Wales's Diabetes Disgrace

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:00:13. > :00:17.I feel that he was betrayed, and his children were betrayed. Tonight,

:00:17. > :00:22.diabetes and the price of neglect. We thought, foolishly, that a

:00:22. > :00:29.patient with diabetes in hospital would be safe. Clearly, he was not

:00:29. > :00:34.say. Diabetes in Wales is a growing problem. New figures show it is not

:00:34. > :00:38.being taken seriously enough. bottom line is it is a ticking

:00:38. > :00:44.timebomb. At the numbers go up and the pressure increases, we hear

:00:44. > :00:46.from nurses to say they can barely cope. They are moving us from task

:00:46. > :00:52.to task instead of thinking logically about the best outcome

:00:52. > :00:57.for patients. What happens when mistakes are made and questions

:00:57. > :01:07.remain? I cannot understand why these nurses have not been held to

:01:07. > :01:24.

:01:24. > :01:30.This is where memories of father are strongest. That is the back of

:01:30. > :01:38.the car. My dress was made out of Liberty silk velvet. I've still got

:01:38. > :01:46.it. Is that the old family together? Yes. They were married

:01:46. > :01:50.for almost 60 years. They have five children and many grandchildren. A

:01:50. > :01:58.noisy family? This is how you like to remember him. And that was one

:01:58. > :02:02.of the final photographs. David was a Cambridge graduate and former

:02:02. > :02:10.Royal Naval officer. He was a regional director for the Open

:02:10. > :02:17.University before he retired. He was a character, by the sound of

:02:17. > :02:26.things. Tell us about him. He was a funny man, very personable, good

:02:26. > :02:36.looking, with a very nice speaking voice. He would speak like Richard

:02:36. > :02:40.Burton. He was very hands-on, even in the mid- 1950s. He would take us

:02:40. > :02:44.on expeditions. Magical mystery tours. We had one of those camper

:02:45. > :02:52.vans, we would pile in the back and off we would go to the Norfolk

:02:52. > :03:02.coast. He was also a diabetic. two diabetic. He was not diagnosed

:03:02. > :03:08.until he was 60. He would call me a control freak. He had two bossy

:03:08. > :03:13.nurses, a wife and a daughter. had no chance at all. He did not

:03:13. > :03:17.like it because he liked good food and good wine. He found it a bit of

:03:17. > :03:24.a drag. We would nag him about what he was eating, making sure he had

:03:24. > :03:29.insulin on time. He used to say, if I need to spend the rest of my life

:03:29. > :03:39.counting grapes, there's no point. We look after his diabetes for

:03:39. > :03:40.

:03:40. > :03:48.decades. Yes. Me and my colleague. Without any hassle. In December

:03:48. > :03:54.2008, David, who was by then 80, was taken ill. His wife did what

:03:54. > :03:58.she could. His blood sugar was low, so I gave him thick brown bread and

:03:58. > :04:07.honey sandwich and a drink of orange juice. He was obviously

:04:07. > :04:15.unwell, so we sent for an ambulance. David was taken to Bronglais

:04:15. > :04:22.Hospital in Aberystwyth. He had a suspected urinary tract infection.

:04:22. > :04:26.Staff were told about his diabetes. We explained that his blood sugar

:04:26. > :04:30.was a bit high because he had sudden attacks of hypoglycaemia

:04:30. > :04:34.without any warning. We explain that he needed a snack, his routine,

:04:34. > :04:39.how we managed 10 at home. There didn't seem to be any problems with

:04:40. > :04:44.that. -- how we would manage him. He was all right, not confused,

:04:44. > :04:51.unhappy at being in hospital but we said he would be home soon. He was

:04:51. > :04:55.OK. We would take his drugs in, his record of his blood sugar as well.

:04:55. > :04:58.When they visited the next day, David was awake and alert. They

:04:58. > :05:02.were confident he would be home in time for Christmas. But in the

:05:02. > :05:08.early hours of the following morning, Mrs Joseph received a

:05:08. > :05:15.phone call from the ward. I was told his condition had deteriorated,

:05:15. > :05:18.he had a respiratory arrest, then a cardiac arrest. They had

:05:18. > :05:27.resuscitated him but his condition was very poor, and how long would I

:05:27. > :05:37.be? If you fear the worst? I was expecting him to be dead when we

:05:37. > :05:37.

:05:37. > :05:41.got there. What did you find? found him totally unresponsive,

:05:41. > :05:46.obviously had been resuscitated, and obviously had some sort of

:05:46. > :05:50.brain damage. He was not given the late-night snack he needed to keep

:05:50. > :05:53.up his blood sugar level so. He became hypoglycaemic and suffered a

:05:53. > :05:59.heart attack. We had looked after him beautifully all those years and

:05:59. > :06:02.he had been in Bronglais Hospital less than 24 hours. I find that

:06:02. > :06:09.absolutely unbelievable. It implies they were not observing him

:06:09. > :06:13.properly. David Joseph died three months later in a nursing home.

:06:13. > :06:18.Three years on, and after escaping ombudsman report, the family are

:06:18. > :06:24.still fighting to uncover the full story. This is the first time that

:06:24. > :06:29.David Joseph's widow has spoken out. The ombudsman's report was damning.

:06:29. > :06:33.It highlighted failure after failure, he's one of them basic.

:06:33. > :06:40.Taken together it contributed to his death. -- each one of them

:06:40. > :06:45.basic. The family are angry at the way he was treated but even angrier

:06:45. > :06:52.that diabetic care across Wales appears to be so inadequate. The

:06:52. > :06:56.facts are startling. Almost 20% of hospital patients has diabetes. 30%

:06:56. > :07:03.of these have experienced at least one mistake in medication. Almost

:07:03. > :07:07.70% have not seen a member of a diabetes team. Even for a family

:07:07. > :07:11.who know the system better than most, uncovering what has happened

:07:11. > :07:18.was difficult. Meeting after meeting at a hospital only make

:07:18. > :07:22.them more determined to carry on. It took a long time over three

:07:22. > :07:26.years to get anywhere with the complaint, and that is not good.

:07:27. > :07:31.Lots of people get fed up and stop but we were not going to get fed up

:07:31. > :07:39.and stop. The family's complaint was upheld by the Ombudsman for

:07:39. > :07:42.public services in Wales. He said David Joseph had received poor care

:07:42. > :07:46.David Joseph had received poor care and was let down by the NHS. They

:07:46. > :07:49.concluded if he had been given at bedtime snack and his blood sugar

:07:49. > :07:54.nominated -- monitored properly, there was a reasonable chance he

:07:54. > :07:57.would not have had a cardiac arrest. He said there was not enough

:07:57. > :07:59.detailed information to show detailed information to show

:07:59. > :08:05.exactly what happened, but found the failings had a contributory

:08:05. > :08:10.effect on his deterioration and death. In her younger days, his

:08:10. > :08:14.wife nursed at Addenbrooke's, one of the top hospitals in Britain.

:08:14. > :08:19.Caring for diabetics was part of the routine. The concern deepened

:08:19. > :08:24.when they saw his medical notes from Bronglais Hospital. This is

:08:24. > :08:30.his blood sugar when he was admitted. This is his blood sugar

:08:30. > :08:37.after his supper, on the evening he had a cardiac arrest. It rises

:08:37. > :08:41.slightly. Yes. David's consultant ordered that his blood sugar level

:08:41. > :08:45.should be monitored every four hours but this did not happen. It

:08:45. > :08:51.appears that the blood sugar charge had been altered later. Then there

:08:51. > :08:55.is a dramatic fall. Down to 1.3. That is catastrophically low. I

:08:55. > :08:58.think somebody has put that in afterwards. They had not on the

:08:58. > :09:04.blood sugar, they were meant to measure it every four hours and

:09:04. > :09:07.they did not do it. That has been added in afterwards, and the

:09:08. > :09:14.ombudsman agrees that you cannot place any reliance on that.

:09:15. > :09:18.there no other way of interpreting that? I do not think so. It is not

:09:18. > :09:22.just my interpretation, it is the interpretation of the medical

:09:22. > :09:26.advisers and the ombudsman. family photocopied the chart and

:09:26. > :09:30.produce it at one of the first meetings, where they discussed the

:09:30. > :09:36.complaint. At a later meeting, the hospital admitted they had lost

:09:36. > :09:40.their original copy. This photo copy is all that remains.

:09:40. > :09:44.nursing staff were instructed to do the blood sugar every four hours

:09:44. > :09:49.and this shows they were not doing it every four hours. The ombudsman

:09:49. > :09:52.noted that there appears to be a false blood sugar reading added

:09:52. > :09:56.retrospectively to the record. That meant he could have been

:09:56. > :09:59.hypoglycaemic for eight hours, hypoglycaemic for eight hours,

:09:59. > :10:02.which was unacceptable. He also said he took a very serious view of

:10:02. > :10:06.attempts to force of by clinical records. It was something he had

:10:06. > :10:13.criticised the health board for in a previous case. If it had been

:10:13. > :10:20.more obvious which nurse was to blame, he would have referred the

:10:20. > :10:27.matter. Peter Hickson is the chief executive of the health executive

:10:27. > :10:32.of Wales. He is responsible for monitoring hospitals. He was asked

:10:32. > :10:34.to consider the report. It is a to consider the report. It is a

:10:34. > :10:39.catalogue of things done badly, and it was unavoidable consequence, a

:10:39. > :10:46.sad one but avoidable. It was unnecessary. This was very basic

:10:46. > :10:50.stuff. Left me feeling quite empty and a poll this had happened.

:10:50. > :10:55.ombudsman expressed particular concern about diabetic care at

:10:55. > :10:59.Bronglais Hospital. This was as recently as October. Evidence

:10:59. > :11:04.gathered from healthcare support worker revealed of blood-sugar

:11:04. > :11:08.monitoring was only carried out every six hours, regardless of

:11:08. > :11:12.instructions from medical staff. The medical adviser said this was

:11:12. > :11:17.an astonishing statement, and she had great concerns in relation to

:11:17. > :11:25.the knowledge and skills about Diabetic monitoring of nurses on an

:11:25. > :11:33.acute medical ward. It also undermined the claim that staff had

:11:33. > :11:38.undergone training regarding its blood-sugar monitoring. Here in

:11:38. > :11:43.Aberystwyth at local MP Office, Elizabeth Evans has been working

:11:44. > :11:47.bid -- helping the Joseph family with their complaint. They had

:11:47. > :11:52.enough about them as a family to make sure that they took photos of

:11:52. > :12:02.the notes. Without that there would not be a case. Did it set off alarm

:12:02. > :12:02.

:12:02. > :12:08.bells? At the time, no. I just thought it was an isolated case.

:12:08. > :12:14.Since that time, other cases have come on my desk. Similar cases. Not

:12:14. > :12:21.as extreme as Mr Joseph's case but certainly bad regarding the

:12:21. > :12:26.treatment of people with diabetes. Other hospitals within the trust

:12:26. > :12:31.have the same problems. Details about these cases have emerged in

:12:31. > :12:36.the last 18 months. How worrying are these? Every case would go into

:12:36. > :12:45.hospital for a different reason, so it was issues about fluid intake,

:12:45. > :12:50.food, not eating, and any diabetic specialist will tell you that a

:12:51. > :13:00.diabetic needs to eat. Were these elderly people? Yes. I did not know

:13:00. > :13:04.this until you mentioned it. Very concerned, and I will ask questions

:13:04. > :13:09.to other health boards about the level of complaints they get about

:13:09. > :13:13.managing people with diabetes. Specifically, part of the follow up

:13:13. > :13:23.will be making it known publicly we are doing this work, and asking

:13:23. > :13:23.

:13:23. > :13:28.people to contact us if they have Mrs Joseph wants better care for

:13:28. > :13:33.diabetics in hospitals. She said it ought to be a basic nursing

:13:33. > :13:36.requirement. Nurses should know, if they are working on a medical ward,

:13:36. > :13:41.they should know about the treatment of diabetes noofplt they

:13:41. > :13:45.should know where ever they are working. Patients are not any more

:13:45. > :13:49.admitted for assessment and treatment of their diabetes. They

:13:49. > :13:55.are admitted for a variety of problems, right across the board.

:13:55. > :14:00.Diabetes is a growing problem? Absolutely. The Royal College of

:14:00. > :14:06.Nursing supports the campaign for greater awareness of diabetes.

:14:06. > :14:10.Nicola is a full-time RCN official who visits members across the

:14:10. > :14:14.country. The concerns we have are lack of education for patients,

:14:14. > :14:21.lack of education for general staff. She say this is is one of a growing

:14:21. > :14:26.list of issues facing overstretched faff staff. They feel devalued,

:14:26. > :14:32.stressed, frustrated and they feel angry that they can't give their

:14:32. > :14:39.best to their patients. That means that nurses can't deliver the care

:14:39. > :14:44.that they know they should and care goes amiss. They are juggling from

:14:44. > :14:51.task to task instead of thinking logically, what is the best outcome

:14:51. > :14:57.for patients. Concern about the care of diabetics doesn't just

:14:57. > :15:01.apply to hospitals. The fact, is diabetes is a life-long condition.

:15:02. > :15:07.Diabetics are meant to be monitored carefully to avoid what can be

:15:07. > :15:14.devastating complications. The fact, is in Wales that just doesn't

:15:14. > :15:17.happen. There is loads of information. There are 160,000 die

:15:17. > :15:24.bet nicks Wales. Each one should have nine important checks every

:15:24. > :15:30.year. Covering eyes, feet and legs and blood pressure, cholesterol and

:15:30. > :15:33.kidney function. 0% of adults with Type 1 and 43% with Type 2 simply

:15:34. > :15:39.aren't getting those vital checks. A long time since I measured my

:15:39. > :15:44.waist. It used to be a 24. I don't know what it is now! The human cost

:15:45. > :15:48.is massive. It's a ticking time bomb. People are wondering around

:15:48. > :15:55.with high blood sugars without realising it will cost them a

:15:55. > :16:00.problem. It's the major problem of kidney failure, limb loss and

:16:00. > :16:05.blindness in adults. Added to that you have vascular damage. The

:16:05. > :16:09.damage of blood large blood vessels. Diabetes is a major cause of stroke

:16:09. > :16:14.and heart attacks. You don't recover from that, generally

:16:14. > :16:19.speaking. This year, among the Olympic celebrations around the

:16:19. > :16:26.country a torch was held high for hope. Getting to carry the Olympic

:16:26. > :16:31.Flame in front of my home city will be a memory I won't forget. A dream

:16:31. > :16:35.come true for diabetic athlete Melanie Stephenson. You know,

:16:35. > :16:40.throughout the day I was still doing my blood sugar checks. Every

:16:40. > :16:44.time I did one I remembered, I'm here because I have diabetes,

:16:44. > :16:49.Diabetes UK nominated me. This is my opportunity to raise awareness

:16:49. > :16:53.that, yes, diabetes isn't a great thing to have, but you can overcome

:16:53. > :16:58.that. Monitoring her blood sugar level is an essential part of life.

:16:58. > :17:02.She depends on a pump which constantly regulates the flow of

:17:02. > :17:09.insulin into hered abouty. It frees her from having to take frequent

:17:09. > :17:14.injections. Melanie is supported by a diabetes clinic. One weekend her

:17:14. > :17:18.pump broke and she had to use another hospital. I was an out-

:17:18. > :17:22.patient for three days because nobody could help me on to the back

:17:22. > :17:27.insulin. Nobody could tell me how much insulin we should be taking.

:17:27. > :17:31.It didn't seem like we were talking the same language. Were you

:17:31. > :17:35.surprised alt that? Surprised and frightened. You imagine hospitals

:17:35. > :17:43.are safe places that are there to help you and fix you, really. They

:17:43. > :17:53.cared and they wanted to help, but the knowledge wasn't there,

:17:53. > :17:53.

:17:53. > :17:58.unfortunately. Back at Mavis' home they have unanswered question. Her

:17:59. > :18:05.daughter is a senior specialist nurse for the health board. She

:18:05. > :18:09.suspects the ward her father was brought into was under staff.

:18:09. > :18:14.admitted they were one trained member of staff down on that night.

:18:14. > :18:19.The om bus budsman noted: -- The om bus budsman noted: --

:18:19. > :18:24.ombudsman noted: From your experience, what difference should

:18:24. > :18:27.that have made to the operation of that have made to the operation of

:18:27. > :18:30.the ward? Or might have done? very well to fill in these charts.

:18:30. > :18:33.If you haven't people filling them in who are aware of the

:18:33. > :18:37.significance of any changes, that usually means it should be a

:18:37. > :18:41.trained member of nursing staff, they can't, you know, healthcare

:18:41. > :18:47.support workers can't report back to the nurses in charge if their

:18:47. > :18:50.patients have had any change in any of their vital signs. Nicola say as

:18:50. > :18:54.worrying problem is that more specialist diabetic nurses are

:18:54. > :19:00.being used to fill gaps on general wards. It means they have less time

:19:00. > :19:05.to do their main job. specialist diabetic nurses and

:19:05. > :19:09.specialist nurses being asked to come back to work ward shifts. That

:19:09. > :19:13.is worrying, who looks after the case-load they have or the clinics

:19:13. > :19:19.they have in the community? It has a knock-on effect for patients who

:19:19. > :19:24.might have a delayed clinic appointment. We asked the health

:19:24. > :19:27.boards in Wales to tell us how many specialist diabetic nurses are on

:19:27. > :19:31.their staff. Across Wales there are only two more than four years ago.

:19:31. > :19:36.An increase of just under 3%. The number of diabetics in Wales has

:19:36. > :19:40.gone up by more than 20%. This worries Nicola, who is concerned

:19:40. > :19:46.about the consequences for patients if there are fewer nurses to look

:19:46. > :19:51.after them. It means that patients are more at risk of developing the

:19:51. > :19:56.serious complications of vascular disease, cardiac and stroke as well

:19:56. > :20:01.as amputation and blindness. Many of these patients are probably

:20:01. > :20:03.frail and elderly. Specialist diabetic nurses are often relied

:20:03. > :20:09.upon to show newly diagnosed patients how to manage their

:20:09. > :20:14.condition. They look out for early signs of complications. Figures

:20:14. > :20:18.from Diabetes UK show that in Wales 2% of diabetics receive this

:20:18. > :20:22.support and and adequate information. It's another cause for

:20:22. > :20:26.concern for the health inspectorate for Wales. That's wrong. Of course

:20:26. > :20:31.it's wrong. That is missing an opportunity to help keep people

:20:31. > :20:38.well. Actually, then help them avoid needing to come into hospital

:20:38. > :20:42.at some point. Mrs Joseph, who trained as a nurse 60 years ago, is

:20:42. > :20:49.concerned about levels of training and awareness in Wales today.

:20:49. > :20:55.were all betrayed because we thought, foolishly, that a patient

:20:55. > :21:01.with diabetes in hospital would be safe and, clearly, due to mistaken

:21:01. > :21:08.ideas about the correct treatment of diabetics, he was not safe. It's

:21:08. > :21:14.now, as we've said, too late for him, but things must improve to

:21:14. > :21:19.make sure that no other patient is treated like this and suffers like

:21:19. > :21:29.that. That no other family. Hywel Dda Health Board declined our

:21:29. > :21:35.

:21:35. > :21:40.request for an interview in a The kd board also accepts the

:21:40. > :21:47.ombudsman's findings. It has apologised to the Joseph family.

:21:47. > :21:52.This health board is pioneering a scheme to reduce errors relating to

:21:52. > :21:59.medication. Had you a low blood glucose a couple of days ago?

:21:59. > :22:05.blood sugar was 2.3, I believe. They gave me two glucose tablets to

:22:05. > :22:11.take. Hannah is on a surgical ward where around 20% of patients are

:22:11. > :22:15.diabetic. It sounds to me as if you had the right treatment. Increasing

:22:15. > :22:23.awardness of the treatment required for diabetics has reduced

:22:23. > :22:31.medication errors in this area from 50% to 6%. The Board call it "their

:22:31. > :22:37.think glucose campaign." on the trolley is the hypo box They are

:22:37. > :22:42.kept on the same trolleys as blood glucose monitoring. If you do a

:22:42. > :22:46.check and you find the blood glucose is low you can pick up the

:22:46. > :22:50.hypo box and get the right treatment. It's important that we

:22:50. > :22:55.go back to the patient and check that it has worked. Often, that was

:22:55. > :23:01.the step that was missing before hand. Another invasion is new

:23:01. > :23:10.insulin charts. How many units this morning? 10. Before Sometimes

:23:10. > :23:15.people would write the number of insulin and put "u" instead of

:23:15. > :23:20."units" if you wrote 5U that could be mistaken for 50 because the

:23:20. > :23:24.units is pre-printed. In one stroke we have God rid of some of the

:23:24. > :23:28.insulin prescriptionerors that used to happen. They also have colour

:23:28. > :23:35.coded monitoring charts that alert staff when blood sugar readings are

:23:35. > :23:40.too high or too low. If it's in the red area, this know they should do

:23:40. > :23:44.something. This is the only Welsh health board using "think glucose"

:23:44. > :23:47.other areas are interested. Hywel Dda will be rolling it out in its

:23:47. > :23:54.hospitals in the new year. Welcome news for the Joseph family. They

:23:54. > :24:00.want someone to be held to account. More than three years on, no-one

:24:00. > :24:04.has been disciplined for failing to check David's blood sugar levels

:24:04. > :24:08.and apparently falsifying his records. It has taken us over three

:24:08. > :24:13.years to get to this. The nurses were not interviewed until two

:24:13. > :24:17.years after he died. That's not acceptable. I can't understand why

:24:17. > :24:21.these nurses haven't been held to account and nobody has been

:24:21. > :24:24.disciplined. The Hywel Dda Health Board say it is takes seriously any

:24:24. > :24:30.allegation of breach of professional standards. Its

:24:30. > :24:36.investigation is continuing. Since dealing with the Joseph case, and

:24:36. > :24:38.the more recent complaint involving diabetes in her area, Liz Evans is

:24:38. > :24:45.particularly concerned for diabetic patients who have no-one to speak

:24:45. > :24:50.on their behalf. If I had a parent with diabetes, obviously I would

:24:50. > :24:55.make sure, having dealt with the Joseph case, I would make sure that

:24:56. > :24:58.the needs of my relative were met. The health board told us it didn't

:24:58. > :25:04.have enough information to comment on the new cases. It said all

:25:04. > :25:07.complaints are investigated thoroughly. Rowena Jones and her

:25:07. > :25:11.sister have come to Cardiff for a meeting with the health

:25:11. > :25:17.inspectorate for Wales. They want inspections of Welsh hospitals in

:25:17. > :25:22.future to include key checks on all care for diabetic patients. A plan

:25:22. > :25:26.is currently being drawn up. think the Joseph case has got

:25:26. > :25:33.lessons for every health board and hospital in Wales and I think that

:25:33. > :25:38.there are things, in terms of awareness, the "think glucose",

:25:38. > :25:44.checking on training, checking on viability of expert advice in

:25:44. > :25:48.hospitals, in hours and out of hours plus us, as ange external

:25:48. > :25:52.inspectorate, checking those arrangements are in place, given

:25:52. > :25:56.the scale of the issue and given the very dire consequences of it

:25:56. > :26:02.not being looked after properly. I think this is fairly high up the

:26:02. > :26:07.priorities, if not near the top. wanted to ask the Welsh Health

:26:07. > :26:10.Minister Lesley Griffiths about the high level of medical errors

:26:10. > :26:14.involving diabetics in Welsh hospitals. We wanted to ask her

:26:14. > :26:21.about the poor number of health checks on diabetics across the

:26:21. > :26:24.country. And, we wanted to ask why 98% of diabetics might not get the

:26:24. > :26:33.education they need to manage their condition, but she refused to talk

:26:33. > :26:39.to us. I'm not entirely surprised the Assembly didn't want to speak

:26:39. > :26:42.to you. You tend not it speak to people if you have nothing positive

:26:42. > :26:46.to say. As far as diabetic care goes there is very little the

:26:46. > :26:50.Assembly can say that is positive. They have the new plan coming out.

:26:50. > :26:59.It's the last chance to get it right. The current number of

:26:59. > :27:01.diabetics in Wales is expected to rise to almost 300,000 by 2025. The

:27:01. > :27:06.Welsh Government say it is will focus on this issue from the new

:27:06. > :27:10.year, when it plans to begin gathering evidence that will

:27:10. > :27:14.eventually lead to a diabetes delivery plan for Wales. Rowena has

:27:14. > :27:17.just met with the health inspectorate for Wales. The family

:27:17. > :27:21.is campaigning to improve care for all diabetics. They still want

:27:21. > :27:27.someone held to account for what happened to their father.

:27:27. > :27:32.personally, don't think it's up to the grieving family to be reporting

:27:32. > :27:36.nursing staff to the NMMC. We are waiting to hear what the health

:27:36. > :27:39.board is going to do, what the outcome of any discipline ri

:27:39. > :27:49.proceedings is going to be. If they feel they will not take it any

:27:49. > :27:51.

:27:51. > :27:56.further forward we will have to think about doing that as a family.

:27:56. > :28:00.Mavis Joseph is still looking for peace of mind. Lovely blue sky.

:28:01. > :28:08.That will only come with the answers to so many questions.

:28:08. > :28:12.loved nursing. I loved the NHS, but... It's difficult to

:28:12. > :28:19.understand... I still don't understand how they could have been