:00:10. > :00:13.Tonight, on Newsnight Scotland. Patients in hospitals are becoming
:00:13. > :00:18.older and sicker and nurses say that means pressure is mounting on
:00:18. > :00:21.them and on the NHS. Is there now a perfect storm in the
:00:21. > :00:25.health service, as nurses' leaders claim?
:00:25. > :00:29.If there is, what can be done about Also tonight.
:00:29. > :00:31.Who's sorry now? The City of Glasgow's been asked to
:00:31. > :00:34.apologise for its part in the 19th Century slave trade.
:00:35. > :00:39.I'll be speaking to a man who says such apologies are correct and
:00:39. > :00:41.should also come with reparations. Good evening.
:00:41. > :00:45.Ward closures, scandals about waiting times and pressures which
:00:45. > :00:48.used to be felt only in the winter, but which are now being felt all
:00:48. > :00:53.year round. Just some of the squalls which
:00:53. > :00:57.could become Force 10 gales, warns the Royal College of Nursing.
:00:57. > :01:07.We'll be discussing those claims with the RCN in a moment, but first
:01:07. > :01:08.
:01:08. > :01:14.Andrew Black's been looking at some The NHS is a treasured service,
:01:14. > :01:21.people and patients can't live without it. The doctors and nurses
:01:21. > :01:25.who work in it strive to deliver the best service they can. Here in
:01:25. > :01:31.Glasgow work continues on this huge new hospital campus which aims to
:01:31. > :01:35.bring together a range of services on one site. It is seen as the gold
:01:36. > :01:39.standard in the future delivery of healthcare. The critics say you can
:01:39. > :01:46.build as many shiny new hospitals you like, without the proper
:01:46. > :01:50.staffing, they say, things just won't improve. Today, the Royal
:01:50. > :01:56.College of Nursing said Scotland is facing a perfect storm of pressures.
:01:56. > :02:01.A survey of members working in NHS hospitals said 89% of nurses were
:02:01. > :02:05.experiencing pressures on beds all year round. 80% say they ran into
:02:05. > :02:10.problems while dealing with moving patients between wards and units.
:02:10. > :02:18.The survey said that compared to this time last year, 63% of
:02:19. > :02:23.patients were now more severely ill. These nurses, who are members of
:02:23. > :02:28.the union, unison, say the pressure is building, they want to focus on
:02:28. > :02:35.doing a good job. Specifically, in the community area and the staff
:02:35. > :02:40.area, you have certain amount of time to deliver the care and,
:02:40. > :02:45.obviously, that has been eaten into. So you have to make adjustments to
:02:45. > :02:50.the care you give. You prioritise the care. You may have to actually
:02:50. > :02:56.work through your breaks, not have any breaks, at all, and work over
:02:56. > :03:00.your shifts to deliver, you know, the level of service we want to
:03:00. > :03:06.deliver. We all have a conscience and caring in our profession. It
:03:06. > :03:12.impacts on your personal life. It gets to a stage where you feel a
:03:12. > :03:16.bit put upon. It's managable it's managable. It's stressful for the
:03:16. > :03:20.nurses at the time when you try to deliver really good care to
:03:20. > :03:25.patients. The paperwork has increased, the bureaucracy has
:03:25. > :03:29.increased, everything has increased for them. So, at times, yes, they
:03:29. > :03:33.are struggling between delivering direct patient care and delivering
:03:33. > :03:39.paperwork care. Moving that balance, like all change change in the NHS,
:03:39. > :03:42.doesn't come without risks. Remember Labour's attempts to close
:03:42. > :03:45.some Accident & Emergency services in 2006. Rouse with local
:03:45. > :03:50.communities meant it became political football, just in time
:03:50. > :03:55.for the 2007 election. With the independence referendum next year,
:03:55. > :03:59.maybe the government is in no rush to rock the boat. It's time for
:03:59. > :04:08.honesty about the real challenges in the NHS. I think the report
:04:08. > :04:13.points the way towards that. We have now 2,400 fewer nurses in the
:04:13. > :04:18.NHS. They cut 1,500 beds. They are pointing to, we cannot keep
:04:18. > :04:22.treating more people with fewer and fewer resources. The Scottish
:04:23. > :04:26.Government recognises the pressures, but says they are being addressed.
:04:26. > :04:30.We have a significant demographic shift taking place within the
:04:30. > :04:33.country with people living longer and more people living with long-
:04:33. > :04:37.term conditions. It's important to get the right balance of care
:04:37. > :04:39.provided between the hospital and community setting. We are taking
:04:39. > :04:43.forward the integration of community care and hospital care so
:04:43. > :04:46.that we can make sure we have got greater support being provided in
:04:46. > :04:49.the right place, whether it be in the community or in a hospital
:04:49. > :04:55.setting so that individuals can get the type of support they need that
:04:55. > :05:01.suits their needs with their health problems. In the next 20 years the
:05:01. > :05:06.number of people over the age of 65 is expected to rise by more than
:05:06. > :05:11.60%. That means more demands on the NHS. The Government says if things
:05:11. > :05:13.are planned right the health service will cope. Get it wrong,
:05:13. > :05:18.organisations like the Royal College of Nursing say things could
:05:18. > :05:21.get much worse. I'm joined now from Liverpool by
:05:21. > :05:23.Norman Provan, an Associate Director of the Royal College of
:05:23. > :05:33.Nursing Scotland and the health journalist, Pennie Taylor, joins me
:05:33. > :05:35.
:05:35. > :05:40.Health budgets were supposed to be protected both here in Scotland and
:05:40. > :05:44.indeed in England and Wales. If they are protected, why are we
:05:44. > :05:48.getting these apparent problems? Well, it's true to say that the
:05:48. > :05:52.health budget to some degree has been protected. We have not seeing
:05:52. > :05:55.the level of investments we saw a few years ago. The difficulty we
:05:55. > :05:58.have is that health inflation outstrips the normal inflation you
:05:58. > :06:04.see in the high street. It's more difficult for Boards to balance the
:06:04. > :06:08.books. They are making tough decisions. Right. This idea that,
:06:08. > :06:12.are you really saying there is a crisis in the NHS in Scotland or...
:06:12. > :06:16.I mean a lot of people say, obviously nurses will complain,
:06:16. > :06:21.like anyone does when there is more work to do, that is not the same
:06:21. > :06:26.thing as a crisis? Absolutely not. What used to happen, there were
:06:26. > :06:31.specific times in the year when there were additional pressures on
:06:31. > :06:36.the NHS particularly in the winter, what our nursing members is that
:06:36. > :06:39.pressure exists all year round now. That is bourne out by the statistic
:06:39. > :06:43.that is came out from Scottish Government that demonstrated that
:06:43. > :06:47.clearly. Are there cuts to the nursing workforce? There have been
:06:47. > :06:51.cuts to the nursing workforce. There have been more than 2,000
:06:51. > :06:58.nursing jobs have gone in the last two years in Scotland. In the last
:06:58. > :07:03.six months or so a number of Boards who had cut posts reinvesting and
:07:03. > :07:07.hiring more nurses. They made the decision they cut too deeply and
:07:07. > :07:12.too quickly something the Royal College of Nursing has been warning
:07:12. > :07:15.about for some time. Is there a genuine issue here? Of course there
:07:15. > :07:19.is a genuine issue here. In 2005, when we had a national review of
:07:19. > :07:23.what we needed to do with our health service in Scotland, it was
:07:23. > :07:30.identified that exactly the pressures described by the Royal
:07:30. > :07:35.College of nurses, they are in the system. They are going to get worse
:07:35. > :07:40.unless we tackle the issues which the care report concluded was the
:07:40. > :07:46.way we operate our health system in Scotland. How we do it. We
:07:46. > :07:49.concentrate all our money in acute hospitals and actually, you know,
:07:49. > :07:56.we could be doing more out in the community to keep people out much
:07:56. > :08:01.hospital. To remind people the CARE report that was done for the
:08:01. > :08:06.previous Labour/Liberal Democrat coalition Government In 2005 an
:08:06. > :08:10.independent group of experts. was shelved? Not shelved. Some of
:08:10. > :08:15.its recommendations about putting quality right at the front of
:08:15. > :08:20.people's minds, about developing integrating health and social care,
:08:20. > :08:23.those things are happening, but we've still - The efficient
:08:23. > :08:28.reform... We have an obsession with hospitals and keeping all the
:08:28. > :08:32.hospitals we have got working as they have worked. It's the 65th
:08:32. > :08:38.anniversary of the NHS this year. I have heard people saying - if you
:08:38. > :08:43.were starting out now and looking at a blank sheet of paper and say -
:08:43. > :08:52.how do we design our health service, you wouldn't start where we are
:08:52. > :08:59.now? There is not much point in the RCN saying we need more resources.
:08:59. > :09:03.It might be better to have proposals to get efficiency into it.
:09:03. > :09:06.I agree with what Pennie says. The intent of the Scottish Government
:09:06. > :09:10.is clear, to provide more services in the community. We would support
:09:10. > :09:13.that. The issue in a sense is we need a transition. We need to
:09:13. > :09:16.invest in the community infrastructure, more district
:09:16. > :09:21.nurses, healthcare workers working in the community that will do
:09:21. > :09:24.certain things, one, provide the level of service that stops people
:09:25. > :09:30.presenting at Accident & Emergency. Two, when people are in hospital
:09:30. > :09:40.they can be in for shortage periods of time as there is enough nurses
:09:40. > :09:46.
:09:46. > :09:50.in the community to provide for All right. Is it about that or do
:09:50. > :09:54.you need more wholesale reform? What CARE was recommending was
:09:54. > :09:59.radical than that? It wasn't really. The point that has been made, we
:09:59. > :10:06.have to invest more in the community, but at the moment that...
:10:06. > :10:10.That can only mean disinvesting in our acute hospital centre. The CARE
:10:10. > :10:14.report was put together by a vast number of experts working in the
:10:14. > :10:19.field in Scotland. It was not a political report, it was a clinical
:10:20. > :10:25.report. It said we need fewer specialist, very specialist
:10:25. > :10:30.services like high end A&E and have our pyramid of care with most care
:10:30. > :10:33.happening in the communities. there isn't any more money. If we
:10:33. > :10:38.are going to do the investment you are suggesting it will have to come
:10:38. > :10:41.at the expense of something else in the NHS? Well, I think there has
:10:41. > :10:45.been some disinvestment, the number of beds available in Scotland have
:10:45. > :10:51.been dropping. It's a transition we are failing to manage appropriately
:10:52. > :10:54.here. If you take the resources out of acute hospitals and transfer
:10:55. > :10:59.them into community services that would help and some savings could
:10:59. > :11:04.be realised in that way. This midwives case that came up today,
:11:04. > :11:08.let us not get into the merits of it, I'm curious as to whether you
:11:08. > :11:11.think that will affect the kind of discussion we have been having? In
:11:11. > :11:18.other words, in order to accommodate this, will it increase
:11:18. > :11:23.the pressures on the NHS or not? Or is it fairly minor? I'm told there
:11:23. > :11:27.are relatively very few midwives who would be the objectors who
:11:27. > :11:32.would refuse to have anything to do with anything to do with abortions.
:11:32. > :11:36.As the law stood, until today, they could choose not to be directly
:11:36. > :11:40.involved. Now, they are saying that they can... The point is, coming
:11:40. > :11:45.back to what we have been talking about, if it's only a few it will
:11:46. > :11:54.not have a major impact...? In some units you might have to have two
:11:54. > :12:00.lots of senior midwives on at any one time. Those who will oversee
:12:00. > :12:02.staff doing abortions and those who won't. Thank you both very much
:12:02. > :12:05.indeed. Glasgow owes a significant part of
:12:05. > :12:07.its historic wealth and success to money made from the slave trade.
:12:07. > :12:10.Next year many Afro-Caribbean athletes will come here for the
:12:10. > :12:12.Commonwealth Games and that, it's being claimed, provides the perfect
:12:12. > :12:22.opportunity for a formal apology from the descendants of the
:12:22. > :12:25.
:12:25. > :12:29.Glaswegians to the descendents of A sincere apology from a public
:12:29. > :12:33.figure with help to heal. The families of the victims of
:12:33. > :12:37.Hillsborough were mainly pleased with the public aacknowledgment of
:12:37. > :12:42.their campaign for justice. The Prime Minister's apology for
:12:42. > :12:46.Derry's Bloody Sunday was said to be widely welcomed among the
:12:46. > :12:50.bereaved families. On behalf of our country, I'm deeply sorry. It gets
:12:50. > :12:55.more complicated when the wrongs were done to people a lnge time ago.
:12:55. > :12:59.When Tony Blair made a public apology for the shortcomings of the
:12:59. > :13:03.British government during the Irish potato famine of the mid 19th
:13:03. > :13:09.century there was a mixed response. While the kind thought was
:13:09. > :13:12.appreciated, questions were raised about political motivation. Gordon
:13:12. > :13:20.Brown impressed some but confused others with his apology for the
:13:20. > :13:26.treatment by the authorities in the 1950s of the wartime code-breaker
:13:26. > :13:33.Alan Turin. He was hounded to death for his homosexuality. Where does
:13:33. > :13:36.this leave Glasgow and the stain of the slave trade? There is no doubt
:13:36. > :13:39.Glasgow profited from slavery, both from the trade itself and the
:13:39. > :13:49.plantation and associated businesses in the West Indies and
:13:49. > :13:58.
:13:58. > :14:08.And a help the opportunity to bank directly the men and women who had
:14:08. > :14:12.
:14:12. > :14:18.taken an interest in the events Would a formal apology helps to
:14:18. > :14:21.cure our position as a forward- thinking democracy or has been a
:14:21. > :14:29.downside? I am joined now by Graham Campbell
:14:29. > :14:35.of the African and Caribbean Network in Glasgow. Is there any
:14:35. > :14:41.point to apologising? Yes, there is a point. We to recognise the
:14:41. > :14:46.historic legacy. An historic crime was committed. People who
:14:46. > :14:51.perpetrated it directly and not with us today, we as the
:14:51. > :14:59.descendants carry that with us as a people. We eat a lot about
:14:59. > :15:03.reparations, what do you mean? very simple. It it beat financial,
:15:04. > :15:08.historic or cultural. I think the best way Glasgow and Scotland could
:15:08. > :15:14.mark that would be through the education system. It would be to
:15:15. > :15:21.recognise the event. How was that - - that is more useful than a formal
:15:21. > :15:25.apology, isn't it? I think it would still help. We have had one for the
:15:25. > :15:31.famine and other circumstances. But who is that it we that is
:15:31. > :15:40.apologising? 40% of the population of London and ethnic pink --
:15:40. > :15:50.ethnic-minority is. TD beer. But in London apologises Benn who is do
:15:50. > :15:50.
:15:50. > :15:57.we? -- TD we are or.A we would not exist the way that we do without
:15:57. > :16:02.slavery. People were possessions and property. People in Edinburgh
:16:02. > :16:07.lead in houses that were the compensation paid to sleep owners,
:16:07. > :16:14.not to sleeps. This is the historic legacy. Many of the buildings in
:16:14. > :16:21.Glasgow were paid for out of it that sale of tobacco and sugar Rum,
:16:21. > :16:26.those commodities were made by shackled sleeves. The seat is.
:16:26. > :16:30.About who is the week, is that in Britain we're trying to make a
:16:30. > :16:37.multicultural society. We are trying to say to people who are not
:16:37. > :16:47.descendants of those people in the 18th century, you two are as
:16:47. > :16:48.
:16:48. > :16:57.British as the art. Or Scottish.Or African Scottish or whatever. So
:16:58. > :17:04.like I say, who is do we? We cannot separate out a bunch of people to
:17:04. > :17:11.make apologies. We can recognise a historic long. The first thing is
:17:11. > :17:16.recognition. We have to start telling the story. It is our story.
:17:16. > :17:24.You could as a Scottish man be related to someone like me through
:17:25. > :17:34.the historic flight of the people who were asleep owners and sleeves.
:17:35. > :17:36.
:17:36. > :17:41.-- slave owners and slaves. We're all this got diaspora. -- the
:17:41. > :17:51.Scottish diaspora. Now a quick look at tomorrow's
:17:51. > :17:55.front pages. This is the question whether it it
:17:55. > :17:59.we will have a coronation after I yes vote.
:17:59. > :18:03.This is the former Rangers chief been reported to the frost -- to