:00:17. > :00:21.Like the boy who cried wolf, we In $:/STARTFEED. Like the boy who
:00:21. > :00:26.cried wolf, we have heard NHS crisis forever, but more people are
:00:26. > :00:29.joining the chorus. The cry goes up that Accident and Emergency
:00:29. > :00:33.departments are stretched to breaking point. Everyone agrees
:00:34. > :00:37.that places like this are under unprecedented strain, unanimity
:00:37. > :00:42.rapidly disappears when it comes to discussing the cause. As the head
:00:42. > :00:49.of the NHS announces his retirement, we will ask can the health service
:00:49. > :00:53.get its house back in order. Also tonight :
:00:53. > :00:58.Pure animal spirits, if you find this incomprehensible, it is
:00:58. > :01:04.nothing to why the stock markets are behaving so wildly. What is
:01:04. > :01:09.there to be so upbeat about. Cheap fashion bought in blood, how
:01:09. > :01:14.much are we in the west to blame for the conditions that caused the
:01:14. > :01:17.catastrophe in Bangladesh. We talk to Nobel Prize winner,
:01:17. > :01:22.Muhammad Yunus, about the price of progress.
:01:22. > :01:32.What is it about the golf shock that has the men in blazers in such
:01:32. > :01:34.
:01:34. > :01:38.a tizz that they are banning it. If you have been unlucky enough to
:01:38. > :01:42.need an emergency visit to hospital at the moment, you will be well
:01:42. > :01:45.aware of the unhappy state of many of our Accident and Emergency
:01:45. > :01:49.departments. The quality care commission says demand is out of
:01:49. > :01:52.control. The NHS federation says the service is getting closer and
:01:52. > :01:55.closer to the cliff edge, and it is all the fault of the last Labour
:01:55. > :01:59.Government, according to the Health Secretary today. He claims it was
:01:59. > :02:02.the deal they did with GPs that meant people were left with no out
:02:02. > :02:10.of hours alternative. For good measure the boss of the NHS in
:02:10. > :02:16.England has decided to quit next year.
:02:16. > :02:23.When the people we rely on in an emergency say they are facing their
:02:23. > :02:27.own emergency well perhaps we should take notice. Daily we are
:02:27. > :02:30.hearing alarmed voices telling us of a crisis in Accident and
:02:30. > :02:36.Emergency department, rising numbers putting intolerable strain
:02:36. > :02:42.on the system. At a Select Committee this morning MPs heard a
:02:42. > :02:48.startling statistic. The change in last year and this year is 250,000
:02:49. > :02:58.new attendances. We will talk about raw figures, that is five emergency
:02:59. > :02:59.
:02:59. > :03:04.departments each seeing those Attendances were stable from the
:03:04. > :03:09.1980s to 2003 they rose sharp low, over the last decade there is a 50%
:03:09. > :03:15.increase in numbers. Places like this are clearly
:03:15. > :03:19.feeling the strain. One telling statistic, the maximum four-hour
:03:19. > :03:23.wait at A&E is more and more being missed. So much for the symptoms,
:03:23. > :03:29.what about the cause? The current Government is clear the blame goes
:03:29. > :03:35.back to the previous administration and their botched renegotiation of
:03:35. > :03:40.the GPs' out of hours contract. Since those changes 90% of GPs have
:03:40. > :03:46.opted out of providing out of hours care, and they have got a pay rise
:03:46. > :03:51.in addition. And as a result of those disastrous changes to the GP
:03:51. > :03:56.contract we have seen a significant rise in attendances at A&E. Indeed
:03:56. > :04:01.four million more people are using A&E every year. If the GP contract
:04:01. > :04:04.is the root cause, as the Secretary of State claims, can he explain why
:04:04. > :04:08.98% people were seen within four hours in 2009, five years after the
:04:08. > :04:13.contract was signed. But has deteriorated sharply under his
:04:13. > :04:19.Government, and mainly on his watch. One thing is certainly true, since
:04:19. > :04:28.the changes there have been some very well publicised failings in GP
:04:28. > :04:33.out of hours air. An out of hours service in Cambridge flew in a
:04:33. > :04:36.German GP, and a man paid with his life. A recent survey by the
:04:36. > :04:43.Patients' Association found 65% of people don't feel safe relying on
:04:43. > :04:46.NHS out of hours services, in a medical emergency. A doctor from
:04:46. > :04:50.The Royal College of Physicians told the committee today that
:04:50. > :04:54.patients now prefer what he called the recognised brand of A&E. That
:04:54. > :05:00.is where patients will go because they know they will see someone who
:05:00. > :05:04.is expert, will see them often within four hours, and they will
:05:04. > :05:08.receive treatment. Patients will go where the lights are on. In many of
:05:08. > :05:13.these alternatives the lights are not on after 5.00pm or at the
:05:13. > :05:19.weekends. We have to face up to the fact that services other than A&E
:05:19. > :05:23.departments are often run own a 9-5 and elective basis. But health
:05:23. > :05:27.economists, who study the long-term trends suggest that blaming GPs is
:05:27. > :05:30.wrong. We have seen a long-term trend in increases in A&E
:05:30. > :05:34.attendance, people seem more willing to go to A&E instead of
:05:34. > :05:37.caring for themselves. We have made it easier, people wait a lot less
:05:37. > :05:40.time now, in some senses it is more convenient, of course the
:05:41. > :05:45.population is ageing and has more multiple conditions. It is not that
:05:45. > :05:51.surprising that there is a long- term trend. But we see impact
:05:51. > :05:59.whatsoever from the change in the GP contract. If the new GP can't
:05:59. > :06:05.isn't to blame for people going to A&E, what is? We have these type
:06:05. > :06:10.one and two A&E clinics, the walk- in clinics, they create demand, in
:06:10. > :06:14.a way that opening a road seems to create more traffic. There is a
:06:14. > :06:17.phenomenon in the health service where we open things and people
:06:17. > :06:20.come. We have seen this big increase over the last couple of
:06:20. > :06:24.decades in medical admissions. These are the emergency admissions,
:06:24. > :06:28.people who are really quite seriously ill. They have these have
:06:28. > :06:31.been increasing, I think this may be at the heart of the current
:06:31. > :06:35.problems in A&E. It is not so much the numbers of people coming have
:06:35. > :06:39.increased in the last couple of years. They haven't really, it has
:06:39. > :06:42.been relatively flat. We have seen an increase in the number of
:06:42. > :06:47.seriously ill people who need admission. If anyone is sorting out
:06:47. > :06:53.the problems in A&E, it probably won't be this man, David Nicholson,
:06:53. > :06:59.under fire after the mid-staffs scandal has announced today he will
:06:59. > :07:03.be retiring next year. The size of his pension pot, �1.9 million, will
:07:03. > :07:08.undoubtedly prove controversial. Someone else has a big job in front
:07:08. > :07:11.of them. Joining us now is Dr Bernadette Garrihy, an Accident and
:07:11. > :07:16.Emergency consultant in the West Midlands, who signed the letter
:07:17. > :07:20.saying A&E is in state of crisis in her area. With us also is Dr Claer
:07:20. > :07:24.Gerada, the chair of the college of GPs, and the former Health
:07:24. > :07:29.Secretary, Stephen Dorrell, who now chairs the Health Select Committee.
:07:29. > :07:33.How bad is it, Dr Garrihy? It is getting pretty bad, and has been
:07:33. > :07:38.getting bad for a number of years as was alluded to there. We are
:07:38. > :07:42.seeing attendance rates going up year-on-year in the order of 3-5%.
:07:42. > :07:47.In some areas it is even higher, particularly out of hours. What we
:07:47. > :07:51.are also seeing, as your speaker mentioned earlier, is the mixture
:07:51. > :07:54.of cases that we are seeing now. We are seeing higher percentages of
:07:54. > :07:59.patients with major illnesses and injuries, who have more complex
:07:59. > :08:04.needs, and who put greater demands on the system. What are you talking
:08:04. > :08:09.about there and what increases? increasingly elderly population who
:08:10. > :08:17.come to hospital, who often have underlying co-morbidties, possibly
:08:17. > :08:23.dementia, respiratory problems. And develop what in younger people
:08:23. > :08:27.could be a minor infection and can be easily dealt with. Where were
:08:27. > :08:30.they before? Coming from old homes or residential and nursing homes
:08:30. > :08:34.that can't provide the level of nursing care that they require when
:08:34. > :08:38.they become so well. Not only are they pitching up in Accident and
:08:38. > :08:42.Emergency, they are having to be admitted. They can't just be
:08:42. > :08:46.discharged with antibiotics like a younger person. One doesn't want to
:08:46. > :08:51.be overexcited, but is this a dangerous situation? Of course it
:08:51. > :08:54.is. Patients like this will frequently die of infections that
:08:54. > :08:57.may seem at the beginning relatively minor, but can very
:08:57. > :09:00.rapidly deteriorate. What do you think is behind this increase,
:09:01. > :09:06.Stephen Dorrell? I think we have just heard that there is actually a
:09:06. > :09:11.changing pattern of the conditions that type of patients we are
:09:11. > :09:14.dealing with. We are dealing with a rising elderly population, more of
:09:14. > :09:19.whom are suffering not just from one condition but multiple
:09:19. > :09:24.conditions. It is partly around the changing demand patterns. There are
:09:24. > :09:30.also social pressures at play. There is undoubtedly a rise in
:09:30. > :09:33.attendances at A&E as a result of alcohol and drug abuse. Some of the
:09:33. > :09:36.pressures in A&E, we were told in the Select Committee this morning
:09:36. > :09:40.are caused by slow movement of patients through Accident and
:09:40. > :09:46.Emergency, and an inability on some owecations to admit to hospitals
:09:46. > :09:52.those that should be admitted out of A&E out of hospital. Is it an
:09:52. > :09:55.exaggeration to use the word "crisis" in A&E? "crisis" is a word
:09:55. > :09:58.to be avoided by praktitsing politicians, but it is getting
:09:58. > :10:02.worse and needs to be addressed. According to the Health Secretary
:10:02. > :10:08.it is all your fault. It is the consequence of the deal that the
:10:08. > :10:13.Labour Government did with GPs? Isn't it a shame that again we are
:10:13. > :10:17.scapegoating GPs. There were so many inaccracy in the piece. It was
:10:17. > :10:21.fantastic deal? Blaming a contract that is ten years old for a crisis
:10:22. > :10:27.that has occurred in the last few months. And GPs have never
:10:27. > :10:31.abdicated responsibility for out of hours, we do it all day, all night,
:10:31. > :10:35.we do it throughout of hours services. Have you tried to get out
:10:35. > :10:41.of hours cover from your local GP? I did out of hours yesterday. Many
:10:41. > :10:44.GPs do. No they don't? Many do out of hours. We have had a problem
:10:44. > :10:48.with GP Co-Ops being replaced by commercial organisations. I think
:10:48. > :10:52.what we have to do now is move on. We have actually got to find a
:10:52. > :10:56.solution to this, which is a whole system solution. In general
:10:56. > :11:00.practice we have seen an enormous increase in demand, we need to sort
:11:00. > :11:04.it. Shifting downstream isn't going to make it any better. Engage first
:11:04. > :11:14.of all with that question of GPs? Jeremy Hunt didn't actually say
:11:14. > :11:14.
:11:14. > :11:19.today it was all the fault of GPs, he did say the GP contract led to a
:11:19. > :11:22.significant increase in salaries for GPs. And decrease in out of
:11:22. > :11:25.hours care? They don't any longer accept clinical responsibility for
:11:25. > :11:30.out of hours care delivered to their patient. That, I think, is a
:11:30. > :11:33.mistake. There are plenty of other factors at play. Is there a
:11:33. > :11:38.confusion here, people don't know where to go? I think that is
:11:38. > :11:41.certainly an element of it. Things like the walk-in centres and minor
:11:41. > :11:44.injury units, people aren't always aware they are there. Everybody
:11:44. > :11:47.knows where their local Accident and Emergency department is. And
:11:47. > :11:52.everybody knows that they don't need an appointment, and everybody
:11:52. > :11:58.knows that it doesn't close. That's the reason people come to us.
:11:58. > :12:04.think we need to explode this myth that GPs are sitting there between
:12:04. > :12:07.9-5 twiddling their thumbs. Nobody said that. GPs have seen a 100%
:12:07. > :12:12.increase in their workload over the last ten years, and it is unfair to
:12:12. > :12:15.ask a GP after an 11-hour day, a tired GP, to then go and do an out
:12:15. > :12:19.of hours shift. We need to sort out fragmentation of our patients and
:12:19. > :12:21.sorting out continuity. Can I pick up that point. That, I think, is
:12:21. > :12:25.actually, from the evidence we heard in the Select Committee this
:12:25. > :12:29.morning is the key to the way through this. Nobody is in favour
:12:29. > :12:32.of doctors or nurses or any other clinician working exceptionally
:12:32. > :12:40.long hours. That is bad for the clinician and bad for the patient.
:12:40. > :12:42.What we do have to learn to do is work smarter and trying to have a
:12:42. > :12:46.solution for Accident and Emergency separate from a solution from
:12:46. > :12:50.primary care, separate from a solution for social care. All of
:12:51. > :12:56.these bits of the system need to work in a much more joined-up way.
:12:56. > :13:00.That's part of the means by which we identify patients at risk
:13:00. > :13:03.earlier, avoid them need to go attend either the GP or the A&E
:13:04. > :13:08.department, because you prevent them becoming ill in the first
:13:08. > :13:12.place. But to do that we need more GPs, we have a shortage of GPs now.
:13:12. > :13:16.We need an integrated approach to this, identifying high-risk
:13:16. > :13:18.patients, providing bespoke solutions to some of our high-risk
:13:18. > :13:21.patients, including the frail and elderly and those at the end of
:13:21. > :13:24.their lives. While this is happening there are some issues I
:13:24. > :13:27.would like to take you up on Claire, first of all this is not something
:13:27. > :13:30.that has happened in the last few month. This has been building for a
:13:30. > :13:34.number of years. We have seen a winter and spring like we have
:13:34. > :13:37.never seen before, sustained, relentless pressure. It is
:13:37. > :13:42.happening in primary care, I accept as well, but we have seen ourselves
:13:42. > :13:47.operating at the margins of safety in emergency medicine in a way we
:13:47. > :13:50.don't accept. Also could I just say, yes we do have significant work
:13:51. > :13:54.force issues, we can't recruit junior doctors into emergency
:13:54. > :13:58.medicine any more. Why? Because they see how unattractive and
:13:58. > :14:04.unsustainable a career it is. The college of medicine is advocating
:14:04. > :14:07.there be a drive for job plans that are sustainable. We can deliver
:14:08. > :14:12.care, we are people who are working seven days a woke, we are people
:14:12. > :14:16.who are working 11 hof hours a day and providing out of hours cover.
:14:16. > :14:21.Given there is a problem here, you are reluctant to call it a crisis,
:14:21. > :14:27.others are. How do we go about solving it? As I have said, the
:14:27. > :14:33.most important single thing we can do is to join the different bits of
:14:33. > :14:37.the system up. It is common sense, Jeremy, is it not, that if you know
:14:37. > :14:41.somebody is getting ill, you intervene earlier to avoid them
:14:41. > :14:45.becoming acutely ill, so they need to go out of hours or any other
:14:45. > :14:49.time to an A&E department. I think GPs need to take that
:14:49. > :14:54.responsibility for commissioning all out of hours services right
:14:54. > :14:58.across. We need to also participate the provision of out of hours with
:14:58. > :15:05.other providers. Your own figures don't show a massive link. There is
:15:05. > :15:08.a 1% increase in A&E attendences and 2% year on year for A&E
:15:08. > :15:11.admissions. That is in line with population. You work incredibly
:15:11. > :15:17.hard, emergency doctors work incredibly hard in very difficult
:15:17. > :15:21.conditions, but we can't scapegoat GPs. You made that point already.
:15:21. > :15:27.There is one other thing today that has happened which is the decision
:15:27. > :15:31.of Sir David Nicholson to quit the health service. Julie Bailey who
:15:31. > :15:35.started Cure the NHS joins us now from a remote studio. What was your
:15:35. > :15:40.reaction to hearing that Sir David Nicholson was on his way? Well
:15:40. > :15:43.we're pleased, because it will be a new start for the NHS. But at the
:15:43. > :15:48.same time disappointed that he's been allowed to retire. This man
:15:48. > :15:53.should be sacked. He's failed, look at the disaster that's going on in
:15:53. > :15:58.your studio now. All this isn't rocket science, this should be
:15:58. > :16:02.planned for. This is much bigger than one man? But he's at the top.
:16:02. > :16:09.That's his job. He's the chief executive of the NHS. Is your
:16:09. > :16:12.argument that it's a consequence of the cuts, which he was charged with
:16:13. > :16:18.implementing? It would be foolish to say it was the cuts, it is his
:16:18. > :16:22.style of leadership as well. He has failed. He has been failing the NHS
:16:22. > :16:26.for years. All this that is happening at the moment should have
:16:26. > :16:31.been planned for. We knew there was an increase in the ageing
:16:31. > :16:35.population, we knew there was a shortage of A&E consultants, this
:16:35. > :16:40.is just, this is his job. This is what should have been happening in
:16:40. > :16:44.the NHS. It is called long-term planning. We just do everything at
:16:44. > :16:49.the last minute, that is why we are in this crisis. Do you accept there
:16:49. > :16:55.is a failure of strategic planning, Stephen Dorrell? Where Julyy Moore
:16:55. > :17:02.is undoubtedly right. Bailey? Bailey, apologies, is undoubtedly
:17:02. > :17:07.right is to say, as was illustrated in mid-staffs, that there has been
:17:07. > :17:11.failure of culture in too many places around the health service, I
:17:11. > :17:14.do agree with that. I don't believe a single individual, in the form of
:17:14. > :17:18.Sir David Nicholson, a distinguished public servant,
:17:18. > :17:24.should be pilloried in the way that Julie just did. Moving forward, we
:17:24. > :17:29.have to find a commitment not just to react to individual crises, but
:17:29. > :17:32.to think through how the health and care system can be made more
:17:32. > :17:37.effective in responding to today's patients and their demands. That's
:17:37. > :17:42.where there has been a failure, not just by one man, but by the system
:17:42. > :17:46.over quite a long period. In all the reforms that a have taken place
:17:46. > :17:50.it is still not right? Indeed it is clearly not right. We have changed
:17:50. > :17:55.the management system, it could be said, again, what we haven't done
:17:55. > :17:58.is to change the way care is delivered to make it more joined up,
:17:58. > :18:02.more integrated, I'm pleased to say that is something that Jeremy Hunt
:18:02. > :18:07.and the Prime Minister have made it clear is now top of their health
:18:07. > :18:11.policy agenda. And I would say about time too. One could say we
:18:11. > :18:16.have far too many top-down reorganisations, part of the
:18:16. > :18:21.present crisis is we have been going through a transition for the
:18:21. > :18:28.last year and taken our eye off the ball, patient care, the issues in
:18:28. > :18:31.the emergency department, and deck backle of 111, to blame Sir David
:18:31. > :18:36.Nicholson is disingenious. everything is going so well, why
:18:36. > :18:39.don't I feel better? Is the way you might feel about what is happening
:18:39. > :18:43.in the stock markets. The Financial Times share index is higher than
:18:43. > :18:47.years, so too the Dow Jones in the states. Yet ordinary people don't
:18:47. > :18:52.feel any better off. Of course the index is just reflecting the casino
:18:52. > :18:58.aspect of capitalism. What is going on? For how much longer and to
:18:58. > :19:00.whose benefit? One for the recently appointed chief business
:19:00. > :19:04.correspondent. You might be surprised to know that
:19:04. > :19:10.despite the economic gloom markets are up. Not just a little bit. UK
:19:10. > :19:17.stocks, the FTSE, it is near its all-time high. Today the FTSE
:19:17. > :19:20.closed at its best level for more than 13 years, and it left the
:19:20. > :19:25.index just 30 points below the record high in December 1999, that
:19:25. > :19:30.was at the height of the dotcom boom. Some companies are doing well.
:19:30. > :19:36.But this well? And it is not just us. Look at the Japanese market the
:19:36. > :19:43.Nikkei, it soared, especially since last autumn. Well that's when the
:19:43. > :19:48.large-scale cash injection programme known as Obenomics was
:19:48. > :19:53.mooted. Japanese stocks are up about 45% since then. That is twice
:19:53. > :19:59.as much as what would be called a bull market, when prices rise 20%.
:19:59. > :20:03.And then there is the S & P in America, you can certainly see the
:20:03. > :20:13.affect of cash injections or quanative easing, QE for short in
:20:13. > :20:17.the United States. Each time there is a cash injection, QE1, QE-2 and
:20:17. > :20:27.the fancy version of praix twist, that is the Federal Reserve trying
:20:27. > :20:29.
:20:29. > :20:32.to buy more in the long end and selling a bit on the short end. QE
:20:32. > :20:42.was supposed to help the real economy, there is not much soaring
:20:42. > :20:43.
:20:43. > :20:50.there. The economy has not recovered, the US has recovered to
:20:50. > :20:53.level that is were higher than the 208 crisis, but the UK and Japan
:20:53. > :20:58.hasn't. The way it was supposed to work was to make households feel
:20:58. > :21:03.better, think of it this way. An American household you lose $10,000
:21:03. > :21:07.and the value of your house, but your stocks have risen by $10,000.
:21:07. > :21:11.Not everyone owns stocks, just the richer households. Now eventually
:21:11. > :21:17.the firms that have been benefiting from these markets they could
:21:17. > :21:21.invest more in the economy and that would help. But they may be wary of
:21:21. > :21:25.inflated share prices, where there is not much demand supporting it.
:21:25. > :21:30.Worse, investors are borrowing to buy stocks, it is even reaching
:21:30. > :21:34.worrying levels in the US. So the overall picture, of course, that
:21:34. > :21:39.low rates do help keep debt manageable in a slowly recovering
:21:39. > :21:41.economy. But could there be other trouble down the line? If lots of
:21:41. > :21:48.investors borrow too much, and there is not a great dole
:21:48. > :21:56.supporting those firms, then we may see markets take a tumble.
:21:56. > :22:05.With us now prominent economic thinkers, Gillian Tett, Allister
:22:05. > :22:09.Heath, and Robert Reich, political economist, author and Professor at
:22:09. > :22:13.Berkeley. Why are the markets so buoyant? Two reasons, firstly
:22:13. > :22:16.although this recovery hasn't been very good for countries or ordinary
:22:16. > :22:20.consumers t has been good for companies, corporate profits have
:22:20. > :22:25.been improving. But secondly, most importantly, you have had the
:22:25. > :22:28.central banks around the world inject $7 trillion worth of
:22:28. > :22:32.liquidity into the system by quanative easing, that money has to
:22:32. > :22:37.go somewhere, and right now, -- quantitative easing, that money has
:22:37. > :22:42.to go somewhere, and bond investors don't like the look of it and are
:22:42. > :22:46.putting it in equity instead. it anything to do with the real
:22:46. > :22:50.economy? Ultimately it does, we are seeing long-term the proportion of
:22:50. > :22:54.the economy going into wages is shrinking, going to real people,
:22:54. > :22:58.the proportion going to profits is increasing. Those profits do go to
:22:58. > :23:02.people but they are investors, not necessarily workers. Is this a good
:23:02. > :23:07.thing? It would be a good thing if the markets were sustainable, if
:23:07. > :23:11.the prices were the correct prices, I'm very worried, we are in a
:23:11. > :23:16.pretty large bubble building at the moment. I think yes corporate
:23:16. > :23:22.profits are very high as a share of GDP, at some point there will be a
:23:22. > :23:24.peak and it will reverse itself. you reckon it is a bubble? There
:23:24. > :23:28.are bubble-like tendencies, there is so much money around the system
:23:28. > :23:32.and it is pumping up asset prices. As of today we have not seen
:23:33. > :23:36.inflation going up, but we are seeing asset prices go up. The real
:23:36. > :23:39.question now is a psychological issue, if stock prices are rising,
:23:39. > :23:43.is that going to make people feel more confident and want to go out
:23:43. > :23:48.and spend money and actually get the economy going? Is it going to
:23:48. > :23:51.ignite animal spirits, or is it the case as Robert says, that it is a
:23:51. > :23:55.tiny proportion of investors benefiting from this, the elite are
:23:55. > :23:58.getting richer and drawing away from the rest of society. In which
:23:58. > :24:04.case, pumping up stock markets may not help get the middle-classes
:24:04. > :24:07.spending more money. In the United States we have about 10%, the
:24:07. > :24:13.richest 10% of the population owning about 90% of all shares of
:24:13. > :24:16.stock by value. They are doing very well. They are feeling very good,
:24:16. > :24:19.they are buying, but you can't sustain economic growth on the
:24:19. > :24:26.basis of just 10% of your population. Even if they are the
:24:26. > :24:30.very richest 10%. It is not desirable that stocks are racing --
:24:30. > :24:33.racing ahead in the way they are doing so? If it is based on the
:24:33. > :24:36.fundamentals, if not only companies are profitable, but if in fact
:24:36. > :24:41.these economies are fundamentally in good shape that would be one
:24:41. > :24:46.thing, they aren't. That is the underlying reality. We have the
:24:46. > :24:50.median wage in the United States, and also here in the UK, going down
:24:50. > :24:54.adjusted for inflation. One piece of good news, I think, if share
:24:54. > :24:57.prices do go up, it is easier for companies to raise money. We have
:24:57. > :25:01.seen quite a few companies recently go to the stock market and
:25:01. > :25:04.investors and raise a lot of money. If they do raise money, finally
:25:04. > :25:07.they might start spending more. In that respect it is directly helpful
:25:07. > :25:11.for the real economy. I think the real problem is, the underlying
:25:11. > :25:15.structure of the UK, of the US, of the eurozone economies is really,
:25:15. > :25:20.really grim, there is huge, huge problems. And those problems are
:25:20. > :25:23.not reflected in this incredible mood of optimisim in the stock
:25:23. > :25:26.market. One of the problems we see is the companies are taking very,
:25:26. > :25:30.very cheap money they are getting from central banks, and they are
:25:30. > :25:34.turning around and buying back their shares of stock. That is
:25:34. > :25:37.artificially pumping the stock prices up like steroids. But the
:25:37. > :25:41.actual underlying reality is anything but a profitable outlook.
:25:41. > :25:45.One of the very interesting things to pick up on that comment is if
:25:45. > :25:52.you look at the relationship or the pattern of unemployment versus
:25:52. > :25:55.equity prices or company earning revisions versus equity prices,
:25:55. > :25:59.historically they have tracked each other. In the last few years they
:25:59. > :26:02.have diverged, these numbers have been looked at recently, again, if
:26:02. > :26:06.you look at the costs for companies borrowing money, the credit spread
:26:06. > :26:08.for risky companies, and compare it to debt burdens, again you had a
:26:08. > :26:13.relationship that has broken down in the last two years. Something
:26:13. > :26:17.has changed in the last two years. Personally I suspect it is
:26:17. > :26:23.quantitative easing. What could or should Governments be doing in
:26:23. > :26:28.these circumstances? One thing, you have central banks on the look out,
:26:28. > :26:33.not so much for inflation but bubbles, they are slightly
:26:33. > :26:38.different. We don't want a repeat of leading up to 207-2008. We have
:26:38. > :26:41.to be careful. Governments over the long-term have got to worry about
:26:41. > :26:45.widening inequality. If your medium wages are not going up but going
:26:45. > :26:47.down, even though more people are being employed, you are not
:26:47. > :26:51.building your economy. You are actually undermining your economy.
:26:51. > :26:54.The bubble point is a key point here, I think central banks and
:26:54. > :26:57.Governments have done far too much to pump liquidity into the economy.
:26:57. > :27:02.They have gone too far. There was a big problem, they were trying to
:27:02. > :27:05.prevent another collapse and another 1930s-style depression, in
:27:05. > :27:11.Japan they are trying to reverse the effects of deflation, but they
:27:11. > :27:14.have gone too far, too much money is in the system. A lot of problems
:27:14. > :27:18.in 2006-2007, people not seeing the real risk out there, all the stuff
:27:18. > :27:22.is going back, the housing market has gone crazy again, the bond
:27:22. > :27:26.market is in a bubble and people are buying equities. It is a
:27:26. > :27:30.dangerous situation. The other way of saying is central banks have put
:27:30. > :27:33.foam on the runway to help the Government as they land a plane of
:27:33. > :27:36.structural reform. Everyone knows it will be difficult to implement
:27:36. > :27:39.the structural reform needed. Central banks are trying to ease a
:27:39. > :27:42.path. The problem is the politicians got addicted to the
:27:42. > :27:46.foam and they don't want to land the plane at all, essential low
:27:46. > :27:51.they are getting the excuse to keep delaying the hard reform, because
:27:51. > :27:58.guess what, the stock markets are rising, why do we have to swallow
:27:59. > :28:02.the bitter medicine. I love that picture. I would state it even more
:28:02. > :28:07.strongly, but a little bit different. As long as we have a
:28:07. > :28:11.fiscal policy that is embracing austerity, in which basically
:28:11. > :28:16.Governments are cutting spending, a monetary policy, that is a Central
:28:16. > :28:21.Bank policy that is very expansionry is a fundamentally
:28:21. > :28:24.imbalanced Government system. Contradictory? Contradictory and it
:28:24. > :28:27.leads to trouble. I'm one of those people who thinks the Government
:28:27. > :28:30.does have to cut spending, I don't think it is cutting very fast in
:28:30. > :28:34.the case of the UK. What we have seen in America is you can cut
:28:34. > :28:38.spending and have an economy that recovers. For me the Government
:28:38. > :28:41.should be really pushing through the structural and supply side
:28:41. > :28:44.reforms to make the economy more competitive and boost human capital,
:28:44. > :28:48.to improve incentives and try to make sure that companies have an
:28:48. > :28:52.incentive to start hiring and spending money again. When you look
:28:52. > :28:56.at a country like Japan, for example, is this a model that will
:28:56. > :29:02.work and we should follow? Exhibit A for why structural reforms matter,
:29:02. > :29:05.frankly. Right now the Central Bank is pumping money into the system,
:29:05. > :29:10.astonishing amounts, but the question for Japan is can an
:29:10. > :29:13.economy grow if its population is shrinking. Japan will need serious
:29:13. > :29:16.structural reform in getting women to work, older people and more
:29:16. > :29:19.immigration and getting companies to use their money much more
:29:19. > :29:22.efficiently to actually create sustainable growth. Structural
:29:22. > :29:27.reform, everybody likes structural reform, but it is one of those
:29:27. > :29:32.terms that has gone from obscurity to meaninglessness without any
:29:32. > :29:38.intervening period of coherence. Let's face it, there do need to be
:29:38. > :29:43.certain structures, flexibility is very nice. But I'm afraid I have to
:29:43. > :29:47.disagree with you, austerity is an absolute disaster, for Europe, the
:29:47. > :29:50.United States is gently putting the toe into the austerity pool and it
:29:50. > :29:54.is holding back economic growth. the case of the UK the Government
:29:54. > :29:58.is cutting by less than 1% a year in terms of total, pendure, I don't
:29:58. > :30:02.think that can be blamed for the problems we are in. One of the big
:30:02. > :30:08.problems is inflation has been too high and real wages have ground to
:30:08. > :30:10.a halt and real wages have suffered a huge amount. There has been
:30:10. > :30:16.massive unprecedented reduction in the purchasing power of people.
:30:16. > :30:21.Private sector wages are going roughly speaking up by zero%, you
:30:21. > :30:25.have inflation 2.5%. People are 7- 8% worse off than they were two or
:30:25. > :30:27.three years ago. That is having a huge effect. Again that is because
:30:27. > :30:34.of excessively loose monetary policy, the Bank of England has got
:30:34. > :30:37.it wrong on that. It is time for us all to slide from obscurity into
:30:37. > :30:45.meaningless and back into obscurity any way.
:30:45. > :30:48.In a moment, why has this golf shot been banned?
:30:48. > :30:51.A Government-appointed panel looking into the building collapse
:30:51. > :30:56.which killed over 1,000 people in Bangladesh has recommended that
:30:56. > :30:58.nine men, arrested by police, be different given life sentences. The
:30:58. > :31:02.worst industrial disaster of the century occurred in a building
:31:02. > :31:06.making cheap clothes for well known western brands. While the
:31:06. > :31:10.corruption of Bangladeshi officials and businessmen isn't necessarily
:31:10. > :31:14.their fault, and the economy of one of the world's poorest countries
:31:14. > :31:20.depends on their business, the disaster does raise questions,
:31:21. > :31:27.economic and ethical, for the west. 300 factories have re-opened after
:31:27. > :31:35.days in which workers struck in protest at pay and conditions in
:31:35. > :31:41.the wake of the claps of the Rana Plaza. Employees choosing to give
:31:41. > :31:44.up wages is one thing, but Bangladesh can't choose to free
:31:44. > :31:48.itself of the rag trade. It is the second biggest clothing
:31:48. > :31:54.manufacturer in the world, it is worth $20 billion and accounts for
:31:54. > :32:00.four fifths of exports. The factory collapse was the worst industrial
:32:00. > :32:03.disaster since the Bhopal poisoning in 1984. But the chain that runs
:32:03. > :32:07.from factory to department store is long and complicated.
:32:07. > :32:12.Responsibility is so often somebody else's duty. It wasn't the high
:32:12. > :32:15.street labels which ordered workers into a building which was visibly
:32:15. > :32:23.cracking. But just supposing that western retailers decided that
:32:23. > :32:27.Bangladesh was more trouble than it was worth? Professor Muhammad Yunus
:32:27. > :32:31.is probably the most famous Bangladeshi in the world, a winner
:32:31. > :32:36.of the Nobel Peace Prize for his work on microfinancial policies, to
:32:36. > :32:38.lift the very poorest out of poverty. He is with us now.
:32:38. > :32:43.Supposing, as I have heard people saying in this country, Bangladesh,
:32:43. > :32:47.bad place to make clothes, why not make them somewhere else. What do
:32:47. > :32:51.you say? Bangladesh is a very good place to make the garments. We have
:32:51. > :32:54.been doing it, we are the second- largest exporter of garments.
:32:54. > :32:59.People are appalled when they hear what people in Bangladesh are paid,
:32:59. > :33:03.and when they see something like this tragedy, these awful working
:33:03. > :33:07.conditions, you can understand them, what is the point of making them in
:33:07. > :33:10.Bangladesh. Can't we do it somewhere else, it would cost some
:33:10. > :33:14.more? We have problems, it doesn't mean the entire industry is going
:33:14. > :33:18.wrong. We have been doing very good work, we have been appreciated for
:33:18. > :33:23.our work. The thing that needed to be done, it is something we can put
:33:24. > :33:27.together, all of us, not just a blame game for the Bangladeshis not
:33:27. > :33:31.going it right. Everybody is involved in this. We are all
:33:31. > :33:35.partners in it. The garment industry gave Bangladesh a chance.
:33:35. > :33:39.We are coming from a peasant economy, for the first time we got
:33:39. > :33:43.involved in this industrial activity. It hasn't made you
:33:43. > :33:47.question whether this strategy hasn't made you question whether
:33:47. > :33:49.there was -- tragedy hasn't made you question whether it is a
:33:49. > :33:55.sensible strategy? The question is we haven't done enough, it is the
:33:55. > :34:00.beginning of the industry, a lot of things were doing in a rush. Buyers
:34:01. > :34:04.were involved and producers were and everyone involved in that. So
:34:04. > :34:08.trying to assign blame to one particular factor is difficult.
:34:08. > :34:12.Walking away from Bangladesh is not a solution. This is the first time
:34:12. > :34:17.this four million young girls, coming from the rural areas to the
:34:18. > :34:22.city. For the first time this is a tremendous social impact in the
:34:22. > :34:25.society, which is sleepy peasant society with remote villages with
:34:26. > :34:29.these women relegated to the back part of the house. They are not
:34:29. > :34:34.even seen in the front part of the house. They are coming out of that
:34:34. > :34:39.and came to the city and made a whole industry survive and become
:34:39. > :34:42.the second-largest exporter of garments next to China. This is a
:34:43. > :34:47.tremendous success. We should see both sides, the success part and
:34:47. > :34:53.also the other part. Should we pay for more our clothes? What I would
:34:53. > :35:01.say is you are paying very little for the wages. If what we produce
:35:01. > :35:05.we sell it for $5, the same thing sold here for $35, so out of that
:35:05. > :35:08.$5 the cotton growers and the cotton and the dyeing and the
:35:08. > :35:13.stitching people, and all those things make the $5. We need a
:35:13. > :35:17.little bit of room, people who have made that shirt whether they are
:35:17. > :35:21.getting the fair wage. So I'm suggesting why don't we come up
:35:21. > :35:28.with an international minimum wage, a fair wage. But this strategy that
:35:28. > :35:31.you praise, of taking people from peasant lives to manufacturing
:35:31. > :35:34.lives has been based on undercutting other parts of the
:35:34. > :35:40.world? It is not undercutting, Bangladesh became attractive
:35:40. > :35:43.because it is the "cheapest" labour. Undercutting other places? No these
:35:43. > :35:49.are people who didn't have any jobs. So whatever money they got they
:35:49. > :35:56.were happy with that. They came, but now the question is if you are
:35:56. > :36:01.paying say for example 25 cents an hour, if you make it 50 cents an
:36:01. > :36:03.hour, a dramatic change. It doesn't add much cost to the total product
:36:03. > :36:08.actually. The question of getting together rather than saying we have
:36:08. > :36:11.the cheapest labour, with the 50 cents it still would be the
:36:11. > :36:16.cheapest. Instead of pushing the wage down and all the competitions
:36:16. > :36:22.and all the things that are happening, mult light bar again is
:36:22. > :36:27.going on the poor -- ultimate bar again is going on these -- brgain
:36:27. > :36:32.is going on these poor women. could you ensure that some sort of
:36:32. > :36:36.surcharge would be implied there? It is not a surcharge it is
:36:36. > :36:41.guarnteeing a minimum wage. All civilised nations do that. All we
:36:41. > :36:44.are saying, I'm proposing that a minimum wage which is consistent
:36:44. > :36:49.with the market they are integrated with. They are partners in the
:36:49. > :36:56.whole business part. They should have their fair part of it. It is
:36:56. > :37:00.not sort of demanding something that is unreasonable. All the costs
:37:00. > :37:05.out of the $35, what percentage will go to the people who are
:37:06. > :37:10.making it. And does it help them? You know my family all came from,
:37:10. > :37:14.they were all in the textile trade, the textile trade has more or less
:37:14. > :37:17.disappeared from much of this country, it has gone to countries
:37:17. > :37:21.like yours. How can you possibly tell people in this country that
:37:21. > :37:26.they should pay for more clothes in order to subsidise wages on jobs
:37:26. > :37:32.that have been taken from this country and other ones? Well it is
:37:32. > :37:36.still, you will not do it for 25 cents, it is still such a tiny
:37:36. > :37:41.piece, that is why Pope Francis said it is slave labour. We are
:37:41. > :37:46.saying let's not make Bangladeshi women slave labourers, let as make
:37:46. > :37:49.them decent workers with a decent wage so they can take care of their
:37:49. > :37:53.level of life. We are not asking for western workers' lives, and
:37:53. > :37:56.nobody will work for 50 cents an hour here. You are quite right
:37:56. > :37:59.there. This is an opportunity for women. This is a whole
:37:59. > :38:05.transformation of the society. If we give them a trans, if we sit
:38:05. > :38:09.down together, we find the solution. It is all this solvable problems.
:38:09. > :38:13.The disaster has drawn attention from the whole world, and attention
:38:13. > :38:16.for the whole nation in Bangladesh. We need to take advantage of it and
:38:16. > :38:21.take it in an urgent basis, to come together and find the solution to
:38:21. > :38:26.this problem. Thank you very much. The incomes item is about golf,
:38:26. > :38:30.this would, in the normal course of things, be the cue for some unfunny
:38:30. > :38:36.jokes. It is serious, the men and women in blazers and unusual
:38:36. > :38:40.trousers who run the game in Britain and America, have decreed
:38:40. > :38:43.it unsporting for players to anchor their putters as they go for the
:38:43. > :38:48.hole. You wonder what on earth could be the offence committed by
:38:48. > :38:53.such an action. It is making the game too easy, apparently. So
:38:53. > :39:02.following months of soul searching the sports bosses today tackled the
:39:02. > :39:07.controversy head-on by introducing new rule 14 (1) (b) to outlaw the
:39:07. > :39:11.practice. We are announcing today that acting through our independent
:39:12. > :39:18.decision-making processes, the USGA and the RNA, have both now approved
:39:18. > :39:23.the adoption of rule 14-1 (b). Not everyone will agree with the final
:39:23. > :39:28.decision, but we do hope the care and love for the game that all have
:39:28. > :39:33.expressed through their participation in this process will
:39:33. > :39:41.facilitate acceptance of rule 14-1 (b) when it takes effect. We are
:39:41. > :39:47.joined on the Newsnight green by pro-golfer justice Fiddler. What
:39:47. > :39:53.does a Pro do? Play golf and a little bit of teaching. He's a big
:39:53. > :39:59.deal at the Royal St George's club in Kent. He's going to demonstrate
:39:59. > :40:06.the putt. Also with us is the club secretary, and joining us from kal
:40:06. > :40:16.Gary is the President of the Canned -- kal Gary is the President of the
:40:16. > :40:19.
:40:19. > :40:24.Canned ian golf who was against the rule but will abide by it. This is
:40:24. > :40:28.the traditional standard length of putter, the actual stroke itself is
:40:28. > :40:38.a free-flowing stroke with the putter moving away from the body.
:40:38. > :40:40.
:40:40. > :40:44.As I will demonstrate here. Well done! More practice needed. As you
:40:44. > :40:49.can see the main difference being is the length of putter. This is
:40:49. > :40:55.the one that is going to be banned? This is the one, not the putter
:40:55. > :40:58.itself, the way you set up to the ball and the stroke. So the main
:40:58. > :41:08.difference being, so with the stroke it is a free-flowing
:41:08. > :41:12.
:41:12. > :41:17.movement, but the putter itself is anchored into the belly. It is not
:41:17. > :41:23.as good either! More practice needed. But it is actually seeming
:41:23. > :41:29.to me to be more difficult to get it in using that one? It is, I
:41:29. > :41:35.would find, I'm not, I use my shorter putter traditional putter.
:41:35. > :41:40.But the reason this is going to be not permissible is because of your
:41:40. > :41:44.tummy? It is attached to the body. You can use it in the belly, in the
:41:44. > :41:48.chest. So the putter is anchored itself. It is not moving away. That
:41:48. > :41:53.is supposed to make it easier? could make it easier for some, as I
:41:53. > :41:59.have proven there, not for myself. OK, well you stay there, you can do
:41:59. > :42:05.a bit of practising while we discuss. Now you are in favour of
:42:05. > :42:09.this new rule are you? I think it is that free movement of the club,
:42:10. > :42:15.whether it is with a driver, or indeed with a putter is probably
:42:15. > :42:20.the sort of ultimateest it of the game in that the golfer -- ultimate
:42:20. > :42:24.test of the game, whether a club player or professional has to
:42:24. > :42:27.deliver the ball in the right place to make it go. It is thought by
:42:27. > :42:31.anchoring the number of moving parts they are reduced and there is
:42:31. > :42:36.an advantage. He got one in, look?'S Doing well, he has been
:42:36. > :42:46.practising all afternoon. Let's go over to Calgary, are you hearing me
:42:46. > :42:47.
:42:47. > :42:56.OK? I am hearing, thank you. Why do you think that this should be
:42:56. > :43:01.permitted this new style of putting? Well the PGA of Canada
:43:01. > :43:05.polled the almost 4,000 members and approximately 66% or two thirds of
:43:05. > :43:09.the members came back and did not support the anchor ban, which would
:43:09. > :43:14.be consistent of the PGA America when they polled their members,
:43:14. > :43:20.they came back with the same numbers. When the first proposal
:43:20. > :43:24.came out in the US GA, our concern was the fun and enjoyment of the
:43:24. > :43:30.game for the ordinary players, not so much the twoods of the game, for
:43:30. > :43:34.the every day enjoyment and fun of it. Since 208 and the industry has
:43:34. > :43:37.fallen -- 2008 and the industry has fallen back a bit, we need to make
:43:38. > :43:46.sure the golfers are coming out to the game and getting entrenched in
:43:46. > :43:51.the game. We have been losing them. We will engage with that question,
:43:51. > :43:56.your sport, or activity, it is a sport, it has a stuffy enough image
:43:56. > :44:02.any way, has a problem recruiting people. Why are you being so pen
:44:02. > :44:06.nickity? I think the -- person nickity? I think the problem has
:44:06. > :44:10.been people's lives, and speeding up the pace of play and access. The
:44:10. > :44:20.putting piece is really an attempt by the regulatory authorities to
:44:20. > :44:24.make sure that That free-flowing club is not compromised. Why does
:44:24. > :44:29.it matter, it is like batting the reverse sweeping cricket, what is
:44:29. > :44:33.the point? They are not, are they? They are not, precisely. There is
:44:33. > :44:39.this anchoring point that fundamentally changes the ethos of
:44:39. > :44:44.that stroke. If you tried it. Changes the ethos? The feel, ethos
:44:44. > :44:50.is a bad word. Entirely it changes, and all four major open winners
:44:50. > :44:55.currently use this way. There is no statistical proof it provides
:44:55. > :45:00.advantage. Why does it matter? think the authorities and the RNA
:45:00. > :45:05.and the golfing certainly public in the sku. I think have come down on
:45:05. > :45:10.the side -- in the UK, I think, have come down on the side that the
:45:10. > :45:17.game must be perpetuated. Is this further evidence of the stuffiness
:45:17. > :45:25.of golf authorities? Sorry can you repeat. Yes, I was asking whether
:45:25. > :45:29.you think this is evidence that the golf authorities are rather stuffy?
:45:29. > :45:32.I'm sorry you are breaking up I'm having trouble catching you there.
:45:32. > :45:36.Oh dear, I'm sorry about the communecation, we have terrible
:45:36. > :45:40.communication problems there. Thank you very much for sparing the time
:45:40. > :45:43.for joining you. Thank you two very much indeed. We will see that
:45:43. > :45:53.justice is done eventually. And some of tomorrow morning's front
:45:53. > :46:20.
:46:20. > :46:30.pages, I did have them, I have lost That's all we have time for tonight.
:46:30. > :46:38.
:46:38. > :46:41.Good evening, a largely dry night out there tonight. One or two
:46:41. > :46:46.showers can't be ruled out to take us into Wednesday morning. Most
:46:46. > :46:49.start the day dry. Varying amounts of cloud, a chilly start in
:46:49. > :46:52.Scotland, with the chill a strengthening wind, increasing
:46:52. > :46:55.risks of showers in the afternoon. One or two showers pushing through
:46:55. > :46:59.Northern Ireland. Still dry and bright here with sunny spells. The
:46:59. > :47:04.showers through the day in Scotland, the northern half of Scotland in
:47:04. > :47:06.particular becoming heavy with hail, sleet and snow over the higher
:47:06. > :47:09.ground, the wind reaching gale- force into Wednesday night. Much of
:47:09. > :47:13.central and western England will be dry. Down the eastern counties
:47:13. > :47:18.always a bit more cloud throughout the day, and increasing risk in the
:47:18. > :47:23.afternoon of a few showers popping up, very much hit and miss, most of
:47:23. > :47:28.you avoiding them, but they could be on the heavy side. Cool in
:47:28. > :47:32.eastern areas, average for the time of year. In the strengthening North
:47:32. > :47:36.West wind around some of these coasts it will feel cooler. The
:47:36. > :47:42.trend is to cooler conditions, if not colder by Thursday. This is the
:47:42. > :47:44.city forecast for northern areas, temperatures dropping away markedly.
:47:44. > :47:47.Showers becoming more frequent. Greater chance of getting wet on
:47:47. > :47:51.Thursday, it will feel significantly colder. Winds