07/09/2016 Victoria Derbyshire


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07/09/2016

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.

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Good morning and welcome our programme.

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

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Plus plus

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I support the strike patient safety is put

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we simply cannot accept this new contract.

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

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but the thought about striking breaks my heart.

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

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

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

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another 15 days of strikes before the year is out.

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

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I fear it will compromise patient safety.

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

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

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

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

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

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

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

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

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Southern Health NHS Foundation Trust has defended the decision to create

:02:04.:02:07.

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

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after she quit in the wake Katrina Percy had faced multiple

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calls to resign over her Trust's failure to investigate

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hundreds of deaths. Now the BBC has learned

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

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

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

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

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

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

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failed to investigate patient be investigating every death that's

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

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

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

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

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

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with the BBC. REPORTER: Did the new job exist

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

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

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

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

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

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

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

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

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

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

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

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outrageous. Southern Heth say they have addressed the failings,

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

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

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

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safety and the quality of care first.

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

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and Safety Executive over the earlier deaths of patients.

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

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on this at 7.30pm tonight on BBC One.

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

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

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

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

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union over who should close the doors on their trains.

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Our Transport Correspondent Richard Westcott reports.

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

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

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

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

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allow trains to be travelling without any guard on board.

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

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trains have been running safely for decades.

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

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part of the solution and not the problem here,

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

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It's piling on the misery for Southern passengers,

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

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Matt Steel used to be a Southern customer until his commute

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

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found work closer to home and started cycling instead.

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

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

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

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

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The UK and Australia are to open preliminary

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negotiations about a future post-Brexit trade arrangement.

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

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to meet International Trade Secretary Liam Fox, said officials

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

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But he added that formal negotiations can't start

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

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

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Our assistant political editor Norman Smith is at Westminster.

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

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

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

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

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

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

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

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

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

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

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negotiations until Britain has actually left the European Union and

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

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

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first. Thank you, Norman.

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Babies delivered by caesarean section are significantly more

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

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

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

:08:31.:08:32.

Experts say rising caesarean rates could contribute to

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Researchers warn of a "vicious circle" because overweight women

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are themselves more likely to need a caesarean.

:08:41.:08:46.

Councillors in London have voted to close

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the well-known nightclub, Fabric.

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

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at the club died as a result of taking drugs.

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Almost 150,000 people signed a petition to try

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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books and reunited The letter was written

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

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disappeared during a It was discovered by chance

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by Gordon Draper who runs a book shop in Bishop

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Aucklands near Durham. Marcus Rashford for his exploits

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last season for both The teenager has now scored

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

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against Norway in their qualifier for the European Championship next

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

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included by Sam Allardyce Because he's not been playing

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for Manchester United. Although on his only

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appearance this season. Last night in Colchester he wrapped

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up the first hattrick How have Portugal been getting on?

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

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

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came in quick succession in the first-half.

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

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

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

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Switzerland also had a man sent off late on.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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their international T20 at Old Trafford. They broke the world

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

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

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

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

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

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

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

:14:30.:14:33.

withdrawal symptoms after what happened in the Olympics, but they

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

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

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

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

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

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

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

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Back to Victoria. This morning - do you support

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

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

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people to play politics with patients' lives.

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

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

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

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

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

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Secretary Jeremy Hunt first proposed a new contract.

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This all began at the tail end of 2012.

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Junior doctors in England needed a new employment contract.

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

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

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

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

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Heart attacks, major accidents, babies - these things

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Then the Conservative Party went into the general election

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

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The Government wanted to make it cheaper for hospitals and surgeries

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to rota doctors on in the evenings and at weekends.

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It planned to raise basic wages, but cut extra pay

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Doctors argued the new plan was unfair and unsafe,

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

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

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

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The most recent saw junior doctors withdraw emergency care

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Then, a pause was agreed and talks restarted.

:17:34.:17:40.

It looked like a breakthrough was possible.

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

:17:43.:17:47.

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

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

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to find realistic solutions to the problems that junior doctors

:17:57.:18:00.

face across the NHS, that is what we have

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

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The Government said it would impose the contract

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

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

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

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

:18:36.:18:38.

Scotland and Wales have both said they will be sticking

:18:39.:18:41.

to their existing contracts, while Northern Ireland has yet

:18:42.:18:43.

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

:18:44.:18:47.

So do you support the junior doctors' strike?

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

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

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

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

:19:12.:19:17.

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

:19:18.:19:23.

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

:19:24.:19:29.

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

:19:30.:19:33.

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

:19:34.:19:40.

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

:19:41.:19:48.

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

:19:49.:19:53.

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

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

:20:00.:20:06.

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

:20:07.:20:11.

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

:20:12.:20:21.

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

:20:22.:20:26.

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

:20:27.:20:32.

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

:20:33.:20:37.

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

:20:38.:20:41.

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

:20:42.:20:48.

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

:20:49.:20:53.

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

:20:54.:21:01.

withdrawal of emergency care. The forthcoming strike that are

:21:02.:21:06.

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

:21:07.:21:12.

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

:21:13.:21:18.

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

:21:19.:21:28.

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

:21:29.:21:33.

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

:21:34.:21:39.

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

:21:40.:21:43.

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

:21:44.:21:48.

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

:21:49.:21:58.

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

:21:59.:22:03.

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

:22:04.:22:08.

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

:22:09.:22:13.

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

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

:22:19.:22:25.

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

:22:26.:22:30.

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

:22:31.:22:39.

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

:22:40.:22:43.

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

:22:44.:22:48.

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

:22:49.:22:52.

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

:22:53.:22:57.

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

:22:58.:23:02.

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

:23:03.:23:07.

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

:23:08.:23:10.

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

:23:11.:23:16.

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

:23:17.:23:23.

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

:23:24.:23:28.

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

:23:29.:23:32.

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

:23:33.:23:39.

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

:23:40.:23:43.

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

:23:44.:23:50.

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

:23:51.:23:52.

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

:23:53.:23:59.

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

:24:00.:24:06.

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

:24:07.:24:10.

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

:24:11.:24:14.

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

:24:15.:24:22.

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

:24:23.:24:26.

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

:24:27.:24:35.

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

:24:36.:24:38.

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

:24:39.:24:47.

than agonising over having to contemplate feeling like we are

:24:48.:24:51.

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

:24:52.:24:55.

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

:24:56.:25:03.

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

:25:04.:25:07.

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

:25:08.:25:13.

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

:25:14.:25:19.

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

:25:20.:25:25.

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

:25:26.:25:31.

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

:25:32.:25:34.

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

:25:35.:25:42.

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

:25:43.:25:44.

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

:25:45.:25:49.

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

:25:50.:25:53.

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

:25:54.:25:59.

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

:26:00.:26:03.

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

:26:04.:26:10.

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

:26:11.:26:16.

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

:26:17.:26:20.

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

:26:21.:26:27.

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

:26:28.:26:32.

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

:26:33.:26:38.

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

:26:39.:26:42.

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

:26:43.:26:46.

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

:26:47.:26:52.

Hunt pushing for this transformation and sustainability agenda, a planned

:26:53.:26:57.

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

:26:58.:27:05.

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

:27:06.:27:14.

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

:27:15.:27:19.

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

:27:20.:27:25.

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

:27:26.:27:33.

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

:27:34.:27:39.

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

:27:40.:27:43.

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

:27:44.:27:47.

elective services like antenatal clinics will have to be cancelled,

:27:48.:27:51.

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

:27:52.:27:55.

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

:27:56.:28:00.

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

:28:01.:28:05.

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

:28:06.:28:10.

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

:28:11.:28:14.

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

:28:15.:28:19.

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

:28:20.:28:24.

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

:28:25.:28:31.

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

:28:32.:28:37.

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

:28:38.:28:44.

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

:28:45.:28:47.

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

:28:48.:28:54.

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

:28:55.:28:58.

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

:28:59.:29:04.

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

:29:05.:29:08.

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

:29:09.:29:14.

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

:29:15.:29:19.

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

:29:20.:29:27.

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

:29:28.:29:32.

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

:29:33.:29:38.

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

:29:39.:29:44.

democratic employment contract. The other publication is that the BMA

:29:45.:29:51.

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

:29:52.:29:55.

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

:29:56.:29:59.

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

:30:00.:30:04.

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

:30:05.:30:09.

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

:30:10.:30:14.

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

:30:15.:30:20.

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

:30:21.:30:26.

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

:30:27.:30:27.

What else? Specifically. We talked about gender

:30:28.:30:41.

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

:30:42.:30:45.

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

:30:46.:30:49.

qualified doctors, but we are training to become consultants.

:30:50.:30:53.

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

:30:54.:30:56.

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

:30:57.:31:02.

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

:31:03.:31:09.

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

:31:10.:31:13.

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

:31:14.:31:16.

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

:31:17.:31:22.

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

:31:23.:31:25.

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

:31:26.:31:29.

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

:31:30.:31:31.

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

:31:32.:31:35.

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

:31:36.:31:40.

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

:31:41.:31:45.

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

:31:46.:31:48.

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

:31:49.:31:53.

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

:31:54.:32:00.

agree on? APPLAUSE

:32:01.:32:06.

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

:32:07.:32:10.

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

:32:11.:32:15.

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

:32:16.:32:23.

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

:32:24.:32:29.

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

:32:30.:32:38.

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

:32:39.:32:47.

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

:32:48.:32:50.

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

:32:51.:32:54.

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

:32:55.:33:00.

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

:33:01.:33:04.

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

:33:05.:33:09.

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

:33:10.:33:13.

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

:33:14.:33:17.

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

:33:18.:33:24.

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

:33:25.:33:27.

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

:33:28.:33:30.

doctor committee described it as beneficial to our patients and

:33:31.:33:34.

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

:33:35.:33:42.

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

:33:43.:33:46.

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

:33:47.:33:50.

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

:33:51.:33:56.

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

:33:57.:34:01.

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

:34:02.:34:05.

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

:34:06.:34:10.

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

:34:11.:34:16.

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

:34:17.:34:20.

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

:34:21.:34:24.

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

:34:25.:34:32.

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

:34:33.:34:35.

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

:34:36.:34:40.

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

:34:41.:34:44.

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

:34:45.:34:47.

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

:34:48.:34:50.

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

:34:51.:34:55.

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

:34:56.:35:00.

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

:35:01.:35:05.

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

:35:06.:35:10.

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

:35:11.:35:14.

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

:35:15.:35:18.

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

:35:19.:35:22.

The problem we have is, unfortunately, the Secretary of

:35:23.:35:25.

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

:35:26.:35:30.

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

:35:31.:35:35.

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

:35:36.:35:39.

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

:35:40.:35:43.

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

:35:44.:35:48.

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

:35:49.:35:51.

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

:35:52.:35:56.

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

:35:57.:36:00.

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

:36:01.:36:04.

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

:36:05.:36:09.

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

:36:10.:36:12.

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

:36:13.:36:18.

informed decision. Victoria, I think that it is

:36:19.:36:23.

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

:36:24.:36:28.

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

:36:29.:36:31.

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

:36:32.:36:35.

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

:36:36.:36:41.

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

:36:42.:36:45.

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

:36:46.:36:52.

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

:36:53.:36:59.

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

:37:00.:37:04.

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

:37:05.:37:09.

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

:37:10.:37:13.

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

:37:14.:37:19.

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

:37:20.:37:23.

suspension of paediatric A services, we have seen reports that

:37:24.:37:27.

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

:37:28.:37:32.

unnecessarily transferred between hospitals because of lack of

:37:33.:37:38.

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

:37:39.:37:43.

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

:37:44.:37:54.

happened, the NHS Public Health England, everything that encompasses

:37:55.:37:57.

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

:37:58.:38:00.

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

:38:01.:38:04.

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

:38:05.:38:09.

considerations into account simultaneously.

:38:10.:38:12.

APPLAUSE Hello. There is a wider health

:38:13.:38:18.

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

:38:19.:38:22.

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

:38:23.:38:26.

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

:38:27.:38:30.

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

:38:31.:38:34.

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

:38:35.:38:38.

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

:38:39.:38:43.

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

:38:44.:38:46.

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

:38:47.:38:51.

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

:38:52.:38:55.

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

:38:56.:39:04.

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

:39:05.:39:10.

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

:39:11.:39:13.

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

:39:14.:39:16.

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

:39:17.:39:20.

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

:39:21.:39:23.

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

:39:24.:39:28.

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

:39:29.:39:32.

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

:39:33.:39:36.

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

:39:37.:39:40.

APPLAUSE I'm an orthopaedic registrar and a

:39:41.:39:43.

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

:39:44.:39:48.

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

:39:49.:39:53.

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

:39:54.:39:56.

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

:39:57.:40:01.

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

:40:02.:40:05.

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

:40:06.:40:08.

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

:40:09.:40:13.

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

:40:14.:40:18.

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

:40:19.:40:23.

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

:40:24.:40:29.

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

:40:30.:40:34.

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

:40:35.:40:38.

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

:40:39.:40:41.

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

:40:42.:40:46.

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

:40:47.:40:50.

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

:40:51.:40:55.

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

:40:56.:41:02.

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

:41:03.:41:06.

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

:41:07.:41:11.

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

:41:12.:41:19.

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

:41:20.:41:23.

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

:41:24.:41:28.

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

:41:29.:41:32.

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

:41:33.:41:34.

priority. APPLAUSE

:41:35.:41:37.

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

:41:38.:41:41.

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

:41:42.:41:44.

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

:41:45.:41:50.

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

:41:51.:41:53.

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

:41:54.:41:57.

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

:41:58.:42:03.

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

:42:04.:42:06.

contract which I know causes harm and which the Government knows

:42:07.:42:11.

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

:42:12.:42:15.

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

:42:16.:42:20.

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

:42:21.:42:24.

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

:42:25.:42:29.

being protected. Equivalent to being employees of health education

:42:30.:42:32.

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

:42:33.:42:35.

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

:42:36.:42:39.

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

:42:40.:42:43.

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

:42:44.:42:50.

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

:42:51.:42:56.

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

:42:57.:43:00.

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

:43:01.:43:04.

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

:43:05.:43:10.

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

:43:11.:43:15.

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

:43:16.:43:20.

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

:43:21.:43:23.

NHS debate has got very confused because when the strikes happened

:43:24.:43:27.

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

:43:28.:43:34.

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

:43:35.:43:37.

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

:43:38.:43:41.

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

:43:42.:43:44.

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

:43:45.:43:51.

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

:43:52.:43:58.

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

:43:59.:44:03.

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

:44:04.:44:08.

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

:44:09.:44:11.

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

:44:12.:44:16.

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

:44:17.:44:20.

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

:44:21.:44:25.

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

:44:26.:44:30.

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

:44:31.:44:34.

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

:44:35.:44:39.

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

:44:40.:44:44.

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

:44:45.:44:49.

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

:44:50.:44:54.

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

:44:55.:44:58.

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

:44:59.:45:02.

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

:45:03.:45:06.

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

:45:07.:45:13.

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

:45:14.:45:14.

NHS. You admit there is a problem at

:45:15.:45:23.

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

:45:24.:45:29.

diagnostics and people waiting in A are not acceptable at the

:45:30.:45:35.

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

:45:36.:45:41.

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

:45:42.:45:48.

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

:45:49.:46:00.

Save our NHS! Save our NHS!

:46:01.:46:02.

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

:46:03.:46:05.

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

:46:06.:46:08.

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

:46:09.:46:11.

With a future Conservative Government, we would

:46:12.:46:13.

The Conservatives envisage people having access to local GPs

:46:14.:46:20.

seven days a week and, crucial to this debate,

:46:21.:46:23.

patients receiving the same level of urgent and emergency care

:46:24.:46:26.

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

:46:27.:46:31.

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

:46:32.:46:34.

represent the bulk of medical professionals on shift.

:46:35.:46:37.

Tweets directed at the Health Secretary,

:46:38.:46:39.

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

:46:40.:46:44.

But while emergency care is available at weekends,

:46:45.:46:46.

And, under the current junior doctors contracts,

:46:47.:46:52.

ministers say it would be too expensive for hospitals to roster

:46:53.:46:54.

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

:46:55.:47:00.

suggestion that a lack of staff is increasing the

:47:01.:47:03.

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

:47:04.:47:08.

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

:47:09.:47:13.

if they are admitted on a Sunday than a Wednesday.

:47:14.:47:16.

The British Medical Journal, however, which published

:47:17.:47:18.

the findings, believes the data has been misinterpreted.

:47:19.:47:22.

It says there are other factors that must be considered,

:47:23.:47:25.

such as how patients admitted at weekends tend to be sicker

:47:26.:47:28.

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

:47:29.:47:31.

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

:47:32.:47:37.

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

:47:38.:47:40.

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

:47:41.:47:47.

Leaked Department of Health documents revealed in August that

:47:48.:47:49.

civil servants worry that a lack of available GPs,

:47:50.:47:51.

hospital consultants and other health professionals

:47:52.:47:54.

would mean the full vision could not be delivered.

:47:55.:47:57.

Government sources said this was a normal risk assessment.

:47:58.:48:08.

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

:48:09.:48:14.

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

:48:15.:48:22.

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

:48:23.:48:32.

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

:48:33.:48:36.

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

:48:37.:48:44.

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

:48:45.:48:50.

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

:48:51.:48:55.

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

:48:56.:49:02.

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

:49:03.:49:05.

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

:49:06.:49:10.

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

:49:11.:49:15.

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

:49:16.:49:19.

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

:49:20.:49:26.

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

:49:27.:49:31.

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

:49:32.:49:38.

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

:49:39.:49:45.

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

:49:46.:49:50.

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

:49:51.:49:54.

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

:49:55.:50:00.

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

:50:01.:50:04.

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

:50:05.:50:07.

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

:50:08.:50:10.

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

:50:11.:50:14.

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

:50:15.:50:19.

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

:50:20.:50:27.

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

:50:28.:50:33.

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

:50:34.:50:41.

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

:50:42.:50:45.

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

:50:46.:50:49.

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

:50:50.:50:54.

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

:50:55.:51:00.

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

:51:01.:51:07.

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

:51:08.:51:14.

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

:51:15.:51:17.

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

:51:18.:51:24.

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

:51:25.:51:35.

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

:51:36.:51:43.

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

:51:44.:51:48.

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

:51:49.:51:53.

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

:51:54.:51:57.

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

:51:58.:52:03.

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

:52:04.:52:14.

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

:52:15.:52:20.

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

:52:21.:52:24.

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

:52:25.:52:30.

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

:52:31.:52:34.

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

:52:35.:52:39.

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

:52:40.:52:44.

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

:52:45.:52:51.

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

:52:52.:52:56.

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

:52:57.:53:02.

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

:53:03.:53:06.

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

:53:07.:53:15.

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

:53:16.:53:26.

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

:53:27.:53:33.

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

:53:34.:53:39.

the point of delivery, say the Conservatives. Hospitals can

:53:40.:53:44.

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

:53:45.:53:49.

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

:53:50.:53:54.

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

:53:55.:53:58.

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

:53:59.:54:03.

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

:54:04.:54:06.

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

:54:07.:54:09.

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

:54:10.:54:16.

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

:54:17.:54:23.

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

:54:24.:54:29.

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

:54:30.:54:38.

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

:54:39.:54:45.

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

:54:46.:54:50.

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

:54:51.:54:54.

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

:54:55.:54:59.

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

:55:00.:55:04.

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

:55:05.:55:10.

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

:55:11.:55:15.

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

:55:16.:55:21.

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

:55:22.:55:26.

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

:55:27.:55:31.

they would not say privatisation was their main motivation in this

:55:32.:55:36.

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

:55:37.:55:38.

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

:55:39.:55:48.

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

:55:49.:55:53.

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

:55:54.:55:57.

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

:55:58.:56:03.

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

:56:04.:56:08.

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

:56:09.:56:13.

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

:56:14.:56:20.

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

:56:21.:56:26.

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

:56:27.:56:30.

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

:56:31.:56:36.

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

:56:37.:56:40.

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

:56:41.:56:46.

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

:56:47.:56:52.

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

:56:53.:56:53.

the weather. It was a warm and humid start today

:56:54.:57:03.

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

:57:04.:57:08.

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

:57:09.:57:12.

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

:57:13.:57:20.

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

:57:21.:57:24.

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

:57:25.:57:30.

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

:57:31.:57:35.

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

:57:36.:57:38.

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

:57:39.:57:43.

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

:57:44.:57:50.

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

:57:51.:57:54.

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

:57:55.:57:58.

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

:57:59.:58:06.

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

:58:07.:58:09.

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

:58:10.:58:13.

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

:58:14.:58:16.

Ireland and northern England and southern and eastern Scotland.

:58:17.:58:22.

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

:58:23.:58:25.

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

:58:26.:58:32.

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

:58:33.:58:37.

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

:58:38.:58:43.

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

:58:44.:58:49.

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

:58:50.:58:54.

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

:58:55.:58:58.

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

:58:59.:59:05.

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

:59:06.:59:10.

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

:59:11.:59:15.

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

:59:16.:59:20.

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

:59:21.:59:24.

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

:59:25.:59:28.

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

:59:29.:59:36.

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

:59:37.:59:37.

Good morning and welcome our programme.

:59:38.:59:39.

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

:59:40.:59:48.

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

:59:49.:59:55.

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

:59:56.:59:59.

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

:00:00.:00:03.

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

:00:04.:00:08.

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

:00:09.:00:13.

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

:00:14.:00:19.

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

:00:20.:00:22.

choose to do. I know how hard they work.

:00:23.:00:26.

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

:00:27.:00:31.

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

:00:32.:00:35.

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

:00:36.:00:39.

this. We will continue our debate on the

:00:40.:00:43.

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

:00:44.:00:48.

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

:00:49.:01:00.

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

:01:01.:01:02.

The chairman of the troubled Southern Health NHS Foundation Trust

:01:03.:01:06.

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

:01:07.:01:09.

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

:01:10.:01:11.

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

:01:12.:01:19.

failure to investigate hundreds of deaths.

:01:20.:01:20.

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

:01:21.:01:23.

didn't exist previously, and she was the only

:01:24.:01:25.

Katrina Percy has faced months of criticism

:01:26.:01:38.

for the way her trust failed to investigate patient deaths.

:01:39.:01:42.

These are people, you should be investigating every death

:01:43.:01:44.

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

:01:45.:01:52.

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

:01:53.:01:58.

Today her chairman gave details of the move in an exclusive

:01:59.:02:07.

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

:02:08.:02:11.

Did that new job exist before Katrina took it?

:02:12.:02:18.

Did you advertise that job so other people could apply?

:02:19.:02:24.

Was she the only candidate?

:02:25.:02:35.

To many people that will sound like a fix?

:02:36.:02:40.

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

:02:41.:02:48.

She will now be giving strategic advice to GPs,

:02:49.:02:51.

Relatives were outraged at the side-ways move.

:02:52.:02:58.

Somebody in her position of responsibility, who is letting

:02:59.:03:03.

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

:03:04.:03:07.

which went by, uninvestigated, and she is still there

:03:08.:03:09.

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

:03:10.:03:13.

Southern Health say they have addressed the failings,

:03:14.:03:20.

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

:03:21.:03:26.

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

:03:27.:03:29.

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

:03:30.:03:32.

is putting patient safety and the quality of care first.

:03:33.:03:41.

They still face criticisms and are now being investigated

:03:42.:03:43.

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

:03:44.:03:55.

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

:03:56.:03:58.

on this at 7.30pm tonight on BBC One.

:03:59.:04:00.

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

:04:01.:04:05.

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

:04:06.:04:09.

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

:04:10.:04:12.

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

:04:13.:04:15.

union over who should close the doors on their trains.

:04:16.:04:18.

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

:04:19.:04:23.

The UK and Australia are to open preliminary

:04:24.:04:26.

negotiations about a future post-Brexit trade agreement.

:04:27.:04:29.

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

:04:30.:04:32.

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

:04:33.:04:37.

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

:04:38.:04:40.

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

:04:41.:04:45.

Our assistant political editor Norman Smith is at Westminster.

:04:46.:04:51.

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

:04:52.:04:57.

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

:04:58.:05:02.

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

:05:03.:05:05.

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

:05:06.:05:10.

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

:05:11.:05:14.

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

:05:15.:05:20.

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

:05:21.:05:23.

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

:05:24.:05:27.

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

:05:28.:05:30.

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

:05:31.:05:34.

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

:05:35.:05:40.

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

:05:41.:05:45.

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

:05:46.:05:50.

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

:05:51.:05:53.

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

:05:54.:05:55.

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

:05:56.:05:59.

action amid concerns about patient safety,

:06:00.:06:00.

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

:06:01.:06:03.

In a special debate, doctors and those in the medical

:06:04.:06:05.

profession have been telling this programme why they feel so strongly

:06:06.:06:08.

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

:06:09.:06:19.

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

:06:20.:06:24.

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

:06:25.:06:28.

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

:06:29.:06:32.

departments, we have fantastic consultants who will cover us when

:06:33.:06:34.

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

:06:35.:06:36.

the latest BBC News. Marcus Rashford has had

:06:37.:06:38.

another debut to remember. The Manchester United teenager

:06:39.:06:45.

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

:06:46.:06:47.

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

:06:48.:06:50.

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

:06:51.:06:53.

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

:06:54.:06:56.

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

:06:57.:06:58.

in Colchester with a Novak Djokovic has reached the semi

:06:59.:07:03.

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

:07:04.:07:21.

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

:07:22.:07:27.

to complete his match. Jo Wilfried Tsonga was two sets

:07:28.:07:28.

down when a knee injury It's the second retirement

:07:29.:07:31.

from which Djokovic has benefitted He also had a walkover

:07:32.:07:34.

in an earlier round. He'll take on another

:07:35.:07:38.

Frenchman Gael Monfils Angelique Kerber is through to

:07:39.:07:39.

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

:07:40.:07:43.

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

:07:44.:07:45.

sets and will now face Caroline Wozniacki for a place

:07:46.:07:48.

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

:07:49.:07:50.

if she betters the performance of Serena Williams at Flushing

:07:51.:07:53.

Meadows. World heavyweight champion

:07:54.:07:54.

Tyson Fury's rematch with Wladimir Klitschko has been

:07:55.:08:03.

set for 29th Octoberh There's some flash photography

:08:04.:08:05.

coming up in these pictures. It'll be

:08:06.:08:10.

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

:08:11.:08:12.

in July had to be scrapped because Fury picked up

:08:13.:08:14.

an ankle injury. The British fighter beat Klitschko

:08:15.:08:16.

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

:08:17.:08:19.

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

:08:20.:08:28.

underway in Rio tonight. Lee Pearson has been named the

:08:29.:08:41.

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

:08:42.:08:43.

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

:08:44.:08:50.

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

:08:51.:08:55.

very much. This morning we've been debating

:08:56.:09:01.

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

:09:02.:09:07.

which has so far led to 162 hours of strike action

:09:08.:09:11.

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

:09:12.:09:22.

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

:09:23.:09:27.

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

:09:28.:09:32.

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

:09:33.:09:35.

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

:09:36.:09:41.

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

:09:42.:09:47.

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

:09:48.:09:52.

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

:09:53.:09:57.

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

:09:58.:10:04.

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

:10:05.:10:14.

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

:10:15.:10:20.

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

:10:21.:10:25.

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

:10:26.:10:31.

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

:10:32.:10:34.

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

:10:35.:10:38.

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

:10:39.:10:43.

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

:10:44.:10:48.

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

:10:49.:10:53.

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

:10:54.:10:58.

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

:10:59.:11:02.

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

:11:03.:11:06.

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

:11:07.:11:11.

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

:11:12.:11:17.

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

:11:18.:11:21.

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

:11:22.:11:25.

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

:11:26.:11:34.

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

:11:35.:11:37.

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

:11:38.:11:42.

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

:11:43.:11:47.

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

:11:48.:11:52.

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

:11:53.:11:56.

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

:11:57.:11:58.

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

:11:59.:12:02.

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

:12:03.:12:06.

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

:12:07.:12:12.

APPLAUSE Dr Jeeves Wijesuriya is here. You

:12:13.:12:17.

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

:12:18.:12:20.

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

:12:21.:12:24.

safety and we talked about the recent set of strikes being

:12:25.:12:28.

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

:12:29.:12:31.

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

:12:32.:12:36.

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

:12:37.:12:41.

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

:12:42.:12:50.

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

:12:51.:12:53.

so if trusts are struggling to provide the coverage during that

:12:54.:12:56.

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

:12:57.:13:00.

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

:13:01.:13:04.

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

:13:05.:13:08.

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

:13:09.:13:13.

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

:13:14.:13:17.

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

:13:18.:13:27.

our associated specialist, other professionals, pharmacists and

:13:28.:13:29.

nurses, junior doctors will spend this month working with their

:13:30.:13:32.

colleagues to ensure that the coverage during that time is

:13:33.:13:37.

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

:13:38.:13:40.

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

:13:41.:13:44.

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

:13:45.:13:48.

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

:13:49.:13:51.

Jeremy Hunt... APPLAUSE

:13:52.:13:54.

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

:13:55.:13:58.

listened to experts and professionals and they have put

:13:59.:14:03.

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

:14:04.:14:06.

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

:14:07.:14:10.

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

:14:11.:14:17.

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

:14:18.:14:21.

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

:14:22.:14:27.

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

:14:28.:14:33.

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

:14:34.:14:37.

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

:14:38.:14:43.

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

:14:44.:14:47.

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

:14:48.:14:50.

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

:14:51.:14:54.

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

:14:55.:14:58.

take it because the benefits outweigh the risks and doctors make

:14:59.:15:02.

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

:15:03.:15:07.

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

:15:08.:15:11.

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

:15:12.:15:16.

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

:15:17.:15:21.

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

:15:22.:15:25.

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

:15:26.:15:30.

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

:15:31.:15:37.

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

:15:38.:15:44.

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

:15:45.:15:50.

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

:15:51.:15:59.

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

:16:00.:16:03.

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

:16:04.:16:08.

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

:16:09.:16:11.

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

:16:12.:16:19.

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

:16:20.:16:27.

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

:16:28.:16:31.

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

:16:32.:16:36.

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

:16:37.:16:43.

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

:16:44.:16:47.

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

:16:48.:16:51.

more about resource constraints within the NHS and trying to deliver

:16:52.:16:56.

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

:16:57.:17:02.

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

:17:03.:17:07.

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

:17:08.:17:12.

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

:17:13.:17:20.

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

:17:21.:17:26.

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

:17:27.:17:30.

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

:17:31.:17:34.

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

:17:35.:17:40.

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

:17:41.:17:44.

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

:17:45.:17:49.

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

:17:50.:17:56.

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

:17:57.:18:05.

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

:18:06.:18:08.

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

:18:09.:18:16.

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

:18:17.:18:18.

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

:18:19.:18:25.

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

:18:26.:18:30.

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

:18:31.:18:35.

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

:18:36.:18:40.

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

:18:41.:18:43.

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

:18:44.:18:49.

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

:18:50.:18:53.

spoken to a single patient organisation. When the patients get

:18:54.:18:59.

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

:19:00.:19:03.

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

:19:04.:19:09.

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

:19:10.:19:16.

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

:19:17.:19:21.

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

:19:22.:19:28.

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

:19:29.:19:31.

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

:19:32.:19:36.

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

:19:37.:19:41.

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

:19:42.:19:54.

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

:19:55.:19:59.

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

:20:00.:20:03.

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

:20:04.:20:09.

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

:20:10.:20:13.

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

:20:14.:20:19.

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

:20:20.:20:25.

something substantive, to review what we mean about health care

:20:26.:20:30.

delivery for the millennial generation and reframe the debate

:20:31.:20:32.

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

:20:33.:20:37.

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

:20:38.:20:44.

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

:20:45.:20:50.

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

:20:51.:21:02.

referred to earlier, the Conservative manifesto clearly

:21:03.:21:03.

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

:21:04.:21:08.

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

:21:09.:21:14.

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

:21:15.:21:22.

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

:21:23.:21:25.

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

:21:26.:21:31.

reduces maximum working hours, it restricts the number of night

:21:32.:21:35.

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

:21:36.:21:47.

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

:21:48.:21:50.

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

:21:51.:21:58.

we believe we have made progress. The junior doctors committee, the

:21:59.:22:00.

people that represent the junior doctors, did not give a view. They

:22:01.:22:04.

said they would stay neutral, because the decision was always

:22:05.:22:09.

going to be that of junior doctors, who were informed to make an

:22:10.:22:15.

educated decision. I am a patient, but I work a lot with the NHS, the

:22:16.:22:26.

third sector. The debate has become polarised. I was supportive of the

:22:27.:22:30.

junior doctors and I signed the petition for it to go to Government

:22:31.:22:33.

earlier on in the year. But I am uncomfortable with this five

:22:34.:22:40.

consecutive days, 50,000 doctors withdrawing their services. My

:22:41.:22:46.

father was a GP. He was by those with cancer and died three months

:22:47.:22:56.

later from his diagnosis. You think the five-day plan is

:22:57.:23:00.

disproportionate? Yes. That is what I am worried about. You have people

:23:01.:23:06.

waiting for important results. What worries me is, we covered earlier

:23:07.:23:12.

on, what are the key issues in this contract? It worries me that when we

:23:13.:23:18.

start moving the debate onto other things other than resolving that...

:23:19.:23:22.

We need to move this forward, and we need to get patients in the room. So

:23:23.:23:28.

it focuses people's minds, the Government and the BMA. We are still

:23:29.:23:34.

waiting for the BMA and Jeremy Hunt to answer our open letter that we

:23:35.:23:38.

signed, a group of patients, as we want to see an end of this. The NHS

:23:39.:23:44.

is already crippled. We will talk about how people here think this

:23:45.:23:49.

dispute might be resolved. Before that, we have talked about the

:23:50.:23:54.

five-day strikes that are due in October, November and December, here

:23:55.:23:56.

are the contingency plans that are in place for the strikes if they go

:23:57.:23:58.

ahead. A five-day strike has

:23:59.:24:13.

never happened before. But, across the three planned this

:24:14.:24:15.

year in England, the Government calculates that 75,000 operations

:24:16.:24:18.

and 750,000 hospital appointments could be postponed as a result,

:24:19.:24:20.

with nonemergency surgery, such as hip replacements and back

:24:21.:24:22.

operations, worst affected. This could mean an increasing number

:24:23.:24:24.

of people fail to have their routine operation within 18 weeks,

:24:25.:24:27.

causing them further discomfort and placing added pressure on an NHS

:24:28.:24:29.

target that is already being missed. Hospitals have, however,

:24:30.:24:32.

been ordered to ensure that most essential services such as A

:24:33.:24:34.

and maternity wards are well They've been told to draft

:24:35.:24:37.

in consultants and other senior doctors in place

:24:38.:24:42.

of the junior doctors. These services reportedly ran

:24:43.:24:45.

smoothly in the last set of strikes, but there have been concerns that,

:24:46.:24:49.

with the NHS traditionally being stretched over the winter months,

:24:50.:24:52.

the next three strikes Striking doctors, however,

:24:53.:24:55.

will return to work if their employers become concerned

:24:56.:24:59.

for patient safety - an option not used in the last

:25:00.:25:03.

set of strikes. The dispute is in England only,

:25:04.:25:16.

Scotland and Wales have both said they will stick to their existing

:25:17.:25:20.

contracts, while Northern Ireland has yet to make a decision.

:25:21.:25:30.

Dr Jeeves Wijesuriya, who is on the junior

:25:31.:25:32.

doctors committee at the British Medical Association.

:25:33.:25:34.

The BMA is the union for healthcare professionals,

:25:35.:25:35.

Mike Wood is Conservative MP for Dudley South.

:25:36.:25:39.

He says the Government has no choice but to impose

:25:40.:25:42.

new contracts for junior doctors after negotiations failed.

:25:43.:25:44.

Also with us, Professor Neena Modi, who is the president

:25:45.:25:46.

of the Royal College of Paediatrics and Child Health, which

:25:47.:25:48.

And Andrew Haldenby is the director of Reform, a centre-right

:25:49.:25:52.

Will the contingency plans be good enough? Having participated in the

:25:53.:26:06.

previous emergency walk-out, during which my service was covered by my

:26:07.:26:09.

consultant, who stepped in to support us in our action, they

:26:10.:26:14.

provided an excellent service for the children who were sick in my

:26:15.:26:18.

hospital during that time. Can the same be done over five days? I was

:26:19.:26:23.

not confident about next week, but with more planning it could be. In

:26:24.:26:29.

the last set of emergency walk-out there was not one single clinical

:26:30.:26:32.

incident reported in the whole country where patients were put at

:26:33.:26:38.

risk. When you hear about people making the accusation that we are

:26:39.:26:42.

being dangerous, it is a myth. We don't know over five days. We have a

:26:43.:26:48.

responsibility, we are working for the GMC, we have a duty of care for

:26:49.:26:54.

patients, even when we are striking, and we have to be confident that our

:26:55.:27:00.

seniors will support us. If it happened that you were on the picket

:27:01.:27:04.

line during the five days and one of your colleagues ran out and said, we

:27:05.:27:09.

need you now... We would go in, of course we could. I have to bring you

:27:10.:27:14.

back to the point that the NHS as it stands is not safe. People argue

:27:15.:27:30.

about that. Two children's A services have closed recently, 1000

:27:31.:27:32.

babies transferred because of lack of capacity, further cuts to the

:27:33.:27:38.

ability of health education England to commission more training places,

:27:39.:27:42.

so there will be an even greater fall in junior doctor numbers, we

:27:43.:27:47.

have a shortage of 1000 paediatric consultants, we have had cuts to

:27:48.:27:50.

Public Health England, we have an increasing burden of chronic

:27:51.:27:57.

diseases in children. The NHS is creaking at the seams, it is not

:27:58.:28:00.

safe at the moment, it is really tragic that it has taken strikes

:28:01.:28:05.

which nobody wants to draw attention to this. But at the least, let's say

:28:06.:28:12.

that if the public debate and she's, which addresses the current

:28:13.:28:17.

shortfalls, the current lack of patient safety, that at least will

:28:18.:28:23.

be a good thing. The contract dispute and some of the specifics we

:28:24.:28:27.

heard earlier is useful, you think, as a way of drawing in other issues?

:28:28.:28:31.

I would not have wished it to happen this way. But now that we are where

:28:32.:28:37.

we are, it has been heart-warming to hear from colleagues in this room,

:28:38.:28:43.

particularly outpatient colleagues, about what it means to be a patient

:28:44.:28:52.

in the NHS. When we are talking about publics and they, the public

:28:53.:28:56.

is always going to be on the side of the doctors. These are people who

:28:57.:29:00.

have dedicated themselves to the service of humanity, making sure we

:29:01.:29:04.

live as comfortable as possible. Me and my sister play sport, we always

:29:05.:29:10.

have injuries and bruises. Each time I have gone to the hospital, I have

:29:11.:29:14.

had wonderful treatment and I have come back home safely. I don't like

:29:15.:29:18.

that doctors are being pushed to the limit of their safe procedures. As a

:29:19.:29:25.

person that uses the NHS frequently, this is terrible to imagine. I hope

:29:26.:29:30.

Jeremy Hunt has a serious think about what he is doing. Let me read

:29:31.:29:35.

some more messages from people watching. Ali says, I am due to go

:29:36.:29:42.

into hospital for a hip replacement soon. The sixth in five years. I

:29:43.:29:52.

hope you are all right! I am sitting here with a fractured femur. I am in

:29:53.:29:58.

great pain, but I am 100% supportive of the junior doctors. This message,

:29:59.:30:03.

why do doctors have the right to pick and choose which shifts they

:30:04.:30:07.

wish to work's no other emergency services have that right. We require

:30:08.:30:14.

306 to five day, 24 hour working by the well-paid professionals, they

:30:15.:30:20.

knew what they were signing up for. Jenny says, last September I had

:30:21.:30:24.

four disks prolapse from my neck down to my lower spine. I could not

:30:25.:30:29.

walk Drive, shower or leave the house. I am 35, I had to wait until

:30:30.:30:36.

January the 3rd to have an MRI you, which took place in the private

:30:37.:30:40.

hospital, as the NHS could not provide the service. I had to wait

:30:41.:30:45.

to consultant specialist. I have no intervention other than pain

:30:46.:30:52.

medication. I have no life. Fix the five-day service, fund a five-day

:30:53.:30:56.

service, and focus on providing an outstanding five-day service.

:30:57.:31:06.

Junior doctors, I full support you, but I think you got it.

:31:07.:31:12.

In the next half hour, we'll look at the current state

:31:13.:31:15.

of the NHS, but first, let's get a summary of all

:31:16.:31:18.

The chairman of the troubled Southern Health NHS Foundation Trust

:31:19.:31:25.

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

:31:26.:31:29.

for the Trust's chief executive after she quit in the wake

:31:30.:31:32.

Katrina Percy had faced multiple calls to resign over her Trust's

:31:33.:31:35.

failure to investigate hundreds of deaths.

:31:36.:31:38.

Now the BBC has learned that her new ?240,000 a year job

:31:39.:31:43.

didn't exist previously and she was the only

:31:44.:31:45.

The Trust's chairman Tim Smart says the job needed doing and that

:31:46.:31:51.

Ms Percy was "uniquely qualified" to carry it out.

:31:52.:31:57.

Passengers on one of Britain's busiest rail lines face more delays

:31:58.:32:00.

today in the latest 48-hour strike by on board guards Southern trains

:32:01.:32:03.

are in the middle of a bitter dispute with the RMT union over

:32:04.:32:06.

who should close the doors on their trains.

:32:07.:32:08.

40% of services won't run during the strike.

:32:09.:32:13.

The UK and Australia are to open preliminary

:32:14.:32:16.

negotiations about a future post-Brexit trade agreement.

:32:17.:32:19.

Officials from the two countries are to meet twice a year to discuss

:32:20.:32:22.

But Australia has warned that formal negotiations can't start

:32:23.:32:27.

until the UK leaves the EU and that it would be at least

:32:28.:32:30.

two-and-a-half years before any agreement could be finalised.

:32:31.:32:43.

Junior doctors have been telling this programme why there is so much

:32:44.:32:52.

anger about the Government trying to impose the crew contract. 15 days of

:32:53.:32:55.

strike action are planned from October. Doctors and those in the

:32:56.:32:59.

medical profession have been telling this programme why they feel so

:33:00.:33:03.

strongly about the strike. You blame the BMA. I don't think they have

:33:04.:33:06.

played their cards particularly right. They could have done better.

:33:07.:33:10.

But I blame Jeremy Hunt. Jeremy Hunt back off. Just leave us

:33:11.:33:13.

APPLAUSE Leave us alone. The thing that

:33:14.:33:19.

really worries me. If the NHS is already crippled, if it is already

:33:20.:33:24.

on its knees, how is the NHS going to be further enhanced by the junior

:33:25.:33:29.

doctors going on strike? Radical preacher Anjem Choudhary

:33:30.:33:34.

is today starting a five-and-a half year jail sentence for inviting

:33:35.:33:36.

support for Islamic State. But how should prisons deal

:33:37.:33:38.

with someone like him? Is it possible to

:33:39.:33:40.

change their views? Secunder Kermani has been speaking

:33:41.:33:43.

to one of Choudhary's high profile former supporters who now, thanks

:33:44.:33:46.

to the work of a de-radicalisation These two men know Anjem Choudhary

:33:47.:34:02.

and his circle like few others. This man used to be one of his followers.

:34:03.:34:11.

That changed after he met a trainer who deradical isz extremists

:34:12.:34:14.

including successfully reforming half a dozen of Anjem Choudhary

:34:15.:34:23.

supporters. Jammal had been part of a group calling themselves Muslim

:34:24.:34:28.

Patrol who claim to be enforcing Sharia rules in London. For that, he

:34:29.:34:39.

spent nearly two years in prison. Since Choudhary's conics, it has

:34:40.:34:44.

been announced the prison regime is changing. Extremists will be split

:34:45.:34:48.

from the general population, but will it work? What they need to have

:34:49.:34:54.

inside the prison are people who are able to challenge when the beliefs

:34:55.:34:58.

arise within the discussions. They need to have people capable of

:34:59.:35:04.

challenging them. And are there enough people there? There needs to

:35:05.:35:09.

be more. Isolating them will not do anything. These individuals one day

:35:10.:35:15.

have to be released. They are not individuals who will spend the rest

:35:16.:35:21.

of their life in prison. It is full of challenges. What could end up is

:35:22.:35:27.

him validating himself and mutating into some type of authority within

:35:28.:35:33.

that system because the prison sentence gives him his stripes.

:35:34.:35:38.

REPORTER: Improves his credibility? Yeah. This man has had more success.

:35:39.:35:49.

How does he get through to them? We're sitting with them. We look at

:35:50.:35:55.

their perception. Islam was traditionally an oral tradition.

:35:56.:36:00.

Yeah, it is about sitting with a teacher who then looks at the

:36:01.:36:08.

textbook and explains what it means. He doesn't just debate ideology, he

:36:09.:36:13.

forms a strong personal connection. For him to, you know, be concerned

:36:14.:36:20.

on a personal level, not just an intellectual level, it was never

:36:21.:36:23.

that discussion to start off with. It is to say we are humans and I

:36:24.:36:27.

care for you as a human being, to take away that divide that existed

:36:28.:36:32.

that us and them that existed and to replace with a xlective

:36:33.:36:41.

understanding. Many de-radicalisation attempts in jail

:36:42.:36:48.

fail. The current way of dealing or trying to deal with this Islam

:36:49.:36:56.

fascist ideology is coming in with your own lit tral interpretation. So

:36:57.:37:03.

we've got a literal interpretation versus a literal interpretation. So

:37:04.:37:07.

you're basically singing off the same hymn sheet except it is a few

:37:08.:37:12.

degrees down. And what happens with this is that the individual will sit

:37:13.:37:18.

there, nod his head, and then as soon as he is at the end of his

:37:19.:37:23.

licence, he is back in the community, back it his old tricks,

:37:24.:37:28.

criticising what he has just been through. They think it is possible

:37:29.:37:34.

Anjem Choudhary could reconsider his beliefs in prison, but in the

:37:35.:37:38.

meantime, they're dealing with the legacy of his influence in the

:37:39.:37:39.

outside world. After scoring on his debut

:37:40.:37:49.

for Manchester United last season AND on his first senior

:37:50.:37:53.

England appearance too, Marcus Rashford makes it three out

:37:54.:37:55.

of three with goals on his first His hat-trick against Norway helped

:37:56.:37:59.

England to a 6-1 win in their European

:38:00.:38:07.

Championship qualifier. Novak Djokovic has reached

:38:08.:38:10.

the semi-finals of the US Open But for the third time in this

:38:11.:38:16.

year's tournament he didn't have Jo Wilfried Tsonga was two sets down

:38:17.:38:22.

when following treatment on a knee Tyson Fury and Wladimir Klitschko

:38:23.:38:26.

have rescheduled their world It'll now take place on 29th October

:38:27.:38:29.

in Manchester after the original date was scrapped because of

:38:30.:38:37.

an injury to the British fighter. Fury won the WBA, WBO AND IBF titles

:38:38.:38:40.

from the Ukrainian in their And after a vote by his teammates,

:38:41.:38:43.

ten-time Paralympic champion Lee Pearson will carry the flag

:38:44.:38:51.

at tonight's opening It'll kick off 11 days

:38:52.:38:53.

of action in Rio. More sport later. Now back to

:38:54.:38:59.

Victoria. We have got people with passionate

:39:00.:39:20.

views about the junior doctors contract dispute and the forthcoming

:39:21.:39:24.

strikes. You know the one next week has been called off. Strikes are due

:39:25.:39:29.

in October, November and December, but as the BMA junior doctors

:39:30.:39:34.

representative told us, they could be cancelled once your process has

:39:35.:39:39.

been gone through if I understood you correctly. An anonymous text, "I

:39:40.:39:50.

am watching from my hospital bed. I can't fault my treatment over the

:39:51.:39:54.

last eight years. I'm concerned about Jeremy Hunt's motives and I

:39:55.:39:58.

feel he is using the junior doctors as pawns in his long-term plans for

:39:59.:40:05.

the NHS." Chris says, "As a former soldier I'm disgusted. In the junior

:40:06.:40:08.

doctors willingness to hold the country to ransom. It is the Armed

:40:09.:40:11.

Forces that covered the backs of those that have gone on strike in

:40:12.:40:15.

the past ie firemen, etcetera. We can't strike and we get paid only a

:40:16.:40:20.

small fraction of the salaries of those that do. You're losing support

:40:21.:40:26.

for your cause now. It is time to enact your oath and your obligations

:40:27.:40:30.

to your public." Let's talk to Hugh Pym about pay. I

:40:31.:40:35.

read the junior doctors draft contract. It is very long. Lots of

:40:36.:40:39.

it, I didn't understand. I did understand there is a basic pay rise

:40:40.:40:44.

of 10% to 11% and if you end up working one weekend in two you will

:40:45.:40:49.

get 10% of your basic salary as a supplement and if you work one in

:40:50.:40:55.

four, it reduces. Is that accurate? Victoria, I commend you for reading

:40:56.:40:58.

the contract! It is a highly complex document. You have possibly read

:40:59.:41:03.

more of it than I have! But the essence of it is and this is what

:41:04.:41:07.

this debate and this dispute has been about is how you reward doctors

:41:08.:41:11.

financially for working very unsocial hours and lots of different

:41:12.:41:17.

weekends. And what's been the aim of the Government is to raise basic pay

:41:18.:41:23.

by about 11% and in return, you cut the extra that was being paid out

:41:24.:41:27.

for working unsocial hours. I think the BMA accepted it was worth

:41:28.:41:32.

looking at this because it had become so complicated, but the deal

:41:33.:41:38.

that was reached, and it remains pretty complicated, clearly 58% of

:41:39.:41:41.

doctors out there didn't feel that it met their concerns. Now, some

:41:42.:41:44.

people out there are saying, "We work at weekends. We don't get paid

:41:45.:41:48.

extra." What doctors would say, they work a lot of unsocial hours and why

:41:49.:41:52.

do they have to sacrifice something financially because there maybe some

:41:53.:41:55.

at the margins who lose out short-term when we work so hard. The

:41:56.:41:59.

bigger picture is this business of recruitment and retention. Do you

:42:00.:42:03.

risk losing doctors longer term if you don't get that balance right at

:42:04.:42:09.

this precise moment in time? OK. Hands shot up then! Pass the

:42:10.:42:16.

microphone over here. Hi. Hi. My name is Maria. I'm a senior nurse. I

:42:17.:42:21.

supported junior doctors through the industrial action last year and I

:42:22.:42:24.

will continue to support them. What I found throughout is doctors are

:42:25.:42:28.

really reluctant to complain about being poorly paid. They're really

:42:29.:42:32.

reluctant to ask for more money. Are they poorly paid do you believe? I'm

:42:33.:42:36.

not saying they are poorly paid, but they are not well paid. They are in

:42:37.:42:41.

no way on par with their colleagues in the City. A few years ago, we had

:42:42.:42:46.

we have to give the bankers their bonus because we don't want to lose

:42:47.:42:51.

the expertise, we are happy to haemorrhage our well trained doctors

:42:52.:42:54.

out of this country. I think it is a disgrace. It wasn't just in the last

:42:55.:43:00.

few years that MPs had been 11% pay rise each year consecutively while

:43:01.:43:04.

we nurses and doctors have actually had pay cuts because we have not

:43:05.:43:08.

even had the percentage with inflation. So I think it is really

:43:09.:43:15.

double standards. Can I ask our representative from the junior

:43:16.:43:19.

committee on the BMA. It is a basic pay rise of 10% to 11% and if you

:43:20.:43:25.

work one in two weekends, 10% of your basic salary on top. Let's just

:43:26.:43:30.

talk about percentage terms. I know there are 100 other issues, what

:43:31.:43:33.

increase do you think would satisfy your members? So, firstly, when

:43:34.:43:38.

we're talking about an increase, it is one way of looking at it. The

:43:39.:43:41.

problem that we have is... Please just answer the question and then

:43:42.:43:44.

you can tell us about problems. This does answer the question.

:43:45.:43:47.

Ultimately, what we have right now and we've talked about today is that

:43:48.:43:52.

we have a huge staffing problem. We have services that are already in

:43:53.:43:56.

one in seven trusts closing down services or cutting them short

:43:57.:43:59.

because we don't have the staff to provide them. The areas that we're

:44:00.:44:04.

seeing that the most in, emergency services, children's doctors, these

:44:05.:44:06.

are the groups that work the most anti-social hours. What these

:44:07.:44:10.

changes mask actually is the people that do work those most anti-social

:44:11.:44:15.

hours are the ones that see a decease in pay. They don't see the

:44:16.:44:19.

increase. That worsens the recruitment crisis and what is

:44:20.:44:22.

counter-intuitive is Mr Hunt has been talking about a seven day

:44:23.:44:26.

service. I'm going to bring you back. What percentage increase would

:44:27.:44:30.

satisfy your colleagues, do you believe? We need to talk about the

:44:31.:44:35.

distribution. I'm asking you a really sensible question... I can't

:44:36.:44:39.

give you an exact percentage because we need to look at those specific

:44:40.:44:44.

areas and speak to the Government about how they intend to fund them.

:44:45.:44:54.

Jeremy Hunt has not produced a plan. Something we have asked for over a

:44:55.:44:57.

yearment we are talking about a plan that no one has seen. There is a man

:44:58.:45:04.

from a Thing tank who is rubbing his chin. Explain why.

:45:05.:45:10.

We have been in a pay dispute for two years, one side cannot even tell

:45:11.:45:16.

us what they would like to settle the dispute. All I want is a

:45:17.:45:24.

percentage, a figure, that you think would be acceptable in terms of

:45:25.:45:29.

either the basic pay going up or the supplement for weekend working. Can

:45:30.:45:34.

you give me a figure? It is not about a percentage. I just want to

:45:35.:45:41.

keep the same salary I have, I don't want a pay cut or a rise, I just

:45:42.:45:46.

want to stay the same. What percentage increase would you need

:45:47.:45:50.

with this contract to bring it back to what you say you have now? My

:45:51.:45:56.

basic salary is ?36,000 plus a 50% banding. Whatever it is that they

:45:57.:46:02.

need to calculate to make sure I can get the same take-home pay. Some

:46:03.:46:05.

sort of increased to match what you get now? OK. Whatever we have now.

:46:06.:46:12.

Just leave us alone, give us the same contract we have already. With

:46:13.:46:19.

the new contract, without the pay protection that is being put in

:46:20.:46:23.

place, I would take a pay cut from the new contract for the same hours.

:46:24.:46:35.

By what percentage? I think it is about ?300 a month. I know you don't

:46:36.:46:45.

like the question, so respond. It is illegitimate question when you think

:46:46.:46:48.

about pay in general and giving a simple answer -- a legitimate. There

:46:49.:46:55.

is a flexible pay premium watch the Government have to put in place to

:46:56.:47:00.

ensure that I as a trainee, who work all day, every night, two weekends

:47:01.:47:06.

every month, the premium can be taken away by the Government

:47:07.:47:09.

whenever it wants just to ensure I get paid the same as any other

:47:10.:47:14.

doctor working in the NHS. That this incentivises people from working

:47:15.:47:20.

they don't have any doctors left, I get e-mails everyday to fill in

:47:21.:47:30.

ready gaps. Introduce yourself. You are a trainee medic. If this

:47:31.:47:33.

contract is brought in, what will happen? I am a final year medical

:47:34.:47:42.

student. How do you feel about going into this profession? Very worried.

:47:43.:47:48.

My colleagues are concerned as well. Already, we can see that the amount

:47:49.:47:54.

of medical students coming in has dropped by 20%. We don't know if

:47:55.:48:00.

that is related to this dispute. I think a lot of it is. As the

:48:01.:48:07.

professor said earlier, there is a shortage of doctors, and if this

:48:08.:48:11.

contract is making fewer prospective students joined the field, that is

:48:12.:48:15.

really dangerous. A lot of the students are sitting exams to go to

:48:16.:48:21.

America or Australia or Canada. If you think that doctors are paid well

:48:22.:48:28.

here, they are not all stop --. ?23,000. That is the basic starting

:48:29.:48:37.

salary. We will talk about how people here think this dispute could

:48:38.:48:39.

be resolved, if they think it can be. It has got to be resolved at

:48:40.:48:45.

some point. The man on behalf of service across the UK is rising, so

:48:46.:48:49.

our costs, which is why the stakes could not be higher.

:48:50.:49:05.

The latest dispute between junior doctors and the Government

:49:06.:49:07.

comes at a difficult time for the NHS in England.

:49:08.:49:10.

NHS England needs to find ?22 billion in annual

:49:11.:49:12.

Added to that, ministers want to extend services at weekends,

:49:13.:49:17.

which puts pressure on the existing challenges already facing the NHS,

:49:18.:49:19.

not just in England, but across the country.

:49:20.:49:21.

After the vote in June, health leaders warned that

:49:22.:49:26.

leaving the EU could make staffing shortages worse.

:49:27.:49:27.

The NHS Confederation said 10% of NHS doctors come from the EU.

:49:28.:49:31.

People are living longer, putting further pressure on the service.

:49:32.:49:36.

The growing number of elderly people means more patients

:49:37.:49:39.

Up to two thirds of hospital beds are estimated to be occupied

:49:40.:49:44.

Changes in what can and can't be done medically has

:49:45.:49:52.

revolutionised care, but it comes at a cost.

:49:53.:49:55.

Treating survivors of medical conditions that in the past

:49:56.:49:57.

might have killed them requires extra money.

:49:58.:50:00.

Paying for progress in medical technology costs the NHS

:50:01.:50:03.

People may be smoking less, but they are drinking more

:50:04.:50:10.

The bill for dealing with alcohol abuse is around ?3 billion per year.

:50:11.:50:15.

Despite campaigns to get people to live healthier, the number

:50:16.:50:18.

of obese people in Britain could double in the next 40 years.

:50:19.:50:22.

So demand on the health service across the UK is rising,

:50:23.:50:25.

and so are the costs, which is why the stakes

:50:26.:50:28.

in the ongoing dispute with the junior doctors

:50:29.:50:30.

Let's hear from more in our audience, talking about how this

:50:31.:50:46.

could get resolved. I am a third-year medical student. Having

:50:47.:50:51.

been in medical school for three years, my degree will be for six

:50:52.:50:56.

years, I think this contract makes me incredibly sad that I will not be

:50:57.:51:01.

doing what I love, I don't think. Purely because it is making me think

:51:02.:51:04.

about either leaving medicine or going to a different country. It

:51:05.:51:10.

saddens me because I value the NHS, I was not born here, but coming to

:51:11.:51:15.

England, this wonderful NHS and everything, it works. I will not be

:51:16.:51:22.

able to be part of it. I don't want this contract to be imposed and I am

:51:23.:51:25.

not happy with it. Let's talk about this dispute. How people think it

:51:26.:51:33.

could be resolved. I am from a campaigning organisation, which has

:51:34.:51:38.

local branches all over the country. I wanted to say that in 2007 our

:51:39.:51:44.

health service was funded to the same proportion of GDP as other

:51:45.:51:48.

European countries, and it has been steadily falling since then. 1% of

:51:49.:51:55.

GDP amounts to ?20 billion will stop if we were funded at the same level

:51:56.:51:59.

as France, we would have 40 billion more, Germany 60 billion more, per

:52:00.:52:05.

year. That has been taken out of the budget so far by cutting the wages

:52:06.:52:11.

of NHS staff, not just junior doctors. Keeping them down to the

:52:12.:52:16.

low -- below levels of inflation. But they have been cut to the limit.

:52:17.:52:21.

What is coming next big cuts in services, and they will be announced

:52:22.:52:25.

in the autumn. I think Jeremy Hunt is using Jeremy -- junior doctors as

:52:26.:52:31.

a shield to protect him against the flak that will fly as soon as people

:52:32.:52:36.

know that their local A will be closed, their local maternity ward

:52:37.:52:39.

will be closed, and they will have to travel much further to get

:52:40.:52:44.

treatment. We will see what happens. How can this be resolved? I am a

:52:45.:52:50.

freelance journalist. I want to look at resolution in two ways. It is

:52:51.:52:55.

difficult in the short-term if you SSP strike is a strategy, to see how

:52:56.:53:01.

it can work. The NHS is political, Jeremy Hunt cannot back off, it is

:53:02.:53:05.

Government run, and by increasing the political pressure on the

:53:06.:53:08.

Government, you give them less room to manoeuvre, and it is a political

:53:09.:53:15.

issue. By rejecting the BMA's proposal a few months ago, the

:53:16.:53:20.

junior doctors have made -- undermined the BMA as a negotiating

:53:21.:53:25.

partner. I don't think the public attitudes to doctors are immutable.

:53:26.:53:32.

If we start introducing this sort of action to the NHS, it could

:53:33.:53:34.

fundamentally change public attitudes are. A junior doctor said

:53:35.:53:42.

Jeremy Hunt should back off. I don't think it is a position where there

:53:43.:53:46.

is an easy win. The Government could have handled itself better, but the

:53:47.:53:51.

long-term risks of a strike a counter-productive. There has been a

:53:52.:53:53.

lot of talk about NHS funding and the shortcomings of supply. We heard

:53:54.:53:58.

earlier one of the things that people think they are striking about

:53:59.:54:04.

is privatisation. My father spent almost a year in NHS care, my

:54:05.:54:08.

mother, who has worked in the NHS, helped to look after him, and he was

:54:09.:54:14.

put up in the hospital where she started training. As we did a tour,

:54:15.:54:21.

she showed me what used to be the pay wing of a public hospital. This

:54:22.:54:25.

brought in private patients, they paid money which was spent on the

:54:26.:54:29.

NHS. Currently, Britain has private health care. Rich people who already

:54:30.:54:36.

pay the taxes towards the NHS pay extra for private health care, but

:54:37.:54:39.

they go to private hospitals and all of the money gets locked up in the

:54:40.:54:44.

private system. Long-term,... We have talked about... We talked about

:54:45.:54:51.

European models, they make it easier to bring money into their health

:54:52.:54:55.

service, so we need to look at in magic to solutions like that. Do you

:54:56.:55:03.

have a resolution? I do. It has been great to hear from lots of different

:55:04.:55:08.

people from lots of groups. The universal thing is there are

:55:09.:55:11.

problems in this contract. Even Andrew said so. People say the

:55:12.:55:17.

contract is not good, but why do they have to strike? Resolution!

:55:18.:55:23.

Number one, take imposition of the table. Number two, even more

:55:24.:55:29.

important, if you want to produce a seven-day service, give me a well

:55:30.:55:32.

costed spreadsheet of what it involves. He pushed the doctors for

:55:33.:55:38.

what percentage would solve this, I am in my last year, I want

:55:39.:55:42.

resources, I don't want a rise in pay. I want a well costed

:55:43.:55:48.

spreadsheet. I am a local councillor in Ealing. I am teaching medical she

:55:49.:55:57.

did as well. -- students. It is money, we need more central funding.

:55:58.:56:04.

This dispute is one of the death by a thousand cuts that the NHS is

:56:05.:56:08.

withstanding. That is what we need, more money. I work in the railway

:56:09.:56:14.

industry. A seven-day week will be robbing Peter to pay Paul. The

:56:15.:56:17.

five-day week is not funded well enough. It is not work because the

:56:18.:56:23.

NHS is not funded well enough. My challenge to the Government is to

:56:24.:56:25.

find the money from wherever you need to find it. From Philip Green,

:56:26.:56:32.

maybe, anyone, really. Find the money, make the five-day week work,

:56:33.:56:36.

stop giving these people a hard time, they are amazing people, and

:56:37.:56:40.

then we can talk about a seven-day week. How do you see this dispute?

:56:41.:56:48.

The two sides were far apart in May, it was the royal colleges who got

:56:49.:56:53.

them around the table, that resulted in the agreement that was thrown up.

:56:54.:56:57.

Now the Government say, why should we negotiate with the BMA is they

:56:58.:57:03.

agree and it goes to a referendum and it is thrown out again? The BMA

:57:04.:57:09.

say, 58% of our members have rejected this contract. It will take

:57:10.:57:13.

somebody, they didn't royal colleges are behind-the-scenes, to get people

:57:14.:57:17.

around the table, but I see that as very distant. Ten seconds to give me

:57:18.:57:24.

a resolution. For a resolution, the doctors have been ground into the

:57:25.:57:32.

ground. Resolution! MPs get paid ?70,000 a year, doctors get 20. Give

:57:33.:57:41.

them a pay rise? Yes, and sit around a table and discuss and leave it to

:57:42.:57:44.

the professionals. Resolution, really briefly. Come back to the

:57:45.:57:51.

table, discuss with doctors, listen to the evidence, we should not make

:57:52.:57:56.

decisions on a whim. They should not be a bad opinion politics, it should

:57:57.:58:02.

be based on evidence. Briefly. Bring it back to the patient, bring in a

:58:03.:58:07.

risk register, matched the risk to resources, it is about patient

:58:08.:58:12.

safety. Thank you. And you do everybody who has taken part. You

:58:13.:58:16.

can give yourselves a round of applause.

:58:17.:58:21.

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.