The funding crisis in Britain's accident and emergency units and negotiations to repatriate the bodies of five Russian helicopter crew. With Kirsty Wark.
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Imagine accident emergency closed at night?
Well, soon it might be a reality as hospitals struggle
with lack of staff, money shortages, and increasing
Lord Robert Winston and junior doctor Rachel Clark -
We have an exclusive interview with the Syrian rebels holding
the remains of the Russian helicopter crew shot
The woman who brought the story of Adnan Syed to Serial,
And this was the moment Michael Phelps won his 21st Olympic Gold.
Our own Olympic great Duncan Goodhew is here to analyse the phenomenal
The pressure on the NHS in England has never been greater,
and perhaps the most acute pressure is on accident emergency.
As an indicator of the myriad problems at A, a hospital
in Lincolnshire warned today it may have to close at night, saying it
Add to that the volume of traffic at A as patients substitute it
for their GP surgery, and the rising demands
Can the NHS in England survive without radical surgery?
The financial crisis is such that the government says NHS England
must save ?22 billion a year for the next five years.
The English NHS is a huge old machine, which has
Short, medium and long-term forces are all running against it.
An A might be cut in Lincolnshire because of recruiting trouble,
and a stark warning today came from a Royal College.
We are seeing deteriorating waiting times.
My own hospital is actually doing reasonably well,
but many trusts in the country are noticing that there
are deteriorating waiting times both for elective surgery,
getting treatment within the appropriate time.
And we are seeing increasing pressure upon A
If you only looked at one graph to understand the NHS in England,
This first line here shows you the change in the amount
of money that we have paid to hospitals per procedure
Something for which we would have paid hospitals ?100 back in 2009-10,
The idea of that squeeze was that it would force hospitals to become
So what happens to the costs faced by hospitals per procedure?
Well, you can see from this line, first of all,
But since 2011-12, hospitals simply haven't kept pace
The gap between those two lines, that's the NHS's financial problem.
It means that hospitals are spending more per operation
So to solve the NHS's financial crisis, we have
Either cut hospitals' costs, and that means lowering
the top line even further, or putting more money in,
The short-term response to that medium-term problem is to encourage
hospitals to squeeze pay bills in particular.
But that means the financial squeeze is exacerbating some long-standing
We've had a history of some small, particularly rural hospitals,
having trouble getting doctors to come and work there.
And that seems to be a problem across the public sector in other
The second issue is that some specialities are not
It's partly a combination of the very high pressure of the job
and the fact that we have, frankly, not trained enough and people do not
want to go into those training posts in the numbers that we need.
You can see why NHS managers have been so worried that the Brexit vote
might make it harder for them to recruit abroad.
Remember, the fall in sterling will be felt most keenly by people
who plan their lives in other currencies.
These are times historians will pore over,
Let's get two medical perspectives on this now.
expert and Labour peer, the reproductive health
and from Rachel Clarke - a junior doctor who has worked in A
Lord Winston first, the financial gap is a given. Does it have to be
some radical change? I think one of the first things the government has
to think about is, how is it to manage to dis- incentivise one of
the most altruistic, most well-qualified, one of the most
intelligent workforces in the country? From the age of 16 these
people have wanted to go to the health service and now they want to
leave it early. They have been trained at a very high level at a
great cost. Now one of the key issues with A, general
practitioners are wanting to leave because they are so dis-
incentivised because of the way they restructured the health service with
the disastrous 2012 act. Rachel, as somebody who worked in A a year
ago, tell me the good things and bad things. Before you start your first
A job, people say to you, it's a battle ground, and it is. There is
blood and gore and drunks and abuse. But none of that actually makes it
bad, necessarily. It makes it an environment where you can strive to
be the best doctor you can, you can save lives everyday. It could be
everything you want as a medical career. But, the brutal truth of the
matter is, in every A wrote there are among junior doctors. But there
are no restrictions on the number of patients coming in so the doctors
left are having to do the jobs of two or more doctors. And that is
unbearable. You literally might have somebody in the first bed who has
just had a life threatening heart attack and the second bed might have
somebody with a stroke. Both lives are in your hands and how do you
look after them both? The Lincolnshire hospital is thinking of
closing night, isn't that unthinkable? It's absolutely
catastrophic. It means millions of people in that environment will
suddenly be denied emergency care and they will go to other A,
swamping those who probably also have gaps in their rotors. The idea
this is happening up and down the country, and the Health Secretary is
turning a blind eye to it, he's not being upfront about it. What do you
think might be done to alleviate the situation? One of the things we
should not do is to have a ridiculous idea meant with junior
hospital doctors over working at weekends when we are closing
hospitals at night-time. That shows the kind of thinking from the
Secretary of State. First of all, we should tell the truth about what
happens at the weekends and wider deaths he records isn't related to
staffing. It's very important for the health service not to be a
political football. We are in a situation where the Tory party is
unopposed by a weak opposition and that doesn't help. Looking at you
with your medical hat on, what do you think can be done, particularly
in A? For example, and this might be unpopular, our patients part of
the problem? You have to go to primary care and see how it has been
delivered. At the moment most general practitioners are totally
dissatisfied because they are running the health service as
commissioners instead of looking after the health service. What would
you do in A, bring in privatisation? You could bring in
private practice, and I speak as a member of the Labour Party, we could
have private practice but make sure it's inside the health service or
the profit goes to the health service and not to private providers
who could tender outside. You might have in A, and you would go there,
but if you can afford to pay you would go faster? It wouldn't help
A As somebody who works in A still, I can offer two other
suggestions. The first is that you have to be honest and candid about
the lack of doctors and you have to recruit more. Jeremy Hunt and his
government don't want to do that because it costs money. But if we
don't do that we deny the population a safe standard of care. Secondly,
and your film doesn't make clear, what the statistics don't point out,
year-on-year since 2010, the share of GDP this government spends on
health has gone down. It's now at 6.7%, almost the lowest in Europe.
Let's have practical solutions. How do you educate patients about going
to A and is not going to it in the first instance? You have to provide
primary care with the general practitioners, and if the GPs are
not there, they have to go to A That's what happens at the moment. I
routinely see patients who are life threatening me sick, at death's
door, and then people who have had a tummy ache for 30 years. Of course
that end of the extreme shouldn't be there, but if you are a worried
mother told by a GP receptionist that it will be three weeks before
you get your child to a GP, what will you do? The crisis isn't just
in A, it's in general practitioners as well. In some GP
training rotors there are 50% gaps. There are nowhere for patients to
go. If the government will not be honest, will not fulfil their duty
of candour with the electorate to come clean about that, then they are
being dangerous and threatening and endangering patients. Once before,
Gordon Brown put a penny on national insurance, and said it could be for
the NHS. Is it time to hypothesise taxes for the NHS? I don't think
that's the right way to do it at all. Very few people who work in
health service believe that's the answer. We have done is create a
very unwieldy structure. Your film focuses on so many different
problems. Let me put it to you, the NHS is not fit for purpose and that
isn't just do with money, it's the way we deliver it. And it's also
with how we encourage staff to come into it. We make it difficult to
recruit staff, we don't even provide work experience. They're all sorts
of things at every level that haven't been thought through. Why is
it impossible to have this kind of debate? Because we have made the
health service into a political football. As Rachel says, we are not
having an honest debate and until we do it will be a major problem. I
would say one of the problems is, Sir Robert Francis, who investigated
the horrors of mid Staffordshire said that junior doctors were the
eyes and ears of the health service, and we are, we see things crumbling
around us at the moment and we are packed with solutions, we know how
to do things differently. The government could listen to us, but
instead they impose policies from on high, such as the notorious
seven-day NHS, and that is a disastrous way to do things.
When the Syrian opposition shot down a Russian military helicopter over
Idlib province ten days ago, killing five people, it was the largest
single loss of Russian life since their involvement in support
The rebels are now trying to barter the bodies and the remains,
in exchange for opposition prisoners.
Our Diplomatic Editor Mark Urban has spoken exclusively to the rebels
who have the bodies, and reports on how negotiations are impacting
on the Erdogan-Putin summit in St Petersburg.
On the last day of July a Russian helicopter returning from a mission
into Aleppo was shot down by Syrian rebels.
As jubilant locals picked over the wreckage,
the bodies of two crew members were defiled.
And the stage was set for a secret negotiation that shows how
the warring parties would use anything or anyone in their cars.
the warring parties would use anything or anyone in their cause.
This afternoon, we contacted the prisoners committee
of the Syrian resistance that says it is now holding the dead crew
and wants concessions before returning the remains.
TRANSLATION: Any further details can be negotiated directly
Hence we cannot discuss the details now.
The committee sent us these images as proof that it holds
Three crewmen have been identified by Russian
journalists as Oleg Shelamov, Roman Pavlov and Pavlo Shirahov.
Who the other two were and whether one of them is the woman
The Syrians told us three bodies were burned beyond recognition.
But in a conflict where so many have died without trace,
and the Russians have been accused of merciless bombing,
is getting the bodies back even a priority?
It is very important to get these bodies back because we
And this is message for all the people around the world.
As Syrians, we're looking to respect others.
The issue of the pilots has been raised on the margins of this week's
The initial rebel demand that the Syrian government release
all 140,000 prisoners it holds is now giving way to a more
realistic discussion about possible humanitarian access.
The idea being that Russia might deliver the Assad government
TRANSLATION: We welcome any international mediation,
especially from the Turkish government, because they have stood
We are very flexible, open to other possibilities,
and we shall use all available methods to release the prisoners
It is in trying to help broker a deal that Anasol Shami has
gone to St Petersburg this week, and believes it could happen.
Like the prisoners, which are not killers, you understand me?
Some prisoners, they are political prisoners.
With heavy fighting going on around Aleppo, neither side
But the talks over the pilots' remains reveal how channels
between Syrians remain open when it is in their mutual interest.
And now to Newsnight's much-laurelled Olympics coverage,
brought to you from a storied sofa not a million miles from here.
In a case of life imitating art, the diving pool
Stephen Smith's bathtub has been that colour for days.
Throne of Games, analysis as clear as a Russian
When you're preparing for an event of this size,
it all comes down to two words - professionalism.
The top athletes will tell you, if you can drag yourself out
of bed even when it's the last thing you want to do,
You know, it came as a horrifying surprise to me that it wasn't
Are they allowed to punch each other?
I think that is frowned on technically.
The number of women's teams, British women's teams that
are incomparably better, internationally speaking,
Women are just better at stuff.
And everybody goes, do women even box?
Well, surely our friend Nicola Adams has changed perceptions there.
She's one of the faces of Team GB, isn't she?
Do you know what, judo, it looks like two kids fighting
It looks like one of them has some Opal Fruits
and the other one's like, gimme an Opal Fruit!
I think that would give it some extra zing.
We need to talk about the colour of the pool because...
Did the guy forget to go out with the chlorine,
is that what it is, the pool boy didn't show up?
I would like to know when they have to start synchronising.
Is it when they come out of the loo, when they open the door?
I guess their outfits have to be the same.
I mean, do they synchronise from the morning just
What do you think would be the easiest
Yeah, because the difference, the tolerances between competent
The number 16 seed causing a major potential shock.
Hang on a sec, I thought the other one just stabbed her.
It will be interesting to see where she is...
You've been watching Throne of Games.
Trust me, no-one's getting paid more than the Prime Minister for this.
Now - we thought we'd take a moment to talk about possibly the greatest
Olympian of all time: the American swimmer Michael Phelps.
More than one hundred countries have won fewer gold medals
Sixteen years after becoming an Olympian -
and ten years older than the age at which most swimmers peak,
he took gold again last night for the 200m butterfly.
Duncan Goodhew knows what it feels like to win gold -
he triumphed in the 100 metres breaststroke in the
Have you been glued to the set? I have, and I only won one gold medal,
and when you look at what Michael Phelps is done, it is extraordinary.
His achievements are almost superhuman. I grew up with Mark
Spitz and we thought, how can anybody win more than nine gold
medals, seven in one games? And now enter Michael Phelps. He seems to
have broken through on so many different levels. And if you just
play your mind back, you have one gold medal, the heats, the
semifinals and finals. But if you want to get two, then they are going
on in sequence, so you were going back to back. So how do you keep
emotionally up, and not tire of it? When you are looking at him,
ordinary think about him? It is just extraordinary. I interviewed him for
the Financial Times when he was just breaking through, when he was 17
years old. Both him and his coach were convinced that one gold medal
would satisfy. One gold metal would satisfy most people! -- gold medal.
For him, he knew he was talented and it was reflected in everybody around
him. And he had that enormous support. Physically, he has changed
massively in that time. It has been a real journey. He has changed his
shape. Some archaeologists have found that gladiators grew longer
arms. I think with Michael Phelps, he has grown more like a fish by the
moment. He is extraordinary in the water. And he is not exactly Mr
super healthy. He used to eat 10,000 calories a day. You have to swim
that much. When you talk to Olympic athletes, they all accept that
swimming is the most demanding of all sports. I think it is because
you are lying down, you can wrap up the engine and keep going for
longer. If you are running, your body is pounded, and you have to get
the blood up through your legs. But he has obviously calibrated what he
is doing as he is getting older. At 31, he is way beyond the age that
most athletes and swimmers peak. How is he changing it? What is the game
plan? For him he was obviously really upset to lose in the 200
metre butterfly in London and that really rankles. Now he has got a
young child and he has settled down a bit. From what I understand of his
attitude, it has changed things massively over the last couple of
years. And we are seeing the results of that. But also what he is doing,
he is going for 100 metres and 200 metres, so it is, dare I say it, a
quick blast without having to deal with the stamina. I am very much for
the taps. Seriously, I think you have to look at him as the man. Can
anybody beat this? It is going to be tough. But they did beat Mark Spitz.
The relays make the difference for him. As an American, he has nine
gold medals on the relay. Unless it is another very strong country, to
win those kind of numbers again will be difficult. But never say
impossible because another Michael Phelps will probably come along.
Thank you very much indeed. Serial is the most popular
and downloaded podcast of all time. It reinvented story telling
for a new generation. The true story of the US murder
conviction of seventeen year old Adnan Syed reached more
than 500 million international Now lawyer and family
friend Rabia Chaudry, who brought the story to Serial,
and has worked to overturn his conviction, has written
about the phenomenon. In case you didn't tune in,
journalist Sarah Koenig explored the case of Adnan Syed,
a 17-year-old American high school student of Pakistani
origin who was convicted of murdering his ex-girlfriend,
Hai Min Lee, in 1999. This is a global cell link,
prepaid calls from... ..an inmate at Maryland Correctional
Facility. He was sentenced to
life plus 30 years. The case rested on a 21 minute
window, the time frame in which the prosecution alleges
Adnan left school and But the podcast raised a number
of questions about whether it was In particular, a key witness
who could have served as an alibi And crucial cell phone evidence
that was used to locate Adnan Syed at the scene of the murder
was unreliable and not cross In June this year,
a judge ordered a retrial. The world now waits
for the next chapter of this I feel like I want to shoot myself
if I hear someone else say, I don't think you did it
because you're a nice guy. But I have heard people say that
to me over the years, I would love them to say,
I don't think you did it because I looked at the case and it
looks kind of flimsy. Earlier, I spoke to lawyer
Rabia Chaudry, a family friend and campaigner for the innocence
of Adnan Syed, about her new book on the case which comes
out in the UK tomorrow. I began by asking her
about the impact Serial Cereal had a tremendous impact. We
never would have gotten this far without the work they did, the
storytelling they did. Without it, we would still be at a dead-end in
the case. And what was the contribution made by the listeners,
as they became more engrossed in the podcast? So many of the listeners
did not just look at this as entertainment, they came out and
supported us. We have raised hundreds of thousands of dollars
because of listener donations. They have written thousands of letters to
Adnan Syed and they followed the story after Serial. They wanted to
know what else there was. They listened to other podcasts and
continued to follow the case. And criminal investigators listened to
the podcast as well. Yes, a lot of experts have come forward and
offered their services. Obviously, my colleagues at Undisclosed our two
lawyers who began investigating on their own. Unlike them, many other
volunteers came forward and helped us continue the investigation. So
the journalists working on Serial did not take a stand. They did not
say innocent or guilty. What do you make of that? I cannot compel
anybody to come to some kind of conclusion. Obviously my hope was
that this would be somebody who would become an advocate for Adnan
Syed, who would feel convinced and follow the story to that end, and
look for the evidence to help exonerate him, feeling that he was
innocent. When that did not happen, it is what it is. You do the best
you can. And I think we have. The fact that Sarah Kane was not able to
reach a conclusion is fine because many other people have taken up the
case. -- Sira Koenig. In a sense, isn't it better that Serial did not
take a stand because it allowed the audience to becoming grassed and
engaged, and the position of the journalist was not clear. Is that
not a better position to be an? Does that not hold more listeners? I
think part of the draw of Serial was the sustained ambiguity. The mystery
is what kept people there. But that does not necessarily mean...
Undisclosed, the podcast we followed up with, it has more than 90 million
listeneds. We have a clear stands. -- listens. I am not a journalist
and I do not know what it means to have journalistic standards. Does it
mean you have to always be neutral? I thought investigative journalism
meant that sometimes you take a stand. I do not think the story
would have been hurt if at the end they decided they would take a stand
knowing what they know now. Very clearly in the book you made it
clear that you have a low opinion of the state often and how they handle
trials and there are many thousands of miscarriages of justice. Is there
a danger that by focusing on this one, not for yourself personally but
programmes focusing on one, it allows people to not think about the
bigger picture? Actually, I think that is a great lesson from Serial,
that people become interested in issues when there is a human story.
When you talk about people and you say that there is systematic racism,
they will say, OK, fine, too bad. But when you sell them -- tell them
about a person, they are able to understand the issue and how it
affects somebody. What has happened, hundreds of people have reached out
to say that because of Adnan Syed's story, we were able to understand
things we did not understand, how the criminal justice system works.
We understand how bad lawyering can ruin a person's life. We understand
bigotry. They are able to understand issues that otherwise might become
intangible. I know you spoke with him recently. How is he now? He is
doing well. We spoke about a week ago and ever since the new ruling in
which his conviction was vacated, he has been positive. We expected the
state to appeal it but he is patient and he has been patient for a long
time. Thank you very much indeed.
The funding crisis in Britain's accident and emergency units, negotiations to repatriate the bodies of five Russian helicopter crew and an exclusive serial podcast interview with Rabia Chaudry.