:00:00. > :00:28.Tonight, five deaths linked to waiting times at the Royal it is a
:00:29. > :01:27.shocking story, which has prompted one doctor who worked there to It
:01:28. > :01:30.has emerged that five patients may have died because they were not
:01:31. > :01:34.treated quickly enough. Health Minister denied there was a crisis.
:01:35. > :01:38.He conceded his department needs to learn lessons. The story has not
:01:39. > :01:45.been out of the headlines in recent months. Staff and patients at the
:01:46. > :01:56.Royal Victoria hospital said conditions last night were
:01:57. > :02:08.horrendous. People are contacting the media on her behalf. I wish that
:02:09. > :02:20.the media would be more mature in how they assess things. It is
:02:21. > :02:27.already about four. I cannot check. Last year, we identified five cases
:02:28. > :02:32.where one factor may have been the length of time people waited. The
:02:33. > :02:36.inspection has confirmed staffing concerns in key areas, allegations
:02:37. > :02:42.of bullying, staff under pressure, and air -- a system that does not
:02:43. > :02:58.function like it was meant to. I'm joined from Glasgow by Doctor
:02:59. > :03:06.Jonathan Miller, who worked in the emergency department. Also with us
:03:07. > :03:10.is John Compton. Welcome to the programme. Jonathan Miller, you
:03:11. > :03:16.personally flagged up your concerns on a number of occasions, how did
:03:17. > :03:22.you do that? As you say, that was over a fairly protracted period of
:03:23. > :03:26.time, initially, that was through senior staff in the emergency
:03:27. > :03:30.department, that escalated to senior managers responsible for the
:03:31. > :03:36.emergency department, and eventually to the medical director. Subsequent
:03:37. > :03:43.to that we had discussions with the College of emergency medicine on
:03:44. > :03:50.their admission. Did you feel the concerns were taken as seriously as
:03:51. > :03:54.they should have been? I did not. I think that is evidenced by the fact
:03:55. > :04:00.that those concerns are to be raised on repeated occasions. I don't think
:04:01. > :04:06.I ever felt in a position where they had been adequately addressed. What
:04:07. > :04:11.kind of issues did you raise and they not take on board? Did they
:04:12. > :04:13.simply not believe you or did they take it that you were telling the
:04:14. > :04:21.truth and then not do anything about it? This is about a pattern that was
:04:22. > :04:25.emerging. Sometimes these concerns would be about individual cases,
:04:26. > :04:35.generally, these were about patterns, situations that had risen
:04:36. > :04:42.over time. As to whether or not people believed it, I think the
:04:43. > :04:46.evidence was certainly there, and we had raised them on sufficient
:04:47. > :04:52.occasions that people could be left in no doubt. You were talking
:04:53. > :04:55.specifically about incidents that happened in accident and emergency
:04:56. > :05:01.where staff simply could not cope with the pressure they were under.
:05:02. > :05:07.Is that it? I think we are all aware in the profession of length between
:05:08. > :05:14.-- the link between overcrowding and outcomes for patients. We saw that
:05:15. > :05:18.played out in real-time. Sometimes that would be about the safety of
:05:19. > :05:21.patients, the delivery of treatment, sometimes it would be about the
:05:22. > :05:27.dignity of patients treated in the Department. This all happened some
:05:28. > :05:35.time ago. Why have you chosen to speak out at this particular time? I
:05:36. > :05:42.raised these concerns almost until the week I left. I took the decision
:05:43. > :05:45.to move away from that system, and I hoped when I left that things would
:05:46. > :05:51.improve and change was in the pipeline, and then in discussion
:05:52. > :06:01.with colleagues and with people that remained in Belfast, then with the
:06:02. > :06:06.news of a major incident, and the details that have emerged this week,
:06:07. > :06:09.I felt that these concerns have not been addressed and patients remain
:06:10. > :06:16.at risk, and I think I felt a real obligation to bring this to light.
:06:17. > :06:25.Is it your contention that patients remain addressed at the Royal? --
:06:26. > :06:28.remain at risk? I don't think anything has changed and there is
:06:29. > :06:35.evidence for that in terms of performance, there is evidence for
:06:36. > :06:39.that in terms of having to resort to using a major incident plan to deal
:06:40. > :06:46.with overcrowding. I think that evidence is clear. In fact, you said
:06:47. > :06:53.this week the five deaths may be the tip of the iceberg. Do you feel that
:06:54. > :06:58.strongly? That is based on an appreciation of evidence that has
:06:59. > :07:03.emerged from all around the developed world, from Australia,
:07:04. > :07:10.Canada, the United States and from within the UK. There is a really
:07:11. > :07:13.clear length between the length of stay for a patient in an emergency
:07:14. > :07:19.department, the level of crowding in an emergency department, and the
:07:20. > :07:23.ultimate outcome for patients. That is not something that is peculiar to
:07:24. > :07:32.Belfast, that exists around the world, and such pure performance
:07:33. > :07:39.there must be mortalities in the system. John Compton said medical
:07:40. > :07:43.staff should feel they have an obligation to speak out. You have
:07:44. > :07:47.done that but your colleagues have not done that. Might they now be
:07:48. > :07:56.encouraged, given what you have done and what has been said, to air their
:07:57. > :08:01.concerns publicly? I have had a lot of communication over the last 48
:08:02. > :08:06.hours, with former colleagues and staff who are there, they have
:08:07. > :08:12.expressed, in some cases, the thanks that I have been able to do this,
:08:13. > :08:22.but I think some people will still remain very concerned about what the
:08:23. > :08:26.potential repercussions will be. One final thing, a claim was made by an
:08:27. > :08:31.MLA that staff felt pressurised to stop the clock in an attempt to give
:08:32. > :08:37.an impression of improved performance. Is that something you
:08:38. > :08:44.ever came across? I can only reference the time I had access to
:08:45. > :08:50.the information, and certainly I think you would find that around a
:08:51. > :08:54.12 hour target there are an inordinate number of people who were
:08:55. > :09:00.clocked as having left the Department, and I think that points
:09:01. > :09:07.towards a situation where numbers may have been managed. You think
:09:08. > :09:13.those figures are unreliable? I think that would be fair to say.
:09:14. > :09:19.Yes. Thanks for joining us. Stay with us, we will hopefully come back
:09:20. > :09:24.to you a little later. Thank you for joining us. You appreciate -- we
:09:25. > :09:29.appreciate you being here. Let me reiterate on that point, do you know
:09:30. > :09:32.anything about stopping this clock to hit the targets? I have heard
:09:33. > :09:38.this allegation but I don't think there is substantial evidence, if
:09:39. > :09:46.that was the case we would not have any 12 hour targets. We do. Jonathan
:09:47. > :09:49.has just told us he believes it happens and representatives said
:09:50. > :09:55.that they believed it. I think the evidence that we have is there maybe
:09:56. > :10:02.some who do on occasion do things referred to as stopping the clock,
:10:03. > :10:05.but if you are asking if I think institutionally the system is
:10:06. > :10:10.designed to work around it, it is not. Nobody is suggesting that. The
:10:11. > :10:14.suggestion is staff are coming under pressure to stop the clock to hit
:10:15. > :10:19.the targets. I think the point I would say back to that is the
:10:20. > :10:23.publicised issue whenever the chief executive articulated that, there
:10:24. > :10:27.were two patients, one who was about to be breached, the other was a lot
:10:28. > :10:32.shorter, and the shorter one was placed in a bed because they need
:10:33. > :10:35.was greater, and I think that is appropriate. Targets are not there
:10:36. > :10:40.to be met artificially, they are there for a reason. We know the
:10:41. > :10:44.information about time and we know about management of risk. The reason
:10:45. > :10:48.is because we know that time is linked to the management of risk and
:10:49. > :10:52.in any emergency department it is all about the appropriateness of the
:10:53. > :10:57.management of risk. Of course. The pointers from the public point of
:10:58. > :11:00.view, these figures only mean anything if they are truthful
:11:01. > :11:07.figures and they are reliable. There is a doctor who worked in accident
:11:08. > :11:11.and emergency saying they were unreliable. It is an opinion and he
:11:12. > :11:15.is giving it on the basis of statistical information, and I
:11:16. > :11:20.accept that it is genuine and well made. I would say to you on the
:11:21. > :11:23.other side, I have spoken at length to very senior people, very senior
:11:24. > :11:30.clinicians inside the Royal Victoria, and I have had an absolute
:11:31. > :11:33.categorical assurance that there is no attempt to manufacture the
:11:34. > :11:39.figures, create a system where they are artificially driven. That is not
:11:40. > :11:44.to say on some occasions individuals might do that. I cannot know how
:11:45. > :11:45.each individual behaves but I can say the system is not set up for
:11:46. > :11:58.that. When was the very first time you
:11:59. > :12:03.became aware that senior doctors in the Royal's department had concerns?
:12:04. > :12:14.I was aware of the first formal occasion I had, is whenever the
:12:15. > :12:18.medical let wept to our QIA. In the normal course we would talk to them
:12:19. > :12:22.about pressures. There's an acknowledge there's pressure in the
:12:23. > :12:26.system. Something which escalated pressures to the point we are
:12:27. > :12:33.talking about is a recent phenomenal. You told Spot Light you
:12:34. > :12:36.had not seen any of these e-mails from doctors. Have you now? No. It
:12:37. > :12:39.is important to get into position who does who inside the health
:12:40. > :12:45.service. That is really important. The organisation that I look after
:12:46. > :12:50.commissions and we buy a certain volume to a certain quality. The
:12:51. > :12:57.organisation that runs the service on a day-to-day service is the
:12:58. > :13:02.Belfast Trust. What the doctor has referred to - with hindsight it
:13:03. > :13:07.might have been appropriate that was escalated to me by the Trust or
:13:08. > :13:14.escalated a little quicker. A lot quicker. It is always easy with
:13:15. > :13:18.hindsight to say I should have done this. I don't believe there was any
:13:19. > :13:21.attempt by the organisation to do anything other than a good job as
:13:22. > :13:25.far as the population who use that service are concerned. How concerned
:13:26. > :13:29.are you that only two of the families affected by this situation
:13:30. > :13:37.currently know about the circumstances of their loved ones
:13:38. > :13:44.deaths? Two know, three don't know. I was very concerned because we are
:13:45. > :13:50.very strict on the serious incident procedure. Families are involved,
:13:51. > :13:55.apart from when a family chooses not to be involved. If that has fallen
:13:56. > :13:59.short on this occasion, I have said before that we will get that fixed.
:14:00. > :14:04.It has fallen short. It has fallen short. I know that later today and
:14:05. > :14:09.during the course of today families have been contacted. We are fixing
:14:10. > :14:16.the system as a response to finding out it did not work as it should
:14:17. > :14:18.have on the first occasion. It is to encourage learning to avoid
:14:19. > :14:24.difficult circumstances into the future. It does seem very slow -
:14:25. > :14:27.with the greatest of respect, we are having this conversation on Thursday
:14:28. > :14:32.night - the programme was on Tuesday night. You know about the two
:14:33. > :14:37.adverse incidents some time ago. You are telling me tonight you have
:14:38. > :14:41.moved as quickly as possible. The incident, what is important to
:14:42. > :14:45.understand is of the five we are talking about only one is fully
:14:46. > :14:49.closed. In other words, the investigation is completed. The
:14:50. > :14:53.other four are outstanding. Now, and until the thing is fully closed and
:14:54. > :14:56.the loop is fully closed in that regard, I think we have to wait
:14:57. > :15:02.until that gets to that position. The reason that the number of five
:15:03. > :15:06.we are in, is we asked the information, is there any other
:15:07. > :15:10.cases pending which involve potentially time? That information
:15:11. > :15:14.has been released. We don't have any desire not to be transparent about
:15:15. > :15:18.that. What is important about these incidents is they involve the notion
:15:19. > :15:22.of time. Time could have made a difference. . That is correct. It
:15:23. > :15:27.could have to the incidents, but it would be wrong to jump to the
:15:28. > :15:30.conclusion that it was the principal causation of the death. And it is
:15:31. > :15:34.very easy in this situation, I would like to take the opportunity,
:15:35. > :15:37.because this is not just about numbers and statistics - this is
:15:38. > :15:40.about people. It is very difficult not to understand the pressure those
:15:41. > :15:46.families have been under during this last week. I have tremendous
:15:47. > :15:53.sympathy for the family who made their position publicly known. Have
:15:54. > :15:57.you apologised to them? Absolutely. Again, as I said to you, the actual
:15:58. > :16:02.investigations are not complete. We have to wait until we get tloo u the
:16:03. > :16:08.system. You -- until we get through the system. You know about five.
:16:09. > :16:12.Jonathan Miller has told us this is the tip of the iceberg. I would be
:16:13. > :16:18.disappointed that if the system does not collate that information. There
:16:19. > :16:20.is an obligation on anybody workings in an emergency department in
:16:21. > :16:24.Northern Ireland, or the health system, where there is a thing which
:16:25. > :16:30.is nearly a problem to raise it formally. We encourage - we have 400
:16:31. > :16:35.incidents raised with us across the whole of the health and social care
:16:36. > :16:39.on an annual basis. We publish that information twice yearly. Here is
:16:40. > :16:44.the problem - I wonder how concerned you are to hear that in one of the
:16:45. > :16:48.two cases where the family do know what happened, the facts only came
:16:49. > :16:53.to light because family members demanded a full investigation into
:16:54. > :16:58.their loved one's treatment. If they had not asked they would not have
:16:59. > :17:01.been told. It is difficult to have a debate about an individual case. I
:17:02. > :17:06.have resisted doing that. It is not because I don't want to talk about
:17:07. > :17:11.the case. There are real issues... The woman has been on the
:17:12. > :17:16.television. She spoke on BBC Newsline tonight. I understand all
:17:17. > :17:19.of that. In terms of the care and social health system there is a
:17:20. > :17:24.principal we do not talk about individual sets of circumstances in
:17:25. > :17:28.the public arena. There is an expectation when people talk to them
:17:29. > :17:33.that it is confidential. That is a principal adhered to across the
:17:34. > :17:37.system. In general terms, to answer your point about the issue about why
:17:38. > :17:42.do we have serious adverse incidents, they can be raised from a
:17:43. > :17:46.series of issues. A clinician can raise it, a family can raise it and
:17:47. > :17:50.we will listen to that and we will deal with that. Nobody is suggesting
:17:51. > :17:54.this is simple and straightforward. We realise it is complex. The
:17:55. > :18:00.difficulty is what the public see in all of this are dramatic headlines.
:18:01. > :18:04.They hear from and see overworked medical staff, working for well-paid
:18:05. > :18:08.managers, who look, with respect, as if they are asleep at the wheel.
:18:09. > :18:12.Well, I understand that. And I understand how that conclusion can
:18:13. > :18:16.be drawn. I would say to you that everyone who works inside health and
:18:17. > :18:20.social care gives their best to deliver the best that we can to the
:18:21. > :18:26.public at any point in time. We leave it there for now. Thank you.
:18:27. > :18:30.Let's hear from the SPLP and Dr Black from the British Medical
:18:31. > :18:35.Association. You have taken an issue in health concerns for a long time.
:18:36. > :18:39.Are you reassure reassured by anything that you have heard
:18:40. > :18:44.tonight? I am flabbergasted. I have heard talk about the Royal, as if
:18:45. > :18:50.this has emerged over the past few days, people have known for months
:18:51. > :18:54.if not years there has been a problem with Accident Emergency.
:18:55. > :18:57.We know that resources have not gone into the community to look after the
:18:58. > :19:01.patients to transform the care. We know that beds are being blocked,
:19:02. > :19:04.that there are not enough beds in the hospital system. Last Saturday
:19:05. > :19:09.night, a friend of mine, her father needed a bed and he had to go up
:19:10. > :19:13.into Northampton to get a bed. There was not one single bed in the whole
:19:14. > :19:19.of the Belfast trust area. I am aghast at what I have heard tonight.
:19:20. > :19:22.There does not seem to be any real, honest debate, among our politicians
:19:23. > :19:26.and where some of the issues are. I would suggest to some of the people
:19:27. > :19:31.sitting up in Stormont that they talk to the people on the ground,
:19:32. > :19:36.such as the GP from Scotland, Jonathan, who has been very honest
:19:37. > :19:41.and has done his colleagues a great service and indeed the patients and
:19:42. > :19:46.users a tremendous service by coming forward over the past few days. Is
:19:47. > :19:51.that how you see it? Are you flabbergasted tonight? Do you share
:19:52. > :19:56.the view that it is not as difficult and awkward as negative a situation
:19:57. > :20:03.perhaps as some people would care to believe it is? First credit to Dr
:20:04. > :20:07.Miller for coming forward. To deal with your question, we are in the
:20:08. > :20:16.middle of the biggest organisation niezational change that we've --
:20:17. > :20:20.organisational change that we've had in Northern Ireland. The two ends of
:20:21. > :20:25.the service are at the sharp end, which is A and E and General
:20:26. > :20:32.practise. We are doing A and E tonight. Have we put the cart before
:20:33. > :20:35.the horse on that? Have we made changes without having the beds
:20:36. > :20:38.there and the Care in the Community that would be necessary? The cart
:20:39. > :20:44.has gone before the horse - that is what a lot of people say. This
:20:45. > :20:48.minister has shown leadership. He has shown courage. The minister has
:20:49. > :20:52.denied there's even been a crisis. Do you know, the minister said there
:20:53. > :20:58.was no crisis over the last few days. The minister and his party has
:20:59. > :21:02.been dragged screaming to the floor of the Assembly. The First Minister
:21:03. > :21:08.is coming forward to back him. A couple of years ago they told him to
:21:09. > :21:18.act within his resources. You will not be surprised to hear that - she
:21:19. > :21:22.is a political opponent. Why do you think he's got it right when he has
:21:23. > :21:28.received criticism from many quarters? He's shown courage to
:21:29. > :21:34.transform the service. We could pretend to have A around the
:21:35. > :21:40.country or we can consolidate and provide a service. It is difficult
:21:41. > :21:43.for doctors in A and the Royal. We need to improve the flows of
:21:44. > :21:48.patients through there. We need... The point is, it is not happening.
:21:49. > :21:53.That is why wef've had these serioused a -- why we've had these
:21:54. > :21:56.serious adverse incidents and people dying partly because of waiting
:21:57. > :22:01.times - how can that be acceptable? It is not acceptable and Dr Miller
:22:02. > :22:07.is nodding his head, off camera here. Ehe knows we need to get the
:22:08. > :22:12.-- he knows we need to get the flows through. We need to get patients
:22:13. > :22:16.straight into the ward and seen. We have been closing hospital beds. We
:22:17. > :22:22.need to get patients efficiently dealt with in hospitals and out the
:22:23. > :22:29.other side. The process need toss be better. -- needs to be better. Is
:22:30. > :22:35.point is, it is not being done. There are patients in recovery ward
:22:36. > :22:39.in a hospital, two or three days post surgery and there is no bed for
:22:40. > :22:44.them to go in. Nurses tonight are being told in the hospital they
:22:45. > :22:51.cannot take their annual leave. When I think again - what is
:22:52. > :22:57.required here is a degree of calm. To address the point and I do speak
:22:58. > :23:01.to the trusts. They use the discharge for the day after, so
:23:02. > :23:05.people are in recovery and in the recovery unit for discharge the next
:23:06. > :23:09.day dhasmt is a standard issue -- the next day. It is a standard
:23:10. > :23:14.issue. That is clearly, from the senior people in the organisation,
:23:15. > :23:18.they have said that to me. I am relating to what I have been told.
:23:19. > :23:22.It is wrong to sensationalise the thing. There was a crisis for five
:23:23. > :23:28.families. There's no question about that. Maybe more families. We don't
:23:29. > :23:33.know at the moment. It is not just the Royal, there are
:23:34. > :23:38.crisis throughout the hospitals, right across... I don't agree with
:23:39. > :23:42.that at all. Again, this is the difficulty and we could talk numbers
:23:43. > :23:47.all evening, couldn't we? At the end, it is people. The numbers are
:23:48. > :23:51.large. We see 700,000 people across Northern Ireland. 90% of them are
:23:52. > :23:57.treated and discharged within six hours. There is a problem.
:23:58. > :24:02.I don't want to ban diy figures about all night. The %age of people
:24:03. > :24:08.seen within four hours, 94% in England. 72.5% in Northern Ireland.
:24:09. > :24:13.62% in the Royal Victoria Hospital. That is more than 30% less than it
:24:14. > :24:18.is in England. Hospital beds in the last five years, Northern Ireland
:24:19. > :24:22.has lost 18% of its hospital beds. The Belfast trust has lost 20% of
:24:23. > :24:27.its beds in that time. It does not make sense. It does not when you
:24:28. > :24:34.present it that way. If you look at who went to do the visit and made
:24:35. > :24:40.comments, they agreed the model of care in the royal Victoria is the
:24:41. > :24:43.right care. The medical unit and the speciality unit. The patients flow
:24:44. > :24:49.through the system. That is the issue and that is the difficulty. If
:24:50. > :24:52.you think of the detail that occurs from somebody going through their
:24:53. > :24:56.front door, through hospital, through the emergency department,
:24:57. > :25:03.through specialist yun knitses and to be -- specialist units and to be
:25:04. > :25:15.back home - there are 100 processes. People don't understand when you use
:25:16. > :25:20.a phrase like "the granuality of the details." The individual has to
:25:21. > :25:26.leave, go via ambulance. They have blood tests. They may have x-rays.
:25:27. > :25:30.They have to move from there to a ward. That is specific detail which
:25:31. > :25:35.has to work out to get to the 94%. I want to give the final work to
:25:36. > :25:40.Jonathan Miller, who has been listening to this. Are you reassured
:25:41. > :25:46.by anything that you have heard tonight, that this is
:25:47. > :25:52.sensationalist, is his suggestion, that people need to look at it.
:25:53. > :25:57.Calmness is different from being sensationalist. I used the word
:25:58. > :26:02.calm. I think you used the word "sensationalist" as well. The point
:26:03. > :26:06.is we need to be calm about it? Are youry assured by anything -- are you
:26:07. > :26:11.reassured by anything that you have heard? I accept these are complex
:26:12. > :26:15.problems which do not have easy solutions. What has concerned me
:26:16. > :26:21.over the last 48 hours is there appears to be a reluctance to accept
:26:22. > :26:27.how big a problem this is. I think the figure you quote tells the whole
:26:28. > :26:37.story. 60% of our performance. We know that that is associated... The
:26:38. > :26:43.minister has called for a review of the Royal A and asked for an
:26:44. > :26:48.examination of the figures as far as adverse incidents are concerned.
:26:49. > :26:53.Helpful? Yes, any examination of the system. Any learning that can be
:26:54. > :26:57.learned from data already there is useful. We have seen this in other
:26:58. > :27:06.parts of the UK and we have to learn the lessons of Mid-Staffordshire.
:27:07. > :27:09.People have to accept there is a problem before you can build a soe
:27:10. > :27:18.lulings. -- solution.
:27:19. > :27:24.The I expect that will dominate the headlines for quite some time to
:27:25. > :27:32.come. You are retiring next month. Are you counting down the days? I
:27:33. > :27:38.have enjoyed what I am doing and I have tremendous belief. I access
:27:39. > :27:41.there are things that need to be done. Nobody is trying to say here
:27:42. > :27:47.that we have no interest in the people and the use of this system. I
:27:48. > :27:53.have a tremendous commitment. We will leave it there. Thank you for
:27:54. > :27:59.joining us. We will make of it what we have been discussing. It is a
:28:00. > :28:04.welcome back to our commentators. Good evening to you both. An honest
:28:05. > :28:12.exchange of views, certainly no meeting of minds. I think it was
:28:13. > :28:16.Enoch Powell who said it was the graveyard of most political careers
:28:17. > :28:23.and he is right. The NHS, there is never enough money, resources,
:28:24. > :28:30.staff. Everybody has a story to tell about it. For most people, going to
:28:31. > :28:33.hospital is one of the scariest things they will face and they come
:28:34. > :28:37.out more scared. They are saying they are fixing the system, it is a
:28:38. > :28:43.process of change, and for a lot of people, it is going back years, the
:28:44. > :28:53.system never seems to be fixed. It is never completed. My view of it is
:28:54. > :29:05.we are experiencing a crisis despite what was said. It frightened the
:29:06. > :29:10.hell out of me that doctors and nurses who have had to go to the
:29:11. > :29:14.media to raise their concerns, some of the stories we have heard, talk
:29:15. > :29:20.of bullying in hospitals, pressure being placed on staff, we are
:29:21. > :29:27.hearing the possibility that a number of patients may have died in
:29:28. > :29:31.accident and emergency while waiting for treatment, there are concerns
:29:32. > :29:35.going unaddressed, we are hearing about beds being lost, and I think
:29:36. > :29:46.the health service is in a worrying state so far. We -- the issue about
:29:47. > :29:51.transforming your care, the minister deserves credit, but the criticism
:29:52. > :29:57.you hear is that while that is fine, we have not put in place a safety
:29:58. > :30:00.net to catch people when things go wrong. If you want to put people in
:30:01. > :30:04.the community and want them to be looked after you need to put
:30:05. > :30:09.domiciliary care in. A lot of people would argue that has not happened.
:30:10. > :30:12.Doctor Black is right, Edwin Poots has not been afraid to make
:30:13. > :30:20.decisions, make himself unpopular, and artists -- that is rare. This is
:30:21. > :30:23.not my field of expertise, but you will never be able to construct a
:30:24. > :30:28.net big enough to catch every single person who falls through. It is just
:30:29. > :30:38.the nature of the system. If you look back to when the NHS was
:30:39. > :30:42.created, they were arguing you would not need this number. It is
:30:43. > :30:51.topsy-turvy and it would continue to grow. It is impossible to reach a
:30:52. > :30:56.moment. Let us pause. We have a question for you to think about, are
:30:57. > :31:01.the politicians about to set their dues aside in favour of pink? It is
:31:02. > :31:08.the official colour of the Giro d'Italia. It is just before the
:31:09. > :31:13.elections, that means there will be a election posters adorning lamp
:31:14. > :31:14.post. Those tuning in will not expect to see them. What chance is
:31:15. > :31:25.there that they will ban posters? Weave an opportunity here of a
:31:26. > :31:33.sporting event televised throughout countries. -- we have. We don't want
:31:34. > :31:39.the posters in the background, putting up like on the perfect
:31:40. > :31:47.scenery of Northern Ireland. -- putting a blight. If there is to be
:31:48. > :31:51.a poster free route there needs to be a cross-party agreement because
:31:52. > :31:56.there is no point in two or three parties not putting posters up and
:31:57. > :32:02.the rest spoiling the show. I believe this is a very positive
:32:03. > :32:10.suggestion. This race has a global audience of 775 million. I have been
:32:11. > :32:20.told that my days as a poster boy might be over. I will examine a
:32:21. > :32:26.range of options including a ban. We have two weeks after for the
:32:27. > :32:32.elections so there will be enough time to see our beautiful faces
:32:33. > :32:39.before election. At least they have a sense of humour on that. What
:32:40. > :32:43.chance of this happening? I don't know. It is possible, it could
:32:44. > :32:48.happen. I think many members of the public would appreciate it, and
:32:49. > :32:53.believe it was said that politics was show business for ugly people.
:32:54. > :32:56.This is something that would suit the big parties rather than the
:32:57. > :33:04.independents, it is the only way of getting the message out there and
:33:05. > :33:08.raising your profile. It will only work if everybody signs up to it.
:33:09. > :33:16.Most people won't sign up to it, they will hope most people don't
:33:17. > :33:25.sign up to it. You cannot this connect politics. -- devolved
:33:26. > :33:30.politics from this. We should ban election posters and pink lycra.
:33:31. > :33:32.That is it this week. Apologies we did not bring you the Irish language
:33:33. > :33:35.story. Thank you for watching.