07/09/2016 Victoria Derbyshire


Victoria Derbyshire holds a debate on the long-running junior doctors' strike. She speaks to the junior doctors planning to walk out, other NHS workers and the patients affected.

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Hello. It's Wednesday.


Good morning and welcome our programme.


Today we're debating with you the junior doctors strike.


Plus plus


I support the strike patient safety is put


we simply cannot accept this new contract.


Hi - I'm Joanna - a junior doctor - I don't support the new contract


but the thought about striking breaks my heart.


With us this morning around 50 people who're either junior doctors,


or who work in the NHS or who hold strong views about the dispute


which has dragged on for several years now and could yet see


another 15 days of strikes before the year is out.


Hi I'm Saurav - a legal consultant - I am against the strike -


I fear it will compromise patient safety.


I've watched the controlled demolition of the NHS and I totally


support the doctors. I'm really, really keen to hear from


you. You can e-mail us. You can tweet us. You can usual the hashtag


or you can text and your texts tab charged at the standard network


rate. We're live until 11am with a special


programme about the junior doctors We'll hear much more from our


audience throughout the programme. But before all that, let's get


all the latest news with Joanna. The chairman of the troubled


Southern Health NHS Foundation Trust has defended the decision to create


a new post on the same salary for the trust's chief executive


after she quit in the wake Katrina Percy had faced multiple


calls to resign over her Trust's failure to investigate


hundreds of deaths. Now the BBC has learned


that her new ?240,000 a year job didn't exist previously,


and she was the only The Trust's chairman Tim Stuart says


the job needed doing and that Ms Percy was "uniquely qualified"


to carry it out. I mean it is fantastic the changes.


Katrina Percy has faced months of criticism for the way her trust


failed to investigate patient deaths. These are people, you should


failed to investigate patient be investigating every death that's


not expected. This is outrageous. You can't do this to people. That's


why your services aren't good because you really don't care about


them. Last week, she resigned and went straight into a new job at the


same trust and on the same salary. ?240,000 a year including benefits.


Today her chairman gave details of the move in an exclusive interview


with the BBC. REPORTER: Did the new job exist


before Katrina took it? The work needed to be done. Did that new job


exist before Katrina took it? No. Did you advertise that job so other


people could apply? No. Was Katrina the only candidate? She is uniquely


qualified for it. Was she the only candidate? Yes. To many people that


will sound like a fix? But that's not the case. He said Katrina Percy


was uniquely qualified to remain at the trust. She will now be giving


strategic advice to GPs, a role that was needed. Relatives were outraged


at the side-ways move. Somebody in her position of responsibility, who


is letting so many people down, and we have seen all of those deaths


which went by, uninvestigated, and she is still there and she is taking


a side-way step with her salary, I think it is outrageous, completely


outrageous. Southern Heth say they have addressed the failings,


highlighted in a series of reports and that patients are now safe. I


can unequivocally look you in the eye and say that every member of


staff that I have met, who works on the front line, is putting patient


safety and the quality of care first.


They still face criticisms and are now being investigated by the Health


and Safety Executive over the earlier deaths of patients.


Viewers in the South of England will be able to see a documentary


on this at 7.30pm tonight on BBC One.


It'll also run across the country on the News Channel at 8.30pm.


Passengers on one of Britain's busiest rail lines face more delays


today in the latest 48-hour strike by on board guards.


Southern trains are in the middle of a bitter dispute with the RMT


union over who should close the doors on their trains.


Our Transport Correspondent Richard Westcott reports.


This is a bitter row that's triggered months of strikes


Southern wants more drivers rather than on-board conductors to start


The RMT union says that's less safe and claims it's an excuse to cut


A guard is an absolutely safety-critical role and we can't


allow trains to be travelling without any guard on board.


The company says no one will lose their job and driver-only


trains have been running safely for decades.


We've said to the RMT, you know, come and be


part of the solution and not the problem here,


come and talk to us about how we implement this because it


It's piling on the misery for Southern passengers,


who already endure the worst delays and cancellations in the country.


Matt Steel used to be a Southern customer until his commute


from Sussex to London got so bad he packed in his job,


found work closer to home and started cycling instead.


I've got a young family and it just meant I never got to see them.


By the time I arrived in they were getting ready to go


to bed, so we didn't really have much time to spend together.


The strike means four out of every ten trains won't run


The UK and Australia are to open preliminary


negotiations about a future post-Brexit trade arrangement.


Australia's trade minister Steven Ciobo, who is in London


to meet International Trade Secretary Liam Fox, said officials


from the two countries would meet twice a year to discuss the outline


But he added that formal negotiations can't start


until the UK leaves the EU and that it would be at least


two-and-a-half years before any deal could be finalised.


Our assistant political editor Norman Smith is at Westminster.


So Norman is this the shape of things to come? Well, it gives an


insight into the amount of time it is going to take to secure trade


deals once we leave the EU and what's significant about these


comments is Australia, probably at front of the pack, when it come to


striking a deal because they are keen to reach an agreement with us.


Theresa May and the Australian Prime Minister at the recent G20 both


stressing the countries close ties with each other and the desire of


both nations to get an agreement. The best we can expect is some deal


within two-and-a-half years. That's the best case scenario and as


importantly, he says that we could not get down to the detailed formal


negotiations until Britain has actually left the European Union and


even then, Australia wants to focus first on getting a deal with the EU,


echoing exactly what President Obama said recently that the EU will come


first. Thank you, Norman.


Babies delivered by caesarean section are significantly more


likely to grow up to be obese according to new research.


The study published in the US medical journal, JAMA Paediatrics,


found babies delivered by C-section are 64% more likely


Experts say rising caesarean rates could contribute to


Researchers warn of a "vicious circle" because overweight women


are themselves more likely to need a caesarean.


Councillors in London have voted to close


the well-known nightclub, Fabric.


Police had called for its licence to be revoked, after two teenagers


at the club died as a result of taking drugs.


Almost 150,000 people signed a petition to try


With me now is Danny Rosney, from BBC Radio One's Newsbeat.


A really well-known club. Is this a surprise? It is really because it is


one of the most visited clubs in the UKment people come from all over the


world to come to Fabric. I was at event last night and there was


hundreds of people there in support of Fabric and it is not the decision


that they were hoping for, but two people did lose their lives there


over the summer. Is it unusual for a decision like this to be taken? I


think for a club of this size and in particular, yes, especially when you


have got huge artists talking it from the likes of SG Lewis, Annie


Mack and Mr Jam, it is a club where a lot of DJs start their career and


develop as artists, it will affect the industry quite significantly, I


think. Is that it? Can they try for another licence? They can appeal,


but you know, who knows what will happen with that? OK, thank you very


much, thank you. A long lost letter from a dying


woman to her young daughter has been discovered in a pile of second-hand


books and reunited The letter was written


to Bethany Gash, by her mother Lisa The book, the letter was kept in,


disappeared during a It was discovered by chance


by Gordon Draper who runs a book shop in Bishop


Aucklands near Durham. Marcus Rashford for his exploits


last season for both The teenager has now scored


on his Manchester United debut. This time he bagged a hattrick


against Norway in their qualifier for the European Championship next


year which finished 6-1. The 18-year-old wasn't


included by Sam Allardyce Because he's not been playing


for Manchester United. Although on his only


appearance this season. Last night in Colchester he wrapped


up the first hattrick How have Portugal been getting on?


Yes, they did well, but not so well last night. They lost 2-0 to


Switzerland in their opening qualifier. The home side's goals


came in quick succession in the first-half.


A the Portugal side were without Cristiano Ronaldo who was injured in


the finals and hasn't played since. Portugal's defence were barely


beating, but they are off to a losing start in this campaign.


Switzerland also had a man sent off late on.


Let's talk about the US Open, Novak Djokovic through to the semis? Yes,


they're parting like the Red Sea for Novak Djokovic. For the third time


in this year's tournament, he didn't have to complete his match. Tsonga


was two sets down when he decide he couldn't continue due to a knee


injury. Djokovic had a walk-over in an earlier round, so the defending


champion only needed to play nine completed sets. He will take on


another Frenchman in the last four. Cricket... Some physical issues I've


in the last month-and-a-half. This was, the scenario that I needed and


I wished for. So I got a lot of days off. Recovered my body and right now


I'm feeling very close to the peak and that's the position where I want


to be. This Grand Slam is very unique for me, I never experienced


something like this. To have three retirements on the route to the


semifinals, I can only wish all of my opponents a speedy recovery. It


is all I can do. Well, let's move on to cricket.


England's final match of the summer today? Yes, that's right. After a


long and not necessarily always hot summer, England take on Pakistan in


their international T20 at Old Trafford. They broke the world


record for the highest ODIs scored with 444-3 at Trent Bridge, but not


to be outdone and a week later, Australia smashed a new record in


T20 cricket with 263-3 against Sri Lanka. The total included 145 here


for Glenn Maxwell off just 65 balls. It is the second highest score in


all T20 internationals. Eight days ago Sri Lanka held the record for


the both the ODI and T20 cricket and now they have neither! Oh dear.


Paralympics begin in Rio. Yes, it has been a wait if you were having


withdrawal symptoms after what happened in the Olympics, but they


do start tonight. It is just over ten days or so that they will be


going on in Rio. This is the flagbearer for Paralympics GB. Lee


Pearson. He is one of the greatest Paralympians this country produced.


He is 42 years old and won ten equestrian gold medals and the


target for Paralympics GB is one better than what they managed in


terms of medals in London 2012. Just the 121. We will see how they get


on. Yes, come on, they can do it. Hugh, thank you very much.


Back to Victoria. This morning - do you support


the junior doctors' strike? Peter says, I am behind them, and I


am awaiting an operation. This on Twitter, the BMA is using these


people to play politics with patients' lives.


Since the beginning of 2016 junior doctors have been on strike six


They were due to walk out for five days next week -


that's been cancelled, as you know, over patient safety,


but they're still due to strike for five days in October,


This row has been going on for two years now since England's Health


Secretary Jeremy Hunt first proposed a new contract.


This all began at the tail end of 2012.


Junior doctors in England needed a new employment contract.


That's 55,000 people, about a third of the medical workforce.


But by 2014 talks on a new deal were already proving difficult.


The doctors' union, the BMA, was worried about working conditions


For years, it has been too hard to access the NHS out of hours.


Heart attacks, major accidents, babies - these things


Then the Conservative Party went into the general election


with a promise - making the NHS a full, seven-day service.


The Government wanted to make it cheaper for hospitals and surgeries


to rota doctors on in the evenings and at weekends.


It planned to raise basic wages, but cut extra pay


Doctors argued the new plan was unfair and unsafe,


and more investment was needed to pay for a full seven-day NHS.


I trained in the UK and Iwant to work in the UK.


But I'm not going to work in an NHS England where this


The most recent saw junior doctors withdraw emergency care


Then, a pause was agreed and talks restarted.


It looked like a breakthrough was possible.


The Government offered concessions on weekend and part-time paid.


The doctors' union, the BMA, said it had reached a deal it could


What we wanted to see was a proper negotiation were both sides tried


to find realistic solutions to the problems that junior doctors


face across the NHS, that is what we have


The BMA still had to put the deal to its members,


The Government said it would impose the contract


More industrial action is now likely, with a series of five-day


The first, planned for next week, has been cancelled because of


The next, at the start of October, will go ahead, though,


The dispute over the contract is an England-only issue.


Scotland and Wales have both said they will be sticking


to their existing contracts, while Northern Ireland has yet


This is largely because they don't have the pressures on costs in terms


So do you support the junior doctors' strike?


Let's get a snapshot of views from our audience.


Hello. I am Alex, a children's doctor in south-east London. I am


glad we are not going on strike next week, I was not ready, I have just


joined a new department, I don't know if the service can be covered


if I am on strike. But I reject the contract, it is unnecessary and


cruel, an intrusion into our working life. Looking at the wider


situation, it is an attack on the NHS, we have seen waves of


privatisation, PFI under Tony Blair and Gordon Brown, and Andrew Lansley


brought in the health once a bill. Today, the NHS is stretched because


of those things, trusts are almost ruined, and the NHS is so stretched.


Jeremy Hunt wants to drive away doctors with this new contract. Do


you believe he wants to drive away doctors? Do you genuinely believe


that? He doesn't care. He has got a manifesto that he wants to carry


out, which was voted for by 24% of people, and he has the short-term


aim. I am Janice, a junior doctor, I work in north-west London, training


to be an anaesthetist. I am mixed. I oppose the contract, it is not a


contract I want to work under, I feel completely disrespected by the


Government and Jeremy Hunt. As a body, we have objected it but they


still think it is acceptable to impose it. But going on strike, you


have responsibility to your patients first and foremost. Did you support


the earlier strikes? Yes, I took part in them. I opposed the


withdrawal of emergency care. The forthcoming strike that are


proposed, it seems that five days of withdrawal of emergency care is a


steep escalation. I support strikes, but the proposed plan in a month's


time does not sit comfortable with me. Withdrawal of emergency care for


such a long period of time. I answered, from Hampshire, a


committee pharmacist. I get what I am hearing, we have the brightest


and best. The issue is twofold, the point you are trying to make and how


you are trying to make it. That is where I would disagree. The NHS has


had years of broken promises, chronic underfunding, it is left


fragmented, week, closing pharmacies down, the staff are not happy. It is


not an issue just for junior doctors. The NHS is not elastic, it


is finite, you tinker with one aspect, it has a domino effect. We


are talking about families, jobs, the wider economy. The thing that


worries me, if the NHS is already on its knees, how is the love of the


NHS going to be further enhanced by junior doctors going on strike's who


is a junior doctor who supports the five-day strikes? Talk to him about


the point he has made. I am Sunday, an accident and emergency training


in east London. I support the strikes, even the withdrawal of


emergency care. We have fantastic consultants who will cover us when


we are not there, the strikes will be from eight until five, I would


have come in to finish my shift after being on the big lines. I


agree that the NHS is not elastic, and we will have an impact, but that


is the point of industrial action. We feel we have been left with


nowhere else to go, there is no alternative. Pharmacists are not


going to go on strike, nor are nurses. He feels there is nothing


left. Either the BMA have let you down or you need to do more in terms


of your reputation. The longer the strikes go on, the more isolated you


will be. There is money in the system to help cover, agency staff,


temping, but that is taking money from other aspects of the NHS, and


you will become more unpopular. Your point will be lost as more impact


will be on families. There was a poll yesterday which suggested that


those people who believe doctors are right to strike is now at about 42%,


that is down from April, when 53% said doctors were right to strike.


You must worry about that. Yes, public support is important. We are


not legally allowed to pay people to come and fill in for us. Extra money


will not be put in for people to cover for our jobs. What option do


we have? We are backed into a corner. I don't think the BMA have


played their cards particularly right, but I blame Jeremy Hunt. Back


off. Leave us alone. Why can't we be like the doctors in Scotland and


Wales, who can concentrate on looking after their patients, rather


than agonising over having to contemplate feeling like we are


rejecting our patients? We have the burden of professionalism, it is a


heavy burden. Having to request that is difficult to contemplate, but


what do we do? I and David, I am an accident and mergers in is in a


major trauma centre. I work alongside Julia doctors, we are a


tight team. It is a busy department. I am also a parent and a patient, a


taxpayer, and aged union steward. Our branch has 2000 members which


have passed a motion supporting the junior doctors and their strikes. I


support them personally. I feel the blame should be laid at Jeremy


Hunt's door, there was no need to push the doctors, they have not gone


on strike for 40 years or longer, they are intelligent, articulate,


well educated, they train for seven years. Do you think of five days of


strikes each month is proportionate to where we are now, even that back


in May the BMA junior doctors committee said the contract is OK?


It is not for me to tell the doctors what they should do. Do you think it


is proportionate? I will support them 100%, whatever they choose to


do. I know how hard they work. The idea of the seven-day NHS, emergency


services run 24/7. We work nights and weekends. It is the elective


services that don't run for seven days. There is no budget for this,


no money being put forward. The NHS has had its budget... Although the


bottom line has stayed the same, in previous years prior to 2010 is that


every year there has been between a 4% and 2% uplift, because of the


extra demand, and that stopped in 2010, so the money that has been


going in for the last six years has declined. That is why we have Jeremy


Hunt pushing for this transformation and sustainability agenda, a planned


we know nothing about, he has not talked to the public about it, a ?22


billion cut in funding. Thank you. Hello. I am Lauren, a GP trainee, a


fifth-year junior doctor. I support the strikes and I and against the


contract imposition. But I hoped that the strikes would not happen.


The escalation is quite scary, to go to five days walk-out. Scary for us.


I am scared our patients will be affected. I am working in obstetrics


and gynaecology, I know the consultants and senior non-trainee


doctors will do an excellent service in covering the emergencies, but


elective services like antenatal clinics will have to be cancelled,


so the doctors will be released to cover the emergency services. What


is it about the contract specifically that you don't like's I


don't like that the Government has recognised it as a contract that


disadvantages women. Do you mean women or part-time workers? I mean


part-time workers, who are predominantly women. One of the good


things about the old contract is with annual pay increments we have


avoided a gender pay gap. If Jeremy Hunt addressed the part-time


workers' pay issue, you would accept the contract? That is one element I


disagree with, there are a number. There is the part-time workers, what


else? Non-resident on-call workers. Staff in areas like oncology, who


work a 9-to-5 shift, and from then they may work from home, they may


work from hospital, they can go home if they are not needed immediately,


they will be on-call overnight, with the willingness to come in or answer


questions by phone. Why is that an issue? They are my colleagues, they


will take a massive pay cut. They are paid as if they are in hospital


currently. The shifts can vary, some of them can be odorous, some can be


less so. Even if you are at home and not called in, you are still waiting


by the phone. Are there more issues? I don't know how many more! I want


to get to the specifics if we can. In the last few minutes, we have


heard one of the problems. For some people, it is about privatisation,


the seven-day NHS, for others, it is about technical details of a


democratic employment contract. The other publication is that the BMA


committee and leadership agreed what was put forward and made clear that


it had dealt with quite a few of these important issues. I know there


is an issue about who recommended it, and I accept it was not fully


recommended by the whole of the BMA. Some people thought it addressed


these concerns. But I get the fact that 58% rejected it for their own


reasons, and that is an important part of the debate as well. Some of


these issues have got confused in an employment dispute. Wide issues


attached to the contract dispute. Let's go through the other issues.


What else? Specifically. We talked about gender


discrimination. We talked about the nonresident on call. I would like to


see better protection for study. We are consultants in training. We are


qualified doctors, but we are training to become consultants.


The next one? If we are looking to spread us over weekends and nights


more thinly, we get our training by working with senior members of


staff. And if we're spread more thinly, we're not going to get those


opportunities. The contract doesn't mention that. All sorts of people


could have all sorts of concerns, anxieties, grievances if you want to


go that far. It is nothing to do with the contract. The contract is


not about that. But the contract will impact upon that is the issue.


The people who are negotiating the contract, we have doctors in the


BMA, but we have the Government's spokes people, they haven't worked


as doctors and they don't understand the pressures and that concerns me.


So you have got a number of issues and a number of other junior doctors


will also have their own issues. I want to ask this question now, but I


want to ask it now. How is this going to be resolved because so many


issues are being attached to this contract? I just wonder why this


contract has to be imposed now? Why can't we make a contract that we


agree on? APPLAUSE


Hugh Pym, we have a doctor who is on the junior doctors committee at the


British Medical Association, that's the union for health care


professionals, we've got Mike Wood, a Conservative MP, we have Professor


Modie. Welcome to you. Sorry Victoria. We don't support the


strikes. We are here to support our members and we are here to speak on


the hab of of children. The Director of Reform. And Hugh Pym who I have


already introduced. Mike Wood, just to say, we invited Jeremy Hunt to


come on the programme and he declined and we asked for anybody


from the Department of Health to come on the programme, they


delivered. The point raised by our junior doctor here, why does Jeremy


Hunt have to impose this contract? Well, I mean, obviously we saw in


the video clip these negotiations have been going on for four years


now. Is that a good enough reason to now impose it? The question is, are


these negotiations going any further forward? We thought we'd got a


solution that was obviously co-authored between the BMA, the


Department of Health and the NHS employers, the leaders of the junior


doctor committee described it as beneficial to our patients and


beneficial to our junior doctors. They said that it addressed the


questions over equalities, that it was an improvement on equalities.


Now, of course... But then the members voted against it?


Absolutely. I think the BMA have to look at how they've engaged their


members in terms of representing and recognising what concerns were, but


there is a wider problem with the amount of hysteria really that was


being whipped up when junior doctors were told they would be losing 30%,


50% of their pay which wasn't true. It is not true in the new contract.


You're representing, you're on the Junyard doctors committee on the


BMA, deal with Mike Dudley's point. You've led your members up to the


top of the hill and you have had to march them back down again by caving


in about the strikes next week, you have people describing you erratic.


You're not in control of the situation? Firstly, thank you for


inviting me here today, it is a privilege to be here and to hear so


many people's opinions on where we are and what's going on. The first


thing I want to do is just talk about the fact that, we have been


talking about are you pro or against strike? I would like to think all of


us are against strike action. No one wants to leave hospital. I'm a


junior doctor first. At the end of the day, my patients are my


priority. I'm sorry to interrupt, I keep hearing you say that, and you


keep going out on strike. This is part of the problem that we have is


that at the moment, we have done everything short of this to this


point. Throughout this process, we have been trying to find a solution.


The problem we have is, unfortunately, the Secretary of


State is not just not listening and not engaging in that process, but


the problem we have now is, he is forcing through plans that not just


independent experts, not just the front-line staff in our hospitals


our junior doctors are saying are uncosted and untested and damaging,


but even the Government's... You said this deal was all right. It is


the same deal. Let's be clear, the leader of the junior doctors said


that within the constraints that we had, in the eight day that is we had


to try and negotiate in that time, under the new sort of criteria that


were laid out with ACAS and David Dalton, unfortunately in that time,


he felt we had reached the best deal we could, but it was always subject


to a referendum because ultimately junior doctors have to decide, they


are the front-line staff and we informed them so they could make an


informed decision. Victoria, I think that it is


unhelpful to polarize the debate into do you support the strikes or


do you not support the strikes? That's for simplistic purposes. I


acknowledge that everybody watching and many people in this room, it is


not as simple as black and white, there are so many nuanced views and


hence two hours to discuss it? Thank you for acnobblinging. Can I ask


colleagues to join me in a thought experiment. Let's for argument's


sake says that the junior doctors strike haven't happened. Let's wipe


them off the face of history. Where would we be with our Health Service


today? We would be with acute trusts in ?2 million in deficit, ?200


million, that was billion the first figure, ?1 million of public health


cuts and find GPs struggling to get sufficient training to look after


children for whom I speak, we have seen in the last fortnight the


suspension of paediatric A services, we have seen reports that


from our national charity that show that 1,000 babies a year have been


unnecessarily transferred between hospitals because of lack of


capacity. We have seen a put to HEEs budget and the relevance to the


point I'm making is that were the junior doctors dispute not to have


happened, the NHS Public Health England, everything that encompasses


general practice services would be in a very, very difficult situation


indeed. So I suggest that if we are going to speak about health care,


patient safety, public well-being, then we have to take all these other


considerations into account simultaneously.


APPLAUSE Hello. There is a wider health


debate, but we're talking about the most extreme strikes in the history


of the NHS, never been done before. There are detailed views about the


contracts, the question is should we go for the strikes to do it? I think


it is a militant response. I don't think we should. I would predict


that the strikes later this year will not happen because the BMA is


losing support. It could not find the support to do this first strike


of these five. I would predict that public support will continue to fall


and we will not have the further strikes. Let me read some more


messages. Dr Jeff O'Leary says, "What I do not understand if the


contract was deemed to be OK in May by the BMA why it seems no not be


now?" Another viewer says, "Accept what is being offered now in


exchange for excellent pay." Caroline says, "Triking is


dangerous, but expecting employees to have no way to protest means we


end up being long-term dangerous rather than being fair and


co-operative. We should back anyone's decision to protest as they


do it when they're left with no other option." And another viewer


says, "It feels like we're witnessing, we are all witnessing


the destruction of the NHS by politicians who are trying to use


doctors as pawns, I support those doctors." Hello.


APPLAUSE I'm an orthopaedic registrar and a


junior doctor of ten years working in north-east London. It is in


response to Andrea and Mike Wood, you used words such as hysteria and


militancy. It is simplistic to consider the aspect of strikes in


isolation without seeing what the alternative is. I don't want to


strike. Striking is a last resort. Striking is a failure to listen. A


failure to come to an agreement, but you have to consider what is the


alternative if this contract goes ahead. I work as an orthopaedic


registrar, I do operations, I know what is required to safely staff a


seven day service. They are trying to stretch five days into seven with


no extra funding, no extra staffing, no extra auxiliary staff, nurses,


physiotherapists, it will lead to danger to patients. Three doctors,


myself and two others cover 130 patients in three hours. We spend


three minutes per patient. To cover those extra clinics on a weekend,


you will take one of those doctors away, so you will have two doctors


covering 130 patients in three hours. The system at the moment is


in a state if anything happens, if a doctor gets sick, if a patient gets


sick, if a member of auxiliary staff gets sick, it collapses and when


your own risk register leaked two weeks ago said of five out of five


severity risk, this is under staffed and it is under funded and I have to


go back to your polls, you said that public support is waning towards a


strike. The ITV poll showed there is an 85% support for the strike. The


poll of members of the public where they surveyed them and said do you


think a seven day service is a priority? Less than 3% thought it


was a priority. They thought that improving the five-day service was a


priority. APPLAUSE


And the last point I would like to make is, the second thing and a lot


of people are not aware of this, junior doctors don't have adequate


whistle-blowing protection in the new contract. At the moment if I see


a problem being done to my patients, harm, malpractice, I want to report


that safely, so that I can actually improve the service and stop harm


being done to patients. So you are putting doctors between a rock and a


hard place. You are asking me to be complicit in driving through a


contract which I know causes harm and which the Government knows


causes harm and you are saying don't report if any harm occurs so you are


lead to go a culture of cover-up. Mike Wood, Conservative MP, respond


to this gentleman. There are clear proposals and improvements in terms


of whistle-blowers and in terms of making sure that junior doctors are


being protected. Equivalent to being employees of health education


England so they will have the legal protection for whistle blowing, but


in terms of the staffing, it is not true to say that we are trying to


stretch a five day staff over a seven day service. There are 9,000


more doctors than there were six years. We're training another 11,500


doctors as part of 80,000 more staff... There was 20% intake into


medical schools this year. I've worked in the NHS for ten years.


Unfortunately, I do know what it takes to staff that. I know what it


takes to staff a weekend service and I'm sorry, that's not true. Let me


bring in Hugh Pym. We are going to talk about this further after 10am.


Let's do it now. Five days into seven days, how does Jeremy Hunt see


that that is going to work? Well, I think the problem with the seven day


NHS debate has got very confused because when the strikes happened


earlier this year it was very much about safety. It was very much about


weekend pay. It was about whistle blowing and fining hospitals and


that's really the key bits of the contract. Now, it has turned into


more of a debate about the seven day NHS and I think the link between the


two in terms of what actually needs to be agreed and the contract is not


entirely clear, but I would put a point to Mike Wood, do you think


Jeremy Hunt confused by saying the doctors contract is linked to a


seven day NHS? Wouldn't it have been better to have focussed on the


contract and not got into the seven day debate? They are linkedment


other parts of the Health Service work seven days a week and they work


night shifts, but the current structure on pay does act as the


disincentive for NHS trusts in terms of how they're structuring their


rotas. It means the same level of support for emergency and urgent


care isn't similar at weekends as it is during the week. Anybody who has


been in hospital at weekends or having to be admitted at night can


see that, it is not equivalent. How are you going to do that if you


haven't got enough doctors, consultants, registrars, there is a


shortage? In terms of the funding that was raised, when Simon Stevens


was head of NHS England reviewed the pressures on the NHS, he said the


NHS would need another ?8 billion in funding by the end of the


Parliament. So the Government has committed to ?10 billion above the


rate of inflation, above normal price increases. That's what is


funding the extra 80,000 people that we're aiming to recruit into the


NHS. You admit there is a problem at


weekends in the emergency service, and I agree, I think services like


diagnostics and people waiting in A are not acceptable at the


moment, but how can you do that by taking extra funding... Sorry, not


putting in extra funding and adding in two extra days? Hugh has done a


film about the seven-day service, the ambition of the service.


Save our NHS! Save our NHS!


At the centre of the junior doctors row is the Government's plan to make


the NHS in England a seven-day service by 2020, a key pledge


in its manifesto and one it believes it has a mandate to deliver.


With a future Conservative Government, we would


The Conservatives envisage people having access to local GPs


seven days a week and, crucial to this debate,


patients receiving the same level of urgent and emergency care


in hospitals in England at weekends as on Monday to Friday.


Junior doctors already work at weekends, and, in fact,


represent the bulk of medical professionals on shift.


Tweets directed at the Health Secretary,


using the hashtag #I'mInWorkJeremy, were keen to prove this point.


But while emergency care is available at weekends,


And, under the current junior doctors contracts,


ministers say it would be too expensive for hospitals to roster


Then there's the controversy caused by Health Secretary Jeremy Hunt's


suggestion that a lack of staff is increasing the


One report he cites, using hospital data from 2013-14,


indicates that a patient is 15% more likely to die within 30 days


if they are admitted on a Sunday than a Wednesday.


The British Medical Journal, however, which published


the findings, believes the data has been misinterpreted.


It says there are other factors that must be considered,


such as how patients admitted at weekends tend to be sicker


than those admitted during the week, and that there is no evidence


to suggest that extra staff would prevent so-called excess deaths.


If the Government gets its way, however, medics believe they would


Whether this will lead to a truly seven-day NHS is unclear.


Leaked Department of Health documents revealed in August that


civil servants worry that a lack of available GPs,


hospital consultants and other health professionals


would mean the full vision could not be delivered.


Government sources said this was a normal risk assessment.


Let's find out more about this ambition for a seven-day NHS. We


have an audience of junior doctors and other health care professionals,


patients, taxpayers, voters. Like Alex, I am a children's doctor. My


father passed away recently, and there were a series of mistakes in


his management that contributed to that, the last was withdrawing his


pain medication was messed up, it was not on a weekend or a strike


date, it was in the middle of a day during the week. Jeremy Hunt is ram


raiding through a contract on the premise of a seven-day NHS with no


extra funding, no extra employment, no actual plan as to how it will


work, and criticism from his department. He will take staff away


from the days that my dad could not be looked after, underfunded days,


putting them onto a weekend with no evidence to say it will work. Even


the papers he is quoting from have said rings like, it is misleading to


say that this will help. It is not something I will stand for, I want


to protect the NHS, and I want the NHS to be something we can be proud


of. Is it right to do that through this dispute? Is a paediatrician and


a British citizen I want to do what is best for the patient, because I


look after formidable children. I am on 13 hour shifts, where I do not


get breaks, and I am looking of the sick children. I fall asleep at the


end in my car and have to get a taxi home. A few hours earlier I are


making decisions about managing a six-year-old child who is not


breathing. The contract will make things worse, not just for the


patients but also for the doctors and the public will stop what are


your thoughts on the seven-day ambition? I am an orthopaedic


surgeon, we do work seven days a week. This weekend I was on call for


48 hours, there was a registrar on site, and I have seen every patient


that has come through the door. We are struggling as we stand to fund


that. To give a smack -- is not shot, we are struggling to get


junior doctors to cover night shift. The system is entirely based on the


goodwill of the junior doctors. We will be able to do what we do -- we


would not be to do what we do without the junior doctors. This


message says, I work shifts, ours are 24/7, 365 days of the year. My


son had to wait over a weekend before his broken ankle was operated


on. I have no support for doctors. Join the rest of us and work shifts,


we don't get special treatment, so wide should doctors? It is not only


me, there has to be anaesthetic staff, and MRI support. Most


hospitals operate on the weekends, I do. What we prioritised was elderly


people who had broken their hips and kids. Ankle fractures have to wait


until Monday. To be clear, as there are not enough of you in that team


to do that operation, you prioritise the very vulnerable and somebody


like this boy would wait until Monday? Your question now is, how


can we continue to do this when there are not more funds? I want to


get more people in, but thank you. I represent the Conservative workers


and trade unionists. I am a patient and I heard our friend say he has


worked for ten years in the NHS, I have been involved for 46 years as a


patient. The seven-day NHS is essential for our modern way of


life. I work in hospitality, my son is an actor, daughter works in


retail, there are so many walks of life where seven-day working is the


norm. If there are not enough people, as many Judeo doctors say,


to do this effectively or safely, what do you say? Look at your


contract. The contract the BMA agreed. The organisation is being


done to make sure the cover is available, extra funding is


available, despite the calls from the BMA. I am a GP, I train Judeo


doctors and I am starting to produce a film called the great NHS heist.


The junior doctors dispute has to be seen in the wider context of NHS


privatisation. What do you mean by that? It will continue to be free at


the point of delivery, say the Conservatives. Hospitals can


generate up to 50% of their income from private patients, the five-year


forward view spells out the closure of 17,000 hospital beds, and it


alludes to the deskilling of hospital staff. Why do you say this


contract is relevant to what you believe in terms of the future


privatisation? There is no more money, we will be the only developed


country in the world offering routine care seven days a week, it


is designed to drive doctors out of the system, that is the intention.


What will happen, you will have a staffing crisis,... You say Jeremy


Hunt wants to drive doctors out of Britain to collapse the NHS, to


enable more private providers to come in? Is that reasonable? In a


bar of people think so. -- a number of people. People have made this


point and putting it together with this issue, what is your take? I


don't see any link between the contract and privatisation.


Privatisation is a loaded term. We mean selling of shares in the NHS


like British Gas, what do we mean use of private providers? That has


never been made clear. The use of private providers with NHS money was


running at about 6%, it is now 7%. For some people it means 93% is


still NHS for others the 7% is significant. It remains a big debate


around the whole service, but linking it with the contract is a


value judgment by some, and if you talk to a range of junior doctors,


they would not say privatisation was their main motivation in this


debate. I am a student, this is directed to you, you are a


Conservative MP, you are not giving... You have not once said...


You are not giving these professionals who take care of us a


straight answer. I will ask you, you are our MP, what are you going to


do? You cannot dismantle the NHS. How are you going to do this? To


resolve the dispute? I am against strikes, I don't should happen. Stop


pushing these poor professionals to a strike, and how... They don't want


a new contract, what are you going to do? You can answer that after the


news and sport, we will get back to that, don't worry. Let me read this


message from one viewer. I am disabled, I often use the NHS, I


support junior doctors, money has been wasted by the changes to the


NHS over the last few years. In my area they have subcontracted out the


Ambulance Service and the cost is enormous. It still does not work


efficiently. I sent an Anne Boleyn is to get to my appointment and I am


the only person in it. Get in touch. News and sport in a second, after


the weather. It was a warm and humid start today


across most parts of the UK. But also really quite grateful sum. This


was the view from one of our weather watchers. There were some breaks in


the cloud. Prior to whether for some of us. Some fairly extensive layered


cloud in Gateshead. A bit of sunshine coming through. A great


start this morning, but some sunshine on offer. We have the weak


weather front to the north and west, tied in with low pressure to the


West. It will become a player in the next day or so. High pressure


between the two. Generating a southerly breeze, bringing in drier


air. It will help to melt the cloud away. We will see some good sunshine


developing across the southern counties. As you head further north,


the cloud is thicker and it will produce some outbreaks of rain. A


good deal of sunshine across South Wales and the southern counties of


England. It will be warm again. A fair bit of cloud lingers through


the Midlands. Even here, the sunshine will try to break through,


but still warm and humid. Some breaks in the cloud for Northern


Ireland and northern England and southern and eastern Scotland.


Through this evening, the cloud continues to melt away, but we look


west for the first signs of a change. The low pressure moving in.


A line of rain through the West of Scotland, will introduce a change.


Ahead of it, it is a warm night. Change is on the way. This cold


weather front moving east. Not much rain in the southern portions. Cloud


and rain moves across the north of the UK. By the afternoon, it has


moved to the east, then we get fresher conditions following behind.


The temperatures will be down, but it is still quite warm. The humid it


will be down as well. A fresher feel. Through the evening, showers


from the West. Towards the end of the week, there will be a line of


showers moving from West to East. Either side of it, fine and dry, but


later in the day, the wind will be picking up, the cloud will be


thickening, and there will be wet and windy weather on Friday night.


If you need more details, it is therefore you online.


Hello, it's Wednesday, I'm Victoria Derbyshire.


Good morning and welcome our programme.


Today we're debating with you the junior doctors' strike.


It is in their dispute with England's Health Secretary, Jeremy


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


particularly right, they could have done better. I blame Jeremy Hunt.


Jeremy Hunt back off. Just leave us alone. We're talking about the most


extreme strikes in the history of the NHS. I think it is a militant


response. I don't think we should. I would predict that the strikes later


this year will not happen. I will support them 100% whatever they


choose to do. I know how hard they work.


In saying that I support the strikes I hoped very much that they wouldn't


happen. I think the escalation is quite scary to go to five days


walk-out. I'm scared that our patients are going to be affected by


this. We will continue our debate on the


programme. Wherever you are, get in touch with your own views. You can


e-mail us and you can tweet us or you can text.


Joanna with a summary of all the morning's news.


The chairman of the troubled Southern Health NHS Foundation Trust


has defended the decision to create a new post on the same salary


for the trust's chief executive after she quit in the wake


Katrina Percy had faced multiple calls to resign over her trust's


failure to investigate hundreds of deaths.


Now the BBC has learned that her new ?240,000-a-year job


didn't exist previously, and she was the only


Katrina Percy has faced months of criticism


for the way her trust failed to investigate patient deaths.


These are people, you should be investigating every death


That's why your services aren't good because you really


Last week she resigned and went straight into a new job at the same


Today her chairman gave details of the move in an exclusive


REPORTER: Did the new job exist before Katrina took it?


Did that new job exist before Katrina took it?


Did you advertise that job so other people could apply?


Was she the only candidate?


To many people that will sound like a fix?


He said Katrina Percy was uniquely qualified to remain at the trust.


She will now be giving strategic advice to GPs,


Relatives were outraged at the side-ways move.


Somebody in her position of responsibility, who is letting


so many people down, and we have seen all of those deaths


which went by, uninvestigated, and she is still there


and she is taking a side-way step with her salary, I think it is


Southern Health say they have addressed the failings,


highlighted in a series of reports and that patients are now safe.


I can unequivocally look you in the eye and say that every


member of staff that I have met, who works on the front line,


is putting patient safety and the quality of care first.


They still face criticisms and are now being investigated


by the Health and Safety Executive over the earlier deaths of patients.


Viewers in the South of England will be able to see a documentary


on this at 7.30pm tonight on BBC One.


It'll also run across the country on the News Channel at 8.30pm.


Passengers on one of Britain's busiest rail lines face more delays


today in the latest 48-hour strike by on-board guards.


Southern Trains are in the middle of a bitter dispute with the RMT


union over who should close the doors on their trains.


40% of services won't run during the strike.


The UK and Australia are to open preliminary


negotiations about a future post-Brexit trade agreement.


Officials from the two countries are to meet twice a year to discuss


But Australia's warned that formal negotiations can't start


until the UK leaves the EU and that it would be at least


two-and-a-half years before any agreement could be finalised.


Our assistant political editor Norman Smith is at Westminster.


Norman, is this the shape of things to come? Well, it gives us an


indication of the amount of time it might take to actually secure trade


deals once we leave the EU with the Australian Trade Minister saying


best case scenario, it'll take two-and-a-half years. Now, why that


matters is because Australia are probably right at the front of the


queue when it comes to future trade deals, they want a deal, both


Theresa May and the Australian Prime Minister at the G20 this week were


stressing the common ties between the two countries and how they would


both benefit from an agreement, but if it is going to take


two-and-a-half years for Australia, then, of course, there will be


speculation in That more complex, bigger markets, less open, less


friendly markets are going to take an awful lot Langer and it will be


an awful lot hard tore reach those crucial trade deals. Thanks, Norman.


Junior doctors have been telling this programme why there is so much


anger about the Government's decision to impose a new contract


The British Medical Association has called off next week's industrial


action amid concerns about patient safety,


but 15 days of strike action are planned from October onwards.


In a special debate, doctors and those in the medical


profession have been telling this programme why they feel so strongly


The thing that really worries me is if the information is already


crippled, if it is also on its knees, how is the love of the NHS


going to be enhanced further by the doctors going on strikes? I support


the strikes, even the withdrawal for emergency care, in the emergency


departments, we have fantastic consultants who will cover us when


we're not there. That's a summary of


the latest BBC News. Marcus Rashford has had


another debut to remember. The Manchester United teenager


scored a hat-trick on his first appearance for England's Under-21


side as they thrashed Norway 6-1 The 18-year-old has


scored on his club debut, his Premier League debut and his


debut for the England senior side, but he wasn't selected


for Sam Allardyce's first squad due Rashford sealed his hat-trick


in Colchester with a Novak Djokovic has reached the semi


finals of the US Open But for the third time in this


year's tournament the world number one didn't have


to complete his match. Jo Wilfried Tsonga was two sets


down when a knee injury It's the second retirement


from which Djokovic has benefitted He also had a walkover


in an earlier round. He'll take on another


Frenchman Gael Monfils Angelique Kerber is through to


the semi-finals of the US Open for the second time after beating


2015 runner-up Roberta Vinci. The world number two won in straight


sets and will now face Caroline Wozniacki for a place


in Saturday's final. Kerber will become world number one


if she betters the performance of Serena Williams at Flushing


Meadows. World heavyweight champion


Tyson Fury's rematch with Wladimir Klitschko has been


set for 29th Octoberh There's some flash photography


coming up in these pictures. It'll be


11 months after their original fight in Germany after an original date


in July had to be scrapped because Fury picked up


an ankle injury. The British fighter beat Klitschko


in November to claim the WBA, Finally, Great Britain will look


to improve on their London 2012 medal haul when the Paralympics get


underway in Rio tonight. Lee Pearson has been named the


team's flagbearer. He was chosen in a vote by his team-mates.


The team are targeting 121 medals - one more than four years ago.


The headlines coming up later on. Now, back to Victoria. Thank you


very much. This morning we've been debating


the long-running row over a new contract for junior doctors


which has so far led to 162 hours of strike action


including junior doctors Let's hear more from patients. We


have a number of them in the audience as you would expect Hello.


My name is Sarah. I was diagnosed with breast cancer a couple of years


ago so I have a lot of experience of the NHS, not necessarily through


good reasons. What I'd really like to talk about is how when he was


first diagnosed, my oncology and all the treatment I had for my cancer


was clockwork, it was precision, everything, I felt incredibly safe.


I felt really well looked after and I would like to say a big thank you


to all the NHS staff for saving my life, bless you, I'm very grateful.


Subsequently I have had a lot of post-treatment and things that led


me to access the NHS via A Most notably probably a problem with my


arm which led to me getting sepsis, so it was an urgent case. I saw


people in A who, I saw during my time as a cancer patient, and they


were within an inch of their life. They were spread to, I mean,


thousands of people, it seemed like, you know, I was lying in a bed


really poorly. And everyone was doing everything they could to help,


but it was just chaos. So you have huge, you are hugely grateful to the


NHS and you have huge sympathy for what you see as overstretched staff?


Absolutely. Do you support doctors striking for five days at a time


over the next few months? I do. I think to take such action, I really


believe these people. I know them intimately. I don't believe that


they would be doing this unless they had to. I personally have got a lot


of experience, I am a campaigner for the NHS and I speak to sorry...


Don't you worry about safety to patients in those five days? That's


why next week's was called off because it was too short notice said


various regulators and the GMC are saying look, this could be harmful?


Yes and no, but I really believe there, I think, the seniors will


come out and support them. I am in contact with a lot of medical people


at a senior level who I have talked to in in-depth about this. I'm no


politicianks and I don't know the details of the contract, but I trust


what I'm hearing from senior doctors, registrars, consultants,


they are fully behind their junior doctors, and I believe that they


will support the junior doctors during that period. Of course, there


will be operations cancelled. I don't believe they would be doing


this unless they had to. I fully support them. All right.


APPLAUSE Dr Jeeves Wijesuriya is here. You


wanted to come in here. Thank you for your story and thank you for


your support. We really appreciate it. We talked briefly about patient


safety and we talked about the recent set of strikes being


suspended. Firstly, I want to say that the reason that's happened is


because patient safety remains our priority. Our goal is not an


industrial action. Our goal is a negotiated settlement. The reality


is, when we set out these plans, we gave the notice period that's


required, but ultimately we have a escalation protocol for that reason


so if trusts are struggling to provide the coverage during that


period of time, of course, we are going to step back. That's a


priority for us. So that, so you could step back from the five day


strike in October, November and December then, over patient safety


concerns? If there is a concern about patient safety during that


time, raised by Trusts, we have a process for that, but from what we


know in the action we have taken, our consultant colleagues are there,


our associated specialist, other professionals, pharmacists and


nurses, junior doctors will spend this month working with their


colleagues to ensure that the coverage during that time is


adequate. It is interesting to hear you say if those concerns about


patient safety are raised again, you will step back again. We have a


process. The really important thing is, the best case scenarios, we have


a month to stop this happening in the first place. We have a month for


Jeremy Hunt... APPLAUSE


We have a month for Jeremy Hunt to say, "You know what, the BMA have


listened to experts and professionals and they have put


safety first." Surely it is time for me to say I'm not going to impose a


contract that makes a lot of the problems we have with services


overstretched and not enough staff even worse. Good morning? I'm Fay. I


am a patient in the NHS. I'm currently under going care and I'm


waiting for more tests and possible treatment. And I know that this, if


industrial action does take place then my care could be disrupted and


I'm really very worried. I have been waiting a long time for the tests


that I need to have and this could make it even longer. However, I have


listened to what junior doctors have had to say and when I speak to my


doctor, who recommends treatment for me, there is always risks with the


treatment. So they always say well, if you take this medicine and there


could be these complications, but we think that it is right for you to


take it because the benefits outweigh the risks and doctors make


those decisions every day for us. We trust them to make those decisions.


They're trained to make those decisions to do risk analysis and I


hear that what the doctors have done now is that they have said to us,


very clearly, we have done a risk analysis and this, the imposition of


this contract is more dangerous for you for your health, for my health,


it is more dangerous for my health for this contract to be imposed than


for me to have a delay in my treatment due to the strike.


I can hear the anxiety in your voice about waiting for those test


results. When you explained to your consultant that you are supporting


the junior doctors, what is the response? They are happy that I


support them, that I trust them as professionals who have been trained


to care for me and my family and the health of everyone in this country,


and they are happy I am trusting them to tell me what the right thing


for my health and all of our health is. Hello. Thank you for inviting


me, I am a patient advocate and I run an organisation which runs an


online peer support group for people with diabetes. Tens of thousands of


people take over -- take part in our activities. I understand the plight


of the junior doctors, but I cannot support five-day strike or strike


action by doctors and the NHS. I understand their position and I


totally support the issues and the fundamental issues appear to be much


more about resource constraints within the NHS and trying to deliver


a seven-day service with five days of money and trying to deliver a


system that was built at a time when the budget and institutions which


are still delivering it worth it for purpose. I will call on any junior


doctor here to talk to Paul. Let's have a junior doctor. Janice. Pass


the microphone forward. Junior doctor, and a gentleman who runs...


I completely disagree with the Government stance on this. Not only


has Jeremy Hunt lost the confidence of the doctors, if you were to do a


poll of patients, he would not have the support of patients either. Who


is he representing? The issue that has been raised about patient safety


is the thing that is paramount to me. I have a lifelong chronic


condition, I am reliant on the NHS for the rest of my life, so I do not


just dip in and be proud. -- dip out. You are not sure about the


five-day strikes, you were supporting them earlier in the year,


but now things have changed. You would say, don't do it? Definitely


not. I would like to ask the BMA and the Government, both sides are


claiming that this is about patient safety, where is the patient voice?


In none of this debate for the last two years has any panel of patients


been brought together representing any area of patient concern. What we


have our professionals on both sides of the fence pointing fingers at


each other and it has boiled down to a dispute about contract terms and


conditions and it has been escalated into one of patient safety. Who did


the BMA talk to, which patient groups? The Government have not


spoken to a single patient organisation. When the patients get


a voice? A quick response. I agree. It needs to be part of what we do


going forward. Why have you not so far? It has been a contract dispute


between us and the people looking to impose it. I am being briefed


because we are galloping towards the end of the programme. What we have


heard today is their are a lot of issues, a contract dispute but many


other issues. Should we put the NHS through the biggest strike in its


history about those contract issues? It does not seem to be the right


response. I would respectfully ask... I have the support of most of


the people in this room for our current Health Secretary to resign.


I totally agree with you that whilst I contend that it is between the


junior doctors, the Government, I get that, but if we could get a


patient voice in their from the people who are experiencing a really


challenge NHS, we would keep the support for the junior doctors, and


hopefully they would not have to strike. There is a chance for the


Government to grab this by the horns with the new Prime Minister and do


something substantive, to review what we mean about health care


delivery for the millennial generation and reframe the debate


about the needs of patients for the next hundred years, not just the


needs of junior doctors for the next ten. The point you raise about the


need to engage patients is important, and I think... You


haven't done it. I don't work for the Department of Health. As Hugh


referred to earlier, the Conservative manifesto clearly


committed us to introducing a seven-day NHS, this was not


something hidden away towards the back, it was line one of page one of


the manifesto, not about the economy or Europe. I don't believe that the


junior doctors on the BMA would have recommended a deal in May that they


thought was going to damage patient safety. Because it doesn't. It


reduces maximum working hours, it restricts the number of night


shifts, it restricts the number of longer shifts. This will make things


safer for patients. Can I just clarify a misconception that has


been repeated several times today. There was a point at which we said,


we believe we have made progress. The junior doctors committee, the


people that represent the junior doctors, did not give a view. They


said they would stay neutral, because the decision was always


going to be that of junior doctors, who were informed to make an


educated decision. I am a patient, but I work a lot with the NHS, the


third sector. The debate has become polarised. I was supportive of the


junior doctors and I signed the petition for it to go to Government


earlier on in the year. But I am uncomfortable with this five


consecutive days, 50,000 doctors withdrawing their services. My


father was a GP. He was by those with cancer and died three months


later from his diagnosis. You think the five-day plan is


disproportionate? Yes. That is what I am worried about. You have people


waiting for important results. What worries me is, we covered earlier


on, what are the key issues in this contract? It worries me that when we


start moving the debate onto other things other than resolving that...


We need to move this forward, and we need to get patients in the room. So


it focuses people's minds, the Government and the BMA. We are still


waiting for the BMA and Jeremy Hunt to answer our open letter that we


signed, a group of patients, as we want to see an end of this. The NHS


is already crippled. We will talk about how people here think this


dispute might be resolved. Before that, we have talked about the


five-day strikes that are due in October, November and December, here


are the contingency plans that are in place for the strikes if they go


ahead. A five-day strike has


never happened before. But, across the three planned this


year in England, the Government calculates that 75,000 operations


and 750,000 hospital appointments could be postponed as a result,


with nonemergency surgery, such as hip replacements and back


operations, worst affected. This could mean an increasing number


of people fail to have their routine operation within 18 weeks,


causing them further discomfort and placing added pressure on an NHS


target that is already being missed. Hospitals have, however,


been ordered to ensure that most essential services such as A


and maternity wards are well They've been told to draft


in consultants and other senior doctors in place


of the junior doctors. These services reportedly ran


smoothly in the last set of strikes, but there have been concerns that,


with the NHS traditionally being stretched over the winter months,


the next three strikes Striking doctors, however,


will return to work if their employers become concerned


for patient safety - an option not used in the last


set of strikes. The dispute is in England only,


Scotland and Wales have both said they will stick to their existing


contracts, while Northern Ireland has yet to make a decision.


Dr Jeeves Wijesuriya, who is on the junior


doctors committee at the British Medical Association.


The BMA is the union for healthcare professionals,


Mike Wood is Conservative MP for Dudley South.


He says the Government has no choice but to impose


new contracts for junior doctors after negotiations failed.


Also with us, Professor Neena Modi, who is the president


of the Royal College of Paediatrics and Child Health, which


And Andrew Haldenby is the director of Reform, a centre-right


Will the contingency plans be good enough? Having participated in the


previous emergency walk-out, during which my service was covered by my


consultant, who stepped in to support us in our action, they


provided an excellent service for the children who were sick in my


hospital during that time. Can the same be done over five days? I was


not confident about next week, but with more planning it could be. In


the last set of emergency walk-out there was not one single clinical


incident reported in the whole country where patients were put at


risk. When you hear about people making the accusation that we are


being dangerous, it is a myth. We don't know over five days. We have a


responsibility, we are working for the GMC, we have a duty of care for


patients, even when we are striking, and we have to be confident that our


seniors will support us. If it happened that you were on the picket


line during the five days and one of your colleagues ran out and said, we


need you now... We would go in, of course we could. I have to bring you


back to the point that the NHS as it stands is not safe. People argue


about that. Two children's A services have closed recently, 1000


babies transferred because of lack of capacity, further cuts to the


ability of health education England to commission more training places,


so there will be an even greater fall in junior doctor numbers, we


have a shortage of 1000 paediatric consultants, we have had cuts to


Public Health England, we have an increasing burden of chronic


diseases in children. The NHS is creaking at the seams, it is not


safe at the moment, it is really tragic that it has taken strikes


which nobody wants to draw attention to this. But at the least, let's say


that if the public debate and she's, which addresses the current


shortfalls, the current lack of patient safety, that at least will


be a good thing. The contract dispute and some of the specifics we


heard earlier is useful, you think, as a way of drawing in other issues?


I would not have wished it to happen this way. But now that we are where


we are, it has been heart-warming to hear from colleagues in this room,


particularly outpatient colleagues, about what it means to be a patient


in the NHS. When we are talking about publics and they, the public


is always going to be on the side of the doctors. These are people who


have dedicated themselves to the service of humanity, making sure we


live as comfortable as possible. Me and my sister play sport, we always


have injuries and bruises. Each time I have gone to the hospital, I have


had wonderful treatment and I have come back home safely. I don't like


that doctors are being pushed to the limit of their safe procedures. As a


person that uses the NHS frequently, this is terrible to imagine. I hope


Jeremy Hunt has a serious think about what he is doing. Let me read


some more messages from people watching. Ali says, I am due to go


into hospital for a hip replacement soon. The sixth in five years. I


hope you are all right! I am sitting here with a fractured femur. I am in


great pain, but I am 100% supportive of the junior doctors. This message,


why do doctors have the right to pick and choose which shifts they


wish to work's no other emergency services have that right. We require


306 to five day, 24 hour working by the well-paid professionals, they


knew what they were signing up for. Jenny says, last September I had


four disks prolapse from my neck down to my lower spine. I could not


walk Drive, shower or leave the house. I am 35, I had to wait until


January the 3rd to have an MRI you, which took place in the private


hospital, as the NHS could not provide the service. I had to wait


to consultant specialist. I have no intervention other than pain


medication. I have no life. Fix the five-day service, fund a five-day


service, and focus on providing an outstanding five-day service.


Junior doctors, I full support you, but I think you got it.


In the next half hour, we'll look at the current state


of the NHS, but first, let's get a summary of all


The chairman of the troubled Southern Health NHS Foundation Trust


has defended the decision to create a new post on the same


for the Trust's chief executive after she quit in the wake


Katrina Percy had faced multiple calls to resign over her Trust's


failure to investigate hundreds of deaths.


Now the BBC has learned that her new ?240,000 a year job


didn't exist previously and she was the only


The Trust's chairman Tim Smart says the job needed doing and that


Ms Percy was "uniquely qualified" to carry it out.


Passengers on one of Britain's busiest rail lines face more delays


today in the latest 48-hour strike by on board guards Southern trains


are in the middle of a bitter dispute with the RMT union over


who should close the doors on their trains.


40% of services won't run during the strike.


The UK and Australia are to open preliminary


negotiations about a future post-Brexit trade agreement.


Officials from the two countries are to meet twice a year to discuss


But Australia has warned that formal negotiations can't start


until the UK leaves the EU and that it would be at least


two-and-a-half years before any agreement could be finalised.


Junior doctors have been telling this programme why there is so much


anger about the Government trying to impose the crew contract. 15 days of


strike action are planned from October. Doctors and those in the


medical profession have been telling this programme why they feel so


strongly about the strike. You blame the BMA. I don't think they have


played their cards particularly right. They could have done better.


But I blame Jeremy Hunt. Jeremy Hunt back off. Just leave us


APPLAUSE Leave us alone. The thing that


really worries me. If the NHS is already crippled, if it is already


on its knees, how is the NHS going to be further enhanced by the junior


doctors going on strike? Radical preacher Anjem Choudhary


is today starting a five-and-a half year jail sentence for inviting


support for Islamic State. But how should prisons deal


with someone like him? Is it possible to


change their views? Secunder Kermani has been speaking


to one of Choudhary's high profile former supporters who now, thanks


to the work of a de-radicalisation These two men know Anjem Choudhary


and his circle like few others. This man used to be one of his followers.


That changed after he met a trainer who deradical isz extremists


including successfully reforming half a dozen of Anjem Choudhary


supporters. Jammal had been part of a group calling themselves Muslim


Patrol who claim to be enforcing Sharia rules in London. For that, he


spent nearly two years in prison. Since Choudhary's conics, it has


been announced the prison regime is changing. Extremists will be split


from the general population, but will it work? What they need to have


inside the prison are people who are able to challenge when the beliefs


arise within the discussions. They need to have people capable of


challenging them. And are there enough people there? There needs to


be more. Isolating them will not do anything. These individuals one day


have to be released. They are not individuals who will spend the rest


of their life in prison. It is full of challenges. What could end up is


him validating himself and mutating into some type of authority within


that system because the prison sentence gives him his stripes.


REPORTER: Improves his credibility? Yeah. This man has had more success.


How does he get through to them? We're sitting with them. We look at


their perception. Islam was traditionally an oral tradition.


Yeah, it is about sitting with a teacher who then looks at the


textbook and explains what it means. He doesn't just debate ideology, he


forms a strong personal connection. For him to, you know, be concerned


on a personal level, not just an intellectual level, it was never


that discussion to start off with. It is to say we are humans and I


care for you as a human being, to take away that divide that existed


that us and them that existed and to replace with a xlective


understanding. Many de-radicalisation attempts in jail


fail. The current way of dealing or trying to deal with this Islam


fascist ideology is coming in with your own lit tral interpretation. So


we've got a literal interpretation versus a literal interpretation. So


you're basically singing off the same hymn sheet except it is a few


degrees down. And what happens with this is that the individual will sit


there, nod his head, and then as soon as he is at the end of his


licence, he is back in the community, back it his old tricks,


criticising what he has just been through. They think it is possible


Anjem Choudhary could reconsider his beliefs in prison, but in the


meantime, they're dealing with the legacy of his influence in the


outside world. After scoring on his debut


for Manchester United last season AND on his first senior


England appearance too, Marcus Rashford makes it three out


of three with goals on his first His hat-trick against Norway helped


England to a 6-1 win in their European


Championship qualifier. Novak Djokovic has reached


the semi-finals of the US Open But for the third time in this


year's tournament he didn't have Jo Wilfried Tsonga was two sets down


when following treatment on a knee Tyson Fury and Wladimir Klitschko


have rescheduled their world It'll now take place on 29th October


in Manchester after the original date was scrapped because of


an injury to the British fighter. Fury won the WBA, WBO AND IBF titles


from the Ukrainian in their And after a vote by his teammates,


ten-time Paralympic champion Lee Pearson will carry the flag


at tonight's opening It'll kick off 11 days


of action in Rio. More sport later. Now back to


Victoria. We have got people with passionate


views about the junior doctors contract dispute and the forthcoming


strikes. You know the one next week has been called off. Strikes are due


in October, November and December, but as the BMA junior doctors


representative told us, they could be cancelled once your process has


been gone through if I understood you correctly. An anonymous text, "I


am watching from my hospital bed. I can't fault my treatment over the


last eight years. I'm concerned about Jeremy Hunt's motives and I


feel he is using the junior doctors as pawns in his long-term plans for


the NHS." Chris says, "As a former soldier I'm disgusted. In the junior


doctors willingness to hold the country to ransom. It is the Armed


Forces that covered the backs of those that have gone on strike in


the past ie firemen, etcetera. We can't strike and we get paid only a


small fraction of the salaries of those that do. You're losing support


for your cause now. It is time to enact your oath and your obligations


to your public." Let's talk to Hugh Pym about pay. I


read the junior doctors draft contract. It is very long. Lots of


it, I didn't understand. I did understand there is a basic pay rise


of 10% to 11% and if you end up working one weekend in two you will


get 10% of your basic salary as a supplement and if you work one in


four, it reduces. Is that accurate? Victoria, I commend you for reading


the contract! It is a highly complex document. You have possibly read


more of it than I have! But the essence of it is and this is what


this debate and this dispute has been about is how you reward doctors


financially for working very unsocial hours and lots of different


weekends. And what's been the aim of the Government is to raise basic pay


by about 11% and in return, you cut the extra that was being paid out


for working unsocial hours. I think the BMA accepted it was worth


looking at this because it had become so complicated, but the deal


that was reached, and it remains pretty complicated, clearly 58% of


doctors out there didn't feel that it met their concerns. Now, some


people out there are saying, "We work at weekends. We don't get paid


extra." What doctors would say, they work a lot of unsocial hours and why


do they have to sacrifice something financially because there maybe some


at the margins who lose out short-term when we work so hard. The


bigger picture is this business of recruitment and retention. Do you


risk losing doctors longer term if you don't get that balance right at


this precise moment in time? OK. Hands shot up then! Pass the


microphone over here. Hi. Hi. My name is Maria. I'm a senior nurse. I


supported junior doctors through the industrial action last year and I


will continue to support them. What I found throughout is doctors are


really reluctant to complain about being poorly paid. They're really


reluctant to ask for more money. Are they poorly paid do you believe? I'm


not saying they are poorly paid, but they are not well paid. They are in


no way on par with their colleagues in the City. A few years ago, we had


we have to give the bankers their bonus because we don't want to lose


the expertise, we are happy to haemorrhage our well trained doctors


out of this country. I think it is a disgrace. It wasn't just in the last


few years that MPs had been 11% pay rise each year consecutively while


we nurses and doctors have actually had pay cuts because we have not


even had the percentage with inflation. So I think it is really


double standards. Can I ask our representative from the junior


committee on the BMA. It is a basic pay rise of 10% to 11% and if you


work one in two weekends, 10% of your basic salary on top. Let's just


talk about percentage terms. I know there are 100 other issues, what


increase do you think would satisfy your members? So, firstly, when


we're talking about an increase, it is one way of looking at it. The


problem that we have is... Please just answer the question and then


you can tell us about problems. This does answer the question.


Ultimately, what we have right now and we've talked about today is that


we have a huge staffing problem. We have services that are already in


one in seven trusts closing down services or cutting them short


because we don't have the staff to provide them. The areas that we're


seeing that the most in, emergency services, children's doctors, these


are the groups that work the most anti-social hours. What these


changes mask actually is the people that do work those most anti-social


hours are the ones that see a decease in pay. They don't see the


increase. That worsens the recruitment crisis and what is


counter-intuitive is Mr Hunt has been talking about a seven day


service. I'm going to bring you back. What percentage increase would


satisfy your colleagues, do you believe? We need to talk about the


distribution. I'm asking you a really sensible question... I can't


give you an exact percentage because we need to look at those specific


areas and speak to the Government about how they intend to fund them.


Jeremy Hunt has not produced a plan. Something we have asked for over a


yearment we are talking about a plan that no one has seen. There is a man


from a Thing tank who is rubbing his chin. Explain why.


We have been in a pay dispute for two years, one side cannot even tell


us what they would like to settle the dispute. All I want is a


percentage, a figure, that you think would be acceptable in terms of


either the basic pay going up or the supplement for weekend working. Can


you give me a figure? It is not about a percentage. I just want to


keep the same salary I have, I don't want a pay cut or a rise, I just


want to stay the same. What percentage increase would you need


with this contract to bring it back to what you say you have now? My


basic salary is ?36,000 plus a 50% banding. Whatever it is that they


need to calculate to make sure I can get the same take-home pay. Some


sort of increased to match what you get now? OK. Whatever we have now.


Just leave us alone, give us the same contract we have already. With


the new contract, without the pay protection that is being put in


place, I would take a pay cut from the new contract for the same hours.


By what percentage? I think it is about ?300 a month. I know you don't


like the question, so respond. It is illegitimate question when you think


about pay in general and giving a simple answer -- a legitimate. There


is a flexible pay premium watch the Government have to put in place to


ensure that I as a trainee, who work all day, every night, two weekends


every month, the premium can be taken away by the Government


whenever it wants just to ensure I get paid the same as any other


doctor working in the NHS. That this incentivises people from working


they don't have any doctors left, I get e-mails everyday to fill in


ready gaps. Introduce yourself. You are a trainee medic. If this


contract is brought in, what will happen? I am a final year medical


student. How do you feel about going into this profession? Very worried.


My colleagues are concerned as well. Already, we can see that the amount


of medical students coming in has dropped by 20%. We don't know if


that is related to this dispute. I think a lot of it is. As the


professor said earlier, there is a shortage of doctors, and if this


contract is making fewer prospective students joined the field, that is


really dangerous. A lot of the students are sitting exams to go to


America or Australia or Canada. If you think that doctors are paid well


here, they are not all stop --. ?23,000. That is the basic starting


salary. We will talk about how people here think this dispute could


be resolved, if they think it can be. It has got to be resolved at


some point. The man on behalf of service across the UK is rising, so


our costs, which is why the stakes could not be higher.


The latest dispute between junior doctors and the Government


comes at a difficult time for the NHS in England.


NHS England needs to find ?22 billion in annual


Added to that, ministers want to extend services at weekends,


which puts pressure on the existing challenges already facing the NHS,


not just in England, but across the country.


After the vote in June, health leaders warned that


leaving the EU could make staffing shortages worse.


The NHS Confederation said 10% of NHS doctors come from the EU.


People are living longer, putting further pressure on the service.


The growing number of elderly people means more patients


Up to two thirds of hospital beds are estimated to be occupied


Changes in what can and can't be done medically has


revolutionised care, but it comes at a cost.


Treating survivors of medical conditions that in the past


might have killed them requires extra money.


Paying for progress in medical technology costs the NHS


People may be smoking less, but they are drinking more


The bill for dealing with alcohol abuse is around ?3 billion per year.


Despite campaigns to get people to live healthier, the number


of obese people in Britain could double in the next 40 years.


So demand on the health service across the UK is rising,


and so are the costs, which is why the stakes


in the ongoing dispute with the junior doctors


Let's hear from more in our audience, talking about how this


could get resolved. I am a third-year medical student. Having


been in medical school for three years, my degree will be for six


years, I think this contract makes me incredibly sad that I will not be


doing what I love, I don't think. Purely because it is making me think


about either leaving medicine or going to a different country. It


saddens me because I value the NHS, I was not born here, but coming to


England, this wonderful NHS and everything, it works. I will not be


able to be part of it. I don't want this contract to be imposed and I am


not happy with it. Let's talk about this dispute. How people think it


could be resolved. I am from a campaigning organisation, which has


local branches all over the country. I wanted to say that in 2007 our


health service was funded to the same proportion of GDP as other


European countries, and it has been steadily falling since then. 1% of


GDP amounts to ?20 billion will stop if we were funded at the same level


as France, we would have 40 billion more, Germany 60 billion more, per


year. That has been taken out of the budget so far by cutting the wages


of NHS staff, not just junior doctors. Keeping them down to the


low -- below levels of inflation. But they have been cut to the limit.


What is coming next big cuts in services, and they will be announced


in the autumn. I think Jeremy Hunt is using Jeremy -- junior doctors as


a shield to protect him against the flak that will fly as soon as people


know that their local A will be closed, their local maternity ward


will be closed, and they will have to travel much further to get


treatment. We will see what happens. How can this be resolved? I am a


freelance journalist. I want to look at resolution in two ways. It is


difficult in the short-term if you SSP strike is a strategy, to see how


it can work. The NHS is political, Jeremy Hunt cannot back off, it is


Government run, and by increasing the political pressure on the


Government, you give them less room to manoeuvre, and it is a political


issue. By rejecting the BMA's proposal a few months ago, the


junior doctors have made -- undermined the BMA as a negotiating


partner. I don't think the public attitudes to doctors are immutable.


If we start introducing this sort of action to the NHS, it could


fundamentally change public attitudes are. A junior doctor said


Jeremy Hunt should back off. I don't think it is a position where there


is an easy win. The Government could have handled itself better, but the


long-term risks of a strike a counter-productive. There has been a


lot of talk about NHS funding and the shortcomings of supply. We heard


earlier one of the things that people think they are striking about


is privatisation. My father spent almost a year in NHS care, my


mother, who has worked in the NHS, helped to look after him, and he was


put up in the hospital where she started training. As we did a tour,


she showed me what used to be the pay wing of a public hospital. This


brought in private patients, they paid money which was spent on the


NHS. Currently, Britain has private health care. Rich people who already


pay the taxes towards the NHS pay extra for private health care, but


they go to private hospitals and all of the money gets locked up in the


private system. Long-term,... We have talked about... We talked about


European models, they make it easier to bring money into their health


service, so we need to look at in magic to solutions like that. Do you


have a resolution? I do. It has been great to hear from lots of different


people from lots of groups. The universal thing is there are


problems in this contract. Even Andrew said so. People say the


contract is not good, but why do they have to strike? Resolution!


Number one, take imposition of the table. Number two, even more


important, if you want to produce a seven-day service, give me a well


costed spreadsheet of what it involves. He pushed the doctors for


what percentage would solve this, I am in my last year, I want


resources, I don't want a rise in pay. I want a well costed


spreadsheet. I am a local councillor in Ealing. I am teaching medical she


did as well. -- students. It is money, we need more central funding.


This dispute is one of the death by a thousand cuts that the NHS is


withstanding. That is what we need, more money. I work in the railway


industry. A seven-day week will be robbing Peter to pay Paul. The


five-day week is not funded well enough. It is not work because the


NHS is not funded well enough. My challenge to the Government is to


find the money from wherever you need to find it. From Philip Green,


maybe, anyone, really. Find the money, make the five-day week work,


stop giving these people a hard time, they are amazing people, and


then we can talk about a seven-day week. How do you see this dispute?


The two sides were far apart in May, it was the royal colleges who got


them around the table, that resulted in the agreement that was thrown up.


Now the Government say, why should we negotiate with the BMA is they


agree and it goes to a referendum and it is thrown out again? The BMA


say, 58% of our members have rejected this contract. It will take


somebody, they didn't royal colleges are behind-the-scenes, to get people


around the table, but I see that as very distant. Ten seconds to give me


a resolution. For a resolution, the doctors have been ground into the


ground. Resolution! MPs get paid ?70,000 a year, doctors get 20. Give


them a pay rise? Yes, and sit around a table and discuss and leave it to


the professionals. Resolution, really briefly. Come back to the


table, discuss with doctors, listen to the evidence, we should not make


decisions on a whim. They should not be a bad opinion politics, it should


be based on evidence. Briefly. Bring it back to the patient, bring in a


risk register, matched the risk to resources, it is about patient


safety. Thank you. And you do everybody who has taken part. You


can give yourselves a round of applause.


Victoria Derbyshire holds a debate on the long-running junior doctors' strike. She speaks to the junior doctors planning to walk out, other NHS workers and the patients that will be affected.

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