21/10/2012 The Wales Report


21/10/2012

Huw Edwards takes a look at issues that matter in Wales. In this edition, an overview of the NHS in Wales, and examining whether tribal loyalties in Welsh rugby have ended.


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Transcript


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

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

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matter of life and death. Also tonight, unemployment is

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

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the Welsh economy and are we getting a fair deal?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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changes to the biggest organisation with the biggest implications

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

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

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

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

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has been investigating for the first The Wales Report.

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

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

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

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

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

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

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

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

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your chance of buying it was hospitals increases if you are

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

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

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

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has gradually consumed him. The inquiry into the circumstances of

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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that the mortality figures for Welsh hospitals remain largely out

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

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

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

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

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but they clearly show a worrying increase in hospital death shops

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during the week. These rates gradually increase during the week

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

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

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markers Longley has been commissioned by the health boards

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

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

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

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

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

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

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

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

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

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

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

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

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difficult campaign. Instead, they have passed that responsibility to

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

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

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provision in the community, and the development of centres of

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excellence. They are widely regarded as political speak for

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

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

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public services. I start would be looking at the current

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

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professor is a leading health economist. Together with Dr

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Christopher Potter, the former Director of Public Health, they

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

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

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

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The professor expresses concern at the proposed changes, that they

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

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

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

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

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

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

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

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

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community hospital. Confronting this group of protective health

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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with the health minister? I think it is getting increasingly

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difficult to have regular conversations with the health

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

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

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

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

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

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

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

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

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

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

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

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

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is more concerned about the immediate and current dangers to

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

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there is something happening somewhere in another hospital to

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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year, giving additional funding over three years, so financial

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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reflecting your opinions because The Wales Report depends on your

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

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

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

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

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

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

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

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

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

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that is important. We want questions, comments and responses

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

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

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

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

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

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

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

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

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

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

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still in recession and yet unemployment is falling, the number

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

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

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the challenge of reducing the deficit and boosting economic

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

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table recently. Every department around this table

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

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

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

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

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

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

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

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

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

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

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

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closely with the Welsh government. Economic development is devolved,

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Children's Commissioner are extremely important. Some resorts

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

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well since devolution. I think getting red of the Welsh

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

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

:19:07.:19:13.

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

:19:13.:19:17.

lots of the cuts in benefits and welfare are really affecting

:19:17.:19:23.

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

:19:23.:19:27.

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

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think when you look at the Welsh Assembly Government budget and

:19:32.:19:35.

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

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

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

:19:44.:19:48.

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

:19:48.:19:52.

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

:19:52.:19:57.

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

:19:57.:20:02.

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

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

:20:07.:20:11.

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

:20:11.:20:15.

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

:20:15.:20:21.

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

:20:21.:20:25.

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

:20:25.:20:29.

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

:20:29.:20:34.

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

:20:34.:20:39.

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

:20:39.:20:44.

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

:20:44.:20:48.

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

:20:48.:20:52.

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

:20:52.:20:57.

it clear that aggressive tax avoidance measures will be targeted.

:20:57.:21:02.

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

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

:21:05.:21:11.

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

:21:11.:21:14.

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

:21:14.:21:17.

work programme is doing a tremendous amount to get people

:21:17.:21:20.

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

:21:20.:21:26.

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

:21:26.:21:30.

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

:21:30.:21:35.

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

:21:35.:21:40.

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

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getting to get into work is something the Government is taking

:21:43.:21:48.

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

:21:48.:21:52.

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

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

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

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

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

:22:09.:22:13.

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

:22:14.:22:18.

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

:22:18.:22:25.

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

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

:22:28.:22:32.

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

:22:32.:22:37.

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

:22:37.:22:40.

Mitchell in touch when he abused the police constable? Andrew

:22:40.:22:43.

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

:22:43.:22:49.

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

:22:49.:22:54.

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

:22:54.:22:58.

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

:22:58.:23:03.

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

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

:23:08.:23:14.

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

:23:14.:23:18.

That is a matter for Andrew Mitchell himself. Andrew Mitchell

:23:18.:23:22.

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

:23:22.:23:26.

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

:23:27.:23:31.

respect of the parliamentary Conservative Party.

:23:31.:23:35.

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

:23:35.:23:38.

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

:23:38.:23:43.

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

:23:43.:23:48.

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

:23:48.:23:52.

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

:23:52.:23:56.

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

:23:56.:24:01.

Butler - and he is on a personal crusade.

:24:01.:24:08.

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

:24:08.:24:15.

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

:24:15.:24:18.

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

:24:18.:24:24.

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

:24:24.:24:28.

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

:24:28.:24:35.

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

:24:35.:24:40.

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

:24:40.:24:46.

But does modern regional rugby have any soul?

:24:46.:24:53.

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

:24:53.:25:00.

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

:25:00.:25:05.

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

:25:05.:25:10.

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

:25:10.:25:14.

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

:25:14.:25:19.

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

:25:19.:25:25.

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

:25:25.:25:35.
:25:35.:25:35.

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

:25:35.:25:39.

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

:25:39.:25:46.

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

:25:46.:25:49.

more people can watch more international rugby than ever

:25:49.:25:55.

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

:25:55.:26:01.

plants -- Grand Slams in eight seasons.

:26:01.:26:06.

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

:26:06.:26:09.

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

:26:09.:26:14.

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

:26:14.:26:18.

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

:26:18.:26:26.

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

:26:26.:26:30.

league, hopefully including Pontypool, playing under lights on

:26:31.:26:34.

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

:26:34.:26:38.

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

:26:38.:26:43.

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

:26:43.:26:47.

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

:26:47.:26:52.

through the turnstiles. Well, it is a plan.

:26:52.:26:56.

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

:26:56.:27:01.

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

:27:01.:27:04.

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

:27:04.:27:08.

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

:27:08.:27:13.

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

:27:13.:27:17.

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

:27:17.:27:23.

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

:27:23.:27:29.

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

:27:29.:27:39.
:27:39.:27:39.

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

:27:39.:27:43.

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

:27:43.:27:53.
:27:53.:27:56.

Huw Edwards asks the questions that matter to you about your job, your health, your future. Confronting decision-makers with the consequences of their choices, and each week David Williams will be investigating the reality of living in modern Wales.

This week, the NHS in Wales - a suitable case for treatment? And is it really the end of tribal loyalties in Welsh rugby?


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