17/11/2013 Sunday Politics Scotland


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Welcome to the Sunday Politics. Downing Street announces an inquiry


into allegations of hardball tactics and intimidation by unions in


industrial disputes. That's our top story.


Thousands dead. Hundreds of thousands without homes. Millions


affected. What is Britain doing to help the Philippines in the wake of


Typhoon Haiyan? We'll ask International Development Secretary


Justine Greening. Winter is coming and so, it seems,


is another crisis in England's hospitals. I'll be asking the Shadow


Health Secretary how he'd put a stop to the NHS's annual woes.


And on Sunday Politics Scotland: We'll be asking the Scottish Health


Secretary, Alex Neil, if hospitals here will be able to cope with the


pressures of the winter months. Janan Ganesh, Nick Watt and this


week, Zoe Williams, who'll be tweeting their thoughts throughout


the programme. The Government has announced a


review to investigate what the Prime Minister has called "industrial


intimidation" by trade union activists. Bruce Carr QC will chair


a panel to examine allegations of the kind of tactics that came to


light during the Grangemouth dispute, when the Unite union took


their protests - replete with a giant rat - outside the family homes


of the firms' bosses. Earlier this morning the Cabinet office minister,


Francis Maude spoke to the BBC and this is what he had to say. To look


at whether the law currently works and see if it is ineffective in


preventing the kind of intimidatory activity that was alleged to have


taken place around range mouth during the previous disputes --


Grangemouth. We make no presumptions at the beginning of this. I do think


it is a responsible thing for the government to establish what


happened and really do a proper review into whether the law is


adequate to meet the needs. That was Francis Maude. This is a purely


political move, isn't it? Unite did this a couple of times, it is hardly


happening all over the country but the government want to say, we are


prepared to investigate Unite properly, Labour isn't. This seemed


a lot worse when I thought it was a real rat. I thought it was a giant


dead rat. I am not sure if you know much about rats but real rats are


not this big, even the ones in London. The thing is, obviously it


is naked politics but I think it is more intelligent than it looks. They


are trying to taint Miliband as a week union puppet and that doesn't


really wash. They hammer away with it and it might wash for some


people. But it really castrates Miliband in the important issues he


has to tackle. Zero hours, living wage, all of those things in which


he needs to be in concert with the unions, and to use their expertise.


He is making them absolutely toxic to go anywhere near. It keeps the


Unite story alive, have to kill -- particularly since Mr Miller band is


under pressure to reopen the investigation into what Unite are up


to -- Mr Miliband. They are frustrated, not only at the BBC but


the media generally at what they think is a lack of coverage. I see


the political rationale from that respect. There is a risk. There are


union members who either vote Tory or are open to the idea of voting


Tory. All Lib Dem. If the party comes across as too zealous in as --


its antipathy, there is an electoral consequence. Ed Miliband has been


careful to keep a distance. Yes, they depend on vast amounts of


money. When Len McCluskey had a real go at the Blairites, Ed Miliband was


straight out there with a very strong statement. Essentially Len


McCluskey wanted Blairites in the shadow cabinet sacked and Ed


Miliband was keen to distance himself or for that is why it is not


quite sticking. Another story in the Sunday papers this morning, the Mail


on Sunday got hold of some e-mails. When I saw the headline I thought it


was a huge cache of e-mails, it turns out to be a couple. They peel


away the cover on the relationship between Ed Miliband and Ed Balls,


with some of Ed Miliband's cohorts describing what Mr balls is trying


to do as a nightmare. How bad are the relations? They are pretty bad


and these e-mails confirm the biggest open signal in Westminster,


which is that relations are pretty tense, -- open secret. That Ed


Miliband doesn't feel that Ed Balls is acknowledging the economy has


grown that Labour needs to admit to past mistakes. The sort of great


open signal is confirmed. On a scale of 1-10, assuming that Blair-Brown


was ten. I think it is between six and seven. They occupy this joint


suite of offices that George Cameron and -- David Cameron and George


Osborne had. It is not just on the economy that there were tensions,


there were clearly tensions over HS2, Ed Balls put a huge question


over it at his conference. There will be more tensions when it comes


to the third runway because my information is that Mr balls wants


to do it and Ed Miliband almost resigned over it when he was in


government. I don't think Ed Miliband is thinking very


politically because he has tried live without Ed Balls and that is


not tenable either. -- life without. He has defined a way of making it


work. That is where Tony Blair had the edge on any modern politician.


He didn't want to make Ed Balls his Shadow Chancellor, he had to.


Somebody said to him, if you make Ed Balls Shadow Chancellor, that will


be the last decision you take as leader of the Labour Party. Is it as


bad? I was surprised at how tame the e-mails were. At the FT it is


compulsory, one French word per sentence! To call him a nightmare,


compared to what they are willing to say in briefings, conversations,


bits of frustrations they express verbally come what is documented in


the e-mails is actually pretty light. It has been a grim week for


the people of the Philippines as they count the cost of the


devastation wrought by Typhoon Haiyan. HMS Daring has just arrived


near the worst hit areas - part of Britain's contribution to bring aid


to the country. It has been one of the worst natural


disasters in the history of the Philippines. Typhoon Haiyan hit the


country nine days ago, leaving devastation in its wake. The numbers


involved are shocking. The official death toll is over 3600 people, with


many thousands more unaccounted for. More than half a million people have


lost their homes and the UN estimates 11 million have been


affected. David Cameron announced on Friday that the UK government is to


give an extra ?30 million in aid, taking the total British figure ?250


million. An RAF Sea 17 aircraft landed yesterday with equipment to


help aid workers get too hard to reach areas. HMS Illustrious is on


its way and due to arrive next weekend. The British public have


once again dipped into their pockets and given generously. They have


given more than ?30 million to the Disasters Emergency Committee.


The International Development Secretary, Justine Greening, joins


me now for the Sunday Interview. Good morning, Secretary of State.


How much of the ?50 million that the government has allocated has got


through so far? All of it has landed on the ground now. HMS Daring has


turned up, that will be able to start getting help out to some of


those more outlying islands that have been hard to reach. We have


those more outlying islands that seen Save the Children and Oxfam


really being able to get aid out on the ground. We have a plane taking


off today that will not read just carrying out more equipment to help


clear the roads but will also have their staff on board, too. We have


?50 million of aid actually on the ground? We instantly chartered


flights directly from Dubai where we have preprepared human Terry and


supplies, and started humanity work -- humanitarian supplies.


A lot of it has now arrived. I think we have done a huge amount so far.


We have gone beyond just providing humanitarian supplies, to getting


the Royal Air Force involved. They have helped us to get equipment out


there quickly. We have HMS Illustrious sailing over there now.


Why has that taken so long? It was based in the Gulf and is not going


to get there until two weeks after the storm first hit and that is the


one ship we have with lots of helicopters. The first decision we


took was to make sure we could get the fastest vessel out there that


was able to help HMS Daring. HMS Illustrious was just finishing an


exercise and planning to start to head back towards the UK. We have


said to not do that, and diverted it. Shouldn't it have happened more


quickly? We took the decisions as fast as we were able to, you can't


just turn a big warship around like the HMS Illustrious. We made sure we


took those decisions and that is while it will be taking over from


HMS Daring come and that is why HMS Daring is ready there. It will be


able to provide key support and expertise that has not been there so


far. The US Navy is doing the heavy lifting here. The US Navy had the


USS Washington, there is an aircraft carrier, 80 planes, 5000 personnel


and they have the fleet, they are doing the real work. We obviously


helping but the Americans are taking the lead. It is a big international


effort. Countries like the US and the UK, that have a broader ability


to support that goes beyond simply call humanitarian supplies -- have


made sure we have brought our logistics knowledge, we have sent


out our naval vessels. It shows we are working across government to


respond to this crisis. Why does only just over 4% of your aid budget


go on emergency disaster and response? A lot depends on what


crises hit in any given year. We have done a huge amount, responding


to the crisis in Syria, the conflict there and the fact we have 2 million


refugees who have fled the country. We are part of an international


effort in supporting them. Shouldn't we beginning more money to that


rather than some of the other programmes where it is harder to see


the results question of if we were to give more money to the refugees,


it would be a visible result. We could see an improvement in the


lives of children, men and women. What we need to do is alongside that


is stop those situations from happening in the first place. A lot


of our development spend is helping countries to stay stable. Look at


some of the work we are doing in Somalia, much more sensible. Not


just from an immigration but there is a threat perspective. There is a


lot of terrorism coming from Somalia. You only have to look at


Kenya recently to see that. Which is why you talk about what we do with


the rest of the spend. It is why it is responsible to work with the


government of Somalia. Should we give more, bigger part of the budget


to disaster relief or not? I think we get it about right, we have to be


flexible and we are. This Philippine relief is on top of the work in


Syria. Where can you show me a correlation between us giving aid to


some failed nation, or nearly failed nation, and that cutting down on


terrorism? If you look at the work we have done in Pakistan, a huge


amount of work. Some of it short-term. It is written by


terrorism. That is -- ridden by terrorism. That is not going to fix


it self in a sense. Look at the work that we do in investing in


education. The things that little girls like Malala talk about as


being absolutely key. We are ramping up our aid to Pakistan, it will be


close to half ?1 billion by the time of the election. Why should British


taxpayers be giving half ?1 billion to a country where only 0.5% of


people in Pakistan pay income tax, and 70% of their own MPs don't pay


income tax. It is a good point and that is why we have been working


with their tax revenue authority to help them increase that and push


forward the tax reform. You are right, and I have setup a team that


will go out and work with many of these countries so they can raise


their own revenues. You really think you will raise the amount of tax by


sending out the British HRM see? How many troops I we sending out to


protect them? They don't need troops. We make sure that we have a


duty of care alongside our staff, but we have to respond to any crisis


like the Philippines, and alongside other countries we have two work


alongside them so that they can reinvest in their own public


services. If they can create their own taxes, will we stop paying aid?


We need to look at that but the new Pakistan Government has been very


clear it is a priority and we will be helping them in pursuing that.


Let me show you a picture. Who are these young women? I don't know, I'm


sure you are about to tell me. They are the Ethiopian Spice Girls and


I'm surprised you don't know because they have only managed to become so


famous because your department has financed them to the tune of ?4


million. All of the work we do with women on the ground, making sure


they have a voice in their local communities, making sure they have


some control over what happens to their own bodies in terms of


tackling FGM, female genital mutilation... Did you know your


department has spent ?4 million on the Ethiopian Spice Girls? Yes, I


do, and we have to work with girls and show them there is a life ahead


of them with opportunity and potential that goes beyond what many


of them will experience, which includes early and forced marriage.


It is part of the work we do with local communities to change


attitudes everything you have just said is immeasurable, and they


broadcast on a radio station that doesn't reach most of the country so


it cannot have the impact. It only reaches 20 million people and the


project has been condemned saying there were serious inefficiencies.


That aid report was done a while ago now, and it was talking about the


project when it first got going, and a lot of improvements have happened


since. I would go back to the point that we are working in very


difficult environments where we are trying to get longer term change on


the ground and that means working directly with communities but also


investing for the long-term, investing in some of these girls


start changing attitudes in them and their communities. Why does the


British taxpayers spend ?5 million on a Bangladesh version of Question


Time? We work with the BBC to make sure we can get accountabilities...


That is bigger then the BBC Question Time Normal -- budget. That includes


the cost of David Dimbleby's tattoo! We are working to improve


people's prospects but also we are working to improve their ability to


hold their governments to account so that when they are not getting


services on the ground, they have ways they can raise those concerns


with the people who are there to deliver services for them. In your


own personal view, should the next Conservative Government, if there is


one, should you continue to ring fence spending on foreign aid? But


it is critical that if we are going to spend 7.7% of our national


income, we should make sure it is in our national interest and that means


having a clear approach to humanitarian responses, in keeping


the country safe, and a clearer approach on helping drive economic


development and jobs so there is a long-term end of the dependency. Do


you believe in an shrine in the percentage of our GDP that goes on


foreign aid in law? Yes, and that is a coalition agreement. There have


been a lot of agreements that you are sceptical about ring fencing. We


are focused on shaking up the economy and improving our public


finances. Why haven't you done that? At the end of the day we will be


accountable but we are committed to doing that. You are running out of


time, will you do it? I hope we can find the Parliamentary time, but


even if we don't, we have acted as if that law is in place and we have


already met 0.7% commitment. If you are British voter that doesn't


believe that we should enshrine that in by law, which means that with a


growing economy foreign aid will rise by definition, and if you think


we should be spending less money on the Ethiopian Spice Girls, for whom


should you wrote in the next election? I think we have a very


sensible approach. I don't know what the various party manifestoes... The


only party who thinks we shouldn't be doing this is UKIP. I think you


have to look at the response to both the Philippines crisis and Children


In Need. Of all the steps we are taking to get the country back on


track, it shows the British people will respond to need when they need


it and it is one of the things that makes Britain's special.


Thank you. "It's always winter but never Christmas" - that's how


doctors describe life inside accident and emergency. The College


of Emergency Medicine have warned that this year could bring the


"worst crisis on record". If that dire prediction comes, expect a


spring of political recriminations, but how prepared are the NHS in


England? And what do they make of this autumnal speculation? Giles has


been to Leeds to find out. This winter has already come to our


hospitals. It had an official start date, November the 3rd. That is when


weekly updates are delivered to the NHS's most senior planners, alerting


them to any sudden changes in patient numbers coming in. Where do


they numbers register most then A They are the barometer for what


is going on everywhere else, and they are the pressure point, so if


the system is beginning to struggle then it is in the A department


that we see the problems. It is not that the problems are the A


departments, but they are the place where it all comes together. Plans


to tackle those problems start being drawn up in May and they look at


trends, even taking notice of any flu epidemics in New Zealand. They


also look at the amount of bets. But the weather, economic realities,


structural reforms, and changes to the general health of the


population, are all factors they have to consider. We get huge


amounts of information through the winter in order to help the NHS be


the best it can be, but we had to redouble our efforts this year


because we expected to be a difficult winter. We know the NHS is


stretched so we are working hard to be as good as we can be. That means


they are looking at winter staffing levels, plans to ask for help from


neighbouring hospitals, and dovetailing help with GP surgeries,


and still having the ability to move up an extra gear, a rehearsed


emergency plan if the NHS had to face a major disease pandemic. You


spend any time in any of our hospitals and you realise the NHS


knows that winter is coming and they are making plans, but you also get a


palpable feeling amongst health workers across the entire system


that they do get fed up of being used as a political football.


Doctors and all health care professionals are frustrated about


the politics that surrounds the NHS in health care. They go to work to


treat patients as best as they can, and the political knock-about does


not help anyone. I find it frustrating when there is a


commentary that suggests the NHS does not planned, when it is


surprised by winter, and wherever that comes from it is hard to take,


knowing how much we do nationally and how much our hard working front


line staff are doing. When the Coalition have recently tried to


open up the NHS to be a more independent body, it is clear the


NHS feel they have had an unhealthy dose of political wrangling between


parties on policy. The NHS is not infallible or making any guarantees,


but they seem confident that they and their patients can survive the


winter. Joining me now from Salford in the


Shadow Health Secretary, Andy Burnham. Tell me this, if you were


health secretary now, you just took over in an emergency election, what


would you do to avoid another winter crisis? I would immediately halt the


closure of NHS walk-in centres. We heard this week that around one in


four walk-in centres are closed so it makes no sense whatsoever for the


Government to allow the continued closure of them. I would put nurses


back on the end of phones and restore an NHS direct style service.


The new 111 service is not in a position to provide help to people


this winter. I think the time has come to rethink how the NHS care is


particularly for older people so I propose the full integration of


health and social care. It cannot make any sense any more to have this


approach where we cut social care and let elderly people drift to


hospitals in greater numbers. We have two rethink it as a whole


service. So you would repeal some of the Tory reforms and move


commissioning to local authorities so the NHS should brace itself for


another major top-down health reorganisation? No, unlike Andrew


Lansley I will work with the organisations ie inherit. He could


work with primary care trusts but he turned it upside down when it needed


stability. I will not do that but I will repeal the health and social


care act because last week we heard that hospitals and health services


cannot get on and make sensible merger collaborations because of


this nonsense now that the NHS is bound by competition law. Let me get


your views on a number of ideas that have been floated either by the


press or the Coalition. We haven't got much time. Do you welcome the


plan to bring back named GPs for over 75s? Yes, but it has got harder


to get the GP appointment under this Government because David Cameron


scrapped the 48-hour guarantee that Tony Blair brought in. He was


challenged in the 2005 election about the difficulty of getting a GP


appointment, and Tony Blair brought in the commitment that people should


be able to get that within 48 hours. That has now been scrapped.


Do you welcome the idea of allowing everyone to choose their own GP


surgery even if it is not in our traditional catchment area? I


proposed that just before the last election, so yes. Do you welcome the


idea of how a practice is being rated being a matter of public


record, and of us knowing how much, at least from the NHS, our GP earns?


Of course, every political party supports transparency in the NHS.


More information for the public of that kind is a good thing. Do you


welcome this plan to make it will form the collect in an NHS hospital


-- make wilful neglect a criminal offence. It is important to say you


can't pick and mix these recommendations, you can't say we


will have that one and not the others. It was a balanced package


that Sir Robert Francis put forward. My message is that it must be


permitted in full. If we are to learn the lessons, the whole package


must be addressed, and that includes safe staffing levels across the NHS.


Staff have a responsible to two patients at the government


People forget that when it came in, there was a shortage of GPs. Some


people but lack the contract helped that. What I would say is that this


myth that the government has built all year that the 2004 GP contract


is responsible for the ANC crisis is eight spin of the worst kind. --


A You would we do that contract now? It was redone in our time in


government and changed to make it better government -- value for


money. Not so great if you cannot get 24-hour access to your practice.


I agree with that, but we brought in evening and weekend opening for


GPs, another thing that is gone into reverse under Mr Cameron. It is


harder to get a GP appointment under him and that is one reason why it


A are under pressure. Two things that aren't on dealer direct sphere


of your portfolio, what do you make of the government's review into


intimidator eat tactics used by unions? If there has been


intimidation, it is unacceptable and it should apply to unions as well as


to employees. Was unite wrong to turn up at that manager 's house? I


don't know the details of that. Presumably, the review will look


into it. I need reassurance that this is not a political call by Mr


Cameron designed to report here the election. We will see how it


develops. Are you sponsored by Unite? No. Do you get any money from


unite all for yourself or for your constituency office? No. It seems


most others seem to be getting something from Unite, it seems odd


that you don't get anything, I will put in a word with Len McCluskey.


What I think is the scandal with funding is that to private health


care companies who between them have given ?1.5 million in donations to


the Tory parties have won ?1.5 billion in NHS contracts since the


last election, I wonder why don't spend as much time talking about


that as you do on trade union funding. We are happy to talk about


that as well do you know. Briefly and finally, we see some -- from


some e-mails that Mr Miliband's closest advisers regard Mr Ed Balls


as a bit of a nightmare, quote, do you think there is a nightmare? No,


I don't. He is a very good friend and I cannot believe, to be honest,


that you are talking about those e-mails on a political programme, my


goodness, you are busy scraping the barrel today. I had been on the


front line for 20 years, I cannot under the front bench and indeed the


wider party be as united as it is today, that is a great credit to Ed


Miliband and Ed Balls. We are a united team. It was worth spending a


few seconds just to establish that you are not having nightmares, we


wouldn't want the Shadow Health Secretary to have them. It has just


gone 11:30am, you are watching Sunday Politics.


Good morning and welcome to Sunday Politics Scotland. Coming up on the


programme: Experts from across the UK are gathering here in Edinburgh


at the Royal College of Physicians to discuss the problem, we will look


at the answer. They've called for an end to


patient's being farmed out to the wrong wards and for the NHS to be


fully operational seven days a week. We'll put that to the Health


Secretary Alex Neil. And from Cameron wearing a condom to


Salmond with his saltire, the wit and lampooning of political figures


over the centuries. A group of medical experts is this


morning calling for an end to the practice of boarding in the NHS,


that's when patients are farmed out to wards inappropriate for their


care when hospitals are busy. Research indicates being treated in


the wrong ward makes you more likely to die. At a time when NHS services


are facing increasing pressure, the specialists are calling for


clinicians and support staff to extend seven-day working. Here's


Andrew Kerr. It is coming up to that time of year, when the pressure on


the NHS. The Scottish government admitted


that they need to improve norovirus and flew at eight indeed


departments. Doctors say they are now experiencing winter pressure all


year around. The Royal College of Physicians of Edinburgh is


concerned. They say 124% bed occupancy in Fife was reported and


101% in Lothian. A symptom of this overcapacity is boarding, patients


being farmed out to ward inappropriate for their care.


Research shows that patients are looked after in the wrong department


are at a greater risk of dying. Patients who are boarded, they have


significantly increased length of stay, risk of readmission and


mortality at 30 days compared to patients who aren't boarded. It is a


major problem. Experts have been gathering in Edinburgh to try to


work out how to solve it. Why our hospitals so busy? Increasing


numbers of elderly people need treatment and patients have high


expectations. Doctors are more cautious and patients are be sent


for more tests. The number of beds has been cut to treat more people in


the community. The debate and discussions are going on here at the


Royal College of Physicians in Edinburgh. It can be very stressful


for a patient being in a busy hospital, but it can be very shy


school for the staff, too. As a numbers game down, so did staff


numbers. The Royal College of Nursing says that 1800 nursing posts


were lost in the three years until last Christmas. This is now being


reversed. There has been a number of workforce cuts. That led to us and


producing the number of students in training. We then found ourselves


having to put more beds into the system and we need to now find more


qualified nurses. Unfortunately, this boom and bust approach that our


members talk about is not good for morale or for when you are trying to


find the right numbers of qualified nurses. Scottish Labour picked up on


the starting point at First Minister's questions. We have seen a


number of things being exposed, for example, a 62% in the -- city could


increase in the use of... The Conservatives say why not try to


produce the rush to the front door. It will require us to have a more


responsible attitude to avoidable conditions to, like addictions or


obesity and how do we combine a need to provide a service information to


that without necessarily referring everyone to a hospital? The experts


recommend sweeping reforms to end boarding. They're calling for an


extension to seven-day working and for patients to be carefully


monitored during their stay. We are very much looking at how you can


take patients from the community through the hospital and back into


the community with the smallest chance of having to be really


admitted. If we can that, appropriately across the health


boards, then we are looking at the most appropriate system for these


patients. Health Secretary is now looking -- considering all of the


comments to try to ensure that patients are treated quickly and end


up in the right place in hospital. Joining me now in the studio is the


Cabinet Secretary for Health and Wellbeing, Alex Neil. Why does it


happen? It is about the flow of patients through the hospital. The


flow of patients is one of the crucial challenges in our system. It


has not received the same attention previously when you had such a high


rate of hospitalisation for dealing with all sorts of problems. Now


there is much more focus on the flow of patients. For example, sometimes


you have patients going into medical wards that should be in surgical


wards and vice versa. We set up this study because we suspected that it


was having a damaging impact on patient health outcomes and also


because we wanted to manage the flow of patients better which is why we


have the recommendations that we are delighted with. Your own figures


suggest that those who are in this position are more likely to die,


that must be worrying for patients. The iMac absolutely. That is why we


are trying to eliminate it altogether, ideally. Were developing


a bed management capacity to. Let me give you an example. One of the


areas of research that we have done in the last year after the problems


we had last winter was looking at the patient flow. What we found out


is that in many wards in hospitals the percentage of patients being


discharged, ready for discharge, clinically ready for discharge, but


only about 6% in some wards were being discharged before lunchtime


with most of them being discharged in the evening. The reason that


those delays were taking place was because the pharmacy services


weren't available, the transport home was not available, what we have


done as part of our is to look at these parts and puts the part in


place. In the incident where it is now closer to 25%. That frees up


their beds for people coming in through unplanned or planned care.


Can you eradicate this practice? I believe we can. What time frame? We


are looking at that. It is one of the priorities and has been a


priority for the last year in improving the management of a bed


capacity in hospitals. We have slightly increase the capacity in


the last year. They are today 400 more beds in the National Health


Service in Scotland than there were 12 months ago. Numbers were reducing


previously. We had the same situation with nurse numbers. Do you


accept the point that was being made in that film that there is a boom


and bust element? That is why we have introduced a mandatory to that


every health board has two planet using the planning tool for planning


nursing staff. -- planning. Let me explain in terms of what happens and


what has happened in terms of staffing. First of all, we have more


qualified nurses and midwives in the national health service than we did


when we came in a number of years ago. There are three reasons why the


number of beds has gone down. This happened under the previous


Administration 's. The rate has gone down significantly and that this


Administration. Number one, you have the transfer from care in hospital


to care in the community. Secondly, you have a much higher incidence now


of day surgery, for example, we do 35,000 cataract operations every


year. The vast bulk of those after nailing a surgery basis. -- done on


hate. It does sound like you have on -- overestimated the benefits of


some of these changes in terms of bed numbers. They did not actually


gets the ratio right. I would not agree with that. There are examples.


Planning ten years ago for the new Victoria in Fife and the new


Edinburgh Royal Infirmary grossly overestimated the decline in the


population and the need for beds. As a result of that, we reinstated bed


capacity significantly in Edinburgh and five. Apart from that, the issue


is not a strategic shortage of beds. The issue is better management of


the bed capacity that we have. Is there still the potential for a


crisis in our hospitals this winter? We heard about the


norovirus, an increase in in the number of flu cases. Could the same


thing happened this year? The norovirus... We had 25 wards closed


on Christmas Eve because of it. We also had a high incidence of


respiratory disease. That led to a major surge in A and one third of


all of the people who went into A were also admitted to hospital. It


could happen this year, but we are much better prepared. I announced an


unscheduled care plan so that, for example compared to last year we


have 400 more beds, we also have a capacity for additional search beds


if they are required. We have recruited more nurses and we have


increased the numbers of the -- A consultants. Over the years we have


been in power, we have doubled the number of A consultants. One of


your ambitions, shared with the Royal College of Physicians, is to


gear up the NHS to be a seven-day week operation. That has


implications of cost, doesn't it? . The reason we are doing it is that


one of the reasons that we have the problem is that is a Fife and others


refer to is that our hospitals are often planned on a five-day working


week basis. The result of that is that towards the end of every week,


there is a major increase in activity and again at the start of


the week instead of an even flow. During the week, people are kept in


hospital unnecessarily over the weekend because the pharmacy


department is not staffed up to provide the pharmacy products that


they need to go home. How much extra will this plan cost? In some ways it


will save money. It cost about ?4600 per week to keep somebody in N


hospital. If you multiply the number of times we are unnecessarily


detaining people in hospital over the weekend, if we don't do that it


will save a significant amount of money. But you will have to pay


staff more. We are sitting down with staff to work out about better


management of the resorts, rather than just putting more people in. It


is about better management and safety management. If you look at


the contract, doctors don't have too formed nonemergency work at 8pm and


at the weekends. If you are asking them to do that, they will rightly


expect some recompense. A lot of people are already on call. They are


being paid to be on call at home. I think it is better and they think it


is better that they are paid to come in and do work in the hospital. It


is about a different way of working. We'll sits down with all of the


people, we will do it by negotiation and consensus. We will not impose


it. The biggest rate two out of -- out of hours is the pension reform.


We have a real problem amongst GPs. Many of them are telling me that


because of the daft reforms that have been introduced to the pension


scheme by the UK government, many feel they are being forced to retire


early and many feel that it is not worth their while doing out of hours


because of the disincentive of the pension scheme. But they do as they


get overtime. There was a report last week that in a four-year


period, ?40 million was spent in less than four years on overtime


payments for consultants in hospitals. Out of a budget of ?12


billion, that is a reasonable figure. I don't know any modern


industry that does not use an element of overtime to manage the


flow and to manage when you get spikes in the flow of patients, ?10


million in the great scheme of things is... It leads to better


patient care. Some consultants are taking an extra ?150,000 because of


the triple time. These contracts were negotiated in 2004. We have


inherited the contracts. I would like to sit down and have already


started the process of sitting down with the GPs to make sure that we


have people working as much as they possibly can and at weekends and in


the evenings as well and during the day, manage the workflow. On the one


hand, better resorts, on the one hand, a better flow of patients


through the system and on the other hand, we don't have overload and


overwork. Another story in the newspapers today, saying you are


looking at whether all not those who wilfully neglect patients might face


jail terms, a move being introduced by the health department for those


who work in the NHS in England. What do you think of that? We already


have a law that says that, as far as full report patients are concerned.


We will consider whether we need to extend that to cover everybody. --


vulnerable patients. First that would only apply in an extreme


circumstance. Second, legislation to deal with something that has already


happened, as that legislation would be, is not the answer. Is is because


it was brought in after mid Staffordshire. Yes but we should be


under no illusion that it is a substitute for quality care. We have


had a safety programme over the last five years and the professor who


drew up many of these proposals for David Cameron, and who is an adviser


to President Obama, he describes the Scottish health service as the


safest in the world. What is your own personal view on this subject?


Is there a need for legislation and would it ultimately protect the


vulnerable? There is sense in extending the legislation we already


have for everybody so that in these extreme cases, if it did happen in


Scotland, we could do the necessary. But we need to look at


the implications but I am certainly minded to introduce that


legislation. So extending it right across the NHS? Yes. Thank you.


Politics is a serious business but there are people employed to make


sure politicians do not take themselves too seriously. Satirical


cartoonists can be found poking fun at those in charge from the pages of


many newspapers. The practice goes back centuries. Two exhibitions are


being held in Aberdeen looking at two of the greatest cartoonists of


all time. It is an art form that few


politicians have escaped from. Those at the top know nothing is beyond


the tip of the satirical cartoonist's pencil. But it can be


damaging, especially for egos. That has been the case for a long time.


David Lowes' repeated caricatures of Hitler for the Evening Standard work


not popular in Berlin. Hitler found it humiliating. He complained about


it to British politicians at the time. He tried to get them banned as


well. This resulted in David Lowe being put on the Gestapo death list.


The idea of satirical cartoons goes back centuries. Historians argue


this was its heyday, with William Hogarth and Garth Cruickshank among


the key figures. Nowadays, the newspapers provide a mass market for


cartoonist, but in the 17th century, it would have been the shop window


of the local printers that would have done the same thing. People


would have congregated around them in large numbers to see the latest


images and have a good early laugh. Electoral corruption provides the


focus for this 18th century Hogarth piece and it is awash with detail.


Must -- it is incredibly detailed. Lots of little details. Even today


there is no escape, despite the decline in newspaper sales and the


prevalence of 24 avenues. The cartoonists' acid in lives on,


poking fun at politics being a past time we are unlikely to tire of.


I am joined by award-winning cartoonist Steve Bell. What would


you say the lasting influence of those early cartoons is? As well as


the great pictures they produce, there is the attitude which


underlies it under which goes back really to me the late 18th century,


when satire got really rude. I am thinking of Gilroy in particular,


who was a supremely political cartoonist. Probably the first real


satirical political cartoonist. He creates figures which we now


remember more through their caricatures and through the real


images. People like William Pitt, George III, George IV. We remember


them or us caricatures than as official images. And these images


that influenced your own work, or was it more contemporary cartoons


when he first started? Certainly, it is this sort of stuff is in your


much green, but the bubbly I am more influenced directly by


contemporaries. I was probably brought up on the Beano, so I was


more influenced by that than anything else. I do strip cartoons.


That is what I love to do. But the more I found out about these guys,


like Cruickshank and Hogarth, the more I marvelled at what they did.


Especially acres of Gilroy, what he got away with at the time. There was


no freedom of the press at the time. He got away with this


Political magazine presented by Andrew Neil and Andrew Kerr.

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