NB: THIS TRANSCRIPT WAS TYPED FROM A TRANSCRIPTION UNIT RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT: BECAUSE OF THE POSSIBILITY OF MIS- HEARING AND THE DIFFICULTY, IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE BBC CANNOT VOUCH FOR ITS ACCURACY. ........................................................................ PANORAMA "Coming Clean" RECORDED FROM TRANSMISSION: BBC-1 DATE11/11/01 ........................................................................ SARAH BARCLAY: In every operation in every hospital the tools of the surgeon's trade, but could they be passing the human form of BSE from patient to patient. The Department of Health commissioned a report, but they didn't like its conclusions. DAVID HURRELL: A letter arrived at the office saying that because of the negative outcome of the report and on the instruction of ministers it was to be kept confidential. I was therefore to destroy all the documents associated with it and all electronic files. BARCLAY: They commissioned another report on how the NHS should deal with patients exposed to risk through medical treatment. But they refused to tell the man they'd asked to write it what was in the one they'd had destroyed. MICHAEL BANNER: A document of this kind certainly should have been made available to the panel which advises the government and it's really quite absurd and unbelievable. BARCLAY: It was this that created a reluctant whistleblower. How strongly do you feel about this? HURRELL: Strongly enough to be here talking to you. BARCLAY: So what are the risks of getting human BSE from surgical instruments, and what happened to the report that was buried, one of whose working titles was "Coming Clean". Not many medical dilemmas lie hidden in hospital attics but this one does. KEITH GOODYER: The instruments are secured in a locked room up in the roof space here so... BARCLAY: The story of why a set of used surgical instruments came to be locked in a hospital attic in a sealed box reveals the potential disaster which lies ahead if the human form of mad cow disease known as variant CJD can be passed from one patient to another on the surface of surgical instruments. What will happen to them now? KEITH GOODYER George Eliot Hospital They won't be used ever again as far as any patient is concerned. BARCLAY: Why is that? GOODYER: We've ascertained that they were used on a patient with variant CJD so the advice is obviously that we will not use them again. They will be quarantined here until we receive further advice on how to dispose of them. Reconstruction BARCLAY: The instruments were used in a caesarean operation in October 1999. A 24 year old woman gave birth to a baby girl at the George Eliot hospital in Nuneaton. A court order protects the family's identity. MOTHER: She wanted a perfect baby, don't all mums. MOTHER: She was thrilled to bits. Absolutely thrilled to bits. It was a wonderful moment to treasure with her. BARCLAY: Afterwards the set of instruments were taken to the hospital's decontamination unit. Thousands of surgical instruments are cleaned here every week. Not long after the baby's birth, the new mother began to get ill. MOTHER: She'd felt so ill. She was becoming unusually tired, and then she started to get pins and needles in the right-hand side of her body, and then it became numb. She wasn't paralysed. It was just very numb. BARCLAY: The instruments were wrapped and put in the steriliser. Nearly all operations in NHS hospitals are performed with instruments used over and over again, often for years. MOTHER: She told me once before Christmas that she thought she'd got mad cow.. "I think I've got mad cow mum" and I just said "No, don't be silly, course you haven't." Reconstruction BARCLAY: Just after Christmas the family's worst fears were confirmed. The new mother was dying. She had variant CJD. When the hospital - where she'd given birth - was told, there was panic. The instruments used on her had been used on other women. Could she have passed on the disease? NICK CARVER: The 28th January 2000, a date that's etched on my memory. PETER HANDSLIP: The alarm bells started ringing. NICK CARVER: We felt a bit shocked. We'd never, any of us, been in this territory before. HANDSLIP: Up until that point we had no idea that we'd had a case in the hospital. Reconstruction BARCLAY: An ordinary birth had become a crisis. Desperate for advice the hospital rang the CJD surveillance unit in Edinburgh. Prof. JAMES IRONSIDE CJD Surveillance Unit I was contacted actually at home out of hours by someone from the hospital. NICK CARVER Chief Executive, George Eliot Hospital We, frankly, didn't quite know what we should do. IRONSIDE: I said well I can't tell you everything what to do but I think one of the first things to do would be to try and identify the instruments used. BARCLAY: They did, that's how they ended up in the attic. So if anyone wants to open them, they have to ask you. GOODYER: They've got to come and see me, that's right. Yes, okay. PAMELA BEYLESS Died 1998, aged 24 BARCLAY: They were taking no chances. These are holes in the brain of someone with variant CJD. The disease is caused by prions, a type protein which, when damaged, destroys healthy cells. One hundred and two people have died of variant CJD so far. Pamela Beyless was 24 when she died in October 1998. The disease causes progressive physical and mental damage. Scientists believe that all the victims of the disease so far have got it by eating food contaminated by BSE. But now scientists have discovered prions in many different human tissues. So could the disease be passed from person to person by surgical instruments. Prof JAMES IRONSIDE CJD Surveillance Unit The risk of human to human transmission of variant CJD is a real risk. This was first suspected when the prion protein was found, but now we've transmitted the disease experimentally so it's no longer a theoretical risk, it is a real risk. SARA BARCLAY There hasn't been a case of variant CJD linked to medical treatment so far, but this is a disease which can incubate for up to 30 years before symptoms appear, so any patient on any operating table could be carrying it and no one would know. That's why the government has told the NHS to take no chances. It's own advisers have told them surgical transmission of variant CJD cannot be ruled out as a risk to public health. Prions are almost impossible to destroy, and the government has been warned that the single most important factor in determining the likely risk of variant CJD being passed from person to person is how well surgical instruments are cleaned. DAVID HURRELL Microbiologist It was felt that the cleaning process was critical in the potential prevention of patient to patient transmission of variant CJD, and therefore there was a need to be assured that standards were adequate in all UK hospitals. BARCLAY: David Hurrell has been an expert in this field for almost 20 years. That's why the Department of Health asked him to join a team they commissioned to write a report on decontamination standards in hospitals. Tonight, the expert turns whistleblower to tell us what happens to this report. In August 1999 he went to a meeting at the Department of Health to discuss the project. The minutes of this meeting say it had been given the highest level of priority and that although hospitals would not be named, it was assumed the document itself would be in the public domain. Was it your assumption that this was a report which would be made public? HURRELL: That was the basis on which the entire team were working from the very beginning. Reconstruction BARCLAY: David Hurrell had been asked to coordinate all the technical data for the report. Specialist auditors were trained, and after taking advice from Department of Health statisticians they agreed that if they visited 43 acute NHS hospitals the study would stand up to scrutiny. HURRELL: I personally, from my experience of a number of hospitals, had a fairly clear idea that we would find significant problems. BARCLAY: They were told that the Health Secretary, Alan Milburn, wanted them to proceed with the utmost urgency. That same month another piece of research began, designed to see how quickly variant CJD might be spread in the operating theatre. Steel wires, replicating surgical instruments, were infected with prions from a diseased mouse, washed and put into the brain of a healthy one. The results published this week in the journal Molecular Medicine are disturbing. Prof JOHN COLLINGE MRC Prion Unit Contact with brain tissue for as little as five minutes is sufficient to render these wires highly infectious. BARCLAY: Five minutes? COLLINGE: Yes, after about five minutes of contact, the wires become infectious. Following subsequent washing procedures we can show that these wires are still quite infectious and can infect other animals with contact with the brain for as little as 30 minutes. BARCLAY: The same amount of time that surgical instruments would come into contact with human tissue during an operation. Although the experiment doesn't prove that prions will be passed on during operations, it proves it's possible. COLLINGE: I think these results inevitably will cause concern, yes, that the prions do stick easily to metal surfaces and they're not easy to get off there, and they can transmit the disease quite efficiently. BARCLAY: What David Hurrell saw when he began to visit hospitals and to ask questions about the way they cleaned surgical instruments made him realise the scale of the problem he and his team had uncovered. When he began to analyse the data, his suspicions were confirmed. DAVID HURRELL Microbiologist Well I think once we'd got sort of six or seven hospitals showing very much the same trend and the same problems that it was apparent that we couldn't just sit on that and wait till we'd analysed all the data, that it needed to be brought to the attention of those higher up the chain. BARCLAY: It was that urgent. HURRELL: It was certainly sufficiently serious that they needed to know that there was a problem and that assumptions that things were satisfactory were misplaced. BARCLAY: The problems they'd uncovered would take months, even years to solve. Their report wasn't due for another three months, but Hurrell and his team decided they needed to alert the Department of Health immediately and prepared an interim report. Overall how would you describe the standards of decontamination in the majority of hospitals? HURRELL: The majority of hospitals are barely adequate. Most fall into that category. Some are very good and a small percentage were very poor. BARCLAY: To see for ourselves where and how dirt might be hidden on surgical instruments we asked Professor David Perrett, a Government funded scientist, to take apart a select of reusable instruments which had just been cleaned. DAVID PERRETT: Now you can see behind the slider there is an area of tarnished, possibly remains of blood, and if we turn it over, we can see exactly the same on the rear side. BARCLAY: And so the normal washing procedure wouldn't remove that, or wouldn't even see it. Prof DAVID PERRETT University of London Wouldn't even see it. BARCLAY: Wouldn't get to it. PERRETT: Wouldn't even see it. HURRELL: Those units where performance was poor, there were often cases of instruments that were still bloodstained, still soiled, going through to the steriliser. BARCLAY: There's clearly stuff that's not clean on there but what might that be? PERRETT: It could be anything from old protein deposits, it could be detergents that are left there. It could be anything. BARCLAY: How often did you see something like that? HURRELL: Oh, I really couldn't put a frequency on it but too often to be comfortable. PERRETT: There's a brown surface, now that could be rust, it could be haemoglobin. BARCLAY: On the 28th March 2000 David Hurrell went to the Department of Health and presented the interim report to the Chief Medical Officer, Professor Liam Donaldson, his deputy and a team of public health directors. He described what they'd found, a series of major deficiencies in a system no one had looked at since 1958. We've managed to get hold of a copy of this report. It was considered so sensitive that each page is marked policy restricted and every copy was different so that if it leaked, the culprit could be identified. But the story it tells is the same, from washers more than ten years old falling far below current standards, to blood stains found on surgical instruments after they've been sterilized. It describes a system of inadequate management and years of neglect. Having briefed some of the most senior officials in the NHS about the scale of the problem, David Hurrell and his team began to write their final report. This report containing detailed evidence on decontamination is a document this man has asked to see more than once. Last year Michael Banner was asked to chair a panel of experts to consider how incidents in which patients had been exposed to the risk of variant CJD should be handled. Prof MICHAEL BANNER Chair, CJD Incidents Panel We need to be open with the public, we shouldn't conceal information and the panel needs to be open with the public about what is known and what is not know, what are the risks and what are the possible risks. VCJD is a dreadful disease. We need to ensure that having closed off, as we hope, the route of infection from meat, we now close off, as best we can, the route of infection that may come through surgery, human to human transmission. PETER HALL Died 1996, aged 20 BARCLAY: Peter Hall's mother, Francis, watched her son die of variant CJD. Ever since she's campaigned on behalf of its victim. Until now hospitals have been advised not to tell patients if they've been exposed because the risks were thought to be low. Even if they'd wanted to, most hospitals don't have systems which can track instruments from patient to patient. One of the few that has is the Nuneaton Hospital where the caesarean took place. What was it that enabled you to identify this set of instruments as being the one that was the problem? KEITH GOODYER George Eliot Hospital Each of the trays that we use within the hospital is bar coded and there is a bar code label on the front of the pack as you can see there. BARCLAY: So if you hadn't had this bar code, how would you have found them? GOODYER: It would have made life a lot more difficult. Possibly we would have to have removed every single caesarean section tray within the hospital just to be sure. BARCLAY: One hundred and twenty-five women had had caesarean since the young mother who was now so ill. The instruments used on her had only been used on seven of the women, but what, if anything, should they be told? NICK CARVER Chief Executive, George Eliot Hospital We had to go out and say something both because it was ethical to do so but also because it wasn't sustainable to say nothing. It just was not sustainable and I think... BARCLAY: You'd have been accused of a cover-up. CARVER: Absolutely... been accused of a cover-up and of being secretive. BARCLAY: Although they knew who the seven women were, the hospital contacted all the 125 told them what had happened and gave them a choice. Did they want to know if they'd been put at risk or not. Dr PETER HANDSLIP Medical Director, George Eliot Hospital I think that you're going into a situation where somebody is perfectly well, fit and healthy as a young baby who is fit and well, and you're bringing in a burden of information, and the question is whether you're right to burden them with this information. BARCLAY: But no one knew the answer to the most important question of all. HANDSLIP: They felt reassured by the information that we gave them. They felt that we had been honest with them, even those who felt that maybe they have been exposed to stress that maybe wasn't necessarily. BARCLAY: Did they ask you the straight question 'what are my chances of contracting this disease?' ? HANDSLIP: Yes, I mean I think in virtually every interview they asked that. BARCLAY: And could you give them an answer? HANDSLIP: No. BARCLAY: Those who wanted to know were told the risks were negligible. Last month the team of experts chaired by Michael Banner published guidelines which attempted to assess which patients were likely to be most at risk. These guidelines proposed the creation of a data base, a risk list containing the names of everyone who might be at risk. Prof MICHAEL BANNER Chair, CJD Incidents Panel The list will be everyone who might have been exposed - and that could be thousands of people - who are... BARCLAY: Thousands? BANNER: Thousands of people who may have been exposed just because we don't know who followed who in an operation. So we may have just a list that in a hospital this instrument was used.. or instrument like it, was used 10,000 times in the months following. So maybe 10,000 people, only one or two of them had the instrument used on them, but we don't know which. BARCLAY: Those considered most at risk are people who've had operations involving the central nervous system in the back of the eye because this is where the highest concentration of prions have been found. The risk list is controversial because while people considered low risk would have the right to take their names off the list, people considered high risk wouldn't, and the proposals go even further. They say that people in the high risk group should be told they've been exposed to variant CJD, a disease for which there is no test and no cure. BANNER: I think people have a right to know even uncertain information. The science is uncertain, that's not the panel's fault, it's not anyone's fault, the science is uncertain. The choice is, giving people uncertain information. We cannot say precisely whether you will get CJD, what your risk of getting it is. We can't say any of those things precisely. We can only tell you what the position is. The choices between doing that and keeping the information from people. BARCLAY: Dave Tonkin has already been told he's on the risk list. A letter arrived one morning when he was alone in the house. What it told him was completely unexpected. DAVID TONKIN Like a bomb, I received a letter telling me that I've been exposed to new variant CJD. It was as though I'd been put in isolation in prison, in solitary confinement. There's nobody there to talk about it. I was scared to tell my wife. BARCLAY: When did you tell her? TONKIN: About two days later. SHARON TONKIN I kind of freaked out a little bit, I got very upset and I says well does that mean that you're going to die? DAVID: It says "Dear David..." as I'm probably aware new variant CJD is a progressive and ultimately fatal disorder. BARCLAY: Is that the first sentence of the letter? DAVID: Yes, it is the first sentence of the letter. BARCLAY: Dave's a haemophiliac and depends on a blood clotting product called factor 8, made from donated blood. The letter said he'd been given some from a batch containing blood from someone who'd died of variant CJD the month before. Prof MICHAEL BANNER Chair, CJD Incidents Panel If you're going to give people this information it can't be in a letter which goes out.. arrives on your material on a Saturday. DAVID: I must have read it about four or five times to try and come to terms with what I was... is it right, are these the words in what I'm reading from this piece of paper, or has someone made a mistake. BARCLAY: But they hadn't. As yet there's no proof that prions can be carried in human blood. But the implications are so serious that the blood service is warning that they can no longer guarantee blood is 100% safe. Dr ANGELA ROBINSON Medical Director, National Blood Service We're faced in the blood service with unique circumstances. We've never before been faced with a situation where there are so many uncertainties, and just to go through those, we don't know if the infected agent is in the blood. We're having to test to be sure whether it is or it isn't. If we do get a test, we won't know what that test means for a long time. And if someone tests positive, we don't know whether that person will go on to get the full blown disease or not. BARCLAY: The blood service has already taken precautions to try and reduce the possible risks. But even more stringent measures are being discussed. These include banning anyone who has had a blood transfusion from becoming a donor themselves, a move which could mean 10% fewer donations every year. ROBINSON: We cannot provide zero risk, and there are lots of measures you could take to make it safer and safer and safer. But if we did that, there wouldn't be enough blood for the patients who need it. BANNER: Whilst we don't know the answer to the question of what risk may be posed by blood, we think we should behave in a precautionary fashion, that's to say put measures in place which will reduce, minimise, even eliminate, the risk of further transmission of VCJD if there is a risk. BARCLAY: Even though obviously it will have enormous implications for the way that the blood service operates and the potential of some people not being able to be donors. BANNER: It will have implications but I think in the interests of public health those implications have got to be met, coped with. BARCLAY: There have been eight blood donors who've died of variant CJD. Some people, like Dave Tonkin, have been told if they've been given any of their blood. But there's a secret list of people who have yet to be told. The guidelines say they should be. MATTHEW PARKER Died 1997, aged 19 BARCLAY: Matthew Parker was one of those blood donors. He was 19 when he died. But for some surgeons, the question of whether patients should be told about a risk which may never become reality seems almost irrelevant. Henry Marsh is one of the country's leading brain surgeons. MARSH: So that's brain tissue and that's tumour here, that lump there, and I shall remove it. BARCLAY: Mr Marsh knows all about risk. Every patient he operates on is seriously ill, and every operation involves serious risks. The possibility that his patients might also be carrying a deadly disease hardly seems to matter. Would you know if this patient was incubating VCJD? MARSH: No. It's possible you and I are as well for all we know. BARCLAY: Does it worry you that you don't know? MARSH: No, it doesn't particularly worry me because the fact of the matter is, from what I'm told by the experts on these problems is that the whole population of this country has been exposed to the BSE agent. BARCLAY: Henry Marsh is also a member of the panel working on the guidelines for dealing with variant CJD. Brain operations are considered high risk, so his patients would automatically be told if they've been exposed. When you first faced the prospect that the surgery that you're doing might actually be transmitting an infection as deadly VCJD, what was your reaction? HENRY MARSH Consultant Neurosurgeon Well no really because my operations are often so dangerous, I mean you problem don't understand the nature of neurosurgery, but as a relative risk, it's not been complacent, it's just being realistic. It seems at the moment, on present evidence, a very minor risk compared to all the other risks my patients face. I think about it but I'm too worried about trying to get the patient alive off the table, rather than worrying about what will happen to them in 30 years time. BARCLAY: Some people might accuse you of scare mongering. How would you respond to that? Prof MICHAEL BANNER Chair, CJD Incidents Panel We could be accused of scare mongering I suppose. I think I would say in response that the panel, in giving advice, has got two options. One is to tell the Department let's keep all this under wraps, or let's make the information open and available and ensure as best we can that it's available in a sensitive and appropriate way. I don't have any doubts that we are right to recommend the open way of going forwards. DONNAMARIE McGIVERN Died 1999, aged 17 BARCLAY: In September 1999 Donnamarie McGivern died. That same month the team commissioned to investigate decontamination standards in hospitals began its work. It was this investigation which David Hurrell hoped would lead to better standards and fewer risks for patients. By June 2000 Hurrell and his team had finished their research and drafted their final report. Someone even proposed a title - 'Coming Clean'. DAVID HURRELL Microbiologist Well the final editing comments from the advisory committee was in July 2000 - July 19th I think - and it then went back to NHS estates for those modifications to be incorporated and for it to be printed and so on, and that's the last that we've seen of it. BARCLAY: Michael Banner who'd been asked to produce guidelines aimed at openness first asked to see this report five months ago. How often did you ask to see a copy of that report? Prof MICHAEL BANNER Chair, CJD Incidents Panel I asked informally and then the panel asked me to ask on behalf of the whole panel officially by writing to the Chief Medical Officer asking for the document. BARCLAY: Did you get a response? BANNER: No, I haven't had a response to the letter I wrote in June and I still haven't had a response to that letter. BARCLAY: We've discovered a possible explanation. On the 26th September 2000 David Hurrell received a letter marked 'Confidential' from the Chief Executive of NHS Estates. HURRELL: The letter says that: "In the light of the somewhat negative outcome" and goes on to say "At the express request of ministers, that the final version and earlier draft reports should remain strictly confidential. It goes on to say that excellent progress has been in implementing the recommendations of the report, but this may be compromised if the findings of the report were to enter the public domain. BARCLAY: What he was asked to do next turned David Hurrell into a whistleblower. HURRELL: It asked me to destroy or return all the copies of reports and draft reports and data that I'd got and to delete all electronic files. BARCLAY: It had become a report that never existed. HURRELL: Yes, it is jokingly referred to like that in professional meetings, even by members of the Department of Health themselves who report on "As you all know from the survey that didn't take place". BARCLAY: That's what they say? HURRELL: Absolutely, several times in public. BARCLAY: They've told us that it was never finished. HURRELL: If it was never finished, that's because they decided not to finish printing the final report. BARCLAY: We wanted to interview the Health Secretary, Alan Milburn, but he said no. So we asked the Department of Health three questions. Question 1: Why had they decided not to publish the report. We got an email from a Department of Health press officer. It said the report was not prepared for publication. But why, if it was not prepared for publication, was art work being prepared and a title discussed? Question 3: Why was Michael Banner, the Chairman of a Government appointed panel, not allowed to see evidence which he considered crucial? We were told in writing that these questions were "silly". So we'd like to ask a fourth. Why, if they were so silly, were many of the people involved in the report telephoned on Friday and asked not to talk to Panorama? So we showed the letter David Hurrell was sent to Michael Banner. Prof MICHAEL BANNER Chair, CJD Incidents Panel I think it's an absolutely outrageous letter for anyone to have written. A document of this kind certainly should have been made available to the panel which advised the Government and it's really quite absurd and unbelievable that that document has not been made available to the expert advisory group, but more from the point of view of a member of the public, I would say I think it's astonishing that anyone would wish to hold back information from the public about the state of hospitals. It seems to me they have a right to know what the state of hospitals is and that information should be in the public domain. DAVID HURRELL Microbiologist Well I was upset and I was very concerned that such a thing should be suppressed. BARCLAY: How significant was that report in terms of the potential risks associated with the transmission of VCJD? HURRELL: Well it clearly indicated that it wasn't possible in many cases to rely upon decontamination as being an effective barrier to such transmission. BARCLAY: Having buried one survey, the Department of Health commissioned another they claimed would be more thorough. They told hospitals to improve standards. Last November the Health Secretary, Alan Milburn, did promise to make some of the information public. 14th November 2000 ALAN MILBURN: [Speaking in the House] By April next year we intend to publish all of the standards reports that we have back from hospitals in order that the public can see the progress that we're beginning to make in this area, but it won't be easier, it will take some time. BARCLAY: In January the Department of Health promised 200 million pounds to help improve decontamination standards. But April came and went. More than a year after the first report was buried, no survey has yet been made public. But the Department's own risk assessment says surgery could result in up to 10% more cases of variant CJD if standards don't improve. And there's another twist. Five months after the government ordered the suppression of the English report on decontamination, the findings of a similar investigation in Scotland were made public. They've been available on the Scottish executive's website since February and the technical coordinator of this report was also David Hurrell. It concluded that the state of decontamination in the NHS in Scotland give serious cause for concern. Was that the conclusion of the English report? DAVID HURRELL Microbiologist Yes and in exactly the same words if I remember. BARCLAY: The Scottish report says "Urgent action is required to remedy a series of major deficiencies" was that what the English report said? HURRELL: Yes, the same conclusion exactly. BARCLAY: And it also identified many shortcomings which could increase risks to both patients and staff. Was that what the English report said? HURRELL: Again, absolutely identical. BARCLAY: Do you think the public had a right to know what was in the English report? HURRELL: Yes, I do. The Scottish public know the state of decontamination in their hospitals if they wish to read the report. The English public I believe have exactly the same right. BARCLAY: So far there have been one hundred and eleven cases of variant CJD. Less than two months ago the Government published its response to the public inquiry into BSE. It agreed the public should be trusted with information and treated like adults. BANNER: This is a government that is on record as being committed to openness and transparency in its dealings with the public and I would be astonished if ministers would be happy to know that this sort of thing was going on. But if they are happy, it's deeply disturbing. ZOE JEFFRIES Died 2000, aged 14 BARCLAY: Zoe Jeffries was just 14 when she died last year. Her parents allowed her to be filmed shortly before her death because they believed the Government should be more open about the risks of spreading the disease that killed their daughter. _________ www.bbc.co.uk/panorama CREDITS Reporter Sarah Barclay Film Camera Neil Higginson Tony Poole Sound Recordists Simon Parmenter Tony Pasfield VT Editor Boyd Nagle Dubbing Mixer Nick Berry Graphic Design Kaye Huddy Julie Tritton Film Research Kate Redman Production Team Karen Sadler Ben Peachey Fiona Crack Rebecca Maidens Amanda Vaughan-Barratt Production Manager Martha Estcourt Unit Manager Maria Ellis Film Editor Bob Hayward Assistant Producers Ruth Thorlby Jonathan Brunert Matthew Gooper Producer Rabinder Minhas Deputy Editor Andrew Bell Editor Mike Robinson 14 ______________________________________________________________________________________________________ Transcribed by 1-Stop Express Services, London W2 1JG Tel: 020 7724 7953 E-mail 1-stop@msn.com