21/10/2012 The Wales Report

On The Wales Report tonight, it is your health service but what is

happening to it? Drastic changes on the way and for some it really is a

matter of life and death. Also tonight, unemployment is

falling but we are still in recession. What is going on with

the Welsh economy and are we getting a fair deal?

Clubs in crisis, why one of our great Welsh institutions faces a

bleak future. One man wants to have his say. I love the raw, crude

devotion of Welsh club rugby. Mr Butler is a man with a message.

Stay with us to find out why. Welcome to you all and thank you

for tuning in. This is the first edition of The Wales Report, the

new weekly meeting place where we will be talking about Wales and the

things that really matter to the people that live in Wales. We will

be looking at what life in all its diversity and asking searching

questions about our future. We will be talking to those making

decisions and the people whose lives are affected by them. And yes,

it does mean politics, that is essential, but The Wales Report is

about more than that. It has to be otherwise you will not be getting

the big picture that we have promised to you. Anything is

possible, just about, and we will be depending on you to tell us what

matters in your part of Wales. We are going to start with the biggest

changes to the biggest organisation with the biggest implications

anywhere in Wales. The NHS is going to change. It is under huge

financial pressure. There is a big consultation under way but parts of

the system are already under immense strain. If you listen to

some experts, they say that lives are clearly at risk. David Williams

has been investigating for the first The Wales Report.

It may look real enough, but this is in fact a film set for a

hospital drama. All sorts of things are enacted here. Art imitating

life, you might think. But out there beyond this make-believe,

there is a real-life drama unfolding and the consequences for

all of us could be far-reaching. Every individual page and believes

that he or she has the right to a universal service. -- individual

patient. And an equal chance of survival, irrespective of which

hospital they are admitted to. But you will be shocked to learn that

your chance of buying it was hospitals increases if you are

admitted at weekends compared to weekdays. -- chance of dying. Life

is often far more complicated than art, and death is for real.

For more than two years, Paul has dedicated himself to a task which

has gradually consumed him. The inquiry into the circumstances of

the death of his wife Janet at the local hospital, the Royal Glamorgan.

She had been suffering from cancer but she was rushed to hospital

early one Sunday morning over two years ago, suffering from severe

abdominal pains. We were there for three-and-a-half hours. They put us

in cubicle number 10, where they closed the door and left us.

Because of the pain factor, it was 10 out of 10, the highest pain

factor that you can get. She literally was crawling up the walls.

That is how bad she was. Janet died the following day from the cancer

that she was suffering from. And from an overwhelming infection, due

to her body's lack of resistance to that infection. She was 65. Her

husband's determination to pursue the events surrounding his wife's

death has had some success. An ombudsman's report, which uphold

the complaint, that Janet should have been given a higher priority

in hospital on the weekend that she was admitted, given her severe

abdominal pain. Death is still a taboo subject. Little wonder then

that the mortality figures for Welsh hospitals remain largely out

of sight of the public. But they do exist, and if you do know where to

look, they make for uncomfortable reading. They show quite clearly

that you are much more likely to die in was hospital at the weekend

than and any weekday. -- in a Welsh hospital. They are just a snapshot

but they clearly show a worrying increase in hospital death shops

during the week. These rates gradually increase during the week

and reach the high point at weekends. Sunday in particular. You

are much more likely to die than on a weekday in hospital. Professor

markers Longley has been commissioned by the health boards

in Wales to advise them on how to improve their health service. We

asked him why it more people are dying at weekends in hospital.

There are a number of reasons for that, as always. There is no one

single answer. It is partly to do with the availability of senior

medical staff. They are not always available at the right time. It is

the way services are arranged in various hospitals. A variety of

reasons, some of which to do with the overall configuration of the

health service and some much more local than that. But Government

recognises that keeping things as they are is not on option. They

have seemingly decided to take the bold step of driving hard for what

they call a world-class service. Except the Welsh Government is not

exactly to be found at the front line of what it knows will be a

difficult campaign. Instead, they have passed that responsibility to

Wales's seven health boards. Their plans include the closure of some

community hospitals, the reduction of services at others, greater care

provision in the community, and the development of centres of

excellence. They are widely regarded as political speak for

greater centralisation. We are at a watershed in our socio-economic

history and we have to radically we considered the way that we provide

public services. I start would be looking at the current

unsustainable mix of hospitals that we have been South Wales. This

professor is a leading health economist. Together with Dr

Christopher Potter, the former Director of Public Health, they

prepared a special report on the health service for this programme.

While that report recognises that a lot of good health care is

delivered in Wales, it also identifies a number of weaknesses.

The professor expresses concern at the proposed changes, that they

have not been properly costed. we are talking about at the moment

is very much a blueprint, a vision. We do not know what the cost

implications of these proposed changes will be and we do not know

if it is affordable. The need for reforming the health service in

Wales, however that is achieved and at what cost, is a tough message to

take anywhere in Wales. Every area, every group is -- has established a

stake in their health service. Here they are challenging the plans to

close the minor injuries unit at the X-ray department at the

community hospital. Confronting this group of protective health

custodians with the arguments for change are likely to go down well

at the local pub. But we risk the round anyway. Can I played devil's

advocate? Do you accept that the service is not fit for purpose

anymore? The Community Health Council, a watchdog, is saying that

the minor injuries unit does not get much use. You hear about

community led health care. How can you have that if they close all of

the community hospitals and wards? Give us the evidence, the rationale,

and if we can understand and digest it, we will work with it. At the

moment we are not getting that and until we do, the people will not

sit down. They should Prosser's stations are reinforced by the

concerns of clinicians and nursing staff. -- patient protestations. In

Cardiff, the director of the Royal College of Nursing are -- is

grappling with the proposed changes. I do not know if health boards are

being set up to fail. There is another difficulty. The difficulty

in discussing the concerns with the health minister. I have met with

the health minister wants. Don't you think you should have dialogue

with the health minister? I think it is getting increasingly

difficult to have regular conversations with the health

minister. Why? I have no idea. Professor Longleat cause to Ferrari

earlier this year when it was disclosed that he had emailed civil

servants asking for killer facts to support his argument. -- Professor

Longleat caused an uproar. He is resolute that the case for change

is strong. The danger is that we postpone some of these things that

the evidence points clearly to. We will fight it and gain some time

but we will not have solved the fundamental problem. We will be

back where we are now in a year or two. That is a shame because bits

of the service will just collapse because there will not be key staff

available and that is very risky. If you have an unplanned closure of

a service, that is worse than planned closures. As the arguments

about the future of the health service swirl around him, one man

is more concerned about the immediate and current dangers to

patients admitted to hospitals at weekends. As we are talking now,

there is something happening somewhere in another hospital to

your grandchildren, to your mother, to your father, where the system

then says, oh, sorry. That report by David Williams.

Joining me from Wrexham is a health minister for Wales. Thank you for

joining us, the first guest on The Wales Report. We are pleased to

have you with us. There was an idea that you are running scared of some

of these stakeholders. Is that right? Absolutely not. I have

several meetings every week with stakeholders. Or importantly, I am

out in health care settings every week talking to staff on the front

line. When are you meeting with the Royal College of Nursing next?

will have to check my diary. Is it fair for her to suggest it is

difficult to get meetings with you? I do not think it is difficult to

get meetings with me. Over the weekend I have been answering a

written question to a member and I was shocked at how many meetings I

have. I wonder that I have time to get out and about but it is

important that I am, meeting frontline staff. As someone that

were done the NHS for 20 years, I have lots of friends in the NHS and

we know they are the best sort of friends. -- as someone that worked

in the NHS. We do not envy the pressure that two or under. Is this

about reforming quality of service or saving money? Both things cannot

be possible, surely? It is about rebalancing and modernising our

services. The reason why we have to change the NHS in Wales has been

very well articulated over many years. You can go back 10 years,

and you can hear that Professor in your report saying the same thing

now. Why it is the health service in Wales taking the bigot -- why is

the health service in Wales taking a bigger proportion of cuts than

England? We cannot compare to England. The figures are there.

They brought yardsticks, that give us a sense of the kind of cuts you

want to make. I absolutely not. My department has 42% of the entire

was Government budget. �6.3 billion. We have protected the health budget.

We have huge sums of money to work with. We increased the money last

year, giving additional funding over three years, so financial

plans could be on a stable setting. I understand the sensitivity

because of your role on commenting on precise plans in local areas,

but there is a lot of sensitivity around about the plans that could

come into effect. Let's talk hypothetically. If I am in an area

with the full casualty unit in a town with many thousands of people,

and someone proposes to change that to a local Accident Centre, I might

be very concerned about those plans. What do you say to those people?

People are incredibly concerned about plans and that is why I was

adamant that health boards had to consult widely. That is being done

in North Wales. They are coming to the end of the consultation there,

and in West Wales as well. The South Wales are out to public

engagement at the present time and will go out to consultation in the

new year. Nothing has been set in stone and people must realise that

their input is extremely important as those plans come to the end of

the consultation period. Minister, I am sure we will talk again in the

months ahead but thank you for talking to us. There will be plenty

of opinions on that and when we returned to it, we will be

reflecting your opinions because The Wales Report depends on your

willingness to let us know what matters to you. Our reporter will

be gathering your opinions every week, making sense of them. How

healthy is the social need to work in Wales as far as politics is

concerned? Pretty healthy. We hear about the democratic deficit pretty

often in Wales. This is one way of starting to put some part of that

right at least. It is a way of making sure that you know what

people are saying, how they feel about interviews, the answers

politicians get. We might hear them and think that the public will not

for -- fall for it, and you find out on Twitter pretty soon. All of

that is important. We want questions, comments and responses

to this programme, that is very important. How can people get in

touch? If people want to get on Twitter, then it is: There is also

I will not repeat everything that comes in, but opinions that are

worth hearing and when people tell us how things are in their patch

and we may not be aware of this, we will talk about that. People have

precise questions for people they know we're into the ring, we would

welcome that? Yes, and sometimes I would say, I am going interview so-

and-so, what would you like to know? That is what we are there to

do, to ask ministers what the voters want to know.

It has been an odd experience reporting this month that we are

still in recession and yet unemployment is falling, the number

of people in full-time and part- time workers at a record high. It

is a curious situation baffling some of the best economists. But

the challenge of reducing the deficit and boosting economic

growth is no less urgent. This was the message around the Cabinet

table recently. Every department around this table

is actually involved in an effort to deal with getting the deficit

down and the economy moving. One of those sitting around the

table, we caught a little glimpse of him, David Jones, the new

Secretary of State for Wales. Are you enjoying the job? Yes. It is

challenging and has been extremely fast-moving, but overall it has

been a good three or four weeks. You were given very precise orders

by the Prime Minister, what have you done? The economy is the name

of the game, we have worked very hard. The first visit I paid after

I became Secretary of State was to end area of crucial importance to

the North Wales economy. We are doing all we can to ensure that it

is built, it is of tremendous importance. We are working in --

closely with the Welsh government. Economic development is devolved,

but lots of areas are not. It will only work if the UK and Welsh

governments work together. Is it a warm and friendly relationship were

just a business relationship? both. It is a good relationship, I

think I have a good relationship with Carwyn Jones, I have known him

for many years because I was an Assembly member. I have had a

couple of meetings with him already, we have done some joint working on

certain projects so it is working well. Because the word is you are

not a great fan of devolution? is the word put out by Labour in

the Commons. The is it not true? They need a line of attack...

could be true? Back in 1997, I campaigned, as did the Conservative

Party, against the establishment of the Assembly? Have you changed your

mind? Yes, it is a fact of life, it is the way Wales has governed and

we have to work for the best of wealth. Has it produced good

results? One or two... Such as? think the Welsh Language

Commissioner... Forgive me, the Welsh Language Commission and the

Children's Commissioner are extremely important. Some resorts

have not been so good and economically Wales has not done too

well since devolution. I think getting red of the Welsh

Development Agency was a huge mistake. -- getting rid of. Such an

emphasis on the deficit and dealing with that because it is a big, big

burden. His Wales bearing a heavier burden than it should be given that

lots of the cuts in benefits and welfare are really affecting

hundreds of thousands of people in Wales? Is that fair? The Welsh

Assembly Government has done rather well out of the CSR settlement. I

think when you look at the Welsh Assembly Government budget and

compare it with Whitehall spending in departments, I think it has been

a fair settlement. At the moment we are seeing the rebalancing of the

Welsh economy. Wells has been very heavily dependent upon the public

sector. It is now becoming less dependent, we are seeing more

private sector jobs being created in Wales. In the last set of

figures last week, Wales was the region of the United Kingdom doing

best in the terms of job creation, I think it is working. The burden,

I am interested in who was bearing the biggest burden. Everybody has

to play a part, we are all in it together and all the rest, even if

that is not true, that is the message. But you asking people who

are, in many cases, very vulnerable, on low income, dependent on

disability -- dependent on benefits, some with disabilities, you're

asking them to contribute. But we know companies like Starbucks and

in some cases IKEA, eBay and Amazon are not paying their fair share of

Corporation Tax. Have you got the balance right? Are you asking

people properly capable of paying to do the right thing? If you are

comparing chalk and cheese. It is a contribution. Companies like

Starbucks should be paying a foul- up of tax, the Chancellor has made

it clear that aggressive tax avoidance measures will be targeted.

But by the same token it is very important that people who maybe

have been out of work for very many years should be encouraged to going

to work, because work is good not only in economic terms but also for

social well-being and self-respect. I believe that programmes like the

work programme is doing a tremendous amount to get people

into work. I have seen these programmes and they are very

effective. You are happy, or satisfied, if I can put it that way,

that, for example, people in Wales on very low incomes, dependent on

benefits, hundreds of thousands of them, are not being asked to pay an

unfair price? I believe they are not. I believe the support they are

getting to get into work is something the Government is taking

very, very seriously. The DWP is working hard to ensure as many

people as possible can get back into work. It will clearly be a

painful process, but nevertheless... You would know better than I do, it

is one of the things people used to say that you are maybe not really

in touch with the real world. Really sensing what is going on in

people's lives. Again, I your concern that your image as a

government is one of people not being quite in touch? They're not

in touch message is put out by Labour, straightforward propaganda.

I think any constituency MP is very, very firmly in touch. I am a

constituency MP, I go back there every Thursday evening and see

people with all sorts of problems. I don't buy the message from Labour

that we are not in touch. Labour to one side, was Andrew

Mitchell in touch when he abused the police constable? Andrew

Mitchell did the right thing, he made an assessment of his

position... It to come four weeks. Was he a bit slow to make the

assessment? That is a matter of Andrew Mitchell. It sounds like you

think so. That is a matter for him, but he assess the level of support

he had within the parliamentary Conservatives apart -- party, he

decided he did not have the right level of support. Did you advise

him to go? You didn't feed your thoughts in? I did not speak to him.

That is a matter for Andrew Mitchell himself. Andrew Mitchell

made the right decision, Andrew Mitchell has resigned. Now we have

Sir George Young as the new Chief Whip, I am sure he will command

respect of the parliamentary Conservative Party.

It is not just the Government struggling with debt, the financial

climate is affecting so many areas of Welsh life and one of our best-

loved institutions is one of them, the local rugby team. The new

regional Welsh rugby structure is looking a bit shaky. Crowds have

dwindled and local games are not pulling in the masses. Who or what

is to blame? Here is the former Wales and Pontypool captain, Eddie

Butler - and he is on a personal crusade.

Way back, before I began to change it, one of the great mum if -- won

much if -- there was a greater derby match. In front of a full

house, the captains would meet and shake hands and the referee would

say, well, gentlemen, what is it to be today, rugby or fighting?

Without question they would reply, it will be rugby. And with that

small matter settled, they would get on with the fighting.

Rugby nowadays is all the better for not so easily spilling over.

But does modern regional rugby have any soul?

There is a harsh reality in 2012. This is now more of a football town

than rugby, in Pontypool, rugby hangs on by eight thread. Fighting

and losing. Even Pontypridd are out of the main strip, clinging to a

thread of their own, dreaming of rekindling valleys would be through

a 5th region. Llanelli they have on, geographically blessed by being

south of the M4. North of the motorway, rugby suppers. South, the

homes of the five professional regions. Five, are you say? There

is the 5th, the ultimate region - a To pay for professional rugby in

Wales, Wales have to play more than ever before. A minimum of a dozen

games a year. Their home is a stadium that can hold nearly 75,000,

more people can watch more international rugby than ever

before. Wales are our local team - and very good they are, too. Three

plants -- Grand Slams in eight seasons.

Transformation at the very top and everywhere below left to do what?

The regions are desperate for more money just to be competitive in

Europe, but the benefactors are withdrawing. Tony Brown of the

Dragons, Mike Cuddy at the Ospreys. It would appear the regions do not

touch our soul. So what can we do? At club level, I'd have a 16 team

league, hopefully including Pontypool, playing under lights on

midweek nights. I would put the development players from south of

the M4 into this floodlit league, to show they can cope with Welsh

club rugby at its most devoted. That would free up rugby lovers to

go and watch the regions on the weekend. Put much-needed money

through the turnstiles. Well, it is a plan.

Would it make any difference? Does anything at all have to be done as

long as wells are winning Grand Slams? Perhaps not? But you don't

have to be a structural engineer to know that if you load the top and

weaken the bottom, even the mightiest of towers can for with a

crash. For me, this is what Welsh rugby is all about. But it appears

I am old and out of touch, as Roger Lewis of the Welsh Rugby Union

would put it, I am a little bit lost in action. But I love rugby

where the sun does not shine. It shines on the southernmost Strip,

Roger's Riviera rugby. It sparkles, Another winning performance from

Eddie Butler, proving that the Wales Report is about opinions,