17/02/2013 The Wales Report


17/02/2013

Is a change in the law the best way to increase organ donation? And in times of austerity, one Welsh author is warning that Wales's children are falling into cultural poverty.


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Transcript


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We look at plans to change the law Welcome to the The Wales Report.

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Good evening and welcome to the programme that looks at the issues

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that matter. There are currently more than 200 people waiting for an

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organ transplant. Only 30% of us are registered as organ donors. The

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Welsh Government says it has the answer by creating the first opt-

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out system in the UK. If it is approved it means everyone will be

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seen as a willing donor when they die unless they have stated

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Medicine has at man dramatically. Auden donations made headlines

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India's previous. Since those days, surgery has been increasingly

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sophisticated and successful, yet today in Wales patients are dying

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at the rate of one a week at because there are not enough organs

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for operations. It was six years before Melanie was able to have her

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kidney transplant. She considers herself lucky and is convinced

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changing the law will increase donor numbers and stop others

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having to go through the agony of The opt-out system will raise

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numbers on the organ Donor Register. The a at the moment, we have to opt

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into the system to become organ donors.

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We have to make our wishes clear by signing up to the organ Donor

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Register, carrying a card or telling family and friends about

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our wishes. Under the new law, they will be a presumption we all want

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to be organ donors unless we opt out of the system.

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The if the plans are approved this year, the law will come into effect

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in 2015. The moral debate is already under way, and aside from

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the ethical discussion, some in the medical profession have deep

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concerns about how it will work in practice. They say the plans have

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not been thought through and insufficient funding need lead to

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chaos. One academic says the whole policy is based on misleading

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information. In explaining the new plans, the

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Welsh Government has stated that Spain's use of the soft opt-out

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system has driven up organ donor levels, but some claim that

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presumed consent is not the reason for Spain's success.

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To pass a bill with such a misleading statement is an

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incredible thing to do. Do To do what the Spanish are doing

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with public relations and so on. There are extra organs available

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for transplant. But there will be more strain on facilities. Some are

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worried we will not have enough intensive care beds to cope. There

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has not been any increased capacity to take into account the

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legislation. We feel if we could increase capacity we could

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potentially increase the use of. would have profound implications

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for our nurses. At the moment there are only 15 specialist donor nurses

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in Wales. They are trained to have that delicate conversation.

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requires a specialist skill said. Of course we will meet nursing and

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medical staff. We do have bona specialists but only a small number.

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Implementing the changes will cause -- cost an estimated �5 million

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over the next five years. There will need to be extra intensive

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care facilities as well as extra training for staff and setting up a

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register. As well as that there will be a comprehensive public

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awareness campaign. The Welsh Government told us they are

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confident with the planned changes. They are already looking at

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training resources. They are not seeking to copy any particular

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country but will put in place a system that is right for Wales.

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changes your life completely. It has given my husband back his wife,

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my parents back their daughter. I am now a wife, sister, and tea,

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:06:31.:06:32.

daughter, not a patient. -- and. Joining me now is the cheer of the

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assembly's health committee. He is this really going to make a

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difference? Every single witness who comes in front of us says we

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want to make sure the system increases the number of donors, the

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number of organs available for donation. What you will also here

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is a lot of concern from clinicians at the sharp end who say we do not

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have the capacity for this. That would be true whatever course you

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took to increased ownership. It is equally possible to argue that the

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issue is not intrinsic to the bill. If you raised the number of donors

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in any other way you would still have the same issue. You cannot do

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this unless you increase resources. Everybody knows that up and down

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the land it is difficult to find a bed under the existing system.

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ambition for the Bill is that it would lead to 15 new donors have

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been Wales in every calendar year. That has won every six months. Is

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it likely to tip the system into a manageability? We are very generous

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people on the hall. Voluntary donations and Wales at the second

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highest in Europe, that begs the question why do we need to do this?

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That is a debate that has been raised with us, would there be an

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easier way to lead to more organ donors? You will also know that

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because of a lot of these specialist procedures they will

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have to happen over the border. Heart transplants take place in

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Birmingham and so on. The whole thing needs to be joined up. There

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is not a simple geographic border with something as specialist as

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organ donation. Some of the practical issues about when they

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are debated and Wendy are used are important. There are financial

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implications in that. -- when they are used. The questions that are

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being booked and challenged in that report, insufficient funding, has

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not been clearly thought through, we are ploughing our own furrow

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when we should not be, we have to be joined up. We do have to be

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joined up. I do not think we have heard evidence that suggests the

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financial implications have not been thought through. It has been

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confirmed what the Government said to us that if we invest more in

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organ donation we will save money we are currently spending on a very

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unsatisfactory quality of life for people, kidney dialysis for example.

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That money will be released back into the donor service. There are

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people out with placards campaigning every week to keep

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their health services opened yet you want to introduce a whole new

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service on top of that. The flaw in the question is that it assumes the

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money that is being spent on donation is not being spent already.

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People who will be fitter from the extra donations are people who are

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being treated now in the NHS. you very much indeed. Most of us at

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the moment are looking very suspiciously at what is on our

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plate. The horsemeat scandal has been dogging us for weeks and there

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are still products disappearing from our shelves over this weekend.

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Now worries about the meat that is supplied to schools across the

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country. What can be done to restore faith in the food we eat

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and what can be done with one of her most important industries,

:11:15.:11:25.
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farming. I am joined by an The AM who is also a farmer. It was

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suggested that ministers were warned about this scandal with

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course make being in the food chain 18 months ago. Consumer confidence

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is so important. There are stories coming out from all sorts of angles.

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It is important that ministers focus on the job in hand, making

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sure confidence is restored in the processing sector. What is

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important is that ministers do the job properly. If it is true they

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were warned 18 months ago that there was horsemeat in the food

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chain why on Earth did they not take action then? The key point is,

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if it were true. What I am interested in and concerned about

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is that we focus all our energies on cleaning up the act of the

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processors. This is not about journalism or the media but about

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public confidence in the food chain. That has been very badly shaken.

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The Government has a role to play, has it not? We need to restore

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confidence. From the primary sector of the farming side, we are

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regulated, we have the checks in place. People can have complete

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confidence. What we have found is because of the difference in the

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price of meat and horsemeat people have been fraudulently adding

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horsemeat to beef. People have to be brought to book on this and I

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hope they are charged with the full Fraudulent activity has happened,

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we have to make sure that is pushed out of the sector. We have good

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bring back the confidence the consumer has in the food industry.

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What is the Welsh Government doing? The Welsh Government needs to work

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collaboratively with Whitehall, because there are two spheres of

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influence, animal welfare legislation and consumer of

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legislation. But the consumer does not want to hear bickering, they

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want to hear it has been cleaned up and they can produce a product with

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complete confidence. Can you honestly say at the moment that

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they can do that? Yes, if they are just a product that has been

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produced at home, has the former steward label on it, they can put

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us that with confidence. -- has the a steward label on it.

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Thank you very much indeed. G and on next week's programme, we

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will have a special investigation into our food, tracking it from the

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farm to your plate. Poverty in Wales and the gap

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between the haves and there have nots in society is widening. Is it

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really a fact of life that can never be changed gimlet after

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benefiting from countless European and Government schemes, some parts

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of Wales still seemed to be pop -- stat in a poverty trap. Our

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correspondent is investigating the many local schemes to combat

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deprivation. Several years since his last visit and millions of

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pounds of investment later, David has returned to one area to find

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that while initiatives have changed the level of poverty seemingly has

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An invisible pall of poverty hangs over places like this estate. Set

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in beautiful countryside just outside Merthyr Tydfil, it remains

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socially isolated and invariably singled out as the epicentre of

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multiple deprivation in Wales and all that goes with it.

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Statistically, this is a pretty ugly place, relegated to the wrong

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end of every table used to measure everything from unemployment to

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education, to health, to crime, and It fills me with sadness to have

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become back to this place and say the same things over, and over

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again. But, despite the efforts of remarkable individuals, despite the

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investment of millions of Pounds in worthwhile projects, and despite

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the promise of politicians of all colours, the same stench of poverty

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purveyed this place. -- pervades this place.

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It is a malignancy that threatens to side and we consume its host.

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Some have even suggested we should give up on this estate.

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-- threatened to silently consumed. More Martin O'Neill, who was

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brought up you, does not think so. He is the chair of a community

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project, a beacon of hope in an island of despair.

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The problems people face here are sometimes too subtle to quantify,

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but those who live here at know what is missing, including

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essentials like a health centre. They had won, but then they took it

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away. -- they had a health centre. He the building was quite old and

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money needed to be spent on upgrading the infrastructure to

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make it fit for purpose. There is no health centre now?

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Not on the estate, no. In one of the sickest communities

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in the UK? Are on top of that there has been a

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planned new health centre of built in the centre of Merthyr Tydfil,

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but the problem is getting there. The Community Group has helped to

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transform this place and transformed the heart of the

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community. It was once known as a route. Now the graffiti spells out

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something different, a belief in some kind of future. For many, it

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is a future dependent on benefits. If you have to move into employment,

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if you have to move to to education, sometimes you need some support. If

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you were sick, you need support. Benefits have been a way of life

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here for as long as I can remember. Benefits - what does that would

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mean? Who has benefited from living in a place like this? -- what does

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that would mean. Every time I have come here over the last 30 years,

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it is to report people suffering, people struggling and people trying

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definitely -- desperately to overcome problems that threaten to

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overwhelm them. The lucky ones escape, most don't. Instead they

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struggle with the consequences. Statistics are an impersonal

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measure of what is happening here, that they are stuck. One in

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particular hit me forcibly - in the last ten years, the number of

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people who have never worked on this estate has almost doubled to

:19:03.:19:09.

over 500 people. The you are familiar with these,

:19:09.:19:15.

employment rates in Merthyr Tydfil below 60%. This is the second

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lowest are amongst 12 -- 22 Welsh local authorities. Then on it goes

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- health, crime, the same old stories. Nothing much has moved,

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has it? No, it is not moving, but those numbers have to be

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appreciated in the face of a global economic recession. Without that

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investment, where would the fakers be? Back in the 1920s, they talked

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about abandoning the police. Is that really an option, or should we

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think about how to address the issues we are facing and not

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abandoned the community? There have been schemes which have tried to

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introduce some practical solutions come and give some hope to this

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place. Schemes like a cooking project,

:19:59.:20:09.
:20:09.:20:14.

I remember this. This was a busy place.

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Diane succeeded in injecting more than just cooking skills into this

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project. The ones we had done a week or two

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of Coke -- of cooking, we thought, why don't we do IT next? Why don't

:20:29.:20:33.

we do English? Somebody wants to do child development. The cooking

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classes opened up a new way of life for many single young mothers, who

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freely admitted that they had never learned to cook and usually fed

:20:43.:20:49.

their children with takeaways and chips. Lots of chips.

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Chips, chips, chips. It is much easier doing a healthy salad than

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ordering out takeaways continuously. The cooking project, which I filmed

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six years ago, has long gone. Its effectiveness in transforming the

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lives of a handful of individuals, however, has not been forgotten.

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But the transient nature of such schemes, vital in areas of

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deprivation, is both regrettable and hurtful.

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It is no good stopping projects and letting people down, because we are

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probably doing more damage than good. If somebody is engaging with

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you and trusting in you, to then send them away and saying we cannot

:21:34.:21:44.
:21:44.:21:44.

do anything more with you, I think There is still investment going on

:21:44.:21:49.

in this place, including extensive refurbishment work on the

:21:49.:21:54.

infrastructure of the social housing. Long overdue. There is the

:21:54.:21:58.

prospect of another �1.5 million worth of investment in community

:21:58.:22:02.

schemes over the next two years. But it was hoped there would be

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more than double that amount available. And, to compound the

:22:07.:22:13.

financial problems, many areas here have found they no longer Pok --

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qualified for communities first funding, provided by the Welsh

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Government. Just when there appeared to be a

:22:19.:22:22.

glimmer of hope and the estate was looking a lot better, at least

:22:22.:22:28.

cosmetically, it was dealt another blow. Well, in fact, a double

:22:28.:22:33.

whammy in the shape of the global financial crisis and the

:22:33.:22:37.

Westminster Government's welfare reforms. A combination which

:22:37.:22:41.

threatens to combine, to destabilise the social structure of

:22:41.:22:45.

this place and undo so much of the good that has been done to try and

:22:45.:22:50.

improve the lives of the people here.

:22:50.:22:54.

David Williams there. Training now is the Children's Commissioner for

:22:54.:22:58.

Wales, who is particularly concerned about how we are tackling

:22:58.:23:02.

child poverty. It is a depressing story that,

:23:02.:23:08.

isn't it? Do we just have to accept that children born into that kind

:23:08.:23:12.

of poverty are going to have to look forward to a life of poverty

:23:12.:23:18.

GMac I do not think we should accept it at all, some of the

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things that came through it in the film is that people are working

:23:22.:23:26.

really hard to mitigate the effects of poverty on children living in

:23:26.:23:29.

disadvantaged families. The Welsh Government has signed up

:23:29.:23:33.

to the UN Convention on the rights of the child. The only Government

:23:33.:23:37.

across the UK, or the world, do have legislated in favour of the

:23:37.:23:43.

Convention. That places a responsibility on Welsh Government

:23:43.:23:47.

to think about the ways we can ensure all young people, regardless

:23:47.:23:51.

of their circumstances, can get access to education and decent food.

:23:51.:23:55.

A but we keep setting targets. The Welsh Government has set the target

:23:55.:24:00.

of eradicating child poverty by 2020, is and that on realistic?

:24:00.:24:06.

It is completely unrealistic now to think we will never hold on to the

:24:06.:24:11.

target for 2020. Children's lives are at risk because of this, I

:24:11.:24:15.

spend a lot of time talking to children talking to them about what

:24:15.:24:20.

is important to them, and things like a decent education and good

:24:20.:24:25.

food to eat or important to them. Are we also guilty of giving people

:24:25.:24:30.

hope, an idea, an ambition? Absolutely, I think education is

:24:30.:24:38.

all about making sure every child can fulfil their individual

:24:38.:24:43.

potential. One of the most depressing lines about that film

:24:43.:24:46.

was that back in the 1920s people were talking about giving up on

:24:46.:24:50.

Merthyr Tydfil, and some people are talking about that today.

:24:50.:24:56.

Some people are, but I would say, come with me there, some of the

:24:56.:25:01.

best time of my life has been on the estate.

:25:01.:25:06.

Of course, the effects of poverty are not only measured by levels of

:25:06.:25:10.

employment and the food we feed our children. Hard times call for belt-

:25:10.:25:14.

tightening across all aspects of life, including leisure time. With

:25:15.:25:18.

less money available for cinema trips and local libraries are under

:25:18.:25:24.

threat, Welsh Opera John Gower has been on a trip to the riverfront

:25:24.:25:28.

theatre of and arts centre in Newport to voice his concerns that

:25:28.:25:35.

will children are falling into cultural poverty. -- Welsh author

:25:35.:25:45.
:25:45.:25:48.

You can get a pretty good sense of how old a person is by asking them

:25:48.:25:54.

which was the first James Bond movie they ever saw. In my case, it

:25:54.:25:58.

was Dr no, which I saw in the classic fleapit cinema of the

:25:58.:26:02.

Palace Theatre in Llanelli. Since then, there have been periods in my

:26:02.:26:07.

life when you could describe be as a semi-professional movie Gore,

:26:07.:26:15.

racking up to four or five films a day. Some children in Wales have

:26:15.:26:20.

never been to the cinema because of poverty. No blockbusters, no All

:26:20.:26:24.

Disney, no popcorn, sometimes because there is no cinema nearby,

:26:24.:26:30.

or simply because ticket prices are prohibitive. Because in Wales up to

:26:30.:26:35.

a quarter of children live within child poverty.

:26:35.:26:39.

When we are talking about child poverty, we're not just talking

:26:39.:26:42.

about education and nutrition, although cultural experience can be

:26:42.:26:47.

a sort of nutrition. I would go as far as to see it is food for the

:26:47.:26:57.

soul, but it is also educational, Imagination and creativity have

:26:57.:27:02.

enormous value in the real world. The Confederation of British

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Industry reckons that in 2013 there will be no fewer than 1.3 million

:27:09.:27:12.

jobs in the creative industries. But you are not going to get on in

:27:12.:27:16.

pretty much any industry if you cannot read and write, and

:27:16.:27:22.

illiteracy, which shut people out of learning, is a new plate on our

:27:22.:27:27.

communities. It is like locking the door on the world of books and

:27:27.:27:33.

throwing away the key. -- is a new light. I am not sure where things

:27:33.:27:37.

started to go wrong. When I grew up, learning was held

:27:37.:27:42.

in very high regard in Wales and we were exporting teachers as much as

:27:42.:27:49.

coal and steel. Now, Ilott to wreak -- illiteracy is a new scourge, and

:27:49.:27:52.

stories from Hans Christian Andersen to Charles Dickens are

:27:52.:27:57.

being locked away from our children. Horizon's contract and there as a

:27:57.:28:04.

poverty of ambition, too. -- horizons contract.

:28:04.:28:08.

It could not be impossible to show some of the world's great films or

:28:08.:28:11.

include some of the finest stories between the covers of a book in the

:28:11.:28:15.

classroom, should it? I try and imagine my own life without such

:28:15.:28:22.

things, and it is a poverty beyond imagining.

:28:22.:28:25.

Well, the Children's Commissioner for Wales is still with me. Is he

:28:25.:28:30.

right? For I think he is absolutely right about cultural poverty, and

:28:30.:28:33.

he is absolutely right about children and young people not

:28:33.:28:36.

getting access to those things. I did a fantastic piece of work

:28:37.:28:40.

this year with kids in museums, where museums were looking at

:28:40.:28:45.

developing a new relationship between themselves and children.

:28:45.:28:49.

What we saw from that was the rich breadth of experience that children

:28:49.:28:52.

and families got from it, and understanding of their cultural

:28:52.:28:59.

history and their contribution as artists, creators and writers.

:28:59.:29:02.

But we have to get them literate, first of all, and there are

:29:02.:29:08.

worrying reports. In Merthyr Tydfil, they are expecting a report to, it

:29:08.:29:12.

with 40% illiteracy by the age of 11. That is not good, is it?

:29:12.:29:18.

Yes, and there was an interested -- interesting piece of work in 2011

:29:18.:29:22.

looking at a disadvantage areas, and they welcomed those schools

:29:22.:29:26.

making that extra mile making sure children were exposed to trips to

:29:26.:29:34.

art galleries, theatres, cinemas, making sure children are exposed to

:29:34.:29:38.

the arts. Because if we can inspire young minds it gives us hope for

:29:38.:29:44.

the future? Absolutely. If the arts is the thing that locks the key --

:29:44.:29:48.

unlocked sticky, fantastic. That is it for this programme, I

:29:48.:29:51.

will be back on Wednesday night investigating how a con man

:29:51.:29:56.

claiming to help war veterans was able to get his hands on a large

:29:56.:29:59.

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