21/06/2012 Dragon's Eye


21/06/2012

A fresh look at politics through the Dragon's Eye. Join Felicity Evans as she probes, scrutinises and sheds light on our democratic institutions.


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Transcript


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It will be another 20 years before the tax payer has finished paying

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for Wales'' biggest PFI hospital but there are already plans to move

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some of its services elsewhere. Was it a giant waste of money? This is

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Good evening. Wales's largest private finance health project,

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Neath Port Talbot Hospital, could be about have some services

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withdrawn from it despite the fact that taxpayers will be paying for

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the building for another 20 years. The university health board that

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runs the hospital has indicated that they could be a drop in the

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number of beds at the side. It has told us that while some provisions

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might be withdrawn, the hospital will become a centre of excellence

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for others. It was a public-private partnership

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approved by an assembly in its infancy to provide a state-of-the-

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art hospital for the Neath Port Talbot area. It opened its doors in

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2002 with the health minister It cost �66 million to build

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according to the Treasury. The NHS will pay �353 million for the

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building and may miss over the course of its life. But now review

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is being undertaken into services across the region. The PFI is very

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inflexible in terms of its contract. It sucks money in. A we are 10

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years into a 30 year contract about that and we'll be paying as a

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health board for another 20 years. It makes sense. I am not an

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accountant but a surgeon. However it seems pretty obvious we will

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want to get the best value at this hospital. So although we are

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looking in general and moving services closer to be's homes,

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doing more at home, more in the community and or in primary care,

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curiously this hospital is probably less likely to see big changes in

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the bed numbers. But what it will do is see changes in what goes on,

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as were all our hospitals. hospital has 270 beds and provides

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a range of in-patient and out- patient services, including dealing

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with medical emergencies. It also has a number of operating theatres

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including those for orthopaedic surgery and it provides mental

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health services, including an acute unit. In a letter to a local AM,

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the health board says it needs to save �45 million to break even by

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the end of the financial year, confirming that changes are being

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proposed to a number of beds and services provided, including some

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with a mental health services. concern as an elected

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representative is to find best value-for-money bet to ensure that

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services are provided as close to people as possible and to make sure

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that we do not waste money in these contracts with PFI contractors, and

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ensure that the health services are sustained in these areas as opposed

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to being taken out of a hospital and move to other places. I have

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not had those assurances yet. board says Neath Port Talbot

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hospital will become a centre of excellence for some services,

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particularly orthopaedic surgery. But problems with finding enough

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qualified staff means other divisions may have to go elsewhere.

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We have always tried, in the NHS, to provide everything everywhere.

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Patients now expect to see consultants at the front door. Bit

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by consultants making the decisions. We do not have enough to do that

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everywhere, 24/7. The debate about Neath Port Talbot mirrors ones that

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are going on across the country. The NHS is launching a wider

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consultation about services this summer. The population is growing

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more elderly, which is just one of the issues facing the NHS. Obesity

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is increasing and the Tappin well- being between the wealthiest and

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the poorest in the country is growing. -- the gap in the well-

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being. All this comes as NHS budgets are being cut in real terms.

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That is why politicians, NHS managers and academics are telling

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us we cannot go on doing things the way they have been done the past.

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But the board argues that money is not the main driving force behind

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the proposed changes. People are always suspicious that change is

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about saving money. Let's be clear - we do need to make the NHS's

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money go further. But there is never a bad time to try to improve

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the quality of what we are doing and luckily, high quality, better

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care nearly always translates into cheaper care. If I do run operation

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and the patient has a complication, that is bad for the patient but it

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is also bad for the Budget. Welsh and UK governments have put a

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hold on the PFI contracts that led to the building of this hospital.

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For that contractor cost the taxpayer so much when we are

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hearing that services may change and when things may need to change

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next year, and we are hearing that staff may be moved, these are vital

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concerns for the future. We really need to ensure that if the

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government are entering into such contracts that these are taken into

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regard and I do not think they were at the time. The answer is to go

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back to government procurement using property government capital,

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which is either raised through borrowing it and itself all through

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taxation. But this mechanism whereby the Government is borrowing

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from the banks that very high rates of interest is actually

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unsustainable. The private financing of public projects was

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always controversial. As budgets shrink and Murray becomes tighter,

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questions will be asked about ensuring the best possible value. -

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- money becomes tighter. During the is a representative of

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the University of Glamorgan and the conservative AM Mig- Ramsey. There

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was a report last year where the Treasury Select Committee said that

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these BFI's were not providing good value for money for the taxpayer.

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Do you think there is still a role for the private sector? There is,

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but it is true to say that the early PFI projects were not well

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managed. Beryl all sorts of disaster stories about how they

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were originally set up. -- there are. But at this point, for us to

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say there is no role at all for the private sector, as there was

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government seems to repeatedly tried to say, that is nonsense. I

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don't think people cared whether the funding is coming from the

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private sector or the public sector. But they care whether they are

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getting good value for money. do, and day care whether they are

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getting the service they won. If it is necessary to rely on a PPI to

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provide those services, I don't think we should cut off our noses

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to spite our face. I think they are historical mistake, the way they

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have been constructed. Their only merit was that they brought forward

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capital investment that would not have been possible otherwise, but

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that it huge cost. If we are to use private capital in future, we have

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to find a new way of doing it. In the next few years, the banks are

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not going to have a lot of money to spare anyway. We will park that all

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the moment and talk about the in flexibilities you were mentioning.

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The taxpayer is in a long-term contract for this hospital and they

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rather the 20 years ago. Does that mean that any Port Talbot is, in

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fact, protected weather comes to decisions being made? And if so it

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does it mean that clinical decision-making is being skewed by

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such inflexible contracts? That is certainly possible. That hospital

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is further away from the exit and some of the others because of the

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cost of coming out of the contracts. It is quite possible, however, in

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that part of Wales that those beds are going to be needed and if they

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can be used in different ways, we may have a happy ending to the

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story. But it is an inflexibility and in the overall pattern of

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health care, that sort of rigidity is not a good idea. I think that

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the NHS will change. It has to change. But I am deeply unhappy

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with the way there was government are approaching this by simply

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thinking reconfiguration is the answer. In certain areas, an amount

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of reconfiguration will be helpful but it has got to address local

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needs. There are deep concerns amongst people across certain parts

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of Wales about where these services are being threatened with

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withdrawal, and his reconfiguration the answer? You can reconfigure and

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reconfigure like we have done with local government. The big problem

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for the NHS in Wales is that it was government is cutting its budget

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far more than it should be. Even if it was not, do you accept that

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demand would still be rising with end elderly population, and the NHS

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cannot continue in the way it has? Yes, the NHS has to change. Anyone

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who denied that would be mad but what I am saying is that that

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change has to be responsible stop it is not a one size fits all

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imposed by Cardiff. It has got to listen to local people. People

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attending the Prince Philip Hospital in Llanelli are worried

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about losing their services. Does the poor are not wrong. The whole

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point of as having a Welsh assembly is to listen to the concerns of

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local people. People are concerned when they hear about

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reconfiguration of services and that services may be moved further

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away from them - what is your position on that? The problem is

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that we have had a very poor public debate on these issues. A lot of

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the bin in Wales who are worried and are labouring under a lack of

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information I have not had a grown- up debate that they need to have.

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Solutions must be locally relevant and people must be persuaded that

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they are necessary. At the moment, people simply do not know the facts.

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Do you think reconfiguration is necessary? Or we are going to see

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some major changes. It is about saving people's lies in reducing

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the amount of disability people suffer. -- saving people's lives.

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We need to have this intelligent debate otherwise the whole thing is

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shrouded in suspicion. We only found doubt yesterday that Cardiff

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Ebbw Vale the trust had been bailed out by a loan. We do not know when

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that was. Let's have a transparent debate but let snow from the

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government what the facts are first otherwise we are trying to make

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policy in the dark. A people want hot for hospitals at a safe,

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effective and efficient, don't they? However you achieve that,

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that is what people want. Yes, and hospitals have to meet a certain

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standard. What I am saying is that there was Government's policy

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should not simply be to speak, "we think this will see Duke". It has

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to address local needs and concerns. -- this will suit you.

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Somewhat parents are having to make more than seven years for children

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with autism to be diagnosed. One in 100 children is born with the

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condition, a lifelong develop mental difficulty that affect how

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people communicate with others. There was government says it has

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only world-leading strategy that it published in 2008 but we can reveal

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that a commission -- a report published by the government

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revealed a number of witnesses. am going to take you into my world.

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Imagination. I will show you how autism affects kids in different

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ways. The BBC recently run at a series about autism on the

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children's Channel CBBC. It discussed issues around autism and

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young people. For some people on the orders and Spectrum, life can

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be confusing but the parents of children showing symptoms of autism

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spectrum disorder, life can be very frustrating. We have heard of

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parents having to wait seven years for a diagnosis. Often until they

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get it, there is little help on offer. The government says its

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waters and strategy is world- leading but the parents we have

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spoken with do not quite agree with that. Lisa from Pembrokeshire had

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to wait over two years for a diagnosis. A I was more or less

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begging for a referral to an educational psychologist to because

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I could see that there was something unusual about my child

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that I could not see in other children of the same age. She has

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since set up a Facebook support group for parents like her. Collins

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I have heard this as a lot - that we have a world-leading autism

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strategy. That sounds fantastic. Aren't we lucky in Wales, to have

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this were leading strategy? That is all very well but we are not seeing

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the benefits in Pembrokeshire. If Pembrokeshire is world-leading,

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then I dread to think what the rest of the world must be like! We are

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floundering. Parents are desperate. One parent whose child had had to

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wait five years for a diagnosis did not want to be identified but told

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us about the experience. My child is of very high intelligence but it

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is getting worse by the day as far as their anxiety levels go. Her

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adverse are more and more frequent and violent. We have nobody to turn

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to, no help and no support. I don't know how I can maintain my job as I

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have been called to the school on a daily basis. Jonathan was diagnosed

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with autism at 21 and says that having an diagnosis made all the

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difference. I think it is crucial. The younger Tilda is diagnosed, the

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better it is for them because going through the education system not

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being understood is extremely to challenging. I think parents a need

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that time to get to grips with the 18 months ago, they commissioned a

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report, looking specifically at young people, crucially, it sought

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the views of clinicians. Their Last night, the National autism

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society was celebrating 50 years of service. It was attended by the

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deputy minister responsible for social services. It is the largest

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orders and charity in Wales and it says the situation here is not as

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good as it should be. More people in Wales are waiting three years or

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more for nought as an diagnosis. 47 % of people in Wales said they had

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waited three years or longer. In England, that figure was 34 %. It

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indicates that people are waiting longer for a diagnosis in Wales.

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Other charities and Wales to spit that although they were not

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available to be interviewed. In April this year, the debt to the

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minister for social services was asked about the government's

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strategy. So since we published our world-leading autistic spectrum

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action plan, much has been achieved. We have developed and there -- and

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infrastructure, facilitated awareness and raising training for

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professionals and supported projects. Despite being very proud

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of the world-leading orders and strategy, the deputy minister

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declined our invitation for an interview on the subject but she

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did give us a statement and says she fully recognises the importance

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to parents and children of receiving a timely diagnosis. She

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goes on to say that workers on going to improve diagnosis in

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children and adults while ensuring greater consistency throughout

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Wales and finishes by saying that access to services is not always

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dependent on completion of a formal diagnosis or assessment. She expect

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professionals to ensure that families receive appropriate

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support at all times. Autism is in grave. One in 100 people artistic

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and it comes in all shapes and sizes. For any child with autism,

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receiving the right support at the right time can make the world of

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difference to their development but the longer they have to wait for

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that support, the more difficult it becomes.

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Arwyn Jones reporting. Mark Isherwood is the chair of the

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Assembly's cross party group on autism. I asked him for his

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assessment of the effectiveness of diagnostic services in Wales.

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are many questions that have been raised by reports and surveys. The

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fact that Wales has and daughters and strategy is a great achievement.

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-- has an autism strategy. It also has cross-party support. The focus

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must be now on the delivery of that strategy and part of that his

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diagnosis so that proper support can be put into people. We have now

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had the 50th birthday survey and 40 % said they had to wait more than

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three years to be diagnosed which is Wellow -- well above the UK

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average. That was a relatively small sample but alongside that we

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have got an official report, dated December 2010. In March or April

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this year, the deputy minister answered a question in the chamber,

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saying she was now in 20th April 12 asking the authors to carry out an

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evaluation of children's diagnostic services. But we find out now this

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report was published in 20th December 10. So the strategy is not

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all it's cracked up to be? strategy is fine but the delivery

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is the problem. Most Assembly Members can give you examples

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involving parents telling them their own horror stories. Nearly

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half reported waiting more than three years is worrying. Services

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will intervene to support a child ever there needs but in reality,

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too often, we find that children and young adults are being denied

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access to speech and language therapy services and early

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intervention services because of delays in being diagnosed. Do you

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accept that this is something the Welsh government is taking

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seriously? There is a strategy, there have ring-fenced or than �7

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million over format years for autism diagnosis and treatment,

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they have commissioned a study themselves to assess how things are

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going. Aren't those the sides -- the signs of a government trying to

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get to grips with the problem? problem is we now discover we have

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a report 18 months ago with evidence from conditions --

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clinicians themselves, talking about postcode lottery diagnosis.

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They talk about the failure and a lack of understanding among senior

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managers. That was 18 months ago. Why is the minister being briefed

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to answer questions only in April? Does she know she has got that

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report? What has been done on the recommendations given to the Welsh

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government? So when that report complains of a postcode lottery,

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that is precisely the sort of inconsistency that they Wales wide

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strategy is supposed to prevent? is. These things involve a big

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change. They involve a lot of services working together in

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communities and a lot of money is going into this. I think you

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mentioned �7 million. The priority is to ensure that funding goes to

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frontline services and this makes sure that the people need the

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support I getting it. These reports are suggesting otherwise. The fact

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we got the funding and the strategy means we are far better off than we

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were but it also indicates there are still problems at delivery

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level which the Welsh government must take responsibility for.

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you for joining us. Badges have received a lot of

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attention over the last few days after it emerged that the First

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Minister approved a plan to buy a new one for the Counsel General,

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Theodore Huckle. It's costing thousands of pounds but we're told

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that the Welsh Government's senior legal adviser needs the silver

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bullion insignia to "distinguish" him during ceremonial events. Our

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reporter, Carl Roberts, is a thrifty chap and also, it turns out,

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a frustrated Blue Peter presenter. So he made me a cheaper version.

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Frankly, I'm insulted. The trouble is, once he got out his sticky back

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plastic, there was no stopping him. Here's one he prepared earlier.

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As I'm sure you know, this is Theodore Huckle QC, the Council

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general for Wales. His duties include holding meetings and

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discussions with other law officers and in the future, he could be

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sporting what one Assembly member has been -- has described as a

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shiny badge. It gave me an idea. I have got my badge. I am waiting for

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the Council general who was answering questions over there.

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We're waiting for him to come over through that door and will see

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whether he will accept this badge. -- and we will see. This is my

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0:24:270:24:28

badge. What about this decision to buy a UA new badge? I am the lawyer

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in all of this. Into your new batch arrives, we have made you one. Will

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you accept it? Have a nice day. The Council general did not seem too

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impressed with my badge but the politician who discovered the

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information in the first place is not impressed either. Decisions

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like this, they do bring politicians into disrepute. It

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gives people the opportunity to say that politicians are all out of

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touch. Decisions like this, you can understand why people say that. It

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makes me angry when things like this happen and the people making

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the decisions don't understand that ordinary people just would not

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spend �5,000 of public money on a piece of jewellery. Business case

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recommends appears to peace with silver bullion which will cost

0:25:290:25:38
0:25:390:25:40

�5,382 including VAT. It is sure to be a busier for staff here at the

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Royal Mint, because they have won prestigious commission that will

0:25:430:25:50

raise their profile. They're making the Olympic medals here as well!

0:25:500:26:00
0:26:000:26:01

this day and age, I would have thought that many is wasted. Other

0:26:010:26:10

people might think differently. What does it matter? It's what

0:26:100:26:16

comes out through his mouth that matters. That badge want making any

0:26:160:26:23

better. It sounds like a good position to being and if that is

0:26:230:26:30

what it's worth, fair enough. Welsh government confirmed that the

0:26:300:26:34

Royal Mint had been commissioned by the First Minister to produce and

0:26:340:26:38

signed the insignia and that the cost had yet to be finalised. He

0:26:380:26:45

has already got one badge and soon he will have another one.

0:26:450:26:55
0:26:550:26:59

Our Welsh Affairs Editor, Vaughan Roderick, is here. You're here to

0:26:590:27:03

talk about the GCSE row because in England, they are planning to bring

0:27:030:27:10

back a O-levels. A leaked document said this morning the government in

0:27:100:27:17

England was considering bringing back a 2 level exam process,

0:27:170:27:23

something like O-levels. That did not impress the Liberal Democrats

0:27:230:27:32

because they had not been consulted. The Welsh Education Minister said

0:27:320:27:36

it was bonkers to launch something like that without any consultation.

0:27:360:27:40

It has erupted from nowhere, that story. The there is a review of

0:27:400:27:46

GCSEs going on in Wales at the moment. There are concerns about

0:27:460:27:52

grade inflation and the Daily Telegraph to covered last year what

0:27:520:28:00

appeared to be exam boards competing with each other. GCSEs

0:28:000:28:05

are England, Wales and Northern Ireland exam and a jointly-owned by

0:28:050:28:09

those three administrations. They are not owned by Michael Gove. Any

0:28:100:28:15

change should have been discussed between the three administrations.

0:28:150:28:20

Has Leighton Andrews ruled out his return to levels? He has absolutely

0:28:210:28:30
0:28:310:28:31

Join Felicity Evans as she takes a fresh look at politics through the Dragon's Eye.

Whether it is your local council, the National Assembly, Westminster or Europe, Dragon's Eye will be probing, scrutinising and shedding light on our democratic institutions.


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