15/07/2013 Newsnight

inadequate, lax. Where is the NHS now failing to many patients?

oldest alarm in the world has gone out. A life is in danger.

One celebrated as the end of the world, tomorrow an inquiry into

high death rates at 14 hospital trusts in England is expected to be

brutal. How could one Health Trust given a clean bill of health by

inspectors this year then allow this to happen. She hated the

nights more than anything. She said the nights are horrific. She would

ring the bell in the middle of the night for pain relief screaming in

agony, they said they would come back and be away for an hour. And

they might just give her a tablet. In the studio doctors, health

policy professionals, politicians and bereaved parents.

And ahead of tomorrow's report a political row tonight with

accusations that in 2010 the Labour Health Secretary, Andy Burnham

ignored more than 1500 warnings of failures at these trusts. Also

tonight this former soldier is to be extradited to America possibly

to face years in prison for fraud. He said he suffers from post

traumatic stress disorder, is it right to hand him over? Good

evening. The Mid Staffs scandal was a terrible moment for the NHS,

people prayed it was a one-off, but it was not. Tomorrow the

investigation led by the NHS Medical Director sur Bruce Keogh,

will report on 14 other trusts with high mortality rates. Brian Jarman,

an advise Tory the Keogh Review, who is here tonight, said there

were 13,000 excess deaths at the 14 Trusts between 2050 and 2010. The

run-up to the report has become intensely political with Labour's

now shadow secretary denying any blame for the failings in the NHS

when he was at the helm. But such is the importance of the Keogh

Review that it may be a defining moment for the future of the health

service in England. One man that hopes it will be the case is James

Titcombe, whose baby son Joshua died when a serious infection was

missed at Furness General Hospital. What are your hopes tomorrow?

hope it is a real light shone on to the 14 Trusts and it exposed really

what has been goingen in those Trusts, and hopefully it can lead

to recommendations to make sure that things improve pretty quickly.

-- Going on in those trusts and hopefully it can lead to

recommendations to make sure that things improve pretty quickly.

What does it say about that number of deaths? The numbers of deaths in

those 14 hospitals exceeded the number that would have taken place

had they had the national death rate for age, sex and diagnosis and

so on, it is compared to what would have been expected by the national

death rates. It is a stark sum then? It is.Do you think we are at

a moment in the NHS with Sir Bruce Keogh's report? I think it is a

tipping point in the NHS. It is a point where we are beginning to say

let's not deny the data, let's actually look at it and make

improvements. That to me is a dramatic change from the attitude

of the last decade or so. We will be discussing all that and we will

be hearing from Sir Brian and James Titcombe and other other guests in

a little while. First we report on why it has taken so long for all

these problems of patient care and inadequate regulation to emerge.

It used to set Britain apart, we could rely on the NHS. It truly is

one of our greatest and proudest achievements. But something has

gone wrong. After the terrible revelations of neglect of

vulnerable patients in Mid- Staffordshire, and with more

hospitals still being put on the watch list, we have all been left

wondering just how safe our local hospital really is? Tameside is one

of 14 Hospital Trusts placed under scrutiny earlier this year. The

Medical Director of the NHS in England, Sir Bruce Keogh, picked

these 14 because they have higher than expected mortality rates.

These urgent reviews go beyond the routine work of the official

hospital regulator, the Care Quality Commission, or CQC, which

is coming under increasing criticism over why it has taken so

long to act. This is the latest hospital to face serious questions

over how well it has been caring for patients. But concern over care

here isn't new, local people have been trying to raise the alarm for

many years and even in the last few months there have been cases that

have troubled families. Always had a smile. She was 84, very

independent. Mark Burns mother olive had been diagnosed with lung

cancer, but in April at Tameside was admitted to A&E with acute pain

and unable to walk. It was three weeks it came to light she had a

fractured hip. She suffered a stroke at the hospital and

contracted the infeck Cdeficile. The staffing levels were

unbelievable. Especially at night, my mum said she hated the nights

more than anything. The nights are horrific. She would ring the bell

in the middlele of the night, screaming in agony, and they would

say they would come back to her, and they would be away for an hour.

They might just give her the tablet. It is just horrendous. Just the way,

the whole organisation, the hospital, seems to be upside down

to me. Surgery seemed out of the question, and the family

concentrated on getting olive home. What effect do you think it had on

your mum the quality of the care in the hospital? Probably a week

before she finally passed away she said she had enough. She was like

she can't cope with this any more. She knew she wasn't going to get

any more, she more or less gave up. Olive died the day after leaving

hospital, the family has told the Keogh Review about what they see as

appalling care. They have put in a hospital complaint but have yet to

receive a formal reply. The coroner has called for an inquest and the

hospital says it cannot now comment further. Though it is in on going

discussions with the Burns family. It is a step in the right direction.

Milton is an orthopaedic consultant at Tameside hospital, he has been

raising concerns about the quality of care for much of the time he has

worked there. He says that has made his working life difficult. He

deals with the stress by hill walking. I have been raising

concerns since 2002, principally because of low nursing staffing

levels. For instance a nurse has been asked to look after up to 24

patients. This is not exceptional, it is happening once or twice a

month. But even one incident when there is so few nurses to look

after patients then that has an impact.

He took his concerns to senior staff at the hospital, and all the

regulatory bodies, including the Care Quality Commission. When the

inquiry into shocking standards of care into Stafford hospital first

reported in 2010 it struck a chord. I could not help but think about

our own situation at Tameside Hospital and I saw the similarities

we had. In many respects internal reorganisation of wards,

application for foundation status, Trust-Foundation status. The high

mortality. Just two weeks ago the hospital suddenly announced that

its chief executive and Medical Director were both to leave. An

interim chief executive is now in place and has announced a six-month

listening exercise for staff, patients and local people. Overall

Milton thinks the hospital is now safe. For planned care. But still

has concerns for the safety of emergency patients. Jill Edwards is

a lawyer with some 20 clients with complaints against Tameside

Hospital. Over a number of years we have seen a pattern of cases coming

through from Tameside Hospital. So we have had inquiries from people

who have expressed concern about the care that they or a family

member have received at Tameside Hospital. It has come as no

surprise to me and my colleagues that this is now the focus of

attention. We know there are concerns about Accident and

Emergency care. But also on the medical admissions unit and in

relation to radiology. It is also known that the hospital has had

higher than expected mortality rates for at least the past decade.

Which is why it was included on Sir Bruce Keogh's list for indepth

review. With all these repeated warnings and chances to put it

right, why is it only now there has been this special in depth review,

and why didn't the official regulator act sooner? Surprisingly

in March this year the CQC judged Tameside Hospital to be safe.

the Care Quality Commission didn't flag up problems as recently as

February 2013 when they gave it a clean bill of health is beyond me.

There have been concerns expressed for many years from local MPs, from

patient support groups and the CQC were supposed to be there to flag

up this sort of problem. They have been in exist since 2009. They had

their -- existence since 2009. They had their chance to act. The CQC

told Newsnight the early inspection was only limited in focus and today

published a new inspection report on Tameside. It now says the

hospital fails on three out of four national standards and warns that

patients are not always protected from the risks of unsafe care. It

noted that emergency staff levels had increased. Tameside told us it

had already begun to address the issues and declined the request for

an interview. The death of baby Joshua Titcombe at Furness General

Hospital in Morecambe Bay has also focused intention on the

inadequacies of past inspections by the CQC. Joshua died in 200 from a

treatable infection. Two years later the CQC registered the

hospital as safe. The absolute tragedy is Joshua's death wasn't

learnt from and other babies continue to be put at risk, and

other lives were lost. That's something that I find very

difficult to come to terms with. the heart of the matter is also the

lack of an investigation into the death of baby Joshua Titcombe.

CQC now acknowledges it should not have said Furness General was safe.

The current chief executive, in post for a year, faced MPs this

month, after a critical independent report found evidence of a possible

cover-up of CQC failings. The individuals involved fiercely

dispute this. But it was your staff that were carrying out inspections,

it was your staff that had to review the action plans, it was

your staff that were making important decisions about the

status whether it was red, amber, green. I don't wish to be evasive

but what the report is saying is there was a lack of rigour and

robustness around the work that CQC did in relation to Morecambe Bay.

We are changing that, and we are moving on from that. There has to

be a recognition that positive CQC inspections, in the past, mean very

little. And I think there must be a lot of uncertainty about the actual

safety of services in the NHS at the moment. That's just an

unacceptable situation. Really we need it look at the CQC

transforming in a very short period of time. So that we can actually

have confidence that it is doing the job that it needs to be doing.

Tomorrow Sir Bruce Keogh will publish his verdict on care at the

14 hospital trusts. Newsnight has had access to all of the figures

showing numbers of deaths above those expected statistic ically,

Basildon and Thurrock is the worst, Most said they will respond once

the full Keogh report appears tomorrow. Colchester and Dudley say

their death rates are within the expected range. Basildon and

Thurrock said they are committed to improving patient care. The data

shows that Stafford was not a one- off. Putting all this right will

not happen overnight. Though it should be simple to care properly

for people when they are at their most vulnerable.

Our political editor Allegra Stratton is here. First of all,

what developments will happen tomorrow? The Keogh Review will

start the summer of mud-slinging and slurs between the political

parties. The Conservatives have been quite shocked so far that so

far nothing seems to have stuck to the previous Government, even

though some of these misdemeanors happened under their watch. So

tonight we have and tomorrow we will hear more about it

Conservative MPs putting forward what they have got out of the

Government, which is in parliament they put down a proper official

answer to a question this MP put. Which is that Andy Burnham was

given 1500 warnings that there were problems going on around the

country and he is supposed to much ignored them. Burn Ham has been

drawn into this repeatedly over the last ten days and consistently said

if you have proper evidence I will respond to it, until that point I

won't. He feels he is being dragged into it when actually possibly this

is more political than policy. Conservatives are desperate to land

a glove. Why does it matter so much to them? It matters to them because

they will never get the lead on the NHS they hankered after, Labour

will get that. What has surprised them over the weeks of emerging ref

layings about the standard of the NHS that nothing has stuck to the

Labour Party. And that lead has actually grown for the Labour Party

that they have got further and further ahead on the NHS, not

actually shrinking. The Tories are trying to negate that lead. David

Cameron once said the three letters that matter to him is the NHS. If

he will get that even he needs to turn to the CQC and failings at it.

Thank you very much. We are going to discuss all this now with our

panel. James Titcombe and Brian Jarman are still here. We're joined

by Camilla Cavendish who sits on the board of the Care Quality

Commission, Andrew Gwynne is shadow health minister and Dr Bernadette

Garrihy is an Accident and Emergency consultant, and Stephen

Dorrell a former Health Minister. First of all Andrew, shadow health,

a lot of flack is coming your way. A lot of what are called excess

deaths happened on your watch, and the accusation is Andy Burnham had

1500 indications? Can I just point out that Tameside Hospital that

featured in your package is the hospital that covers the majority

of my constituency, I know what has happened at Tameside over a period

of time very well. You find it shocking? I do find it shocking, I

found it shocking in 2009 that led myself and two other Tameside MPs

at the time, James Purnell and David Hayes to go and see the

Secretary of State, Andy Brunham, I have to say when we met with Andy

in his office, and these words stuck with me over the years, he

said to his officials who didn't want him to intervene in Tameside.

He said the authoritative voice in these matters is the CQC, the Care

Quality Commission, he said, and that has proved to be the case they

were erroneous, they didn't have their finger on the pulse and they

were wrong, he should have listened to those voices? He did listen to

those voices. James did he listen to those voices? His words were

very clear, he said there is no place in the National Health

Service for sub-standard care. And that's when he ordered Monitor, the

foundation trust regulator and the Care Quality Commission to go into

Tameside Hospital. There is no doubt the previous Government made

big mistake, not least the Foundation Trust programme that led

to so many of these programmes in the first place. So Sir Brian you

talk about the whole denial, the health service being in denial.

There is no doubt that a lot of the problems happened during Labour's

watch? Yes. After the Bristol inquiry, I was medical member of

that, we decided we needed to do something. Every year we published

in national newspapers these figures. Tameside was higher way

back in 2001. It has been higher pretty well all the way through.

They have known and we went to the Department of Health many times to

try to get them to do something about it. It really was a

continuous process of denial of the information. For someone who has

been involved in the health service for so long was it profoundly

depressing? I have always, I mean I went to the states and part of my

training was there I was a medical resident in the states, I used to

give lectures about how marvellous the NHS and of to Harvard students.

About five years ago I decided I could no longer do it. I'm very

much in favour of the principle of the National Health Service in that

people are covered. No-one has to worry about the cost of their

healthcare, compared with the states that is fantastic. But we

can't make it poor care. Camilla Cavendish you were going to come on

to a report you did on care workers in a moment, but you are on the

Care Quality Commission now? Yes, I have just gone on to the board.

it has a very, very tainted history? Of course, yes. Everybody

has said it. It missed Mid Staffs, it missed add whole lot of other

things, it probably missed hospitals we don't even know about

yet. It was using generalists instead of experts to go into these

hospitals. One of those people, Amanda Pollard, former inspector,

has talked about how she was an expert in infection control, she

was taken off doing that, sat in front of a computer and licensing

all the bodies it had to license. It was not listening clearly to

complaints from people, it failed. Even when it was meant to be

reformed, you know, within the last nine months, look at Tameside. Is

it still making mistakes? The point is how can patients have any faith

in a regulatory system which even though it is under scrutiny is

still failing? Well I think the answer to that is they are trying

very hard to build a totally new system. So it used to have a

thousand indicators, which was crazy, they are now reducing those

indicator, they are hiring experts to go in rather than generalists,

they have got a new Chief Inspector of hospitals who is coming on board

this week. It is a tanker. It takes some time to turn it round. They

are running as fast as they K but there is a risk. The major problem

in the CQC, they say from 2009 they do not investigate poor care? How

can you believe that our regulator does not investigate instances of

poor care? It has a whole series of...What Is really happening, from

2009 when the CQC and Monitor had Tameside Hospital on its radar at

the insistence of Andy Burnham, every report they have published

they have highlighted concerns about Tameside. What is baffling in

March this year all of a sudden it is given a clean bill of health. I

don't understand that as a Tameside MP. This whole point about not

investigating poor care, do you understand why this is not

happening, Stephen Dorrell? I don't understand why the CQC doesn't

accept responsibility for looking at the quality of care delivered by

each healthcare provider. I also think there is a huge trap in this

which is is to imagine that the CQC is the solution to the whole

problem. What we have to remember here is that Brian Jarman has been

a very courageous campaigner determined to throw light op what

goes on in the health service so that -- on what goes on in the

health service so we face the truth about an institution that all of us

are deeply committed to. It is that willingness to face the truth that

the health service has found difficult over a long period.

want to talk now about the whole patient experience and the patient

care at ward level. You are a senior consultant in A&E and you

have repeatedly voiced concerns about the level of patient care and

what they experienced in being a patient? There is no doubt about it

the Accident and Emergency service throughout the UK has been building

towards a crisis for a number of years. We have been highlighting it

in a number of ways. It was very difficult to meet with any positive

response until very recently when a group of us in the Midland got

together and found we were experiencing exactly the same

problems. It is a critical mass?It was. In Susan's film you have

Milton in the film saying he was repeatedly and had problems in his

job for repeatedly bringing up problems about 24 patients to one

nurse. Is there not a culture of coming together and airing these

problems. The idea that whistle blowing is still a bad thing in the

NHS? I think it is very hard for individuals whistle blow. What made

it easier for us, but it gave our message more power was the fact

that we could come together. We weren't necessarily criticising our

individual organisations, because there were some very good things

going on, but we were highlighting a problem that our speciality has,

and a crisis. It is only recently a number of you got together. From

the parents' point of view, when Joshua was very little and your

wife had an infection and your son had an infection, you repeatedly

said to the midwives there is something wrong? The concern was

could Joshua have an infection, we asked about that and we were

repeatedly told he was sign. Sadly he died as a consequence of that.

Nine days laterment you asked to see a doctor? We asked is Joshua OK,

we were told he was. We accepted that reassurance that the people

that were looking after him were the experts and we accepted that.

We shouldn't have and should have done something about it. Do you

think the whole question of the NHS is there is not institutional low a

lack of compassion, but compassion is not rated -- institutionally a

lack of compassion, but compassion is not rated highly and compassion

has gone out of the health service? I would say there is a culture of

contempt in some parts of the health service for patient. I'm an

associate editor of the Sunday Times, we have started a campaign

on seven-day working, I have a slew of e-mails from people who arrived

on a Saturday or Sunday and whose complaints have been ignored and

not listened to. Some of the stories. They are not as terrible

as James's story, but it is repeated. One person wrote to me

and said the cleaners were more caring than any of the other staff

in the hospital. This is because the caring isn't really valued.

are hearing that firsthand there, why do you think that happens?

think that most people in the NHS certainly going into it wanting to

do a really good job, and go in every day wanting to care for

people, what is really important is that if you haven't got the

resource to do your job properly, if you haven't got the skills, if

you haven't got the man power, if you haven't got the equipment, you

need to be able to highlight that. That is where a lot of the issues

arise. Camilla's recording care workers, there was an inadequacy of

training and imbalance of training? The most important thing is to

challenge poor care. What we found was junior people were not being

listened to. That is the problem with the culture. So there is no

sense in which junior people actually should have a say? Well, I

think you know this discussion, there are two major problems,

number one with regard to the doctors, if you report a complaint,

a problem of the health service, and you have tried locally, and you

tried to bring it to the attention of the authorities and so on

outside, that doctor will be dismissed. They will have to sign a

gagging clause to get any compensation for dismissal. Second

of all regarding complaints, up to 2004 any person who made a

complaint and it went beyond the hospital they were investigated by

a local independent panel coroner and so on. From 2004 on wards all

complaints, it is almost impossible to believe this, all complaints,

except for less than one third of 1% have been thrown into a national

waste paper basket, they have not been independent. Why did that

happen? They haven't been fully investigated. Why?What happened

was that they got rid of the independent review panel. And now

they have gone to the primary Health Service Ombudsman, out of

13,000 last year she fully investigated 222. That is shocking

isn't it? Out of that only 232 got investigated? Mid Staffs for

example between 2008-2011 there were 79 complaints to the ombudsman,

she investigated two of them. That's what I'm talking about. That

is lessons going unlearned. We did a review of the complaint process

within the Select Committee. Where does the pressure come from? There

used to be three tiers of examination of complaints when

something went wrong in hospital. What's now, the system was

simplified in order to require, first of all, the hospital to

investigate its own complaints. Then with an appeal to the

ombudsman. That is how the system is supposed to work. I entirely

accept that it doesn't work properly, that is why we issued a

report two years ago now. Which said that one of the problems of

the qulure in the health service is that when a complaint arises of a

patient -- culture, in the health service is that when a patient

makes a complaint the first instance is explain what happened

rather than investigate openly and honestly what went on that needs to

be addressed. That is the cultural issue, let's look at the economic

issue, economic and demographic pressures the NHS faces over the

next 20 years, the line-up going steeply on this graph shows how

much extra money would need to be spent just to keep the current

level of service for our growing and ageing population. The straight

line at the bottom is what happens if we keep spending frozen. The gap

by 2020 is �54 billion. We are joined now by Fraser Nelson the

Edgaror of the Spectator. This model, is it sustainable? Of course

not. We have seen over the last decade the NHS's budget was more

than doubled. If money was the answer we wouldn't be sitting here

now having this conversation. Wait it is run is the problem. And this

chart looks a bit suspicious to me, it looks like another demand for

money. Sure, you can put a computer model and say, yes, we need X

amount of money, but is the NHS twice as God as it was at the

beginning of the last decade. I don't think anybody would say so.

There is massive demographic pressures on the NHS. An ageing

population and no more money. Problems of old age increasing, how

will we deal with those? The rest of the developed world is dealing

with these problems, they do not give a health service run by a

massive and failing bureaucracy that we have at the moment. There

are ways of running health services better than we do. Just look

anywhere, Ireland literally anywhere else in the world.

Bernadette you accept there has to be change and the model isn't

sustainable? Within emergency medicine we are under incredible

pressure, we have increasing attendances, and the numbers don't

reflect the increasing complexity of cases we are seen, eld low

people with a multiple health and social and mental problems. There

needs to be a crossover with health and social care to help these

people properly. The pressure will be massive on the money, so you

would say some A&Es would close, will services have to go by the

bored on the NHS? I certainly think in emergency medicine we can't

continue with the current model, we can't have 250 departments across

the UK providing 24/7 cover. It is not safe at the moment, we haven't

enough staff to do it. If we give them all the money in the world, we

haven't enough trainees coming through. We have to -- We have to

accept and fess up to that? We have to, trying to do 250 trauma units

around the country leads to poor care. We need a hierarchy that

ensures that...Don't We have to have politicians to be honest and

say this is going to happen. Of course when it comes to

constituency by constituency no MP wants to lose the service, but we

are going to have to speak honestly? If the service is sub-

standard any MP should want high- quality care for constituents, what

we have have do is ensure the health service changes

fundamentally to deliver high- quality care. What happened at

Morecambe Bay and what is happening tomorrow with the Keogh Review is

the scales will finally fall from our eyes, I think. We will lose the

romance of the NHS and say we are now going to be open-minded about

how to make it better. We haven't been until now. That whole question

of the romance, it is just over a year ago since Danny Boyle's 2012

Olympic ceremony included this tribute to the role of the NHS

played in British life. Some regard the celebration we saw at the

Olympics as part of the problem. Do we actually fail to notice

fundamental problems in healthcare because we do, as Camilla says row

Manchester United size the NHS. -- -- romanticise the NHS? We do make

it romantic, we are wanting a health service free at the point of

use, don't give it to a failing bureaucracy to run. That is the

problem. What everyone is striving for is fine but the way we are

doing it is from the last century. I'm incredibly proud of much of

what the NHS does, and what people working in the NHS do, Kirsty, it

would be very unfair on a lot of very dedicated staff, nurses,

doctorss and support workers to say it is all rotten. Because actual it

isn't. That is a given. But the problem is, the very things you are

saying are almost romanticising, and you are part of the problem?

They are not romanticising, beau actually most people's experience

of the -- because most people's experience of the NHS is good.

Where we have poor care we need to move in and quickly and not accept

the second-rate care. That is a failure of the NHS values. The NHS

is national religion and the Tories are unbelievers, is that the

problem? The problem is both parties are competing to see who

the biggest believer in the last few years. When Labour reformed the

NHS the Tories said hands off the NH S. We are finally seeing only

too late when both parties have been going back and forth. It is

not the workers but the bureaucracy. I would put in a great drive from

patients and clinicians who would then employ the managers to make

sure that our aim is to live within whatever we are given from the

resource allocation from parliament to having got that amount it is to

improve the quality of care. Not managers doinging it. To improve

the quality of care but the extent of the care, do we have to be

realistic at the extent of the care? Look we have only just under

the European average of GDP. How can you have a system whereby acute

abdominal pain, acute chest pain is managed by 111, a computer. When I

for 28 years was visiting patients, if I did not examine the patient

with acute abdominal pain I would be struck off and rightly so. This

is incredible that these managers can run this system like that. How

did we let that happen? What you have done is provided the

information. The power here is the information. Once people, for years

doctors have known which hospitals they wouldn't be treated in. The

rest of us haven't known that. Once we get the manufacturing out there

we will empower people to make -- manufactures out there we will

empower people to make the right choices. What will it take to

restore your faith in the NHS? complaints system that work, a

system where when something tragic goes wrong the NHS doesn't cover up

and the NHS concerns something about it and does something about

it, and learns about it, and effective regulation. McIntyre is a

former soldier who served in Northern Ireland, Bosnia, Iraq and

Afghanistan. Now he's set to be extradited to the US on eight

charges of fraud relating to a contract putting Quantum Risk, a

security firm he ran in Baghdad in 2009 and the US Institute of Peace.

The allegations of overcharging to the tune of $100,000, which he

denies, emerged when he was serving with the royal military police, he

was flown home to face charges. In a moment we will speak to him.

First here is our report. David McIntyre was a soldier in the

Queen's Lancashire Regiment, doing tours in Bosnia and Northern

Ireland. He served in the royal military police in Afghanistan. But

it was after he left the army, during his time as a contractor in

Baghdad, providing security to American clients, such as the US

Ambassador, that he's alleged to have carried out this fraud.

Overcharging the American NGO, the United States Institute of Peace,

by �65,000. The US indictment alleges that David McIntyre

conspired knowingly and willfully to de advise and attempt to devise

a scheme to fraud the NGO. David McIntyre is fighting all the

charges, and his defence is on health grounds as he has been

diagnosed with post traumatic stress disorder. Colonel McAlastair

said that David McIntyre was at high-risk of suicide around the

time, and that thoughts of his family may not be sufficient to

counter the grave and immediate danger he may pose to himself.

David McIntyre is not the first person to fight extradition on

mental health grounds. Gary MacKinnon, accused by the United

States of carrying out the biggest military computer hack of all time

eventually won his battle against extradition when the Home Office

said he was at high risk of suicide. But the Home Office is unconvinced

that David McIntyre's condition is severe enough to prevent

extradition. Saying it was treatable without the need for in-

patient care. But there was no suggestion it couldn't be managed

in custody either in the UK or the US. And the letter concluded that

extradition would not be incompatible with his rights under

the European convention. In 2006 these British businessmen, the

NatWest 3, who were implemented in the Enron scandal were extradited

and jailed in the US. One of them, David Birmingham, served time in

five American prison, he's worried that David McIntyre will not get

treatment in an American jail. have been in prison up close and

personal with a number of people with very, very difficult

psychiatric conditions who went absolutely completely and utterly

untreat. It is desperate frankly. It is not the place to be if you

have any kind of a mental disorder. I would not fancy being in Mr

McIntyre's shoes in this particular scenario. David McIntyre's legal

team has 14 days to consider whether to apply for a judicial

review. David McIntyre joins me now. First of all you deny the eight

charges, what is the American case against you? Unsubstantiated, and

yeah I categorically deny all the charges against me. You know the

charges as they exist? I know they have been read out to me from the

documentation from the US. So they are quite specific, overcharging

for a villa's rent when you could have got it more cheaply, you paid

a bribe toe the contractors according to the indictment, and

suddenly in mid-June you upped sticks from Baghdad and abandoned

the contract and came away with $100,000? I didn't abandon the

contract, back in the UK I lost my business and I was back in the UK.

I insured the US IP could continue their mission in Iraq, in Baghdad,

specifically in the villa I organised for them. So I didn't

walk away from it at all, that isn't in the indictment that they

have sent across from the US. During that time in Baghdad there

was all sorts of rumours that things were done with cash in hand

and the odd bribe, it might not have been called a bribe. Was it a

lax system? To be honest I couldn't comment on that because obviously I

couldn't comment, I wasn't privvy to everything that went on. It was

certainly talked about but I wasn't privvy to everything that went on.

Why, if they are asking you to face these charges you think you

shouldn't be extradited? It is not that I don't want to face the

charges, I'm happy to face ep this. I'm not happy to be put over to the

United States and put in solitary confinement immediately and face 20

years in a US pen tensionry. There is no way you to face these charges

here. My Government isn't prepared to allow me to do that.

At the very beginning that was not brought up your team when it could

have been? This post traumatic stress disorder? I was serving in

Afghanistan, I was taken into a room in uniform, I was taken on to

a plane 45-minutes later, I was thrown into the UK 36 hours later I

was in court in Westminster in uniform. My life had just gone into

spiral. Unfortunately I do now know that I have been suffering from

PTSD for several years. But it is not something you like to talk

about in an open forum. But then that is surely if you raised it

early, it seems that there were several times when your counsel

could have raised in September, January and March, it was only

raised at the 11th hour, if you raised it early, right at the

beginning when you knew you had post traumatic stress disorder your

case might have gone differently? You are quite correct. Why didn't

you raise it? I didn't raise it because I'm an ex-soldier and if

I'm told to go somewhere I did it. I listened to my legal counsel at

the time, I had no concept of the procedure. I was told to be at a

court at a particular time and date. I arrived there. My counsel was

absolutely useless to that end this is why I asked for a change of

counsel. In all the papers, did you know that you could raise the

medical situation, because you raised the fact of a broken tendon

or trained tendon at the beginning. Did your legal -- a strained tendon

at the beginning. Did your legal team tell you could raise post

traumatic stress disorder, if it was going to be material to your

case, wouldn't you try everything in your armour to make sure your

case was as strong as it could be? Yes you would do and I'm trying to

do that now and is being put forward. Like I said my legal team

was absolutely useless. I have subsequently found out potentially

this wouldn't have got this car, it could have been can I Bosched the

first day I was back in the UK if I had decent representation. What is

the procedure? I have got 14 days where the Home Office ask for my

removal to the US. I will be taken by US mash shells in a plane in

shackle, taken into solitary confinement and given a piece of

paper in front of me and I will be offered a plea bargain. It will be

sign here, three years in a US jail or don't sign and 20 years in a US

jail and never see your family again. In terms of what will happen

in the next few days is it to get your case together for a judicial

review? I'm still coming to terms with the fact that the Home

Secretary, who hasn't read anything about the case, but just had a

piece of paper put in front of her and signed it, she knows nothing

about it. How will you cope?Again my life has gone into spiral and my

family are going with me into spiral. It is difficult to put it

into words how you are able to cope. Tomorrow morning's front pages now.

The Guardian on the right-hand side That's all tonight, we leave you

with 101 female skydivers in Russia, the latest jump called Pearls in

the Sky, formed a flower in memory of the leader who died last year.

It is open in the middle to Hello, more fine weather, more

sunshine and more heat to come for England and Wales this Tuesday. For

Northern Ireland perhaps a bit more cloud than we started the week with.

Cloud across western Scotland bringing patchy outbreaks of rain.

In the far north-east through the middle of the day, around the

midday 1.00 time, there could be an isolated thunderstorm. We should

see sunshine through eastern Scotland and that could bolster our

temperature up here well into the mid-20s. For northern England a lot

of sunshine, temperatures again widely in the mid-20s, we hot

things up further as we slide further south. Around the coasts

always a bit fresher thanks to a sea breeze, across parts of the

Midlands and through into the south-east we are talking about the

high 20s, perhaps even 31 or 32 degrees. A little bit cooler around

some of our coasts to the south west of England and Wales, partly

because of a sea breeze, we may just fetch on the shore some low

cloud mist and fog. Even through the middle part of the week the

sunshine continues to burn down on England and Wales, if anything it

could be a hotter day still. Looking further north towards

Scotland and Northern Ireland, we keep quite a bit of cloud around

here for the middle part of the week, there will be outbreak of