Browse content similar to 12/07/2012. Check below for episodes and series from the same categories and more!
Line | From | To | |
---|---|---|---|
Party politics aside, how should we change the Welsh health service? | :00:05. | :00:15. | |
:00:15. | :00:22. | ||
This is Dragon's Eye. Good evening. People across the UK | :00:22. | :00:26. | |
are being encouraged to sign up to the Organ Donor Register as part of | :00:26. | :00:27. | |
National Transplant Week, but the debate over the Welsh Government's | :00:27. | :00:31. | |
plans to introduce an opt-out system continue to be controversial. | :00:31. | :00:33. | |
Dragon's Eye has received copies of documents under the Freedom of | :00:33. | :00:36. | |
Information Act that show that the UK Government raised concerns over | :00:36. | :00:39. | |
whether it was desirable, feasible or necessary to run two different | :00:39. | :00:45. | |
systems. The Welsh Government also promised to continue paying for the | :00:45. | :00:48. | |
UK organ donation system while it found the money for the new opt-out | :00:48. | :00:58. | |
:00:58. | :01:06. | ||
system from its own budget. Here's Brian Meechan. Ultimately everyone | :01:06. | :01:10. | |
wants to the same outcome - increasing the number of donors to | :01:10. | :01:15. | |
save lives. But how to do that is a source of passionate disagreement. | :01:15. | :01:19. | |
The transplant figures for Wales have increased in the last five | :01:19. | :01:27. | |
years. The number of donors has risen to 45 in 2007-08 to 67 in | :01:27. | :01:32. | |
2011-12. There's been a rise in the number of people on the register, | :01:32. | :01:38. | |
by 5% over the same period. The co- ordinators of the organ donation | :01:38. | :01:42. | |
system say it is because they've changed the way it operates. Since | :01:42. | :01:51. | |
2008 when the team increased to 12 and they were placed as residents | :01:51. | :01:57. | |
within hospitals, we have almost reached the 50% increase target set | :01:57. | :02:01. | |
down by the task force. Some critics of the presumed consent | :02:01. | :02:07. | |
proposals suggest kite damage the successes seen so far. People may | :02:07. | :02:11. | |
feel uneasy whether we call it presumed consent or deemed con | :02:11. | :02:16. | |
sthaent there is somehow some sort of line being -- consent, that | :02:16. | :02:21. | |
there is somehow some sort of line being crossed that their organs or | :02:21. | :02:24. | |
bodies are no longer their property. Unfortunately that might leave | :02:24. | :02:29. | |
people to take the decision to opt out. Mike Stevens a transplant | :02:30. | :02:39. | |
:02:40. | :02:44. | ||
What we are talking about is an opt-out system with safeguards, the | :02:44. | :02:48. | |
of the opt-out if you like. There is an opportunity to opt out but | :02:48. | :02:54. | |
there'll be a discussion with the family of every potential donor to | :02:54. | :02:58. | |
ascertain whether this really was their zifrplt as is the case now, | :02:58. | :03:03. | |
at the moment if your name is on the Organ Donor Register legally | :03:03. | :03:08. | |
your organs can be used for transplantation. That doesn't mean | :03:08. | :03:12. | |
that there's a mandate that they have to be removed. That's still | :03:12. | :03:18. | |
going to be the case if we change to this new proposal. Spain was | :03:19. | :03:25. | |
widely quoted as the example when presumed consent was proposed in | :03:25. | :03:29. | |
Wales. But the Spanish co- ordinators say presumed consent had | :03:29. | :03:34. | |
no impact when it was introduced and is no longer used in practise. | :03:34. | :03:38. | |
They argue that having specialist medical staff in hospitals and more | :03:38. | :03:45. | |
intensive care beds is what organs are deemed to be suitable | :03:45. | :03:50. | |
for transplantation purposes, then they must die in a critical care | :03:50. | :03:53. | |
environment. I think that research demonstrates that in countries | :03:53. | :03:58. | |
abroad where there's been a welcome improvement in levels of organ | :03:58. | :04:05. | |
donation that money has been pumped into seeing to it that there is | :04:05. | :04:09. | |
plenty of critical care space available. The Royal College of | :04:09. | :04:12. | |
Surgeons has raised concerns about operating one system in Wales and | :04:12. | :04:17. | |
another in England. It could lead to legal as well as practical | :04:17. | :04:21. | |
problems for medics, since surgeons are responsible for ensuring that | :04:21. | :04:29. | |
Scotland and England have a slightly different law and they | :04:29. | :04:33. | |
make things work without too many difficulties. I believe we will be | :04:33. | :04:38. | |
able to do the same. I believe this will be successful, as long as we | :04:38. | :04:42. | |
approach it in the right way. Scandal engulfed Alder Hey Hospital | :04:42. | :04:45. | |
in Liverpool when it emerged that organs had been removed from | :04:45. | :04:50. | |
children without consent. It led to the Human Tissue Act and the Human | :04:50. | :04:58. | |
Tissue Authority. The Human Tissue Act is very clear that consent | :04:58. | :05:03. | |
should be a positive act. That is simply -- to simply have an option | :05:04. | :05:07. | |
of opting out and being deemed to have given consent is concerning. I | :05:07. | :05:11. | |
understand why they are doing it but I think it is concerning. | :05:11. | :05:15. | |
asked the Welsh government for details of discussions with UK | :05:15. | :05:19. | |
ministers on this issue. It continuously refused to release | :05:19. | :05:29. | |
:05:29. | :05:30. | ||
Dragon's Eye received documents that showed deep concerns on the | :05:30. | :05:36. | |
part of Ministers in London about presumed consent operating only in | :05:36. | :05:40. | |
Wales. They said they weren't convinced a separate system was | :05:40. | :05:44. | |
feasible, desirable or necessary. think the problem of having two | :05:44. | :05:49. | |
systems, the problem of having people who move between | :05:49. | :05:52. | |
jurisdiction and the uncertainty of the clinicians and the surgeons, | :05:52. | :05:55. | |
clearly says that there is an issue here that has to be addressed. It | :05:56. | :06:00. | |
goes back to the starting point - what's the purpose of this is they | :06:00. | :06:04. | |
are achieving increased organ donation through education and | :06:04. | :06:07. | |
communication? The Welsh Government also told Ministers in London that | :06:07. | :06:11. | |
the new register would be funded from the Welsh budget and it would | :06:11. | :06:15. | |
be continuing to pay into the UK system too. Supporters say it is | :06:15. | :06:21. | |
worth getting behind the presumed consent model. What we'll see is an | :06:21. | :06:25. | |
increase in donors and transplants. I think the rest of the UK will be | :06:25. | :06:30. | |
looking at us with envy and are likely to change their system. I | :06:30. | :06:36. | |
think we'll be the leaders in the UK and around the world as well. | :06:36. | :06:39. | |
When matters of life and death are involved it is no surprise they | :06:39. | :06:46. | |
motions run high. As everyone aims for the ultimate goal of increasing | :06:46. | :06:50. | |
the number of donors. As it's National Transplant Week, | :06:50. | :06:52. | |
we asked the Health Minister, Lesley Griffiths, for an interview | :06:52. | :06:56. | |
on the Government's plans for organ donation. She said no, but she did | :06:56. | :06:59. | |
give us a statement. It says that the freedom of information request | :06:59. | :07:02. | |
related to issues relevant to a previous attempt to bring in an | :07:02. | :07:06. | |
opt-out system in the last Assembly. And that the Welsh Government is | :07:06. | :07:08. | |
"maintaining dialogue" with the UK Government to address their | :07:08. | :07:14. | |
concerns. It also denies that the Welsh Government will be funding | :07:14. | :07:22. | |
two systems of organ donation. Joining me now is Professor John | :07:22. | :07:24. | |
Saunders, chair of the Royal College of Physicians' Ethics | :07:24. | :07:33. | |
Committee, and the chair of Kidney Wales Foundation, Roy Thomas. You | :07:33. | :07:39. | |
are a keen supporter of the new proposals. What do you make of the | :07:39. | :07:42. | |
argument that says we are getting where we want to be anyway. | :07:43. | :07:45. | |
Donation rates are going up, the number of people signing the | :07:45. | :07:49. | |
register is going up. It looks as if the Government is going to hit | :07:49. | :07:54. | |
the target that it set itself by 2013. It is working, don't Tam we | :07:54. | :07:57. | |
are with? First of all the Government in the UK won't reach | :07:57. | :08:04. | |
its target in 2013. No, I'm talking about in a Wales. In Wales we will. | :08:04. | :08:07. | |
We've been debating this for six or seven years. The people of Wales | :08:07. | :08:10. | |
understand the issues. We understand we have a good | :08:10. | :08:13. | |
transplant unit, a world-class transplant unit in Cardiff, and | :08:13. | :08:16. | |
they understand the issues. They have through campaigns over the | :08:16. | :08:20. | |
last three or four campaigns increased the Organ Donor Register. | :08:21. | :08:25. | |
But that system is outdated. It hasn't achieved what it should | :08:25. | :08:29. | |
achieve and we need a new system. Professor, do you agree with that, | :08:29. | :08:33. | |
is the current system outdated? it is not. It doesn't work as well | :08:34. | :08:37. | |
as it should, but the rising number of people on the Organ Donor | :08:37. | :08:41. | |
Register is in Wales, that's terrific news. The percentage is | :08:41. | :08:45. | |
going up. Wales has always been ahead of the rest of the UK in this | :08:45. | :08:49. | |
respect. With respect to England, there is enormous variation in | :08:49. | :08:53. | |
English regions. None of emare quite up to Wales but one or two | :08:53. | :08:58. | |
are close to it. What are your concerns about an opt-out system? | :08:58. | :09:02. | |
It is cheerful the impact of people's choices of how many people | :09:02. | :09:07. | |
will opt out because they don't like the idea of organs being taken. | :09:07. | :09:11. | |
I don't think there's a primary ethical objection. So are you | :09:11. | :09:15. | |
concerned that perhaps the progressed that in Wales will be | :09:15. | :09:21. | |
jeopardised by an opt-out system? That's the angzifplt There is no | :09:21. | :09:27. | |
evidence of that. You talked in your clip about Spain. We've been | :09:27. | :09:31. | |
highly successful. They have more intensive care beds. We hopeful | :09:31. | :09:36. | |
will do that. It has increased donation in place like Belgium, | :09:36. | :09:41. | |
where they introduced this in 1986. The fears of people on the opt-out | :09:41. | :09:45. | |
register. They are there and I can understand that. John has a good | :09:45. | :09:52. | |
point on that. I'm clear this Wales, the BBC poll in March showed a 62% | :09:52. | :09:56. | |
support. We've only got 33% on the Organ Donor Register. It is | :09:56. | :10:01. | |
fantastic to see more people on that. I do say it is outdated. | :10:01. | :10:05. | |
about some of the concerns around safeguards and that sort of thing? | :10:06. | :10:10. | |
I know the Royal College of surgeons has been expressing | :10:10. | :10:13. | |
concerns, because legally it's the obligation of the surgeon | :10:13. | :10:17. | |
performing the transplant to ensure that proper core sent has been | :10:17. | :10:21. | |
given. What about mental capacity issues? You do have concerns about | :10:21. | :10:25. | |
how that will be dealt with, in terms of people with learning | :10:25. | :10:30. | |
disabilities, perhaps people with dementia, the mentally ill? | :10:30. | :10:35. | |
sensitivities that we have in the NHS, and Alder Hey was mentioned. | :10:35. | :10:40. | |
Alder Hey was historic. It was a very sad episode in NHS Stu, but | :10:40. | :10:45. | |
the human tissue Act dealt with that. It should be consigned to the | :10:45. | :10:50. | |
history books, now doctors are aware of consent. They do look at | :10:50. | :10:56. | |
the immediate family for guidance. Naz your clip, the organ donor co- | :10:56. | :11:01. | |
ordinators are experts all of this. What about that, that ultimately | :11:01. | :11:05. | |
because the families will still be consulted and their weres will be | :11:05. | :11:10. | |
taken into account you have the ultimate safeguard? I rather | :11:10. | :11:14. | |
support Roy's views on this. It doesn't worry me, I think it has | :11:14. | :11:19. | |
been taken care of. Roy is right to emphasise that some of these issues | :11:19. | :11:22. | |
over consent belong to pleasant experiences in the past. Gentlemen, | :11:22. | :11:25. | |
thank you. Unless you've been away all week, | :11:25. | :11:28. | |
you'll know there's been a blazing row over changes to the health | :11:28. | :11:31. | |
service. More specifically, a report into the changes. Or more | :11:31. | :11:33. | |
specifically still, e-mails between the author of the report and senior | :11:33. | :11:37. | |
Government officials. In all the political mudslinging, it's easy | :11:37. | :11:41. | |
enough to forget the real issue - the far-reaching changes to the NHS | :11:41. | :11:45. | |
in Wales. We know it's difficult, we're told it's necessary, but is | :11:45. | :11:55. | |
:11:55. | :11:57. | ||
it achievable? Arwyn Jones reports. Since taking the job just over a | :11:57. | :12:01. | |
year ago the Health Minister has said on several occasions she will | :12:01. | :12:06. | |
have to face some flak over influence restructure hospitals in | :12:06. | :12:10. | |
Wales. This week she saw exactly what that flak can look like. | :12:10. | :12:15. | |
do accept that you do not have a grip on your department? We can | :12:15. | :12:19. | |
have no trust in the Welsh Government now. The people of Wales, | :12:20. | :12:24. | |
Llanelli and Mid and West Wales will feel they've been sold a pig | :12:24. | :12:31. | |
in a poke. Let's see what led to such a tumultuous week in Wales | :12:31. | :12:37. | |
politics. The report was to articulate the reasons why health | :12:37. | :12:42. | |
boards need to change services. And to help health boards in engaging | :12:42. | :12:45. | |
with their communities about the future of hospital services in | :12:45. | :12:50. | |
Wales. The report published in the spring said mortality rates for | :12:50. | :12:55. | |
general surgery, trauma and oorth pedics, general medicine and stroke | :12:55. | :12:59. | |
services are higher in Wales than in England. It said there is | :12:59. | :13:02. | |
evidence that centralising emergency surgery brings mortality | :13:02. | :13:07. | |
rates up to the English average, and mortality for heart attacks, | :13:07. | :13:10. | |
stroke and major trauma are improved when services are | :13:10. | :13:15. | |
centralised. It also said that outcomes improved significantly if | :13:15. | :13:19. | |
patients receive the right care and treatments within the first golden | :13:19. | :13:23. | |
hour of falling ill or getting injured. So what's caused this | :13:23. | :13:27. | |
debate? Well this, week BBC Wales highlighted e-mail correspondence | :13:28. | :13:32. | |
between the author of the report, Professor Marcus Longley, and | :13:32. | :13:36. | |
senior Welsh Government officials. In one e-mail exchange, Professor | :13:36. | :13:40. | |
Longley asks the medical director of the NHS in Wales, Dr Chris Jones, | :13:40. | :13:44. | |
for more killer facts. And expresses concerns that the | :13:44. | :13:48. | |
evidence as presented does not seem to be as incisive as we might have | :13:48. | :13:53. | |
hoped. Who, asked the opposition, is we? In another, he asks for more | :13:53. | :13:57. | |
evidence to Sian up the document and its impact in supporting the | :13:58. | :14:02. | |
case for change Return Dr Jones advises the Professor That the | :14:02. | :14:06. | |
document needs to be more positive if possible, and set out a more | :14:06. | :14:10. | |
persuasive vision of how things could be better. So a showdown was | :14:11. | :14:14. | |
set for First Minister's Questions on Tuesday, with accusations and | :14:14. | :14:18. | |
counter accusations. First out, the First Minister. It is cowardice to | :14:18. | :14:25. | |
attack the reputation of an academic, to try to suggest he is | :14:25. | :14:30. | |
independent, to ruin his reputation in the academic world, without | :14:30. | :14:36. | |
there being any comeback The correspondence, the Government says, | :14:36. | :14:40. | |
was no more than sharing information.. There has been | :14:40. | :14:43. | |
nothing in this process which has lacked in transparency. I have | :14:43. | :14:47. | |
neither lived nor connived with anyone. But that wasn't enough to | :14:47. | :14:51. | |
silence the opposition, who decided to come out in force. Will you | :14:51. | :14:54. | |
apologise for mislead this Assembly and the people of Wales about the | :14:54. | :14:58. | |
fact that it was not an independent report in if you didn't know, you | :14:58. | :15:03. | |
do accept thaw do not have a grip on your department? And that it is | :15:03. | :15:06. | |
time for you to resign? This is another case of the Labour Party | :15:06. | :15:10. | |
sex up a document to try to prove their case. People across Wales are | :15:10. | :15:14. | |
really frightened about the future of their local hospitals. They can | :15:14. | :15:22. | |
have no trust in the Welsh Next week, she will go before the | :15:22. | :15:25. | |
health committee on the eve of a vote of no confidence in her. It is | :15:25. | :15:28. | |
clearly an issue which will dominate the political landscape in | :15:28. | :15:33. | |
Wales for the foreseeable future. If we can leave aside the political | :15:33. | :15:36. | |
cut-and-thrust, at its heart this debate is about the future of the | :15:37. | :15:41. | |
NHS, the next direction for our hospitals and so on. Professor | :15:41. | :15:46. | |
Marcus Longley's report was supposed to feed into that. The | :15:46. | :15:50. | |
health minister has said that the status quo, no change, is no longer | :15:50. | :15:55. | |
an option. But changing away from the status quo, not just for this | :15:55. | :15:59. | |
government, but for others, too, has proven more easily said than | :15:59. | :16:03. | |
done. Because this is what you get when you talk about restructuring | :16:03. | :16:08. | |
health services. Locals out in force to oppose plans. This man | :16:08. | :16:12. | |
used to be a top official at the UK Government's Department of Health, | :16:12. | :16:18. | |
and he says it is clear why the NHS has trouble convincing locals. | :16:18. | :16:22. | |
the same locality, the NHS bureaucracy offer the same | :16:22. | :16:26. | |
unpopular choice, get rebuffed and come back five years later with it | :16:26. | :16:30. | |
again, get rebuffed and come back five years later again. The people | :16:30. | :16:33. | |
pushing it might have only just got the job, might be newly elected, | :16:33. | :16:38. | |
but the people rejecting it have seen it four times. They did not | :16:38. | :16:42. | |
like at the last three times and do not like it this time. But it is | :16:42. | :16:49. | |
not just from the public. It tends to fracture because the retail | :16:49. | :16:53. | |
constituency members understand they cannot travel with this. So | :16:53. | :16:57. | |
although it is the official party line, the locals understand this is | :16:57. | :17:01. | |
not a pathway to re-election, so they peel off. So you get cross- | :17:01. | :17:06. | |
party tension and Intra party tension. So the consensus breaks | :17:06. | :17:11. | |
down. That might not be the only problem. Today, the Auditor-General | :17:11. | :17:14. | |
for Wales said although current health services are not affordable, | :17:14. | :17:19. | |
it might not have enough funds to pay for major reforms either. | :17:19. | :17:23. | |
are waiting for the Government proposals as to how they are going | :17:23. | :17:29. | |
to react to the ideas the boards are going to bring forward over the | :17:29. | :17:33. | |
next year, in terms of changing the pattern of services. Those have to | :17:33. | :17:38. | |
stay within the budgets available in Wales. That is the challenge. | :17:38. | :17:42. | |
Because if you move from current provision to future provision, you | :17:42. | :17:48. | |
need to spend money. And as I said, money is very tight. What exactly | :17:48. | :17:51. | |
the new plans are will be revealed over the next few weeks and months. | :17:51. | :17:58. | |
One thing is for sure - in politics, health always gets the pulse racing. | :17:58. | :18:03. | |
Let's discuss some of that. With me, the chair of the Assembly's health | :18:03. | :18:06. | |
committee, Mark Drakeford, Plaid Cymru's health spokesperson Elin | :18:06. | :18:10. | |
Jones, and the former Conservative AM of Jonathan Morgan, also a | :18:11. | :18:15. | |
former chair of the health committee. Well come. Do any of you | :18:15. | :18:19. | |
think that the status quo is the way forward for the Welsh Health | :18:19. | :18:26. | |
Service? Well, the health service is continually evolving. It changes | :18:26. | :18:30. | |
all the time. I have been the Assembly Member for Ceredigion for | :18:30. | :18:34. | |
13 years. It has changed during my time and will continue to change, | :18:34. | :18:38. | |
especially with new technology that offers new opportunities of | :18:38. | :18:43. | |
delivering a service. But they are fundamental services in a district | :18:43. | :18:47. | |
general hospital that need to be there to save lives and provide the | :18:47. | :18:52. | |
ability of babies to be born in that community, and for services to | :18:52. | :18:57. | |
care for the elderly. So is it your position that services at district | :18:57. | :19:01. | |
general hospitals should never be up for discussion, that what is | :19:01. | :19:05. | |
there must remain for ever and a day? That is not what I said. I | :19:05. | :19:09. | |
accept that change will happen, technology will change and afford | :19:09. | :19:13. | |
new opportunities, but there are basic services that a community | :19:13. | :19:20. | |
will require within a distance, within a timely intervention... | :19:20. | :19:24. | |
you consider those untouchable? From my perspective, in | :19:24. | :19:28. | |
representing Ceredigion and the hospital we saw in some of those | :19:28. | :19:34. | |
pictures, that access to emergency surgery that can save lives, access | :19:34. | :19:39. | |
to emergency Caesarean that can deliver babies safely and save the | :19:39. | :19:45. | |
lives of mothers, those are pretty fundamental. If those are removed | :19:45. | :19:48. | |
from a community where there is then no ability to have those | :19:48. | :19:55. | |
services within reach of life saving opportunities, that is not | :19:55. | :19:59. | |
acceptable to those communities and no politician could sell that. | :19:59. | :20:04. | |
are pulling a face. We have to be realistic about where we are in | :20:04. | :20:09. | |
delivering health services in Wales. Since devolution in 1999, we have | :20:09. | :20:13. | |
been told by independent experts, clinicians, by people working in | :20:14. | :20:17. | |
the Wales Audit Office and others, not just by politicians or | :20:17. | :20:20. | |
Government ministers, that the NHS and the way we deliver services, | :20:20. | :20:25. | |
how we deliver them, the localities, what services we deliver, has to | :20:25. | :20:30. | |
change. Because if you keep thinking that the NHS of the 1950s | :20:30. | :20:34. | |
is something you can deliver today, we are kidding ourselves. The | :20:34. | :20:38. | |
health service has become much more expensive to deliver. There are | :20:38. | :20:41. | |
examples throughout the world where services are delivered more closely | :20:41. | :20:44. | |
to people and become far more effective and efficient. We know | :20:44. | :20:49. | |
that closer collaboration between health and social services is | :20:49. | :20:53. | |
needed to make sure we spend money more wisely. I think some of the | :20:53. | :20:56. | |
health service provision we have had in Wales, although that has | :20:56. | :20:59. | |
been very good, there have been poor examples. Some community | :20:59. | :21:03. | |
hospitals, frankly, should have closed years ago. We spent months, | :21:04. | :21:08. | |
if not years, talking about when neurosurgery ought to be located in | :21:08. | :21:12. | |
South Wales. The problem in Wales is that very often we are good at | :21:12. | :21:16. | |
analysing the problem, at sick -- accepting that what we have will | :21:16. | :21:20. | |
not work, and taking forever and a day to provide a solution. We are | :21:20. | :21:23. | |
now hitting the buffers because we are running out of money and the | :21:23. | :21:27. | |
local health boards, which have tried to do a very difficult job in | :21:27. | :21:30. | |
difficult circumstances, are now facing the biggest challenge of | :21:30. | :21:35. | |
their lives. Mark Drakeford, how do you go about trying to build | :21:35. | :21:37. | |
political consensus for what is obviously very difficult change, | :21:37. | :21:41. | |
given that everyone seems to have a different concept of what change | :21:41. | :21:47. | |
means for the NHS? Change is very difficult in the NHS. Not just in | :21:47. | :21:52. | |
Wales, but anywhere that change is trying to be brought about. Let me | :21:52. | :21:56. | |
give three reasons for optimism about what can be achieved. First, | :21:56. | :22:01. | |
inside the Assembly Chamber, not universally, but I think across a | :22:01. | :22:03. | |
considerable majority of members, there is a shared understanding of | :22:04. | :22:07. | |
what the problem is. You have heard some of it already this evening. | :22:07. | :22:11. | |
Lots of what they have said, I would agree with in understanding | :22:11. | :22:16. | |
what the problem is. That is a good starting-point. Second, we have | :22:16. | :22:19. | |
managed to bring about change in places. We have actually succeeded | :22:19. | :22:27. | |
in it. I was recently in a fantastic new hospital. Three old | :22:27. | :22:30. | |
community hospitals had to be closed to make that happen and it | :22:30. | :22:33. | |
was done with the agreement of the local population. We can make this | :22:33. | :22:37. | |
happen. Third, and maybe slightly strangely, that again in the way | :22:37. | :22:40. | |
that Jonathan Stead, the pressures from funding are such that the | :22:40. | :22:44. | |
choice about change is no longer, shall we think about it, when will | :22:44. | :22:50. | |
we do it? It is an urgent thing on our doorstep. Is that what makes | :22:50. | :22:53. | |
people suspicious when it comes to establishing the agreement of the | :22:53. | :22:57. | |
local population? People think, this is actually about saving money, | :22:57. | :23:02. | |
not giving me better services. And as Elin Jones was saying, even if | :23:02. | :23:05. | |
they had to travel that little bit further when they are about to give | :23:05. | :23:09. | |
birth to their baby, or an emergency, that could compromise | :23:09. | :23:14. | |
their chances of a successful outcome. They are a couple of | :23:14. | :23:17. | |
issues. People become suspicious when politicians and health boards | :23:17. | :23:22. | |
talk about changing local services. Automatically, they think they will | :23:22. | :23:25. | |
end up with something worse than what they have. The problem with | :23:25. | :23:32. | |
where we Arnaud, and I know it is being retrospective, but we had | :23:32. | :23:36. | |
year on year significant increases in health expenditure between 1999 | :23:36. | :23:41. | |
and 2005-2006. At no point in that period was there an attempt to | :23:41. | :23:46. | |
radically reform the delivery of health services. The Government | :23:46. | :23:49. | |
spent time restructuring health boards and Trusts. It was | :23:49. | :23:53. | |
bureaucratic. It was not about service delivery, but about | :23:53. | :23:57. | |
shifting the chairs in the local health board structures. That is a | :23:57. | :24:02. | |
challenge. A we have to do much to take the public with us. Local | :24:02. | :24:07. | |
health boards should consult with the public. If push has come to | :24:07. | :24:10. | |
shove, and you have expressed there are grounds for optimism, do you | :24:10. | :24:14. | |
believe that in the course of this Assembly political consensus can be | :24:14. | :24:17. | |
established, voters can be brought along with the proposals the | :24:18. | :24:22. | |
Government is about to make? certainly think that in the process | :24:22. | :24:26. | |
of change you have to think of the patients as assets. The reason we | :24:26. | :24:29. | |
sometimes have difficulties is because people feel passionately | :24:29. | :24:33. | |
about the NHS and their services. If you regard people as the enemy, | :24:33. | :24:37. | |
you will never bring about change. You have to harness enthusiasm for | :24:37. | :24:43. | |
the NHS and turn it into an asset. Thank you for joining us. | :24:43. | :24:46. | |
Cardiff council employees are planning to use the Olympics in | :24:46. | :24:49. | |
Cardiff as a platform to protest against plans to appoint a team of | :24:49. | :24:53. | |
senior managers. With the eyes of the world on the capital city as | :24:53. | :24:56. | |
the Games kick-off, the GMB union says it will target Olympic | :24:56. | :25:03. | |
football events which are being played at the Millennium Stadium. | :25:03. | :25:06. | |
The Rings are up, we have seen the Olympic torch in the capital, and | :25:06. | :25:10. | |
in less than two weeks, thousands will be in the Millennium Stadium | :25:10. | :25:13. | |
to watch Great Britain take on New Zealand in the women's football. | :25:13. | :25:17. | |
And as the eyes of the world focus on Cardiff, they could see some in | :25:17. | :25:21. | |
the crowd wearing T-shirts protesting against plans for the | :25:21. | :25:28. | |
council to employee up to 24 senior managers on salaries of up to | :25:28. | :25:32. | |
�120,000. The plans have been drawn up by the council has no chief | :25:32. | :25:37. | |
executive, and the proposal is to appoint a team of senior managers | :25:37. | :25:41. | |
to support the council's cabinet. The aim is to put the Cabinet at | :25:41. | :25:47. | |
the heart of decision-making. The plans will cost �1.7 million a year | :25:47. | :25:53. | |
in wages. And that is spending that the trade unions' call obscene. | :25:53. | :25:57. | |
have �55 million to save them the next three years. We understand | :25:57. | :26:03. | |
that we are in economic meltdown. This is obscene and immoral. | :26:03. | :26:06. | |
Earlier this month, Cardiff Council announce that lowest paid workers | :26:06. | :26:12. | |
will receive a wage increase of around 1500 pounds per year if, as | :26:12. | :26:15. | |
the authority claims to be the first in Wales to introduce a | :26:15. | :26:19. | |
living wage. On the same day, staff at the council were informed of | :26:19. | :26:22. | |
plans to change the management structure. One former Cabinet | :26:22. | :26:26. | |
member is sceptical of the reasoning for the appointments. | :26:26. | :26:32. | |
as they say in the paper there goes the full Cabinet, if they want to | :26:32. | :26:41. | |
make a truly member-led administration, they are talking | :26:41. | :26:45. | |
about not responding birdie at a supplementary meeting two questions. | :26:45. | :26:49. | |
Why would a Cabinet member be afraid to answer my supplementary | :26:49. | :26:53. | |
question verbally if they had the ability? Unions say many staff had | :26:53. | :26:59. | |
seen wages reduced by up to �8,000 following job evaluation. They are | :26:59. | :27:02. | |
actively discussing ways to vent their opposition to the proposals. | :27:02. | :27:07. | |
At the end of the day, some of our members have said that they have | :27:07. | :27:11. | |
already bought tickets for the Olympic venues. And they may well | :27:11. | :27:15. | |
be wearing T-shirts to say how ludicrous it what is currently | :27:15. | :27:19. | |
being proposed by this establishment. The council says | :27:19. | :27:23. | |
that they are investing now in order to save money on consultant | :27:23. | :27:27. | |
fees in future. Cabinet members are meeting this evening and are | :27:27. | :27:31. | |
expected to rubber-stamp the senior management model and approve a 30 | :27:31. | :27:35. | |
day consultation process. In the meantime, council employees in | :27:35. | :27:39. | |
unison and the GMB unions could be making an Olympian effort to oppose | :27:39. | :27:44. | |
the plans. Betsan Powys is here. Let's return | :27:44. | :27:48. | |
to the health row. It has been a difficult week for the health | :27:48. | :27:51. | |
minister and she faces another difficult week. Yes, super | :27:51. | :27:55. | |
Wednesday. In the morning, the Health Committee, where she will | :27:55. | :27:59. | |
appear with Marcus Longley and Dr Chris Jones. That is where the | :27:59. | :28:03. | |
opposition want answers. If they do not get them, they will be a motion | :28:03. | :28:08. | |
of no confidence in the afternoon. She was regarded as one of the | :28:08. | :28:12. | |
weakest links in the Cabinet. After all this, if she survives, she is | :28:12. | :28:16. | |
bound to be the safest number of the Cabinet. How could Carwyn Jones | :28:16. | :28:21. | |
get rid of her? We have come to the end of the road on Dragon's Eye I. | :28:21. | :28:26. | |
At this point, it has been customary to do this. Vicky for | :28:26. | :28:33. | |
watching, have a good summer, good night. Take care and good night. | :28:33. | :28:39. |