one gets sick, even though one tries someone gets alzheimer's, hypertension, something comes up and at that point the human nature is not going to prevent it. it needs to be solved. it needs to, it needs a medical intervention and that medical intervention is a good diagnosis and a good treatment and treatment is going to be a

medication if not a --, a medication. the what happens the pharmaceutical industry does know this. what is happening. this is slide from 2009, but this trend has continued over the years up to now is that the price of medicines are increasing all the time. so twice as, at a level twice as much as the increase of inflation. so as many of these reforms have been implemented in the united states then the strategy has been to increase pricing. so even though the industry has a, contributed with some money to the health care reform, well that money is going to be recovered very quickly because of the price increases that have been taken in the united states. so what does that imply? well that implies that the world is then playing for all of these issues. if we're looking to, this graph, for instance, if we look at the

united states and compare it, this is the dark green is the general an warm government expenditure in health care. the light green is other privates which are other private expenditures and then the light green is out-of-pocket. we see in the united states is less than what it is in other countries but when you go down to europe, india, china, and go to developing world like india, or low income countries they depend on external resources like international aid and a lot of coverage in health care come from their own pocket. that means what the government gives them in terms of health care, even though it could be universal, what happens it is offset by the expenditures that they have to do out of their own pockets. so that is a big problem right now. and i would like to delve a little bit what it is the pharmaceutical industry and what

and how this relates to health care. to put this into perspective. we have basically one of the most powerful industrieses in the world, so the market right now of the pharmaceutical industry is almost one trillion dollars a year. by 2016, it will become 1.trillion and the, pharmaceutical industry alone represents 75% of all what is, of all the market value within the health care system. 75% is a lot when they think about it. when it comes to the gains, returns on equity and how much they make is way higher than in the other sectors. for instance, return on equity of 23% and the percentage of profits as in terms of revenues is 20%. so this has been an industry that has gone through a lot of changes and it is boeing in

transition. so to put this into perspective again, these are the top 10 largest pharmaceutical companies in the world. the big one is pfizer. pfizer is a giant of $67 billion in sales a year. i will tell you one thing. in panama the current budget, where we have 4 million people, four million people in the country right now. the budget is about 10 billion right now. the then the panama canal produces only one billion a year. so only one single company produces 67 more than what would go through the panama canal to see how big this business is. and then we see the market shares. they are increasing. so in the u.s. the market share has been about 38%. in europe, 31%. the rest of the world soft what it means is that the united states has become the most profitable market. this is affecting this country

severely because, here because of no price control and what is happening with medicare, so, medicaid, so that is actually having a big, big impact. then it continues, pretty much the numbers remain the same but what we see is an increase. europe realized this is a -- medicines. look at 31.5% in 2009, they dropped to 17%. they have a controls on medicine because they can not afford it. this is becoming a big issue. this industry right now is going through a lot, going through a very, very big transition period which is has become very difficult to come up with new drugs. drugs have been spread, by 1950 most of the drugs to treat common ailments, hypertension, diabetes, cancer in many ways and others, they were, these diseases were -- very difficult

to improve on them. coming up with a drug which is better and more effective and more affordable has become extremely, extremely difficult. what happens now over the years especially since the 2003 the amount of money that is invested in all of this research has escalated to $60 billion or more. then what has happened is now that the amount of new molecular entity, the amount of new drugs, drugs have been approved have been declining dramatically over the last 10 years. last year was good because the fda approved 39 new molecular entities that was one year. is this a trend? no. that has to do with some strategies that the industry has done in terms of mergers and acquisitions as well as some changes in the regulatory system at the fda. so this is a trend which, here

is an issue. a lot of money has been spent, literally is coming out. somehow these companies which have $60 billion, $70 billion a year, somehow they have to make money. who will pay for that? we as patients have to pay for that. that is creating a lot of a strain not only in the united states and stress on the united states system but also in the entire world because as in the united states, as i said before, people can afford them because of their private health insurance. then what happens now, drugs become more expensive, then the premiums are higher and what happens is that not only the premiums are higher but also insurance companies create different tiers. the more sophisticated the diseases, more difficult to treat it is, the more deadly the disease is, the cure will be more and more expensive and that obviously is creating a huge problem in terms of the issues. so over the last year the

pharmaceutical industry had a lot of problems especially because of expiration of drugs. what does that mean mean? here in the united states the law of, intellectual property law its covered by 20 years from date of filing. a patent lasts after 20 years, after those 20 years what happens the drugs go off patent and they become generic. so any copy can produce a copy of it. so that creates a little bit of a problem because over the last few years the pharmaceutical industry has lost very, very profitable drug for instance, lipitor went off patent. so in 2012 the price it, i it was about, before 12 was $9.6 billion. went to 3.98. the amount of sales for lipitor will continue to increase because it has become generic. the next one will be nexium. this is, nexium is an antiulcer

drug which is used for used for $6 billion of sales. we can see the other ones. these are the top prescription drugs. we see that these are very, very profitable drugs. so bit year 2016 we're going to see a see a lot of drugs in terms of revenue, excuse me, loss of revenue because of expiration of the patents of about $127 billion. so this is some of the potential expirations we're going to get. this is obviously affecting the industry and it is affecting the strategies that they are implementing in order to survive. so this is affecting biotechnology products which are becoming half of all new drugs approved because they are moving to that level. so what happens is that right now, we look at the market,

there are, in oncology sector has become number one. it has become very, very profitable of the so the price for these drugs treatment, $100,000, or $50,000, $100,000. if we relate that to the obamacare, to obamacare plan, what is going to happen? we have now this insurance, we have to ask the question who will pay for those drugs? is it going to be sustainable or is it going to go bankrupt? because as of now, we are having problems with the system as it is, even for people who have to purchase private health insurance. so their premiums are going higher and higher and higher. there are tiers which different plans have different tiers. so who is going to pay for these drugs, especially with an aging population? when we incremental incidence of cancer which is becoming in some countries is becoming the number

one cause of death in some countries. used to be cardiovascular. now it is becoming cancer. so what happens even if we live longer, if we live 200 years we all would die of cancer because this is the way which the organism is growing. so the business knows this. this is the reason why now with the obamacare what happens is that the one that will profit the most will be pharmaceutical industry because what is happening now, there will be more people insured and many of these people are going to be needing these drugs. the issue is, is this health care reform really health care reform? is it going to be sustainable? that is a big question. and honestly i don't think it is because eventually, this is only, these are only the top 10. mental health with alzheimer's, with problems with parkinson's disease, all of these central nervous system disorders,

depression, diabetic, diabetes, it is becoming right now one of the largest signs of morbidity in the world. in middle east and my country of panama because of obesity and because of other issues are having problems due to diabetes. all of these diseases are very common and very popular. they are extremely profitable and eventually they are going to have really a very strong impact in, in the health care. now, we think about genetics too. genetics, there is issue with genetics. many of these drugs after 20 years they go off patent. then what happens is they become genetics. there is an issue. there is in the world in terms of sis resistance to antibiotics and to developed drugs. genetics are not innovating. who will come up, we will need innovative drugs, with changes

within climate change, access, access to different resources genetics will that be sufficient. that will be an issue. economists say 85% of all prescriptions are given in the united states are generics. with these prompts we'll find limitation as well there. so development process is, i will go very quickly go over this because this get flexes a little bit technical but it's a very complex process we have to do discovery, in which we have to do a lot of investment. takes 12 to if i have teen years to develop a drug and takes about one billion dollars to come up on average. not all drugs, by the way, not all drugs take $1 billion to develop. if that was the case more biotechnology companies would go out of business, but some of them especially in the cardiovascular sector are extremely difficult to develop

because of the clinical trials. so we have a phase of discovery of the we have a phase of development. and then we have to go through the fda in order to approve that and in order to get a drug. this is process that takes a lot of time. it is a time-consuming. in many ways these companies do need to seek the rewards out of work that they do. the problem is the pricing and problem is marketing. because it is a, the amount of marketing these drug companies is make is twice as much as what they spend on research and development. we pay more that. consumer advertising for instance. we pay for all of these things and they are having an impact in our own pockets. so, to make this long story short, what i wanted to get at is that, pharmaceutical industry has had a lot of, developed a lot of strategies in order to go over this, a development crisis

and then they have adopted prices increases, all of which, by the way affect our health care. price increase, reformulation. that means that they changed something in the molecules so they could extend their patents. and then they look for other indications, like something works for cancer or work for something else for instance, and to keep the revenues coming the companies are looking to niche markets. they are cutting a lot of operating costs and they are cutting a lot of costs in research and development which is a mistake and doing a lot of mergers and acquisitions. those 39 new molecules approved last year were many ways a result of these mergers and acquisitions. in many ways some of these technologies are becoming a convergant and being integrated. so one knowledge that belonged to one company is now linked to another company so it facilitates development but at the same time it could be artificial too.

this is short-term trend but this will not be sustainable for the long run either. so the pharmaceutical industry right now is in the process of transition, restructuring and diversification and so as we can see this has some of the, the development of these drugs are having impact also because in the area of biotechnology we find these drugs could cost about $31,000 a month. some of these drugs even cost $400,000. so, as case of this drug for instance. this is affecting many people, people who will be covered for this, they would have to have special insurance. so the other issue is, okay, fine, if they have private insurance in the united states, they could afford that maybe but what would happen to people in argentina? what happens to people in brazil? what will happen to people in switzerland or in france? are they going to be able to afford this or in the u.k. where

there are so many restriction caps? that is a big, big issue there. and then this unfortunately affects people. in the united states as i say before, people say, i want that, because if i am dying and i need this i have the right to have it. well in other countries it is not that mentality. other countries it is, if i don't have it, i die. so we need to come up with solutions to this problem because in the final analysis it all boils down to the disease and to ways to treat it and to prevent and to cure it. so what is going on this is having a lot of problems not only in the united states. this is happening also a lot of problems in the developing world in which there are a lot of imbalances in terms of money, in terms of infrastructure, in terms of access to, to all of these things and also and --

this for elderly that makes trip to canada, found it was cheaper in canada, that is problem, importtation. many people buying medicines online. guess what? about over 90% of those medicines which are sold online are fake. so, and this is a problem because at least the 10% of the drugs which are a, in the market right now are fake, counterfeited drugs. what happens is, because people sometimes they don't know, people are desperate, they can not afford medicines or split it with their spouse, and then what happens? people instead of looking for a, finding a cure, the disease gets complicated. i was recently in a forum, a world justice forum in the hague and what we need to do is to treat an -- create an international treaty to fight counterfeit and fake drugs. what happens it becomes very, very easy for the mafia and

criminal organizations to sell drugs to people. so in developing world usually they have a connection with the local government and their local people and and they are allowing it. this is the reason why, for instance in panama in 2,006,000s of people, they say hundred, it is thousands of people who were really killed. they, the national laboratories prepared cold syrup that had ingredient which is used in antifreeze. these people were killed and many of them had renal failure for the rest of their life and got complications. recently because of a fake, because of a fake drug now, eight or nine newborns were killed. this is very sad. this is not only happening in panama, it is happening in other places. the reason because these countries do not have a strong, stringent laboratory system. if they had a laboratory system

they do not work. they need to create a system at international level, especially these mafia that introduce a counterfeit drugs as generics. the reason why they introduced them as generics, the generics once a brand name expires the generic does not have to do clinical trials over because the clinical trials are done. they have to show by equivalence. demonstrate that the compound will have the same action in the body. so many people could easily then, especially in developing worlds introduce these drugs. we need to do something about it. we need to fight, especially because 90 to 95% of the world health care problems would be solved with that jakes -- again makers at least now. this is something we need to look into, the issue now interest of many of countries especially in the pharmaceutical industry and in terms of government are focused on drugs like cancer, hypertension and rightly so, what happens now is

the world has changed. atmosphere has changed and then the environment has changed. so the biggest threat in the world right now is resistance to bacterial infection. we see that in new york with tuberculosis for instance. we're seeing it with malaria in other countries. many people in general, they believe, okay, so the problems in the third world country, well, those are problems of poor people. the issue is that given the facility for transport tearings and communications right now, what happens is that those diseases common to the developed world as happened with the hiv/aids crisis, as could happen with the pan demic influenza. is could affect us in the western world quickly. these things spread so quickly and we're not prepared. so what is happening now the focus is very profitable drugs but the world is not prepared for what is coming next. i personally believe, and this is not to scare people, i think up fortunately the world is

going to succumb soon, sooner than later to a plague and to something like what happened in the middle ages which a large percentages of world population were basically killed. and that is the situation because we don't have enough antibiotics right now. and the one that is we have, unfortunately the bacteria have shown resistance to them. so this is an issue which the developed world should contribute to in order to help other worlds, other countries but also to help themself. there issues of neglect of medicines and neglected diseases because there are some different, there are different areas in which there are not medicines at all. so to sum up about this issue what happens is now, regardless whether one has universal insurance, regardless whether people are covered, then the issue becomes the population is

always being more and more affected by one sort of an order of disease and people are not prepared because obviously we have changed our life-styles. people used to run before, to be very active physically and that is not the case. there is a real crisis in our country. so that is an important issue, fingerprints when it comes to food, a person who is not well-nourished and a person who suffers from malnutrition is more haverrable to disease and their immune system is not prepared to fight whatever is creating their ailment. so, as i've said earlier, all of these things is global. so there is a big interrelationship, so people should be considering especially when it comes to development of policies and in terms of pharmaceutical development people should always be thinking we live in a global village truly. so we need to think about the development of these drugs that

could help other countries but also could help people in the united states, in europe as well. and some pharmaceutical companies do have programs like glaxosmithkline, novartis, et cetera, about providing social, corporate responsibility but truly it is not enough. there is much more than they could do. and then there is a long way especially in helping and indicating to people, i'm providing means of diagnostics. because that is issue, early diagnosis of diseases. so the issue in the developed world then health care is, has become and it is become be unaffordable and it can not continue that way. even though now in the united states for instance, we're starting health care reform. but that is just a patch truly. it is not going to solve the problem and issue of pharmaceutical development is not addressed. so, this is the correct situation in the world right now which we are reforming.

here are the patients. here is the medicine. we have the whole health care infrastructure. so all of the reforms have been done in this direction unilaterally. none of these areas have been reformed right now. in terms of what is happening for the development of pharmaceuticals. so what about pricing reform? what about intellectual property reform, marketing reform? all of these issues which are, which would not seem so obvious when we deal with the health care crisis, actually are very powerful and the weight is tremendous because at end of the day if one person becomes sick that person needs to be treated or that person needs to be cured. and you do that through medication. so and that is a very, very concerning issue. so when we talk about solutions to this problem, we talk about what we could do about this, first of all, we need to think about this issue, we need to

find global solutions. there is no point in just finding solutions for the united states or for france or for switzerland. we need too think about from the perspective globally. so, even though we do the infrastructure changes, we to think about the also development of medicines. so we need to create a system which we develop better medicines, safer medicines. and make them more affordable too. .. .

there must be a course in every country in the world and about health care education so that children learn about what they are basically and have a health care that is killing people so it is having a big impact on the world. so we need to work on prevention. we need to create a global campaign about international economic development. we need to fight poverty and corruption. we need to fight injustice and inequality. and it is not that this is not happening right now. it is just that people do not see the relationship between each one of them to bring all of these things together. so that people who are working and justice need to work and justice and health care, too.

they're fighting about women's rights, whatever rights to the have to fight for her rights to madison, too. so i think it is very important that when we think about this health care crisis and in terms of the problem in the economy interrelated and therefore, healthcare is interrelated, too. also, what we need to do is create a system in which we create a better sense of humanity to go back to its roots not so much about being a business and a way to make money. it is something that really affects the life of people so their must be changed in the mentality of coming to the doctor but also have someone that is compassion at and who actually wants to work towards

the betterment of the health of the patient and that acquires a lot of thinking and reform so what we need to do is work on an adoptable health care system. for instance in the united states because the united states is the leading in terms of health care reform and in terms of pharmaceutical development there are many ways that we contribute to the collaboration in terms of the academic and also the industry. people have a negative attitude towards the industry relationship but in the end at the end of the day what we want to do is translate this idea into medicine and compare them into something in a society because all of this is on the economy and feed on the people's health. we need to work on the

pharmaceutical industry organization and also the need to become conscientious in the sense that yes they have to make money but at the same time it cannot be so far in which the idea is to develop blockbuster drugs that means drugs that cost of of drugs that sell for 100 million more a year -. we need to get a different system in terms of the poverty in which they should be accessible because as we are interdependent i think it is very unfair that people could have a system while other people cannot have access to anything. so i think that we need to find a way to improve on that because eventually, as i said, 90 to 95% of the developing world health care problems could be solved with genetics. so, we need to make sure that in helping them we help ourselves, too triet and then in terms of the development work i think the

key issue is working on the national economic development. truly there is no point in giving donations to people to invest money in africa if that money is going to be wasted. if we don't work and occasion especially, if we don't teach people that such is because of this disease or at least the wave of information. so it is very difficult to work with some of these people and the experience of myself, too because to talk to people in africa one is to profit from them somehow and one wants to take advantage of them were give them a bill that is going to kill them because they're so used to that system a fake drugs that eventually the of lost their trust. so we need to work on the economic development but we need to work hand-in-hand. if we work on access to food, access to grow for instance

pregnancy that is something that should be required and also medication. these need to be the start of the health care and also especially to fight corruption because that is one of the major problems in the developing world and that this something that has a lot of problems besides the access to medicine so when it comes to the united states and this health care reform in this country should be about, more than only a health insurance reform, which is not going to work, should be the eventual reform, intellectual property reform, medical and education reform. the cost of education here in the united states is so high that many of the students have

to get a high loan in order to finance their studies but then they have to recover the money went to become doctors. it is a money driven system that unfortunately is not healthy whatsoever. and we need to work on of reform about all of these. there must be a limit for that situation because all of that actually is part of felker system. so part of the issue especially when it comes to this relationship is the easiest way to come up with a better system to develop drugs and lower the cost. we need to integrate knowledge and collaborate more and perhaps a lot of cross fertilization in order to create a system that is more efficient. and the issue is to work on all of them together. so there is no point in doing one thing now and one thing and another year or the next system. we have to work on all of the things together in order for it

to work because if we don't work on this, we are going to see an increase in the longevity. we are going to continue fighting for survival basically because we have too many people on the planet already. so, all of those things represent a unfortunately consumption of resources, and we have to see how each one of those can provide in the system. so, i know that i have focused much more on the pharmaceutical problem, but i think that this is the real instance. it is also the most difficult to address about health insurance it is easier as we go to the united states and other countries and going to the university together in medical training is not expensive at all. anyone can be a doctor to anyone can be a lawyer to get it comes from how we find a better treatment.

it is a big issue and i have already developed a system on how to do that and is based on collaboration and it is the core of model and an escort model i develop a way for the drug for the treatment of multiple myeloma. if we adopted a system similar to that, if the government were able to implement something of this sort and which they create policies that would be extremely sound in terms of the development and working on this area, i think that we are going to see a huge defense and educating people and prevention as well as and the betterment of the health care system. and i would like to finish this talk with two things. one of them is a beautiful quote but i found from a paynter that

is precisely the greatest thing there are too many people all over the world who want to talk about problems that do not act. if our goal is to save the world, then we need to start a crusade. as a weed is not only about publishing all of our ills but about finding remedies for them, and especially i think that we should be true for medicine right now. it is about providing the labor and access to the more mobile and dignified concept of human kind. and with that, i finish my talk. thanks. [applause] >> if you have any questions i would be happy to answer them. >> yes, sir. >> when a person in the third world wants to come to the u.s., does the u.s. require them to

have the examination that we could be sure to find out for sure that they do not have the disease? >> in general, no. to apply for a green card i think that it was required and i think that now president obama banda that. so, unless it is a country where they say it is an issue then i would say that would be a part of any other countries but in general it is very straightforward set for instance when one applies for the united states in general, it is not acquired examination. what is required is basically the amount of money that the person has in the bank. it's been a good about preventing the disease is from coming into the u.s.? >> it is literally in the developing world into the united states also remember that some people go from the united states and the other countries. sometimes they get exposed and

they bring them back. yes. >> on one of the slides you pointed out that generics are lacking in many parts of the developing world. i don't know if you are aware of this, but there is a global shortage of generic drugs, including the united states. there are over 300 drugs on the list that is administered by the society of the health system pharmacists. including cancer drugs, breast cancer, leukemia, and as the next, anesthesiologists and the united states cannot get because it is manufactured by a single supplier near chicago.

and the whole system was created by an anticompetitive system of hospital purchasing in the united states or called hospital group purchasing organizations. as a control the entire supply chain of drugs that used in hospital clinics and outpatient facilities and so forth and there was a statute that was enacted in 1987 that someone ran through congress and the dead of night called the medicare and thai kick back safe harbor that xm did that she p.o. from criminal prosecution from taking the kickbacks from the vendors. so, basically, the savings on the system of like a harvard co

of kind of arrangement that had been in place since about 1910 the whole business model was reversed to the point where you had the beginnings of the pay to play system in which the vendors including of the generic drug companies paid huge fees to get exclusive contracts that sell the product to 5,000 american hospitals. so, the number of suppliers have been reduced. >> you set the buhle alert or shortages all over the world. >> we are having that problem right now.

>> they treat it effective and they still are effective for the disease for ovarian cancer where the presentation focused more on the innovative brand of the drug, but as the other slide points out, 95 to 90% of the health care problem in the world >> i want to adel little bit to what you are saying because right now there is a current issue from the companies that are actually being sued because there was a deal behind them with the generic drugs in which they said well, listen cut don't become genetic and that is a big issue which is actually the point that you are making right now. >> absolutely.

>> [inaudible] generic drugs floating around the world to places the would pay the highest prices >> to address several points that you made, not everyone that is professional comes off so quickly as a professional by engaging in the paper chase. these doctors and these professionals and the hospitals are overworked. they cannot continue dealing with populations who feel that they are equal or superior to the doctor's understanding. so they just write off and say next patient. and this is logical because these men and women deserve to have families and children of their own and continue the lives of their own.

number two, 50% of the drugs that you mentioned, 13% for hypertension, 23% for the mental illness etc., etc.. those are all engaged on addressing people who have cultural problems in this country. the attention deficit disorder, for example, has doubled in this country in the english-speaking country in ten years. this used to be in the balance and have now increased due to the canadian study. many of these problems for example of substance abuse and staggered points out that the american regulatory agency

involved in substance abuse dictates have a canadian, how the australian, the swiss, the british deal with the speculations and those studies have proven to be more effective i have two questions. does your agency deal with the problem of border such as the environmental agencies are doing in ecuador about the water coming down the stream so people get water and is your agency dealing with those anxieties that the refrigerator populations have acquired through cultural the activity is by taking certain types of foods that may have worked 100 years ago but don't work today in this culture climate? >> so, the question would be --

>> to get an effort on your part equal to the environmental agencies like the national conservatory etc., etc. the deal with the border problems in the country or just as -- >> if their national or international organizations, some that are really focused on this, but unfortunately, at that point with this feeling is the population of the public. so, the systems are there to work but it doesn't become a priority. therefore it doesn't become as effective because there is very little education in terms of people getting involved in that. so, when it comes to the natural resources i would tell about panel that is one of the countries in the world that has one of the largest varieties of plants and animals and what we've seen in the last few years actually i'm talking then the

last five or six years now we have the construction of a electricity plants which are unfortunately based on what verso there is no water especially in. as of the government is not helping much. and again, the answer to the question is their local organizations like the u.n., etc.. but then won it comes to the implementation the government is really not doing their share. >> they don't have a central american clearing house. >> there are some areas and the associations that work together. in latin america, central america or south america but in some others there is the health organization, too. but again.

>> another question? >> hello? okay. thank you. i appreciated the presentation. and i appreciated the systems perspective. one of my question deals with the fact that i believe that many of us don't think systemically are not aware of all of the factors and certainly not aware of all of the interrelationships. and i'm just wondering it requires to be able to work with those and requires transparency, which apparently some of these examples show there is and transparency. requires feedback hearing it requires timely understanding about how the factors are affecting each other. you know, and like you said, this cultural issue, how do you

see for the viability of pulling the courts a little bit so there is some loosening and global systemic thinking? >> i think at that level one of them is the ngo and the other is the government for instance education as i mentioned the government should implied health care. of course they teach mathematics or the minority or whatever. the same thing could be done and that is the way to do it and actually i have spent a lot of my time in the last six months in panama and i go and i did a lot of volunteer work especially working in the populations in the communities with a lot of children and adolescents and a lot of people especially educating them about the same type of lecture that i give about the importance of science

and the relationship and that is for the university in panama. the way to do this is through education. now, when it comes to the ngo i think that is a very powerful way to do it, but again, the people who for participating in these should also be trained. and that is an issue that sometimes people are not well-trained and they cannot see this relationship so they have to work with from the government level and they must be always a cross between them and i think that the scientists and physicians should do more about this. you need to clean up the image. it is because of these issues. so they were more and more on this issue. thank you. yes?

>> can you comment on the insurance companies to understand the biggest companies in the country. >> in general, people blame the insurance companies for this crisis and this issue but least from my perspective i would tell you my perspective it is like they are not as people portray them because they are like the middle man. so it is a very opportune mix system in which they will try to get away with as many claims so they would try not to cover as much so that this role. it is an economic editorial system so they play their best and they are there to make money and to gain the system. so this is mathematics. i don't want to say -- i don't see that that should be targeted

because as we see the pharmaceutical element it is working dever so what they are doing is basically profiting out of a situation which is already bad. so that is. yes? >> what kind of disease deutsch children die of most in panama? >> the major issue with children would be i think one of the major problems in panama. malnutrition there is a lot of malnutrition in panama and that has a lot of problems and infectious diseases. i would say that there would be the number that would give them

to you but i think that it would be in that line of the infectious diseases and malnutrition and they would not appeal to resist some of these infections. so, -- >> we have a lot of genetic disorders and nothing is being done for these people. so right now we are working on the foundation of the creation for the diagnosis and treatment where it is possible of genetic resources because they have no resources there and the government is not interested in investing at all. it is just so bad. so if you would like to get more on those numbers i would be happy to get them back to you with those numbers. >> it is very general.

can you give a specific solution for fighting corruption in developing countries? >> in the last month i was in the hague in the world justice tour. when it comes to corruption i think in some countries corruption seems to be the second major or becomes the first major. it cannot work without corruption and unfortunately in my own country i can among the most corrupt actually in the world unfortunately. the work of justice project it is especially in the rule of law and implementation to work with them and work generally and they make proposals and then after that then the government should

be able to incorporate them and people with special the people should free the pressure so this proposal is implemented because that is the role as citizens, too. from my perspective, that is the way to do it so that they go to the legislation and eventually are implemented. >> a few years ago i needed some fat cream so i bought it here at a pharmacy. a very well-known product and i paid over $50 for it and about a year later i got it in the pharmacy in germany for $14. so who is making this huge

profit? >> in the united states yadin? it is a pharmaceutical the industry because the process first to the first distributors but to the wholesalers the of the price to the wholesalers that is higher but in the beginning they are expensive. >> there are no price controls, so that is the way that the system is here unfortunately. >> how is it a cultural problem? because if you have agreed to the people who need it or not the ones missing themselves up for instance you have the politicians trying to keep the hospital then in that area in brooklyn the last five or six years, five hospitals have been closed at serve the poor so people don't have access and

there are more homeless coming and they don't have access to anything. i once lived in france where there is one of the best medical systems for everything that the teacher had to eat. that's education. they teach people how to appreciate food cannot eat so much, how to eat well. that's education. it has nothing to do with the culture. people who need it or not the ones giving themselves and on madison and they aren't going to read what's out there. how do you educate them about the issue not about the culture. [inaudible] fix the food to make yourself better and they want to anything for you they will put you in the hospital a little while and then let you go. >> i agree it's very difficult but at the same time in terms of the culture think the overall question is wherever you go

instead of getting sugar it is also see to it gets very hectic and complicated so they don't have time to go and sit down and have a meal. but this is a complex issue that we have to explore the historic issue of not only the united states but also the west and how the industrial revolution it is a problem that is very difficult. but i agree with you. it is very sad. and the last question? >> could you comment on the so-called medical tourism, and to what degree that may contribute eight lowering of the cost as a percentage of gdp of the enhanced procedures in the west when they are performed until low labour cost economies? >> is travelling right now. in the countries in panel for instance the example this is an

emerging economy. if one can afford it we would have access to health care and medicine which is spectacular. and then what happens is that many of the hospitals like in panama is associated with johns hopkins. so what happens then is that many of the patient is especially the ones with latin roots they go there and get treated and get the operation and an excellent bargain because whatever they are going to get here they get there because they have excellent doctors. that is available for very few people and cannot think of it as a general thing that it is unsustainable ha.

it is happening in so many of the developing countries working on this area of the medical tourism our health care tourism. >> [inaudible] >> it is a growth sector but i don't think that would be significant compared to other areas. it's not that large. it could be important but more than that would be if they become less dependable on the innovative drugs in the developed world. so why not work on the education and investment? why should i wait until i get in medicine from the u.s. or u.k. when i could try to develop it in my own country and this is an interesting case because cuba, for instance recently came up with a drug that actually helps avoid the amputation of limbs so

now from the pharmaceutical companies that is important to license it and so it is happening. so why not work on that? then there are more people from panama and true, i am from panama and they are smart people and people that need to make a difference in the world coming from the emerging economies. so why not government but to use their own resources? why don't they train their own physicians and their own people and then instead of a -- to create a whole source of cultural development and activate the pharmaceutical industry that would be extremely important because that asset for the economy. if i did felt the genetic drugs, create something for the economy and when i create something for the economy also create something for my country and the

other countries as well. so that could be even more profitable and even more influential from the economic growth perspective in the developing world. >> usually it is atip like educ, tv. but people are taking it at the grassroots or taking it on their own. that doesn't have to do with the government. and they are very conscious of the steps. they are eating better. you see at lunchtime i don't

know. but as an icy positive notes that kind of tip this. >> absolutely. >> it is happening, you know. >> it is happening. in the first quote people are becoming more informed, so they are fighting for their rights and that is the way. >> it sounds like you are interested anyone world medical system. like you said if somebody in cuba or pan -- panel developed something they should share it with the world. it's like i agree with you because of the and we are fighting for these and live in the same planet, so it couldn't be the only some people could have access to the system. that is the problem just deal with it. i don't think that -- >> we live in a world that is kind of resistant to date. when clinton or obama or anybody

says -- like you were pointing out in canada or france they have a health care system for everybody but all of the negatives and they pay high taxes. i.t. 35% in taxes and i don't think i get anything in return. i wouldn't mind paying 45% or whatever on taxes if it included health care or something like that. but i get nothing from my high taxes and everything else that i am screwed out of in this country. and i haven't had medical coverage for years. and any type of -- if i go to the emergency room or any doctor, i can't afford it. and i am somebody that has worked hard all of my life. and i just -- i get nothing in return. >> many millions of americans and people that do actually work and they cannot afford health and care. it is a big issue but would eventually is -- this is right now and sustainable.

the government that had to work on getting people better tools to take care of their own health. that is a big challenge. but yes there is a lot of work to do. someone had a question and then i will come back to you. yes, sir. >> i just wanted to say in your country instead of using the water to feed the people use the ocean water to use the plant's. just a suggestion to you. >> i am not so sure whether the president would be happy but thank you very much. >> yes, you have -- >> to come across or consider the relationship between dental work and health. >> that is very important. and indeed i was talking to a colleague of mine and he works

at boston university and for what ever reason he didn't know where i was and then he said where are you from and i said i'm from panama. panama that's interesting because i'm working on something from panama about these people who have a disease that is genetically inherited. i see that some countries do not pay enough attention to this. if one doesn't take care where one could have problems and kidney disease and some other type of complications. >> unfortunately when one talks like this one should just try to get to the core of the problem because it is second place on so

many issues that it should be holistic in the health system to provide for people going to the doctor and feeling well about it and i don't see that many people having that attitude towards the comparative in the world. and so it should be mental and psychological and spiritual, too because many of not having a reason to live and feeling sad and when one's mental health is not good medicine should also work towards that and provide people with a sense of spirituality or faith and mutual love. and that i think i will close with. [applause]

about ten or 15 years ago we started looking at the census department data and something very strange pops out. when you look where the profits are of the multinationals, you know, if you look at a map of europe you see germany, france, ireland, italy. but if you look to the data on where the profits are, france, germany, ireland. it's just this all love not -- usually disproportionate amount within ireland. so that was one indication that something was going on.

the deadline is approaching for the studentcam video competition open to middle and high school students. answering the question of what is the most important issue congress should address this year with a five to seven minute documentary that includes c-span programming. this $100,000 in total prices with a grand prize of $5,000 to the entries are due by january 28. get more information at studentcam.org. the british parliament is in recess for the holidays. members return to the house of commons on monday. next ptc parliament westminster review takes a look back at the major defense in the british parliament since september. the parliament correspondent hosts this one hour evin.

♪ >> hello and welcome to the look at the german parliament shot fired at the leader at the conference. the next labor government will freeze gas and electricity prices until the start of 2017. [applause] >> and not to be outdone, the first minister of scotland said on the agenda the border. >> the independent is not at its high of this administration about the fundamental space choice for scotland. the people like to choose a government of their own. [applause] >> some of the politicians are not backwards about coming forward. even the security services made a brief fire out of the shadows to the recent security leaks.

>> al qaeda is laughing at. >> the prospects for the u.k. economy were starting to look better. the first healthy recovery were coming into sight according to the figures. and the coalition claimed it's also an austerity program was working today that the politicians had to change the tax that concentrated on the cost of living. and in particular on the household energy bills at the party conference the labor leader made a pledge that came to dominate much of the next few weeks. >> the system is broken and we can fix it. if we win that election in 2015, the next labor government will freeze the gas and electricity prices until the start of 2017. >> the first of what turned out to be a series run on gas and electricity companies can coincidentally at the very time that the energy secretary had

questions and comments. >> in the course of the questions the british caps have announced that november 23rd they will increase their gas prices by 8.4%. and electricity prices by 10.4%. >> it is a company that has passed on a high share of the profit to the shareholders at the same time making the least amount of investors. >> first, mr. speaker, it is extremely disappointing news for the british gas customers. the british gas will need to justify, they need to justify openly and transparently to the payer. >> week after week as the prime minister's questions leader just kept talking about energy. >> the prime minister said, and i quote, there is a certain amount that you can do freezing the energy prices while the chancellor said in a speech it was something out of, and i quote, that capital. >> so, is the free the energy

crisis a good idea or a communist plot? >> he's the to the energy secretary and produced policy after policy, regulation after regulation, target for target all of which the the energy prices up to eight opposing the free she has on his side the big six energy companies. and supporting the freeze we have the consumer bodies like which energy producers and the vast majority of the british people. if an energy price freeze was such a good idea, why didn't he introduce it when he stood -- the fact is it is not. >> of the defense at this point took an unexpected twist. out of the retirement of former prime minister to read some of getting there certainly is a crisis and many people are extremely worried about it.

the energy prices that we have seen are way beyond anything that i personally think is acceptable. >> said he said that he said people the winter might have to choose between heat. it was an intervention. >> the prime minister said anybody that wanted to intervene in the market was living in a marxist universe. [laughter] >> how does he feel now that it has claimed the major? >> we are intervening. i want more companies and more regulation. i want a better deals for consumers. but yes, we also need to rollback the charges that he put in place. >> high time they heard from the big six and sure enough the energy company stepped out of the energy committee. >> i fundamentally believe the market is competitive and said

many times therefore i would need to have a very thorough competition commission in the investigation, and i believe it would be helpful to be politicize the debate. estimate is it not just about the biggest problem and that is that consumers can no longer afford the energy bill? what are you going to do for the consumers? [inaudible] >> two key things to talk about first -- how can the profits be fair -- >> because the second part of the negotiation is what to do

with the profits. if it's to make the fight [inaudible] of the societies in britain, and to cooperate the company is less than making the fraction of what mobile phone companies make it is a big number. >> realizing they have to have a policy that calculates the challenge to coalition ministers finally came up with a 50-pound reduction of of the average energy bills. >> the governor has reviewed the cost profile of the social environmental policies and i can today announce the proposals the would reduce the average household bill of next year by 50 pounds on average. as a major energy company has now confirmed, there will be no need in 2014 unless of course there is a major change of the wholesale network cost. some have come further. the whole crisis down larger.

>> can he confirm that the average increase in bill this winter is 120 pounds than even if the companies do pass on the reduction to the levees it would actually be 70 pounds? >> what about the economy in general? the chancellor delivered the autumn statement on december 5th to the packed house of commons. if they put a spring in the chancellor's step on the mission for an upbeat tone by the demand in the global financial collapse that helped send the u.k. economy into a downward spiral things are on the way back out. but still some way to go. >> mr. speaker, britain's economic plan is working. but the job is not done. we need to secure the economy

for the long term. the biggest risk comes from those that would abandon the plan. while those that predicted that there would be no growth until we turn the spending cuts back on have improved comprehensively thanks to the sacrifice and the endeavor of the british people i can today record of the hard evidence that shows the economic plan is working. the chancellor happened he struggled to make himself heard. >> the chancellor is in complete denial about the government in office and under this prime minister come under this chancellor and this prime

minister for most people in the country they are falling. he is falling 198 billion pounds more than he planned in 2010. more than three years of economic failure. the last 13 years, mr. speaker. you do wonder what he has been up to with his time but he gave a clue in the newspaper industry when he said this. i've had to cancel my 3 p.m. exams because it is the same time charge osborn is standing [inaudible] if he should have gone ahead with the chopsticks condition. >> on the day of the autumn statement i am joined now in the

studio by the chief political correspondent norman's death. welcome to the program. that energy prices pledge, how big of an impact did that have publicly? >> it was probably the defining moment of the year in that it changed the terms of the trade over the economy because suddenly it gave labour a comparative narrative of the time that we know the economy was beginning to pick up and it seemed that sleeper not working was simply beginning to fail. then they shifted the ground to say it's all about the cost of living. and focus particularly on energy prices. now that us two things. one is that it was very much in sync with the public opinion. and it enabled ed miller band to sort of rise to the crest of the public outrage of the colossal increases in energy prices but it also why think through the government on the back burner since they had to scramble round to find some sort of a repulse

to the labor cost of living. >> they came up with 50 pounds. everybody's average energy bill. to you think this was quick enough? >> my sense is that they were stumbling their way to some sort of a recalls. but at the end of the day they came up with the 50 lb. cut on the so-called green leverage. but must be honest, 50 pounds on an average bill of the 1400 is not going to make many households feel, you know, much better off. so it was very limited. first the difficulty has is a genuinely intellectually to believe the only way to tackle the cost of living is to get the economy going because that is the only way you create jobs and people get better wages and businesses grow. everything else is a short-term take. so they would sort of pushed into coming up with the 50 lb. golf. but that is not how they believe that you really address the cost of living argument in the way that there was a defensive move. but there were limited because they don't really believe the

short term measures for the way to address the cost of living. >> when they saw the chancellor really struggling there against the wall of malaise in the commons was that because he [inaudible] because he wasn't challenging the point? i think it reflects two things. one is there is now a serious sort of weakness in the labor stance on the economy because it was a reviving economy and it is very hard not to simply get up and say plan a isn't working. the argument begins to look increasingly thin. and i think that shows the response he was looking for some sort of argument to cut and he didn't really have it. the second thing which i just observed on a personal level, you remember i think it was in of a budget where again he got into difficulties and then was put into the stammer and i just wondered on these big occasions when he has huge barricades on

the benches and they do have a sort of personal disliked that he's actually thrown off quite a lot by that. so partly i think it is a personal difficulty that he has coping with that sort of malaise. but i think that reflects the weakness in the argument on the economy now. >> we will be coming back to you later in the program. the global financial crisis of five years ago may be slipping into history that the stories about the bank's have kept on coming. this year we learned the cooperative bank was facing a huge financial shortfall and is now in the hands of american hedge funds. the co-op a group no longer control its own banks and the former boss of the group told them its loss of the majority control while the tragedy. >> i don't believe that i could have changed the whole government of the cooperative movement which is established.

>> we have to do something about it. we can't have this organization run by the telecom engineer and the computer technician, the nurse, the [inaudible] >> that was the nature to comment on the way that the co-op was developed in history and so on there was the power to say you need to stop electing the members democratically from the board. the was the fundamental principle. >> the working of the banks in general it has over in the house and the government was suffering defeat on its legislation to change the banking system to the

financial-services bill aimed at improving the bankers professional standards and a member of the parliamentary commission on banking standards is the archbishop who called for more separation between the high street banking and investment banking. >> the second is in the structural reform of the banking sector. i urge the minister to look again at the recommendation of the act. they have gone so far surely as a possibility of full subornation in the review is only a small step and a very reasonable one. recognizing that we are trying to build a banking system for the next half century, not for the next five years. estimate the culture on retail banking those are two quite separate cultures, quite separate. one is or should be the culture

of the prudence and the other is the culture of creationists, which is very risk-taking although totally different order. it's been a cow's well as putting pressure on credit, the downturn and the cutbacks on welfare the government introduced the change to the housing benefit, but it was called the spare room subsidy and opponents called it the bedroom tax. whatever it was it came in in april in the comments. >> it was the labor party in government that didn't produce the taxes in the private sector. now on the 19th of january, 2004, the labor minister said they hope to implement the benefit system and the social sector that was anticipated in the private sector and the

question is when did you change your policy? >> it is when their party said that this is an unfair tax. let me be very clear this will be the first on the tax. people in scotland didn't vote for the tax. ..

put them in chains if necessary, make them work and make them pay. back society for the cost of bringing up the children they chose to bring up in this world. i also met a young couple, 17 years old, neither of whom had ever worked in their life. they were in a flat and were being expected to suffer some inconvenience to move into studio. again i say to the ministers, you have been far too generous in many instances. why should the state be paying for two people to set up in a teenage love nest? when i was 15 years old, if i wanted to see my girlfriend at the age of 17 i will go see her on a park bench in newport. why does the government paying for them to have a flat all by themselves? >> one of the coalition's most

ambitious changes to the welfare system has been the introduction of universal credit which replaces six existing benefits with a single monthly payment. the inspiration of iain duncan smith, when the rollout of universal credits or you see began to fall behind schedule nearly all the criticism came his way. he admitted u.c. wouldn't be fully ready by 2017 and it claims 40 million pounds of spending on i.t. software for the project had been wasted and at the committee hearing the minister attempted an explanation. >> when you're dealing with software and there are policy problems, it's not an exact science innocent you try to resolve something through a series of code changes. you go down the road and then it doesn't completely resolve the issue. in other words, what you're trying to do becomes a dead end. it doesn't actually work. you go back to square one and say we have to look at the anotr way to do that. there's a lot of work, and

sometimes it simply doesn't come to the conclusion when you set out on a. that's gone on long before i.t. was around in building all sorts of things. ibo reach a point that this process doesn't work. work. >> next day labour stepped up the pressure. >> mr. speaker, the secretary of state is in denial. he will deny he is in denial. [laughter] we all know that until he faces up no one will have any confidence in his management of this program. it's no surprise, mr. speaker, that the chancellor says, and i quote, there are some ministers who improved in office, and others like iain duncan smith, who show that they are just not up to it. >> i said all along and i repeat, this program is going to be on time. [laughter] by 2017, by 2017 some

6.5 million people will be on the program receiving the benefit. >> he promised all new claims would be on universal credit by may 2014. they weren't. he then promised they would be accessing the simplest claims by the end of october. they aren't. so why should anyone believe him when he says the delivery of universal credit is now on track? >> we intervene early when there were problems. we did not let this program rollout so that anybody was damaged. >> the people of somerset think that it is a mark of the statesman to take a deliberative and intelligent approach to these problems, and not to rush it in a typical socialist fashion. i wonder if he agrees with me that his critics have forgotten to read their bible and remember the line, for there may be the tiny specks in his proposals, they had a force in their i.t.

suggestions. >> norman smith is with me once again the universal credit not coming up to scratch and the target date has slipped back. how big a setback for the government is this do you think? >> potentially a massive setback, but perhaps not in time for the general election. massive setback because this is the linchpin basically of the government welfare reforms and if it falls apart, that'll agenda falls apart. you have to say there is mounting nervousness not just in the treasury but in other parts of government about what on earth is going on with universal credit. the deadline has slipped in slipped and slid. the only person who seems confident it will be delivered on time is iain duncan smith. you have to say the track record of success is governments with these massive computer schemes is pretty catastrophic. you think of the child support agency, patient passport and if all ended in tears. universal credit is the mother of all i key schemes but it will

involve around 19 million different claims bringing them down to 8 million claims, and it's a live system. the potential for it to go wrong is colossal. i think that day of reckoning though will not finally come until after the election. >> thanks a lot. when history comes to be written, 2014 just could come to be viewed as a land work year, the year when one part of the united kingdom voted to make its way to the exit door. the scots are having a referendum in september, and i guess that will undoubtedly mean a shrunken uk. it was on the 26 november the leaders of the scottish national party, the party in charge of the scottish parliament unveiled their blueprint for white paper for independence. the 670 page document was designed to answer all questions about how an independent scotland would operate. >> the prime minister has vowed to fight for the united kingdom with his head, heart and soul.

[inaudible] you know how the blueprint for independence. [inaudible] we know what it will look like. will now stop it? [shouting] >> i'm in joined the debate we are having now. that's what the debate should take place. of course, they should be a debate, including televised debates but this is a debate between people in scotland. this is not a debate between a leader of the conservative party or even the uk prime minister and the scottish first minister. it's a debate, rightly, between the leader of the no campaign and the leader of the yes campaign. >> talking of debating the issues is exactly what they're doing at the scottish parliament. straight after the blueprints was launched. >> within our of this publication, they described it as being totally ridiculous, not of any worth whatsoever which amazed me because i must

congratulate that man on speed-reading. by my estimation that is 3000 words a minute that he has managed to assimilate before he gave his carefully considered reaction to the white paper of scotland's future. >> his speech entirely in tune with his worldviews rooted entirely in negativity and grievance. [laughter] >> in the white paper there was not one single example, not one single example of anything that even might be slightly difficult under independence. >> along with the people of scotland people by government in westminster whom we did not elect. never has the future of our country been so well carefully planned. but there is one certainty, not a certainty which gets much attention, in itself surprising given the positive -- [inaudible] i'm referring to job losses and defense whether direct or enter

navy shipyards, high school scottish companies which support defense technology. >> i can hold this document and my hand. and my other hand i think it's unlikely that we'll ever see that document. because in my opinion that document would be the agenda for austerity, decimation of the welfare state that we all know and love. spent as the white paper sets out so starkly for 34 of the 68 years since 1945, we have been ruled by governments that had no majority in scotland. >> i challenge any speaker on the government to tell us what they would do in the result that the rest of the united kingdom decided not to enter into a union. >> on the 18th of september next your scotland has the opportunity to gain the stewardship of the oil and gas assets for the benefit of the

nation. on the eu, nicholas said yesterday that she didn't want special arrangements to apply to scotland. just the arrangement that apply to us now. it may have escaped her attention but uk has special arrangements within the eu. it has the opt out. it has the rebate. leave that country and you leave the special arrangements behind. >> independent is a natural choice of scotland and i cannot for the life of a think the structure that is one of fortune going up in poverty, all the big contacts, all the rise in food banks is to remain within the. >> speculation on what the post-referendum landscape might look like intensified. the thinking in the house of lords was becoming seriously theoretical. >> my lord come in the event scotland votes to secede from united kingdom in september of next year, will the general

election is still take place in scotland in may of the following year? [laughter] and if so, at what point will the scottish mps who were elected to the house of commons be asked to leave? and if it is before the general election would not result in the integration of the coalition an overall majority for the conservative party? [laughter] >> my lord, those who have been elected to this parliament in the other place, received the written a summons to the other place i don't think have any clause in it that tells them to go. clearly in the event of the unhappy event that scotland will decide to leave the united kingdom, that is the legislation to stop the united kingdom, election 2015 applying throughout. >> would've scottish peers as foreign nationals be able to retain their seats? [laughter] or would indeed my friend here

answer the question? >> here, here. >> my noble friend asked a very interesting question. [laughter] can i tell her that question 564 on page five and 68 of the document says arrangements for the house of lords will be for united kingdom to decide. house of lords will no longer be involved in legislating for scotland. >> norman smith is with me once again. that independence campaign is certainly raging north of the border. the debate, precious little debate and the rest of the uk. don't you think this whole scottish independence question will hit westminster. >> it may not because there is a real concern in the unionist parties across the board that they should not be seen as interesting in the debate in the scottish government. when we had alex hammond launching his white paper it was a notable david cameron kept his head right below the parapet. this is the one thing which i think the coalition and labour

for because alex sammons way, is if this becomes a fight between scotland and tory england. and for that reason the one thing which alex samet wants everyone in which david cameron is obsolete not going to give them is a debate. because that i think they believe would be a game changer. that actually could change the dynamic and potentially give alex samet the momentum which so far, so far he has lacked. but the no campaign which i think led by alastair darlings been accused of being very quiet, very low profile. fair criticism? >> i don't think it's a criticism. i think that is a positive. because a lot of people i think of you alastair darlings as rather a clever counterpoint than alex salmond and this is alex salmond is a very sort of

pugilistic, smart, quick witted, fast talking politician. alastair darlings is sort of like the earnest angle, much more sober, much more levelheaded. i think there is a view that actually plays to the argument which the no campaign are trying to put, which is why break up something which is working so well? why do you need to do this? i think there is a view if you're trying to engage alex salmond for having a much more abrasive character, that would actually play to his advantage. in a funny sort of way, although there have been slight crumbles about alice our ghana, ivory coast people involved in the campaign actually think he's rather a clever counterpoint. >> but for alex salmond there isn't that much joined at the moment in the opinion polls but it's not budged support for independence much about 32, 33%. >> that's absolutely true. the big caveat is that alex

salmond has been hurt before. in elections to the scottish parliament, basic the whole system was rigged to try and ensure that you could never have a majority administration. and he defeat the system and he defied the polls. if you talk to people in the s&p they would see where we are now in the independence campaign is no worse than where we were in elections for the scottish public. so he has been to before. the second thing to say is they are trying to kind of diffuse many of the crunchy issues. so we've had alex sammons and don't worry, we will keep the queen. don't worry, we will still get the same television programs. in other words, to try to play down the enormity of the event. that may reassure voters, but there's no getting away from the. he's got an awful lot of ground still to make up and not a vast amount of time to do it in. >> thanks law. now, talking of referendums, a

conservative backbencher is doing what he can to bring us closer to the date when we can all have a vote european union, or at least britain's membership of the. the reality of coalition life means it has been left to this man to introduce his own bill ring in a referendum by 2017. his bill finally cleared the comments at the end of november. >> it is right for the people to be given their say. it is right for a british government to seek a new settlement in europe. it's right for us to put that on the statute book now. it's been outstanding of my honorable friend to put this before the house, and this bill deserves the support of the house on its third reading tod today. >> this bill is not about giving the british people a choice. it is about managing the internal divisions within the conservative party. as has already been said, it is not possible in this parliament to commit a parliament which

would be elected in 2015, for what it will do. >> it's clear this house believes it is the right thing to do to go back to europe to try to get the best possible deal that we can but whatever that it looks like, to put it to the british people in and in out about. >> james wharton, but that's not the end of the. his bill still has to be scrutinized by the house of lords and his peers are likely to have plenty to say. europe is bound to be a big subject in 2014. at the end of may, elections to the european parliament are taking place, and before that, what are known as the accession rules means the first time the free movement of bulgarians and romanians across eu member states. the uk independence party, the party that wants britain to say goodbye to the eu has predicted a mass influx and there have been warnings the new parliament spent i do think today dereliction of duty of her majesty's government do not even attempt an estimate of the

numbers who make them in from romania and bulgaria on the first of january. i can understand ultimately why they decided not to publish an estimate, because they don't want to make the outrageous mistake of the previous labour government which said that the numbers from the eastern european countries would all be 13,000 a year. i understand that the population that has come in is 1.1 million. >> i made the growing nervousness of the mass influx, suggestions that the home secretary might be favoring a camp on eu migrants. >> the opportunity that is ahead of us to reform the european union, i think we should take that opportunity to look at free movement. there are concerns across europe am a number of other countries about free mother. i think it is right for us to say we should look at the accession treaties, new country them into europe, and within that we can look at the question of whether we should have greater flexibility rather than

just a period of time for transitional control. control should be in place until the national income of the country has reached a certain percentage of the main country, or indeed if migration reaches a certain level. >> joining us in the city once again, norman smith. we saw conservative backbencher saying the government had no idea about the numbers that could be coming from a romania and bulgaria. do you think that she is right? >> what is right is they give no one any good as to whether they have an idea. they've refused to engage in that whole argument. about numbers but i think the bulgarians and romanians have put data tens of thousands. certainly not on the scale we had under previous labour government, but what we have seen i think is an attempt by the government to show that it is aware of just how much anxiety there is over the issue regardless of whether these

fears materialized. and, therefore, we've seen a plethora of extensions and ideas and briefings to indicate the government is actually doing something. we that all these proposals on tightening up on benefits, tightening up on access to the health service, limiting access to social housing to try and minimize if you like the drawback to bringing people to britain. and then we that david cameron kind of floating this idea of maybe even a cap on the number of migrants. it seems to me none of this is going to happen to stop bulgarians and remain is coming on january 1. the point of it is to put down a rhetorical marker to say to the great british public, we understand your concern, we are doing something about it, we are addressing the issue. it is a rhetorical ploy to show we understand, we are listening. >> undoubtedly a hindsight of 2014 political be the european elections and ukip candidates, certain to do well. do you think the mainstream

parties have just written these elections off to the ukip victory? >> i think there is in toward ranks almost almost a fatalism that they're going to take a hammering from ukip just because of what they saw, for example, at beastly. you know, a targeted for the conservative and they pushed by ukip and no doubt the europe issue. that plays to the uk. the one thing that may trip them up is the candidates. they've had repeated difficulties with candidates coming out and saying things that they shouldn't have. you think of floodgate, bongo bongo land. the list goes on. and the problem nigel has that is what his party to be different. we are not like the others, we are more relaxed, we don't have this obsession with control and discipline. the consequence of that is sometimes from your candidates go on little walkabout and i can

like and also to difficulty. you would have to say ukip is extraordinarily well-positioned in the run up to the elections but it can't take away from the fact they have the potential to votlook at some of the candidats go awol. >> thanks very much indeed for joining us on the program. when a building project is going to cost an estimated 50 billion pounds, you might expect some details of its affirmative impact. that's what the government delivered when it published a high-speed rail bill, complete with an environmental policy here running to 30 -- 50,000 pages but a printout will wait about 1.5 times are stretched to around 21 feet in length. instead, it was all put on the memory stick. the formal consultation ends in january. the campaign complaints they only have 56 days to wait for the information, the equivalent of getting through 40 copies of war and piece. depending of course on how fast

you read. the transfer secretary told the transport committee he was fully up to speed on the high speed rail built. >> everyone will know that we get published the hybrid bill, almost 50,000 pages of detailed description work. and the first time i believe that the whole hybrid bill was us to put on a computer stick. so this represents the entire workings of the 50,000 page document. i would say though i believe that a just to is vital to our economy, to the future prosperity of the united kingdom. >> do we really know who is out there scouring the internet? the specter of big brother was raising 2013 by the former u.s. intelligence worker edward snowden. is mass leaking of details and house -- house events is carried

on both sides of the atlantic has questions. mi5 in mi6 overstepping the mark in their efforts to keep the country safe? does this building, the top secret gchq surveillance center know too much about our daily lives? was the right for the guarding newspaper to get so much detailed coverage to the revelations of mr. snowden? went in piece held a special debate on the disclosures of lib dem sprang to the defense. >> for technology changes and ththe captive state and companis to collect and analyze data grows massively, we are in danger of sleepwalking into a surveillance state. >> we are in a situation today where "the guardian" which had every right to report on this issue, which has raised important topics of debate, which has done so in a digital, a global way, an interesting way

with good journalism, has threatened the security of our country, in which today stand guilty, potentially, of mischievous behavior. >> the focus, this obsession with the garden -- "the guardian" is extraordinary. in the u.s. they are talking about the really important issues like mass surveillance and its implications to should we get onto talking about that and worry less about what seems to be -- >> this is the secret state fair, the government acted without the knowledge or commission of its citizens, a flagrant breach of individuals moral and probably legal rights. >> who is judge and jury. i would venture a state with some oversight is a better judge and jury in this process as a whole load of journalists locking themselves up and deciding that they are judge and jury spent the agencies recruit

and procedures are designed to ensure those operating within the ring of secrecy can be trusted to do so lawfully and ethically. a culture of compliance with both the letter and the spirit of the law pervades everything that they do. >> britain's spy chiefs have perhaps by definition been pretty invisible. their public appearances have been few and far between. which meant there was intense interest when the heads of mi5, mi6 and gchq came to parliament for the first ever public questioning, by the party that monitors the work of the nation's by quantization, the intelligence and security committee. >> just to clarify, we do not spend our time listening to the telephone calls or reading the e-mails of the majority. that would not be proportionate it would not be legal. we did not do it. my people are motivated by saving the lives of the british force on the battlefield,

finding kerry's, sears criminals. by meeting before the judge's mission as well. if they were asked to snoop, i wouldn't have if the workforce. >> although we appreciate you may be limited in some detail you may be would go into today, i think the public are entitled to know more about this enormous damage that you say are being caused by the publication of classified material. can either you or your coworker give examples as to how this has in your words been a gift to the terrorist? >> we've seen terrorist groups in the middle east, in afghanistan and elsewhere in south asia discussing the revelations in specific terms, in terms of the communication packages that the use, the communication packages they wish to move to. >> the mean to say this is online or are using it other ways of knowing? >> we have intelligence on a. we have seen chats on a specific terrorist groups, including

close to the home, discussing how to avoid what they now perceived to be vulnerable communication methods, or how to select communications which they now perceived not to be exploitable. i am not going to compound the damage by being specific in public. happy to be specific in private. >> it is sometimes argued that the people responsible for these publications have not mention any names, have not mentio mentd any details. they have simply referred to general capabilities. is there any validity, because it seems on the face of it that is bound to be much less damaging, if it is damaging at all? how would you comment? >> ras i can make a comment on that. i'm not sure that the journalists who are managing this very sensitive information are particularly well-placed actually to make those judgments. what i can tell you is that the leaks from snowden have been

very damaging. they put our operations at risk. it is clear that our adversaries are rubbing their hands in glee. al qaeda is laughing it up. >> you made that remark. i think we need to hear why you feel you're entitled to say that. is that just what you are sending? a bit more about why you believe that to be true spent i don't want to repeat what my colleagues have said that they have very cloudy set out just how the alerting of targets and adversaries to our capabilities means that it becomes more difficult to acquire the intelligence that this country needs. >> so with the guarding cast as a responsible the paper's editor was called upon to defend his papers record. when he came before the home affairs committee. >> now, all heads of the secure the services were very clear in their evidence to the intelligence and security committee that you have damaged this country as a result of what you have done. do you recognize what you have

done? do you accept that this has damaged the country? this is severe criticism that i haven't seen before from the head of our security services. >> a senior administration official of the obama administered and told us last week, asked the same question, damage can he said, i have been impressed by the judgment and care that you would expect from a great news organization. and finally a senior whitehall official at the heart of these stories, september 9, i have not seen anything you have published to date which is rest lies. >> you and i both were born outside this country. i love this country. do you love this country? [laughter] >> how do you answer that kind of question? >> we live in a democracy. most of the people working on this story are british people for families in this country who love this