Browse content similar to 29/05/2013. Check below for episodes and series from the same categories and more!
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NHS can schedule your much-needed operation, but it is on a Friday and | :00:14. | :00:17. | |
you are much more likely to die than after the same operation on a | :00:17. | :00:23. | |
Monday. Why is the date of the week a matter of life and death? We will | :00:23. | :00:28. | |
discuss with the medical director of NHS England. | :00:28. | :00:32. | |
David Cameron is looking for friends in Europe as he tries to renegotiate | :00:32. | :00:37. | |
our membership. The Polish foreign minister tells us whether Britain in | :00:37. | :00:39. | |
or out really matters to the rest of the continent. | :00:39. | :00:46. | |
The cosmopolitan world of the Afropolitan, roots in Africa, home | :00:46. | :00:51. | |
in Europe or North America, Taiye Selasi on the nomadic culture of the | :00:51. | :00:57. | |
21st century. No need to worry, termite you see | :00:57. | :01:01. | |
before you the artistic, sensitive side of me. | :01:01. | :01:07. | |
Now, it is one of the BBC's great iconic brands, so why was Doctor Who | :01:07. | :01:17. | |
:01:17. | :01:17. | ||
so badly neglected in the lost decade of the 1980s? | :01:18. | :01:22. | |
Could evening. If you wander into Sainsbury's or Tesco's, you would | :01:22. | :01:27. | |
expect the same range of food and roughly the same service, but if you | :01:27. | :01:32. | |
end up in hospital at the weekend, you do not get the same service as | :01:32. | :01:37. | |
on a weekday. You are more likely to die. Researchers have discovered if | :01:37. | :01:42. | |
your operation is on a Monday, your survival rate is 50% higher than the | :01:42. | :01:46. | |
same procedure carried out on a Friday. This raises questions. Why | :01:46. | :01:51. | |
the discrepancy, and with something approaching seven-day service and | :01:51. | :01:57. | |
the lottery? Whether we are sick during the day | :01:57. | :02:04. | |
or at night on a weekday or at the weekend, we rely on the NHS to treat | :02:04. | :02:09. | |
us the same. But that does not always happen. In the past, research | :02:09. | :02:13. | |
has suggested it is riskier for patients to be admitted over the | :02:13. | :02:18. | |
weekend than it is cheering the week. Now, a new study suggests the | :02:18. | :02:22. | |
same pattern applies when it comes to elective surgery. It is safer to | :02:22. | :02:26. | |
have an operation on a Monday than on Friday. The overall mortality | :02:26. | :02:34. | |
rate is low, 0.67%, but the research found that surgery carried out on a | :02:34. | :02:38. | |
Monday carries the lowest likelihood of death. Using Monday as a base | :02:38. | :02:45. | |
point, this graph shows how the risk increases. Surgery carried out on a | :02:45. | :02:51. | |
Friday carries a 44% greater risk. Weekend surgery is even riskier, | :02:51. | :02:57. | |
though the sample size for smaller. When we looked at the data, we found | :02:57. | :03:00. | |
no difference in the types of patients admitted on Friday | :03:00. | :03:07. | |
competitor Monday, -- prepared to Monday, so we think this effect is | :03:07. | :03:13. | |
likely not to be due to the patients but to the quality of care. If the | :03:13. | :03:19. | |
NHS were to offer a truly seven days a week service, we would expect to | :03:19. | :03:25. | |
see these differences even out. research bears out many patients' | :03:25. | :03:30. | |
experience, what one charity has described as weekend malaise. This | :03:30. | :03:35. | |
woman had a hysterectomy on a Friday morning. A friend came in who was a | :03:35. | :03:39. | |
nurse who noticed that my trip had run out and that my painkiller had | :03:39. | :03:45. | |
run out. She called the nurse, she was overstretched, there was too | :03:45. | :03:50. | |
much to do, not enough time. But eventually, it got sorted. Over the | :03:51. | :03:58. | |
weekend, on the Sunday, they had been let down by an agency nurse, so | :03:58. | :04:03. | |
there were only two nurses on cover. Again, they were struggling. That | :04:03. | :04:09. | |
pattern is not the same everywhere. In Southampton, some surgeons say | :04:09. | :04:18. | |
they do not see that Friday is out. Maureen Cox came in as an emergency | :04:18. | :04:22. | |
late in the week. After a tricky operation, she spent the weekend in | :04:22. | :04:30. | |
intensive care. She is recovering now. It is remarkable.Her surgeon | :04:30. | :04:33. | |
specialises in stomach and oesophagus surgery. We do this three | :04:33. | :04:40. | |
days a week, and we do not see a difference in our outcomes, we | :04:40. | :04:45. | |
scrutinise them, so we are the first to know if there is a problem. If's | :04:45. | :04:50. | |
over the past five years, we have changed the way we deliver the | :04:50. | :04:57. | |
service, so we can provide care around the clock. He says it is not | :04:57. | :05:01. | |
just a question of resources, but the way the hospital is organised. | :05:01. | :05:04. | |
We have a large number of consultants, the economies of | :05:04. | :05:13. | |
scale, and that is the future of the delivery of complex surgery. Within | :05:13. | :05:16. | |
big centres, lots of consultants, providing 24 hour care for completed | :05:16. | :05:23. | |
patients. For many, including obstetricians, that underlines the | :05:23. | :05:27. | |
need for reconfiguration in the NHS, to concentrate services in fewer | :05:27. | :05:32. | |
hospitals, let them become centres of excellence seven days a week. | :05:32. | :05:36. | |
Even those who support this recognise it is hard to sell the | :05:36. | :05:39. | |
idea of closing hospitals to patients. In the large conurbations | :05:39. | :05:44. | |
in the UK, where there are many hospitals, they do have to realise | :05:44. | :05:48. | |
there has to be rationalisation of some of the facilities that | :05:48. | :05:53. | |
hospitals can offer. It is more challenging in parts of the world | :05:53. | :05:57. | |
like where I work, in the West Country, where you have greater | :05:57. | :06:02. | |
distances, and people expect a sick core functions to be provided in | :06:02. | :06:09. | |
their local hospital. But in the cities, there needs to be greater | :06:09. | :06:16. | |
centralisation, as has been shown for conditions like/. The survey's | :06:16. | :06:19. | |
authors did not explain the differences they found, though they | :06:19. | :06:23. | |
said that as the NHS is trying to become more efficient it has two | :06:23. | :06:26. | |
make provision to ensure the best outcomes, especially for vulnerable | :06:26. | :06:32. | |
patients. Bruce Keogh is the medical director | :06:32. | :06:38. | |
of NHS England. We will also hear from Mark Porter from the BMA and | :06:38. | :06:42. | |
Philip Lee, a doctor and a Conservative MP, who thinks the NHS | :06:42. | :06:48. | |
needs a shake-up. How worried are you by the discrepancy? I am worried | :06:48. | :06:52. | |
by any discrepancies that I see. I would like to put this in some | :06:52. | :06:59. | |
context. The results for elective surgery are very good, with | :06:59. | :07:07. | |
mortality less than 1%. Some of the statistics that have been quoted | :07:08. | :07:11. | |
showing higher mortality at different times of the week need to | :07:11. | :07:15. | |
be seen in context. The authors looked at mortality two days | :07:15. | :07:23. | |
following surgery. On a Monday, the number of deaths cost 0.7 per 1000, | :07:23. | :07:29. | |
rising to 0.9 per 1000 on a Friday. Whilst that is quite a big increase | :07:29. | :07:36. | |
in percentage, in general terms, it should not frighten patients. | :07:36. | :07:43. | |
not think it is acceptable, however? No, and you will know that | :07:43. | :07:48. | |
I have been central to trying and raised the debate of how we can | :07:48. | :07:53. | |
improve services, seven days a week. It is my sense that other service | :07:53. | :07:58. | |
industries have moved on and off routine services seven days a week, | :07:58. | :08:04. | |
but healthcare has liked behind. have raised this repeatedly, as have | :08:04. | :08:10. | |
other people, but given that you are the director of NHS England, what is | :08:10. | :08:16. | |
stopping this happening? One of the things is we need to agree a | :08:16. | :08:22. | |
sustainable, clinical model and a sustainable financial model, so on | :08:22. | :08:27. | |
the half of NHS England, I am convening a forum of chief | :08:27. | :08:31. | |
executives, finance directors, clinicians, presidents of colleges, | :08:31. | :08:36. | |
to work out an agreed way forward. Many hospitals have moved in this | :08:36. | :08:43. | |
direction, you have mentioned Southampton, and they are ahead of | :08:43. | :08:46. | |
many hospitals. Others are following. There are some complexity | :08:46. | :08:51. | |
she is. Isn't one of them, if you move to seven-day working with the | :08:51. | :08:59. | |
same resources, and we know the resources problem, you can make | :08:59. | :09:06. | |
things worse? I do not believe that is the case necessarily. It is a | :09:06. | :09:12. | |
matter of working practices. Much of the research which has shown | :09:12. | :09:19. | |
differences in outcomes at the weekend has shown that by delivering | :09:19. | :09:22. | |
services in a different way we can significantly influence outcomes, | :09:22. | :09:29. | |
which has led to the Royal colleges and other professional groups | :09:29. | :09:32. | |
starting to identify potential solutions, like having more | :09:33. | :09:38. | |
consultant residents at the weekend, and improving access to diagnostic | :09:38. | :09:44. | |
services for GPs and hospitals. do you make of the argument that in | :09:44. | :09:48. | |
the end it is going to mean a bit of pain, because what has got to happen | :09:48. | :09:52. | |
is more centres of excellence, more bigger hospitals, so some people | :09:52. | :09:57. | |
will lose out occurs hospitals that do not provide surgery will have to | :09:58. | :10:02. | |
close? That is a realistic possibility. In some specialties, | :10:02. | :10:06. | |
centralising services, bringing expertise together, improves | :10:06. | :10:15. | |
outcomes. An example would be /services in London, there were 32 | :10:15. | :10:18. | |
hospitals at one point, but after the reorganisation, there will only | :10:18. | :10:25. | |
be paid hospitals -- only eight hospitals were left, and the result | :10:25. | :10:28. | |
is a lower death rate, better outcomes, more patients returning | :10:28. | :10:35. | |
home, a shorter length of stay, and tens of millions of pounds saved. | :10:35. | :10:41. | |
be clear, the outcome would be better for all of us in general, but | :10:41. | :10:46. | |
it would mean some hospitals would have to close because they would be | :10:46. | :10:53. | |
no place for them? I would not say that, but some services would have | :10:53. | :10:57. | |
to be centralised. People like to have hospitals and services near | :10:57. | :11:01. | |
their home. It is important we do not deprive people of that. But | :11:01. | :11:07. | |
where there is clear evidence that centralisation of services would | :11:07. | :11:13. | |
revive better outcomes for patients, that is an area that we | :11:13. | :11:18. | |
need to explore. We have got a slight problem with the sound, we | :11:18. | :11:24. | |
will try to fix that. That last bit was music to your ears, because you | :11:24. | :11:29. | |
are doing something that MPs are not going, campaigning for a closure of | :11:29. | :11:34. | |
a hospital in your area? I and the only one, I have been doing it for | :11:34. | :11:40. | |
three years in the Thames Valley. My constituency is practical, but I | :11:40. | :11:43. | |
have worked in the Thames Valley for almost ten years, I have looked | :11:43. | :11:49. | |
after 50,000 patients, I have long thought we needed a more | :11:49. | :11:54. | |
consolidated acute service on the M4, with more community hospital | :11:54. | :12:00. | |
locations doing the chronic care. Before I became an MP, Mike argued | :12:00. | :12:06. | |
for it, and since I have been giving it, I have done the same thing. | :12:06. | :12:11. | |
big hospital and others lose the right to do surgery, so they will be | :12:11. | :12:16. | |
closed or diminished? diminished, I would say changed. The | :12:17. | :12:21. | |
majority of expenditure is on chronic care, and most of that can | :12:21. | :12:26. | |
be delivered closer to home. With the advances of telemedicine, we can | :12:26. | :12:32. | |
be in the home or in the GP practice or in the community. The impression | :12:33. | :12:39. | |
is that a lot of MPs are responsive to the people in their area, they | :12:39. | :12:44. | |
say, do not close, do not change. the past, it was good politics to | :12:44. | :12:49. | |
defend services that were indefensible. Now, it is good | :12:49. | :12:54. | |
politics to save lives. You are a lone voice. At the moment. | :12:55. | :12:58. | |
Colleagues share my view, but they are reluctant because of the way in | :12:59. | :13:03. | |
which you describe politics. Do you see the system is being an | :13:03. | :13:09. | |
anachronism, and in the 21st century we need something different? No, it | :13:09. | :13:16. | |
has been planned, not centrally from the start, it has grown up according | :13:16. | :13:20. | |
to local need, with specialties provided in different places. But it | :13:20. | :13:25. | |
is not just there, it delivers an excellent service that we need to | :13:25. | :13:30. | |
continue to improve. This research gives us information about the sort | :13:30. | :13:35. | |
of things we need to do to continue improving. What about the things | :13:35. | :13:40. | |
Philip Lee was talking about, that way forward? The important thing is | :13:40. | :13:45. | |
getting a balance between local delivery of services and the | :13:45. | :13:48. | |
necessity to follow the evidence where it exists, to make sure we are | :13:48. | :13:53. | |
not actually delivering below standard care for conditions where | :13:54. | :13:57. | |
we can show that centralisation is best, but in other conditions, the | :13:57. | :14:03. | |
clinical evidence may show that it is not necessary to centralise, we | :14:03. | :14:11. | |
can deliver everywhere. What do you say to this view that part of the | :14:11. | :14:14. | |
NHS are run more for the benefit of people who work there rather than | :14:14. | :14:19. | |
patients? That is putting it badly? That is something that anybody in | :14:20. | :14:24. | |
any work face has to think about, are you serving the people who use | :14:24. | :14:33. | |
the service? That is the argument? The NHS has a mould of working that | :14:33. | :14:37. | |
mirrors what happens in the rest of society and we talked about | :14:37. | :14:44. | |
supermarkets being open all day and at weekends and the NHS is open all | :14:44. | :14:48. | |
day and night and takes people, whatever the need or the time. | :14:48. | :14:53. | |
about seven-day working? I am in favour of that by directly knows | :14:53. | :14:58. | |
that in order to deliver that, you need fewer sites because to have a | :14:58. | :15:02. | |
life outside of work, you cannot have a long list of district | :15:02. | :15:06. | |
hospitals in which we expect consultants to work seven days every | :15:06. | :15:11. | |
week. With a consolidated service, like with Southampton, you can have | :15:11. | :15:16. | |
more consultants and they only do so many weekends every year so in order | :15:16. | :15:22. | |
to deliver seven days, care which would address the figures that have | :15:22. | :15:28. | |
come out, you need fewer acute surgical sites. Do you accept that? | :15:28. | :15:33. | |
In some specialties, the evidence points that way. The key is to | :15:33. | :15:36. | |
follow the evidence, and where it can be shown that this specialising | :15:36. | :15:42. | |
helps, do so but that does not mean we must move to is simple solitary | :15:42. | :15:48. | |
system. That would not serve the population well. I hope the line has | :15:48. | :15:57. | |
been re-established. The political context of this is we have had the | :15:57. | :15:59. | |
Mid Staffordshire report and reports suggesting nurses should care more | :15:59. | :16:04. | |
for patients and cheap keys are not prepared to work outside of their | :16:04. | :16:08. | |
powers and so on, so the politics science that patients of being | :16:08. | :16:17. | |
softened up. -- are being. The NHS is owned by the people and it is | :16:17. | :16:20. | |
there to serve the people and rightly there will be vigorous | :16:20. | :16:27. | |
debate about the direction of travel for the NHS over the next few years. | :16:27. | :16:32. | |
All healthcare systems are in the grip of a triple pincer of | :16:32. | :16:36. | |
increasing costs and escalating demand and tight fiscal | :16:36. | :16:42. | |
environments. Those things can be very difficult to balance. What this | :16:42. | :16:47. | |
does is it provides an impetus for us to focus on new, different ways | :16:47. | :16:52. | |
of delivering services and I believe that with appropriate public rebate | :16:52. | :16:57. | |
and the intellectual capital that resides within the people who work | :16:57. | :17:03. | |
in the NHS, we can solve this. Philip, you have not blamed staff | :17:03. | :17:08. | |
but some have and the implication of some reports has been that. If the | :17:08. | :17:14. | |
basis of the reforms is trust staff more, give clinicians more power, | :17:14. | :17:19. | |
how does that square with some reports that seemed to undermined | :17:19. | :17:24. | |
the confidence of some doctors? The reforms to years ago by the | :17:24. | :17:30. | |
collation were more about trusting primary-care physicians to construct | :17:30. | :17:34. | |
services to suit patients so it was not necessarily about hospital | :17:34. | :17:41. | |
consultants. But what I must emphasise is that all I am | :17:41. | :17:45. | |
interested in is clinical outcomes, the best outcomes, and I am not | :17:45. | :17:49. | |
convinced that we have the structure, hospitals and clinics in | :17:49. | :17:57. | |
place to deliver the best outcomes. Thank you all very much. Thank you. | :17:57. | :18:06. | |
In a moment. The legacy of the 1980s version of Doctor Who. Was it really | :18:06. | :18:14. | |
rubbish? Today the European Commission continued its tiptoeing | :18:14. | :18:16. | |
away from austerity, giving France and five other countries extra time | :18:16. | :18:23. | |
to cut their deficits. But if the big European plan isn't austerity, | :18:23. | :18:27. | |
what is it? Most are waiting for the German elections in September to | :18:27. | :18:30. | |
give some kind of answer to that. But some are also nervously awaiting | :18:31. | :18:33. | |
a British referendum. The Polish Foreign Minister, Radek Shikorski, | :18:33. | :18:36. | |
is here, briefly a contemporary of David Cameron at both Eton and | :18:36. | :18:42. | |
Oxford. But first, our diplomatic editor, Mark Urban. In terms of a | :18:42. | :18:48. | |
sturdy, is the commission moving the goalposts? This is a journey and in | :18:48. | :18:54. | |
December 2011, this was meant to be tough stuff with legally enforceable | :18:54. | :19:00. | |
limits on deficit spending. We get to the report card today and the | :19:00. | :19:02. | |
European commission says that several countries have not made | :19:02. | :19:08. | |
those limits. Will they give them more time? Portugal and the | :19:08. | :19:13. | |
Netherlands, if you like, being given one more year. And another | :19:13. | :19:18. | |
group of countries, further out of line, being given two more years. | :19:18. | :19:24. | |
That includes France, one of the cheerleaders of the pact, it was a | :19:24. | :19:30. | |
different president, Spain and Poland. Not in the Eurozone at the | :19:30. | :19:35. | |
moment, they want to join but public opinion is difficult on that issue. | :19:35. | :19:40. | |
You wonder where this leaves the dreams of further European | :19:40. | :19:48. | |
integration? It is fascinating. Isn't it? David Cameron has built a | :19:48. | :19:52. | |
lot of his politics are around the referendum issue. On the assumption | :19:52. | :19:57. | |
that there must be some mean negotiation of the European treaties | :19:57. | :20:01. | |
and this thinking, when it first came into being 20 months ago, was | :20:01. | :20:04. | |
based on the idea that Eurozone countries needed closer integration | :20:04. | :20:08. | |
to save the euro, what about the rest? Their rights are to be | :20:08. | :20:13. | |
protected. This provides him with a template to open up a conversation | :20:13. | :20:18. | |
in return for helping out Eurozone countries. And the UK might get | :20:18. | :20:26. | |
concessions. Recently, key people in the -- in the EU, they seem less | :20:26. | :20:27. | |
certain that this type of fundamental renegotiation is | :20:27. | :20:33. | |
feasible and desirable. Where does this leave the support of Mr | :20:33. | :20:35. | |
Cameron? He has been doing courting of some leaders, where is the | :20:36. | :20:41. | |
support? He has had some displays of support from some governments, the | :20:41. | :20:47. | |
Netherlands, Denmark and Sweden have been helpful, at least not in | :20:47. | :20:52. | |
putting down his ideas. Angela Merkel has given him some room for | :20:53. | :20:58. | |
manoeuvre. But there is the feeling among many Europeans that there is a | :20:58. | :21:03. | |
loss of influence. Radek Shikorski in January talked about written from | :21:03. | :21:08. | |
a country which was a natural member of the triumvirate kibble of ruling | :21:08. | :21:12. | |
the EU and has moved to the category of a country of special concern. | :21:12. | :21:16. | |
That is the key thing in the coming months. What influence can Britain | :21:16. | :21:23. | |
exert in these delicate negotiations? Indeed. Thank you. | :21:23. | :21:30. | |
Radek Shikorski is here. You know this country very well and you have | :21:30. | :21:34. | |
lived here, how important is it to the people of Poland whether they | :21:34. | :21:40. | |
are in or out? It does matter, particularly to those who admire | :21:40. | :21:50. | |
Britain. You are a voice for liberal economics and for common-sense | :21:50. | :21:55. | |
approaches and you will be missed in Europe. But it is a free union and a | :21:55. | :22:01. | |
voluntary one so if you decide to leave, we will miss you and we hope | :22:01. | :22:07. | |
it will not come to that! You have been here for quite a while, this | :22:07. | :22:11. | |
debate has gone on for quite a while and are quite a few people saying, | :22:12. | :22:18. | |
make up your mind. Would that we a good idea? To decide? It would be | :22:18. | :22:22. | |
nice to resolve this. I spoke to Deputy Prime Minister this | :22:22. | :22:27. | |
afternoon, Nick Clegg, who told me that it is extremely unlikely that | :22:27. | :22:33. | |
Britain would vote to leave. When you talk about us being a country of | :22:33. | :22:38. | |
special concern, the implication of that quote, is that that we have | :22:38. | :22:46. | |
blown it? We could have been a bigger player? And we are not? It is | :22:46. | :22:50. | |
difficult to lead a club when you're considering whether to stay in or | :22:50. | :22:58. | |
out. So, yes, in that sense, you have weakened your hand. But not | :22:58. | :23:02. | |
everything is lost, some of your concerns are being impressed, like | :23:02. | :23:08. | |
the fisheries policy. And other reddish objections are relatively | :23:08. | :23:14. | |
easy to address, the working time directive, for example. That is | :23:14. | :23:21. | |
something you are getting sympathy from. Do you think we could be | :23:21. | :23:25. | |
moving towards a situation where Mr Cameron will re-negotiate certain | :23:25. | :23:30. | |
things which would amount to less that major treaty change? The | :23:30. | :23:37. | |
premise of the referendum might not be right? It would not necessarily | :23:37. | :23:42. | |
mean a change in the treaty? Well, the conditions have not been stated, | :23:42. | :23:48. | |
I understand that some of these things don't even require treaty | :23:48. | :23:56. | |
change, for example the working time directive which is the outcome of a | :23:56. | :24:00. | |
verdict of the European court of justice. And that could be addressed | :24:00. | :24:07. | |
at that level. In terms of European politics, it might mean that a | :24:07. | :24:10. | |
number of countries want to re-negotiate and they could come to | :24:10. | :24:15. | |
an agreement and that would require treaty change and the premise that | :24:15. | :24:19. | |
Mr Cameron has launched, this view of having some referendum, might not | :24:19. | :24:25. | |
be necessary? He has also, I understand, predicated the | :24:25. | :24:30. | |
referendum on his party winning an outright majority in the next | :24:30. | :24:39. | |
election. But on that point, then, you understand very well the | :24:39. | :24:42. | |
domestic political concerns and not just domestic, but within his own | :24:42. | :24:48. | |
party? I am confident that when the arguments are deployed and it is | :24:48. | :24:53. | |
explained to the Tory party that the European commission is a force for | :24:53. | :25:03. | |
:25:03. | :25:04. | ||
opening markets, for competition, for no monopolisation, when this is | :25:04. | :25:10. | |
explained how much influence Britain gets as a multiplier, in foreign | :25:10. | :25:14. | |
policy, when it is explained that America would take a very dim view | :25:14. | :25:19. | |
of Britain leaving the EU, when it is explained that European | :25:19. | :25:25. | |
directives are not just invented by the European commission. They are | :25:25. | :25:30. | |
agreed by member states. And when the alternative path is sketched | :25:30. | :25:36. | |
out, Britain going it alone, while the rest of us are making a | :25:36. | :25:40. | |
transatlantic free-trade area with America, I hope the British people | :25:40. | :25:46. | |
will take the sensible decision. That is a very interesting list. | :25:46. | :25:50. | |
a reflection on how things and Poland might see our debate here, | :25:50. | :25:57. | |
that has not been at the forefront? Our opposition is against us joining | :25:57. | :26:05. | |
the Eurozone. So nothing unusual about that. I think and hope that we | :26:05. | :26:09. | |
shall get a mature debate in Britain with a real argument being | :26:09. | :26:16. | |
addressed. But if you look at the state of the Eurozone, which we will | :26:16. | :26:20. | |
come onto, if you look at the state of that, nobody in Britain is making | :26:20. | :26:26. | |
any argument that we should join, it is seen really as either a dead duck | :26:26. | :26:33. | |
or continuing trouble and staggering towards more trouble. We are not | :26:33. | :26:37. | |
eager to join either until it fixes itself but remember, Eurozone gave | :26:37. | :26:42. | |
members one decade of extremely cheap money. And when it overcomes | :26:42. | :26:47. | |
those problems, those interest rates might converge again to something | :26:47. | :26:53. | |
like German levels and then it will be an official again to be a member. | :26:53. | :26:56. | |
You have called for more German leadership, which given the shared | :26:56. | :27:03. | |
history, could be... And they have provided that. But we are waiting on | :27:03. | :27:13. | |
:27:13. | :27:14. | ||
what will happen with the German electorate in September. It will be | :27:14. | :27:17. | |
harder fast troubled countries carry out their reforms. In Poland, we | :27:17. | :27:23. | |
introduced because of judicial limit -- constitutional limit. Some other | :27:23. | :27:30. | |
countries are only now fixing their public sector and the issue of | :27:30. | :27:36. | |
competitiveness. Yes, I think bold decisions will become possible in | :27:37. | :27:40. | |
Germany after the election but the real work is to be done in the | :27:40. | :27:46. | |
troubled economies because the Eurozone is like the gold standard, | :27:46. | :27:55. | |
it magnifies your competitiveness or lack thereof. Thank you very much. | :27:55. | :27:58. | |
There's an old Bob Dylan song, I Pity the Poor Immigrant, which | :27:58. | :28:01. | |
reflects on the rootlessness of people who move from one culture to | :28:01. | :28:03. | |
another and could have roots everywhere but end up with roots | :28:03. | :28:06. | |
nowhere. The London born novelist Taiye Selasi reflects on precisely | :28:06. | :28:09. | |
that in her work, coining the phrase Lost in Transnation and the | :28:09. | :28:16. | |
suggestion that she, among others, is an Afropolitan. One of Granta's | :28:16. | :28:19. | |
young stars and a protege of Toni Morrison, she'll explain what she | :28:19. | :28:29. | |
:28:29. | :28:30. | ||
means in a moment. A full biography of Ty Selassie 's life would require | :28:30. | :28:36. | |
a small novella. She is London born, American educated but with a deep | :28:36. | :28:42. | |
attachment to parents's West African homeland. He still way behind him | :28:42. | :28:48. | |
all those decades ago with the Ocean beside and he followed him | :28:48. | :28:52. | |
everywhere since. Why are we not filming his life or the life of the | :28:52. | :28:58. | |
men who he wishes to be? A writer and photographer, her debut novel | :28:58. | :29:04. | |
has earned her a spot in Granta's stages list of Best Young British | :29:04. | :29:08. | |
novelists. Her writing and photography raise questions about | :29:08. | :29:14. | |
the nature of identity itself. Her concept of the Afropolitan has come | :29:14. | :29:17. | |
to define a new generation of dynamic young Africans with complex | :29:17. | :29:24. | |
heritage, one foot mounted in the heartlands of Africa, the other in | :29:24. | :29:27. | |
their new Cosmopolitan lives in Western Europe and America. In the | :29:27. | :29:32. | |
Bob Dylan song, the poor immigrant wishes he stayed at home. But the | :29:32. | :29:41. | |
real question is where home might actually be. | :29:41. | :29:47. | |
You have gone they Nigerian roots, Britain, United States... Where is | :29:47. | :29:54. | |
home? I have got four of them! feels like home? There are four | :29:54. | :30:01. | |
places. It has nothing to do with geography, it is personal, which is | :30:01. | :30:05. | |
the case for the characters in this novel. When you are moving around | :30:05. | :30:13. | |
like I do and my family, home because it's -- home becomes | :30:13. | :30:20. | |
emotional, not geographical. There is a Roman India, a Roman New | :30:20. | :30:27. | |
Jersey... Some people would see all of that as enriching, because you | :30:27. | :30:31. | |
can dip into cultures, but it might be destabilising, and that is part | :30:31. | :30:38. | |
of what you write about. You can enjoy the richness of it, but you | :30:38. | :30:45. | |
are slightly uncertain of yourself, perhaps. In 2005 I wrote an essay, | :30:45. | :30:51. | |
what is an Afropolitan? Those of us who have a fraught time and touring | :30:51. | :30:56. | |
the question, where are you from? You say, I was born in London, I | :30:56. | :31:03. | |
speak with an American accent... One can become self-conscious of the | :31:03. | :31:07. | |
fact that everybody else can give a simple answer, but you are stuck in | :31:07. | :31:14. | |
between. You have written about the nature of colour itself, blackness | :31:14. | :31:24. | |
:31:24. | :31:26. | ||
and beautiful round skinned people. -- round skinned. You consciously do | :31:26. | :31:34. | |
this. Why do I reject the label Black? It is a fiction. The idea of | :31:34. | :31:40. | |
race, blackness and whiteness, is an invention, it has been doggedly | :31:40. | :31:47. | |
sustained over time and reinforced in institution, which is the best | :31:47. | :31:52. | |
way to keep things going, especially if you can get songs and slogans | :31:52. | :31:59. | |
involved, but it is a myth. I live in Rome at the moment, and I have a | :31:59. | :32:07. | |
friend who is a white American, blond haired, blue-eyed, marrying a | :32:07. | :32:10. | |
girl from Sardinia, so in the States, we would call her Italian | :32:10. | :32:16. | |
Emma and we would call him white, but my Sardinian friend's father | :32:16. | :32:24. | |
said, few marry a white men -- if you marry a white man, I will be so | :32:24. | :32:34. | |
:32:34. | :32:36. | ||
new. So what are you? When you peel back the layers of the fiction of | :32:36. | :32:41. | |
racial identity, you end up with what is more salient and human, in | :32:41. | :32:47. | |
during, and that is culture. other thing that struck me about | :32:48. | :32:51. | |
your writing, notions of beauty, the weight that is a construct, the | :32:51. | :33:01. | |
:33:01. | :33:01. | ||
Barbie culture, what's it that society gets wrong? There is a | :33:01. | :33:07. | |
character, the youngest of the four children, she has a moment when she | :33:07. | :33:12. | |
reflects that, growing up, she is aware that she wanted to look like a | :33:12. | :33:16. | |
Barbie doll, but being the daughter of an African immigrant, she does | :33:16. | :33:26. | |
:33:26. | :33:29. | ||
not. She says she looks like a doll when she would not have wanted. This | :33:29. | :33:33. | |
was an allusion to a study when the young African-American girls were | :33:33. | :33:37. | |
shown a black doll and a white doll and they all preferred the white | :33:37. | :33:47. | |
:33:47. | :33:48. | ||
doll. Intellectually, she gets it, suffering, she has a skinny blonde | :33:48. | :33:57. | |
best friend that she would rather be. That comes from the expressions | :33:57. | :34:03. | |
of hegemony, every time that she opens a magazine or tones on the TV | :34:03. | :34:11. | |
or watches a film, what is considered beautiful looks one-way, | :34:11. | :34:16. | |
and the poor immigrant looks the other way. These basic images that | :34:16. | :34:21. | |
are thrown at young brown girls are something that I try to combat with | :34:21. | :34:28. | |
documentary films and photography. We will have tomorrow's front pages | :34:28. | :34:35. | |
before the end of the programme, but prestigious is the way Peter Davison | :34:35. | :34:40. | |
chose to demonstrate the BBC's current attitude towards Doctor Who. | :34:40. | :34:44. | |
It will mark its 50th anniversary later this year, and the British | :34:44. | :34:47. | |
Film Institute has been screening stories from each incarnation of the | :34:47. | :34:53. | |
Doctor. This month, it reached the 1980s, when prestigious hospital | :34:53. | :35:02. | |
last word BBC bosses would have used to describe it. But it managed to | :35:02. | :35:05. | |
stay on air until 1989, despite the reputation that it was a bit | :35:05. | :35:15. | |
:35:15. | :35:18. | ||
rubbish. We ask Shaun Ley to go back to the 80s and explain. | :35:19. | :35:26. | |
It looks just like a body of quarry. In fact, this is another world. Put | :35:26. | :35:34. | |
this back on! OK, it is a muddy old quarry in the Home Counties. During | :35:34. | :35:37. | |
the heyday, places like this would have been full of alien invasions | :35:37. | :35:44. | |
and rubber monsters. But it has still managed to scare the living | :35:44. | :35:48. | |
daylights out of generations of kids, this one included. Then | :35:48. | :35:58. | |
:35:58. | :36:00. | ||
something changed. For this was the 1980s. It was a rough ride in the | :36:00. | :36:05. | |
1980s. It was not just the police box which dated Doctor Who. Star | :36:06. | :36:09. | |
Wars and other films delivered science-fiction with panache. | :36:09. | :36:19. | |
:36:19. | :36:20. | ||
Meanwhile, Doctor Who. On the small screen, it had a old, glossy new | :36:20. | :36:25. | |
look, but the way it was made had not received a makeover. People | :36:25. | :36:31. | |
blade used to a faster pace, more complex characters, and there was a | :36:31. | :36:34. | |
simplicity about the way it was doing things that was making it look | :36:34. | :36:38. | |
increasingly out of step. In studios, several cameras covered the | :36:38. | :36:45. | |
same scene. It relied on special effects, recorded in the same weight | :36:45. | :36:51. | |
as a courtroom drama or a soap. I was a timelord and we had no time. | :36:51. | :36:57. | |
We had to do things by pulling the plug at ten o'clock, and if we did | :36:57. | :37:06. | |
not get the scene in, it did not go in. Once more, please. We cannot. | :37:06. | :37:16. | |
:37:16. | :37:16. | ||
sorry, it is ten o'clock. Fire again! A film would have been a bit | :37:16. | :37:20. | |
more subtle in lighting this futuristic sea bass, but time and TV | :37:20. | :37:30. | |
:37:30. | :37:32. | ||
tradition served to expose the limits of the budget. Just a few | :37:32. | :37:38. | |
weeks after the green sea monster came this, a relatively new director | :37:38. | :37:44. | |
stirring things up. His Doctor Hugh debut so -- showed the programme | :37:44. | :37:51. | |
could changed. He even got the lights turned down. I knew the way | :37:51. | :37:58. | |
to present it cost to use a single camera, more than it had been used. | :37:58. | :38:02. | |
Instead of doing a whole scene at once, cutting between several | :38:02. | :38:06. | |
cameras, he tried to record like a film, one shot at a time, editing | :38:06. | :38:16. | |
:38:16. | :38:23. | ||
the accolade of a special showing at the BFI on London's South bank, part | :38:23. | :38:28. | |
of celebrations for the 50th year. It is the relentlessness of the pace | :38:28. | :38:32. | |
of the story, it starts off high and goes up from there. It is so | :38:32. | :38:37. | |
exciting. It has got a punch, there is a grittiness. It begs the | :38:37. | :38:43. | |
question, could 80s Doctor Who have been made this way all the time? | :38:43. | :38:49. | |
Could I do this in the time given? had a good try! But after the first | :38:49. | :38:55. | |
block, when I got myself into serious trouble and did not | :38:55. | :39:05. | |
:39:05. | :39:07. | ||
complete, I have to use four or five cameras per scene. But at least he | :39:08. | :39:11. | |
did get the opportunity to put his directorial stamp on a moment that | :39:11. | :39:20. | |
is uniquely Doctor Who, the change of lead actors. I must have been | :39:20. | :39:23. | |
listening to a fantastic piece of music by the Beatles, and at the | :39:23. | :39:33. | |
end, the orchestra driving itself bonkers, to a big explosion of a big | :39:33. | :39:43. | |
:39:43. | :39:50. | ||
piano chord. So I used that as my casting quality mix used by John | :39:50. | :39:54. | |
Turner, producer for the whole of the 1980s, to keep it in the public | :39:54. | :40:00. | |
eye. The programme attracted some amazing names, but sometimes the way | :40:00. | :40:04. | |
they were directed all dressed undermined the fact that they were | :40:04. | :40:10. | |
good at is. If they were being encouraged to camp it up. Sometimes | :40:10. | :40:20. | |
:40:20. | :40:22. | ||
the programme looked less drama, more pantomime. How evil! Some | :40:23. | :40:32. | |
:40:33. | :40:34. | ||
grumbled. I played my spoons on her front, and it bounced! I arrived | :40:34. | :40:38. | |
with my bag of tricks and started playing them all, but as we went | :40:38. | :40:44. | |
through, I realised, there is more, this is a great acting role, one of | :40:44. | :40:49. | |
the best on television, because you can go so many places. There was a | :40:49. | :40:56. | |
pantomime aspect, you have the glutinous and camp, and it is deeply | :40:56. | :41:06. | |
:41:06. | :41:08. | ||
sinister. You make sweets that kill people? There is a danger that | :41:08. | :41:17. | |
people only see the surface. A more contemporary travelling companion | :41:17. | :41:20. | |
allowed Doctor Who to engage in social commentary, exploring issues | :41:20. | :41:26. | |
like racism. The companion was too often there to ask the question and | :41:27. | :41:33. | |
trip over and lead to get rescued, and audiences were tired of that. It | :41:33. | :41:37. | |
was only towards the end of the decade that a hint of emotional | :41:37. | :41:47. | |
intelligence krypton. An emotional cripple, a social misfit! She was | :41:47. | :41:54. | |
the first step to what we have now. It is not true. But there is nothing | :41:54. | :42:00. | |
like a Doctor Who monster to scupper a writer's Scott -- subtext. | :42:00. | :42:06. | |
thought there would be a subtle but discernible lesbian subtext between | :42:06. | :42:16. | |
her and Cara. The subtlety of that was conveyed in the face and the | :42:16. | :42:20. | |
close-up and the movement, and this was buried under the teddy bear | :42:20. | :42:30. | |
:42:30. | :42:30. | ||
heads, which was slightly disappointing. Bold ideas like that | :42:30. | :42:35. | |
are one answer to the question, was 80s Doctor Who rubbish? Michael | :42:35. | :42:41. | |
grade could not see beyond the effects. I thought it was pathetic. | :42:41. | :42:45. | |
I had seen Star Wars, and close encounters of the third kind, and | :42:45. | :42:51. | |
ET, and then I had to watch these cardboard things clunking across the | :42:51. | :43:01. | |
:43:01. | :43:01. | ||
floor. If he moves really badly, poorly animated... But she looks | :43:01. | :43:08. | |
great. The rocks are plastic holders that do not weigh anything at all, | :43:09. | :43:13. | |
it is the dichotomy of the show, the good design and the bad design in | :43:13. | :43:23. | |
the same shop. Even a quarter of a century later, in an age of CGI, | :43:23. | :43:27. | |
some of the effects work still stands up to scrutiny. I remember | :43:27. | :43:37. | |
:43:37. | :43:39. | ||
this. It was a high Marsh to Indiana Jones. It is very effective. It was | :43:39. | :43:45. | |
brilliantly done, so simple. Very well made from wax, and they got | :43:45. | :43:49. | |
hairdryers on either side of the camera and blew onto it. It was | :43:49. | :43:59. | |
:43:59. | :43:59. | ||
glorious. Doctor! Soon, British TV viewers would enjoy the delights of | :43:59. | :44:05. | |
reality TV instead, something Doctor Who addicted, and like the people in | :44:05. | :44:11. | |
charge on Doctor Who, the BBC decided it would be better off | :44:11. | :44:20. | |
without the doctor. The execution of Doctor Who in the 80s did not always | :44:20. | :44:25. | |
live up to the bold ideas, but the youngsters who grew up with it are | :44:25. | :44:28. | |
the ones making the multi-award-winning programme now. | :44:28. | :44:34. | |
Perhaps 80s Doctor Who was the catalyst. | :44:34. | :44:44. | |
:44:44. | :45:14. | ||
To not have nightmares! The front That is it for tonight, we leave you | :45:14. | :45:17. | |
with pictures of the highest base jump ever to mark the 60th | :45:17. | :45:22. | |
anniversary of the conquest of Everest, Valery Rozov jumped from | :45:22. | :45:32. | |
:45:32. | :46:02. | ||
the North face at a height of 23,000 are continuing with sunshine to the | :46:02. | :46:08. | |
West, thicker cloud further east. Patchy rain first thing in the | :46:08. | :46:16. | |
morning. One or two showers might be heavy. Sunshine is abundant across | :46:16. | :46:21. | |
Northern Ireland. The North West of Scotland stays fine and dry. Further | :46:22. | :46:27. | |
east, a bit more cloud. The temperatures creeping up into double | :46:27. | :46:33. | |
figures along the east coast of England. A cold day. Moved inland, | :46:33. | :46:37. | |
some holes in the cloud, come the afternoon. A better chance of this | :46:37. | :46:43. | |
sunshine, we have the showers. One ought to have the potential to be | :46:43. | :46:53. | |
:46:53. | :47:00. | ||
slightly. Scotland and Northern Ireland start to see their | :47:00. | :47:05. | |
temperatures dropping away, as cloud arrives. Further south, across | :47:05. | :47:10. | |
England and Wales, things should write an up and warm up on Friday, | :47:10. | :47:16. |