:00:35. > :00:39.Welcome to the Sunday Politics. Downing Street announces an inquiry
:00:40. > :00:44.into allegations of hardball tactics and intimidation by unions in
:00:45. > :00:47.industrial disputes. That's our top story.
:00:48. > :00:50.Thousands dead. Hundreds of thousands without homes. Millions
:00:51. > :00:55.affected. What is Britain doing to help the Philippines in the wake of
:00:56. > :01:00.Typhoon Haiyan? We'll ask International Development Secretary
:01:01. > :01:03.Justine Greening. Winter is coming and so, it seems,
:01:04. > :01:06.is another crisis in England's hospitals. I'll be asking the Shadow
:01:07. > :01:12.Health Secretary how he'd put a stop to the NHS's annual woes.
:01:13. > :01:15.And on Sunday Politics Scotland: We'll be asking the Scottish Health
:01:16. > :01:17.Secretary, Alex Neil, if hospitals here will be able to cope with the
:01:18. > :01:39.pressures of the winter months. Janan Ganesh, Nick Watt and this
:01:40. > :01:43.week, Zoe Williams, who'll be tweeting their thoughts throughout
:01:44. > :01:47.the programme. The Government has announced a
:01:48. > :01:49.review to investigate what the Prime Minister has called "industrial
:01:50. > :02:01.intimidation" by trade union activists. Bruce Carr QC will chair
:02:02. > :02:04.a panel to examine allegations of the kind of tactics that came to
:02:05. > :02:07.light during the Grangemouth dispute, when the Unite union took
:02:08. > :02:14.their protests - replete with a giant rat - outside the family homes
:02:15. > :02:18.of the firms' bosses. Earlier this morning the Cabinet office minister,
:02:19. > :02:23.Francis Maude spoke to the BBC and this is what he had to say. To look
:02:24. > :02:27.at whether the law currently works and see if it is ineffective in
:02:28. > :02:32.preventing the kind of intimidatory activity that was alleged to have
:02:33. > :02:41.taken place around range mouth during the previous disputes --
:02:42. > :02:46.Grangemouth. We make no presumptions at the beginning of this. I do think
:02:47. > :02:50.it is a responsible thing for the government to establish what
:02:51. > :02:55.happened and really do a proper review into whether the law is
:02:56. > :03:01.adequate to meet the needs. That was Francis Maude. This is a purely
:03:02. > :03:06.political move, isn't it? Unite did this a couple of times, it is hardly
:03:07. > :03:09.happening all over the country but the government want to say, we are
:03:10. > :03:16.prepared to investigate Unite properly, Labour isn't. This seemed
:03:17. > :03:22.a lot worse when I thought it was a real rat. I thought it was a giant
:03:23. > :03:26.dead rat. I am not sure if you know much about rats but real rats are
:03:27. > :03:32.not this big, even the ones in London. The thing is, obviously it
:03:33. > :03:38.is naked politics but I think it is more intelligent than it looks. They
:03:39. > :03:43.are trying to taint Miliband as a week union puppet and that doesn't
:03:44. > :03:49.really wash. They hammer away with it and it might wash for some
:03:50. > :03:53.people. But it really castrates Miliband in the important issues he
:03:54. > :03:56.has to tackle. Zero hours, living wage, all of those things in which
:03:57. > :04:03.he needs to be in concert with the unions, and to use their expertise.
:04:04. > :04:15.He is making them absolutely toxic to go anywhere near. It keeps the
:04:16. > :04:18.Unite story alive, have to kill -- particularly since Mr Miller band is
:04:19. > :04:33.under pressure to reopen the investigation into what Unite are up
:04:34. > :04:36.to -- Mr Miliband. They are frustrated, not only at the BBC but
:04:37. > :04:40.the media generally at what they think is a lack of coverage. I see
:04:41. > :04:45.the political rationale from that respect. There is a risk. There are
:04:46. > :04:51.union members who either vote Tory or are open to the idea of voting
:04:52. > :05:04.Tory. All Lib Dem. If the party comes across as too zealous in as --
:05:05. > :05:11.its antipathy, there is an electoral consequence. Ed Miliband has been
:05:12. > :05:16.careful to keep a distance. Yes, they depend on vast amounts of
:05:17. > :05:19.money. When Len McCluskey had a real go at the Blairites, Ed Miliband was
:05:20. > :05:22.straight out there with a very strong statement. Essentially Len
:05:23. > :05:27.McCluskey wanted Blairites in the shadow cabinet sacked and Ed
:05:28. > :05:33.Miliband was keen to distance himself or for that is why it is not
:05:34. > :05:37.quite sticking. Another story in the Sunday papers this morning, the Mail
:05:38. > :05:43.on Sunday got hold of some e-mails. When I saw the headline I thought it
:05:44. > :05:48.was a huge cache of e-mails, it turns out to be a couple. They peel
:05:49. > :05:56.away the cover on the relationship between Ed Miliband and Ed Balls,
:05:57. > :06:02.with some of Ed Miliband's cohorts describing what Mr balls is trying
:06:03. > :06:07.to do as a nightmare. How bad are the relations? They are pretty bad
:06:08. > :06:10.and these e-mails confirm the biggest open signal in Westminster,
:06:11. > :06:16.which is that relations are pretty tense, -- open secret. That Ed
:06:17. > :06:21.Miliband doesn't feel that Ed Balls is acknowledging the economy has
:06:22. > :06:28.grown that Labour needs to admit to past mistakes. The sort of great
:06:29. > :06:36.open signal is confirmed. On a scale of 1-10, assuming that Blair-Brown
:06:37. > :06:40.was ten. I think it is between six and seven. They occupy this joint
:06:41. > :06:46.suite of offices that George Cameron and -- David Cameron and George
:06:47. > :06:50.Osborne had. It is not just on the economy that there were tensions,
:06:51. > :06:56.there were clearly tensions over HS2, Ed Balls put a huge question
:06:57. > :07:00.over it at his conference. There will be more tensions when it comes
:07:01. > :07:04.to the third runway because my information is that Mr balls wants
:07:05. > :07:10.to do it and Ed Miliband almost resigned over it when he was in
:07:11. > :07:13.government. I don't think Ed Miliband is thinking very
:07:14. > :07:19.politically because he has tried live without Ed Balls and that is
:07:20. > :07:23.not tenable either. -- life without. He has defined a way of making it
:07:24. > :07:28.work. That is where Tony Blair had the edge on any modern politician.
:07:29. > :07:32.He didn't want to make Ed Balls his Shadow Chancellor, he had to.
:07:33. > :07:35.Somebody said to him, if you make Ed Balls Shadow Chancellor, that will
:07:36. > :07:45.be the last decision you take as leader of the Labour Party. Is it as
:07:46. > :07:56.bad? I was surprised at how tame the e-mails were. At the FT it is
:07:57. > :08:01.compulsory, one French word per sentence! To call him a nightmare,
:08:02. > :08:06.compared to what they are willing to say in briefings, conversations,
:08:07. > :08:09.bits of frustrations they express verbally come what is documented in
:08:10. > :08:15.the e-mails is actually pretty light. It has been a grim week for
:08:16. > :08:17.the people of the Philippines as they count the cost of the
:08:18. > :08:24.devastation wrought by Typhoon Haiyan. HMS Daring has just arrived
:08:25. > :08:28.near the worst hit areas - part of Britain's contribution to bring aid
:08:29. > :08:32.to the country. It has been one of the worst natural
:08:33. > :08:35.disasters in the history of the Philippines. Typhoon Haiyan hit the
:08:36. > :08:40.country nine days ago, leaving devastation in its wake. The numbers
:08:41. > :08:45.involved are shocking. The official death toll is over 3600 people, with
:08:46. > :08:49.many thousands more unaccounted for. More than half a million people have
:08:50. > :08:54.lost their homes and the UN estimates 11 million have been
:08:55. > :08:57.affected. David Cameron announced on Friday that the UK government is to
:08:58. > :09:04.give an extra ?30 million in aid, taking the total British figure ?250
:09:05. > :09:07.million. An RAF Sea 17 aircraft landed yesterday with equipment to
:09:08. > :09:13.help aid workers get too hard to reach areas. HMS Illustrious is on
:09:14. > :09:20.its way and due to arrive next weekend. The British public have
:09:21. > :09:25.once again dipped into their pockets and given generously. They have
:09:26. > :09:27.given more than ?30 million to the Disasters Emergency Committee.
:09:28. > :09:31.The International Development Secretary, Justine Greening, joins
:09:32. > :09:35.me now for the Sunday Interview. Good morning, Secretary of State.
:09:36. > :09:40.How much of the ?50 million that the government has allocated has got
:09:41. > :09:44.through so far? All of it has landed on the ground now. HMS Daring has
:09:45. > :09:48.turned up, that will be able to start getting help out to some of
:09:49. > :09:50.those more outlying islands that have been hard to reach. We have
:09:51. > :09:55.those more outlying islands that seen Save the Children and Oxfam
:09:56. > :10:01.really being able to get aid out on the ground. We have a plane taking
:10:02. > :10:04.off today that will not read just carrying out more equipment to help
:10:05. > :10:11.clear the roads but will also have their staff on board, too. We have
:10:12. > :10:17.?50 million of aid actually on the ground? We instantly chartered
:10:18. > :10:23.flights directly from Dubai where we have preprepared human Terry and
:10:24. > :10:30.supplies, and started humanity work -- humanitarian supplies.
:10:31. > :10:37.A lot of it has now arrived. I think we have done a huge amount so far.
:10:38. > :10:42.We have gone beyond just providing humanitarian supplies, to getting
:10:43. > :10:46.the Royal Air Force involved. They have helped us to get equipment out
:10:47. > :10:51.there quickly. We have HMS Illustrious sailing over there now.
:10:52. > :10:55.Why has that taken so long? It was based in the Gulf and is not going
:10:56. > :10:58.to get there until two weeks after the storm first hit and that is the
:10:59. > :11:03.one ship we have with lots of helicopters. The first decision we
:11:04. > :11:08.took was to make sure we could get the fastest vessel out there that
:11:09. > :11:11.was able to help HMS Daring. HMS Illustrious was just finishing an
:11:12. > :11:15.exercise and planning to start to head back towards the UK. We have
:11:16. > :11:21.said to not do that, and diverted it. Shouldn't it have happened more
:11:22. > :11:26.quickly? We took the decisions as fast as we were able to, you can't
:11:27. > :11:30.just turn a big warship around like the HMS Illustrious. We made sure we
:11:31. > :11:35.took those decisions and that is while it will be taking over from
:11:36. > :11:40.HMS Daring come and that is why HMS Daring is ready there. It will be
:11:41. > :11:44.able to provide key support and expertise that has not been there so
:11:45. > :11:50.far. The US Navy is doing the heavy lifting here. The US Navy had the
:11:51. > :11:55.USS Washington, there is an aircraft carrier, 80 planes, 5000 personnel
:11:56. > :11:58.and they have the fleet, they are doing the real work. We obviously
:11:59. > :12:03.helping but the Americans are taking the lead. It is a big international
:12:04. > :12:07.effort. Countries like the US and the UK, that have a broader ability
:12:08. > :12:15.to support that goes beyond simply call humanitarian supplies -- have
:12:16. > :12:20.made sure we have brought our logistics knowledge, we have sent
:12:21. > :12:25.out our naval vessels. It shows we are working across government to
:12:26. > :12:32.respond to this crisis. Why does only just over 4% of your aid budget
:12:33. > :12:37.go on emergency disaster and response? A lot depends on what
:12:38. > :12:42.crises hit in any given year. We have done a huge amount, responding
:12:43. > :12:46.to the crisis in Syria, the conflict there and the fact we have 2 million
:12:47. > :12:50.refugees who have fled the country. We are part of an international
:12:51. > :12:55.effort in supporting them. Shouldn't we beginning more money to that
:12:56. > :12:59.rather than some of the other programmes where it is harder to see
:13:00. > :13:05.the results question of if we were to give more money to the refugees,
:13:06. > :13:10.it would be a visible result. We could see an improvement in the
:13:11. > :13:15.lives of children, men and women. What we need to do is alongside that
:13:16. > :13:20.is stop those situations from happening in the first place. A lot
:13:21. > :13:22.of our development spend is helping countries to stay stable. Look at
:13:23. > :13:28.some of the work we are doing in Somalia, much more sensible. Not
:13:29. > :13:33.just from an immigration but there is a threat perspective. There is a
:13:34. > :13:38.lot of terrorism coming from Somalia. You only have to look at
:13:39. > :13:44.Kenya recently to see that. Which is why you talk about what we do with
:13:45. > :13:48.the rest of the spend. It is why it is responsible to work with the
:13:49. > :13:54.government of Somalia. Should we give more, bigger part of the budget
:13:55. > :13:59.to disaster relief or not? I think we get it about right, we have to be
:14:00. > :14:05.flexible and we are. This Philippine relief is on top of the work in
:14:06. > :14:09.Syria. Where can you show me a correlation between us giving aid to
:14:10. > :14:15.some failed nation, or nearly failed nation, and that cutting down on
:14:16. > :14:17.terrorism? If you look at the work we have done in Pakistan, a huge
:14:18. > :14:24.amount of work. Some of it short-term. It is written by
:14:25. > :14:32.terrorism. That is -- ridden by terrorism. That is not going to fix
:14:33. > :14:41.it self in a sense. Look at the work that we do in investing in
:14:42. > :14:48.education. The things that little girls like Malala talk about as
:14:49. > :14:54.being absolutely key. We are ramping up our aid to Pakistan, it will be
:14:55. > :14:59.close to half ?1 billion by the time of the election. Why should British
:15:00. > :15:07.taxpayers be giving half ?1 billion to a country where only 0.5% of
:15:08. > :15:16.people in Pakistan pay income tax, and 70% of their own MPs don't pay
:15:17. > :15:20.income tax. It is a good point and that is why we have been working
:15:21. > :15:30.with their tax revenue authority to help them increase that and push
:15:31. > :15:36.forward the tax reform. You are right, and I have setup a team that
:15:37. > :15:41.will go out and work with many of these countries so they can raise
:15:42. > :15:54.their own revenues. You really think you will raise the amount of tax by
:15:55. > :15:59.sending out the British HRM see? How many troops I we sending out to
:16:00. > :16:07.protect them? They don't need troops. We make sure that we have a
:16:08. > :16:17.duty of care alongside our staff, but we have to respond to any crisis
:16:18. > :16:23.like the Philippines, and alongside other countries we have two work
:16:24. > :16:28.alongside them so that they can reinvest in their own public
:16:29. > :16:34.services. If they can create their own taxes, will we stop paying aid?
:16:35. > :16:39.We need to look at that but the new Pakistan Government has been very
:16:40. > :16:47.clear it is a priority and we will be helping them in pursuing that.
:16:48. > :16:54.Let me show you a picture. Who are these young women? I don't know, I'm
:16:55. > :16:58.sure you are about to tell me. They are the Ethiopian Spice Girls and
:16:59. > :17:05.I'm surprised you don't know because they have only managed to become so
:17:06. > :17:11.famous because your department has financed them to the tune of ?4
:17:12. > :17:14.million. All of the work we do with women on the ground, making sure
:17:15. > :17:21.they have a voice in their local communities, making sure they have
:17:22. > :17:30.some control over what happens to their own bodies in terms of
:17:31. > :17:36.tackling FGM, female genital mutilation... Did you know your
:17:37. > :17:43.department has spent ?4 million on the Ethiopian Spice Girls? Yes, I
:17:44. > :17:48.do, and we have to work with girls and show them there is a life ahead
:17:49. > :17:52.of them with opportunity and potential that goes beyond what many
:17:53. > :17:57.of them will experience, which includes early and forced marriage.
:17:58. > :18:09.It is part of the work we do with local communities to change
:18:10. > :18:12.attitudes everything you have just said is immeasurable, and they
:18:13. > :18:17.broadcast on a radio station that doesn't reach most of the country so
:18:18. > :18:25.it cannot have the impact. It only reaches 20 million people and the
:18:26. > :18:33.project has been condemned saying there were serious inefficiencies.
:18:34. > :18:37.That aid report was done a while ago now, and it was talking about the
:18:38. > :18:41.project when it first got going, and a lot of improvements have happened
:18:42. > :18:45.since. I would go back to the point that we are working in very
:18:46. > :18:50.difficult environments where we are trying to get longer term change on
:18:51. > :18:54.the ground and that means working directly with communities but also
:18:55. > :19:00.investing for the long-term, investing in some of these girls
:19:01. > :19:06.start changing attitudes in them and their communities. Why does the
:19:07. > :19:18.British taxpayers spend ?5 million on a Bangladesh version of Question
:19:19. > :19:23.Time? We work with the BBC to make sure we can get accountabilities...
:19:24. > :19:44.That is bigger then the BBC Question Time Normal -- budget. That includes
:19:45. > :19:51.the cost of David Dimbleby's tattoo! We are working to improve
:19:52. > :19:54.people's prospects but also we are working to improve their ability to
:19:55. > :19:58.hold their governments to account so that when they are not getting
:19:59. > :20:02.services on the ground, they have ways they can raise those concerns
:20:03. > :20:08.with the people who are there to deliver services for them. In your
:20:09. > :20:15.own personal view, should the next Conservative Government, if there is
:20:16. > :20:19.one, should you continue to ring fence spending on foreign aid? But
:20:20. > :20:25.it is critical that if we are going to spend 7.7% of our national
:20:26. > :20:30.income, we should make sure it is in our national interest and that means
:20:31. > :20:35.having a clear approach to humanitarian responses, in keeping
:20:36. > :20:40.the country safe, and a clearer approach on helping drive economic
:20:41. > :20:46.development and jobs so there is a long-term end of the dependency. Do
:20:47. > :20:54.you believe in an shrine in the percentage of our GDP that goes on
:20:55. > :21:00.foreign aid in law? Yes, and that is a coalition agreement. There have
:21:01. > :21:05.been a lot of agreements that you are sceptical about ring fencing. We
:21:06. > :21:16.are focused on shaking up the economy and improving our public
:21:17. > :21:25.finances. Why haven't you done that? At the end of the day we will be
:21:26. > :21:32.accountable but we are committed to doing that. You are running out of
:21:33. > :21:36.time, will you do it? I hope we can find the Parliamentary time, but
:21:37. > :21:44.even if we don't, we have acted as if that law is in place and we have
:21:45. > :21:47.already met 0.7% commitment. If you are British voter that doesn't
:21:48. > :21:55.believe that we should enshrine that in by law, which means that with a
:21:56. > :21:59.growing economy foreign aid will rise by definition, and if you think
:22:00. > :22:03.we should be spending less money on the Ethiopian Spice Girls, for whom
:22:04. > :22:10.should you wrote in the next election? I think we have a very
:22:11. > :22:17.sensible approach. I don't know what the various party manifestoes... The
:22:18. > :22:23.only party who thinks we shouldn't be doing this is UKIP. I think you
:22:24. > :22:36.have to look at the response to both the Philippines crisis and Children
:22:37. > :22:41.In Need. Of all the steps we are taking to get the country back on
:22:42. > :22:46.track, it shows the British people will respond to need when they need
:22:47. > :22:53.it and it is one of the things that makes Britain's special.
:22:54. > :22:55.Thank you. "It's always winter but never Christmas" - that's how
:22:56. > :22:57.doctors describe life inside accident and emergency. The College
:22:58. > :23:02.of Emergency Medicine have warned that this year could bring the
:23:03. > :23:04."worst crisis on record". If that dire prediction comes, expect a
:23:05. > :23:09.spring of political recriminations, but how prepared are the NHS in
:23:10. > :23:16.England? And what do they make of this autumnal speculation? Giles has
:23:17. > :23:21.been to Leeds to find out. This winter has already come to our
:23:22. > :23:30.hospitals. It had an official start date, November the 3rd. That is when
:23:31. > :23:35.weekly updates are delivered to the NHS's most senior planners, alerting
:23:36. > :23:43.them to any sudden changes in patient numbers coming in. Where do
:23:44. > :23:48.they numbers register most then A They are the barometer for what
:23:49. > :23:53.is going on everywhere else, and they are the pressure point, so if
:23:54. > :23:59.the system is beginning to struggle then it is in the A department
:24:00. > :24:05.that we see the problems. It is not that the problems are the A
:24:06. > :24:11.departments, but they are the place where it all comes together. Plans
:24:12. > :24:16.to tackle those problems start being drawn up in May and they look at
:24:17. > :24:29.trends, even taking notice of any flu epidemics in New Zealand. They
:24:30. > :24:34.also look at the amount of bets. But the weather, economic realities,
:24:35. > :24:38.structural reforms, and changes to the general health of the
:24:39. > :24:43.population, are all factors they have to consider. We get huge
:24:44. > :24:49.amounts of information through the winter in order to help the NHS be
:24:50. > :24:52.the best it can be, but we had to redouble our efforts this year
:24:53. > :24:59.because we expected to be a difficult winter. We know the NHS is
:25:00. > :25:04.stretched so we are working hard to be as good as we can be. That means
:25:05. > :25:11.they are looking at winter staffing levels, plans to ask for help from
:25:12. > :25:15.neighbouring hospitals, and dovetailing help with GP surgeries,
:25:16. > :25:22.and still having the ability to move up an extra gear, a rehearsed
:25:23. > :25:28.emergency plan if the NHS had to face a major disease pandemic. You
:25:29. > :25:32.spend any time in any of our hospitals and you realise the NHS
:25:33. > :25:36.knows that winter is coming and they are making plans, but you also get a
:25:37. > :25:41.palpable feeling amongst health workers across the entire system
:25:42. > :25:47.that they do get fed up of being used as a political football.
:25:48. > :25:51.Doctors and all health care professionals are frustrated about
:25:52. > :25:57.the politics that surrounds the NHS in health care. They go to work to
:25:58. > :26:03.treat patients as best as they can, and the political knock-about does
:26:04. > :26:06.not help anyone. I find it frustrating when there is a
:26:07. > :26:12.commentary that suggests the NHS does not planned, when it is
:26:13. > :26:16.surprised by winter, and wherever that comes from it is hard to take,
:26:17. > :26:27.knowing how much we do nationally and how much our hard working front
:26:28. > :26:34.line staff are doing. When the Coalition have recently tried to
:26:35. > :26:40.open up the NHS to be a more independent body, it is clear the
:26:41. > :26:46.NHS feel they have had an unhealthy dose of political wrangling between
:26:47. > :26:51.parties on policy. The NHS is not infallible or making any guarantees,
:26:52. > :26:54.but they seem confident that they and their patients can survive the
:26:55. > :26:56.winter. Joining me now from Salford in the
:26:57. > :27:07.Shadow Health Secretary, Andy Burnham. Tell me this, if you were
:27:08. > :27:14.health secretary now, you just took over in an emergency election, what
:27:15. > :27:21.would you do to avoid another winter crisis? I would immediately halt the
:27:22. > :27:27.closure of NHS walk-in centres. We heard this week that around one in
:27:28. > :27:32.four walk-in centres are closed so it makes no sense whatsoever for the
:27:33. > :27:37.Government to allow the continued closure of them. I would put nurses
:27:38. > :27:43.back on the end of phones and restore an NHS direct style service.
:27:44. > :27:50.The new 111 service is not in a position to provide help to people
:27:51. > :27:56.this winter. I think the time has come to rethink how the NHS care is
:27:57. > :28:00.particularly for older people so I propose the full integration of
:28:01. > :28:05.health and social care. It cannot make any sense any more to have this
:28:06. > :28:10.approach where we cut social care and let elderly people drift to
:28:11. > :28:19.hospitals in greater numbers. We have two rethink it as a whole
:28:20. > :28:22.service. So you would repeal some of the Tory reforms and move
:28:23. > :28:28.commissioning to local authorities so the NHS should brace itself for
:28:29. > :28:33.another major top-down health reorganisation? No, unlike Andrew
:28:34. > :28:45.Lansley I will work with the organisations ie inherit. He could
:28:46. > :28:49.work with primary care trusts but he turned it upside down when it needed
:28:50. > :29:03.stability. I will not do that but I will repeal the health and social
:29:04. > :29:07.care act because last week we heard that hospitals and health services
:29:08. > :29:12.cannot get on and make sensible merger collaborations because of
:29:13. > :29:17.this nonsense now that the NHS is bound by competition law. Let me get
:29:18. > :29:21.your views on a number of ideas that have been floated either by the
:29:22. > :29:31.press or the Coalition. We haven't got much time. Do you welcome the
:29:32. > :29:40.plan to bring back named GPs for over 75s? Yes, but it has got harder
:29:41. > :29:42.to get the GP appointment under this Government because David Cameron
:29:43. > :29:48.scrapped the 48-hour guarantee that Tony Blair brought in. He was
:29:49. > :29:53.challenged in the 2005 election about the difficulty of getting a GP
:29:54. > :29:57.appointment, and Tony Blair brought in the commitment that people should
:29:58. > :30:04.be able to get that within 48 hours. That has now been scrapped.
:30:05. > :30:08.Do you welcome the idea of allowing everyone to choose their own GP
:30:09. > :30:15.surgery even if it is not in our traditional catchment area? I
:30:16. > :30:20.proposed that just before the last election, so yes. Do you welcome the
:30:21. > :30:25.idea of how a practice is being rated being a matter of public
:30:26. > :30:31.record, and of us knowing how much, at least from the NHS, our GP earns?
:30:32. > :30:35.Of course, every political party supports transparency in the NHS.
:30:36. > :30:40.More information for the public of that kind is a good thing. Do you
:30:41. > :30:47.welcome this plan to make it will form the collect in an NHS hospital
:30:48. > :30:52.-- make wilful neglect a criminal offence. It is important to say you
:30:53. > :30:56.can't pick and mix these recommendations, you can't say we
:30:57. > :31:00.will have that one and not the others. It was a balanced package
:31:01. > :31:04.that Sir Robert Francis put forward. My message is that it must be
:31:05. > :31:09.permitted in full. If we are to learn the lessons, the whole package
:31:10. > :31:14.must be addressed, and that includes safe staffing levels across the NHS.
:31:15. > :31:45.Staff have a responsible to two patients at the government
:31:46. > :31:53.People forget that when it came in, there was a shortage of GPs. Some
:31:54. > :31:57.people but lack the contract helped that. What I would say is that this
:31:58. > :32:03.myth that the government has built all year that the 2004 GP contract
:32:04. > :32:11.is responsible for the ANC crisis is eight spin of the worst kind. --
:32:12. > :32:16.A You would we do that contract now? It was redone in our time in
:32:17. > :32:26.government and changed to make it better government -- value for
:32:27. > :32:33.money. Not so great if you cannot get 24-hour access to your practice.
:32:34. > :32:37.I agree with that, but we brought in evening and weekend opening for
:32:38. > :32:41.GPs, another thing that is gone into reverse under Mr Cameron. It is
:32:42. > :32:47.harder to get a GP appointment under him and that is one reason why it
:32:48. > :32:51.A are under pressure. Two things that aren't on dealer direct sphere
:32:52. > :32:56.of your portfolio, what do you make of the government's review into
:32:57. > :33:01.intimidator eat tactics used by unions? If there has been
:33:02. > :33:06.intimidation, it is unacceptable and it should apply to unions as well as
:33:07. > :33:11.to employees. Was unite wrong to turn up at that manager 's house? I
:33:12. > :33:15.don't know the details of that. Presumably, the review will look
:33:16. > :33:20.into it. I need reassurance that this is not a political call by Mr
:33:21. > :33:25.Cameron designed to report here the election. We will see how it
:33:26. > :33:32.develops. Are you sponsored by Unite? No. Do you get any money from
:33:33. > :33:40.unite all for yourself or for your constituency office? No. It seems
:33:41. > :33:43.most others seem to be getting something from Unite, it seems odd
:33:44. > :33:48.that you don't get anything, I will put in a word with Len McCluskey.
:33:49. > :33:52.What I think is the scandal with funding is that to private health
:33:53. > :33:57.care companies who between them have given ?1.5 million in donations to
:33:58. > :34:01.the Tory parties have won ?1.5 billion in NHS contracts since the
:34:02. > :34:05.last election, I wonder why don't spend as much time talking about
:34:06. > :34:10.that as you do on trade union funding. We are happy to talk about
:34:11. > :34:16.that as well do you know. Briefly and finally, we see some -- from
:34:17. > :34:20.some e-mails that Mr Miliband's closest advisers regard Mr Ed Balls
:34:21. > :34:26.as a bit of a nightmare, quote, do you think there is a nightmare? No,
:34:27. > :34:30.I don't. He is a very good friend and I cannot believe, to be honest,
:34:31. > :34:34.that you are talking about those e-mails on a political programme, my
:34:35. > :34:38.goodness, you are busy scraping the barrel today. I had been on the
:34:39. > :34:43.front line for 20 years, I cannot under the front bench and indeed the
:34:44. > :34:47.wider party be as united as it is today, that is a great credit to Ed
:34:48. > :34:54.Miliband and Ed Balls. We are a united team. It was worth spending a
:34:55. > :34:58.few seconds just to establish that you are not having nightmares, we
:34:59. > :35:03.wouldn't want the Shadow Health Secretary to have them. It has just
:35:04. > :35:11.gone 11:30am, you are watching Sunday Politics.
:35:12. > :35:18.Good morning and welcome to Sunday Politics Scotland. Coming up on the
:35:19. > :35:21.programme: Experts from across the UK are gathering here in Edinburgh
:35:22. > :35:24.at the Royal College of Physicians to discuss the problem, we will look
:35:25. > :35:28.at the answer. They've called for an end to
:35:29. > :35:31.patient's being farmed out to the wrong wards and for the NHS to be
:35:32. > :35:34.fully operational seven days a week. We'll put that to the Health
:35:35. > :35:37.Secretary Alex Neil. And from Cameron wearing a condom to
:35:38. > :35:41.Salmond with his saltire, the wit and lampooning of political figures
:35:42. > :35:45.over the centuries. A group of medical experts is this
:35:46. > :35:48.morning calling for an end to the practice of boarding in the NHS,
:35:49. > :35:51.that's when patients are farmed out to wards inappropriate for their
:35:52. > :35:54.care when hospitals are busy. Research indicates being treated in
:35:55. > :35:59.the wrong ward makes you more likely to die. At a time when NHS services
:36:00. > :36:01.are facing increasing pressure, the specialists are calling for
:36:02. > :36:13.clinicians and support staff to extend seven-day working. Here's
:36:14. > :36:15.Andrew Kerr. It is coming up to that time of year, when the pressure on
:36:16. > :36:19.the NHS. The Scottish government admitted
:36:20. > :36:25.that they need to improve norovirus and flew at eight indeed
:36:26. > :36:30.departments. Doctors say they are now experiencing winter pressure all
:36:31. > :36:37.year around. The Royal College of Physicians of Edinburgh is
:36:38. > :36:44.concerned. They say 124% bed occupancy in Fife was reported and
:36:45. > :36:46.101% in Lothian. A symptom of this overcapacity is boarding, patients
:36:47. > :36:53.being farmed out to ward inappropriate for their care.
:36:54. > :36:57.Research shows that patients are looked after in the wrong department
:36:58. > :37:03.are at a greater risk of dying. Patients who are boarded, they have
:37:04. > :37:09.significantly increased length of stay, risk of readmission and
:37:10. > :37:13.mortality at 30 days compared to patients who aren't boarded. It is a
:37:14. > :37:18.major problem. Experts have been gathering in Edinburgh to try to
:37:19. > :37:22.work out how to solve it. Why our hospitals so busy? Increasing
:37:23. > :37:27.numbers of elderly people need treatment and patients have high
:37:28. > :37:30.expectations. Doctors are more cautious and patients are be sent
:37:31. > :37:35.for more tests. The number of beds has been cut to treat more people in
:37:36. > :37:38.the community. The debate and discussions are going on here at the
:37:39. > :37:42.Royal College of Physicians in Edinburgh. It can be very stressful
:37:43. > :37:48.for a patient being in a busy hospital, but it can be very shy
:37:49. > :37:53.school for the staff, too. As a numbers game down, so did staff
:37:54. > :37:57.numbers. The Royal College of Nursing says that 1800 nursing posts
:37:58. > :38:02.were lost in the three years until last Christmas. This is now being
:38:03. > :38:08.reversed. There has been a number of workforce cuts. That led to us and
:38:09. > :38:14.producing the number of students in training. We then found ourselves
:38:15. > :38:18.having to put more beds into the system and we need to now find more
:38:19. > :38:26.qualified nurses. Unfortunately, this boom and bust approach that our
:38:27. > :38:29.members talk about is not good for morale or for when you are trying to
:38:30. > :38:35.find the right numbers of qualified nurses. Scottish Labour picked up on
:38:36. > :38:39.the starting point at First Minister's questions. We have seen a
:38:40. > :38:48.number of things being exposed, for example, a 62% in the -- city could
:38:49. > :38:53.increase in the use of... The Conservatives say why not try to
:38:54. > :38:58.produce the rush to the front door. It will require us to have a more
:38:59. > :39:03.responsible attitude to avoidable conditions to, like addictions or
:39:04. > :39:07.obesity and how do we combine a need to provide a service information to
:39:08. > :39:15.that without necessarily referring everyone to a hospital? The experts
:39:16. > :39:19.recommend sweeping reforms to end boarding. They're calling for an
:39:20. > :39:23.extension to seven-day working and for patients to be carefully
:39:24. > :39:29.monitored during their stay. We are very much looking at how you can
:39:30. > :39:33.take patients from the community through the hospital and back into
:39:34. > :39:37.the community with the smallest chance of having to be really
:39:38. > :39:42.admitted. If we can that, appropriately across the health
:39:43. > :39:47.boards, then we are looking at the most appropriate system for these
:39:48. > :39:50.patients. Health Secretary is now looking -- considering all of the
:39:51. > :39:56.comments to try to ensure that patients are treated quickly and end
:39:57. > :40:00.up in the right place in hospital. Joining me now in the studio is the
:40:01. > :40:06.Cabinet Secretary for Health and Wellbeing, Alex Neil. Why does it
:40:07. > :40:10.happen? It is about the flow of patients through the hospital. The
:40:11. > :40:13.flow of patients is one of the crucial challenges in our system. It
:40:14. > :40:17.has not received the same attention previously when you had such a high
:40:18. > :40:21.rate of hospitalisation for dealing with all sorts of problems. Now
:40:22. > :40:25.there is much more focus on the flow of patients. For example, sometimes
:40:26. > :40:29.you have patients going into medical wards that should be in surgical
:40:30. > :40:34.wards and vice versa. We set up this study because we suspected that it
:40:35. > :40:37.was having a damaging impact on patient health outcomes and also
:40:38. > :40:40.because we wanted to manage the flow of patients better which is why we
:40:41. > :40:46.have the recommendations that we are delighted with. Your own figures
:40:47. > :40:51.suggest that those who are in this position are more likely to die,
:40:52. > :40:54.that must be worrying for patients. The iMac absolutely. That is why we
:40:55. > :41:04.are trying to eliminate it altogether, ideally. Were developing
:41:05. > :41:07.a bed management capacity to. Let me give you an example. One of the
:41:08. > :41:12.areas of research that we have done in the last year after the problems
:41:13. > :41:16.we had last winter was looking at the patient flow. What we found out
:41:17. > :41:20.is that in many wards in hospitals the percentage of patients being
:41:21. > :41:26.discharged, ready for discharge, clinically ready for discharge, but
:41:27. > :41:28.only about 6% in some wards were being discharged before lunchtime
:41:29. > :41:35.with most of them being discharged in the evening. The reason that
:41:36. > :41:38.those delays were taking place was because the pharmacy services
:41:39. > :41:45.weren't available, the transport home was not available, what we have
:41:46. > :41:51.done as part of our is to look at these parts and puts the part in
:41:52. > :41:57.place. In the incident where it is now closer to 25%. That frees up
:41:58. > :42:03.their beds for people coming in through unplanned or planned care.
:42:04. > :42:14.Can you eradicate this practice? I believe we can. What time frame? We
:42:15. > :42:17.are looking at that. It is one of the priorities and has been a
:42:18. > :42:21.priority for the last year in improving the management of a bed
:42:22. > :42:25.capacity in hospitals. We have slightly increase the capacity in
:42:26. > :42:28.the last year. They are today 400 more beds in the National Health
:42:29. > :42:33.Service in Scotland than there were 12 months ago. Numbers were reducing
:42:34. > :42:37.previously. We had the same situation with nurse numbers. Do you
:42:38. > :42:45.accept the point that was being made in that film that there is a boom
:42:46. > :42:49.and bust element? That is why we have introduced a mandatory to that
:42:50. > :42:55.every health board has two planet using the planning tool for planning
:42:56. > :42:59.nursing staff. -- planning. Let me explain in terms of what happens and
:43:00. > :43:04.what has happened in terms of staffing. First of all, we have more
:43:05. > :43:07.qualified nurses and midwives in the national health service than we did
:43:08. > :43:12.when we came in a number of years ago. There are three reasons why the
:43:13. > :43:18.number of beds has gone down. This happened under the previous
:43:19. > :43:21.Administration 's. The rate has gone down significantly and that this
:43:22. > :43:25.Administration. Number one, you have the transfer from care in hospital
:43:26. > :43:30.to care in the community. Secondly, you have a much higher incidence now
:43:31. > :43:37.of day surgery, for example, we do 35,000 cataract operations every
:43:38. > :43:46.year. The vast bulk of those after nailing a surgery basis. -- done on
:43:47. > :43:49.hate. It does sound like you have on -- overestimated the benefits of
:43:50. > :43:53.some of these changes in terms of bed numbers. They did not actually
:43:54. > :43:59.gets the ratio right. I would not agree with that. There are examples.
:44:00. > :44:05.Planning ten years ago for the new Victoria in Fife and the new
:44:06. > :44:09.Edinburgh Royal Infirmary grossly overestimated the decline in the
:44:10. > :44:14.population and the need for beds. As a result of that, we reinstated bed
:44:15. > :44:18.capacity significantly in Edinburgh and five. Apart from that, the issue
:44:19. > :44:24.is not a strategic shortage of beds. The issue is better management of
:44:25. > :44:28.the bed capacity that we have. Is there still the potential for a
:44:29. > :44:32.crisis in our hospitals this winter? We heard about the
:44:33. > :44:40.norovirus, an increase in in the number of flu cases. Could the same
:44:41. > :44:44.thing happened this year? The norovirus... We had 25 wards closed
:44:45. > :44:54.on Christmas Eve because of it. We also had a high incidence of
:44:55. > :44:58.respiratory disease. That led to a major surge in A and one third of
:44:59. > :45:03.all of the people who went into A were also admitted to hospital. It
:45:04. > :45:08.could happen this year, but we are much better prepared. I announced an
:45:09. > :45:14.unscheduled care plan so that, for example compared to last year we
:45:15. > :45:18.have 400 more beds, we also have a capacity for additional search beds
:45:19. > :45:23.if they are required. We have recruited more nurses and we have
:45:24. > :45:27.increased the numbers of the -- A consultants. Over the years we have
:45:28. > :45:33.been in power, we have doubled the number of A consultants. One of
:45:34. > :45:38.your ambitions, shared with the Royal College of Physicians, is to
:45:39. > :45:43.gear up the NHS to be a seven-day week operation. That has
:45:44. > :45:47.implications of cost, doesn't it? . The reason we are doing it is that
:45:48. > :45:52.one of the reasons that we have the problem is that is a Fife and others
:45:53. > :45:57.refer to is that our hospitals are often planned on a five-day working
:45:58. > :46:00.week basis. The result of that is that towards the end of every week,
:46:01. > :46:04.there is a major increase in activity and again at the start of
:46:05. > :46:10.the week instead of an even flow. During the week, people are kept in
:46:11. > :46:14.hospital unnecessarily over the weekend because the pharmacy
:46:15. > :46:19.department is not staffed up to provide the pharmacy products that
:46:20. > :46:26.they need to go home. How much extra will this plan cost? In some ways it
:46:27. > :46:31.will save money. It cost about ?4600 per week to keep somebody in N
:46:32. > :46:34.hospital. If you multiply the number of times we are unnecessarily
:46:35. > :46:41.detaining people in hospital over the weekend, if we don't do that it
:46:42. > :46:46.will save a significant amount of money. But you will have to pay
:46:47. > :46:50.staff more. We are sitting down with staff to work out about better
:46:51. > :46:57.management of the resorts, rather than just putting more people in. It
:46:58. > :47:03.is about better management and safety management. If you look at
:47:04. > :47:06.the contract, doctors don't have too formed nonemergency work at 8pm and
:47:07. > :47:15.at the weekends. If you are asking them to do that, they will rightly
:47:16. > :47:19.expect some recompense. A lot of people are already on call. They are
:47:20. > :47:23.being paid to be on call at home. I think it is better and they think it
:47:24. > :47:27.is better that they are paid to come in and do work in the hospital. It
:47:28. > :47:32.is about a different way of working. We'll sits down with all of the
:47:33. > :47:38.people, we will do it by negotiation and consensus. We will not impose
:47:39. > :47:45.it. The biggest rate two out of -- out of hours is the pension reform.
:47:46. > :47:49.We have a real problem amongst GPs. Many of them are telling me that
:47:50. > :47:53.because of the daft reforms that have been introduced to the pension
:47:54. > :47:57.scheme by the UK government, many feel they are being forced to retire
:47:58. > :48:01.early and many feel that it is not worth their while doing out of hours
:48:02. > :48:05.because of the disincentive of the pension scheme. But they do as they
:48:06. > :48:10.get overtime. There was a report last week that in a four-year
:48:11. > :48:13.period, ?40 million was spent in less than four years on overtime
:48:14. > :48:20.payments for consultants in hospitals. Out of a budget of ?12
:48:21. > :48:25.billion, that is a reasonable figure. I don't know any modern
:48:26. > :48:30.industry that does not use an element of overtime to manage the
:48:31. > :48:35.flow and to manage when you get spikes in the flow of patients, ?10
:48:36. > :48:41.million in the great scheme of things is... It leads to better
:48:42. > :48:48.patient care. Some consultants are taking an extra ?150,000 because of
:48:49. > :48:53.the triple time. These contracts were negotiated in 2004. We have
:48:54. > :48:56.inherited the contracts. I would like to sit down and have already
:48:57. > :49:02.started the process of sitting down with the GPs to make sure that we
:49:03. > :49:06.have people working as much as they possibly can and at weekends and in
:49:07. > :49:12.the evenings as well and during the day, manage the workflow. On the one
:49:13. > :49:16.hand, better resorts, on the one hand, a better flow of patients
:49:17. > :49:24.through the system and on the other hand, we don't have overload and
:49:25. > :49:29.overwork. Another story in the newspapers today, saying you are
:49:30. > :49:35.looking at whether all not those who wilfully neglect patients might face
:49:36. > :49:38.jail terms, a move being introduced by the health department for those
:49:39. > :49:46.who work in the NHS in England. What do you think of that? We already
:49:47. > :49:51.have a law that says that, as far as full report patients are concerned.
:49:52. > :49:55.We will consider whether we need to extend that to cover everybody. --
:49:56. > :50:00.vulnerable patients. First that would only apply in an extreme
:50:01. > :50:04.circumstance. Second, legislation to deal with something that has already
:50:05. > :50:11.happened, as that legislation would be, is not the answer. Is is because
:50:12. > :50:18.it was brought in after mid Staffordshire. Yes but we should be
:50:19. > :50:22.under no illusion that it is a substitute for quality care. We have
:50:23. > :50:25.had a safety programme over the last five years and the professor who
:50:26. > :50:31.drew up many of these proposals for David Cameron, and who is an adviser
:50:32. > :50:35.to President Obama, he describes the Scottish health service as the
:50:36. > :50:39.safest in the world. What is your own personal view on this subject?
:50:40. > :50:47.Is there a need for legislation and would it ultimately protect the
:50:48. > :50:50.vulnerable? There is sense in extending the legislation we already
:50:51. > :50:54.have for everybody so that in these extreme cases, if it did happen in
:50:55. > :51:00.Scotland, we could do the necessary. But we need to look at
:51:01. > :51:05.the implications but I am certainly minded to introduce that
:51:06. > :51:13.legislation. So extending it right across the NHS? Yes. Thank you.
:51:14. > :51:16.Politics is a serious business but there are people employed to make
:51:17. > :51:20.sure politicians do not take themselves too seriously. Satirical
:51:21. > :51:25.cartoonists can be found poking fun at those in charge from the pages of
:51:26. > :51:31.many newspapers. The practice goes back centuries. Two exhibitions are
:51:32. > :51:39.being held in Aberdeen looking at two of the greatest cartoonists of
:51:40. > :51:43.all time. It is an art form that few
:51:44. > :51:47.politicians have escaped from. Those at the top know nothing is beyond
:51:48. > :51:51.the tip of the satirical cartoonist's pencil. But it can be
:51:52. > :51:59.damaging, especially for egos. That has been the case for a long time.
:52:00. > :52:09.David Lowes' repeated caricatures of Hitler for the Evening Standard work
:52:10. > :52:14.not popular in Berlin. Hitler found it humiliating. He complained about
:52:15. > :52:21.it to British politicians at the time. He tried to get them banned as
:52:22. > :52:27.well. This resulted in David Lowe being put on the Gestapo death list.
:52:28. > :52:31.The idea of satirical cartoons goes back centuries. Historians argue
:52:32. > :52:36.this was its heyday, with William Hogarth and Garth Cruickshank among
:52:37. > :52:40.the key figures. Nowadays, the newspapers provide a mass market for
:52:41. > :52:44.cartoonist, but in the 17th century, it would have been the shop window
:52:45. > :52:47.of the local printers that would have done the same thing. People
:52:48. > :52:52.would have congregated around them in large numbers to see the latest
:52:53. > :52:56.images and have a good early laugh. Electoral corruption provides the
:52:57. > :53:07.focus for this 18th century Hogarth piece and it is awash with detail.
:53:08. > :53:15.Must -- it is incredibly detailed. Lots of little details. Even today
:53:16. > :53:20.there is no escape, despite the decline in newspaper sales and the
:53:21. > :53:26.prevalence of 24 avenues. The cartoonists' acid in lives on,
:53:27. > :53:30.poking fun at politics being a past time we are unlikely to tire of.
:53:31. > :53:34.I am joined by award-winning cartoonist Steve Bell. What would
:53:35. > :53:40.you say the lasting influence of those early cartoons is? As well as
:53:41. > :53:46.the great pictures they produce, there is the attitude which
:53:47. > :53:52.underlies it under which goes back really to me the late 18th century,
:53:53. > :53:57.when satire got really rude. I am thinking of Gilroy in particular,
:53:58. > :54:02.who was a supremely political cartoonist. Probably the first real
:54:03. > :54:08.satirical political cartoonist. He creates figures which we now
:54:09. > :54:13.remember more through their caricatures and through the real
:54:14. > :54:19.images. People like William Pitt, George III, George IV. We remember
:54:20. > :54:23.them or us caricatures than as official images. And these images
:54:24. > :54:27.that influenced your own work, or was it more contemporary cartoons
:54:28. > :54:34.when he first started? Certainly, it is this sort of stuff is in your
:54:35. > :54:36.much green, but the bubbly I am more influenced directly by
:54:37. > :54:39.contemporaries. I was probably brought up on the Beano, so I was
:54:40. > :54:44.more influenced by that than anything else. I do strip cartoons.
:54:45. > :54:51.That is what I love to do. But the more I found out about these guys,
:54:52. > :54:55.like Cruickshank and Hogarth, the more I marvelled at what they did.
:54:56. > :54:59.Especially acres of Gilroy, what he got away with at the time. There was
:55:00. > :55:02.no freedom of the press at the time. He got away with this