24/04/2013 Newsnight Scotland

Tonight, on Newsnight Scotland. Patients in hospitals are becoming

older and sicker and nurses say that means pressure is mounting on

them and on the NHS. Is there now a perfect storm in the

health service, as nurses' leaders claim?

If there is, what can be done about Also tonight.

Who's sorry now? The City of Glasgow's been asked to

apologise for its part in the 19th Century slave trade.

I'll be speaking to a man who says such apologies are correct and

should also come with reparations. Good evening.

Ward closures, scandals about waiting times and pressures which

used to be felt only in the winter, but which are now being felt all

year round. Just some of the squalls which

could become Force 10 gales, warns the Royal College of Nursing.

We'll be discussing those claims with the RCN in a moment, but first

Andrew Black's been looking at some The NHS is a treasured service,

people and patients can't live without it. The doctors and nurses

who work in it strive to deliver the best service they can. Here in

Glasgow work continues on this huge new hospital campus which aims to

bring together a range of services on one site. It is seen as the gold

standard in the future delivery of healthcare. The critics say you can

build as many shiny new hospitals you like, without the proper

staffing, they say, things just won't improve. Today, the Royal

College of Nursing said Scotland is facing a perfect storm of pressures.

A survey of members working in NHS hospitals said 89% of nurses were

experiencing pressures on beds all year round. 80% say they ran into

problems while dealing with moving patients between wards and units.

The survey said that compared to this time last year, 63% of

patients were now more severely ill. These nurses, who are members of

the union, unison, say the pressure is building, they want to focus on

doing a good job. Specifically, in the community area and the staff

area, you have certain amount of time to deliver the care and,

obviously, that has been eaten into. So you have to make adjustments to

the care you give. You prioritise the care. You may have to actually

work through your breaks, not have any breaks, at all, and work over

your shifts to deliver, you know, the level of service we want to

deliver. We all have a conscience and caring in our profession. It

impacts on your personal life. It gets to a stage where you feel a

bit put upon. It's managable it's managable. It's stressful for the

nurses at the time when you try to deliver really good care to

patients. The paperwork has increased, the bureaucracy has

increased, everything has increased for them. So, at times, yes, they

are struggling between delivering direct patient care and delivering

paperwork care. Moving that balance, like all change change in the NHS,

doesn't come without risks. Remember Labour's attempts to close

some Accident & Emergency services in 2006. Rouse with local

communities meant it became political football, just in time

for the 2007 election. With the independence referendum next year,

maybe the government is in no rush to rock the boat. It's time for

honesty about the real challenges in the NHS. I think the report

points the way towards that. We have now 2,400 fewer nurses in the

NHS. They cut 1,500 beds. They are pointing to, we cannot keep

treating more people with fewer and fewer resources. The Scottish

Government recognises the pressures, but says they are being addressed.

We have a significant demographic shift taking place within the

country with people living longer and more people living with long-

term conditions. It's important to get the right balance of care

provided between the hospital and community setting. We are taking

forward the integration of community care and hospital care so

that we can make sure we have got greater support being provided in

the right place, whether it be in the community or in a hospital

setting so that individuals can get the type of support they need that

suits their needs with their health problems. In the next 20 years the

number of people over the age of 65 is expected to rise by more than

60%. That means more demands on the NHS. The Government says if things

are planned right the health service will cope. Get it wrong,

organisations like the Royal College of Nursing say things could

get much worse. I'm joined now from Liverpool by

Norman Provan, an Associate Director of the Royal College of

Nursing Scotland and the health journalist, Pennie Taylor, joins me

Health budgets were supposed to be protected both here in Scotland and

indeed in England and Wales. If they are protected, why are we

getting these apparent problems? Well, it's true to say that the

health budget to some degree has been protected. We have not seeing

the level of investments we saw a few years ago. The difficulty we

have is that health inflation outstrips the normal inflation you

see in the high street. It's more difficult for Boards to balance the

books. They are making tough decisions. Right. This idea that,

are you really saying there is a crisis in the NHS in Scotland or...

I mean a lot of people say, obviously nurses will complain,

like anyone does when there is more work to do, that is not the same

thing as a crisis? Absolutely not. What used to happen, there were

specific times in the year when there were additional pressures on

the NHS particularly in the winter, what our nursing members is that

pressure exists all year round now. That is bourne out by the statistic

that is came out from Scottish Government that demonstrated that

clearly. Are there cuts to the nursing workforce? There have been

cuts to the nursing workforce. There have been more than 2,000

nursing jobs have gone in the last two years in Scotland. In the last

six months or so a number of Boards who had cut posts reinvesting and

hiring more nurses. They made the decision they cut too deeply and

too quickly something the Royal College of Nursing has been warning

about for some time. Is there a genuine issue here? Of course there

is a genuine issue here. In 2005, when we had a national review of

what we needed to do with our health service in Scotland, it was

identified that exactly the pressures described by the Royal

College of nurses, they are in the system. They are going to get worse

unless we tackle the issues which the care report concluded was the

way we operate our health system in Scotland. How we do it. We

concentrate all our money in acute hospitals and actually, you know,

we could be doing more out in the community to keep people out much

hospital. To remind people the CARE report that was done for the

previous Labour/Liberal Democrat coalition Government In 2005 an

independent group of experts. was shelved? Not shelved. Some of

its recommendations about putting quality right at the front of

people's minds, about developing integrating health and social care,

those things are happening, but we've still - The efficient

reform... We have an obsession with hospitals and keeping all the

hospitals we have got working as they have worked. It's the 65th

anniversary of the NHS this year. I have heard people saying - if you

were starting out now and looking at a blank sheet of paper and say -

how do we design our health service, you wouldn't start where we are

now? There is not much point in the RCN saying we need more resources.

It might be better to have proposals to get efficiency into it.

I agree with what Pennie says. The intent of the Scottish Government

is clear, to provide more services in the community. We would support

that. The issue in a sense is we need a transition. We need to

invest in the community infrastructure, more district

nurses, healthcare workers working in the community that will do

certain things, one, provide the level of service that stops people

presenting at Accident & Emergency. Two, when people are in hospital

they can be in for shortage periods of time as there is enough nurses

in the community to provide for All right. Is it about that or do

you need more wholesale reform? What CARE was recommending was

radical than that? It wasn't really. The point that has been made, we

have to invest more in the community, but at the moment that...

That can only mean disinvesting in our acute hospital centre. The CARE

report was put together by a vast number of experts working in the

field in Scotland. It was not a political report, it was a clinical

report. It said we need fewer specialist, very specialist

services like high end A&E and have our pyramid of care with most care

happening in the communities. there isn't any more money. If we

are going to do the investment you are suggesting it will have to come

at the expense of something else in the NHS? Well, I think there has

been some disinvestment, the number of beds available in Scotland have

been dropping. It's a transition we are failing to manage appropriately

here. If you take the resources out of acute hospitals and transfer

them into community services that would help and some savings could

be realised in that way. This midwives case that came up today,

let us not get into the merits of it, I'm curious as to whether you

think that will affect the kind of discussion we have been having? In

other words, in order to accommodate this, will it increase

the pressures on the NHS or not? Or is it fairly minor? I'm told there

are relatively very few midwives who would be the objectors who

would refuse to have anything to do with anything to do with abortions.

As the law stood, until today, they could choose not to be directly

involved. Now, they are saying that they can... The point is, coming

back to what we have been talking about, if it's only a few it will

not have a major impact...? In some units you might have to have two

lots of senior midwives on at any one time. Those who will oversee

staff doing abortions and those who won't. Thank you both very much

indeed. Glasgow owes a significant part of

its historic wealth and success to money made from the slave trade.

Next year many Afro-Caribbean athletes will come here for the

Commonwealth Games and that, it's being claimed, provides the perfect

opportunity for a formal apology from the descendants of the

Glaswegians to the descendents of A sincere apology from a public

figure with help to heal. The families of the victims of

Hillsborough were mainly pleased with the public aacknowledgment of

their campaign for justice. The Prime Minister's apology for

Derry's Bloody Sunday was said to be widely welcomed among the

bereaved families. On behalf of our country, I'm deeply sorry. It gets

more complicated when the wrongs were done to people a lnge time ago.

When Tony Blair made a public apology for the shortcomings of the

British government during the Irish potato famine of the mid 19th

century there was a mixed response. While the kind thought was

appreciated, questions were raised about political motivation. Gordon

Brown impressed some but confused others with his apology for the

treatment by the authorities in the 1950s of the wartime code-breaker

Alan Turin. He was hounded to death for his homosexuality. Where does

this leave Glasgow and the stain of the slave trade? There is no doubt

Glasgow profited from slavery, both from the trade itself and the

plantation and associated businesses in the West Indies and

And a help the opportunity to bank directly the men and women who had

taken an interest in the events Would a formal apology helps to

cure our position as a forward- thinking democracy or has been a

downside? I am joined now by Graham Campbell

of the African and Caribbean Network in Glasgow. Is there any

point to apologising? Yes, there is a point. We to recognise the

historic legacy. An historic crime was committed. People who

perpetrated it directly and not with us today, we as the

descendants carry that with us as a people. We eat a lot about

reparations, what do you mean? very simple. It it beat financial,

historic or cultural. I think the best way Glasgow and Scotland could

mark that would be through the education system. It would be to

recognise the event. How was that - - that is more useful than a formal

apology, isn't it? I think it would still help. We have had one for the

famine and other circumstances. But who is that it we that is

apologising? 40% of the population of London and ethnic pink --

ethnic-minority is. TD beer. But in London apologises Benn who is do

we? -- TD we are or.A we would not exist the way that we do without

slavery. People were possessions and property. People in Edinburgh

lead in houses that were the compensation paid to sleep owners,

not to sleeps. This is the historic legacy. Many of the buildings in

Glasgow were paid for out of it that sale of tobacco and sugar Rum,

those commodities were made by shackled sleeves. The seat is.

About who is the week, is that in Britain we're trying to make a

multicultural society. We are trying to say to people who are not

descendants of those people in the 18th century, you two are as

British as the art. Or Scottish.Or African Scottish or whatever. So

like I say, who is do we? We cannot separate out a bunch of people to

make apologies. We can recognise a historic long. The first thing is

recognition. We have to start telling the story. It is our story.

You could as a Scottish man be related to someone like me through

the historic flight of the people who were asleep owners and sleeves.

-- slave owners and slaves. We're all this got diaspora. -- the

Scottish diaspora. Now a quick look at tomorrow's

front pages. This is the question whether it it

we will have a coronation after I yes vote.

This is the former Rangers chief been reported to the frost -- to