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tv   BBC News  BBC News  February 10, 2017 2:00pm-3:01pm GMT

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this is bbc news. the headlines at 2pm: record waiting times in a&e, as the health secretary concedes the nhs in england is facing "completely unacceptable" problems. you know, i'm doing thisjob because i want you know, i'm doing thisjob because iwant nhs you know, i'm doing thisjob because i want nhs care to be the safest and best in the world. and that kind of ca re best in the world. and that kind of care is completely unacceptable. nobody would want it for members of their own family. coming up at 2:30pm, we'll be talking your questions on the state of the nhs on ask this. send in yours using the hashtag #bbcaskthis. also in this hour: "see you in the court". the message from president trump as a federal appeals court blocks the attempts to reinstall the travel ban. in the next hour, we'll look at the lack of british submarines currently deployed. all seven of the uks attack submarines are currently classed as non—operational — including three new astute class subs, costing £1 billion each.
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the ministry of defence says the may —— the navy does has some submarines which are operationally capable. a self—employed plumber wins his battle for basic workers‘ rights at the court of appeal. the ruling could affect thousands of others. a firm of london plumbers loses legal battle over whether to give and, first it was beyonce and jay z, now the clooneys celebrate as well, as george and amal announce they'll be having twins. good afternoon, and welcome to bbc news. the health secretaryjeremy hunt says it's "completely unacceptable" that some patients in england are waiting up to 13 hours in a&e. figures show that waiting times in casualty units are worse than at any time in the last decade. mr hunt says he does have an improvement plan, but admits it will take time, and says there's no silver bullet.
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our health editor hugh pym reports. it began more than a decade ago. jeremy hunt paid tribute to the work of staff, but said that the problems of staff, but said that the problems of high patient demand will not unique to the nhs. and all leading health systems were grappling with the same challenge. he said there was no silver bullet. i think it is wrong to suggest people that these profound challenges of ones where there is a silver bullet that you can solve the problem overnight. we have a very good plan that has the support of the nhs. it will take time to deliver. asked about bbc coverage of patients enjoying lengthy waits in erasme hospital, he
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said he did not want to make excuses, and these examples were com pletely u na cce pta ble excuses, and these examples were completely unacceptable —— in a&e. it is frustrating for me. i'm doing thisjob it is frustrating for me. i'm doing this job because it is frustrating for me. i'm doing thisjob because i want nhs care it is frustrating for me. i'm doing this job because i want nhs care to be the safest and best in the world. and that kind of care is completely unacceptable, nobody would want it for members of their own family. but it is happening in a hospital rated good. what can you do about it?|j think you have to recognise that overall there are positive things as well as negative things, and there is huge commitment to the nhs to sort out those negative things, and the particular pressure point we haveis the particular pressure point we have is a&e. what we need to do is to find ways of treating particularly people with complex conditions, older people with dementia, treating them at home or in the community. and that is the big direction of the range that we have embarked upon. there have been cuts to social care under your
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government. has that created the problem we are now seeing? no, the prime minister has been very clear, we recognise the pressures on social care, we we recognise the pressures on social ca re, we recognise we recognise the pressures on social care, we recognise there is a problem about the sustainability of the social care system that has to be addressed and we are going to do that. more money in the budget? that is for the chancellor and the prime minister. look at what the prime minister. look at what the prime minister said this week, there is an area where there is pressure, and if we are going to have a solution it needs to be a long—term, sustainable solution is not a quick fix. labour has accused the government of losing control of the nhs this winter, with patients paying the price as hospital targets are missed. meanwhile, sir robert francis, who headed the mid staffordshire inquiry, said that the nhs is in extra social crisis and of current pressures continue there could be a repeat of the mid—staffs patient ca re repeat of the mid—staffs patient care failings. at 2:30pm we will be answering your
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questions and suggestions on nhs finances, asking if the nhs budget needs to be bigger or whether money could be spent more efficiently. news is coming into us from the national crime agency. there has been a lot of cocaine washed up on two beaches in norfolk. 360 kilograms of cocaine, with a potential value of £50 million washed up on a couple of beaches in norfolk. that's according to the national crime agency. we will be bringing you more on that as soon as we find more details. a federal appeals court in the united states has refused to reinstate donald trump's ban on travellers from seven mainly—muslim countries. the controversial immigration reform was suspended last week, when a judge in seattle issued a temporary order. but the president appears determined to continue the legal battle, saying on twitter: "see
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you in court. the security of our nation is at stake!". david willis reports. the office upon which i'm about to enter... as his controversial pick for attorney general was sworn in, donald trump hailed a new era ofjustice in america. former senatorjeff sessions, now the us‘ top law enforcement officer, may have his work cut out. i'm establishing new vetting measures to keep radical islamic terrorists out of the united states of america. we don't want them here. donald trump's sudden ban on visitors from seven mainly muslim nations caused chaos at airports and sparked protests across the us. then, last week, a districtjudge in seattle granted a stay, and now a san francisco—based appeals court has backed that stay, citing, amongst other things, the fact that nobody from those seven nations has actually carried out an attack on the us. the decision infuriated donald trump. "see you in court," he wrote,
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"the security of our nation is at stake!" prompting the leader of one of the states leading the court challenge, washington governorjay inslee, to reply, "mr president, we just saw you in court, and we beat you." the president is nonetheless convinced he will win. it's a political decision, we're going to see them in court and i look forward to doing it. so you believe the judge has made... we have a situation where the security of our country is at stake, and it's a very, very serious situation so i look forward, as ijust said, to seeing them in court. we are a nation of laws, and as i've said, as we have said, from day one, those laws apply to everybody in our country. and that includes the president of the united states. an appeal to the highest court in the land, the us supreme court, now seems likely. but that could put the decision in the hands of a court that's currently evenly divided, and a tied decision would leave the lower court's ruling in place. mr trump maintains his ban
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is necessary in order to protect the us from the threat of terrorism, but it may yet be proven unconstitutional. and, until he has his day in court, refugees from around the world and citizens of those seven muslim nations can continue to come into this country. david willis, bbc news, washington. with me is dr marie newhouse from surrey university's centre for law and philosophy. donald trump isn't having much luck in the courts. why not? he had a bad day yesterday, that's for sure. part of the problem is he dragged this case far too soon. if this case was a person it would have been dragged into the ninth circuit with a bathrobe with one sock on and one sock. it was not fully baked. what
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he got from the ninth circuit was the resolution of preliminary issues, and not in his favour. the state of washington and minnesota have made it amid claims that deserve to be heard. secondly, they have a reasonable likelihood of prevailing on these claims. it wouldn't be reasonable to eliminate the temporary steaming water that has been placed at the level. one of the questions in the judge's has been placed at the level. one of the questions in thejudge's mind seems to be, actually is there a terrorist threat from the seven countries that have been named? well, the moira presenting the federal government got some searching questions from the panel about that during the oral arguments all the lawyer. they said, what evidence do you really have? when is your evidence? basically, the federal government's position is that they don't need to show that for the supreme court. and they made a very, very strong claim that executive action in this field is simply an renewable. the ninth
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circuit came down very firmly against that claim. they said, certainly, when you raise the substance of constitutional claims about executive orders, even those bearing on national security and immigration, we can review them. we offer a deferral to the executive but that doesn't make these claims an reviewable. now, he says, see you". a lot of people think this is going to end up in the supreme court. is that how you see it —— see you in court. i think it will eventually, the question is when. when he says the un court, there is a lot of personality behind that week. but if donald trump was well advised —— when he says, see you". he would be well advised not to appeal this decision, because it is an internal decision. he doesn't make a decision about any of the constitutional issues, he has nothing to gain by appealing to the supreme court. the best that would happen is that we get a deadlock decision on these preliminary
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issues, in which case the ninth circuit opinion with sound anyway. the real game, the battle, the next front in this war is going to be back up the federal court level right now we where they are presented evidence to the trial judge so he will be in a position to enter something called a preliminary injunction, which is actually a more substantive ruling than it sounds. he will be able to build a good factor all record, probably on the merits of the constitutional claim —— factor all method. merits of the constitutional claim -- factor all method. when you boil it all down, is this a question of whether this travel ban is constitutional, whether it fits with the american constitution? yes, when you boil it all down, when we get that, yes. but they have not reached the station of really considering those claims. do you have a legal opinion on whether it is constitutional? you know, i don't wa nt to constitutional? you know, i don't want to second—guess how the supreme court is going to come out on this. but i think that the ninth circuit issued an opinion that did not bode
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well for the trump administration. add the future of these claims. for one thing, they pointed out, we can look to outside evidence to decide whether or not a particular order discriminates against certain religious groups. you know, the trump administration tried to say, no, no, you have to look up the order. the ninth circuit said, no, no, we are interested in statements made on the campaign trail about a so—called muslim ban. we are interested in the fact that former new york mayor rudy giuliani went on fox news last week and said that you wa nted fox news last week and said that you wanted to implement a muslim ban and asked him for advice on how to do it properly. they are going to look at that. they are taking it in a wider and more political perspective?” wouldn't say there is a more political perspective. they are taking into account the political background? they have precedents that suggest that when you are raising a claim of discrimination,
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the context and history leading up to the adoption of some particular policy is relevant. so that's a factual record that is right now being built in the federal district court in washington state. so in a word, you think that president trump is heading for defeat on this travel ban? i do, i hate to get out my crystal ball but i think it doesn't look that good for him. well, thank you for talking to us. i'm sure he would not be happy to hear you say that! but that is the verdict from doctor marie newhouse from the university of surrey. thank you for your time. that's might bring you some more on the breaking news that a large amount of cocaine has washed up a large amount of cocaine has washed up on two beaches in norfolk. you can see it there. cocaine with a street value estimated at £50 million. it was washed up yesterday afternoon. and there is a statement which has been issued by the authorities saying that a member of the public contacted norfolk police
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after discovering a number of holdalls on the beach near great yarmouth. police and border force officers initially attended the scene and secured the holdalls, they say, which investigators suspect to contain cocaine. they think that the cocaine comes to around 360 kilograms, a very large amount indeed. there is a statement from matthew rivers from the national crime agency's investigation team, saying that it's extremely unlikely that these beaches were there intended destination. this is obviously a substantial seizure of class a drugs, and its loss will represent a major blow to any organised criminals involved. the london firm pimlico plumbers has lost its challenge over the employment status of a former worker. the court of appeal upheld the ruling that gary smith, who worked for the firm for six years, should have been entitled to basic workers' rights,
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despite being classed as self—employed. the head of the company had said the employee involved had wanted to "have his cake and eat it." 0ur industry correspondent john moylan reports. pimlico plumbers is one of london's best—known firms. it is claimed that plumbers here can earn more than £100,000 a year, but they are all self—employed, so they don't have the rights enjoyed by employees. when gary smith went to a tribunal, it found that his employment status was the same as that of a worker. he was classed as a worker because he provided a personal service to pimlico plumbers. they controlled him. he had to wear the uniform, to drive their vand,
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and he was tightly controlled by pimlico plumbers. self—employment has soared in recent years, with many peoplejuggling several insecure jobs, what some call the gig economy. tribunals have ruled against high—profile businesses, including uber and city sprint. the government has launched a review of modern working practices. the founder of pimlico plumbers said that mr smith wanted to have his cake and eat it. this is an historic case. this was a contract we had with gary six years ago, on a self—employed basis, approved by the inland revenue and employment lawyers. he had the benefit of being self—employed. six years down the line, he had a heart attack and wanted the benefits of being an employee. this is the highest court yet to tackle this complicated issue of employment status, but it will not be the last. there are a number of cases pending and more about to be launched, which looks set to challenge firms over how they treat people in the so—called gig economy.
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john moylan, bbc news. it has just it hasjust gone it has just gone to 15 pm. the headlines... record waiting times in a&e, as the health secretary concedes the nhs in england is facing "completely unacceptable" problems. lengthening weights and a&e and patients being left on trolleys. also in this hour: "see you in the court". the message from president trump as a federal appeals court blocks the attempts to reinstall the travel ban. a self—employed plumber wins his battle for basic workers' rights at the court of appeal. the ruling could affect thousands of others. and in sport... another russian athlete has been punished following state—sponsored doping. mariya savinova has been stripped of the 800m gold and banned untold 2019 by the court of arbitration for sport. scotla nd the court of arbitration for sport. scotland make one change to the side
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that beat ireland as they prepared to the front in the six nations. —— to the front in the six nations. —— to face france. john barclay comes in. the football association of wales will appeal against their punishment for displaying poppies during a world cup qualifier in november. and i'll be back with more on those stories thatjust november. and i'll be back with more on those stories that just after june 30 pm. —— after 2:30pm. let's get more of our exclusive interview with the health secretary. jeremy hunt acknowledges that patients are facing unacceptable delays, but he says that the nhs are not alone in dealing with patient numbers. jon ashworth is labour's shadow health secretary. hejoins me from our leicester newsroom. there is an acceptance across—the—board that the nhs is facing real issues in certain sectors. but there's no silver bullet, says the health secretary,
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do you agree with him on that?” bullet, says the health secretary, do you agree with him on that? i am pleased thatjeremy hunt is finally waking up to the scale of the crisis facing the nhs. we have been warning him for some time, and until now he has been burying his head in the sand. ido has been burying his head in the sand. i do ask, well, has been in charge of the health service in the last few years? it has been mr hunt. the nhs is going through a big financial squeeze. the social care sector has been severely cut back, and this is putting huge pressures on the front line in our nhs and it is patients who are suffering, waiting unacceptable times on trolleys and corridors, waiting unacceptable times in a&e departments. ifjeremy hunt was to do some big about it, he has got the budget coming up, i want him to put the money into nhs and social care that it desperately needs a. you are as well as anybody else that it is a real debate going on about whether it is money or efficiency or restructuring that is needed. what would you do if you were in the
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ocean today. what would you as health secretary do?” ocean today. what would you as health secretary do? i would be banging on the door of the chancellor and say, look, you have cut corporation tax for big businesses, you're cutting inheritance tax for very wealthiest dates, you are putting millions into building new grammar schools and you are not putting extra penny piece into the social social care sector. we have these huge pressures on our health sector is because we have got a elderly, vulnerable people trapped in hospital with nowhere to go because the government, this tory government, have cut back social ca re government, have cut back social care so government, have cut back social ca re so severely. government, have cut back social care so severely. if they want to sort out some of the problems our health service faces, they have really got to deal with the prizes in our social care sector. they can't shrug their shoulders or bury their heads in the sand. it's all very welljeremy hunt saying it is all acceptable, what is unacceptable is him on the prime minister refusing to put the money into social care. do you think the nhs is
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sustainable in its current form? yes, absolutely. if anybody wants to introduce sort of charging for operations and privatised nhs like you sometimes get suggested from right—wing conservatives, to be fair, they usually tend to be backbench conservatives or even this new ukip leader who tends to go on about those sort of ideas, we are the labour party, we would never support anything which introduces charging into the nhs. the nhs is free at the point of view is coming universal, provided by everybody, paid for by the taxpayer, it is the fa i rest paid for by the taxpayer, it is the fairest and most equitable way of delivering health care and we will never support anyone who wants to reduce charging into rahul dravid. that's not what i meant by the question. do you think it would be desirable to raise taxes in order to be able to better fund the nhs? the nhs serves a population that wasn't originally designed to serve, it is an ageing population, we are all living longer, that's great news but there are commands placed on it now
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that simply won't —— were not their 50 or 60 years ago. they have compounded the problems facing the nhs by refusing to give at the level of funding that it needs, and indeed cutting back social care so severely. the priority in the last parliament was a huge reorganisation which cost billions of pounds and has actually given the nhs into further outsourcing... but mr ashworth, sorry to into rock, but what would you cut, then, in order to get more funding to the nhs? -- sorry to interrupt. i havejust said, government is about choices, and this government has chosen to cut corporation tax or big business, and put millions into building new grammar schools. in the immediate term, they could reverse some of those new decisions and put that funding into the nhs. they could do that in the budget in march in a few weeks' time. ifjeremy hunt really believes that what is happening is com pletely believes that what is happening is completely unacceptable, the test of
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his words will be the budget next month. but you're quite right, more long—term, where the nhs is in the next ten and 20 years, i think this country needs to have a big debate about that. i'll be up for engaging in that debate. it was the labour government to introduce the national insurance in order to put the money in the nhs. the labour government troubled in cash terms than money going into this nhs. under this conservative government, the nhs is going to be cut head for head next year. we'll have to leave it there, thank you, john ashworth. change is coming to saudi arabia. it's the world's biggest oil producer and wa nts to world's biggest oil producer and wants to be less dependent on that one commodity, oil. to boost its private sector, the 31—year—old deputy crown prince is saying he also wants to start opening up the conservative kingdom, where senna mars are banned and women are still not allowed to dry. let's get more on all of this from our chief
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international correspondent lyse doucet in riyadh. —— where cinemas are banned and women are not allowed to drive. 0il are banned and women are not allowed to drive. oil is important in saudi arabia and the world, but is saudi arabia and the world, but is saudi arabia trying to wean itself off dependency on oil? imagine if your government revenues and the revenues of the royal family were dependent for 90% on this one fuel, oil and gas. the discovery of oil here in the kingdom eight decades ago absolutely transformed saudi arabia from a small, remote desert kingdom into a powerhouse on the world stage. world oil prices crashed a few years ago, and the government lost half of its revenue. that has forced it to think about diversifying away from oil. but also is realises that if it is going to do that it has to start opening up. this is a very conservative, some would say older conservative kingdom, what do you do with a
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highly educated generation, more than 70% are under the age of 30, and they have benefited from a generous scholarship programme, so you have hundreds of thousands of people, many with ph.d. is, coming back to the country and looking for jobs and a life worth living to keep them here. what do you do, cinemas are banned and there are restrictions on women working? saudi arabia is opening up because it has two. are we really going to see genuine social reform, for example, women are being able to drive? what's really interesting is that on previous visits to saudi arabia when you would ask questions like that, when is the ban on women driving going to be lifted, they would a nswer going to be lifted, they would answer vaguely, well, we'll do it in our own answer vaguely, well, we'll do it in ourown time, we answer vaguely, well, we'll do it in our own time, we have our own values and identity etc. now, people talk in terms of months, it might be the first six months of next year. everyone i speak to say, it will be lifted, possibly within the next year. but it will be lifted
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cautiously, because it saudi arabia. perhaps women over a0 will first be allowed to dry. even cinemas are not allowed to dry. even cinemas are not allowed in this country. they granted all of these cinema licenses and then the grand mufti issued a fatwa saying that cinemas are departed two. the royal rulers are trying to find a way to get cinemas through without invoking by either of the conservative clerics here. everything has to be negotiated, everything has to be prepared to avoid a backlash. thank you, lyse doucet in riyadh. french police sources say four people have been arrested by anti—terror police in montpellier in southern france they are police made four arrests in uncovering a makeshift laboratory. naomi grimley in paris has more on this. can you tell us about how the
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arrests came about? well, it seems that at least some of this group we re that at least some of this group were already known to the police for their links to radical islam. it has been suggested on the newswires that perhaps one of them had already tried to go to syria at some point in the last couple of years. it included by the way a 16—year—old girl, who was arrested as part of that group. and she was obviously also on social media, and that may have been the way that the police got hold of them. as to how far on the plot was, the police are saying that it was an in imminent attack that it was an in imminent attack that they managed to fraught. they found acetone, a highly flammable liquid that is used in the production of a home—made explosive called the atp, the same explosive that has been used in other recent attacks, including those in paris in 2015 and in brussels last year. so,
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all in all, the police seem to have been taking this very, very seriously indeed. although we don't actually know what the target was supposed to be. noemi, do we have any idea who these people were linked to or whether they were linked to or whether they were linked to or whether they were linked to a rather larger organisation? not at all at the moment. details are still sketchy. the only interesting fact that the interior ministry told us that i'm not sure that we knew before was that in the last few months since those bastille day attacks in these last year, they say they have thwarted 13 plots involving 30 people. so, you do get a sense that the police here are really trying to deal with the threat on multiple fronts, and indeed only yesterday we heard that the eiffel tower is going to have reinforced glass wall put around it. and that is just a sign of how permanent, really, a lot of these security measures are going to become, especially as we are now in
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the run—up to a big presidential election in april and may. thank you, nyom e. they look at the weekend whether. thank you, ben and rita. i have these snow graphics on behind me because we have snow in the forecast this weekend. some areas could see quite a lot, especially across the pennines. we have had reports of sleet and snow across central and eastern parts of england. some sunshine and gaps in the cloud, the best of the brightness has been across scotland. it will continue to filter its way west was this evening, late sunshine there. a new rash of showers pushing in from the east, central and eastern parts of england and scotland, snow at lower levels as well. don't be surprised if you get a modest covering in one or two places by saturday morning. it will be cold across western areas, where we will see frost and ice. the weekend will be cold and rather
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cloudy, wintry showers and longer spells of snow, especially on saturday evening in towards sunday morning. central and eastern parts of the country will see most of the wintry showers. rain in the coast, but in land, sleet and snow, significant snow over the hills. 0nce significant snow over the hills. once again significant snow over the hills. 0nce againa significant snow over the hills. once again a cold, grey day for most. the best of the sunshine across the far west of the uk. hello. this is bbc news. the headlines. the health secretary, jeremy hunt, concedes the nhs in england is facing completely unacceptable problems considering the long waits in a&e. speaking to the bbc, mr hunt said the key was to treat more people at home and in the community. president trump tweets, see you in court, that's after federal courtjudges reject his appeal.
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a plumber has won a legal battle for working rights in the latest significant court ruling over freelance operations in the modern workplace. gary smith wanted to reduce his working days at pimlico plumbers following a heart attack. around £50 million worth of cocaine has washed up on two beaches in norfolk near great yarmouth. the national crime agency have launched an investigation. all the latest sports news now. good afternoon. our main story: the london 2012 gold medallist mariya savinova has been stripped of her 800 metres title and banned until 2019. it means south africa's caster semenya could have her 2012 olympic silver upgraded to gold and could have rammifications for britain'sjenny meadows. earlier, sports news correspondent richard conway filled me in on the story. maia savinova one of russia's most
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famous athletes, now one of the most notorious drugs cheats. between 2010, july, and august of 2013 all her medals, all her prizes, all her money she as won will be forfeited because of abnormalities in her biological passport, that's a system which detects over a period of time whether an athlete has been using a performance enhancing drug. she had previously been recommended for a lifetime ban by the world anti—doping authority inquiry, led by kick pound. today's news does have consequences, it will see her lose those medals, it will also see her lose a medalfrom lose those medals, it will also see her lose a medal from the barcelona european championships in 2010. that has repercussions for britain's jenny meadows, she should be boosted from a bronze to the silver medal
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position because of this retro active orderfor position because of this retro active order for savinova to lose her prize money and medals during that period. full—back stuart hogg will become the youngest scotland player to win 50 caps when he lines up against france in the six nations on sunday. he will be 2a years and 233 days at kick—off, and breaks the record currently held by teammate richie gray. vern cotter makes one change, from the win over ireland — flanker john barclay replaces the injured ryan wilson in the back—row. scotland haven't beaten france in paris since 1999. don't forget you can watch a special inside six nations sportsday on the news channel at 6.30pm this evening. the football association of wales will be appealing against sanctions imposed by fifa for displaying poppies during a world cup qualifier. they were fined over £15,000 following commemorations prior to wales' world cup qualifier against serbia in november. fifa took action because fans wore poppies in the stands and the armed
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forces held bunches of poppies at the side of the pitch. great britain will face second seeds croatia or hungary in the fed cup promotion play—off on saturday. their place was sealed after lativa beat portugal in britain's group which meant gb will top group c having won all of three ties under new captain anne keothavong 3—0. turkey were the latest team to be defeated with laura robson and jocelyn rae rounding off the whitewash in the doubles after singles victories for heather watson and johanna konta. right now i guessjust right now i guess just really happy to come through that. it wasn't easy. she definitely played herself into the match. to come through that and to give us the opportunity to go into the play—off tomorrow, i am very happy for us and the team. england's danny willett is one shot off the lead after the second round at the european tour event in malaysia. the day on 5—under par. he trails bernd wiesberger. the austrian made an
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impressive 9—under—par 63. scotland's marc warren lost the lead after a second round of 75. the overnight leader hit three bogeys and a triple bogey on the last six holes as his 3—over round left him on 6—under. that's all the sport. more in the next hour. we've been asking for your questions and suggestions on nhs finance. do you think the health service budget needs to bigger or whether money could be spent more efficiently? we've got two experts here to answer your questions — anita charlesworth from the health foundation and professor neena modi from the royal college of paediatrics and child health. but first, our health correspondent smitha mundasad has been looking this week at the finances of the nhs and how britain's ageing population
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is increasing demands on our health system. this graph shows that funding for the nhs has pretty much gone up year on year. last year, it was around £1a0 billion. that's ten times more thanit £1a0 billion. that's ten times more than it was 60 years ago. that isn't the whole picture, though. from about 2010 in england though funding has gone up, it's gone up more slowly tha n has gone up, it's gone up more slowly than it generally has in previous years. take scotland and wales, for example, in the last few yea rs wales, for example, in the last few years they faced funding freezes. it is not all about money, though. some people argue that the nhs has simply become a victim of its own success , simply become a victim of its own success, people are living longer. about 13 years longer than when the nhs was created in 19a8. while that's a good thing, the older people get, the more they tend to get complex health problems, things like dementia that need long—term care. that like dementia that need long—term ca re. that costs like dementia that need long—term care. that costs money. look at this. it costs about six times more
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on average to treat an 85—year—old in the nhs than a 30—year—old. of course new treatments and inventions are coming in all the time. but they don't come cheap either. joining us from brussels is anita charlesworth from the health foundation. also professor neena modi is from the royal college of paediatrics and child health, she joins us from chelsea and westminster hospital in central london. thank you to both of you. perhaps i can ask you first of all, this is a question from william in glasgow. 0ne question from william in glasgow. one idea might be to open private insurance schemes for all workers as an extra that would see all employers pay a small amount of their monthly salary to a private insurance company so that if they needed hospital care the nhs would claim against that insurance company. i suppose in a sense that is talking about the partial
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privatisation really of the national health service. what would be your reaction to that? let's hear from both of you on that. anita first of all. so, the issue i guess with private insurance, particularly if it is compulsory for people of working age, is firstly that people of working age aren't big users of the nhs, it is as your introduction showed, when we get old and have complex conditions that we are high users of the service. the other thing is that it adds to the cost of employing people and essentially if it is compulsory it is a form of tax. so we can change how we pay for it, but the fundamental point remains that if we want our high quality service over the longer term, we will have to pay and tax is generally seen as a pretty fair way and an efficient way of raising funding. you don't need all the
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admin costs of billing and charging that many other systems have. would you go along with that, would you like to see extra resources, i am sure you would at your hospital, and if that came from private insurance schemes would you welcome that? well, the nhs is one of the most simple and most efficient and most effective healthcare simple and most efficient and most effective healthca re systems simple and most efficient and most effective healthcare systems in the world, why would we wish to replace that with an expensive system of insurance—based that with an expensive system of insurance— based healthca re which that with an expensive system of insurance—based healthcare which is only going to increase middlemen costs and going to detract from the amount of funding that is available for our great health service. sol am afraid an insurance based healthcare system am afraid an insurance based healthca re system doesn't am afraid an insurance based healthcare system doesn't make sense when we have the best system in the world. ok. our second question comes from janet who has e—mailed in and asks can anyone explain how a private provider can give a better service for the same or less cost than in—house or public ownership
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and management? she goes on to sayf wages and conditions including pensions are kept the same, how can a private company pay executives and shareholders from the same pot of taxpayers' money, how can it be more efficient she's saying? so, one of the ways that it may be more efficient is if it is allowed to specialise. so what we see is that most hospitals cover a huge amount of services, whereas what some of the private sector providers tend to do and charities, for that matter, is focus on one particular area. they can really hone that and design all their processes around that. but of course what that does mean potentially is if they do all the easier things is that the nhs is left with some of the most difficult things. so, really it is less about public sector inefficient and private sector more efficient but across all the potential providers we make sure that we understand how
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to use resources well and really hone our processes, use technology, train our people, so that they can use every pound really wisely. train our people, so that they can use every pound really wiselym this something you are seeing in your hospital, at the chelsea and westminster, that private providers are coming in and cherry—picking, if you like? well, let's talk about this from the perspective of the national health service as a whole. a series of private providers is going to provide increasingly fragmented care by definition and again one of the virtues of our simple national health service is that it simple national health service is thatitis simple national health service is that it is designed to provide holistic care. we already have news coming in from our members, paediatricians around the country, hearing from families and patients about how children are falling between the cracks, because our health service is becoming fragmented. 0ne health service is becoming fragmented. one of the most marked examples is the fragmentation
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between public health and acute services and of course primary care services. we would like to see those joined up. i am afraid the questioner has asked a spot on question, so congratulations. private healthcare is going to increase fragmentation and costs and of course it is going to also increase inequities and children, the elderly and the most vulnerable will be the first to suffer when these. another question about whether the nhs is joined these. another question about whether the nhs isjoined up enough. somebody saying that they live in south east london, had a number of hospital tests recently, had to have blood tests in sidcup, a consultant appointment and ct scan at farnborough. all those tests a few yea rs farnborough. all those tests a few years ago could have been carried out where they lived. what a waste of everyone's time and nhs resources . of everyone's time and nhs resources. why is it necessary to go
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to so many hospitals for various tests ? to so many hospitals for various tests? you are there at the chelsea and westminster, do you agree at times the nhs isjust notjoined up enough, there aren't enough economies of scale perhaps? well, once again, in its original form the national health service had a very big n in the title, it was national, it wasjoined big n in the title, it was national, it was joined up. big n in the title, it was national, it wasjoined up. with big n in the title, it was national, it was joined up. with the big n in the title, it was national, it wasjoined up. with the internal market, back in 1990, don't forget the health select committee in 2010 called this an appalling waste of money, but we had the internal market introduced in 1990, and then increasingly we have an external market introduced. so not only do we have the fragmentation between the various parts of the health system, and with social care and with public ca re and with social care and with public care and primary care, but we are now seeing increasing fragmentation between different providers. this is going to get worse if we carry along
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our current trajectory and what we would like to see exactly as the questioner says, isjoined would like to see exactly as the questioner says, is joined up services being the goal that we are allaiming for. anita, do you agree, is it too fragmented and is that fragmentation due to political meddling, i suppose, is really what neena is saying? there is a longer term issue where medicine has tended to be organised around different diseases organised around different diseases or different interventions. so i could be a hip fracture one day if i am an elderly lady and then a dementia patient and i also have diabetes and we have organised our services around those problems that are wrong with people and potential solutions like surgery or tests. what we have not been very good at and we are not alone in this, most countries struggle with this, is
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organising services around the person and as we have got older and chronic conditions have increased, people have got more and more things wrong with them and we need to really make sure that we start with the patient but that actually has profound implications for the way we organise care, for the way we train our staff, because medical staff are increasingly in a fragmented in different specialtys, it's difficult to balance the excellence from specialising with the need to be able to deal with the complex awry that people — of conditions that people present with now. let's move on to another question. a couple of different people asked this. richard asks, why not introduce a national national what do you think of that as a
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proposal? once again, we have had a very good funding model for the national health service and that's funded through taxation, central taxation. that's a very fair model because of course you pay according to what you earn. it also covers every single system in the country. sol every single system in the country. so i can understand the questioner's reason for asking the question, but it seems to me that as a nation we need to make a decision that we are going to continue to want to support the nhs through public taxation because of course as i said earlier, thatis because of course as i said earlier, that is very fair, it is also very efficient and it is also moving the maximum amount of money directly from taxation straight into front line healthcare services without it being syphoned off by a series of different middlemen. it seems that's the model we should aim for and what
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we need is strong cross—party commitment, not subject to a five—year political cycle so that year on year incrementally the national health service can be funded according to the needs of the population. anita, politicians do seem to be allergic to talking about raising taxes for any public service. what about the use of a lottery for topping up? well, the national lottery at the moment does provide quite a bit of funding for some of the services that might not be seen as core nhs services, but are very valued by people, so some of the services for older people to help them to connect together and meet and greet, which are a really important activity in the community. 0ur health service requires long—term predictable funding in order to provide the certainty of a high quality care. the sums of money it costs to run the health service
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are huge. it is more than £300 million a day to run the nhs. £1 in every five of tax that we raise from individuals and businesses goes on our nhs and any lottery wouldn't provide that predictability, that fairness in funding where all sections of society pay and wouldn't give you the amount of money that you need to deliver care across the country. one last question. a suggestion on e—mail, why don't we charge people for missing their appointments or wasting nhs time for something that could be treated at their local gp? not sure how easy that would be to enforce and whether it would raise very much money at all. neena maybe you want top answer that. more generally what are your thoughts about nhs funding and some people think the nhs is a bottomless pit. we have an ageing population.
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we almost never have enough resources . we almost never have enough resources. is that how you see it?” wouldn't say that at all. i think it is true there is waste in the system but there is some very large exa m ples of but there is some very large examples of the waste in the system too. let's say first of all, yes it is expensive but we get incredible value for money. if you compare the uk's expenditure on healthcare with other comparable nations around the world, we certainly are not the most expensive. we are spending about half of our gdp in comparison to the united states and certainly less than most of our european countries so we are very efficient. yes, there is waste in the system. the questioner talks about waste when people don't turn up to appointments, that's certainly waste. but that's an example of waste. but that's an example of waste that's perhaps not nearly as large as some of the most huge exa m ples of waste, large as some of the most huge examples of waste, one of which i alluded to previously, according to the department of health about 6 nt
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£6 billion last year went into the full profit sector, that was money that could have been spent on front line nhs services. there are other exa m ples of line nhs services. there are other examples of huge waste in the system. let's take the private finance initiative which is funding ordid fund many finance initiative which is funding or did fund many hospital rebuilds. this is costing the taxpayer about £2 billion a year. now if pfi payments could be renegotiated in some way and this is a question for the government, then think of that saving. the final point i would make is that of course one has to consider how much it takes to administer a service such as charging people for failed appointments in conjunction with how much money you might seek to gain by doing that. lots of things to take into consideration. ok. thank you very much. anita, a quick word from you, is there too much waste, any way of stopping that waste in the nhs? 50,
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way of stopping that waste in the nhs? so, we could improve our productivity. in particular one of the things we are very aware of at the things we are very aware of at the moment is that because of the lack of services in our social care systems so many patients are stuck in hospital at the moment and hospital is very expensive place to be staying. it is also very bad for people, it is poor quality. if you are medically fit to go home, you are medically fit to go home, you are much better off in your own home. so there failure to invest in social care is actually leading to poor outcomes and waste in the nhs. very good to hear from both of you. anita charlesworth from the health foundation. also professor neena modi is from the royal college of paediatrics and child health, she joins us from chelsea and westminster hospital in central london. as britain prepares to leave the european union, there are a range of voices
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influencing the debate. a key part of the referendum campaign focussed on the voice of businesses. the bbc‘s business team has been focussing on various sectors to see how they are reacting. today, we are looking into the fishing industry. let's join vishala sri—pathma who is in grimsby. a little blustery and wet, but are you enjoying yourself there? you are not wrong. yes it is a bit windy, yes i am having a great time here. this is one of the biggest fishing ports in the uk. this town and industry voted largely to leave the european union. it is late in the european union. it is late in the day forfishermen, the european union. it is late in the day for fishermen, they've gone home. they sell their catch around the corner at the auction. you are manager of the fish market here. what's the mood in the market? on a bit of a downer at the moment, the boys, because the fishermen in iceland are on strike, we rely on most of theirfish. iceland are on strike, we rely on most of their fish. so lads are uncertain about futures. they are on a downer at the minute. you used to
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bea a downer at the minute. you used to be a fisherman before you managed the market, why did you leave?” started in the 70s. the water fleet went late 70s, then the middle water boats. then i had to work abroad, all over iceland, holland, denmark. i got fed up of working away, i settled down again and gave it up for my children. in terms of how the government can help the industry thrive again what do they need to do? well, probably look into building some more boats and getting some lads to go back to sea. but they need training schools obviously because there is not a lot of skilled men and if they are they are well past it i would imagine. you would need to encourage younger kids to get into training and go to sea. that's interesting. a number of fishermen in the country has declined over the last decade, why do you think that is? no boats. there is no crews, no boats, no way
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for them apart from these smaller vessels, that's about it in grimsby u nless vessels, that's about it in grimsby unless they want to work abroad and i don't think that works out any more either. do we get fishermen from abroad? no, on these boats there is a few but they're regular guys. there is not a lot. are people worried about demand for fish at the market? we are at the minute because purely because of the strike which is affecting everybody. there is fish around from direct fish but i still think they need the market. thank you very much. iam here thank you very much. i am here all afternoon. i will be back with more business in grimsby later. thank you very much. we will see you later. the hollywood film star george clooney and his wife amal are expecting twins with reports suggesting that they are due this june.
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the news was confirmed by clooney‘s fellow actor and close friend matt damon, who said he was "thrilled for the pair" and that they were going to be "awesome parents." david sillito reports. congratulations are in order for george and amal clooney. the news was broken by entertainment tonight. it has been confirmed that the 55—year—old superstar and his very accomplished attorney wife are expecting twins. at 55, george clooney has hung back a bit before taking on fatherhood, but his good friend matt damon has no doubts about how suited he will be to his new role. he's a good man, incredibly smart. he is a loving, funny guy. he is married to a spectacular woman, who is going to be an amazing mother. and you know, again, those kids are just incredibly lucky. they are all going to be fine. george clooney‘s marriage just over two years ago finally took him off
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the list of hollywood's most eligible bachelors. and today's news has brought congratulations. in a little echo of beyonce's famous photo posted to announce that she was expecting twins, ellen degeneres posted this version of the famous picture. amal clooney, a human rights lawyer, has worked on cases including julian assange of wikileaks and the campaign to return the elgin marbles to greece. she's also the president of the clooney foundation forjustice. her twins are expected injune. the demands and pleasures of raising a family now to add to her and her husband's already full public life. a report by mps says that a
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discredited £60 million government inquiry into allegations against iraq war veterans has been an unmitigated failure and must be shut down within months. that inquiry is known as the ihat, iraq historical allegations inquiry. theresa may already said the government was working to cut the number of cases being looked at by that team, only those that were credible. the whole issue has been raised again after phil shiner, the controversial human rights lawyer, was struck off after being found to have dishonestly acted in bringing claims against british veterans from the iraq war. more on tho thank as it comes in. let's get the weather. it is set to stay cold into the weekend and more significant snow in the forecast around the middle of the forecast around the middle of the weekend. today we are seeing
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sleet and snow under this blanket of cloud. there are sunny spells across the centre of the country and for scotland. a cluster of showers moving in off the north sea this evening and overnight. snow over the higher ground of north—east england. some areas catching a covering of snow for saturday morning. further west it stays dry and very cold. this weekend will be rather cloudy, further sleet and snow showers and it will feel cold because the wind will pick up on saturday and through sunday. more showers across central and eastern areas. snow further inland. 0ver and eastern areas. snow further inland. over the higher ground and even down to lower levels, as well. the best of any brightness will be across the far west. this is bbc news. the headlines at 3pm: record waiting times in a&e, as the health secretary concedes the nhs in england is facing "completely unacceptable" problems. you know, i'm doing thisjob
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because i want nhs care to be the safest and best in the world. and that kind of care is completely unacceptable. nobody would want it for members of their own family. "see you in the court". the message from president trump as a federal appeals court blocks the attempts to reinstall the travel ban. cocaine with street value of up to £50 million is found washed up in holdalls on the norfolk coast. a 16—year—old girl is among four people arrested by french police on suspicion of plotting an imminent terror attack. home—made explosives were found.
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