16/07/2013

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:00:09. > :00:13.Tonight at Ten: Major failings lead to 11 hospital trusts in England

:00:13. > :00:16.being placed in special measures. A review mentions weak leadership,

:00:16. > :00:26.poor care and overstretched staff, as relatives say their concerns

:00:26. > :00:26.

:00:26. > :00:32.were ignored. He started to deteriorate medically because he

:00:32. > :00:35.was not getting basic care - lack of care - no care. Special teams

:00:35. > :00:38.will be sent in to improve standards, as government and

:00:38. > :00:44.opposition blame each other for what has gone wrong. If founding

:00:44. > :00:48.the NHS is considered the proudest achievement for Labour, today is

:00:48. > :00:52.their darkest moment. You should not play politics with people's

:00:52. > :00:57.lives and you should not play politics on the NHS on which all

:00:57. > :01:00.people depend. We will be asking if this review is changing the terms

:01:00. > :01:03.of the political debate on the NHS. Also tonight... The use of dead

:01:03. > :01:05.children's names by undercover police at Scotland Yard was

:01:05. > :01:08.authorised at the highest level. The missile parts discovered on a

:01:08. > :01:17.North Korean ship about to enter the Panama Canal. A special report

:01:17. > :01:23.on the American boom in shale gas and potential lessons for the UK.

:01:23. > :01:27.Here in the heat of Texas, there is a shale gas gold rush. They have so

:01:27. > :01:33.much they or even going to sell it to Britain. And, can Britain's

:01:33. > :01:39.Chris Froome hold on to the yellow jersey in the Tour de France? In

:01:39. > :01:49.the sport, Wayne Rooney is angry and confused about his position at

:01:49. > :02:01.

:02:01. > :02:05.Good evening. 11 hospital trusts in England have been placed in special

:02:05. > :02:08.measures because of major failings. A review led by NHS England's

:02:08. > :02:12.medical director, Sir Bruce Keogh, cites examples of staffing problems,

:02:12. > :02:22.poor care and weak leadership. The findings provoked bitter exchanges

:02:22. > :02:26.

:02:26. > :02:31.Some of the 14 hospital trusts in England under the spotlight due to

:02:31. > :02:36.their abnormally high death rates. 11 have been put into special

:02:36. > :02:41.measures for fundamental breaches of care. It follows inspections by

:02:42. > :02:47.the NHS medical director, Sir Bruce Keogh. One of those under scrutiny

:02:47. > :02:51.is the trust that runs Basildon Hospital, where 90-year-old Fred

:02:51. > :02:57.Harris, a war veteran, died. His granddaughter's told me after being

:02:57. > :03:04.admitted he was moved to nine wards in just 12 days. It was as if he

:03:04. > :03:08.gave up. Grandad was a fighter. To go through the war, going to

:03:08. > :03:13.hospital, it was the saddest thing and heartbreaking to watch. He said

:03:13. > :03:16.he went from a man to boy. Inspectors found Basildon Trust had

:03:16. > :03:20.seven serious preventable incidents in three years and that

:03:20. > :03:24.improvements were needed in staffing levels and infection

:03:24. > :03:30.control. We are looking at every single patient who dies in hospital

:03:30. > :03:36.to make sure that, if there are lessons to be learned, we learn

:03:36. > :03:41.them. And what does learning points are. Today's review highlights a

:03:41. > :03:46.number of concerns. At Burton Hospitals NHS Foundation Trust,

:03:46. > :03:50.staff were put on rotas requiring them to work 12 days in a row. East

:03:50. > :03:55.Lancashire NHS Trust had a high level of stillborn babies in March

:03:55. > :04:05.this year. 10 side Hospital NHS Foundation Trust was criticised for

:04:05. > :04:06.

:04:06. > :04:10.the poor management did -- deteriorating patience. Stafford

:04:11. > :04:16.hospital sparked the review. This has been seen as a watershed moment

:04:16. > :04:21.for the NHS which must never be repeated. Patients have been making

:04:21. > :04:25.serious complaints about hospitals like this for more than 10 years.

:04:25. > :04:29.Questions are being asked as to why it has taken so long for the NHS to

:04:30. > :04:36.take it seriously. The Health Secretary accused Labour of turning

:04:36. > :04:41.a blind eye to the problems in the NHS when they were in power.

:04:41. > :04:46.sounding the NHS is considered Labour's proudest achievement,

:04:46. > :04:51.today is their darkest moment, as a Labour government is exposed for

:04:51. > :04:56.caring more about its own reputation than our most vulnerable

:04:56. > :05:00.citizens in the NHS. Labour insisted the report highlighted the

:05:00. > :05:04.coalition's own failings. I hope the Government itself will learn a

:05:04. > :05:09.painful lesson from this. You should not play politics with

:05:09. > :05:15.people's lives. You should not play politics with the NHS, on which all

:05:16. > :05:20.people depend. Teams of experts are now being sent into the 11 trusts

:05:20. > :05:25.in trouble and chief executives warned that heads could roll. The

:05:25. > :05:29.NHS medical director said he hoped today would be a turning point for

:05:29. > :05:32.hospitals and their patients. As well as sending in teams of experts

:05:32. > :05:36.to the hospitals in special measures, Professor Sir Bruce Keogh

:05:36. > :05:39.has set targets to improve patient care. But some are already

:05:39. > :05:49.questioning how realistic that is, at a time when the NHS is trying to

:05:49. > :05:53.

:05:53. > :05:58.How to replace mediocrity with excellence? That is the challenge

:05:58. > :06:03.set by the Keogh report and the 14 hospital teams come seen him in

:06:03. > :06:09.action, sent into the failing trusts. One recurrent problem,

:06:09. > :06:14.inadequate numbers of doctors and especially nurses on many wards.

:06:14. > :06:19.Staff in these organisations can be difficult. Many are geographically

:06:19. > :06:24.isolated, they may be a multiple sites. Some are small hospitals

:06:24. > :06:29.which have problems recruiting. Staffing is an issue. We have taken

:06:29. > :06:34.immediate reaction when we have seen problems with staffing.

:06:34. > :06:39.report sets out achievable ambitions for improvement. These

:06:39. > :06:44.include attempting to reduce avoidable deaths. All trusts must

:06:44. > :06:49.use an early warning system if rates rise. Managers must use the

:06:49. > :06:55.wealth of data on outcomes to improve quality. There should be

:06:55. > :06:59.real-time patient feedback with complaints welcomed. Nine out of 10

:06:59. > :07:04.hospital deaths happen after emergency admissions. Like all the

:07:04. > :07:10.14 trusts reviewed, East Lancashire had higher than expected mortality

:07:10. > :07:15.in urgent care. This new resuscitation unit at the Royal

:07:15. > :07:21.Blackburn hospital opens to patients next week. It is part of

:07:21. > :07:25.the trusts solution to the serious failings uncovered. The NHS is

:07:25. > :07:30.facing a difficult future. It needs to make huge efficiency savings.

:07:30. > :07:35.Some doubt whether that is possible whilst also improving standards.

:07:35. > :07:42.cannot put my hand on my heart and say the NHS will balance its budget

:07:42. > :07:46.and provide the best possible standards of NHS care. We need to

:07:46. > :07:52.find �30 billion of efficiency savings and improved quality. That

:07:52. > :07:57.has never been done before. Death rates in NHS hospitals have fallen

:07:57. > :08:02.by nearly a third in the past decade. That improvement includes

:08:02. > :08:06.the trust put under review. The challenge is to eliminate pockets

:08:06. > :08:16.of inadequate care, which threatened to undermine the

:08:16. > :08:20.excellence bound insomuch of the NHS. -- found in so much of the NHS.

:08:20. > :08:23.Our deputy political editor, James Landale, is at Westminster. Is

:08:23. > :08:31.there a sense this review is changing the terms of political

:08:31. > :08:35.debate? In the past, no one could criticise the NHS. Events in

:08:36. > :08:43.Stafford Hospital and today's report have changed that. Criticism

:08:43. > :08:48.is possible. The Conservatives can stop talking about reforming the

:08:48. > :08:53.NHS but can place themselves on the side of patience. It allows them to

:08:53. > :08:57.accuse Labour of covering up the problems when they were in office.

:08:57. > :09:03.For years, Labour has been treated by the British people as the party

:09:03. > :09:09.that can be trusted to look after the NHS. That reputation is under

:09:09. > :09:13.attack. That is why today's exchanges were so venomous and so

:09:13. > :09:23.partisan. They are accused of smearing Andy Burnham and

:09:23. > :09:23.

:09:23. > :09:28.exaggerating the numbers of people who have died at a hospital. --

:09:28. > :09:36.hospitals. He too said that Labour has got are wedded to match and

:09:36. > :09:40.Andy Burnham should resign. -- it is said that Labour has got away

:09:40. > :09:46.with too much. The general election may be just under two years away

:09:46. > :09:50.but campaigning is well under way. And a reminder that we have a

:09:50. > :09:56.question and answer page on the inquiry into hospital death rates.

:09:56. > :09:59.Just go to the website. The link is there. The use of dead children's

:09:59. > :10:04.names by undercover police at Scotland Yard was authorised at the

:10:04. > :10:07.highest level, according to an official inquiry. It concludes that

:10:07. > :10:11.the identities of 42 children were taken and that families deserved an

:10:11. > :10:21.apology. But the children's names have not been published because of

:10:21. > :10:23.

:10:23. > :10:28.a potential risk to the officers Scotland Yard has acknowledged that

:10:28. > :10:32.a tactic it used for nearly 30 years has shocked and offended

:10:32. > :10:37.people. Undercover officers used the identities of dead children. A

:10:38. > :10:42.report says they did not break the law. It was used extensively over

:10:42. > :10:48.several decades. The tactic was seen right at the time and has

:10:48. > :10:52.authorised. The people who used the tactic did it as part of their

:10:52. > :10:54.training. Back in the days when his building used to house the

:10:55. > :11:00.registers of births and deaths, undercover police officers used to

:11:00. > :11:08.come here before their deployments began. They would look for a child

:11:08. > :11:14.that was borne about the same time as them and use that identity to

:11:14. > :11:18.create a legend - a false identity that stood up to scrutiny.

:11:18. > :11:25.Fortitude children had identities used. It is highly likely there

:11:25. > :11:29.were more. -- 42 children. It was sanctioned at the highest level.

:11:29. > :11:33.The Metropolitan Police has apologised for any offence caused

:11:33. > :11:39.but not for the tactic itself. apologise for the shock and defence

:11:39. > :11:43.that has been caused by this particular tactic. It has caused

:11:43. > :11:47.concern to the public and, for that, we apologise. The Met were not

:11:47. > :11:51.confirm the names of the children because it could be risky for

:11:51. > :11:56.operatives. A former officer has already admitted using the identity

:11:56. > :11:59.of this boy, who died at seven. The child's parents died before finding

:11:59. > :12:07.out. The solicitor of another mother said families of dead

:12:07. > :12:10.children could have been put at risk of mistaken recreation.

:12:10. > :12:15.officers had their own real identities that would protect them

:12:15. > :12:19.from being discovered. The families who appear on the birth certificate

:12:19. > :12:24.would have no protection. We have seen in one case a political

:12:24. > :12:29.activist turning up at a house of the family of the dead child, whose

:12:29. > :12:32.identity was used. More investigation is to follow after a

:12:33. > :12:40.series of claims that police officers fathered children and

:12:40. > :12:47.tried to smear innocent people as part of their undercover work. A

:12:47. > :12:52.North Korean ship has been seized by you authorities in Panama. It

:12:52. > :13:00.was stopped at the entrance to the Panama Canal as it was suspected it

:13:00. > :13:05.was carrying tracks. It was seen as an attempt by North Korea to break

:13:05. > :13:09.resolutions on arms trafficking. It has the ingredients of a thriller.

:13:09. > :13:15.A North Korean freighter is seized with what appears to be a plan

:13:15. > :13:20.Destine cargo of banned missile parts. The ship is still being

:13:20. > :13:25.searched after reportedly arriving from Cuba last week, hidden between

:13:25. > :13:32.thousands of sacks of cane sugar. Officials say they have found this

:13:33. > :13:39.- suspected components to missiles strictly banned by UN sanctions.

:13:39. > :13:44.The President came aboard for a personal inspection.

:13:44. > :13:49.TRANSLATION: This is extremely sophisticated. These are aerial

:13:49. > :13:55.defence missiles. We do not know what is inside the other containers.

:13:55. > :14:01.Panama is a peaceful country, not one of war. Here is a breakdown of

:14:01. > :14:06.the route taken by that North Korean ship. On 17th April, it left

:14:06. > :14:11.the Russian port and crossed the Pacific Ocean. Analysts say the

:14:11. > :14:18.ship's transponder was switched off, arousing suspicions. On 1st June,

:14:18. > :14:23.it passed through the Panama Canal, stated destination Havana. Then it

:14:23. > :14:28.disappeared. On July 11th, it arrived back in Panama and was

:14:28. > :14:37.ordered back to port. A day later, the ship was searched. Noss career

:14:37. > :14:41.has fruit -- North Korea has few friends internationally. There is a

:14:41. > :14:46.long-standing diplomatic and military co-operation. The chief of

:14:46. > :14:51.staff of the North Korean Army visited Havana earlier this month.

:14:51. > :14:57.This seizure - this shipment - might be seen within the wider

:14:57. > :15:03.context of renewed military co- operation. Panama says the North

:15:03. > :15:06.Korean crew of 35 put up a fight and broke the cranes to make it

:15:07. > :15:16.harder to unload. It will take days to find the answers they are

:15:17. > :15:22.

:15:22. > :15:27.The American boom in energy supplies is not just limited to oil. The

:15:27. > :15:31.latest boom is underway extracting gas from shale rock, deep

:15:31. > :15:39.underground, from a process known as fracking. The trade has boosted

:15:39. > :15:45.sales of US gas by 600% over 12 years. The US. Selling gas to

:15:45. > :15:49.Britain by 2015. David Shukman has sent this report from Texas.

:15:49. > :15:58.A glimpse of the underworld, a 3-D view revealing the geology beneath

:15:58. > :16:03.our feet. This is the latest way to discover shale, a type of rock

:16:03. > :16:08.holding so much gas it is transforming the future of fuel.

:16:08. > :16:14.has changed the face of the energy picture in the US. In 2007 we were

:16:14. > :16:23.looking at import in gas to the US. In 2015 we are looking at exporting

:16:23. > :16:29.gas. Southern Texas is one shale gas frontier. America now produces more

:16:29. > :16:32.gas than Russia, and the key is fracking, breaking up the shale.

:16:32. > :16:38.Fracking has been around for years but new techniques keep making it

:16:38. > :16:43.easier all the time to get hold of the gas which lies deep underground.

:16:43. > :16:46.The first stage is to drill straight down, maybe for a mile or more. Then

:16:46. > :16:52.to turn the drill horizontally and run it right through the layer of

:16:52. > :16:56.shale rock. The aim, to get at tiny fissures of rock. Some are less than

:16:56. > :17:03.a millimetre across. Inside them are molecules of gas trapped down

:17:03. > :17:12.inside. What is called slip of water and chemicals are pumped in at high

:17:12. > :17:15.pressure. This is to widen those fissures. Tiny grains, a bit like

:17:15. > :17:18.sand are added to the mix and they are designed to hold the cracks

:17:18. > :17:26.open. What this does is release the gas. It is then flushed along

:17:26. > :17:29.through the drill pipe and then back up to the surface. New research is

:17:29. > :17:38.enhancing how this process happens all the time. What this means is

:17:38. > :17:42.there is a shale gas boom underway. A mass of machinery. One risk of

:17:42. > :17:50.fracking is Tremor is, but they are very rare. Another risk is polluting

:17:50. > :17:58.the water. If the work is not done carefully. In open country there are

:17:58. > :18:06.few objections but it is controversial close to homes. This

:18:06. > :18:11.man had fracking right on his doorstep, just beside his house in

:18:11. > :18:15.California. The company involved would not comment. The fracking was

:18:15. > :18:19.for oil and not gas but the process was the same. It was a major

:18:19. > :18:26.inconvenience because of the activity around the lock, the

:18:26. > :18:30.smells, the dust on the road from the amount of trucks, the noise.

:18:30. > :18:35.fracking is worth billions. This terminal in Louisiana, built to

:18:35. > :18:40.import gas is now being converted to export it. American shale gas will

:18:40. > :18:47.be sent from here to Britain, Spain and other countries, potentially

:18:47. > :18:52.huge business. So fracking operations are speeding up, with

:18:52. > :18:56.more than a million in America so far. There is a lot of opposition.

:18:56. > :19:03.One state has banned it but with huge demand for the fuel, a gold

:19:03. > :19:07.rush is on. A review led by the Liberal

:19:07. > :19:14.Democrats exploring alternatives to Britain's Trident nuclear deterrent

:19:14. > :19:16.has highlighted divisions within the coalition government. The report

:19:16. > :19:18.proposes cutting the number of missile carrying submarines which

:19:18. > :19:22.the Lib Dems insist will not want demise national-security but the

:19:22. > :19:29.defence secretary Philip Hammond says the decision is either naive or

:19:29. > :19:32.reckless. For more than 40 years, the UK's

:19:32. > :19:38.nuclear armed submarines have stormed the seas, with at least one

:19:38. > :19:43.on patrol at any given time. That is seen by supporters as the ultimate

:19:43. > :19:49.guarantee of the UK's security. Its ability to launch long range

:19:49. > :19:53.missiles at a moment notice, deterring a potential attack. But

:19:53. > :19:58.the Trident system will reach the end of its current life at the end

:19:58. > :20:04.of the decade, renewing it could cost �20 billion. The Liberal

:20:04. > :20:08.Democrats insisted on a review as to whether there was a cheaper option.

:20:08. > :20:13.We can adapt our deterrent in the 21st century by ending 24-hour

:20:13. > :20:17.patrols when we do not need them and buying fewer submarines. That way we

:20:17. > :20:24.can take a big step down the ladder of disarmament and keep our country

:20:24. > :20:28.safe. At the moment, the UK has four Vanguard submarines armed with

:20:28. > :20:32.nuclear weapons. But the review says it could end 24-hour patrols and go

:20:32. > :20:37.down to three submarines, although it has ruled out other ideas such as

:20:37. > :20:42.using cruise missiles and, aircraft. All this has highlighted the

:20:42. > :20:47.coalition's differences. If you reduce from four boats to three

:20:47. > :20:52.boats, that is not at all the same level of deterrence. It would not be

:20:52. > :20:58.credible as a deterrent on the same scale. For a small saving in money,

:20:58. > :21:01.it is making a big reduction in Britain's nationals at it if.

:21:01. > :21:05.decision on replacing the Vanguard submarines does not have to be made

:21:05. > :21:11.until after the next election, allowing plenty more time for debate

:21:11. > :21:14.over what having the deterrent means for the UK and its allies abroad.

:21:14. > :21:20.Whether we like it or not, people still admire and respect brute

:21:20. > :21:22.force. We have not gone beyond that. The possession of nuclear

:21:22. > :21:28.weapons and an effective deterrent are extremely important to

:21:28. > :21:32.Britain's face in the world. Without a like-for-like replacement for

:21:32. > :21:37.Trident, some fear the UK's permanent seat on the UN Security

:21:37. > :21:41.Council could be at risk. But antinuclear campaigners, CMD, say

:21:41. > :21:45.the government's review should have looked at not replacing Trident at

:21:45. > :21:49.all. The BBC has revealed that the cost

:21:49. > :21:54.of investigating the Jimmy Savile scandal and other related issues has

:21:54. > :21:57.reached more than �5 million. The figure was published as part of the

:21:57. > :22:04.corporation's accounts and annual report, which also includes details

:22:04. > :22:07.of some of the BBC's most successful programme exports. We can talk to

:22:07. > :22:13.David Sillitoe outside New Broadcasting House. The BBC says

:22:13. > :22:17.there are extreme highs and extreme lows in this. Desperate lows was the

:22:17. > :22:26.phrase used and the most desperate was the saddle scandal. That is what

:22:26. > :22:31.lies behind these three enquiries -- the Jimmy Savile scandal. They look

:22:31. > :22:36.at what happened in the 60s and 70s, contemporary BBC culture and why did

:22:36. > :22:41.Newsnight not report on the Jimmy Savile scandal? Lord Patten, the BBC

:22:41. > :22:48.chairman said, yes, it is expensive but levels of BBC Trust are

:22:48. > :22:52.beginning to recover. It was not all bad news. For instance, we found out

:22:52. > :22:57.the programme Top Gear is now the most successful programme and the

:22:57. > :23:01.BBC commercial arm will be making even more out of it. That deal has

:23:01. > :23:05.shareholders and they paid those shareholders, one of them, the top

:23:05. > :23:14.gear presenter Jeremy Clarkson stands to make around �30 million.

:23:14. > :23:17.Thank you. The Prime Minister of Italy has arrived in London for

:23:17. > :23:23.talks with David Cameron and says the United Kingdom poses a big risk

:23:23. > :23:30.to the European Union. Enrico Letta was talking about David Cameron's

:23:30. > :23:33.proposed referendum on the EU. This is the Italian prime

:23:33. > :23:40.Minister's office in Rome. The 46-year-old prime minister is Enrico

:23:40. > :23:46.Letta. As he arrives for his first official visit to Britain, he warns

:23:46. > :23:52.the UK poses a risk to the future of the European Union. The big risk is

:23:52. > :23:59.the exit of the United Kingdom. In my view it would be a disaster for

:23:59. > :24:06.Europe. It would be a very negative step for the UK and for our common

:24:06. > :24:11.future. Do you think Britain can win back significant powers? Do you

:24:11. > :24:17.think that is a realisable goal? think it can be possible and it can

:24:17. > :24:22.be useful for us as well. At home, Italy is in its worst recession for

:24:22. > :24:26.20 years. Take this carpentry business, a victim of the

:24:26. > :24:33.construction industry in deep crisis. Half the staff here have

:24:33. > :24:37.been laid off and youth unemployment nationally is at 40%. TRANSLATION:

:24:37. > :24:46.There is no future. We are living day to day, hand to mouth, fighting

:24:46. > :24:52.with the banks every day. Is there a risk here of losing an entire

:24:52. > :24:58.generation which might conclude that Europe cannot deliver? I think it is

:24:58. > :25:01.the main risk and my view is really the nightmare of my job. In the

:25:01. > :25:07.midst of this crisis, there are questions about the stability of the

:25:07. > :25:13.government. Enrico Letta is in coalition with the party of Silvio

:25:13. > :25:15.Berlusconi and some of his allies are warning that if the country's

:25:15. > :25:21.highest court rejects his appeal against a corruption charge, it

:25:21. > :25:25.could ring down the coalition. course, it is their choice, they can

:25:25. > :25:33.decide what to do. But I am completely convinced that there is a

:25:33. > :25:39.big separation between what the government can do and what the

:25:39. > :25:44.destiny of Mr Berlusconi will be. For all of that, Enrico Letta

:25:44. > :25:49.insists his coalition is strong but Italy is still seen as a risk to the

:25:49. > :25:55.euro zone. As for the British government, it will want to explore

:25:56. > :25:58.what the Italian leader means when he proposes a more flexible Europe.

:25:58. > :26:03.Britain's Chris Froome has reinforced his position as leader in

:26:03. > :26:08.the Tour de France with five stages to go. He is ahead of his nearest

:26:08. > :26:11.rival by over four minutes. Froome is not just contending with the

:26:11. > :26:17.challenge of the race, he is also having to deal with persistent

:26:17. > :26:22.questions about doping. Last year, he was the servant, now

:26:22. > :26:28.he is the master. In the absence of Sir Bradley Wiggins, Chris Froome

:26:28. > :26:31.has assumed the lead in his team and the Tour de France. With success,

:26:31. > :26:37.comes the inevitable cynicism. He has two answer speculation that he

:26:37. > :26:43.is doping. I can understand why people are asking, given the history

:26:43. > :26:46.of the sport and they have been let down similar times before. But I

:26:46. > :26:52.have also been let down. I have believed in people who have turned

:26:52. > :26:58.out to be cheats and liars but I can assure you I am not. Froome began

:26:58. > :27:02.Tuesday's stage with a lead of four minutes. He has the lead's yellow

:27:02. > :27:11.jersey. He has team-mates in black to take the headwind and watch out

:27:11. > :27:17.for opponents. Accidents can happen and one did, very nearly. There was

:27:17. > :27:25.little margin for error. One of his big rivals, Alberto Contador, was in

:27:25. > :27:30.a rush. Trying to avoid that fall almost cost Froome. He was off the

:27:30. > :27:34.road and briefly off his bike. He resumed unscathed and accused his

:27:34. > :27:40.rider of being careless. It was a timely reminder that nothing is

:27:40. > :27:45.straightforward. One little accident and that can be the end of your

:27:45. > :27:50.tour. I'm trying to take the least this cover can but stay at the front

:27:50. > :27:55.of the race. He is still four minutes and 14 seconds ahead