07/09/2016

:00:08. > :00:08.Hello. It's Wednesday.

:00:09. > :00:16.Good morning and welcome our programme.

:00:17. > :00:21.Today we're debating with you the junior doctors strike.

:00:22. > :00:24.Plus plus

:00:25. > :00:34.I support the strike patient safety is put

:00:35. > :00:39.we simply cannot accept this new contract.

:00:40. > :00:42.Hi - I'm Joanna - a junior doctor - I don't support the new contract

:00:43. > :00:46.but the thought about striking breaks my heart.

:00:47. > :00:49.With us this morning around 50 people who're either junior doctors,

:00:50. > :00:55.or who work in the NHS or who hold strong views about the dispute

:00:56. > :00:58.which has dragged on for several years now and could yet see

:00:59. > :01:04.another 15 days of strikes before the year is out.

:01:05. > :01:13.Hi I'm Saurav - a legal consultant - I am against the strike -

:01:14. > :01:19.I fear it will compromise patient safety.

:01:20. > :01:28.I've watched the controlled demolition of the NHS and I totally

:01:29. > :01:32.support the doctors. I'm really, really keen to hear from

:01:33. > :01:39.you. You can e-mail us. You can tweet us. You can usual the hashtag

:01:40. > :01:40.or you can text and your texts tab charged at the standard network

:01:41. > :01:50.rate. We're live until 11am with a special

:01:51. > :01:57.programme about the junior doctors We'll hear much more from our

:01:58. > :02:00.audience throughout the programme. But before all that, let's get

:02:01. > :02:03.all the latest news with Joanna. The chairman of the troubled

:02:04. > :02:07.Southern Health NHS Foundation Trust has defended the decision to create

:02:08. > :02:11.a new post on the same salary for the trust's chief executive

:02:12. > :02:13.after she quit in the wake Katrina Percy had faced multiple

:02:14. > :02:18.calls to resign over her Trust's failure to investigate

:02:19. > :02:22.hundreds of deaths. Now the BBC has learned

:02:23. > :02:25.that her new ?240,000 a year job didn't exist previously,

:02:26. > :02:29.and she was the only The Trust's chairman Tim Stuart says

:02:30. > :02:34.the job needed doing and that Ms Percy was "uniquely qualified"

:02:35. > :02:48.to carry it out. I mean it is fantastic the changes.

:02:49. > :02:51.Katrina Percy has faced months of criticism for the way her trust

:02:52. > :02:58.failed to investigate patient deaths. These are people, you should

:02:59. > :02:58.failed to investigate patient be investigating every death that's

:02:59. > :03:02.not expected. This is outrageous. You can't do this to people. That's

:03:03. > :03:05.why your services aren't good because you really don't care about

:03:06. > :03:15.them. Last week, she resigned and went straight into a new job at the

:03:16. > :03:18.same trust and on the same salary. ?240,000 a year including benefits.

:03:19. > :03:22.Today her chairman gave details of the move in an exclusive interview

:03:23. > :03:28.with the BBC. REPORTER: Did the new job exist

:03:29. > :03:33.before Katrina took it? The work needed to be done. Did that new job

:03:34. > :03:40.exist before Katrina took it? No. Did you advertise that job so other

:03:41. > :03:46.people could apply? No. Was Katrina the only candidate? She is uniquely

:03:47. > :03:52.qualified for it. Was she the only candidate? Yes. To many people that

:03:53. > :03:59.will sound like a fix? But that's not the case. He said Katrina Percy

:04:00. > :04:04.was uniquely qualified to remain at the trust. She will now be giving

:04:05. > :04:11.strategic advice to GPs, a role that was needed. Relatives were outraged

:04:12. > :04:14.at the side-ways move. Somebody in her position of responsibility, who

:04:15. > :04:20.is letting so many people down, and we have seen all of those deaths

:04:21. > :04:25.which went by, uninvestigated, and she is still there and she is taking

:04:26. > :04:29.a side-way step with her salary, I think it is outrageous, completely

:04:30. > :04:32.outrageous. Southern Heth say they have addressed the failings,

:04:33. > :04:39.highlighted in a series of reports and that patients are now safe. I

:04:40. > :04:47.can unequivocally look you in the eye and say that every member of

:04:48. > :04:50.staff that I have met, who works on the front line, is putting patient

:04:51. > :04:55.safety and the quality of care first.

:04:56. > :05:00.They still face criticisms and are now being investigated by the Health

:05:01. > :05:04.and Safety Executive over the earlier deaths of patients.

:05:05. > :05:07.Viewers in the South of England will be able to see a documentary

:05:08. > :05:09.on this at 7.30pm tonight on BBC One.

:05:10. > :05:14.It'll also run across the country on the News Channel at 8.30pm.

:05:15. > :05:16.Passengers on one of Britain's busiest rail lines face more delays

:05:17. > :05:20.today in the latest 48-hour strike by on board guards.

:05:21. > :05:24.Southern trains are in the middle of a bitter dispute with the RMT

:05:25. > :05:26.union over who should close the doors on their trains.

:05:27. > :05:31.Our Transport Correspondent Richard Westcott reports.

:05:32. > :05:33.This is a bitter row that's triggered months of strikes

:05:34. > :05:38.Southern wants more drivers rather than on-board conductors to start

:05:39. > :05:44.The RMT union says that's less safe and claims it's an excuse to cut

:05:45. > :05:50.A guard is an absolutely safety-critical role and we can't

:05:51. > :05:54.allow trains to be travelling without any guard on board.

:05:55. > :05:57.The company says no one will lose their job and driver-only

:05:58. > :05:59.trains have been running safely for decades.

:06:00. > :06:01.We've said to the RMT, you know, come and be

:06:02. > :06:04.part of the solution and not the problem here,

:06:05. > :06:06.come and talk to us about how we implement this because it

:06:07. > :06:09.It's piling on the misery for Southern passengers,

:06:10. > :06:12.who already endure the worst delays and cancellations in the country.

:06:13. > :06:15.Matt Steel used to be a Southern customer until his commute

:06:16. > :06:18.from Sussex to London got so bad he packed in his job,

:06:19. > :06:24.found work closer to home and started cycling instead.

:06:25. > :06:28.I've got a young family and it just meant I never got to see them.

:06:29. > :06:31.By the time I arrived in they were getting ready to go

:06:32. > :06:34.to bed, so we didn't really have much time to spend together.

:06:35. > :06:36.The strike means four out of every ten trains won't run

:06:37. > :06:45.The UK and Australia are to open preliminary

:06:46. > :06:50.negotiations about a future post-Brexit trade arrangement.

:06:51. > :06:54.Australia's trade minister Steven Ciobo, who is in London

:06:55. > :06:56.to meet International Trade Secretary Liam Fox, said officials

:06:57. > :07:00.from the two countries would meet twice a year to discuss the outline

:07:01. > :07:03.But he added that formal negotiations can't start

:07:04. > :07:06.until the UK leaves the EU and that it would be at least

:07:07. > :07:09.two-and-a-half years before any deal could be finalised.

:07:10. > :07:15.Our assistant political editor Norman Smith is at Westminster.

:07:16. > :07:21.So Norman is this the shape of things to come? Well, it gives an

:07:22. > :07:27.insight into the amount of time it is going to take to secure trade

:07:28. > :07:30.deals once we leave the EU and what's significant about these

:07:31. > :07:33.comments is Australia, probably at front of the pack, when it come to

:07:34. > :07:39.striking a deal because they are keen to reach an agreement with us.

:07:40. > :07:43.Theresa May and the Australian Prime Minister at the recent G20 both

:07:44. > :07:49.stressing the countries close ties with each other and the desire of

:07:50. > :07:54.both nations to get an agreement. The best we can expect is some deal

:07:55. > :07:57.within two-and-a-half years. That's the best case scenario and as

:07:58. > :08:03.importantly, he says that we could not get down to the detailed formal

:08:04. > :08:08.negotiations until Britain has actually left the European Union and

:08:09. > :08:14.even then, Australia wants to focus first on getting a deal with the EU,

:08:15. > :08:17.echoing exactly what President Obama said recently that the EU will come

:08:18. > :08:23.first. Thank you, Norman.

:08:24. > :08:25.Babies delivered by caesarean section are significantly more

:08:26. > :08:27.likely to grow up to be obese according to new research.

:08:28. > :08:30.The study published in the US medical journal, JAMA Paediatrics,

:08:31. > :08:32.found babies delivered by C-section are 64% more likely

:08:33. > :08:35.Experts say rising caesarean rates could contribute to

:08:36. > :08:40.Researchers warn of a "vicious circle" because overweight women

:08:41. > :08:46.are themselves more likely to need a caesarean.

:08:47. > :08:47.Councillors in London have voted to close

:08:48. > :08:49.the well-known nightclub, Fabric.

:08:50. > :08:51.Police had called for its licence to be revoked, after two teenagers

:08:52. > :08:57.at the club died as a result of taking drugs.

:08:58. > :08:59.Almost 150,000 people signed a petition to try

:09:00. > :09:06.With me now is Danny Rosney, from BBC Radio One's Newsbeat.

:09:07. > :09:11.A really well-known club. Is this a surprise? It is really because it is

:09:12. > :09:15.one of the most visited clubs in the UKment people come from all over the

:09:16. > :09:18.world to come to Fabric. I was at event last night and there was

:09:19. > :09:22.hundreds of people there in support of Fabric and it is not the decision

:09:23. > :09:26.that they were hoping for, but two people did lose their lives there

:09:27. > :09:30.over the summer. Is it unusual for a decision like this to be taken? I

:09:31. > :09:34.think for a club of this size and in particular, yes, especially when you

:09:35. > :09:42.have got huge artists talking it from the likes of SG Lewis, Annie

:09:43. > :09:45.Mack and Mr Jam, it is a club where a lot of DJs start their career and

:09:46. > :09:49.develop as artists, it will affect the industry quite significantly, I

:09:50. > :09:52.think. Is that it? Can they try for another licence? They can appeal,

:09:53. > :09:54.but you know, who knows what will happen with that? OK, thank you very

:09:55. > :09:58.much, thank you. A long lost letter from a dying

:09:59. > :10:02.woman to her young daughter has been discovered in a pile of second-hand

:10:03. > :10:04.books and reunited The letter was written

:10:05. > :10:07.to Bethany Gash, by her mother Lisa The book, the letter was kept in,

:10:08. > :10:12.disappeared during a It was discovered by chance

:10:13. > :10:15.by Gordon Draper who runs a book shop in Bishop

:10:16. > :10:27.Aucklands near Durham. Marcus Rashford for his exploits

:10:28. > :10:33.last season for both The teenager has now scored

:10:34. > :10:45.on his Manchester United debut. This time he bagged a hattrick

:10:46. > :10:58.against Norway in their qualifier for the European Championship next

:10:59. > :11:01.year which finished 6-1. The 18-year-old wasn't

:11:02. > :11:03.included by Sam Allardyce Because he's not been playing

:11:04. > :11:10.for Manchester United. Although on his only

:11:11. > :11:21.appearance this season. Last night in Colchester he wrapped

:11:22. > :11:32.up the first hattrick How have Portugal been getting on?

:11:33. > :11:36.Yes, they did well, but not so well last night. They lost 2-0 to

:11:37. > :11:40.Switzerland in their opening qualifier. The home side's goals

:11:41. > :11:49.came in quick succession in the first-half.

:11:50. > :11:55.A the Portugal side were without Cristiano Ronaldo who was injured in

:11:56. > :11:58.the finals and hasn't played since. Portugal's defence were barely

:11:59. > :12:04.beating, but they are off to a losing start in this campaign.

:12:05. > :12:08.Switzerland also had a man sent off late on.

:12:09. > :12:15.Let's talk about the US Open, Novak Djokovic through to the semis? Yes,

:12:16. > :12:20.they're parting like the Red Sea for Novak Djokovic. For the third time

:12:21. > :12:29.in this year's tournament, he didn't have to complete his match. Tsonga

:12:30. > :12:36.was two sets down when he decide he couldn't continue due to a knee

:12:37. > :12:40.injury. Djokovic had a walk-over in an earlier round, so the defending

:12:41. > :12:45.champion only needed to play nine completed sets. He will take on

:12:46. > :12:54.another Frenchman in the last four. Cricket... Some physical issues I've

:12:55. > :12:58.in the last month-and-a-half. This was, the scenario that I needed and

:12:59. > :13:06.I wished for. So I got a lot of days off. Recovered my body and right now

:13:07. > :13:10.I'm feeling very close to the peak and that's the position where I want

:13:11. > :13:14.to be. This Grand Slam is very unique for me, I never experienced

:13:15. > :13:20.something like this. To have three retirements on the route to the

:13:21. > :13:26.semifinals, I can only wish all of my opponents a speedy recovery. It

:13:27. > :13:29.is all I can do. Well, let's move on to cricket.

:13:30. > :13:34.England's final match of the summer today? Yes, that's right. After a

:13:35. > :13:38.long and not necessarily always hot summer, England take on Pakistan in

:13:39. > :13:48.their international T20 at Old Trafford. They broke the world

:13:49. > :13:53.record for the highest ODIs scored with 444-3 at Trent Bridge, but not

:13:54. > :14:01.to be outdone and a week later, Australia smashed a new record in

:14:02. > :14:10.T20 cricket with 263-3 against Sri Lanka. The total included 145 here

:14:11. > :14:17.for Glenn Maxwell off just 65 balls. It is the second highest score in

:14:18. > :14:22.all T20 internationals. Eight days ago Sri Lanka held the record for

:14:23. > :14:29.the both the ODI and T20 cricket and now they have neither! Oh dear.

:14:30. > :14:33.Paralympics begin in Rio. Yes, it has been a wait if you were having

:14:34. > :14:37.withdrawal symptoms after what happened in the Olympics, but they

:14:38. > :14:43.do start tonight. It is just over ten days or so that they will be

:14:44. > :14:52.going on in Rio. This is the flagbearer for Paralympics GB. Lee

:14:53. > :14:57.Pearson. He is one of the greatest Paralympians this country produced.

:14:58. > :15:01.He is 42 years old and won ten equestrian gold medals and the

:15:02. > :15:07.target for Paralympics GB is one better than what they managed in

:15:08. > :15:11.terms of medals in London 2012. Just the 121. We will see how they get

:15:12. > :15:13.on. Yes, come on, they can do it. Hugh, thank you very much.

:15:14. > :15:17.Back to Victoria. This morning - do you support

:15:18. > :15:38.the junior doctors' strike? Peter says, I am behind them, and I

:15:39. > :15:43.am awaiting an operation. This on Twitter, the BMA is using these

:15:44. > :15:47.people to play politics with patients' lives.

:15:48. > :15:49.Since the beginning of 2016 junior doctors have been on strike six

:15:50. > :15:56.They were due to walk out for five days next week -

:15:57. > :15:59.that's been cancelled, as you know, over patient safety,

:16:00. > :16:01.but they're still due to strike for five days in October,

:16:02. > :16:06.This row has been going on for two years now since England's Health

:16:07. > :16:13.Secretary Jeremy Hunt first proposed a new contract.

:16:14. > :16:16.This all began at the tail end of 2012.

:16:17. > :16:21.Junior doctors in England needed a new employment contract.

:16:22. > :16:25.That's 55,000 people, about a third of the medical workforce.

:16:26. > :16:31.But by 2014 talks on a new deal were already proving difficult.

:16:32. > :16:34.The doctors' union, the BMA, was worried about working conditions

:16:35. > :16:40.For years, it has been too hard to access the NHS out of hours.

:16:41. > :16:45.Heart attacks, major accidents, babies - these things

:16:46. > :16:49.Then the Conservative Party went into the general election

:16:50. > :16:53.with a promise - making the NHS a full, seven-day service.

:16:54. > :16:56.The Government wanted to make it cheaper for hospitals and surgeries

:16:57. > :17:00.to rota doctors on in the evenings and at weekends.

:17:01. > :17:04.It planned to raise basic wages, but cut extra pay

:17:05. > :17:14.Doctors argued the new plan was unfair and unsafe,

:17:15. > :17:20.and more investment was needed to pay for a full seven-day NHS.

:17:21. > :17:24.I trained in the UK and Iwant to work in the UK.

:17:25. > :17:27.But I'm not going to work in an NHS England where this

:17:28. > :17:33.The most recent saw junior doctors withdraw emergency care

:17:34. > :17:40.Then, a pause was agreed and talks restarted.

:17:41. > :17:42.It looked like a breakthrough was possible.

:17:43. > :17:47.The Government offered concessions on weekend and part-time paid.

:17:48. > :17:50.The doctors' union, the BMA, said it had reached a deal it could

:17:51. > :17:56.What we wanted to see was a proper negotiation were both sides tried

:17:57. > :18:00.to find realistic solutions to the problems that junior doctors

:18:01. > :18:02.face across the NHS, that is what we have

:18:03. > :18:09.The BMA still had to put the deal to its members,

:18:10. > :18:13.The Government said it would impose the contract

:18:14. > :18:20.More industrial action is now likely, with a series of five-day

:18:21. > :18:25.The first, planned for next week, has been cancelled because of

:18:26. > :18:35.The next, at the start of October, will go ahead, though,

:18:36. > :18:38.The dispute over the contract is an England-only issue.

:18:39. > :18:41.Scotland and Wales have both said they will be sticking

:18:42. > :18:43.to their existing contracts, while Northern Ireland has yet

:18:44. > :18:47.This is largely because they don't have the pressures on costs in terms

:18:48. > :18:51.So do you support the junior doctors' strike?

:18:52. > :18:56.Let's get a snapshot of views from our audience.

:18:57. > :19:05.Hello. I am Alex, a children's doctor in south-east London. I am

:19:06. > :19:11.glad we are not going on strike next week, I was not ready, I have just

:19:12. > :19:17.joined a new department, I don't know if the service can be covered

:19:18. > :19:23.if I am on strike. But I reject the contract, it is unnecessary and

:19:24. > :19:29.cruel, an intrusion into our working life. Looking at the wider

:19:30. > :19:33.situation, it is an attack on the NHS, we have seen waves of

:19:34. > :19:40.privatisation, PFI under Tony Blair and Gordon Brown, and Andrew Lansley

:19:41. > :19:48.brought in the health once a bill. Today, the NHS is stretched because

:19:49. > :19:53.of those things, trusts are almost ruined, and the NHS is so stretched.

:19:54. > :19:59.Jeremy Hunt wants to drive away doctors with this new contract. Do

:20:00. > :20:06.you believe he wants to drive away doctors? Do you genuinely believe

:20:07. > :20:11.that? He doesn't care. He has got a manifesto that he wants to carry

:20:12. > :20:21.out, which was voted for by 24% of people, and he has the short-term

:20:22. > :20:26.aim. I am Janice, a junior doctor, I work in north-west London, training

:20:27. > :20:32.to be an anaesthetist. I am mixed. I oppose the contract, it is not a

:20:33. > :20:37.contract I want to work under, I feel completely disrespected by the

:20:38. > :20:41.Government and Jeremy Hunt. As a body, we have objected it but they

:20:42. > :20:48.still think it is acceptable to impose it. But going on strike, you

:20:49. > :20:53.have responsibility to your patients first and foremost. Did you support

:20:54. > :21:01.the earlier strikes? Yes, I took part in them. I opposed the

:21:02. > :21:06.withdrawal of emergency care. The forthcoming strike that are

:21:07. > :21:12.proposed, it seems that five days of withdrawal of emergency care is a

:21:13. > :21:18.steep escalation. I support strikes, but the proposed plan in a month's

:21:19. > :21:28.time does not sit comfortable with me. Withdrawal of emergency care for

:21:29. > :21:33.such a long period of time. I answered, from Hampshire, a

:21:34. > :21:39.committee pharmacist. I get what I am hearing, we have the brightest

:21:40. > :21:43.and best. The issue is twofold, the point you are trying to make and how

:21:44. > :21:48.you are trying to make it. That is where I would disagree. The NHS has

:21:49. > :21:58.had years of broken promises, chronic underfunding, it is left

:21:59. > :22:03.fragmented, week, closing pharmacies down, the staff are not happy. It is

:22:04. > :22:08.not an issue just for junior doctors. The NHS is not elastic, it

:22:09. > :22:13.is finite, you tinker with one aspect, it has a domino effect. We

:22:14. > :22:18.are talking about families, jobs, the wider economy. The thing that

:22:19. > :22:25.worries me, if the NHS is already on its knees, how is the love of the

:22:26. > :22:30.NHS going to be further enhanced by junior doctors going on strike's who

:22:31. > :22:39.is a junior doctor who supports the five-day strikes? Talk to him about

:22:40. > :22:43.the point he has made. I am Sunday, an accident and emergency training

:22:44. > :22:48.in east London. I support the strikes, even the withdrawal of

:22:49. > :22:52.emergency care. We have fantastic consultants who will cover us when

:22:53. > :22:57.we are not there, the strikes will be from eight until five, I would

:22:58. > :23:02.have come in to finish my shift after being on the big lines. I

:23:03. > :23:07.agree that the NHS is not elastic, and we will have an impact, but that

:23:08. > :23:10.is the point of industrial action. We feel we have been left with

:23:11. > :23:16.nowhere else to go, there is no alternative. Pharmacists are not

:23:17. > :23:23.going to go on strike, nor are nurses. He feels there is nothing

:23:24. > :23:28.left. Either the BMA have let you down or you need to do more in terms

:23:29. > :23:32.of your reputation. The longer the strikes go on, the more isolated you

:23:33. > :23:39.will be. There is money in the system to help cover, agency staff,

:23:40. > :23:43.temping, but that is taking money from other aspects of the NHS, and

:23:44. > :23:50.you will become more unpopular. Your point will be lost as more impact

:23:51. > :23:52.will be on families. There was a poll yesterday which suggested that

:23:53. > :23:59.those people who believe doctors are right to strike is now at about 42%,

:24:00. > :24:06.that is down from April, when 53% said doctors were right to strike.

:24:07. > :24:10.You must worry about that. Yes, public support is important. We are

:24:11. > :24:14.not legally allowed to pay people to come and fill in for us. Extra money

:24:15. > :24:22.will not be put in for people to cover for our jobs. What option do

:24:23. > :24:26.we have? We are backed into a corner. I don't think the BMA have

:24:27. > :24:35.played their cards particularly right, but I blame Jeremy Hunt. Back

:24:36. > :24:38.off. Leave us alone. Why can't we be like the doctors in Scotland and

:24:39. > :24:47.Wales, who can concentrate on looking after their patients, rather

:24:48. > :24:51.than agonising over having to contemplate feeling like we are

:24:52. > :24:55.rejecting our patients? We have the burden of professionalism, it is a

:24:56. > :25:03.heavy burden. Having to request that is difficult to contemplate, but

:25:04. > :25:07.what do we do? I and David, I am an accident and mergers in is in a

:25:08. > :25:13.major trauma centre. I work alongside Julia doctors, we are a

:25:14. > :25:19.tight team. It is a busy department. I am also a parent and a patient, a

:25:20. > :25:25.taxpayer, and aged union steward. Our branch has 2000 members which

:25:26. > :25:31.have passed a motion supporting the junior doctors and their strikes. I

:25:32. > :25:34.support them personally. I feel the blame should be laid at Jeremy

:25:35. > :25:42.Hunt's door, there was no need to push the doctors, they have not gone

:25:43. > :25:44.on strike for 40 years or longer, they are intelligent, articulate,

:25:45. > :25:49.well educated, they train for seven years. Do you think of five days of

:25:50. > :25:53.strikes each month is proportionate to where we are now, even that back

:25:54. > :25:59.in May the BMA junior doctors committee said the contract is OK?

:26:00. > :26:03.It is not for me to tell the doctors what they should do. Do you think it

:26:04. > :26:10.is proportionate? I will support them 100%, whatever they choose to

:26:11. > :26:16.do. I know how hard they work. The idea of the seven-day NHS, emergency

:26:17. > :26:20.services run 24/7. We work nights and weekends. It is the elective

:26:21. > :26:27.services that don't run for seven days. There is no budget for this,

:26:28. > :26:32.no money being put forward. The NHS has had its budget... Although the

:26:33. > :26:38.bottom line has stayed the same, in previous years prior to 2010 is that

:26:39. > :26:42.every year there has been between a 4% and 2% uplift, because of the

:26:43. > :26:46.extra demand, and that stopped in 2010, so the money that has been

:26:47. > :26:52.going in for the last six years has declined. That is why we have Jeremy

:26:53. > :26:57.Hunt pushing for this transformation and sustainability agenda, a planned

:26:58. > :27:05.we know nothing about, he has not talked to the public about it, a ?22

:27:06. > :27:14.billion cut in funding. Thank you. Hello. I am Lauren, a GP trainee, a

:27:15. > :27:19.fifth-year junior doctor. I support the strikes and I and against the

:27:20. > :27:25.contract imposition. But I hoped that the strikes would not happen.

:27:26. > :27:33.The escalation is quite scary, to go to five days walk-out. Scary for us.

:27:34. > :27:39.I am scared our patients will be affected. I am working in obstetrics

:27:40. > :27:43.and gynaecology, I know the consultants and senior non-trainee

:27:44. > :27:47.doctors will do an excellent service in covering the emergencies, but

:27:48. > :27:51.elective services like antenatal clinics will have to be cancelled,

:27:52. > :27:55.so the doctors will be released to cover the emergency services. What

:27:56. > :28:00.is it about the contract specifically that you don't like's I

:28:01. > :28:05.don't like that the Government has recognised it as a contract that

:28:06. > :28:10.disadvantages women. Do you mean women or part-time workers? I mean

:28:11. > :28:14.part-time workers, who are predominantly women. One of the good

:28:15. > :28:19.things about the old contract is with annual pay increments we have

:28:20. > :28:24.avoided a gender pay gap. If Jeremy Hunt addressed the part-time

:28:25. > :28:31.workers' pay issue, you would accept the contract? That is one element I

:28:32. > :28:37.disagree with, there are a number. There is the part-time workers, what

:28:38. > :28:44.else? Non-resident on-call workers. Staff in areas like oncology, who

:28:45. > :28:47.work a 9-to-5 shift, and from then they may work from home, they may

:28:48. > :28:54.work from hospital, they can go home if they are not needed immediately,

:28:55. > :28:58.they will be on-call overnight, with the willingness to come in or answer

:28:59. > :29:04.questions by phone. Why is that an issue? They are my colleagues, they

:29:05. > :29:08.will take a massive pay cut. They are paid as if they are in hospital

:29:09. > :29:14.currently. The shifts can vary, some of them can be odorous, some can be

:29:15. > :29:19.less so. Even if you are at home and not called in, you are still waiting

:29:20. > :29:27.by the phone. Are there more issues? I don't know how many more! I want

:29:28. > :29:32.to get to the specifics if we can. In the last few minutes, we have

:29:33. > :29:38.heard one of the problems. For some people, it is about privatisation,

:29:39. > :29:44.the seven-day NHS, for others, it is about technical details of a

:29:45. > :29:51.democratic employment contract. The other publication is that the BMA

:29:52. > :29:55.committee and leadership agreed what was put forward and made clear that

:29:56. > :29:59.it had dealt with quite a few of these important issues. I know there

:30:00. > :30:04.is an issue about who recommended it, and I accept it was not fully

:30:05. > :30:09.recommended by the whole of the BMA. Some people thought it addressed

:30:10. > :30:14.these concerns. But I get the fact that 58% rejected it for their own

:30:15. > :30:20.reasons, and that is an important part of the debate as well. Some of

:30:21. > :30:26.these issues have got confused in an employment dispute. Wide issues

:30:27. > :30:27.attached to the contract dispute. Let's go through the other issues.

:30:28. > :30:41.What else? Specifically. We talked about gender

:30:42. > :30:45.discrimination. We talked about the nonresident on call. I would like to

:30:46. > :30:49.see better protection for study. We are consultants in training. We are

:30:50. > :30:53.qualified doctors, but we are training to become consultants.

:30:54. > :30:56.The next one? If we are looking to spread us over weekends and nights

:30:57. > :31:02.more thinly, we get our training by working with senior members of

:31:03. > :31:09.staff. And if we're spread more thinly, we're not going to get those

:31:10. > :31:13.opportunities. The contract doesn't mention that. All sorts of people

:31:14. > :31:16.could have all sorts of concerns, anxieties, grievances if you want to

:31:17. > :31:22.go that far. It is nothing to do with the contract. The contract is

:31:23. > :31:25.not about that. But the contract will impact upon that is the issue.

:31:26. > :31:29.The people who are negotiating the contract, we have doctors in the

:31:30. > :31:31.BMA, but we have the Government's spokes people, they haven't worked

:31:32. > :31:35.as doctors and they don't understand the pressures and that concerns me.

:31:36. > :31:40.So you have got a number of issues and a number of other junior doctors

:31:41. > :31:45.will also have their own issues. I want to ask this question now, but I

:31:46. > :31:48.want to ask it now. How is this going to be resolved because so many

:31:49. > :31:53.issues are being attached to this contract? I just wonder why this

:31:54. > :32:00.contract has to be imposed now? Why can't we make a contract that we

:32:01. > :32:06.agree on? APPLAUSE

:32:07. > :32:10.Hugh Pym, we have a doctor who is on the junior doctors committee at the

:32:11. > :32:15.British Medical Association, that's the union for health care

:32:16. > :32:23.professionals, we've got Mike Wood, a Conservative MP, we have Professor

:32:24. > :32:29.Modie. Welcome to you. Sorry Victoria. We don't support the

:32:30. > :32:38.strikes. We are here to support our members and we are here to speak on

:32:39. > :32:47.the hab of of children. The Director of Reform. And Hugh Pym who I have

:32:48. > :32:50.already introduced. Mike Wood, just to say, we invited Jeremy Hunt to

:32:51. > :32:54.come on the programme and he declined and we asked for anybody

:32:55. > :33:00.from the Department of Health to come on the programme, they

:33:01. > :33:04.delivered. The point raised by our junior doctor here, why does Jeremy

:33:05. > :33:09.Hunt have to impose this contract? Well, I mean, obviously we saw in

:33:10. > :33:13.the video clip these negotiations have been going on for four years

:33:14. > :33:17.now. Is that a good enough reason to now impose it? The question is, are

:33:18. > :33:24.these negotiations going any further forward? We thought we'd got a

:33:25. > :33:27.solution that was obviously co-authored between the BMA, the

:33:28. > :33:30.Department of Health and the NHS employers, the leaders of the junior

:33:31. > :33:34.doctor committee described it as beneficial to our patients and

:33:35. > :33:42.beneficial to our junior doctors. They said that it addressed the

:33:43. > :33:46.questions over equalities, that it was an improvement on equalities.

:33:47. > :33:50.Now, of course... But then the members voted against it?

:33:51. > :33:56.Absolutely. I think the BMA have to look at how they've engaged their

:33:57. > :34:01.members in terms of representing and recognising what concerns were, but

:34:02. > :34:05.there is a wider problem with the amount of hysteria really that was

:34:06. > :34:10.being whipped up when junior doctors were told they would be losing 30%,

:34:11. > :34:16.50% of their pay which wasn't true. It is not true in the new contract.

:34:17. > :34:20.You're representing, you're on the Junyard doctors committee on the

:34:21. > :34:24.BMA, deal with Mike Dudley's point. You've led your members up to the

:34:25. > :34:32.top of the hill and you have had to march them back down again by caving

:34:33. > :34:35.in about the strikes next week, you have people describing you erratic.

:34:36. > :34:40.You're not in control of the situation? Firstly, thank you for

:34:41. > :34:44.inviting me here today, it is a privilege to be here and to hear so

:34:45. > :34:47.many people's opinions on where we are and what's going on. The first

:34:48. > :34:50.thing I want to do is just talk about the fact that, we have been

:34:51. > :34:55.talking about are you pro or against strike? I would like to think all of

:34:56. > :35:00.us are against strike action. No one wants to leave hospital. I'm a

:35:01. > :35:05.junior doctor first. At the end of the day, my patients are my

:35:06. > :35:10.priority. I'm sorry to interrupt, I keep hearing you say that, and you

:35:11. > :35:14.keep going out on strike. This is part of the problem that we have is

:35:15. > :35:18.that at the moment, we have done everything short of this to this

:35:19. > :35:22.point. Throughout this process, we have been trying to find a solution.

:35:23. > :35:25.The problem we have is, unfortunately, the Secretary of

:35:26. > :35:30.State is not just not listening and not engaging in that process, but

:35:31. > :35:35.the problem we have now is, he is forcing through plans that not just

:35:36. > :35:39.independent experts, not just the front-line staff in our hospitals

:35:40. > :35:43.our junior doctors are saying are uncosted and untested and damaging,

:35:44. > :35:48.but even the Government's... You said this deal was all right. It is

:35:49. > :35:51.the same deal. Let's be clear, the leader of the junior doctors said

:35:52. > :35:56.that within the constraints that we had, in the eight day that is we had

:35:57. > :36:00.to try and negotiate in that time, under the new sort of criteria that

:36:01. > :36:04.were laid out with ACAS and David Dalton, unfortunately in that time,

:36:05. > :36:09.he felt we had reached the best deal we could, but it was always subject

:36:10. > :36:12.to a referendum because ultimately junior doctors have to decide, they

:36:13. > :36:18.are the front-line staff and we informed them so they could make an

:36:19. > :36:23.informed decision. Victoria, I think that it is

:36:24. > :36:28.unhelpful to polarize the debate into do you support the strikes or

:36:29. > :36:31.do you not support the strikes? That's for simplistic purposes. I

:36:32. > :36:35.acknowledge that everybody watching and many people in this room, it is

:36:36. > :36:41.not as simple as black and white, there are so many nuanced views and

:36:42. > :36:45.hence two hours to discuss it? Thank you for acnobblinging. Can I ask

:36:46. > :36:52.colleagues to join me in a thought experiment. Let's for argument's

:36:53. > :36:59.sake says that the junior doctors strike haven't happened. Let's wipe

:37:00. > :37:04.them off the face of history. Where would we be with our Health Service

:37:05. > :37:09.today? We would be with acute trusts in ?2 million in deficit, ?200

:37:10. > :37:13.million, that was billion the first figure, ?1 million of public health

:37:14. > :37:19.cuts and find GPs struggling to get sufficient training to look after

:37:20. > :37:23.children for whom I speak, we have seen in the last fortnight the

:37:24. > :37:27.suspension of paediatric A services, we have seen reports that

:37:28. > :37:32.from our national charity that show that 1,000 babies a year have been

:37:33. > :37:38.unnecessarily transferred between hospitals because of lack of

:37:39. > :37:43.capacity. We have seen a put to HEEs budget and the relevance to the

:37:44. > :37:54.point I'm making is that were the junior doctors dispute not to have

:37:55. > :37:57.happened, the NHS Public Health England, everything that encompasses

:37:58. > :38:00.general practice services would be in a very, very difficult situation

:38:01. > :38:04.indeed. So I suggest that if we are going to speak about health care,

:38:05. > :38:09.patient safety, public well-being, then we have to take all these other

:38:10. > :38:12.considerations into account simultaneously.

:38:13. > :38:18.APPLAUSE Hello. There is a wider health

:38:19. > :38:22.debate, but we're talking about the most extreme strikes in the history

:38:23. > :38:26.of the NHS, never been done before. There are detailed views about the

:38:27. > :38:30.contracts, the question is should we go for the strikes to do it? I think

:38:31. > :38:34.it is a militant response. I don't think we should. I would predict

:38:35. > :38:38.that the strikes later this year will not happen because the BMA is

:38:39. > :38:43.losing support. It could not find the support to do this first strike

:38:44. > :38:46.of these five. I would predict that public support will continue to fall

:38:47. > :38:51.and we will not have the further strikes. Let me read some more

:38:52. > :38:55.messages. Dr Jeff O'Leary says, "What I do not understand if the

:38:56. > :39:04.contract was deemed to be OK in May by the BMA why it seems no not be

:39:05. > :39:10.now?" Another viewer says, "Accept what is being offered now in

:39:11. > :39:13.exchange for excellent pay." Caroline says, "Triking is

:39:14. > :39:16.dangerous, but expecting employees to have no way to protest means we

:39:17. > :39:20.end up being long-term dangerous rather than being fair and

:39:21. > :39:23.co-operative. We should back anyone's decision to protest as they

:39:24. > :39:28.do it when they're left with no other option." And another viewer

:39:29. > :39:32.says, "It feels like we're witnessing, we are all witnessing

:39:33. > :39:36.the destruction of the NHS by politicians who are trying to use

:39:37. > :39:40.doctors as pawns, I support those doctors." Hello.

:39:41. > :39:43.APPLAUSE I'm an orthopaedic registrar and a

:39:44. > :39:48.junior doctor of ten years working in north-east London. It is in

:39:49. > :39:53.response to Andrea and Mike Wood, you used words such as hysteria and

:39:54. > :39:56.militancy. It is simplistic to consider the aspect of strikes in

:39:57. > :40:01.isolation without seeing what the alternative is. I don't want to

:40:02. > :40:05.strike. Striking is a last resort. Striking is a failure to listen. A

:40:06. > :40:08.failure to come to an agreement, but you have to consider what is the

:40:09. > :40:13.alternative if this contract goes ahead. I work as an orthopaedic

:40:14. > :40:18.registrar, I do operations, I know what is required to safely staff a

:40:19. > :40:23.seven day service. They are trying to stretch five days into seven with

:40:24. > :40:29.no extra funding, no extra staffing, no extra auxiliary staff, nurses,

:40:30. > :40:34.physiotherapists, it will lead to danger to patients. Three doctors,

:40:35. > :40:38.myself and two others cover 130 patients in three hours. We spend

:40:39. > :40:41.three minutes per patient. To cover those extra clinics on a weekend,

:40:42. > :40:46.you will take one of those doctors away, so you will have two doctors

:40:47. > :40:50.covering 130 patients in three hours. The system at the moment is

:40:51. > :40:55.in a state if anything happens, if a doctor gets sick, if a patient gets

:40:56. > :41:02.sick, if a member of auxiliary staff gets sick, it collapses and when

:41:03. > :41:06.your own risk register leaked two weeks ago said of five out of five

:41:07. > :41:11.severity risk, this is under staffed and it is under funded and I have to

:41:12. > :41:19.go back to your polls, you said that public support is waning towards a

:41:20. > :41:23.strike. The ITV poll showed there is an 85% support for the strike. The

:41:24. > :41:28.poll of members of the public where they surveyed them and said do you

:41:29. > :41:32.think a seven day service is a priority? Less than 3% thought it

:41:33. > :41:34.was a priority. They thought that improving the five-day service was a

:41:35. > :41:37.priority. APPLAUSE

:41:38. > :41:41.And the last point I would like to make is, the second thing and a lot

:41:42. > :41:44.of people are not aware of this, junior doctors don't have adequate

:41:45. > :41:50.whistle-blowing protection in the new contract. At the moment if I see

:41:51. > :41:53.a problem being done to my patients, harm, malpractice, I want to report

:41:54. > :41:57.that safely, so that I can actually improve the service and stop harm

:41:58. > :42:03.being done to patients. So you are putting doctors between a rock and a

:42:04. > :42:06.hard place. You are asking me to be complicit in driving through a

:42:07. > :42:11.contract which I know causes harm and which the Government knows

:42:12. > :42:15.causes harm and you are saying don't report if any harm occurs so you are

:42:16. > :42:20.lead to go a culture of cover-up. Mike Wood, Conservative MP, respond

:42:21. > :42:24.to this gentleman. There are clear proposals and improvements in terms

:42:25. > :42:29.of whistle-blowers and in terms of making sure that junior doctors are

:42:30. > :42:32.being protected. Equivalent to being employees of health education

:42:33. > :42:35.England so they will have the legal protection for whistle blowing, but

:42:36. > :42:39.in terms of the staffing, it is not true to say that we are trying to

:42:40. > :42:43.stretch a five day staff over a seven day service. There are 9,000

:42:44. > :42:50.more doctors than there were six years. We're training another 11,500

:42:51. > :42:56.doctors as part of 80,000 more staff... There was 20% intake into

:42:57. > :43:00.medical schools this year. I've worked in the NHS for ten years.

:43:01. > :43:04.Unfortunately, I do know what it takes to staff that. I know what it

:43:05. > :43:10.takes to staff a weekend service and I'm sorry, that's not true. Let me

:43:11. > :43:15.bring in Hugh Pym. We are going to talk about this further after 10am.

:43:16. > :43:20.Let's do it now. Five days into seven days, how does Jeremy Hunt see

:43:21. > :43:23.that that is going to work? Well, I think the problem with the seven day

:43:24. > :43:27.NHS debate has got very confused because when the strikes happened

:43:28. > :43:34.earlier this year it was very much about safety. It was very much about

:43:35. > :43:37.weekend pay. It was about whistle blowing and fining hospitals and

:43:38. > :43:41.that's really the key bits of the contract. Now, it has turned into

:43:42. > :43:44.more of a debate about the seven day NHS and I think the link between the

:43:45. > :43:51.two in terms of what actually needs to be agreed and the contract is not

:43:52. > :43:58.entirely clear, but I would put a point to Mike Wood, do you think

:43:59. > :44:03.Jeremy Hunt confused by saying the doctors contract is linked to a

:44:04. > :44:08.seven day NHS? Wouldn't it have been better to have focussed on the

:44:09. > :44:11.contract and not got into the seven day debate? They are linkedment

:44:12. > :44:16.other parts of the Health Service work seven days a week and they work

:44:17. > :44:20.night shifts, but the current structure on pay does act as the

:44:21. > :44:25.disincentive for NHS trusts in terms of how they're structuring their

:44:26. > :44:30.rotas. It means the same level of support for emergency and urgent

:44:31. > :44:34.care isn't similar at weekends as it is during the week. Anybody who has

:44:35. > :44:39.been in hospital at weekends or having to be admitted at night can

:44:40. > :44:44.see that, it is not equivalent. How are you going to do that if you

:44:45. > :44:49.haven't got enough doctors, consultants, registrars, there is a

:44:50. > :44:54.shortage? In terms of the funding that was raised, when Simon Stevens

:44:55. > :44:58.was head of NHS England reviewed the pressures on the NHS, he said the

:44:59. > :45:02.NHS would need another ?8 billion in funding by the end of the

:45:03. > :45:06.Parliament. So the Government has committed to ?10 billion above the

:45:07. > :45:13.rate of inflation, above normal price increases. That's what is

:45:14. > :45:14.funding the extra 80,000 people that we're aiming to recruit into the

:45:15. > :45:23.NHS. You admit there is a problem at

:45:24. > :45:29.weekends in the emergency service, and I agree, I think services like

:45:30. > :45:35.diagnostics and people waiting in A are not acceptable at the

:45:36. > :45:41.moment, but how can you do that by taking extra funding... Sorry, not

:45:42. > :45:48.putting in extra funding and adding in two extra days? Hugh has done a

:45:49. > :46:00.film about the seven-day service, the ambition of the service.

:46:01. > :46:02.Save our NHS! Save our NHS!

:46:03. > :46:05.At the centre of the junior doctors row is the Government's plan to make

:46:06. > :46:08.the NHS in England a seven-day service by 2020, a key pledge

:46:09. > :46:11.in its manifesto and one it believes it has a mandate to deliver.

:46:12. > :46:13.With a future Conservative Government, we would

:46:14. > :46:20.The Conservatives envisage people having access to local GPs

:46:21. > :46:23.seven days a week and, crucial to this debate,

:46:24. > :46:26.patients receiving the same level of urgent and emergency care

:46:27. > :46:31.in hospitals in England at weekends as on Monday to Friday.

:46:32. > :46:34.Junior doctors already work at weekends, and, in fact,

:46:35. > :46:37.represent the bulk of medical professionals on shift.

:46:38. > :46:39.Tweets directed at the Health Secretary,

:46:40. > :46:44.using the hashtag #I'mInWorkJeremy, were keen to prove this point.

:46:45. > :46:46.But while emergency care is available at weekends,

:46:47. > :46:52.And, under the current junior doctors contracts,

:46:53. > :46:54.ministers say it would be too expensive for hospitals to roster

:46:55. > :47:00.Then there's the controversy caused by Health Secretary Jeremy Hunt's

:47:01. > :47:03.suggestion that a lack of staff is increasing the

:47:04. > :47:08.One report he cites, using hospital data from 2013-14,

:47:09. > :47:13.indicates that a patient is 15% more likely to die within 30 days

:47:14. > :47:16.if they are admitted on a Sunday than a Wednesday.

:47:17. > :47:18.The British Medical Journal, however, which published

:47:19. > :47:22.the findings, believes the data has been misinterpreted.

:47:23. > :47:25.It says there are other factors that must be considered,

:47:26. > :47:28.such as how patients admitted at weekends tend to be sicker

:47:29. > :47:31.than those admitted during the week, and that there is no evidence

:47:32. > :47:37.to suggest that extra staff would prevent so-called excess deaths.

:47:38. > :47:40.If the Government gets its way, however, medics believe they would

:47:41. > :47:47.Whether this will lead to a truly seven-day NHS is unclear.

:47:48. > :47:49.Leaked Department of Health documents revealed in August that

:47:50. > :47:51.civil servants worry that a lack of available GPs,

:47:52. > :47:54.hospital consultants and other health professionals

:47:55. > :47:57.would mean the full vision could not be delivered.

:47:58. > :48:08.Government sources said this was a normal risk assessment.

:48:09. > :48:14.Let's find out more about this ambition for a seven-day NHS. We

:48:15. > :48:22.have an audience of junior doctors and other health care professionals,

:48:23. > :48:32.patients, taxpayers, voters. Like Alex, I am a children's doctor. My

:48:33. > :48:36.father passed away recently, and there were a series of mistakes in

:48:37. > :48:44.his management that contributed to that, the last was withdrawing his

:48:45. > :48:50.pain medication was messed up, it was not on a weekend or a strike

:48:51. > :48:55.date, it was in the middle of a day during the week. Jeremy Hunt is ram

:48:56. > :49:02.raiding through a contract on the premise of a seven-day NHS with no

:49:03. > :49:05.extra funding, no extra employment, no actual plan as to how it will

:49:06. > :49:10.work, and criticism from his department. He will take staff away

:49:11. > :49:15.from the days that my dad could not be looked after, underfunded days,

:49:16. > :49:19.putting them onto a weekend with no evidence to say it will work. Even

:49:20. > :49:26.the papers he is quoting from have said rings like, it is misleading to

:49:27. > :49:31.say that this will help. It is not something I will stand for, I want

:49:32. > :49:38.to protect the NHS, and I want the NHS to be something we can be proud

:49:39. > :49:45.of. Is it right to do that through this dispute? Is a paediatrician and

:49:46. > :49:50.a British citizen I want to do what is best for the patient, because I

:49:51. > :49:54.look after formidable children. I am on 13 hour shifts, where I do not

:49:55. > :50:00.get breaks, and I am looking of the sick children. I fall asleep at the

:50:01. > :50:04.end in my car and have to get a taxi home. A few hours earlier I are

:50:05. > :50:07.making decisions about managing a six-year-old child who is not

:50:08. > :50:10.breathing. The contract will make things worse, not just for the

:50:11. > :50:14.patients but also for the doctors and the public will stop what are

:50:15. > :50:19.your thoughts on the seven-day ambition? I am an orthopaedic

:50:20. > :50:27.surgeon, we do work seven days a week. This weekend I was on call for

:50:28. > :50:33.48 hours, there was a registrar on site, and I have seen every patient

:50:34. > :50:41.that has come through the door. We are struggling as we stand to fund

:50:42. > :50:45.that. To give a smack -- is not shot, we are struggling to get

:50:46. > :50:49.junior doctors to cover night shift. The system is entirely based on the

:50:50. > :50:54.goodwill of the junior doctors. We will be able to do what we do -- we

:50:55. > :51:00.would not be to do what we do without the junior doctors. This

:51:01. > :51:07.message says, I work shifts, ours are 24/7, 365 days of the year. My

:51:08. > :51:14.son had to wait over a weekend before his broken ankle was operated

:51:15. > :51:17.on. I have no support for doctors. Join the rest of us and work shifts,

:51:18. > :51:24.we don't get special treatment, so wide should doctors? It is not only

:51:25. > :51:35.me, there has to be anaesthetic staff, and MRI support. Most

:51:36. > :51:43.hospitals operate on the weekends, I do. What we prioritised was elderly

:51:44. > :51:48.people who had broken their hips and kids. Ankle fractures have to wait

:51:49. > :51:53.until Monday. To be clear, as there are not enough of you in that team

:51:54. > :51:57.to do that operation, you prioritise the very vulnerable and somebody

:51:58. > :52:03.like this boy would wait until Monday? Your question now is, how

:52:04. > :52:14.can we continue to do this when there are not more funds? I want to

:52:15. > :52:20.get more people in, but thank you. I represent the Conservative workers

:52:21. > :52:24.and trade unionists. I am a patient and I heard our friend say he has

:52:25. > :52:30.worked for ten years in the NHS, I have been involved for 46 years as a

:52:31. > :52:34.patient. The seven-day NHS is essential for our modern way of

:52:35. > :52:39.life. I work in hospitality, my son is an actor, daughter works in

:52:40. > :52:44.retail, there are so many walks of life where seven-day working is the

:52:45. > :52:51.norm. If there are not enough people, as many Judeo doctors say,

:52:52. > :52:56.to do this effectively or safely, what do you say? Look at your

:52:57. > :53:02.contract. The contract the BMA agreed. The organisation is being

:53:03. > :53:06.done to make sure the cover is available, extra funding is

:53:07. > :53:15.available, despite the calls from the BMA. I am a GP, I train Judeo

:53:16. > :53:26.doctors and I am starting to produce a film called the great NHS heist.

:53:27. > :53:33.The junior doctors dispute has to be seen in the wider context of NHS

:53:34. > :53:39.privatisation. What do you mean by that? It will continue to be free at

:53:40. > :53:44.the point of delivery, say the Conservatives. Hospitals can

:53:45. > :53:49.generate up to 50% of their income from private patients, the five-year

:53:50. > :53:54.forward view spells out the closure of 17,000 hospital beds, and it

:53:55. > :53:58.alludes to the deskilling of hospital staff. Why do you say this

:53:59. > :54:03.contract is relevant to what you believe in terms of the future

:54:04. > :54:06.privatisation? There is no more money, we will be the only developed

:54:07. > :54:09.country in the world offering routine care seven days a week, it

:54:10. > :54:16.is designed to drive doctors out of the system, that is the intention.

:54:17. > :54:23.What will happen, you will have a staffing crisis,... You say Jeremy

:54:24. > :54:29.Hunt wants to drive doctors out of Britain to collapse the NHS, to

:54:30. > :54:38.enable more private providers to come in? Is that reasonable? In a

:54:39. > :54:45.bar of people think so. -- a number of people. People have made this

:54:46. > :54:50.point and putting it together with this issue, what is your take? I

:54:51. > :54:54.don't see any link between the contract and privatisation.

:54:55. > :54:59.Privatisation is a loaded term. We mean selling of shares in the NHS

:55:00. > :55:04.like British Gas, what do we mean use of private providers? That has

:55:05. > :55:10.never been made clear. The use of private providers with NHS money was

:55:11. > :55:15.running at about 6%, it is now 7%. For some people it means 93% is

:55:16. > :55:21.still NHS for others the 7% is significant. It remains a big debate

:55:22. > :55:26.around the whole service, but linking it with the contract is a

:55:27. > :55:31.value judgment by some, and if you talk to a range of junior doctors,

:55:32. > :55:36.they would not say privatisation was their main motivation in this

:55:37. > :55:38.debate. I am a student, this is directed to you, you are a

:55:39. > :55:48.Conservative MP, you are not giving... You have not once said...

:55:49. > :55:53.You are not giving these professionals who take care of us a

:55:54. > :55:57.straight answer. I will ask you, you are our MP, what are you going to

:55:58. > :56:03.do? You cannot dismantle the NHS. How are you going to do this? To

:56:04. > :56:08.resolve the dispute? I am against strikes, I don't should happen. Stop

:56:09. > :56:13.pushing these poor professionals to a strike, and how... They don't want

:56:14. > :56:20.a new contract, what are you going to do? You can answer that after the

:56:21. > :56:26.news and sport, we will get back to that, don't worry. Let me read this

:56:27. > :56:30.message from one viewer. I am disabled, I often use the NHS, I

:56:31. > :56:36.support junior doctors, money has been wasted by the changes to the

:56:37. > :56:40.NHS over the last few years. In my area they have subcontracted out the

:56:41. > :56:46.Ambulance Service and the cost is enormous. It still does not work

:56:47. > :56:52.efficiently. I sent an Anne Boleyn is to get to my appointment and I am

:56:53. > :56:53.the only person in it. Get in touch. News and sport in a second, after

:56:54. > :57:03.the weather. It was a warm and humid start today

:57:04. > :57:08.across most parts of the UK. But also really quite grateful sum. This

:57:09. > :57:12.was the view from one of our weather watchers. There were some breaks in

:57:13. > :57:20.the cloud. Prior to whether for some of us. Some fairly extensive layered

:57:21. > :57:24.cloud in Gateshead. A bit of sunshine coming through. A great

:57:25. > :57:30.start this morning, but some sunshine on offer. We have the weak

:57:31. > :57:35.weather front to the north and west, tied in with low pressure to the

:57:36. > :57:38.West. It will become a player in the next day or so. High pressure

:57:39. > :57:43.between the two. Generating a southerly breeze, bringing in drier

:57:44. > :57:50.air. It will help to melt the cloud away. We will see some good sunshine

:57:51. > :57:54.developing across the southern counties. As you head further north,

:57:55. > :57:58.the cloud is thicker and it will produce some outbreaks of rain. A

:57:59. > :58:06.good deal of sunshine across South Wales and the southern counties of

:58:07. > :58:09.England. It will be warm again. A fair bit of cloud lingers through

:58:10. > :58:13.the Midlands. Even here, the sunshine will try to break through,

:58:14. > :58:16.but still warm and humid. Some breaks in the cloud for Northern

:58:17. > :58:22.Ireland and northern England and southern and eastern Scotland.

:58:23. > :58:25.Through this evening, the cloud continues to melt away, but we look

:58:26. > :58:32.west for the first signs of a change. The low pressure moving in.

:58:33. > :58:37.A line of rain through the West of Scotland, will introduce a change.

:58:38. > :58:43.Ahead of it, it is a warm night. Change is on the way. This cold

:58:44. > :58:49.weather front moving east. Not much rain in the southern portions. Cloud

:58:50. > :58:54.and rain moves across the north of the UK. By the afternoon, it has

:58:55. > :58:58.moved to the east, then we get fresher conditions following behind.

:58:59. > :59:05.The temperatures will be down, but it is still quite warm. The humid it

:59:06. > :59:10.will be down as well. A fresher feel. Through the evening, showers

:59:11. > :59:15.from the West. Towards the end of the week, there will be a line of

:59:16. > :59:20.showers moving from West to East. Either side of it, fine and dry, but

:59:21. > :59:24.later in the day, the wind will be picking up, the cloud will be

:59:25. > :59:28.thickening, and there will be wet and windy weather on Friday night.

:59:29. > :59:36.If you need more details, it is therefore you online.

:59:37. > :59:37.Hello, it's Wednesday, I'm Victoria Derbyshire.

:59:38. > :59:39.Good morning and welcome our programme.

:59:40. > :59:48.Today we're debating with you the junior doctors' strike.

:59:49. > :59:55.It is in their dispute with England's Health Secretary, Jeremy

:59:56. > :59:59.Hunt. You blame the BMA, I don't think they have played their cards

:00:00. > :00:03.particularly right, they could have done better. I blame Jeremy Hunt.

:00:04. > :00:08.Jeremy Hunt back off. Just leave us alone. We're talking about the most

:00:09. > :00:13.extreme strikes in the history of the NHS. I think it is a militant

:00:14. > :00:19.response. I don't think we should. I would predict that the strikes later

:00:20. > :00:22.this year will not happen. I will support them 100% whatever they

:00:23. > :00:26.choose to do. I know how hard they work.

:00:27. > :00:31.In saying that I support the strikes I hoped very much that they wouldn't

:00:32. > :00:35.happen. I think the escalation is quite scary to go to five days

:00:36. > :00:39.walk-out. I'm scared that our patients are going to be affected by

:00:40. > :00:43.this. We will continue our debate on the

:00:44. > :00:48.programme. Wherever you are, get in touch with your own views. You can

:00:49. > :01:00.e-mail us and you can tweet us or you can text.

:01:01. > :01:02.Joanna with a summary of all the morning's news.

:01:03. > :01:06.The chairman of the troubled Southern Health NHS Foundation Trust

:01:07. > :01:09.has defended the decision to create a new post on the same salary

:01:10. > :01:11.for the trust's chief executive after she quit in the wake

:01:12. > :01:19.Katrina Percy had faced multiple calls to resign over her trust's

:01:20. > :01:20.failure to investigate hundreds of deaths.

:01:21. > :01:23.Now the BBC has learned that her new ?240,000-a-year job

:01:24. > :01:25.didn't exist previously, and she was the only

:01:26. > :01:38.Katrina Percy has faced months of criticism

:01:39. > :01:42.for the way her trust failed to investigate patient deaths.

:01:43. > :01:44.These are people, you should be investigating every death

:01:45. > :01:52.That's why your services aren't good because you really

:01:53. > :01:58.Last week she resigned and went straight into a new job at the same

:01:59. > :02:07.Today her chairman gave details of the move in an exclusive

:02:08. > :02:11.REPORTER: Did the new job exist before Katrina took it?

:02:12. > :02:18.Did that new job exist before Katrina took it?

:02:19. > :02:24.Did you advertise that job so other people could apply?

:02:25. > :02:35.Was she the only candidate?

:02:36. > :02:40.To many people that will sound like a fix?

:02:41. > :02:48.He said Katrina Percy was uniquely qualified to remain at the trust.

:02:49. > :02:51.She will now be giving strategic advice to GPs,

:02:52. > :02:58.Relatives were outraged at the side-ways move.

:02:59. > :03:03.Somebody in her position of responsibility, who is letting

:03:04. > :03:07.so many people down, and we have seen all of those deaths

:03:08. > :03:09.which went by, uninvestigated, and she is still there

:03:10. > :03:13.and she is taking a side-way step with her salary, I think it is

:03:14. > :03:20.Southern Health say they have addressed the failings,

:03:21. > :03:26.highlighted in a series of reports and that patients are now safe.

:03:27. > :03:29.I can unequivocally look you in the eye and say that every

:03:30. > :03:32.member of staff that I have met, who works on the front line,

:03:33. > :03:41.is putting patient safety and the quality of care first.

:03:42. > :03:43.They still face criticisms and are now being investigated

:03:44. > :03:55.by the Health and Safety Executive over the earlier deaths of patients.

:03:56. > :03:58.Viewers in the South of England will be able to see a documentary

:03:59. > :04:00.on this at 7.30pm tonight on BBC One.

:04:01. > :04:05.It'll also run across the country on the News Channel at 8.30pm.

:04:06. > :04:09.Passengers on one of Britain's busiest rail lines face more delays

:04:10. > :04:12.today in the latest 48-hour strike by on-board guards.

:04:13. > :04:15.Southern Trains are in the middle of a bitter dispute with the RMT

:04:16. > :04:18.union over who should close the doors on their trains.

:04:19. > :04:23.40% of services won't run during the strike.

:04:24. > :04:26.The UK and Australia are to open preliminary

:04:27. > :04:29.negotiations about a future post-Brexit trade agreement.

:04:30. > :04:32.Officials from the two countries are to meet twice a year to discuss

:04:33. > :04:37.But Australia's warned that formal negotiations can't start

:04:38. > :04:40.until the UK leaves the EU and that it would be at least

:04:41. > :04:45.two-and-a-half years before any agreement could be finalised.

:04:46. > :04:51.Our assistant political editor Norman Smith is at Westminster.

:04:52. > :04:57.Norman, is this the shape of things to come? Well, it gives us an

:04:58. > :05:02.indication of the amount of time it might take to actually secure trade

:05:03. > :05:05.deals once we leave the EU with the Australian Trade Minister saying

:05:06. > :05:10.best case scenario, it'll take two-and-a-half years. Now, why that

:05:11. > :05:14.matters is because Australia are probably right at the front of the

:05:15. > :05:20.queue when it comes to future trade deals, they want a deal, both

:05:21. > :05:23.Theresa May and the Australian Prime Minister at the G20 this week were

:05:24. > :05:27.stressing the common ties between the two countries and how they would

:05:28. > :05:30.both benefit from an agreement, but if it is going to take

:05:31. > :05:34.two-and-a-half years for Australia, then, of course, there will be

:05:35. > :05:40.speculation in That more complex, bigger markets, less open, less

:05:41. > :05:45.friendly markets are going to take an awful lot Langer and it will be

:05:46. > :05:50.an awful lot hard tore reach those crucial trade deals. Thanks, Norman.

:05:51. > :05:53.Junior doctors have been telling this programme why there is so much

:05:54. > :05:55.anger about the Government's decision to impose a new contract

:05:56. > :05:59.The British Medical Association has called off next week's industrial

:06:00. > :06:00.action amid concerns about patient safety,

:06:01. > :06:03.but 15 days of strike action are planned from October onwards.

:06:04. > :06:05.In a special debate, doctors and those in the medical

:06:06. > :06:08.profession have been telling this programme why they feel so strongly

:06:09. > :06:19.The thing that really worries me is if the information is already

:06:20. > :06:24.crippled, if it is also on its knees, how is the love of the NHS

:06:25. > :06:28.going to be enhanced further by the doctors going on strikes? I support

:06:29. > :06:32.the strikes, even the withdrawal for emergency care, in the emergency

:06:33. > :06:34.departments, we have fantastic consultants who will cover us when

:06:35. > :06:36.we're not there. That's a summary of

:06:37. > :06:38.the latest BBC News. Marcus Rashford has had

:06:39. > :06:45.another debut to remember. The Manchester United teenager

:06:46. > :06:47.scored a hat-trick on his first appearance for England's Under-21

:06:48. > :06:50.side as they thrashed Norway 6-1 The 18-year-old has

:06:51. > :06:53.scored on his club debut, his Premier League debut and his

:06:54. > :06:56.debut for the England senior side, but he wasn't selected

:06:57. > :06:58.for Sam Allardyce's first squad due Rashford sealed his hat-trick

:06:59. > :07:03.in Colchester with a Novak Djokovic has reached the semi

:07:04. > :07:21.finals of the US Open But for the third time in this

:07:22. > :07:27.year's tournament the world number one didn't have

:07:28. > :07:28.to complete his match. Jo Wilfried Tsonga was two sets

:07:29. > :07:31.down when a knee injury It's the second retirement

:07:32. > :07:34.from which Djokovic has benefitted He also had a walkover

:07:35. > :07:38.in an earlier round. He'll take on another

:07:39. > :07:39.Frenchman Gael Monfils Angelique Kerber is through to

:07:40. > :07:43.the semi-finals of the US Open for the second time after beating

:07:44. > :07:45.2015 runner-up Roberta Vinci. The world number two won in straight

:07:46. > :07:48.sets and will now face Caroline Wozniacki for a place

:07:49. > :07:50.in Saturday's final. Kerber will become world number one

:07:51. > :07:53.if she betters the performance of Serena Williams at Flushing

:07:54. > :07:54.Meadows. World heavyweight champion

:07:55. > :08:03.Tyson Fury's rematch with Wladimir Klitschko has been

:08:04. > :08:05.set for 29th Octoberh There's some flash photography

:08:06. > :08:10.coming up in these pictures. It'll be

:08:11. > :08:12.11 months after their original fight in Germany after an original date

:08:13. > :08:14.in July had to be scrapped because Fury picked up

:08:15. > :08:16.an ankle injury. The British fighter beat Klitschko

:08:17. > :08:19.in November to claim the WBA, Finally, Great Britain will look

:08:20. > :08:28.to improve on their London 2012 medal haul when the Paralympics get

:08:29. > :08:41.underway in Rio tonight. Lee Pearson has been named the

:08:42. > :08:43.team's flagbearer. He was chosen in a vote by his team-mates.

:08:44. > :08:50.The team are targeting 121 medals - one more than four years ago.

:08:51. > :08:55.The headlines coming up later on. Now, back to Victoria. Thank you

:08:56. > :09:01.very much. This morning we've been debating

:09:02. > :09:07.the long-running row over a new contract for junior doctors

:09:08. > :09:11.which has so far led to 162 hours of strike action

:09:12. > :09:22.including junior doctors Let's hear more from patients. We

:09:23. > :09:27.have a number of them in the audience as you would expect Hello.

:09:28. > :09:32.My name is Sarah. I was diagnosed with breast cancer a couple of years

:09:33. > :09:35.ago so I have a lot of experience of the NHS, not necessarily through

:09:36. > :09:41.good reasons. What I'd really like to talk about is how when he was

:09:42. > :09:47.first diagnosed, my oncology and all the treatment I had for my cancer

:09:48. > :09:52.was clockwork, it was precision, everything, I felt incredibly safe.

:09:53. > :09:57.I felt really well looked after and I would like to say a big thank you

:09:58. > :10:04.to all the NHS staff for saving my life, bless you, I'm very grateful.

:10:05. > :10:14.Subsequently I have had a lot of post-treatment and things that led

:10:15. > :10:20.me to access the NHS via A Most notably probably a problem with my

:10:21. > :10:25.arm which led to me getting sepsis, so it was an urgent case. I saw

:10:26. > :10:31.people in A who, I saw during my time as a cancer patient, and they

:10:32. > :10:34.were within an inch of their life. They were spread to, I mean,

:10:35. > :10:38.thousands of people, it seemed like, you know, I was lying in a bed

:10:39. > :10:43.really poorly. And everyone was doing everything they could to help,

:10:44. > :10:48.but it was just chaos. So you have huge, you are hugely grateful to the

:10:49. > :10:53.NHS and you have huge sympathy for what you see as overstretched staff?

:10:54. > :10:58.Absolutely. Do you support doctors striking for five days at a time

:10:59. > :11:02.over the next few months? I do. I think to take such action, I really

:11:03. > :11:06.believe these people. I know them intimately. I don't believe that

:11:07. > :11:11.they would be doing this unless they had to. I personally have got a lot

:11:12. > :11:17.of experience, I am a campaigner for the NHS and I speak to sorry...

:11:18. > :11:21.Don't you worry about safety to patients in those five days? That's

:11:22. > :11:25.why next week's was called off because it was too short notice said

:11:26. > :11:34.various regulators and the GMC are saying look, this could be harmful?

:11:35. > :11:37.Yes and no, but I really believe there, I think, the seniors will

:11:38. > :11:42.come out and support them. I am in contact with a lot of medical people

:11:43. > :11:47.at a senior level who I have talked to in in-depth about this. I'm no

:11:48. > :11:52.politicianks and I don't know the details of the contract, but I trust

:11:53. > :11:56.what I'm hearing from senior doctors, registrars, consultants,

:11:57. > :11:58.they are fully behind their junior doctors, and I believe that they

:11:59. > :12:02.will support the junior doctors during that period. Of course, there

:12:03. > :12:06.will be operations cancelled. I don't believe they would be doing

:12:07. > :12:12.this unless they had to. I fully support them. All right.

:12:13. > :12:17.APPLAUSE Dr Jeeves Wijesuriya is here. You

:12:18. > :12:20.wanted to come in here. Thank you for your story and thank you for

:12:21. > :12:24.your support. We really appreciate it. We talked briefly about patient

:12:25. > :12:28.safety and we talked about the recent set of strikes being

:12:29. > :12:31.suspended. Firstly, I want to say that the reason that's happened is

:12:32. > :12:36.because patient safety remains our priority. Our goal is not an

:12:37. > :12:41.industrial action. Our goal is a negotiated settlement. The reality

:12:42. > :12:50.is, when we set out these plans, we gave the notice period that's

:12:51. > :12:53.required, but ultimately we have a escalation protocol for that reason

:12:54. > :12:56.so if trusts are struggling to provide the coverage during that

:12:57. > :13:00.period of time, of course, we are going to step back. That's a

:13:01. > :13:04.priority for us. So that, so you could step back from the five day

:13:05. > :13:08.strike in October, November and December then, over patient safety

:13:09. > :13:13.concerns? If there is a concern about patient safety during that

:13:14. > :13:17.time, raised by Trusts, we have a process for that, but from what we

:13:18. > :13:27.know in the action we have taken, our consultant colleagues are there,

:13:28. > :13:29.our associated specialist, other professionals, pharmacists and

:13:30. > :13:32.nurses, junior doctors will spend this month working with their

:13:33. > :13:37.colleagues to ensure that the coverage during that time is

:13:38. > :13:40.adequate. It is interesting to hear you say if those concerns about

:13:41. > :13:44.patient safety are raised again, you will step back again. We have a

:13:45. > :13:48.process. The really important thing is, the best case scenarios, we have

:13:49. > :13:51.a month to stop this happening in the first place. We have a month for

:13:52. > :13:54.Jeremy Hunt... APPLAUSE

:13:55. > :13:58.We have a month for Jeremy Hunt to say, "You know what, the BMA have

:13:59. > :14:03.listened to experts and professionals and they have put

:14:04. > :14:06.safety first." Surely it is time for me to say I'm not going to impose a

:14:07. > :14:10.contract that makes a lot of the problems we have with services

:14:11. > :14:17.overstretched and not enough staff even worse. Good morning? I'm Fay. I

:14:18. > :14:21.am a patient in the NHS. I'm currently under going care and I'm

:14:22. > :14:27.waiting for more tests and possible treatment. And I know that this, if

:14:28. > :14:33.industrial action does take place then my care could be disrupted and

:14:34. > :14:37.I'm really very worried. I have been waiting a long time for the tests

:14:38. > :14:43.that I need to have and this could make it even longer. However, I have

:14:44. > :14:47.listened to what junior doctors have had to say and when I speak to my

:14:48. > :14:50.doctor, who recommends treatment for me, there is always risks with the

:14:51. > :14:54.treatment. So they always say well, if you take this medicine and there

:14:55. > :14:58.could be these complications, but we think that it is right for you to

:14:59. > :15:02.take it because the benefits outweigh the risks and doctors make

:15:03. > :15:07.those decisions every day for us. We trust them to make those decisions.

:15:08. > :15:11.They're trained to make those decisions to do risk analysis and I

:15:12. > :15:16.hear that what the doctors have done now is that they have said to us,

:15:17. > :15:21.very clearly, we have done a risk analysis and this, the imposition of

:15:22. > :15:25.this contract is more dangerous for you for your health, for my health,

:15:26. > :15:30.it is more dangerous for my health for this contract to be imposed than

:15:31. > :15:37.for me to have a delay in my treatment due to the strike.

:15:38. > :15:44.I can hear the anxiety in your voice about waiting for those test

:15:45. > :15:50.results. When you explained to your consultant that you are supporting

:15:51. > :15:59.the junior doctors, what is the response? They are happy that I

:16:00. > :16:03.support them, that I trust them as professionals who have been trained

:16:04. > :16:08.to care for me and my family and the health of everyone in this country,

:16:09. > :16:11.and they are happy I am trusting them to tell me what the right thing

:16:12. > :16:19.for my health and all of our health is. Hello. Thank you for inviting

:16:20. > :16:27.me, I am a patient advocate and I run an organisation which runs an

:16:28. > :16:31.online peer support group for people with diabetes. Tens of thousands of

:16:32. > :16:36.people take over -- take part in our activities. I understand the plight

:16:37. > :16:43.of the junior doctors, but I cannot support five-day strike or strike

:16:44. > :16:47.action by doctors and the NHS. I understand their position and I

:16:48. > :16:51.totally support the issues and the fundamental issues appear to be much

:16:52. > :16:56.more about resource constraints within the NHS and trying to deliver

:16:57. > :17:02.a seven-day service with five days of money and trying to deliver a

:17:03. > :17:07.system that was built at a time when the budget and institutions which

:17:08. > :17:12.are still delivering it worth it for purpose. I will call on any junior

:17:13. > :17:20.doctor here to talk to Paul. Let's have a junior doctor. Janice. Pass

:17:21. > :17:26.the microphone forward. Junior doctor, and a gentleman who runs...

:17:27. > :17:30.I completely disagree with the Government stance on this. Not only

:17:31. > :17:34.has Jeremy Hunt lost the confidence of the doctors, if you were to do a

:17:35. > :17:40.poll of patients, he would not have the support of patients either. Who

:17:41. > :17:44.is he representing? The issue that has been raised about patient safety

:17:45. > :17:49.is the thing that is paramount to me. I have a lifelong chronic

:17:50. > :17:56.condition, I am reliant on the NHS for the rest of my life, so I do not

:17:57. > :18:05.just dip in and be proud. -- dip out. You are not sure about the

:18:06. > :18:08.five-day strikes, you were supporting them earlier in the year,

:18:09. > :18:16.but now things have changed. You would say, don't do it? Definitely

:18:17. > :18:18.not. I would like to ask the BMA and the Government, both sides are

:18:19. > :18:25.claiming that this is about patient safety, where is the patient voice?

:18:26. > :18:30.In none of this debate for the last two years has any panel of patients

:18:31. > :18:35.been brought together representing any area of patient concern. What we

:18:36. > :18:40.have our professionals on both sides of the fence pointing fingers at

:18:41. > :18:43.each other and it has boiled down to a dispute about contract terms and

:18:44. > :18:49.conditions and it has been escalated into one of patient safety. Who did

:18:50. > :18:53.the BMA talk to, which patient groups? The Government have not

:18:54. > :18:59.spoken to a single patient organisation. When the patients get

:19:00. > :19:03.a voice? A quick response. I agree. It needs to be part of what we do

:19:04. > :19:09.going forward. Why have you not so far? It has been a contract dispute

:19:10. > :19:16.between us and the people looking to impose it. I am being briefed

:19:17. > :19:21.because we are galloping towards the end of the programme. What we have

:19:22. > :19:28.heard today is their are a lot of issues, a contract dispute but many

:19:29. > :19:31.other issues. Should we put the NHS through the biggest strike in its

:19:32. > :19:36.history about those contract issues? It does not seem to be the right

:19:37. > :19:41.response. I would respectfully ask... I have the support of most of

:19:42. > :19:54.the people in this room for our current Health Secretary to resign.

:19:55. > :19:59.I totally agree with you that whilst I contend that it is between the

:20:00. > :20:03.junior doctors, the Government, I get that, but if we could get a

:20:04. > :20:09.patient voice in their from the people who are experiencing a really

:20:10. > :20:13.challenge NHS, we would keep the support for the junior doctors, and

:20:14. > :20:19.hopefully they would not have to strike. There is a chance for the

:20:20. > :20:25.Government to grab this by the horns with the new Prime Minister and do

:20:26. > :20:30.something substantive, to review what we mean about health care

:20:31. > :20:32.delivery for the millennial generation and reframe the debate

:20:33. > :20:37.about the needs of patients for the next hundred years, not just the

:20:38. > :20:44.needs of junior doctors for the next ten. The point you raise about the

:20:45. > :20:50.need to engage patients is important, and I think... You

:20:51. > :21:02.haven't done it. I don't work for the Department of Health. As Hugh

:21:03. > :21:03.referred to earlier, the Conservative manifesto clearly

:21:04. > :21:08.committed us to introducing a seven-day NHS, this was not

:21:09. > :21:14.something hidden away towards the back, it was line one of page one of

:21:15. > :21:22.the manifesto, not about the economy or Europe. I don't believe that the

:21:23. > :21:25.junior doctors on the BMA would have recommended a deal in May that they

:21:26. > :21:31.thought was going to damage patient safety. Because it doesn't. It

:21:32. > :21:35.reduces maximum working hours, it restricts the number of night

:21:36. > :21:47.shifts, it restricts the number of longer shifts. This will make things

:21:48. > :21:50.safer for patients. Can I just clarify a misconception that has

:21:51. > :21:58.been repeated several times today. There was a point at which we said,

:21:59. > :22:00.we believe we have made progress. The junior doctors committee, the

:22:01. > :22:04.people that represent the junior doctors, did not give a view. They

:22:05. > :22:09.said they would stay neutral, because the decision was always

:22:10. > :22:15.going to be that of junior doctors, who were informed to make an

:22:16. > :22:26.educated decision. I am a patient, but I work a lot with the NHS, the

:22:27. > :22:30.third sector. The debate has become polarised. I was supportive of the

:22:31. > :22:33.junior doctors and I signed the petition for it to go to Government

:22:34. > :22:40.earlier on in the year. But I am uncomfortable with this five

:22:41. > :22:46.consecutive days, 50,000 doctors withdrawing their services. My

:22:47. > :22:56.father was a GP. He was by those with cancer and died three months

:22:57. > :23:00.later from his diagnosis. You think the five-day plan is

:23:01. > :23:06.disproportionate? Yes. That is what I am worried about. You have people

:23:07. > :23:12.waiting for important results. What worries me is, we covered earlier

:23:13. > :23:18.on, what are the key issues in this contract? It worries me that when we

:23:19. > :23:22.start moving the debate onto other things other than resolving that...

:23:23. > :23:28.We need to move this forward, and we need to get patients in the room. So

:23:29. > :23:34.it focuses people's minds, the Government and the BMA. We are still

:23:35. > :23:38.waiting for the BMA and Jeremy Hunt to answer our open letter that we

:23:39. > :23:44.signed, a group of patients, as we want to see an end of this. The NHS

:23:45. > :23:49.is already crippled. We will talk about how people here think this

:23:50. > :23:54.dispute might be resolved. Before that, we have talked about the

:23:55. > :23:56.five-day strikes that are due in October, November and December, here

:23:57. > :23:58.are the contingency plans that are in place for the strikes if they go

:23:59. > :24:13.ahead. A five-day strike has

:24:14. > :24:15.never happened before. But, across the three planned this

:24:16. > :24:18.year in England, the Government calculates that 75,000 operations

:24:19. > :24:20.and 750,000 hospital appointments could be postponed as a result,

:24:21. > :24:22.with nonemergency surgery, such as hip replacements and back

:24:23. > :24:24.operations, worst affected. This could mean an increasing number

:24:25. > :24:27.of people fail to have their routine operation within 18 weeks,

:24:28. > :24:29.causing them further discomfort and placing added pressure on an NHS

:24:30. > :24:32.target that is already being missed. Hospitals have, however,

:24:33. > :24:34.been ordered to ensure that most essential services such as A

:24:35. > :24:37.and maternity wards are well They've been told to draft

:24:38. > :24:42.in consultants and other senior doctors in place

:24:43. > :24:45.of the junior doctors. These services reportedly ran

:24:46. > :24:49.smoothly in the last set of strikes, but there have been concerns that,

:24:50. > :24:52.with the NHS traditionally being stretched over the winter months,

:24:53. > :24:55.the next three strikes Striking doctors, however,

:24:56. > :24:59.will return to work if their employers become concerned

:25:00. > :25:03.for patient safety - an option not used in the last

:25:04. > :25:16.set of strikes. The dispute is in England only,

:25:17. > :25:20.Scotland and Wales have both said they will stick to their existing

:25:21. > :25:30.contracts, while Northern Ireland has yet to make a decision.

:25:31. > :25:32.Dr Jeeves Wijesuriya, who is on the junior

:25:33. > :25:34.doctors committee at the British Medical Association.

:25:35. > :25:35.The BMA is the union for healthcare professionals,

:25:36. > :25:39.Mike Wood is Conservative MP for Dudley South.

:25:40. > :25:42.He says the Government has no choice but to impose

:25:43. > :25:44.new contracts for junior doctors after negotiations failed.

:25:45. > :25:46.Also with us, Professor Neena Modi, who is the president

:25:47. > :25:48.of the Royal College of Paediatrics and Child Health, which

:25:49. > :25:52.And Andrew Haldenby is the director of Reform, a centre-right

:25:53. > :26:06.Will the contingency plans be good enough? Having participated in the

:26:07. > :26:09.previous emergency walk-out, during which my service was covered by my

:26:10. > :26:14.consultant, who stepped in to support us in our action, they

:26:15. > :26:18.provided an excellent service for the children who were sick in my

:26:19. > :26:23.hospital during that time. Can the same be done over five days? I was

:26:24. > :26:29.not confident about next week, but with more planning it could be. In

:26:30. > :26:32.the last set of emergency walk-out there was not one single clinical

:26:33. > :26:38.incident reported in the whole country where patients were put at

:26:39. > :26:42.risk. When you hear about people making the accusation that we are

:26:43. > :26:48.being dangerous, it is a myth. We don't know over five days. We have a

:26:49. > :26:54.responsibility, we are working for the GMC, we have a duty of care for

:26:55. > :27:00.patients, even when we are striking, and we have to be confident that our

:27:01. > :27:04.seniors will support us. If it happened that you were on the picket

:27:05. > :27:09.line during the five days and one of your colleagues ran out and said, we

:27:10. > :27:14.need you now... We would go in, of course we could. I have to bring you

:27:15. > :27:30.back to the point that the NHS as it stands is not safe. People argue

:27:31. > :27:32.about that. Two children's A services have closed recently, 1000

:27:33. > :27:38.babies transferred because of lack of capacity, further cuts to the

:27:39. > :27:42.ability of health education England to commission more training places,

:27:43. > :27:47.so there will be an even greater fall in junior doctor numbers, we

:27:48. > :27:50.have a shortage of 1000 paediatric consultants, we have had cuts to

:27:51. > :27:57.Public Health England, we have an increasing burden of chronic

:27:58. > :28:00.diseases in children. The NHS is creaking at the seams, it is not

:28:01. > :28:05.safe at the moment, it is really tragic that it has taken strikes

:28:06. > :28:12.which nobody wants to draw attention to this. But at the least, let's say

:28:13. > :28:17.that if the public debate and she's, which addresses the current

:28:18. > :28:23.shortfalls, the current lack of patient safety, that at least will

:28:24. > :28:27.be a good thing. The contract dispute and some of the specifics we

:28:28. > :28:31.heard earlier is useful, you think, as a way of drawing in other issues?

:28:32. > :28:37.I would not have wished it to happen this way. But now that we are where

:28:38. > :28:43.we are, it has been heart-warming to hear from colleagues in this room,

:28:44. > :28:52.particularly outpatient colleagues, about what it means to be a patient

:28:53. > :28:56.in the NHS. When we are talking about publics and they, the public

:28:57. > :29:00.is always going to be on the side of the doctors. These are people who

:29:01. > :29:04.have dedicated themselves to the service of humanity, making sure we

:29:05. > :29:10.live as comfortable as possible. Me and my sister play sport, we always

:29:11. > :29:14.have injuries and bruises. Each time I have gone to the hospital, I have

:29:15. > :29:18.had wonderful treatment and I have come back home safely. I don't like

:29:19. > :29:25.that doctors are being pushed to the limit of their safe procedures. As a

:29:26. > :29:30.person that uses the NHS frequently, this is terrible to imagine. I hope

:29:31. > :29:35.Jeremy Hunt has a serious think about what he is doing. Let me read

:29:36. > :29:42.some more messages from people watching. Ali says, I am due to go

:29:43. > :29:52.into hospital for a hip replacement soon. The sixth in five years. I

:29:53. > :29:58.hope you are all right! I am sitting here with a fractured femur. I am in

:29:59. > :30:03.great pain, but I am 100% supportive of the junior doctors. This message,

:30:04. > :30:07.why do doctors have the right to pick and choose which shifts they

:30:08. > :30:14.wish to work's no other emergency services have that right. We require

:30:15. > :30:20.306 to five day, 24 hour working by the well-paid professionals, they

:30:21. > :30:24.knew what they were signing up for. Jenny says, last September I had

:30:25. > :30:29.four disks prolapse from my neck down to my lower spine. I could not

:30:30. > :30:36.walk Drive, shower or leave the house. I am 35, I had to wait until

:30:37. > :30:40.January the 3rd to have an MRI you, which took place in the private

:30:41. > :30:45.hospital, as the NHS could not provide the service. I had to wait

:30:46. > :30:52.to consultant specialist. I have no intervention other than pain

:30:53. > :30:56.medication. I have no life. Fix the five-day service, fund a five-day

:30:57. > :31:06.service, and focus on providing an outstanding five-day service.

:31:07. > :31:12.Junior doctors, I full support you, but I think you got it.

:31:13. > :31:15.In the next half hour, we'll look at the current state

:31:16. > :31:18.of the NHS, but first, let's get a summary of all

:31:19. > :31:25.The chairman of the troubled Southern Health NHS Foundation Trust

:31:26. > :31:29.has defended the decision to create a new post on the same

:31:30. > :31:32.for the Trust's chief executive after she quit in the wake

:31:33. > :31:35.Katrina Percy had faced multiple calls to resign over her Trust's

:31:36. > :31:38.failure to investigate hundreds of deaths.

:31:39. > :31:43.Now the BBC has learned that her new ?240,000 a year job

:31:44. > :31:45.didn't exist previously and she was the only

:31:46. > :31:51.The Trust's chairman Tim Smart says the job needed doing and that

:31:52. > :31:57.Ms Percy was "uniquely qualified" to carry it out.

:31:58. > :32:00.Passengers on one of Britain's busiest rail lines face more delays

:32:01. > :32:03.today in the latest 48-hour strike by on board guards Southern trains

:32:04. > :32:06.are in the middle of a bitter dispute with the RMT union over

:32:07. > :32:08.who should close the doors on their trains.

:32:09. > :32:13.40% of services won't run during the strike.

:32:14. > :32:16.The UK and Australia are to open preliminary

:32:17. > :32:19.negotiations about a future post-Brexit trade agreement.

:32:20. > :32:22.Officials from the two countries are to meet twice a year to discuss

:32:23. > :32:27.But Australia has warned that formal negotiations can't start

:32:28. > :32:30.until the UK leaves the EU and that it would be at least

:32:31. > :32:43.two-and-a-half years before any agreement could be finalised.

:32:44. > :32:52.Junior doctors have been telling this programme why there is so much

:32:53. > :32:55.anger about the Government trying to impose the crew contract. 15 days of

:32:56. > :32:59.strike action are planned from October. Doctors and those in the

:33:00. > :33:03.medical profession have been telling this programme why they feel so

:33:04. > :33:06.strongly about the strike. You blame the BMA. I don't think they have

:33:07. > :33:10.played their cards particularly right. They could have done better.

:33:11. > :33:13.But I blame Jeremy Hunt. Jeremy Hunt back off. Just leave us

:33:14. > :33:19.APPLAUSE Leave us alone. The thing that

:33:20. > :33:24.really worries me. If the NHS is already crippled, if it is already

:33:25. > :33:29.on its knees, how is the NHS going to be further enhanced by the junior

:33:30. > :33:34.doctors going on strike? Radical preacher Anjem Choudhary

:33:35. > :33:36.is today starting a five-and-a half year jail sentence for inviting

:33:37. > :33:38.support for Islamic State. But how should prisons deal

:33:39. > :33:40.with someone like him? Is it possible to

:33:41. > :33:43.change their views? Secunder Kermani has been speaking

:33:44. > :33:46.to one of Choudhary's high profile former supporters who now, thanks

:33:47. > :34:02.to the work of a de-radicalisation These two men know Anjem Choudhary

:34:03. > :34:11.and his circle like few others. This man used to be one of his followers.

:34:12. > :34:14.That changed after he met a trainer who deradical isz extremists

:34:15. > :34:23.including successfully reforming half a dozen of Anjem Choudhary

:34:24. > :34:28.supporters. Jammal had been part of a group calling themselves Muslim

:34:29. > :34:39.Patrol who claim to be enforcing Sharia rules in London. For that, he

:34:40. > :34:44.spent nearly two years in prison. Since Choudhary's conics, it has

:34:45. > :34:48.been announced the prison regime is changing. Extremists will be split

:34:49. > :34:54.from the general population, but will it work? What they need to have

:34:55. > :34:58.inside the prison are people who are able to challenge when the beliefs

:34:59. > :35:04.arise within the discussions. They need to have people capable of

:35:05. > :35:09.challenging them. And are there enough people there? There needs to

:35:10. > :35:15.be more. Isolating them will not do anything. These individuals one day

:35:16. > :35:21.have to be released. They are not individuals who will spend the rest

:35:22. > :35:27.of their life in prison. It is full of challenges. What could end up is

:35:28. > :35:33.him validating himself and mutating into some type of authority within

:35:34. > :35:38.that system because the prison sentence gives him his stripes.

:35:39. > :35:49.REPORTER: Improves his credibility? Yeah. This man has had more success.

:35:50. > :35:55.How does he get through to them? We're sitting with them. We look at

:35:56. > :36:00.their perception. Islam was traditionally an oral tradition.

:36:01. > :36:08.Yeah, it is about sitting with a teacher who then looks at the

:36:09. > :36:13.textbook and explains what it means. He doesn't just debate ideology, he

:36:14. > :36:20.forms a strong personal connection. For him to, you know, be concerned

:36:21. > :36:23.on a personal level, not just an intellectual level, it was never

:36:24. > :36:27.that discussion to start off with. It is to say we are humans and I

:36:28. > :36:32.care for you as a human being, to take away that divide that existed

:36:33. > :36:41.that us and them that existed and to replace with a xlective

:36:42. > :36:48.understanding. Many de-radicalisation attempts in jail

:36:49. > :36:56.fail. The current way of dealing or trying to deal with this Islam

:36:57. > :37:03.fascist ideology is coming in with your own lit tral interpretation. So

:37:04. > :37:07.we've got a literal interpretation versus a literal interpretation. So

:37:08. > :37:12.you're basically singing off the same hymn sheet except it is a few

:37:13. > :37:18.degrees down. And what happens with this is that the individual will sit

:37:19. > :37:23.there, nod his head, and then as soon as he is at the end of his

:37:24. > :37:28.licence, he is back in the community, back it his old tricks,

:37:29. > :37:34.criticising what he has just been through. They think it is possible

:37:35. > :37:38.Anjem Choudhary could reconsider his beliefs in prison, but in the

:37:39. > :37:39.meantime, they're dealing with the legacy of his influence in the

:37:40. > :37:49.outside world. After scoring on his debut

:37:50. > :37:53.for Manchester United last season AND on his first senior

:37:54. > :37:55.England appearance too, Marcus Rashford makes it three out

:37:56. > :37:59.of three with goals on his first His hat-trick against Norway helped

:38:00. > :38:07.England to a 6-1 win in their European

:38:08. > :38:10.Championship qualifier. Novak Djokovic has reached

:38:11. > :38:16.the semi-finals of the US Open But for the third time in this

:38:17. > :38:22.year's tournament he didn't have Jo Wilfried Tsonga was two sets down

:38:23. > :38:26.when following treatment on a knee Tyson Fury and Wladimir Klitschko

:38:27. > :38:29.have rescheduled their world It'll now take place on 29th October

:38:30. > :38:37.in Manchester after the original date was scrapped because of

:38:38. > :38:40.an injury to the British fighter. Fury won the WBA, WBO AND IBF titles

:38:41. > :38:43.from the Ukrainian in their And after a vote by his teammates,

:38:44. > :38:51.ten-time Paralympic champion Lee Pearson will carry the flag

:38:52. > :38:53.at tonight's opening It'll kick off 11 days

:38:54. > :38:59.of action in Rio. More sport later. Now back to

:39:00. > :39:20.Victoria. We have got people with passionate

:39:21. > :39:24.views about the junior doctors contract dispute and the forthcoming

:39:25. > :39:29.strikes. You know the one next week has been called off. Strikes are due

:39:30. > :39:34.in October, November and December, but as the BMA junior doctors

:39:35. > :39:39.representative told us, they could be cancelled once your process has

:39:40. > :39:50.been gone through if I understood you correctly. An anonymous text, "I

:39:51. > :39:54.am watching from my hospital bed. I can't fault my treatment over the

:39:55. > :39:58.last eight years. I'm concerned about Jeremy Hunt's motives and I

:39:59. > :40:05.feel he is using the junior doctors as pawns in his long-term plans for

:40:06. > :40:08.the NHS." Chris says, "As a former soldier I'm disgusted. In the junior

:40:09. > :40:11.doctors willingness to hold the country to ransom. It is the Armed

:40:12. > :40:15.Forces that covered the backs of those that have gone on strike in

:40:16. > :40:20.the past ie firemen, etcetera. We can't strike and we get paid only a

:40:21. > :40:26.small fraction of the salaries of those that do. You're losing support

:40:27. > :40:30.for your cause now. It is time to enact your oath and your obligations

:40:31. > :40:35.to your public." Let's talk to Hugh Pym about pay. I

:40:36. > :40:39.read the junior doctors draft contract. It is very long. Lots of

:40:40. > :40:44.it, I didn't understand. I did understand there is a basic pay rise

:40:45. > :40:49.of 10% to 11% and if you end up working one weekend in two you will

:40:50. > :40:55.get 10% of your basic salary as a supplement and if you work one in

:40:56. > :40:58.four, it reduces. Is that accurate? Victoria, I commend you for reading

:40:59. > :41:03.the contract! It is a highly complex document. You have possibly read

:41:04. > :41:07.more of it than I have! But the essence of it is and this is what

:41:08. > :41:11.this debate and this dispute has been about is how you reward doctors

:41:12. > :41:17.financially for working very unsocial hours and lots of different

:41:18. > :41:23.weekends. And what's been the aim of the Government is to raise basic pay

:41:24. > :41:27.by about 11% and in return, you cut the extra that was being paid out

:41:28. > :41:32.for working unsocial hours. I think the BMA accepted it was worth

:41:33. > :41:38.looking at this because it had become so complicated, but the deal

:41:39. > :41:41.that was reached, and it remains pretty complicated, clearly 58% of

:41:42. > :41:44.doctors out there didn't feel that it met their concerns. Now, some

:41:45. > :41:48.people out there are saying, "We work at weekends. We don't get paid

:41:49. > :41:52.extra." What doctors would say, they work a lot of unsocial hours and why

:41:53. > :41:55.do they have to sacrifice something financially because there maybe some

:41:56. > :41:59.at the margins who lose out short-term when we work so hard. The

:42:00. > :42:03.bigger picture is this business of recruitment and retention. Do you

:42:04. > :42:09.risk losing doctors longer term if you don't get that balance right at

:42:10. > :42:16.this precise moment in time? OK. Hands shot up then! Pass the

:42:17. > :42:21.microphone over here. Hi. Hi. My name is Maria. I'm a senior nurse. I

:42:22. > :42:24.supported junior doctors through the industrial action last year and I

:42:25. > :42:28.will continue to support them. What I found throughout is doctors are

:42:29. > :42:32.really reluctant to complain about being poorly paid. They're really

:42:33. > :42:36.reluctant to ask for more money. Are they poorly paid do you believe? I'm

:42:37. > :42:41.not saying they are poorly paid, but they are not well paid. They are in

:42:42. > :42:46.no way on par with their colleagues in the City. A few years ago, we had

:42:47. > :42:51.we have to give the bankers their bonus because we don't want to lose

:42:52. > :42:54.the expertise, we are happy to haemorrhage our well trained doctors

:42:55. > :43:00.out of this country. I think it is a disgrace. It wasn't just in the last

:43:01. > :43:04.few years that MPs had been 11% pay rise each year consecutively while

:43:05. > :43:08.we nurses and doctors have actually had pay cuts because we have not

:43:09. > :43:15.even had the percentage with inflation. So I think it is really

:43:16. > :43:19.double standards. Can I ask our representative from the junior

:43:20. > :43:25.committee on the BMA. It is a basic pay rise of 10% to 11% and if you

:43:26. > :43:30.work one in two weekends, 10% of your basic salary on top. Let's just

:43:31. > :43:33.talk about percentage terms. I know there are 100 other issues, what

:43:34. > :43:38.increase do you think would satisfy your members? So, firstly, when

:43:39. > :43:41.we're talking about an increase, it is one way of looking at it. The

:43:42. > :43:44.problem that we have is... Please just answer the question and then

:43:45. > :43:47.you can tell us about problems. This does answer the question.

:43:48. > :43:52.Ultimately, what we have right now and we've talked about today is that

:43:53. > :43:56.we have a huge staffing problem. We have services that are already in

:43:57. > :43:59.one in seven trusts closing down services or cutting them short

:44:00. > :44:04.because we don't have the staff to provide them. The areas that we're

:44:05. > :44:06.seeing that the most in, emergency services, children's doctors, these

:44:07. > :44:10.are the groups that work the most anti-social hours. What these

:44:11. > :44:15.changes mask actually is the people that do work those most anti-social

:44:16. > :44:19.hours are the ones that see a decease in pay. They don't see the

:44:20. > :44:22.increase. That worsens the recruitment crisis and what is

:44:23. > :44:26.counter-intuitive is Mr Hunt has been talking about a seven day

:44:27. > :44:30.service. I'm going to bring you back. What percentage increase would

:44:31. > :44:35.satisfy your colleagues, do you believe? We need to talk about the

:44:36. > :44:39.distribution. I'm asking you a really sensible question... I can't

:44:40. > :44:44.give you an exact percentage because we need to look at those specific

:44:45. > :44:54.areas and speak to the Government about how they intend to fund them.

:44:55. > :44:57.Jeremy Hunt has not produced a plan. Something we have asked for over a

:44:58. > :45:04.yearment we are talking about a plan that no one has seen. There is a man

:45:05. > :45:10.from a Thing tank who is rubbing his chin. Explain why.

:45:11. > :45:16.We have been in a pay dispute for two years, one side cannot even tell

:45:17. > :45:24.us what they would like to settle the dispute. All I want is a

:45:25. > :45:29.percentage, a figure, that you think would be acceptable in terms of

:45:30. > :45:34.either the basic pay going up or the supplement for weekend working. Can

:45:35. > :45:41.you give me a figure? It is not about a percentage. I just want to

:45:42. > :45:46.keep the same salary I have, I don't want a pay cut or a rise, I just

:45:47. > :45:50.want to stay the same. What percentage increase would you need

:45:51. > :45:56.with this contract to bring it back to what you say you have now? My

:45:57. > :46:02.basic salary is ?36,000 plus a 50% banding. Whatever it is that they

:46:03. > :46:05.need to calculate to make sure I can get the same take-home pay. Some

:46:06. > :46:12.sort of increased to match what you get now? OK. Whatever we have now.

:46:13. > :46:19.Just leave us alone, give us the same contract we have already. With

:46:20. > :46:23.the new contract, without the pay protection that is being put in

:46:24. > :46:35.place, I would take a pay cut from the new contract for the same hours.

:46:36. > :46:45.By what percentage? I think it is about ?300 a month. I know you don't

:46:46. > :46:48.like the question, so respond. It is illegitimate question when you think

:46:49. > :46:55.about pay in general and giving a simple answer -- a legitimate. There

:46:56. > :47:00.is a flexible pay premium watch the Government have to put in place to

:47:01. > :47:06.ensure that I as a trainee, who work all day, every night, two weekends

:47:07. > :47:09.every month, the premium can be taken away by the Government

:47:10. > :47:14.whenever it wants just to ensure I get paid the same as any other

:47:15. > :47:20.doctor working in the NHS. That this incentivises people from working

:47:21. > :47:30.they don't have any doctors left, I get e-mails everyday to fill in

:47:31. > :47:33.ready gaps. Introduce yourself. You are a trainee medic. If this

:47:34. > :47:42.contract is brought in, what will happen? I am a final year medical

:47:43. > :47:48.student. How do you feel about going into this profession? Very worried.

:47:49. > :47:54.My colleagues are concerned as well. Already, we can see that the amount

:47:55. > :48:00.of medical students coming in has dropped by 20%. We don't know if

:48:01. > :48:07.that is related to this dispute. I think a lot of it is. As the

:48:08. > :48:11.professor said earlier, there is a shortage of doctors, and if this

:48:12. > :48:15.contract is making fewer prospective students joined the field, that is

:48:16. > :48:21.really dangerous. A lot of the students are sitting exams to go to

:48:22. > :48:28.America or Australia or Canada. If you think that doctors are paid well

:48:29. > :48:37.here, they are not all stop --. ?23,000. That is the basic starting

:48:38. > :48:39.salary. We will talk about how people here think this dispute could

:48:40. > :48:45.be resolved, if they think it can be. It has got to be resolved at

:48:46. > :48:49.some point. The man on behalf of service across the UK is rising, so

:48:50. > :49:05.our costs, which is why the stakes could not be higher.

:49:06. > :49:07.The latest dispute between junior doctors and the Government

:49:08. > :49:10.comes at a difficult time for the NHS in England.

:49:11. > :49:12.NHS England needs to find ?22 billion in annual

:49:13. > :49:17.Added to that, ministers want to extend services at weekends,

:49:18. > :49:19.which puts pressure on the existing challenges already facing the NHS,

:49:20. > :49:21.not just in England, but across the country.

:49:22. > :49:26.After the vote in June, health leaders warned that

:49:27. > :49:27.leaving the EU could make staffing shortages worse.

:49:28. > :49:31.The NHS Confederation said 10% of NHS doctors come from the EU.

:49:32. > :49:36.People are living longer, putting further pressure on the service.

:49:37. > :49:39.The growing number of elderly people means more patients

:49:40. > :49:44.Up to two thirds of hospital beds are estimated to be occupied

:49:45. > :49:52.Changes in what can and can't be done medically has

:49:53. > :49:55.revolutionised care, but it comes at a cost.

:49:56. > :49:57.Treating survivors of medical conditions that in the past

:49:58. > :50:00.might have killed them requires extra money.

:50:01. > :50:03.Paying for progress in medical technology costs the NHS

:50:04. > :50:10.People may be smoking less, but they are drinking more

:50:11. > :50:15.The bill for dealing with alcohol abuse is around ?3 billion per year.

:50:16. > :50:18.Despite campaigns to get people to live healthier, the number

:50:19. > :50:22.of obese people in Britain could double in the next 40 years.

:50:23. > :50:25.So demand on the health service across the UK is rising,

:50:26. > :50:28.and so are the costs, which is why the stakes

:50:29. > :50:30.in the ongoing dispute with the junior doctors

:50:31. > :50:46.Let's hear from more in our audience, talking about how this

:50:47. > :50:51.could get resolved. I am a third-year medical student. Having

:50:52. > :50:56.been in medical school for three years, my degree will be for six

:50:57. > :51:01.years, I think this contract makes me incredibly sad that I will not be

:51:02. > :51:04.doing what I love, I don't think. Purely because it is making me think

:51:05. > :51:10.about either leaving medicine or going to a different country. It

:51:11. > :51:15.saddens me because I value the NHS, I was not born here, but coming to

:51:16. > :51:22.England, this wonderful NHS and everything, it works. I will not be

:51:23. > :51:25.able to be part of it. I don't want this contract to be imposed and I am

:51:26. > :51:33.not happy with it. Let's talk about this dispute. How people think it

:51:34. > :51:38.could be resolved. I am from a campaigning organisation, which has

:51:39. > :51:44.local branches all over the country. I wanted to say that in 2007 our

:51:45. > :51:48.health service was funded to the same proportion of GDP as other

:51:49. > :51:55.European countries, and it has been steadily falling since then. 1% of

:51:56. > :51:59.GDP amounts to ?20 billion will stop if we were funded at the same level

:52:00. > :52:05.as France, we would have 40 billion more, Germany 60 billion more, per

:52:06. > :52:11.year. That has been taken out of the budget so far by cutting the wages

:52:12. > :52:16.of NHS staff, not just junior doctors. Keeping them down to the

:52:17. > :52:21.low -- below levels of inflation. But they have been cut to the limit.

:52:22. > :52:25.What is coming next big cuts in services, and they will be announced

:52:26. > :52:31.in the autumn. I think Jeremy Hunt is using Jeremy -- junior doctors as

:52:32. > :52:36.a shield to protect him against the flak that will fly as soon as people

:52:37. > :52:39.know that their local A will be closed, their local maternity ward

:52:40. > :52:44.will be closed, and they will have to travel much further to get

:52:45. > :52:50.treatment. We will see what happens. How can this be resolved? I am a

:52:51. > :52:55.freelance journalist. I want to look at resolution in two ways. It is

:52:56. > :53:01.difficult in the short-term if you SSP strike is a strategy, to see how

:53:02. > :53:05.it can work. The NHS is political, Jeremy Hunt cannot back off, it is

:53:06. > :53:08.Government run, and by increasing the political pressure on the

:53:09. > :53:15.Government, you give them less room to manoeuvre, and it is a political

:53:16. > :53:20.issue. By rejecting the BMA's proposal a few months ago, the

:53:21. > :53:25.junior doctors have made -- undermined the BMA as a negotiating

:53:26. > :53:32.partner. I don't think the public attitudes to doctors are immutable.

:53:33. > :53:34.If we start introducing this sort of action to the NHS, it could

:53:35. > :53:42.fundamentally change public attitudes are. A junior doctor said

:53:43. > :53:46.Jeremy Hunt should back off. I don't think it is a position where there

:53:47. > :53:51.is an easy win. The Government could have handled itself better, but the

:53:52. > :53:53.long-term risks of a strike a counter-productive. There has been a

:53:54. > :53:58.lot of talk about NHS funding and the shortcomings of supply. We heard

:53:59. > :54:04.earlier one of the things that people think they are striking about

:54:05. > :54:08.is privatisation. My father spent almost a year in NHS care, my

:54:09. > :54:14.mother, who has worked in the NHS, helped to look after him, and he was

:54:15. > :54:21.put up in the hospital where she started training. As we did a tour,

:54:22. > :54:25.she showed me what used to be the pay wing of a public hospital. This

:54:26. > :54:29.brought in private patients, they paid money which was spent on the

:54:30. > :54:36.NHS. Currently, Britain has private health care. Rich people who already

:54:37. > :54:39.pay the taxes towards the NHS pay extra for private health care, but

:54:40. > :54:44.they go to private hospitals and all of the money gets locked up in the

:54:45. > :54:51.private system. Long-term,... We have talked about... We talked about

:54:52. > :54:55.European models, they make it easier to bring money into their health

:54:56. > :55:03.service, so we need to look at in magic to solutions like that. Do you

:55:04. > :55:08.have a resolution? I do. It has been great to hear from lots of different

:55:09. > :55:11.people from lots of groups. The universal thing is there are

:55:12. > :55:17.problems in this contract. Even Andrew said so. People say the

:55:18. > :55:23.contract is not good, but why do they have to strike? Resolution!

:55:24. > :55:29.Number one, take imposition of the table. Number two, even more

:55:30. > :55:32.important, if you want to produce a seven-day service, give me a well

:55:33. > :55:38.costed spreadsheet of what it involves. He pushed the doctors for

:55:39. > :55:42.what percentage would solve this, I am in my last year, I want

:55:43. > :55:48.resources, I don't want a rise in pay. I want a well costed

:55:49. > :55:57.spreadsheet. I am a local councillor in Ealing. I am teaching medical she

:55:58. > :56:04.did as well. -- students. It is money, we need more central funding.

:56:05. > :56:08.This dispute is one of the death by a thousand cuts that the NHS is

:56:09. > :56:14.withstanding. That is what we need, more money. I work in the railway

:56:15. > :56:17.industry. A seven-day week will be robbing Peter to pay Paul. The

:56:18. > :56:23.five-day week is not funded well enough. It is not work because the

:56:24. > :56:25.NHS is not funded well enough. My challenge to the Government is to

:56:26. > :56:32.find the money from wherever you need to find it. From Philip Green,

:56:33. > :56:36.maybe, anyone, really. Find the money, make the five-day week work,

:56:37. > :56:40.stop giving these people a hard time, they are amazing people, and

:56:41. > :56:48.then we can talk about a seven-day week. How do you see this dispute?

:56:49. > :56:53.The two sides were far apart in May, it was the royal colleges who got

:56:54. > :56:57.them around the table, that resulted in the agreement that was thrown up.

:56:58. > :57:03.Now the Government say, why should we negotiate with the BMA is they

:57:04. > :57:09.agree and it goes to a referendum and it is thrown out again? The BMA

:57:10. > :57:13.say, 58% of our members have rejected this contract. It will take

:57:14. > :57:17.somebody, they didn't royal colleges are behind-the-scenes, to get people

:57:18. > :57:24.around the table, but I see that as very distant. Ten seconds to give me

:57:25. > :57:32.a resolution. For a resolution, the doctors have been ground into the

:57:33. > :57:41.ground. Resolution! MPs get paid ?70,000 a year, doctors get 20. Give

:57:42. > :57:44.them a pay rise? Yes, and sit around a table and discuss and leave it to

:57:45. > :57:51.the professionals. Resolution, really briefly. Come back to the

:57:52. > :57:56.table, discuss with doctors, listen to the evidence, we should not make

:57:57. > :58:02.decisions on a whim. They should not be a bad opinion politics, it should

:58:03. > :58:07.be based on evidence. Briefly. Bring it back to the patient, bring in a

:58:08. > :58:12.risk register, matched the risk to resources, it is about patient

:58:13. > :58:16.safety. Thank you. And you do everybody who has taken part. You

:58:17. > :58:21.can give yourselves a round of applause.