04/09/2014 Newsnight


04/09/2014

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Are NATO leaders in South Wales preparing for a new Cold War?

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After Afghanistan NATO needs another mission, but a new cold war? Views

:00:14.:00:18.

on that here seem to depend on how close to Russia you live? The

:00:19.:00:26.

aggression will be sooner or later on the NATO borders and then it will

:00:27.:00:31.

be a wider conflict and cost more to be stopped. Now that everybody knows

:00:32.:00:35.

that the frontline aid worker David Haines is the British hostage under

:00:36.:00:39.

threat of death at the hands of IS, David Cameron says he's taking

:00:40.:00:44.

charge of efforts to bring him home alive. What can Britain do? We have

:00:45.:00:51.

the right policy saying we won't pay ransoms to terrorists who kidnap our

:00:52.:00:54.

citizens. That is difficult for families when they are the victims

:00:55.:01:02.

of these terrorists. Meet the Meek family, they have pulled their

:01:03.:01:06.

children out of school for a year to take them on educational odyssey

:01:07.:01:09.

around Britain in a caravan. What happens when they go stir crazy?

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Good evening, has Vladimir Putin set NATO his biggest test since the end

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of the Cold War. While the 18 leaders of the North Atlantic Treaty

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Organisation were gathering in Newport, South Wales today,

:01:31.:01:34.

pro-Russian separatist were advancing on the seaport of Mariupol

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with tanks and artillery. The secretary-general of NATO demanded

:01:41.:01:45.

Moscow withdraw the thousands of troops it has in Ukraine and stop

:01:46.:01:48.

the flow of arms and funds and troops. Vladimir Putin has raised

:01:49.:01:52.

the prospect of an imminent ceasefire, who has the whip hand.

:01:53.:01:56.

Our diplomatic editor is at the summit.

:01:57.:02:02.

You know when Petro Poroshenko the Ukrainian President came here he

:02:03.:02:05.

knew already that NATO would offer him very little in terms of firm

:02:06.:02:10.

military-type support. And that's why earlier this week he seems to

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have grasped the nettle of going for this peace negotiation. A

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negotiation that many people here regard as extremely unequal and

:02:20.:02:24.

likely to freeze in the gains of Russian separatist in east Ukraine

:02:25.:02:28.

and to call into question the integrity and sovereignty of

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Ukraine. But long along in this certain countries within the western

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alliance, like Germany and Italy have favoured talking over other

:02:37.:02:43.

more or potentially confrontational-type action, and

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that is how it has been here today. That has meant they haven't moved

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ahead in offering more assertive type of support to Ukraine and they

:02:50.:02:54.

haven't put any new sanctions on Russia yet. Although that could

:02:55.:03:01.

still happen in the coming days. So with those differences of view

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that begs the question about whether this threat to Ukraine and the new

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assertiveness of Russia, under Mr Putin does give NATO the type of

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mission, purpose, it has been looking for, since the end of the

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Cold War and whether it is in fact the beginning of what you might call

:03:19.:03:23.

a new Cold War. Golf courses and weapons of war

:03:24.:03:28.

don't really mix. But you could do worse if searching for a metaphor,

:03:29.:03:32.

for an alliance that is trying to get people thinking less about

:03:33.:03:37.

leisure and more about security. For some of the leaders here the idea of

:03:38.:03:40.

leisure and more about security. For a second Cold War is not so far

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fetched. We will, very often meet Russians in our airspace and we have

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to show them that we have capacity like that. We will have, we will

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have larger investments especially in the air area. You clearly have

:03:57.:04:00.

concerns about what Russia is doing right now, do you think those are

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shared across the alliance or do you think there is still important

:04:06.:04:07.

differences for example over Ukraine? I think it is, I think most

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NATO countries are now, especially after this summer's shooting down of

:04:16.:04:21.

the Dutch plane, the Malaysian plane that was shot down, I think it was a

:04:22.:04:26.

change of tone seeing the aggression, seeing how the

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separatist were working. I think the last weeks proved that there are

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Russian soldiers inside Ukraine, participating in the fighting. I

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think all of this has convinced most NATO countries that the Russian

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aggression has to be stopped. There was a demonstration of life-saving

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medical skills, learned in the hard school of Afghanistan. A

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medical skills, learned in the hard NATO operations and all the horror

:04:56.:05:00.

they involve has left the alliance weary and perhaps freed it of any

:05:01.:05:08.

glib notions of war. The end of the Afghan campaign inevitae begs

:05:09.:05:16.

questions about what NATO is for. NATO was founded in 1949 on the

:05:17.:05:20.

simple basis that an attack on one would be an attack on all. Since

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then it has grown to 28 members, including some of the Republics that

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used to be in the Soviet Union. They in particular now argue that Ukraine

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has become a test case for a new Russian expansionism that requires

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unity and firmness. If we will not stop an agressor in Ukraine the

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agressor will sooner or later on our NATO borders, and then it will be

:05:50.:05:54.

wider to spread conflict and cost a lot more to be stopped. Should

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western countries supply Ukraine with weapons? I think that the

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Ukraine needs to be supported in all necessary security measures

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available and because the nation is united, at least the nation is ready

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to go and fight and the history lessons are saying that you never

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give in, countries and never give up countries. But even as this summit

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was convening it was clear it could offer the Ukrainians money, training

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and ration, but no weapons. And while it gave their President a VIP

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welcome, it also sent him on his way to peace talks with President Putin

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where much may have to be conceded. I think he faces a very difficult

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situation, because he's clearly confronted with regular Russian

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troops that have invaded his country. And that's why he needs the

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support of us, the political support, the sanctions support, the

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economic support, because he's taking a beating with the Ukrainian

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economy, it is not only military things that count, it is quite a lot

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of other things now. What has been striking here today is the countries

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that have been most interested in coming out and talking to us are

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what you might call Russia's nervous neighbours. Those who think trade

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should be disrupted less, or who have perhaps been reluctant to call

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events in eastern Ukraine an invasion have been less visible

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here. And that hints at divisions in the alliance that have so far

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prevented it from getting back to that type of Cold War unity and

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common purpose. President Obama left for dinner this evening resisting

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the temptation for a spot of putting. He doesn't like talk of a

:07:36.:07:40.

second Cold War. But it is to America that many nations now look

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for leadership as a resurgent Russia unsettles NATO. Joining us now from

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Moscow is a former adviser to Boris Yeltsin, and now a director of the

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Institute of Democracy and Cooperation think-tank, good

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evening. First of all, is Vladimir Putin trying to remake the USSR? It

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is absurd to think in these terms, because Vladimir Putin said who

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didn't regret the disbandment and the collapse of the Soviet Union. He

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didn't have a heart but who is trying to or would like to restore

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the Soviet Union doesn't have any mind or brains which means Putin

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very clearly formulated his position on this issue. What you But what he

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has done so far, and it seems with impunity has annexed Crimea, how

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much of Ukraine does he want in a peace deal, does he want eastern

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Ukraine, or will Ukraine be allowed to remain within its sovereign

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boundaries? You know, we have different narratives from London you

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say see the things in one mirror, from Moscow we see in another. It is

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not Anwar nextation. In Kiev there was military coup against legitimate

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President after which Kiev happened to be in a chaos, collapsed and

:09:19.:09:25.

under the dominance of extreme nationalists from western parts of

:09:26.:09:30.

the Ukraine. What business is that of Russia? Legitimate authorities in

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Crimea decided that they don't want to live with this and they decided

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to organise a referendum and decide their own fate. And nobody

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eliminated the rights of the nation for self-determination. That's why,

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that's exactly what happened. Does, you talk about Vladimir Putin and

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the fact that the west has a different mirror through which to

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see things than Russia. Does the west have any influence at all on

:10:04.:10:09.

Vladimir Putin? The west doesn't have any influence because Russia is

:10:10.:10:16.

too big to let anybody to have influence over Russia. Can you

:10:17.:10:21.

believe that somebody has influence over America. If Obama confessed

:10:22.:10:27.

that anybody had influence the next day he will not be the President of

:10:28.:10:34.

America. Military, nuclear superpowers can't let anybody to

:10:35.:10:40.

have influence over him. If Ukraine had already been a member of NATO

:10:41.:10:44.

and they seek NATO membership, if Ukraine had been a member of NATO,

:10:45.:10:49.

would Vladimir Putin have got involved sending troops into

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Ukraine? Thank God once, even Bush Junior and westerners were smart

:11:02.:11:07.

enough not to let Georgia to be in NATO and in 2008 that proved

:11:08.:11:11.

otherwise it could be a catastrophe for the west and for the world. When

:11:12.:11:22.

Ossett at that was attacked and then there was a peace enforcement on

:11:23.:11:27.

behalf of Russian forces in Georgia. And now thank God that Ukraine is

:11:28.:11:35.

not part of NATO because this is the salvation for Ukraine, for the

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Europe and the world. Because the people in Ukraine who run the

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country they are absolutely irresponsible people. Let's be clear

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if Ukraine had been a member of NATO would Vladimir Putin have risked

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putting troops into Ukraine? You know you are raising incorrect

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questions. Thank God that in Bucharest European, French and

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German politicians decided that it is not going to be Georgia and

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Ukraine in NATO because this irresponsible people which never had

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any experience of statehood they can really create serious danger for the

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peace and security in Europe and in the world. And now we are witnessing

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exactly what is happening, but the surrounding people are killing their

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people, they are using artillery, aviation, multiple rocket launchers

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against peaceful population, killing everybody over there and

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unfortunately this is the reality. Here in the studio we have the pull

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letser prize-winning journalist and author of a number of books on the

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history of Russia and the Soviet Union. Has Vladimir Putin got the

:13:10.:13:14.

whip hand over NATO right now? It is important to understand what Putin's

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goal is now, his primary goal is for himself to stay in power. Almost

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everything we have seen in the last few months has been part of that

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game for him to stay in power. A piece of that means that in order

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for him to stay in power he has to prevent the creation of a

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democratic, integrated, western Ukraine. Because that would be a

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direct challenge to him. A secondary piece of that is he has to undo,

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undermine and eventually begin to pull apart the strands of NATO. And

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I think that's the game, those are the important questions to ask, is

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he succeeding in doing that. Is he. It seems you have the former Baltic

:13:53.:13:59.

states agitated, much less so than perhaps Italy or Germany or

:14:00.:14:02.

whatever? Certainly at the start of the crisis there were very deep

:14:03.:14:05.

divisions among European states. One of the effects of Putin's behaviour

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in the last few months, paradoxically, given this is not

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what his goal was, has been to bring more people together. Even the

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French a couple of days ago withdrew or they announced the postponement

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of their sale of warships to Russia. That was unexpected. Simply with

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French newspapers and television reporting simply the news from

:14:27.:14:30.

Ukraine the incursion of Russian troops it became simply too

:14:31.:14:33.

embarrassing, even for the French President. It is interesting because

:14:34.:14:36.

two things seem to be happening here, first of all maybe sanctions,

:14:37.:14:41.

and of course obviously the military sanctions, France not with standing

:14:42.:14:44.

have just announced, but sanctions are hitting the Russian people. But

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it is as if Putin doesn't care, in the sense that this is for Mother

:14:49.:14:54.

Russia, by the same token he seems to have made himself the embodiment

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of Russia? You have pointed to an important point about the crisis and

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relevant to Russia and other place, we in the west seem to think the

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point of Government is the material well being of people. We argue over

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which politician will bring us more wealth. Putin is playing a different

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game, he's bringing people power, he's bringing them some kind of

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imperial glory. He's really trying to appeal to something very

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different and maintain power in a different way. These material

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considerations that we care about, Russian food prices have gone up by

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4. 5%, seem right now not to be bothering him or anybody else. What

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he's saying if you have to suffer for Mother Russia I know you will

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suffer with me. That seems to be the line? It has worked before. There

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and in other places. Here we have it though, what will happen f there is

:15:42.:15:44.

this ceasefire, these talks of a ceasefire and the idea that Porter

:15:45.:15:52.

they are not giving away anything. Will the boundaries of Ukraine

:15:53.:15:56.

change, and secondly is the President of Lithuania right. If we

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don't stop him in Ukraine he will be knocking on Estonia and Latvia's

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door? The loonilyic of the crisis would lead us to believe it is

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possible. At every point in the crisis he has made a move and waited

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and how will the west react. If you are Lithuanian and you are watching

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that happening, all you can think is once he has divided Ukraine or

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frozen conflict, what is next, Belarus, the Baltic states and who

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knows. Are you pest mistic, or having said all this do you think

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there is a way of stopping this. Is NATO actually going to act. That is

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the point, had Ukraine what would have happened? I still believe if

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Ukraine had have been in NATO, which was never on the cards, I still

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believe he wouldn't have done T but for that reason it is very important

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now that we begin to re-think what NATO is and how it functions. It is

:16:54.:16:58.

still very bureaucratic, it is very old fashioned and out of date. Its

:16:59.:17:01.

bases are all in the wrong base. We need to have bases in Lithuania, in

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the Baltic states, along the borders which may be the next line of

:17:07.:17:11.

defence. Thank you very much indeed. The British hostage being held by IS

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and who appeared in the latest IS video being warned he will die next

:17:16.:17:19.

is named as David Haines. He has been involved in frontline aid work

:17:20.:17:23.

for more than 20 years in areas such as Libya, south Sudan and Syria. It

:17:24.:17:29.

was in a Syrian refugee camp in March last year he was captured.

:17:30.:17:31.

Hostages from other countries, including Italy and France, taken by

:17:32.:17:35.

IS have been released and this morning David Cameron said he was

:17:36.:17:40.

taking personal charge of efforts to secure David Haines's release. But

:17:41.:17:43.

tonight at the NATO conference he condemned the payment of ransoms as

:17:44.:17:48.

utterly self-defeating. What options does the British Government have.

:17:49.:17:53.

This report contains references to previous hostage situations. This is

:17:54.:17:58.

David Haines, he has been a hostage for 18 months. His life is now in

:17:59.:18:03.

the hands of terrorists. His fate seemingly beyond the reach of his

:18:04.:18:08.

family and his Government. His might conjures memories of Terry

:18:09.:18:15.

Waite and John McCarthy, British hostage held captive in a different

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time. 30 years ago they were household names. Their families

:18:19.:18:22.

tried everything, including fundraising evenings to get them

:18:23.:18:27.

released. There were appeals direct to the kidnappers. I appeal to you,

:18:28.:18:33.

whoever you are, in this holy month of Ramadan, the month of blessings

:18:34.:18:39.

and charity, to release my son John McCarthy and return him to his

:18:40.:18:43.

mother and father who miss him a very great deal. 25 years ago

:18:44.:18:49.

diplomats made public pleas. I would appeal to all those who have

:18:50.:18:54.

knowledge of them... This time they and the family sought a media

:18:55.:18:58.

blackout. Only when his name was circulated so widely on social media

:18:59.:19:02.

did most news organisations, including the BBC, feel it untenable

:19:03.:19:10.

to withhold it. This is Alastair Burt arriving for Cobra meeting.

:19:11.:19:17.

Until last year he was the minister overseeing hostage situation. The

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best advice we get is there should be as little information release as

:19:23.:19:26.

possible. I think there has been a realisation that the media is not

:19:27.:19:29.

campaigning with those who are holding them to release them.

:19:30.:19:32.

Because the people are not going to respond to that. Captors of a

:19:33.:19:38.

hostage will release them when it suits them and they will deal with

:19:39.:19:41.

them otherwise when it suits them. I think they have no interest

:19:42.:19:44.

whatsoever in what anyone else may be saying and will use the media for

:19:45.:19:49.

their own purposes. The judgment of the British Government is that

:19:50.:19:53.

publicity can actually make things much worse. If hostages become

:19:54.:19:57.

high-profile it may encourage the kidnappers to sell them on to even

:19:58.:20:03.

more dangerous groups, they in turn ask for higher ransoms. All of which

:20:04.:20:08.

can make potential rescues even more difficult.

:20:09.:20:13.

Earlier this year France denied paying a ransom to release these

:20:14.:20:17.

journalists held hostage in Syria. But they have done it before, and it

:20:18.:20:23.

is this that infuriates Britain. We don't pay. Tonight at the NATO

:20:24.:20:28.

summit, David Cameron was haranguing countries that do. That money goes

:20:29.:20:33.

into arms, it goes into weapons, it goes into terror plots, it goes into

:20:34.:20:38.

more kidnaps, it is utterly self-defeating, it is worse, it is

:20:39.:20:42.

actually a risk to us back at home. A New York Times analysis of

:20:43.:20:48.

reported hostage takings by Al-Qaeda and affiliates since 2009 suggests

:20:49.:20:52.

terrorists may be targeting by nationality. It may deter British

:20:53.:20:56.

people from being kidnapped in the first place, but doesn't it

:20:57.:20:59.

therefore make it much more difficult for us to get them back

:21:00.:21:04.

once they have been taken? This is an impossible dilemma, because how

:21:05.:21:08.

do you weigh up the benefits to citizens in the United Kingdom in

:21:09.:21:14.

not being targets of kidnapping, because the kidnappers know they

:21:15.:21:17.

won't get anything for it against the risk to individuals. Terry Waite

:21:18.:21:28.

is a reminder that hostages can come home. But times have changed and so

:21:29.:21:34.

have the terrorists. The true scale of the number of

:21:35.:21:40.

military veterans suffering from PTSD, post drawatic stress disorder

:21:41.:21:44.

has never been quantified or properly recognised. After recent

:21:45.:21:48.

conflicts, including Northern Ireland, Bosnia, Iraq and

:21:49.:21:51.

Afghanistan, increasing numbers are searching for help to stop it

:21:52.:21:55.

destroying their lives and the lives of their families. That help is not

:21:56.:21:59.

sufficient to the task in every days. Sometimes it takes years for

:22:00.:22:07.

PTSD to emerge, often in the form of flashbacks, veterans feel they are

:22:08.:22:11.

experiencing the battle over and over again. Fiona Lloyd-Davies's

:22:12.:22:18.

husband sustained PTSD from the height of the war in Bosnia in 1992.

:22:19.:22:23.

After he failed to find help she decided to investigate, and this is

:22:24.:22:32.

what she found. I can see the blood, I can see the injured guys, I can

:22:33.:22:42.

hear the noises. You are there again, you smell it. The last four

:22:43.:22:50.

years around about 32 hospitalisations via 999 calls. The

:22:51.:22:55.

NHS experience for me has been a complete snakes and ladders game of

:22:56.:23:01.

revolving doors. Our life completely revolves on PTSD. If we're not

:23:02.:23:06.

fighting the PTSD on a daily basis then we're fighting to get services.

:23:07.:23:14.

All over Britain behind closed doors families are having to endure the

:23:15.:23:18.

daily torture of seeing their loved ones battle with post-traumatic

:23:19.:23:21.

stress disorder. They tell us they are struggling to find treatment and

:23:22.:23:30.

it is ruining their lives. In Liverpool, Sue started a group to

:23:31.:23:34.

support wives like her, whose husbands and partners are suffering

:23:35.:23:39.

from post-traumatic stress disorder after serving in the forces. It has

:23:40.:23:43.

just got worse and worse and worse. He has different stages all the

:23:44.:23:47.

time. One minute he it be, you can see the change in his eyes, he can

:23:48.:23:53.

be like the devil. PTSD, as it is known, is thought to affect roughly

:23:54.:23:56.

7,000 people in the Armed Forces. What we don't know is how many

:23:57.:24:00.

veterans are suffering with it because there has never been a

:24:01.:24:05.

comprehensive study. When I got home the police were at the house and he

:24:06.:24:09.

was already in the back of the police van and a lovely policeman

:24:10.:24:13.

that had actually served came up to me and he said to me he doesn't need

:24:14.:24:17.

to be in a cell, needs a hospital doesn't he. I said, yeah he does.

:24:18.:24:23.

Sue's husband had done 13 tours of Northern Ireland in six years and

:24:24.:24:28.

was invalided out of the army with physical injuries. Once he had left

:24:29.:24:32.

he was under the care of the NHS and a growing charity sector. We had two

:24:33.:24:38.

years of what they call a revolving door admission, my husband would be

:24:39.:24:41.

in hospital for six weeks then home for a couple of weeks, another

:24:42.:24:46.

flashback would be triggered, the police would come out, they would

:24:47.:24:49.

slap him back in hospital, they would keep him on the ward for

:24:50.:24:53.

another six weeks and then send him home. Some veterans are getting the

:24:54.:24:58.

treatment they need, but those like Sue's husband, who are the most

:24:59.:25:03.

acute, and others, the majority with associated addictions such as

:25:04.:25:09.

alcohol and drugs, are struggling. Until he retired this year Dr Kerin

:25:10.:25:16.

Fletcher was one of the only two NHS psychiatrists who specialised in

:25:17.:25:20.

both trauma and addictions. The National Health Service the level of

:25:21.:25:27.

trauma training is very poor, and it is unusual for doctors, even

:25:28.:25:30.

psychiatrists to get particular training in treating people with

:25:31.:25:34.

psychological trauma. When I flashback and I collapse, very good

:25:35.:25:38.

chance that I have a stroke, which would be catastrophic. My cupboard

:25:39.:25:48.

now contains antidepressants. Sodium to stop me fitting and more

:25:49.:25:53.

importantly if I do fit they stop me, or will help to stop me having a

:25:54.:26:00.

stroke. At least two-thirds of veterans suffering from PTSD use

:26:01.:26:03.

alcohol because of their condition. Dave is one of them. One will always

:26:04.:26:08.

go with the other, I don't drink normally, it is only if I say I have

:26:09.:26:12.

been suffering three, four, five days on the trot, no sleep,

:26:13.:26:17.

flashback, nightmares, I'm going crazy out of my mind, then I will

:26:18.:26:25.

start drinking because it will persuade me after a litre of Vodka,

:26:26.:26:31.

like a pint or two for people, it calms me down. People who take

:26:32.:26:36.

alcohol are actually in that context completely misunderstood, because

:26:37.:26:39.

they are regarded as people who could stop it if they wanted to.

:26:40.:26:43.

That they are doing it to self-medicate consciously, they are

:26:44.:26:47.

not. They in fact are doing it because they unconsciously need to

:26:48.:26:51.

have the endorphins to be able to make themselves feel reasonably

:26:52.:27:00.

normal. Dave was finally diagnosed with PTSD in 2007 and spent nearly a

:27:01.:27:04.

year in a clinic. For a while things were better, but his PTSD returned

:27:05.:27:11.

way it his need for alcohol. When you fix the PTSD the people don't

:27:12.:27:14.

need to have those particular substances. So to entirely divorce

:27:15.:27:22.

addictions as being a sort of chemical consequence of having PTSD

:27:23.:27:26.

and treat that as a separate entity all together misses the point.

:27:27.:27:30.

Because the PTSD is the driving force behind it, you have to take it

:27:31.:27:37.

into account. We don't have any services in the UK where a

:27:38.:27:40.

significant level of alcohol dependence and a significant level

:27:41.:27:44.

of psychological trauma can be treated together. So you have this

:27:45.:27:49.

dreadful situation where the chances of you being able to get the

:27:50.:27:53.

treatment you need are extremely low. The NHS, as good as they are,

:27:54.:27:59.

they have saved my life a couple of times at least. But they have to

:28:00.:28:06.

keep referring me to combat stress, and combass stress is a small

:28:07.:28:09.

charitable organisation. There is thousands of us. Veterans like Les

:28:10.:28:19.

can also receive treatment from the charity sector, either directly or

:28:20.:28:26.

via the NHS. It is led by Combat Stress, which receives 40% of

:28:27.:28:29.

funding from the Government. It was set up in 1919 to help soldiers

:28:30.:28:33.

suffering from shell shock, and over the last 95 years has developed a

:28:34.:28:37.

range of treatments and services. The number of veterans contacting

:28:38.:28:41.

them is steadily increasing and last year over 1,000 veterans were

:28:42.:28:45.

admitted for residential treatment. They have also established a

:28:46.:28:49.

six-week intensive treatment programme. Les was accepted on to it

:28:50.:28:55.

in November 2012. It was more group therapy than individual therapy. And

:28:56.:29:02.

group therapy you know didn't help me much. Combat Stress says the

:29:03.:29:06.

programme is showing good results and it helps approximately 200

:29:07.:29:10.

people each year. But the veterans we have spoken to, like Les, have

:29:11.:29:16.

criticisms. I just couldn't take it all in. As I say, after the first

:29:17.:29:20.

three weeks I didn't want to go back. And while I was there all the

:29:21.:29:27.

little boxes were opened up again. They gave us the tools to close

:29:28.:29:35.

them, but it didn't work. So I left there feeling pretty much worse than

:29:36.:29:39.

I was when I got there. I came back and for the first three weeks I

:29:40.:29:47.

didn't leave my house. I don't know who Compat Stress sent me, it wasn't

:29:48.:29:53.

my husband. They destroyed him. They absolutely tore him apart. The first

:29:54.:29:59.

four weeks I don't think I slept in our bed, two particular nights. Can

:30:00.:30:04.

you describe why? He was having nightmares, and these were the worst

:30:05.:30:10.

I have ever seen. Previously before he went in, I don't know if you

:30:11.:30:16.

actually know this, but before the arm would come across, his whole

:30:17.:30:23.

body would tense up. I had no warning after he came out of Combat

:30:24.:30:30.

Stress until I felt with his first or his elbow or his head. He put his

:30:31.:30:38.

hand around my throat and squeezed and he has never done that before.

:30:39.:30:44.

Others also had concerns about the course, Dr Fletcher resigned from

:30:45.:30:48.

Combat Stress last year after working there for nearly two

:30:49.:30:53.

decades. You don't ever, ever get people out of a deeply ingrained

:30:54.:30:59.

disorder in the space of a single six-week episode of treatment. You

:31:00.:31:03.

need continuing care, repeated episodes of treatment and so on.

:31:04.:31:10.

Combat Stress offer follow-up sessions, three, six and 12 months

:31:11.:31:13.

after their intensive treatment programme. You worked at Combat

:31:14.:31:18.

Stress for nearly 20 years and you left last year, can you tell us what

:31:19.:31:24.

led you to resign? I think clinical exasperation is the reason that I

:31:25.:31:33.

left. I was also discouraged by the managerial pressures to push people

:31:34.:31:37.

through groups that I didn't think were sometimes fit for purpose. And

:31:38.:31:47.

the degree of managerial influence over clinical decision making so,

:31:48.:31:51.

because I'm old and tired I decided to leave rather than stay with those

:31:52.:32:00.

frustrations. Les did find alternative treatment from several

:32:01.:32:03.

different charities and he's now able to leave the house and lead a

:32:04.:32:09.

more normal life. Dave Salt has previously been to Combat Stress

:32:10.:32:13.

three times and was accepted on to their six-week intensive treatment

:32:14.:32:17.

programme. Under the condition that he stays alcohol-free for three

:32:18.:32:21.

months. But because he's failed this criteria he won't be allowed on to

:32:22.:32:27.

the course at the moment. We're talking my life, it gets very

:32:28.:32:34.

serious. My body won't take any more alcohol, any more poise sin, and --

:32:35.:32:44.

poise sin, and you become suicidal, when you are that low it is death.

:32:45.:32:50.

You are Dead Man Walking, you won't see old age. What they have been

:32:51.:32:54.

through is appalling and they have done it for their country and the

:32:55.:33:02.

impact of PTSD and alcohol dependence on their lives is so

:33:03.:33:06.

appalling you would thought a small degree of priority to be given to

:33:07.:33:09.

this severely affected group and it is not being given and it should be

:33:10.:33:14.

given. That's why it is essential to

:33:15.:33:19.

preplan that safety plan if you need to escape the house and have it set

:33:20.:33:23.

in your mind and have code words for the kids. Even our dog knows if I

:33:24.:33:29.

say "here now", the dog comes running and we're out the door. It

:33:30.:33:34.

is madness, isn't it. For Sue and her group, they want to find help

:33:35.:33:39.

for their husbands now. Yet for the vast majority of veterans, those who

:33:40.:33:44.

have acute PTSD and those who use alcohol or drugs because of it, they

:33:45.:33:48.

are struggling to find the treatment they need when they need it most.

:33:49.:33:54.

When my husband was injured serving in the army I thought he was gone. I

:33:55.:34:01.

was told he wasn't gone, and I was assured that due to the Military

:34:02.:34:07.

Covenant ourselves, my husband, myself, my family would get any

:34:08.:34:13.

required medical care and any required financial care that he

:34:14.:34:17.

needed for life, for having done his duty, for having made sure the

:34:18.:34:20.

people of this country were protected. This isn't happening and

:34:21.:34:26.

it is not happening in a lot of households across the country. We

:34:27.:34:30.

asked for an interview with someone from the health service in England

:34:31.:34:34.

but no-one was available. But the NHS gave us the following statement.

:34:35.:34:39.

"NHS England recognises there is significant room for improvement...

:34:40.:35:08.

We have the director of medical services at Combat Stress, we will

:35:09.:35:19.

come on to the specific which is are being directed towards Combat

:35:20.:35:24.

Stress. On the general point do you accept that provision is limited to

:35:25.:35:28.

veterans? Provision has improved over the last seven-and-a-half years

:35:29.:35:33.

since I joined the charity, it is better than it was. It needs to grow

:35:34.:35:36.

further. I would accept more can be done. Some veterans that we spoke to

:35:37.:35:44.

had found that the treatment by Combat Stress had actually made

:35:45.:35:48.

their condition worse rather than better, it doesn't work for all

:35:49.:35:51.

people? Treatment doesn't work for all people. Having said that I was

:35:52.:35:54.

concerned to see the film and of course I will look at each

:35:55.:35:58.

individual case as best I can and try to put things right for them. It

:35:59.:36:06.

seemed to me that treatment could be stopped half way through or people

:36:07.:36:08.

didn't engage fully. But a lot of the treatments we do have do work.

:36:09.:36:14.

The difficulty is always about engaging the individual into the

:36:15.:36:17.

treatment pathway and keeping him there. Two things, both Dr Fletcher

:36:18.:36:26.

and Professor Turnball talked about the dual nature of the condition,

:36:27.:36:32.

both alcohol and PTSD, and what the professor seemed to be saying is

:36:33.:36:38.

there is a misuning it is not an alcohol dependence but a need for a

:36:39.:36:43.

kick in the endorphin, dealing with alcohol first or demanding a

:36:44.:36:47.

three-month withdrawal period before the six-week programme is

:36:48.:36:50.

counter-productive? It is very difficult to know precisely what

:36:51.:36:55.

will work for each individual. Each individual needs a tailor-made plan

:36:56.:36:58.

and that is what we try to do. At the front end of a clinical pathway

:36:59.:37:02.

we assess their needs and if they have alcohol or drug problems, now

:37:03.:37:07.

they are rolling out an alcohol service management in the community

:37:08.:37:11.

which means we would allow the individual to access a local

:37:12.:37:14.

statutory service to have their des to go and then case manage them back

:37:15.:37:18.

to a treatment to deal with the mental health problems as quickly as

:37:19.:37:22.

possible. What the doctors seem to be saying is actually the des to go

:37:23.:37:26.

is impossible, the two things are so interlinked there is no service that

:37:27.:37:31.

deals both with the trauma and the alcohol together that actually what

:37:32.:37:36.

happens is some veterans are barred from the programme because they

:37:37.:37:39.

can't deal with the drug and alcohol? The main issue about our

:37:40.:37:46.

six week programme is it does mean a lot of trauma-focussed and cognitive

:37:47.:37:51.

behaviour therapy, so you have psychotherapy to confront the

:37:52.:37:53.

horrible things you have been through, we have to have you in the

:37:54.:37:56.

room to do that. If you are drinking before and after it won't work. It

:37:57.:38:00.

is a big dilemma we want them treated as soon as practicable. Then

:38:01.:38:02.

you have the case there of treated as soon as practicable. Then

:38:03.:38:07.

who said what happened was he came to the programme and got the tool

:38:08.:38:11.

box in order to help but couldn't close that box. What he seemed to be

:38:12.:38:15.

saying was that the six-week programme is really not sufficient

:38:16.:38:20.

to the task? Well the issue, I can't discuss the individual case because

:38:21.:38:22.

I don't know the details. But the fact is we have treated around 477

:38:23.:38:29.

patients through the six-week programmes, and the outcome is good.

:38:30.:38:33.

The programme was devised in Australia where it treated 4,000

:38:34.:38:39.

veterans with serious PTSD, severe PTSD and passed problems with

:38:40.:38:43.

alcohol that were stable and their outcomes were about 70% that one

:38:44.:38:48.

year follow up did well. Two-thirds have these alcohol and drug-related

:38:49.:38:54.

issues as well with PTSD. For some that six-week programme when I say

:38:55.:38:58.

it hasn't worked, you heard families there saying that actually their

:38:59.:39:02.

partners or husband came out in a sense a worse state because they

:39:03.:39:06.

found they were uncontrollable violence and so forth. Presumably as

:39:07.:39:12.

Combat Stress increases its own expertise that actually you might

:39:13.:39:17.

consider changing that programme? The programme will evolve and get

:39:18.:39:19.

better, that is my observation about it. But at the moment the evidence

:39:20.:39:24.

so far is that the outcomes are better than the Australian outcomes.

:39:25.:39:32.

We are benchmarked by the Australian veterans' mental health leads. We

:39:33.:39:36.

are benchmarked every year, we submit quarterly reports to the NHS.

:39:37.:39:41.

We have very high satisfaction and exit rates that are independently

:39:42.:39:45.

scrutinised of the veterans that attend. There are a lot of veterans

:39:46.:39:50.

who have benefitted tremenduously, life-changing benefits from the

:39:51.:39:52.

programme. Thank you very much indeed. It is back to school time,

:39:53.:40:00.

parents can heave a sigh of relief. But not one very dedicated or

:40:01.:40:05.

perhaps crazy family, the Meeks, parents Tim and Kerry and daughters

:40:06.:40:11.

Amy and Ella have embarked on an epic year-long education road tripe

:40:12.:40:14.

around the UK. Often dovetailing their curriculum of everything from

:40:15.:40:19.

maths to bush skills with Radio 4's timetable, anything from Thought for

:40:20.:40:25.

the Day to Moral Maze, travelling with a caravan, they limbered up by

:40:26.:40:30.

setting the girls 100 challenges to achieve in a year. They recorded it

:40:31.:40:34.

all. Here is a flavour of their ideal of informal learning. One of

:40:35.:40:40.

our changes we have been told to name our caravan and to record the

:40:41.:40:47.

places it visits, we have named it Ellie.

:40:48.:41:56.

Well I'm now going in to meet the Meek family in their shiny caravan,

:41:57.:42:01.

the girls have obviously been allowed to stay up very late tonight

:42:02.:42:05.

to watch Newsnight. Good evening all of you. Hello. This is an adventure.

:42:06.:42:10.

Tell me first of all why have you taken them out of primary school?

:42:11.:42:15.

Well we spent a lot of time in the last year doing 100 adventures

:42:16.:42:19.

together when the chance to win a caravan came up we thought it was

:42:20.:42:22.

the perfect opportunity to try to make more of that and exploit the

:42:23.:42:26.

opportunities to teach our own children for a year. Do you think

:42:27.:42:30.

though that as a teacher yourself you can often the children something

:42:31.:42:33.

special or do you think anybody could do this, it is a huge risk? We

:42:34.:42:37.

have an advantage because we're teachers and that we know what

:42:38.:42:40.

schools teach. But I don't think you need to be a teacher. I think a

:42:41.:42:44.

parent knows their child better than anyone else. And they should be able

:42:45.:42:48.

to give them enough of a wide curriculum, with home schooling

:42:49.:42:51.

there isn't a set curriculum, you can teach them what you want and

:42:52.:42:54.

they can follow their interests. So did you have a hand in this or was

:42:55.:42:59.

this handed down to you, you will go away from school for a year or it

:43:00.:43:02.

was a decision you were involved in Amy? We were involved in it, it

:43:03.:43:07.

wasn't just the parents say we are taking you out of school now. We

:43:08.:43:11.

were involved in the decision and we were eager to do it as well. We

:43:12.:43:17.

enjoyed school but this is a new opportunity and we are eager for new

:43:18.:43:21.

opportunities. I hear you are going to do things by Radio 4, do you

:43:22.:43:26.

Lizzen to Moral Maze is that one of the things you are listening to?

:43:27.:43:32.

Things on Radio 4. Do you listen to the Archers? Maybe. What about you,

:43:33.:43:37.

Ella, did you not worry about leaving all your friends and being

:43:38.:43:40.

stuck with the family for a year? Yes but we are keeping in contact on

:43:41.:43:45.

Skype. Last night I went on Skype with one of my best friends and also

:43:46.:43:51.

we're going to go Nottingham where all our friends are this weekend to

:43:52.:43:57.

see them. Also we're not just lonely because we're on caravan sites with

:43:58.:44:01.

lots of friends that we meet. So you are meeting lots and lots of people.

:44:02.:44:05.

What kind of things, you have just started on this, I know you did the

:44:06.:44:07.

big challenge this year, you have only been on the road for four days.

:44:08.:44:11.

What have you learned so far. Tell me something unusual you have

:44:12.:44:15.

learned? Well we have been to Warwick Castle and we have learned

:44:16.:44:18.

lots of things from there, but probably the most exciting thing

:44:19.:44:22.

that we learned there was the, what's it called? The trebouchet

:44:23.:44:29.

where it fired things like fireballs miles away. You learned about that

:44:30.:44:33.

and you might not have learned about that in school? No, probably not.

:44:34.:44:36.

What happens when you have done this for a year. You sold your house, you

:44:37.:44:40.

don't know where you are going to land up, and presumably at some

:44:41.:44:43.

point you will need to make a decision whether the girls will go

:44:44.:44:47.

back to school or back to... Also the financial reason as well. We

:44:48.:44:51.

have sold our house and given up our jobs and we have allocated an amount

:44:52.:44:55.

of money to survive on for a year. The answer to that is there isn't an

:44:56.:44:59.

answer really it is an open book. We are hopefully going to see if we can

:45:00.:45:04.

extend it further f we can't there is always the option of taking them

:45:05.:45:07.

back to school. What tell me beyond the curriculum and you both know the

:45:08.:45:11.

curriculum as teachers, what are you teaching them, what are you giving

:45:12.:45:13.

them that the school can't give them? I have always thought than I

:45:14.:45:19.

formal learning is underrated. Learning isn't formalised and sat at

:45:20.:45:25.

a table, but learning outside. Multisensory learning, being able to

:45:26.:45:29.

design a curriculum we think is tailor-made for our children and

:45:30.:45:33.

adapt is where they want to take it within reason. Very briefly, what

:45:34.:45:36.

happens when you all fall out and you think I have been with mum and

:45:37.:45:40.

dad far too much? Sometimes we might just close the divider that's there

:45:41.:45:45.

and sit in our bed for a while, thinking gosh, but we get over it

:45:46.:45:49.

and have a great time. We haven't had too many scuffles. Good luck to

:45:50.:45:53.

you. Make sure you get no problems with the caravan and you have a

:45:54.:45:56.

wonderful trip. Thank you very much indeed. Thank you. We finish

:45:57.:46:01.

tonight, she was the Queen of the one liner, she had an acid wit and

:46:02.:46:07.

she often turned that wit on everybody including herself. Joan

:46:08.:46:13.

Rivers died at the age of 81. She joked when she got to the pearly

:46:14.:46:16.

gates the chances are God wouldn't recognise her because she had so

:46:17.:46:22.

much plastic surgery. Here she is in incomparable form, good night. Take

:46:23.:46:30.

your time, what are you using? Tell me? Excuse me, we are going to be

:46:31.:46:37.

very adult tonight, Dr Ruth out here, we are talking adult level,

:46:38.:46:42.

what are you using for contraception? Are you using

:46:43.:46:53.

something? Does it look round? Had (laughter) because you also put make

:46:54.:46:58.

up on with it because that would be the sponge or something really

:46:59.:47:01.

stupid you could take a pill and go like that. See you are taking the

:47:02.:47:06.

pill, just curious, people get so testy these day, I was taking the

:47:07.:47:10.

pill but I was putting it in the wrong place so I had my kid!

:47:11.:47:13.

pill but I was putting it in the wrong place so I had my kid! Good

:47:14.:47:20.

evening, let's see what is happening on the weather front for the final

:47:21.:47:24.

day of the working week for most of us. We have some rain to

:47:25.:47:26.

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