:01:36. > :01:41.In the Midlands, the millions of pounds lost when patients Mr
:01:41. > :01:51.hospital appointments. With nearly 10% failing to turn up, is there
:01:51. > :01:51.
:01:51. > :35:16.Apology for the loss of subtitles for 2004 seconds
:35:16. > :35:22.From the Midlands, RIM Patrick Burns. I am joined by two MPs to
:35:22. > :35:25.have more than a passing interest in the great debate raging over the
:35:26. > :35:32.West Coast Main Line franchise issue, Gisela Stuart, the Labour MP
:35:32. > :35:39.for Edgbaston, and John Hemming, the Liberal Democrat MP for Yardley,
:35:39. > :35:46.whose party in the West Midlands.A parliamentary cheerleader for a
:35:46. > :35:54.just two. It must have been music to your ears to hear her talk about
:35:54. > :36:00.the FirstGroup being a prologue to High Speed Rail. He is right. By
:36:00. > :36:03.9th December, we have to have a decision about whether Richard
:36:03. > :36:07.Branson will challenge the franchise. It is �900,000 we're
:36:07. > :36:12.talking about. You could build a big hospital. The Government needs
:36:12. > :36:22.to prove that the decision was the right thing. John Hemming, some
:36:22. > :36:22.
:36:23. > :36:30.people clearly have sympathy for Virgin. I am a heavy train user
:36:30. > :36:33.myself, but my concern is a long- term concern that if you reduce the
:36:33. > :36:37.number of players in the business, you have less competition, which
:36:37. > :36:40.could end up costing the Treasury more in the long term. I am
:36:40. > :36:44.concerned about that. I have not seen the grounds for the judicial
:36:44. > :36:50.review and I do not know what the chances are. The Government
:36:50. > :36:52.decision to reward the West Coast Main Line contract to FirstGroup in
:36:52. > :36:57.preference over Version was the subject of a Westminster debate
:36:57. > :37:04.last week. I asked the Prime Minister a question at PMQs about
:37:04. > :37:09.the process. I do not recall hearing any questions from Labour
:37:09. > :37:13.ministers or MPs challenging the process or challenging when the
:37:13. > :37:18.decision would be made. Is this not the Labour Party jumping on the
:37:18. > :37:21.bandwagon? If staff are concerned about their futures, they may
:37:21. > :37:26.decide that if there are any opportunities available, to go
:37:26. > :37:32.elsewhere, which may impact on the service that the public can expect.
:37:32. > :37:37.Gisela, did Labour jump on the bandwagon? There was no great fuss
:37:37. > :37:41.made while this process was going on. While the process was going on,
:37:41. > :37:43.I think they were right to see that proper procedures were being
:37:43. > :37:50.followed and that the Government should make a decision based on
:37:50. > :37:55.fact. Also, of former ministers know that sometimes projections
:37:55. > :38:02.need to be a bit of testing, and they are making sure they are
:38:02. > :38:10.getting it right. They need to get this pinned down quickly. Briefly,
:38:10. > :38:14.it was a competitive process. might mean less competition in the
:38:14. > :38:18.future and more money from the taxpayer.
:38:18. > :38:23.Coming up, we report from the hospitals where it costs over �100
:38:23. > :38:26.every time a patient this is an appointment. By almost 10% of
:38:26. > :38:35.outpatients across the Midlands failed to show up, millions of
:38:35. > :38:38.pounds are wasted every year. His party's ratings have slumped to
:38:38. > :38:45.half of what they were before the general election. The Liberal
:38:45. > :38:49.Democrats have three MPs in a region with a 60 constituencies,
:38:49. > :38:52.only one MEP, and they only run one local authority here. When I caught
:38:52. > :38:59.up with Nick Clegg in Whitehall preparing for his party conference,
:38:59. > :39:02.he was in no mood to say sorry. Prime Minister -- Deputy Prime
:39:02. > :39:07.Minister, can we begin with the question of regional pay, not
:39:07. > :39:11.something that generally commands much favour by your party. The
:39:11. > :39:15.Chancellor does think that it would make sense to bring to regions like
:39:15. > :39:19.the Midlands more in touch with the real economy rather than an
:39:19. > :39:23.artificial -- artificial one-size- fits-all model. If there is
:39:23. > :39:30.evidence that this would be good for everybody, we should be
:39:30. > :39:35.considerate. But if there is any risk that this will deepen the
:39:35. > :39:41.North-South divide, I am against it. Let's turn to another issue which
:39:41. > :39:44.is very sensitive, which is aviation policy, airports. He said
:39:44. > :39:49.recently that developing Birmingham as a possible major transport her
:39:49. > :39:52.book might make more sense than a third runway at Heathrow for will
:39:52. > :39:56.stop a new link between Birmingham and Heathrow could be part of the
:39:57. > :40:01.answer. I don't know. I do know that I am not in favour of a third
:40:01. > :40:04.runway at Heathrow. Let's that the experts do the work, and then we
:40:04. > :40:09.are free to look at their recommendations and to decide
:40:09. > :40:14.whether to listen to them or not. The constituencies boundary review,
:40:14. > :40:17.we have had a chance to look in some detail at how some individual
:40:17. > :40:24.constituencies would be affected, and by standardising the electoral
:40:24. > :40:28.size, you would produce a situation where one voted one part of that --
:40:28. > :40:33.one vote in one part of the country is the same weight as anywhere else.
:40:33. > :40:38.That has got to be fair. Why are you withdrawing your support?
:40:38. > :40:43.Because, unfortunately, this being part of a wider package of
:40:43. > :40:47.political changes, constitutional changes that we wanted to introduce,
:40:47. > :40:53.another part of the package, which was House of Lords reform, that has
:40:53. > :40:56.not proceeded because of objections from the Conservative Party. If one
:40:56. > :41:01.party does not stick to it side of the bargain, that has implications
:41:01. > :41:04.for other parts of the package will stop Nick Clegg carefully
:41:04. > :41:10.preserving his position on the constituencies issue. John Hemming,
:41:10. > :41:16.do you feel that they could be some kind of a deal coming in?
:41:16. > :41:20.I think one can assume that the boundaries are now as they are
:41:20. > :41:26.going to be. Say you have, in effect, block something that would
:41:26. > :41:28.deliver fairer votes? The argument is very simple. There is a balance
:41:28. > :41:32.between the executive and parliament, the Government and
:41:32. > :41:36.parliament, and the proposal was to reduce the number of MPs but have
:41:36. > :41:40.an elected House of Lords, which would have balanced out so that
:41:40. > :41:44.Parliament would remain strong compared to be Elek - back
:41:44. > :41:47.executive. If you reduce the number of MPs without having an elected
:41:47. > :41:53.House of Lords, you are strengthening the power of the
:41:53. > :41:58.executive, and that is wrong. Gisela, you are one of the Labour
:41:58. > :42:00.MPs which supports present boundaries.
:42:01. > :42:04.For the first time in the last three years, my constituency
:42:04. > :42:06.boundaries have been concurrent with ward boundaries. The
:42:07. > :42:16.Birmingham seats were contained within the city of Birmingham, so
:42:17. > :42:22.
:42:22. > :42:29.there was a direct relationship. It would have created constituencies
:42:29. > :42:35.without a natural centre. A completely mad system!
:42:35. > :42:39.airport now. This is a great area of sensitivity. You have a
:42:39. > :42:45.constituency close to Birmingham Airport. What is your view of the
:42:45. > :42:48.possibility of expansion? I don't think we should have a second
:42:48. > :42:53.runway at Birmingham Airport. Their policy, which we support his
:42:53. > :42:57.maximum use of the airport, because it provides jobs locally. We have a
:42:57. > :43:01.global problem with a shortage of energy which will affect the price
:43:01. > :43:09.of air travel, and you will not be able to have a massive increase of
:43:09. > :43:13.air travel generally, because there is no oil. Should it be developed?
:43:13. > :43:16.Yes, it could in the current Configuration be used far more.
:43:16. > :43:21.That would not just relieve congestion in the South East but
:43:22. > :43:24.would also rebalance a regional inequality. Using burning a more is
:43:24. > :43:29.good for us in the West Midlands and also for the rest of the
:43:29. > :43:34.country. She is right about that. Too much agreement at the moment!
:43:34. > :43:37.What about regional pay? I think if you take the Civil Service, it is
:43:37. > :43:41.difficult, if you are going to have regional variations other than
:43:41. > :43:49.between London and the rest of the country, so I do not think it is a
:43:49. > :43:52.good idea. If it were only about regenerating areas that you could
:43:53. > :43:57.regenerate, I do not think the Government have ever intend to do
:43:57. > :44:02.that. I do not support it. It is just a cost-cutting exercise.
:44:03. > :44:05.The Liberal Democrats are not the only ones in conference mode. The
:44:05. > :44:08.UK Independence Party gathered at Birmingham's town hall in the last
:44:08. > :44:14.few days, breathing down the necks of the Liberal Democrats, according
:44:14. > :44:21.to most opinion polls. Elected as a West Midlands UKIP MEP, but now
:44:21. > :44:25.sitting as an independent, Nikki Sinclaire is forming a party to
:44:25. > :44:33.fight the 2014 European elections with a demand for an in and out
:44:33. > :44:43.referendum. I put did te UK's even this could split the vote. -- I put
:44:43. > :44:44.
:44:44. > :44:49.it to UK's leader. I don't think so. It is very much harder to establish
:44:49. > :44:56.political parties in this country and to get them through national
:44:56. > :45:00.elections than people realise. point is that the debate is
:45:00. > :45:05.shopping around a referendum. She says she is making more of a
:45:05. > :45:10.running on this and your party is. That is nonsense! Let her say what
:45:10. > :45:14.she likes. I am not interested. used seriously thinking that you
:45:14. > :45:18.could ever take over the Liberal Democrats? York ratings suggest you
:45:18. > :45:22.are breathing down their necks at the moment. I first said this 18
:45:22. > :45:29.months ago. We have a chance to get things right to become the third
:45:29. > :45:39.force in UK politics, and part of that is Porton in our policy based
:45:39. > :45:40.
:45:40. > :45:44.and -- policy based. A couple of recent opinion polls have put us
:45:44. > :45:46.ahead of the Liberal Democrats. I will not stand here now and say
:45:46. > :45:56.that we are the third party, but we are getting there.
:45:56. > :45:57.
:45:57. > :46:02.Nigel Briers. -- Nigel Farage. think they were third will seconds
:46:02. > :46:06.in the European elections last time. But they will not be the same in
:46:06. > :46:13.the general election. Whatever the political party leaders are saying
:46:13. > :46:23.now, Nikki Sinclaire clearly feels she has made a lot of the running
:46:23. > :46:25.
:46:25. > :46:29.on this.. -- on this point. three parties promise a referendum.
:46:29. > :46:39.Some countries were forced into, like France and the Netherlands,
:46:39. > :46:45.they had it. I think a lot of the factor is what will happen in
:46:45. > :46:52.mainland Europe. At his conference, Nigel Farage says that your party
:46:52. > :46:57.was the most Europhile of the lot. In the end, they will have to be a
:46:58. > :47:03.vote. Gisela Egan has got it right. Things are shifting substantially,
:47:04. > :47:06.and we need to work out where we are sitting in respect to that.
:47:06. > :47:11.There is a logic to have a referendum and that stage. Thank
:47:11. > :47:15.you very much. Our big talking point this week his
:47:15. > :47:22.research by this programme which has discovered that people failing
:47:22. > :47:27.to turn up for out-patient. Mense - - out-patient appointments is
:47:27. > :47:32.costing millions of pounds to our hospitals every year. While people
:47:32. > :47:42.abusing his free service? Whispered to a politician who has spent a
:47:42. > :47:43.
:47:43. > :47:46.lifetime working in the NHS. Anxious, nervous, headache. Out-
:47:46. > :47:55.patient clinics are some of the busiest times in hospitals across
:47:55. > :47:58.the region. But they should be even busier. Sarah has turned up as
:47:59. > :48:04.requested at hospital, but there are plenty of people who haven't.
:48:04. > :48:09.In the health service, Mr Quinn mints are known as it did not
:48:09. > :48:15.attend. They are a headache. have about 19,000 Mr Twigg makes
:48:15. > :48:19.every year. It is a lot of resource time gone. Across the West Midlands
:48:19. > :48:25.last year, there were more than 6.7 million out-patient appointments,
:48:25. > :48:28.but more than 600,000 were missed, which is more than 10%. It might
:48:28. > :48:32.look busier today, but this empty chair represents one of the people
:48:32. > :48:36.who has not turned up for their appointment, which is costing
:48:36. > :48:40.hospitals in Coventry and Warwickshire more than �8 million.
:48:40. > :48:45.It is a cost multiplied across the region, as hospitals have told this
:48:45. > :48:50.programme. The bill for missed appointments in Wolverhampton tops
:48:50. > :48:53.�900,000. In Birmingham, it is just over �2 million. It has put a
:48:53. > :49:01.strain on departments like this. They are working at full tilt all
:49:01. > :49:05.the time. People to have more of a conscience. They send out all the
:49:05. > :49:09.remind us through the post now and text messages to remind you. If you
:49:09. > :49:13.can't turn up to the appointments, whatever is wrong with you got be
:49:13. > :49:18.that serious. The doctor is here waiting for you, and somebody else
:49:18. > :49:21.could have taken it. It is wrong. Why don't people turn up? I am off
:49:21. > :49:26.to talk to GPs to send us to hospital in first place. In
:49:26. > :49:29.Coventry, they have been analysing the proper and. Some people no
:49:29. > :49:32.longer require the appointment and they may be don't think it is
:49:32. > :49:36.important to cancel the appointment in advance. He did not realise the
:49:36. > :49:41.impact it has on the service. Some people forget all they have
:49:41. > :49:45.childcare issues or sudden illness. It is a mish-mash. The Government
:49:46. > :49:49.is urging hospitals to come up with new ideas such as text messages and
:49:49. > :49:53.internet consultations to get the number of missed appointments down,
:49:53. > :49:59.but even they understand that will make mistakes. Speaking as one who
:49:59. > :50:02.has actually missed an appointment by mistake, and I was very
:50:02. > :50:05.embarrassed about that, but it was one of the appointments which was
:50:05. > :50:11.set a long time in advance and I forgot to put it in my diary and I
:50:11. > :50:16.thought it was nearer than it was and I forgot. That was terrible. So
:50:16. > :50:21.I know how these things can happen. Hospitals and the Government insist
:50:21. > :50:26.the best cure for this chronic problem is that will take more
:50:26. > :50:31.responsibility. We have the right to treatment, they say, but not to
:50:31. > :50:35.waste resources. Incidentally, our reporter tells me
:50:35. > :50:40.that they are expecting 565 patients on the day she filmed
:50:40. > :50:49.there, and 61 did not turn up. We are joined here today by Philip
:50:49. > :50:52.Hunt, labour's deputy leader in the House of Lords. He began his career
:50:52. > :50:56.in the NHS 40 years ago, although he may not thank me for pointing
:50:56. > :51:00.that out. He is the chair of the Trust which runs hospitals in
:51:00. > :51:06.Birmingham. The figures are staggering. What can be done about
:51:06. > :51:11.them? They are staggering. I have an attack our own figures, and we
:51:12. > :51:17.reckon it is about 90,000 a year, 10% of all outpatients to do not
:51:17. > :51:22.turn up. It causes mayhem. It is really bad for doctors and nurses,
:51:22. > :51:26.who are not sure how many people will actually come. It wastes a lot
:51:26. > :51:31.of time and resources. We really have to do something about it.
:51:32. > :51:37.Government is talking about using technology to pursue people, Skype,
:51:37. > :51:41.text messages and so on. Should the NHS be chasing people for what is
:51:42. > :51:46.really a privileged? We send letters out four weeks before every
:51:46. > :51:51.appoint them. We bring up two weeks before. We are looking at text
:51:51. > :51:57.messages and Skype. We are looking at a campaign with GPs, putting up
:51:57. > :52:02.notices and encouraging GPs to get their patients to turn up for
:52:02. > :52:05.appointments. We need to get it over to people that missing an
:52:05. > :52:09.appointment messes it up for everyone else. The NHS is a
:52:09. > :52:17.wonderful service, but we need to use it responsibly. One of the
:52:17. > :52:20.things that is clearly enshrined in the constitution of the NHS is that
:52:21. > :52:26.patients have rights, which are well known, but with that goes
:52:26. > :52:30.responsibility. Yes, and if you think about 90,000 Mr. Beds, that
:52:30. > :52:36.is a problem. Whilst we can do a lot to remind people, and I think
:52:37. > :52:40.text messages do offer a lot for the pew -- future, because you can
:52:40. > :52:43.descend deeper message just before they are due to come, in the end,
:52:43. > :52:47.what you want people to do is exercise responsibility and
:52:47. > :52:55.recognise that if I don't turn up, I am excluding somebody else that
:52:55. > :53:01.needs to see a doctor. Margot James there, candid about missing her
:53:01. > :53:06.appointment. Is it an issue that sometimes appointments are set too
:53:06. > :53:11.far ahead? Yes, they are, and that is why we have phone calls four
:53:11. > :53:19.weeks before we have letters. I think a text message the day before
:53:19. > :53:26.is what people need. I think, myself, my chiropodist knows that
:53:26. > :53:29.she needs to ring me the day before I have an appointment. Have you
:53:29. > :53:33.ever missed an appointment? I don't remember doing so, but we have to
:53:33. > :53:37.remember that it is not a massive saving, necessarily, because people
:53:37. > :53:41.expect some people to miss appointments, so they tend to go to
:53:41. > :53:45.the next in the queue. Although it is worth trying to reduce it, it
:53:45. > :53:51.will never be brought down to zero. Some people miss appointments for
:53:51. > :53:54.valid reasons, and you cannot find people for missing appointments. It
:53:54. > :53:58.is not a magic pot of money which we can invent for the health
:53:58. > :54:02.service. In practice, the same people are there and they do not
:54:02. > :54:11.sit around doing nothing when people don't turn up. Have you ever
:54:12. > :54:16.Mr. -- an appointment, Gisela? recently! We need to point lead to
:54:16. > :54:25.people afterwards, we are sorry that you have missed Europe. Then,
:54:25. > :54:30.is there anything we could have done to help? Nevertheless, this
:54:30. > :54:34.does cost something, and it costs the NHS something. That raises the
:54:34. > :54:40.thought that perhaps they should be sanctions imposed on people if they
:54:40. > :54:44.miss an appointment. If you take Gisela's suggestion, it is fine for
:54:44. > :54:49.GPs to be told if patients are not turning up for appointments. BTP
:54:49. > :54:53.needs to know that. If you start to charge people a couple of pounds,
:54:53. > :54:58.the problem is that it costs so much money to administer that you
:54:58. > :55:03.would actually lose money. I do not think that would make sense.
:55:03. > :55:08.find people is unfair. Thank you very much. Here is our
:55:08. > :55:15.regular round-up of the political round-up -- the political week in
:55:15. > :55:18.the Midlands. Another significant week in the
:55:18. > :55:23.life of Stafford Hospital. The public inquiry into appalling
:55:23. > :55:27.standards of care has delayed its final report. The news came as
:55:27. > :55:32.campaigners delivered a 25,000 signature petition to the Prime
:55:32. > :55:35.Minister. They are upset at the continued overnight closure of
:55:35. > :55:39.accident and emergency departments. The waiting continues. We thought
:55:39. > :55:43.it would be October, and now it is going to be in January.
:55:43. > :55:47.Farmers in Gloucestershire will be allowed to shoot badges. The coal
:55:47. > :55:54.is designed to stop the spread of TB in cattle. Opponents are
:55:54. > :55:58.considering legal action. Hundreds of -- hundreds have come
:55:58. > :56:03.forward to buy a boarded-up houses in Stoke-on-Trent for just �1 as
:56:03. > :56:06.part of a city council regeneration scheme. Meanwhile, the National
:56:06. > :56:11.Housing Federation says that waiting lists for social homes
:56:11. > :56:17.across the Midlands have risen to 180 thousands. They are calling for
:56:17. > :56:21.more affordable developments like this one in the Black Country.
:56:21. > :56:25.Imaginative solution they in Stoke- on-Trent, but given the scale of
:56:25. > :56:31.the problem here, the length of the waiting lists, we do need an offer
:56:31. > :56:34.of dances if we're going to solve this, don't we? If you look at what
:56:34. > :56:39.Stoke did, because some of the Government funding streams were
:56:39. > :56:48.taken away, that made some of the schemes no longer viable, Stoke-on-
:56:48. > :56:52.Trent looked at their -- look at that and asked what they could do.
:56:52. > :56:59.Do you see a way, John, of getting houses into use and building new
:56:59. > :57:03.ones? There are always going to be limits on building, because you do
:57:03. > :57:07.have issues like green belts and the losing of parks and that sort
:57:07. > :57:12.of thing. We also need to be aware that the word affordable often
:57:12. > :57:16.means cheap houses to sell. Some people cannot afford an affordable
:57:16. > :57:21.property. We need to be aware that we need low-cost housing for rent
:57:21. > :57:26.as well, of an adequate standard. My parents were both born in
:57:26. > :57:31.council houses in Birmingham, and I think council housing was a good
:57:31. > :57:37.system to have. We have moved away from that. Do you have a final word,
:57:37. > :57:41.a magic bullet? IT not think the Tory government was right to reduce
:57:41. > :57:44.maintenance grants which were going out. That is why places like Stoke-
:57:44. > :57:51.on-Trent had to come up with new idea is. That is really where we
:57:51. > :57:55.have to leave it for today. Thank you both for being with us. Gisela
:57:55. > :58:00.Stuart and John Hemming, thank you. Next week, in the second of our