Episode 5

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0:00:02 > 0:00:09This programme contains scenes which some viewers may find upsetting

0:00:12 > 0:00:1418th October, 2012.

0:00:16 > 0:00:21Across Britain, 100 cameras are filming the NHS on a single day.

0:00:21 > 0:00:24This change will be a disaster.

0:00:26 > 0:00:29On this day, more than 1.5 million of us will be treated.

0:00:31 > 0:00:34Three days ago you had a stroke.

0:00:34 > 0:00:371,500 of us will die.

0:00:37 > 0:00:402,000 will be born.

0:00:42 > 0:00:47The NHS is the largest public healthcare system in the world.

0:00:48 > 0:00:52We want that to be in your voice all of the time.

0:00:52 > 0:00:54Hello, we're going to help you.

0:00:54 > 0:00:56- We rely on it... - Be really brave.

0:00:56 > 0:00:59- ..complain about it... - In the bin, that's because of you!

0:00:59 > 0:01:02..often we take it for granted.

0:01:02 > 0:01:04Lucas! Lucas!

0:01:04 > 0:01:07What we expect from the NHS is ever-increasing.

0:01:07 > 0:01:10The money to pay for it isn't.

0:01:12 > 0:01:16If we could see what this institution does in a single day...

0:01:18 > 0:01:21..what would it make us think?

0:01:21 > 0:01:25This entire series tells the story of one day.

0:01:25 > 0:01:26So, why isn't she waking up?

0:01:26 > 0:01:29100 cameras,

0:01:29 > 0:01:33capturing the NHS as you've never seen it before.

0:01:33 > 0:01:35Baby born at five to three.

0:01:44 > 0:01:47RADIO: 'A top temperature today of 12 degrees...'

0:01:47 > 0:01:49'Tayside and Fife have been badly affected...'

0:01:49 > 0:01:51'Sunshine and showers today...

0:01:51 > 0:01:52'Eastern parts of England...'

0:01:52 > 0:01:55'Clockwise between 23...'

0:01:55 > 0:02:00'Later on this afternoon we will see some showery outbreaks of rain

0:02:00 > 0:02:03'just spreading into East Anglia and the south-east of England.'

0:02:07 > 0:02:09'Why brains?

0:02:09 > 0:02:12'Well, first of all brains are beautiful, I have got to say that.

0:02:13 > 0:02:15'My father is a neurosurgeon

0:02:15 > 0:02:19'but I was quite keen on becoming an engineer.

0:02:19 > 0:02:21'Then there was a big tragedy'

0:02:21 > 0:02:23in Malta, which is where I grew up,

0:02:23 > 0:02:28there was a hijack and the hijacked plane was forced to land

0:02:28 > 0:02:31in Malta, and the terrorists were shooting passengers in the head

0:02:31 > 0:02:35every hour and demanding that the plane be refuelled.

0:02:35 > 0:02:39'But I remember quite vividly my father going into hospital

0:02:39 > 0:02:41'and coming back after two or three days,

0:02:41 > 0:02:44'having operated on five of these people who had suffered

0:02:44 > 0:02:47'horrific injuries and that three of them had survived.'

0:02:47 > 0:02:51So I just decided that I wanted to become a neurosurgeon.

0:02:55 > 0:02:58Today, Ludvic has two patients booked in for surgery.

0:02:59 > 0:03:02He specialises in deep brain stimulation,

0:03:02 > 0:03:06a surgical procedure used to treat extreme tremors.

0:03:09 > 0:03:13His first patient, 70-year-old Agnes, has a neurological disorder

0:03:13 > 0:03:18called dystonia and 67-year-old Rose has Parkinson's disease.

0:03:19 > 0:03:21Although both conditions are incurable,

0:03:21 > 0:03:26surgery could make a significant difference to the symptoms.

0:03:28 > 0:03:30Deep brain stimulation involves placing electrodes

0:03:30 > 0:03:35deep within the brain, so, just to give you a demonstration,

0:03:35 > 0:03:37this is the sort of thing that we are implanting,

0:03:37 > 0:03:39it's a very thin lead,

0:03:39 > 0:03:43which is about the size of an uncooked spaghetti,

0:03:43 > 0:03:46with four little contacts at the end.

0:03:46 > 0:03:50So, what we end up with is a lead that we put in the brain,

0:03:50 > 0:03:54connected to a battery which is implanted either underneath

0:03:54 > 0:03:57the collarbone or in the tummy.

0:03:58 > 0:04:02For some patients, like Agnes and Rose, it is less risky to have

0:04:02 > 0:04:06two separate operations, one for each side of the body.

0:04:06 > 0:04:11I had it done before because my right hand had a severe tremor.

0:04:11 > 0:04:14I just can't wait for the end result.

0:04:14 > 0:04:20I'm hoping it will be as successful as last year's operation.

0:04:20 > 0:04:24Agnes uses a remote control to switch on the electrode

0:04:24 > 0:04:27already implanted in her brain.

0:04:27 > 0:04:28That's on.

0:04:28 > 0:04:33When it goes on, I can feel a shot of electricity go into my brain.

0:04:35 > 0:04:37And this is the difference.

0:04:43 > 0:04:46In the last two years, Rose's tremors have become

0:04:46 > 0:04:49so violent she has lost two-and-a-half stone in weight.

0:04:49 > 0:04:54What are you most looking forward to after you have had the operation?

0:04:54 > 0:04:59Being able to slice and move a pan

0:04:59 > 0:05:04over to the other side without burning myself.

0:05:04 > 0:05:08Carrying a cup of tea and things like that, you know.

0:05:08 > 0:05:10She couldn't...

0:05:10 > 0:05:14Sometimes she might get there with it and sometimes she'll spill it.

0:05:14 > 0:05:18Then when I go to the post office and get my pension,

0:05:18 > 0:05:21I can't sign that.

0:05:21 > 0:05:24All the staff do it for me.

0:05:24 > 0:05:26Just simple things like that.

0:05:27 > 0:05:31It's going to be a new beginning. I am sure.

0:05:41 > 0:05:45Karen, it is lying breach at the minute, bottom down, OK?

0:05:48 > 0:05:51Mornings are good towards the end of the week

0:05:51 > 0:05:57but I quite like doing lates on a Monday, straight after the weekend.

0:05:57 > 0:06:00I think there's an element of putting a bit of a face on,

0:06:00 > 0:06:05yes, cos you don't want to, sort of, be blubbering all day

0:06:05 > 0:06:07and things like that.

0:06:07 > 0:06:10You have got to put a bit of a face on, like a bit of a smiley face,

0:06:10 > 0:06:14because you know, everyone has got issues, everyone has got their own

0:06:14 > 0:06:18problems that they have to come into work with and stuff like that, like,

0:06:18 > 0:06:21you know if you have had an argument in the morning you've still

0:06:21 > 0:06:25got to go in and smile at everyone when really you don't want to but...

0:06:25 > 0:06:28You know, it's just the way it is. It's just nursing, that.

0:06:28 > 0:06:30But that's like any job, though, isn't it?

0:06:30 > 0:06:36Giving chemo for the very first time is horrible for all involved

0:06:36 > 0:06:41really, just because this is...you're starting them off.

0:06:41 > 0:06:44They are always going to remember you, they are always going to

0:06:44 > 0:06:47remember you as the first person that ever gave them the chemo,

0:06:47 > 0:06:52which most of the time is a good thing, but sometimes,

0:06:52 > 0:06:55you know, you are always going to have that stigma of,

0:06:55 > 0:07:00"Oh, you were the first one, when I came to the Christie, you were the

0:07:00 > 0:07:04"first one that gave me treatment and made me feel really sick."

0:07:07 > 0:07:09Right, come on!

0:07:13 > 0:07:16Right, out.

0:07:16 > 0:07:19Now, come on.

0:07:19 > 0:07:21Move, come on!

0:07:32 > 0:07:35- A nice red colour for you. - That'll be lovely, that, won't it?

0:07:35 > 0:07:37That is a change, isn't it?

0:07:37 > 0:07:42- This is the one that makes your hair come out.- Right.- All right?

0:07:42 > 0:07:46I had a haircut last week because I said it was less to drop out.

0:07:46 > 0:07:48Yes, it looks nice.

0:07:48 > 0:07:51- RADIO:- 'Rangers fans were going to buy these tickets...'

0:07:53 > 0:07:54Right, through we go then.

0:07:56 > 0:08:00Well done. You are doing really well.

0:08:00 > 0:08:04I have a patient on the island of Islay who has got schizophrenia.

0:08:07 > 0:08:11THEY SPEAK IN GAELIC

0:08:23 > 0:08:25Like all surgical patients,

0:08:25 > 0:08:28Agnes has been screened for superbugs such as MRSA.

0:08:31 > 0:08:33- So you know that your GP did a swab for you.- Yes.

0:08:33 > 0:08:34That came back as negative.

0:08:34 > 0:08:36- Yes, I was clear.- That was clear.

0:08:36 > 0:08:39- But the swap that they did yesterday came back as positive.- MRSA?

0:08:39 > 0:08:42I don't think we should be taking risks with your health.

0:08:42 > 0:08:46- You are not going to do it?- Not now. - Oh!

0:08:46 > 0:08:48- Sorry.- I had it last year.

0:08:48 > 0:08:53- But we cleared it before the operation.- No!- We did, we did.

0:08:53 > 0:08:57When it come back from the ward they put me in isolation.

0:08:57 > 0:08:59But we cleared it beforehand.

0:08:59 > 0:09:03- It doesn't make sense to do it now and take that extra risk.- Yes.

0:09:03 > 0:09:08Rather than postponing it by a few weeks. So, I'm really sorry.

0:09:08 > 0:09:11- You were psyched up for this. - I know. I'm very disappointed.

0:09:11 > 0:09:13- You have had a bit of an audience, as well.- Yes.

0:09:13 > 0:09:15But I think we should do what is best for your health

0:09:15 > 0:09:17because the last thing... You won't thank me

0:09:17 > 0:09:21if we do the operation and the hardware gets infected...

0:09:21 > 0:09:23- That's right.- ..and we have to take both sides out.

0:09:23 > 0:09:26- I forget about that. I forgot. - Do you understand?- Yes, I do.

0:09:26 > 0:09:29- We've got to do the best for you, all right?- Thank you.

0:09:29 > 0:09:33- I'll come back and have a chat. - Thank you anyway.- No worries.

0:09:33 > 0:09:34- See you later.- OK, bye.

0:09:38 > 0:09:41I wasn't expecting that.

0:09:41 > 0:09:43- No?- No.

0:09:43 > 0:09:47- I'm really sorry. - I'm trying to keep brave about it.

0:09:47 > 0:09:52I was so hyped up.... to have this operation.

0:09:52 > 0:09:56As I said, I was looking forward to the end result

0:09:56 > 0:10:01and now to have to go through it all again...

0:10:01 > 0:10:03Just one of these things.

0:10:03 > 0:10:06But I just feel like crying.

0:10:08 > 0:10:13Now Agnes is going home, Rose is moved up the operating list.

0:10:13 > 0:10:17- Hi there.- Hi there.- How are you? - Very well, thank you.

0:10:17 > 0:10:19- All set?- All set.

0:10:19 > 0:10:21How long has it been since we did the first operation?

0:10:21 > 0:10:26- 17th of August last year. - So just over a year.- Yes.

0:10:26 > 0:10:31Let's have a look, how are we getting on? So what about the tremor here?

0:10:31 > 0:10:32Very good. Are you happy with that?

0:10:32 > 0:10:36- What are we going to do for you today?- You are going to do this side.

0:10:36 > 0:10:40Absolutely. So we are going to put an electrode on this side of the head

0:10:40 > 0:10:43because it's this side of the brain that controls that side of the body.

0:10:43 > 0:10:48- But you are happy for us to go ahead. - Oh, yes.- Perfect.- I have to do.

0:10:48 > 0:10:51- So we will see you downstairs very shortly.- Please, God.

0:10:51 > 0:10:53- Thanks a million.- We will do the very best for you.

0:10:53 > 0:10:55- Thank you.- Take care.

0:11:01 > 0:11:02Hi, Fred.

0:11:02 > 0:11:04How are you?

0:11:09 > 0:11:12BABY CRIES

0:11:17 > 0:11:22Ladies and gentlemen, if you are here for chemotherapy today,

0:11:22 > 0:11:25please be aware there is a slight delay in getting blood results...

0:11:25 > 0:11:28Although cancer remains Britain's biggest killer,

0:11:28 > 0:11:30survival rates are better than ever.

0:11:30 > 0:11:33Two million people are now living with or beyond the disease.

0:11:33 > 0:11:36Hello there, Mike Whitaker. Thank you.

0:11:36 > 0:11:40Around 130 of them will come here today for chemotherapy.

0:11:42 > 0:11:44Some are hoping to be cured.

0:11:44 > 0:11:46Others know it can only buy them time.

0:11:48 > 0:11:52To get as far as the chemo treatment is absolutely brilliant.

0:11:52 > 0:11:58Because from what was said at the beginning, it wasn't looking good.

0:11:58 > 0:12:04- It wasn't looking good. I was going for... Is it the EMR scan?- Yes.

0:12:04 > 0:12:08If that showed anything up then there was nothing he could do.

0:12:08 > 0:12:10Well, I have had so many tests since and I am down

0:12:10 > 0:12:13and I am here, so that is brilliant.

0:12:13 > 0:12:17Yes, that's the best thing, that's the best news, isn't it,

0:12:17 > 0:12:19that anyone can ask for?

0:12:19 > 0:12:23'The reasons I came into this job are still the same, you know,

0:12:23 > 0:12:26'cancer is always going to be there and I think, you know,'

0:12:26 > 0:12:30it's something, if you've got the chance to be on

0:12:30 > 0:12:33the other side of it and help, for as long as possible,

0:12:33 > 0:12:34then, why wouldn't you?

0:12:34 > 0:12:35'You know?

0:12:35 > 0:12:39'I want to be on this side of it so that I can see and help people'

0:12:39 > 0:12:43and, you know, make them smile a little bit, maybe.

0:12:43 > 0:12:45Sometimes.

0:12:45 > 0:12:48- Right, so this is your steroid. - Okey-doke.

0:12:48 > 0:12:51Now this can give you a bit of a prickly bottom.

0:12:51 > 0:12:53Oh, right, OK.

0:12:53 > 0:12:56It only lasts for a couple of seconds.

0:12:56 > 0:12:59Don't make me laugh!

0:12:59 > 0:13:01Sorry!

0:13:03 > 0:13:07- Oh, dear.- Some people say it feels like nettles.- Oh, right.

0:13:07 > 0:13:09So that is pleasant for you(!)

0:13:09 > 0:13:11Barry has cancer of the oesophagus.

0:13:11 > 0:13:13He was first diagnosed two months ago.

0:13:13 > 0:13:16'This is my first treatment.'

0:13:16 > 0:13:19I've got three months' treatment, then an operation,

0:13:19 > 0:13:23and then a rest, and then three months' treatment after

0:13:23 > 0:13:25what they call mopping up.

0:13:25 > 0:13:32So, um, yes, I was wary about this morning but so far so good.

0:13:32 > 0:13:34He seems to be pretty straightforward. He knew

0:13:34 > 0:13:38exactly what he was doing, he knew what to expect and things like that.

0:13:38 > 0:13:40The only thing that he was worried about was his son.

0:13:40 > 0:13:45- How old is Liam then? - 24 in December, and a star.

0:13:45 > 0:13:49He is a magic lad, special needs, he is profoundly handicapped,

0:13:49 > 0:13:54- but he is like...- Will you do anything for his birthday?

0:13:55 > 0:13:58We've nothing planned as yet because it has thrown things

0:13:58 > 0:14:01but we are fortunate, we've got a place in Wales

0:14:01 > 0:14:04so we can walk down the beach

0:14:04 > 0:14:06and because it's concrete you can walk about three miles

0:14:06 > 0:14:08in his wheelchair so that's brilliant.

0:14:08 > 0:14:11He just loves it down there.

0:14:11 > 0:14:14Especially when the tide's in, and it's coming over.

0:14:15 > 0:14:17We just have great fun.

0:14:33 > 0:14:35# Well they talk about me

0:14:35 > 0:14:38# But people don't really care... #

0:14:38 > 0:14:42Today, one in six of us is living with some kind of mental illness.

0:14:42 > 0:14:45# ..We're going to keep on going... #

0:14:45 > 0:14:50Terry is a patient in a secure psychiatric unit in Blackpool.

0:14:50 > 0:14:53As part of a programme to prepare patients for their return

0:14:53 > 0:14:57to the community they are sent on a supervised visit to the zoo.

0:14:57 > 0:15:01..bipolar yourself, I tell you, you're off your head!

0:15:01 > 0:15:02I will!

0:15:04 > 0:15:08'I think, just going outside, in the normal environment,'

0:15:08 > 0:15:11which they will be spending most of their life,

0:15:11 > 0:15:13see how they interact with people,

0:15:13 > 0:15:15see how they interact with the staff there,

0:15:15 > 0:15:18'how they manage their money,

0:15:18 > 0:15:22'basic safety measures like, you know, crossing the road,'

0:15:22 > 0:15:23whether they are able to

0:15:23 > 0:15:25handle themselves safely throughout the visit.

0:15:25 > 0:15:28Thanks, everybody, for sticking to road safety.

0:15:28 > 0:15:32THEY ALL LAUGH

0:15:34 > 0:15:37'You cannot cure mental illness,'

0:15:37 > 0:15:42but what we can do is there are different treatment regimes

0:15:42 > 0:15:47pharmacological, psychological and, you know, social treatments

0:15:47 > 0:15:51which would help to contain these symptoms.

0:15:56 > 0:16:00Terry has bipolar disorder. He's been at the unit for six weeks

0:16:00 > 0:16:04but is due to released at the end of today.

0:16:04 > 0:16:07Just grabbing hold of your fingers, that's what they want.

0:16:07 > 0:16:10Would you expect at some point you'll come back to the hospital?

0:16:10 > 0:16:16I can never really tell. If I go a bit high and I go too much,

0:16:16 > 0:16:19- I might have to.- Yeah.

0:16:19 > 0:16:22But sometimes I remain all right for two years.

0:16:22 > 0:16:28Giraffes! Go and see my giraffes! I've seen the lions now so...

0:16:28 > 0:16:31And the tigers, so we are going to go and see the giraffes.

0:16:31 > 0:16:33Chris has a personality disorder,

0:16:33 > 0:16:36he's bipolar and suffers from delusions.

0:16:36 > 0:16:40He's been known to mental health services since he was 13.

0:16:40 > 0:16:42Mother, daddy and a baby.

0:16:42 > 0:16:47It is amazing, they are beautiful creatures, so, so sensitive.

0:16:47 > 0:16:48Wow!

0:16:51 > 0:16:52Oh!

0:16:54 > 0:16:55I was...

0:16:55 > 0:17:02I was a difficult child and I was abrupt and I was disobedient

0:17:02 > 0:17:05and very, very unsettled as a child.

0:17:05 > 0:17:07Apple.

0:17:07 > 0:17:09'I left my mother's home at the age of 14'

0:17:09 > 0:17:12and won the lottery at the age of 25...

0:17:12 > 0:17:17I'm 27 now so I won the lottery when I was 23.

0:17:17 > 0:17:19Wow.

0:17:19 > 0:17:21'I'm hoping the authorities have got it.

0:17:21 > 0:17:22'It was £10.7 million'

0:17:22 > 0:17:25and it was a lot of money -

0:17:25 > 0:17:28could have changed my life and many more lives.

0:17:29 > 0:17:30I wouldn't be here now,

0:17:30 > 0:17:36I'd maybe be travelling in Asia or travelling in America,

0:17:36 > 0:17:40on business, entrepreneurial business.

0:17:40 > 0:17:43What do you do with £10.7 million, what do you do with all that money?

0:17:45 > 0:17:47Buy a dog.

0:17:47 > 0:17:50I'd buy a dog, and buy a car

0:17:50 > 0:17:53and buy a home, somewhere nice.

0:17:53 > 0:17:56Dog first, I always wanted a dog.

0:17:56 > 0:18:00- TERRY:- That's what they all say in Blackpool, they all call me Elvis.

0:18:00 > 0:18:03They say there is nobody as fluent as you singing Elvis.

0:18:04 > 0:18:10He said, "I always liked Elvis songs but you can sing exactly like him."

0:18:10 > 0:18:14- Christopher!- Chris!- Christopher! - Chris!

0:18:17 > 0:18:19- TERRY:- Christopher! Christopher!

0:18:19 > 0:18:23- You can get here this way. - Christopher! Chris!

0:18:23 > 0:18:27- Chris, are you going that way? - He reckons this way is quicker.

0:18:27 > 0:18:30No, we're not.

0:18:30 > 0:18:32SIRENS WAIL

0:18:35 > 0:18:37RADIO: 'Two accidents in West Yorkshire on the A1.

0:18:37 > 0:18:41'M1 northbound, lane out at junction 13 because of an accident.

0:18:41 > 0:18:44'If you are heading out of London, the A13 is closed eastbound.'

0:18:47 > 0:18:50Rose is about to undergo deep brain stimulation.

0:18:52 > 0:18:54Shall we come straight in?

0:18:54 > 0:18:55Hello.

0:18:55 > 0:18:59Fewer than one in ten Parkinson's patients

0:18:59 > 0:19:03are considered suitable for this life-changing treatment.

0:19:09 > 0:19:13'She started tremoring about May, 2006.'

0:19:13 > 0:19:17'It got worse all the time.

0:19:17 > 0:19:20'I couldn't walk from the sink'

0:19:20 > 0:19:22to the table.

0:19:22 > 0:19:25Oh, it was horrible. It really was horrible.

0:19:32 > 0:19:35Rose has really exhausted all the medical options

0:19:35 > 0:19:38for trying to help with the tremor.

0:19:38 > 0:19:40The tremor is becoming so bad,

0:19:40 > 0:19:43it really has progressed over the last year or so.

0:19:43 > 0:19:45It's become so bad that her whole body shakes

0:19:45 > 0:19:49and I think if we can diminish that tremor,

0:19:49 > 0:19:52of course it would be lovely to get rid of it, but if we can improve it,

0:19:52 > 0:19:55then I think it would make a big effect on her quality of life.

0:19:55 > 0:19:58'I think if we didn't have this operation

0:19:58 > 0:20:01'she would have to cope as best she can with the symptoms.'

0:20:07 > 0:20:10The arduous procedure will take four hours,

0:20:10 > 0:20:13and Rose will be awake throughout.

0:20:13 > 0:20:14I'll take good care of her.

0:20:18 > 0:20:21- So, you remember this little fella? - I do.

0:20:21 > 0:20:23- We are going to put that on the head.- Yes.

0:20:23 > 0:20:25These little bars will go in your ears.

0:20:25 > 0:20:28You'll feel a bit of pressure for five minutes or so.

0:20:28 > 0:20:29If that becomes unbearable,

0:20:29 > 0:20:31- you let us know and we'll pull it out.- Right.

0:20:31 > 0:20:35- Then we'll numb these four areas and put those little screws in.- Right.

0:20:35 > 0:20:38- Then the frame will be on.- Right. - All right?- Yes.

0:20:38 > 0:20:40Let's get it over and done with.

0:20:40 > 0:20:42This is the worst bit, you remember that.

0:20:42 > 0:20:45- In for a penny... TOGETHER:- ..in for a pound.

0:20:45 > 0:20:47Good luck. OK. Here we go.

0:20:48 > 0:20:51'To start the procedure requires putting a frame on the head

0:20:51 > 0:20:56'and getting an MRI scan which will be a personal map to Rose's brain.

0:20:56 > 0:20:58'But if you look at any map,'

0:20:58 > 0:20:59in order to navigate accurately,

0:20:59 > 0:21:02you have to place a reference grid over it

0:21:02 > 0:21:05and that is exactly what the frame does.

0:21:05 > 0:21:09It allows us to have what we call coordinates, that guide us

0:21:09 > 0:21:11to very precise locations within the brain

0:21:11 > 0:21:13'with millimetric accuracy.'

0:21:13 > 0:21:16- Just going into the ears, they'll feel a bit uncomfortable.- Yes.

0:21:16 > 0:21:18Do let us know if it becomes unbearable.

0:21:18 > 0:21:21- The right one's a bit... - It's a bit painful already, is it?

0:21:27 > 0:21:29- Is it tight?- Yes, very.

0:21:29 > 0:21:30- Is it unbearable?- Yes.

0:21:30 > 0:21:32- Which side is worse?- Left. - The left?

0:21:32 > 0:21:36- Top right is hurting. - On the forehead?- Yes.

0:21:36 > 0:21:38OK, let that out a little bit.

0:21:38 > 0:21:40Rob, could you hold her hand a little bit?

0:21:40 > 0:21:42Just maybe help control the tremor a bit.

0:21:42 > 0:21:46- It's really hurting me. - The right? Here? Hold on.

0:21:55 > 0:21:59- I'm sorry.- You are being very good. - The frame's moved this side.

0:21:59 > 0:22:01- Are you all right, Rose?- Yes.

0:22:02 > 0:22:04Close your eyes for me.

0:22:04 > 0:22:08A sharp scratch above your right eye. A little bit of burning.

0:22:10 > 0:22:13Just behind your right ear again.

0:22:13 > 0:22:15- And just behind your left.- Yes.

0:22:24 > 0:22:28- Have you got any pain anywhere at the moment?- No.- Good.

0:22:28 > 0:22:30Get you lying down in just a second, OK?

0:22:30 > 0:22:33Just going to tighten those things up a little bit more.

0:22:33 > 0:22:34Good.

0:22:34 > 0:22:39- I right deserve a brew.- That does deserve a brew, absolutely!

0:22:39 > 0:22:42We need something stronger in it!

0:22:42 > 0:22:45- THEY LAUGH- A wee drop of something!

0:22:47 > 0:22:50OK. Take it easy.

0:22:50 > 0:22:53Can you remember this plastic box that we put on top of everything?

0:22:56 > 0:22:59- You can hear a bit of a click.- Yes.

0:23:00 > 0:23:02OK.

0:23:02 > 0:23:03Good.

0:23:03 > 0:23:05Good.

0:23:05 > 0:23:08- OK, this is just going to come over you.- OK.

0:23:13 > 0:23:16All right? You can close your eyes if you want to.

0:23:16 > 0:23:20- It's entirely up to you. - ROSE'S COMMENT INDISTINCT

0:23:20 > 0:23:22And then up a little bit.

0:23:25 > 0:23:32'A lot of what doctors do is thought be life-saving'

0:23:32 > 0:23:36and a lot of it is, of course it is an important part of what we do,

0:23:36 > 0:23:40but I think quality of life is increasingly being recognised

0:23:40 > 0:23:44over the decades as being one of the most important things

0:23:44 > 0:23:47that we can do other than saving lives.

0:23:47 > 0:23:51'The more technology that we have, the more we are spending

0:23:51 > 0:23:54'to provide people with these increases in quality of life.

0:23:54 > 0:23:55'So it is a big challenge,

0:23:55 > 0:23:59'a big economic health challenge for the society at large to say,'

0:23:59 > 0:24:01all right, how much are we prepared to invest

0:24:01 > 0:24:04in a National Health Service, that is going to provide

0:24:04 > 0:24:09quality of life which is important for us as human beings?

0:24:09 > 0:24:12And what's that cut-off? Where do we have to say,

0:24:12 > 0:24:16these are the resources that we have got and above that resource

0:24:16 > 0:24:19we can't afford it and below that resource, we can?

0:24:19 > 0:24:21There we go.

0:24:31 > 0:24:35Mental health is one of the most complex challenges facing the NHS.

0:24:36 > 0:24:39Treating mental health disorders

0:24:39 > 0:24:41costs the NHS more than any other illness.

0:24:43 > 0:24:46# He has the strength to move the tide

0:24:46 > 0:24:49# Without his love you won't survive

0:24:49 > 0:24:52# I'm singing praise together

0:24:52 > 0:24:54# Sing together

0:24:54 > 0:24:57# Pray with one mighty roar... #

0:24:57 > 0:25:01This evening, Terry is due to be discharged from the unit

0:25:01 > 0:25:05and will return to the care home he has lived in for nearly two years.

0:25:05 > 0:25:07# ..Rejoice. #

0:25:08 > 0:25:12Over the last week, the psychiatric team have been meeting to discuss

0:25:12 > 0:25:16whether or not he is ready and safe to leave the unit.

0:25:17 > 0:25:21Terry is around 63-years-old and more than half of his life

0:25:21 > 0:25:24he has been dealing with this bipolar illness.

0:25:24 > 0:25:31He has a 37 year history of this and he has had plenty of admissions.

0:25:31 > 0:25:35When he came to us on this particular instance, Terry was demanding

0:25:35 > 0:25:37and aggressive and agitated on the ward

0:25:37 > 0:25:41'and he was singing lots of songs of Elvis Presley.'

0:25:42 > 0:25:46- How do you cope with that? How do you cope when you are low?- Well...

0:25:46 > 0:25:49You know the best thing to do about it, when you are lying in bed

0:25:49 > 0:25:52and you can't even motivate yourself to get up?

0:25:52 > 0:25:53Force yourself to get up

0:25:53 > 0:25:56and just make yourself get up and take up walking.

0:25:56 > 0:26:00And as you're walking, look at the sea going out or coming in.

0:26:00 > 0:26:03Walking is the best thing for depression.

0:26:04 > 0:26:07'What tends to happen is Terry will come onto the ward

0:26:07 > 0:26:10'and his physical health problems will be looked after.

0:26:10 > 0:26:12'We sort of look into his medications'

0:26:12 > 0:26:14and then he gradually starts to improve

0:26:14 > 0:26:18and then he is at a point where all his abnormal beliefs,

0:26:18 > 0:26:22they tend to retreat and his normal self

0:26:22 > 0:26:24comes more and more into the front.

0:26:24 > 0:26:26Shall we get Terry in then? Yes.

0:26:29 > 0:26:33- Hello.- Sorry.

0:26:38 > 0:26:42- Morning, Terry.- Morning.- You know all of us in the room here.- Yes.

0:26:42 > 0:26:46And, I get, you know, you think you are getting better now,

0:26:46 > 0:26:49- you are on your road to recovery at the moment.- I am, yes.

0:26:49 > 0:26:52And I think we all share the same thing that Terry is showing

0:26:52 > 0:26:55improvement. How do you feel about your medication?

0:26:55 > 0:26:57It's done right. It's levelled out.

0:26:57 > 0:27:01It is helping me, um, just be normal.

0:27:01 > 0:27:04You know when you have not been well in the past,

0:27:04 > 0:27:07- you have sometimes felt like life is not worth living.- Yes.

0:27:07 > 0:27:11- Has it happened recently when you have had such thoughts?- No, no.

0:27:11 > 0:27:15How would you feel about going back to this residential

0:27:15 > 0:27:17accommodation you were at previously?

0:27:17 > 0:27:22- Yes, I want to go back there. I think I am all right.- Absolutely.

0:27:22 > 0:27:24We are all in agreement of that, Terry.

0:27:24 > 0:27:27I'll be all right in my care home anyway.

0:27:27 > 0:27:29- Yes, you will. - AROKIA:- Well done, Terry.

0:27:29 > 0:27:31Thank you very much. Thank you.

0:27:33 > 0:27:36'Every time we turn around a patient's life I think that's

0:27:36 > 0:27:38'the biggest satisfaction we get in our jobs.'

0:27:38 > 0:27:41So I am really pleased that Terry has got better

0:27:41 > 0:27:44and is able to go home today. I wish him well.

0:27:44 > 0:27:46Sorry, just excuse me.

0:27:47 > 0:27:50Unlike Terry, Chris is not ready to leave the unit.

0:27:50 > 0:27:53Oh! Oh!

0:27:56 > 0:27:57Excuse me.

0:27:57 > 0:27:59Go on!

0:27:59 > 0:28:02'Christopher was known to mental health services as a child.

0:28:02 > 0:28:05'When he is low he is very depressed and when he is high,

0:28:05 > 0:28:09'which he experiences a lot, he can experience delusions,'

0:28:09 > 0:28:11you know,

0:28:11 > 0:28:13mostly of a grandiose nature.

0:28:16 > 0:28:17This is it.

0:28:17 > 0:28:20This is my computer where I am doing all my work on at the moment.

0:28:20 > 0:28:24I have got a dossier to type up, a couple of dossiers.

0:28:24 > 0:28:27This is Bonnie Prince Charlie, he is a relative of mine,

0:28:27 > 0:28:30back in the olden days, Culloden,

0:28:30 > 0:28:35and he's now buried with the Pope in the Vatican City.

0:28:35 > 0:28:37Charles Edward Stuart.

0:28:38 > 0:28:41There is some issues I'd like to get off my chest

0:28:41 > 0:28:43whilst you are filming within the NHS.

0:28:45 > 0:28:49The services could be a lot better, given the better Government funding

0:28:49 > 0:28:55and a lot of people miss out on the potential the NHS could reach.

0:28:55 > 0:28:58The National Health Service of this nation could be an awful lot better

0:28:58 > 0:29:01and Jeremy Hunt of the member of the Parliament...

0:29:01 > 0:29:04Member of Parliament for Healthcare,

0:29:04 > 0:29:08he knows that he has the money to transform the NHS,

0:29:08 > 0:29:10the National Health Service of Great Britain,

0:29:10 > 0:29:13and unfortunately he just won't.

0:29:20 > 0:29:24Jeremy Hunt, Secretary of State for Health,

0:29:24 > 0:29:28is in charge of the £105 billion NHS budget.

0:29:33 > 0:29:37Now that over 15 million of us are living with long-term illness,

0:29:37 > 0:29:41Jeremy Hunt has to find a way to finance the growing demand

0:29:41 > 0:29:43this makes on the NHS.

0:29:45 > 0:29:50At the moment demand in the NHS is rising by around 4% a year,

0:29:50 > 0:29:52in some parts of the system it's more.

0:29:52 > 0:29:55Admissions to A&E are going up by about 5% a year

0:29:55 > 0:30:00and that is an increasing burden on public finances

0:30:00 > 0:30:03which is why it's so important to have a strong economy,

0:30:03 > 0:30:06because the public want us to be able to carry on investing

0:30:06 > 0:30:10and it's top of their priorities in terms of the area

0:30:10 > 0:30:13that they want to see the Government focusing on.

0:30:16 > 0:30:20Today, Jeremy is visiting a cancer centre in central London

0:30:20 > 0:30:24- which is partly charity funded. - Thank you for coming.- Pleasure.

0:30:24 > 0:30:27- Robert Naylor, Chief Executive. - Nice to meet you.- Geoff Bellingan.

0:30:27 > 0:30:31- Hello, Jeremy.- Nice to meet you. - Katherine Fenton.

0:30:31 > 0:30:32Katherine, very nice to meet you.

0:30:37 > 0:30:39- Right.- All right?- Yes.

0:30:39 > 0:30:42I will take you to our ambulatory care unit,

0:30:42 > 0:30:45so this is really a way in which we can treat patients with

0:30:45 > 0:30:49complex chemotherapy regimes without needing to keep them in hospital.

0:30:49 > 0:30:54- Is chemotherapy normally an injection?- Well, it's a variety...

0:30:54 > 0:30:56It is usually infusions.

0:30:56 > 0:30:58Sometimes tablets, sometimes injections,

0:30:58 > 0:31:03but usually it's a series of infusions maybe lasting an hour,

0:31:03 > 0:31:04maybe a bit longer.

0:31:04 > 0:31:07What do you mean by an infusion?

0:31:07 > 0:31:12- Claire, do you have somebody who is having an infusion?- Um, yes. I do.

0:31:12 > 0:31:14No cuts in services!

0:31:30 > 0:31:32Morning.

0:31:32 > 0:31:36When we was going to the toilet, blood,

0:31:36 > 0:31:40you have seen the adverts, diagnosed with bowel cancer.

0:31:40 > 0:31:42Had the op in February, put me on the old chemo.

0:31:42 > 0:31:45Then they tell me the chemo hasn't worked.

0:31:45 > 0:31:47Then they tell me you have five or ten years left,

0:31:47 > 0:31:50then I saw my main doctor a fortnight later,

0:31:50 > 0:31:54she tells me, "No, it's not, it's one or two years."

0:31:54 > 0:31:56I said, "Thanks!"

0:31:56 > 0:32:00- Bottom line is, I say, you don't know.- No.- You don't know.

0:32:00 > 0:32:04You don't know, you've just got to stay positive and, you know,

0:32:04 > 0:32:08trying just keep plodding away.

0:32:08 > 0:32:11Yes. Without doubt.

0:32:11 > 0:32:14- Angela Newnan, please. - See you in a bit.

0:32:22 > 0:32:25- That other nurse, on here, she's got them...- Chinchillas.

0:32:25 > 0:32:27- That's it, yes. - How many chinchillas has she got?

0:32:27 > 0:32:30- I think she had five, one died. - Oh, did it die?

0:32:30 > 0:32:33- Yes, and then she got another one. - Oh, bless.- Now she is thinking...

0:32:33 > 0:32:36- She is thinking of getting one. - Yeah, I want one.- Are you?

0:32:36 > 0:32:38He is holding his head. THEY LAUGH

0:32:38 > 0:32:42- You got another one to go?- Yes, I've got another hour to go. Yes.

0:32:42 > 0:32:44- No, you haven't.- Serious!

0:32:44 > 0:32:47No, no, no, no. This is the last. Don't have me on.

0:32:47 > 0:32:50- We have got another hour to go. - We haven't.- We have.

0:32:50 > 0:32:52'It's always there, isn't it?

0:32:52 > 0:32:55'It's always at the back of your mind.

0:32:55 > 0:32:58'How many people have cancer, but I think when you are faced with it

0:32:58 > 0:32:59'on a day-to-day basis'

0:32:59 > 0:33:02it does make you think a little bit more.

0:33:02 > 0:33:06'I can't do this job and not spot signs or symptoms

0:33:06 > 0:33:08'or things like that

0:33:08 > 0:33:11'I think it makes you more aware of things that maybe aren't

0:33:11 > 0:33:13'really there and you think, "Oh, well,'

0:33:13 > 0:33:17- "I'll just go and check it out." - Where do you go?- GP.

0:33:17 > 0:33:21Definitely. I think he has seen me more since I have started here

0:33:21 > 0:33:23'than he's ever seen me before.

0:33:23 > 0:33:26'He's never nasty. They're just sort of,'

0:33:26 > 0:33:29"Where do you work?" "Christie's." "Right."

0:33:31 > 0:33:35Hello! Good afternoon.

0:33:53 > 0:33:58One biopsy there which is showing us the oesophagus.

0:33:58 > 0:34:02This is a normal lining, perhaps a bit of inflammation,

0:34:02 > 0:34:04but nothing too much to worry about.

0:34:04 > 0:34:08Then we go on this higher magnification.

0:34:08 > 0:34:11I've spotted

0:34:11 > 0:34:17that the cells underneath the normal lining are quite worrying.

0:34:17 > 0:34:21I can quite confidently say that this is a cancerous tumour.

0:34:23 > 0:34:29And so what they have seen is definitely a malignancy.

0:34:31 > 0:34:36Every two minutes, someone in the UK will be diagnosed with cancer.

0:34:38 > 0:34:41This is a specimen from a middle-aged lady,

0:34:41 > 0:34:44they did an ultrasound for her and they found that her uterus

0:34:44 > 0:34:49is very big and there is a mass bulging from the uterus.

0:34:49 > 0:34:55The tumour itself was 24 centimetres in maximum dimension.

0:34:55 > 0:34:58The whole specimen was more than five kilograms.

0:34:58 > 0:35:02- Is the patient still alive? - Yes, she is still alive.

0:35:06 > 0:35:08Michael Whitaker.

0:35:10 > 0:35:1449-year-old Mike was diagnosed with bowel cancer two years ago.

0:35:16 > 0:35:18- How are you today? - Not too bad, thank you.

0:35:18 > 0:35:22I have been battling through the traffic for the last hour or so.

0:35:22 > 0:35:25Have you got anything planned this weekend?

0:35:25 > 0:35:26The little ones are on half term

0:35:26 > 0:35:29- so we will try and keep them entertained.- Aw! Yes.

0:35:33 > 0:35:36I don't go there with the, "Why me?"

0:35:36 > 0:35:39Because I just like to get on with matters

0:35:39 > 0:35:42and it's a case of what will be, will be. You know?

0:35:42 > 0:35:44I look back on my lifestyle and think,

0:35:44 > 0:35:46were there anything I could have changed? You know?

0:35:46 > 0:35:49Did anything really contribute to this suddenly happening,

0:35:49 > 0:35:52and no, there were nothing like that.

0:35:52 > 0:35:55Never smoked all my life, drank in moderation,

0:35:55 > 0:36:00never took drugs! No.

0:36:01 > 0:36:06Some people say life's a lottery, you know? And what will be, will be.

0:36:07 > 0:36:09Lovely, thank you.

0:36:09 > 0:36:14'I have four boys I have twins at 12 and two elder guys at 21 and 23.

0:36:14 > 0:36:16'They are both in the Army.'

0:36:16 > 0:36:18Yes, yes.

0:36:18 > 0:36:22'I have sat down with the elder two had a good chat about matters.'

0:36:22 > 0:36:25The little ones are aware of my operation in February

0:36:25 > 0:36:30and why Dad was going for the operation and since then,

0:36:30 > 0:36:32obviously, them being 12,

0:36:32 > 0:36:35we didn't want to rock the boat as such with their school life.

0:36:37 > 0:36:41I'm going to let them enjoy Christmas and then, in the New Year,

0:36:41 > 0:36:44probably we'll have the sit-down chat

0:36:44 > 0:36:47regarding matters and my health.

0:36:49 > 0:36:53When somebody tells you you've got 12 months to you left here,

0:36:53 > 0:36:56you know, you've just got to stay as positive as possible

0:36:56 > 0:36:59and, in a sense, in a funny sort of way, that's a challenge,

0:36:59 > 0:37:02that's a challenge to me to prove people wrong.

0:37:03 > 0:37:07'So I just try to live every day, you know, doing what I enjoy,

0:37:07 > 0:37:11'and doing what we can do with the family, as much as possible,

0:37:11 > 0:37:15'while I still have time here and that's how I look at matters.'

0:37:17 > 0:37:20My wife wants the bedroom decorating for Christmas.

0:37:20 > 0:37:25So she still has a little list of jobs for me, to keep me going.

0:37:25 > 0:37:28I won't die of boredom if anything else.

0:37:40 > 0:37:46Today, the NHS will spend over £6 million on emergency services.

0:37:46 > 0:37:50The Midlands Air Ambulance is bringing in a 19-year-old girl

0:37:50 > 0:37:51with burns to her face.

0:37:58 > 0:38:00This is Sophie. She is 19.

0:38:00 > 0:38:03She was attempting to do a poached egg in the microwave.

0:38:03 > 0:38:07She opened the door of the microwave and it exploded in her face.

0:38:07 > 0:38:10- Where are my glasses? Were they burning me?- Yes.

0:38:10 > 0:38:12- We'll sort out something for that. - You all right?

0:38:12 > 0:38:14- Lots of people around here.- I know.

0:38:14 > 0:38:17I know, the exciting bit now is we need to have a little look,

0:38:17 > 0:38:20all right? Was the poached egg in some water in a glass jar, was it?

0:38:20 > 0:38:23- Yes? Hot water.- Boiled the kettle before I put it in the pot.

0:38:23 > 0:38:25OK, so it was already going quite well?

0:38:25 > 0:38:27And it exploded in your face as you opened the door, did it?

0:38:27 > 0:38:32- I popped the cup out and... - And it just exploded?

0:38:32 > 0:38:37- Did the glass break at all?- No. I didn't really look, I just ran.

0:38:39 > 0:38:42- That is grand.- Ow!- No pressure, man.

0:38:45 > 0:38:47There we go.

0:38:47 > 0:38:50- That wasn't too bad, was it? - Let me look at your face.

0:38:53 > 0:38:57- Have you got any pain in your scalp at all?- No.- OK.

0:38:58 > 0:39:01The burns look quite superficial. OK, that means it is not very deep.

0:39:01 > 0:39:04That is probably why it is very painful, all right?

0:39:04 > 0:39:06We are also going to have a look in your eyes

0:39:06 > 0:39:08to make sure that your eyes are OK, with some special dye.

0:39:08 > 0:39:10We'll shine some bright lights in your face.

0:39:10 > 0:39:11Did you do any first aid?

0:39:11 > 0:39:14You ran out of the room, did you put anything on it?

0:39:14 > 0:39:16- I ran my face under cold water. - For ten minutes.

0:39:16 > 0:39:19- OK, and you called the ambulance?- I fainted. They called while I was...

0:39:19 > 0:39:23- Where do you live?- Stafford. - Stafford!- Yeah.

0:39:23 > 0:39:26- Where am I?- You're in Birmingham.

0:39:26 > 0:39:29So big, deep breaths.

0:39:29 > 0:39:31By the look of you, you've been very lucky.

0:39:31 > 0:39:34Nothing we need to do an operation for, I don't think. All right?

0:39:34 > 0:39:37You've basically got a bad sunburn and a bit of a burny nose.

0:39:37 > 0:39:40We just need to have a look at your eyes though, all right?

0:39:40 > 0:39:43Can I please ring my sister because she is on the way from Stafford.

0:39:43 > 0:39:45Is she? We shall give her a call, shall we? All right.

0:39:45 > 0:39:47If there is a burn to a face that affects your nostrils,

0:39:47 > 0:39:51your mouth, whether it be a flame burn or steam burn in this case,

0:39:51 > 0:39:54then it can cause the airway to swell and therefore stop patients

0:39:54 > 0:39:58from breathing so it's more of an emergency. That's why

0:39:58 > 0:40:03she would have been brought in by an air ambulance in this situation.

0:40:03 > 0:40:07However, this young lady might have gone to her local hospital

0:40:07 > 0:40:09which, in retrospect, would have been fine as well.

0:40:09 > 0:40:12- What is this hospital called? - Queen Elizabeth Hospital.

0:40:12 > 0:40:14It's called Queen Elizabeth.

0:40:14 > 0:40:16So, there we go. It is my first egg burn.

0:40:18 > 0:40:20Gemma, will you come to me, I'm scared.

0:40:20 > 0:40:22Do you want me to have a word with her?

0:40:22 > 0:40:25Do you want the doctor to speak to you? Yeah?

0:40:25 > 0:40:27You're all right, mate?

0:40:27 > 0:40:31- What is your sister's name? - Gemma.- Hello, Gemma.

0:40:31 > 0:40:35You are not allowed to cry in this hospital, OK?

0:40:35 > 0:40:38- Are you all right?- Yes.

0:40:38 > 0:40:40No worries.

0:40:40 > 0:40:42No, no. A bit of an injury to the face.

0:40:42 > 0:40:45It is all sorted.

0:40:46 > 0:40:47Any yoghurt?

0:40:49 > 0:40:51She is a pickle.

0:40:53 > 0:40:55There you go, love. Are you all right there? Can you manage?

0:40:57 > 0:40:59Yes, I made it myself, it's gross.

0:41:02 > 0:41:07- No, it's not, it's nice.- Gross. - It's like broccoli soup.- It's gross.

0:41:07 > 0:41:10You're going to hear a big noise now.

0:41:10 > 0:41:12We're just going to make the little hole. It is very noisy,

0:41:12 > 0:41:15- lots of vibration but no pain at all.- All right.

0:41:15 > 0:41:18DRILL WHIRRS

0:41:21 > 0:41:23You're doing really well.

0:41:26 > 0:41:30- That's it.- I don't remember last one being like that.

0:41:30 > 0:41:34No, you forget that sort of thing pretty quickly, don't you?

0:41:34 > 0:41:38Ludvic needs to be sure that he doesn't damage the parts

0:41:38 > 0:41:42of Rose's brain responsible for speech, movement and emotion.

0:41:42 > 0:41:46- Here is the night train...- Crossing the border.- Crossing the border.

0:41:46 > 0:41:48Bringing the cheques and the postal order.

0:41:48 > 0:41:51Bringing the cheques and the postal order.

0:41:51 > 0:41:56You sound like my three-year-old now, she likes copying everything

0:41:56 > 0:41:59that everybody else says, she is going through that phase.

0:41:59 > 0:42:03- I have a grandson.- How old is he?

0:42:03 > 0:42:05He's eight in February.

0:42:05 > 0:42:09He rang me up on Sunday and said,

0:42:09 > 0:42:14"Nana, has your shakes gone yet?"

0:42:14 > 0:42:18And I said, "No, not yet, love." "Well, why?"

0:42:18 > 0:42:20He's fabulous, he really is.

0:42:20 > 0:42:23Right, can I have a new pair of gloves, please?

0:42:25 > 0:42:29The electrodes, I think they cost around £2,000 each,

0:42:29 > 0:42:31something like that.

0:42:31 > 0:42:34I think it is important to realise that the amount of money

0:42:34 > 0:42:36that's spent on medication,

0:42:36 > 0:42:38the amount of money that's spent on care,

0:42:38 > 0:42:41there's quite a lot of evidence out there to actually suggest,

0:42:41 > 0:42:44and certainly for Parkinson's disease, if you do the surgery

0:42:44 > 0:42:47in patients that are not responding to medication,

0:42:47 > 0:42:50you actually start saving money after two-and-a-half years,

0:42:50 > 0:42:55so it's a false economy not to offer it to people.

0:42:55 > 0:42:57Of course, with the added benefit

0:42:57 > 0:42:59of these people having a better quality of life.

0:43:03 > 0:43:06- That is 101.- 101.

0:43:06 > 0:43:09In an arc of...

0:43:09 > 0:43:1066.9...

0:43:12 > 0:43:13That's how the...

0:43:13 > 0:43:16'The biggest risk of all is that we do the operation

0:43:16 > 0:43:18'and it doesn't help.

0:43:18 > 0:43:19'But at the end of the day,

0:43:19 > 0:43:21'when you are doing an operation to help with function,

0:43:21 > 0:43:23'the most important thing is that

0:43:23 > 0:43:24'you don't leave your patients worse off.'

0:43:24 > 0:43:27'Going back to the Hippocratic oath, "First, do no harm."

0:43:27 > 0:43:30'But it is impossible to do any sort of surgery without risk.'

0:43:33 > 0:43:37I'm 40, so I've got another 25 years plus,

0:43:37 > 0:43:41if the Government gets its way, of doing this surgery,

0:43:41 > 0:43:46and I hope I'm never faced with that knowledge

0:43:46 > 0:43:49that I have left someone worse off than when I started.

0:43:49 > 0:43:52And if I am in a position to say that I never have,

0:43:52 > 0:43:54I think I'll be a very lucky man indeed.

0:43:54 > 0:43:57- Rose?- Yes.- I don't know if you remember from last time

0:43:57 > 0:44:00but do you remember we measured some of the electricity of the brain

0:44:00 > 0:44:01- as we were doing the operation?- Yes.

0:44:01 > 0:44:03- Some of the music of the brain.- Yes.

0:44:03 > 0:44:06- We going to hear a little bit of that now, OK?- Right.

0:44:06 > 0:44:09- MUSICAL BEEPING - That's fine, that's working well.

0:44:09 > 0:44:13Before we do that, we want to test that all of our equipment

0:44:13 > 0:44:16is working fine and ready for action.

0:44:16 > 0:44:17Then once we are happy with that,

0:44:17 > 0:44:20we will make a very small hole in the covering of the brain

0:44:20 > 0:44:24and a very small hole on the surface and then pass that electrode

0:44:24 > 0:44:27down, hopefully, to the spot that is going to affect the tremor.

0:44:38 > 0:44:41'If the probe didn't end up where we wanted it to go,

0:44:41 > 0:44:45'at the very least we wouldn't get the effect that we desire.

0:44:45 > 0:44:47'If the probe is in the wrong place

0:44:47 > 0:44:52'and you cause a bleed at that point, then you can cause a stroke.

0:44:52 > 0:44:53'There's a lot that relies on us

0:44:53 > 0:44:55'getting our probe at the right spot.'

0:44:58 > 0:45:01- ..Have you got that?- Yes.

0:45:02 > 0:45:04Thank you kindly.

0:45:04 > 0:45:07- Suction here now, please. - Suction down, please.

0:45:07 > 0:45:09- There is no pain, right? - No, no.- Good.

0:45:09 > 0:45:11MUSICAL BEEPING

0:45:14 > 0:45:17Can you get that left hand out slowly...

0:45:17 > 0:45:20and lift it up in the air?

0:45:24 > 0:45:28Just leave it outstretched if you can. Just for about a minute.

0:45:47 > 0:45:50Point to your chin. Then out again.

0:45:52 > 0:45:55And then straighten your hand right out.

0:45:55 > 0:45:56- Is that better?- Yes.

0:45:56 > 0:45:58Point to your chin.

0:46:00 > 0:46:02Now straight out for us.

0:46:02 > 0:46:04Well, do you know what? I think we have done the business.

0:46:04 > 0:46:07Well done. Lovely.

0:46:12 > 0:46:17- How different does it feel? - It's very calm.

0:46:19 > 0:46:22I have had it that long it doesn't seem real, it's not moving.

0:46:24 > 0:46:28- So, Rose, we are just securing the electrode in place now.- Right.

0:46:28 > 0:46:33- The bed's not shaking any more. - No! My hips aren't aching either.

0:46:33 > 0:46:36- Good.- I might put a bit of weight on now.

0:46:36 > 0:46:39You couldn't really hope for more than that.

0:46:39 > 0:46:42When we see patients who have such a good effect. Just by

0:46:42 > 0:46:46implanting an electrode you get this very clear effect on the tremor,

0:46:46 > 0:46:48and the outcome is usually good.

0:46:50 > 0:46:52Almost there.

0:46:52 > 0:46:55Just support her head from the back a bit.

0:46:59 > 0:47:01- Oh, thank God for that.- Free!

0:47:02 > 0:47:05If I had to have that on my head again I don't think

0:47:05 > 0:47:08- I could go through with that. - So, it wasn't worth it then?

0:47:08 > 0:47:11Oh, it was, yes! HE LAUGHS

0:47:11 > 0:47:16As you say, it is half a day's discomfort for the rest of your life.

0:47:16 > 0:47:21And if you had my life when I had them shakes, you do believe it.

0:47:21 > 0:47:25That's very good. Very, very, very good.

0:47:25 > 0:47:29- You can do neurosurgery now with these hands.- Yes!

0:47:29 > 0:47:33- I can strangle you as well! - With some training. Some training.

0:47:33 > 0:47:35Don't give me any ideas!

0:47:35 > 0:47:36No. Oh, yeah!

0:47:42 > 0:47:45Um, two small and two large.

0:47:51 > 0:47:53Are you happy in this room?

0:47:53 > 0:47:55I am brilliant in this room at the moment, yes.

0:47:55 > 0:47:59Just looking for accommodation at the moment, looking for a nice home.

0:47:59 > 0:48:02- Right. So when you leave here. - When I leave here, nice home.

0:48:02 > 0:48:06- Are you likely to be leaving fairly soon?- Hopefully.

0:48:06 > 0:48:09I am hoping to be leaving very soon.

0:48:11 > 0:48:12I'd like to.

0:48:12 > 0:48:14And how long have you been on this unit?

0:48:14 > 0:48:19I have been on here for four months. Four months.

0:48:19 > 0:48:21The staff have been brilliant with me.

0:48:21 > 0:48:25Sometimes I can be very, very difficult. Sometimes...

0:48:25 > 0:48:28I'm very, very charming and they're nice, brilliant to have around me

0:48:28 > 0:48:33so cigarette time and down for a coffee.

0:48:33 > 0:48:35How were you when you came in here then?

0:48:35 > 0:48:39Cut off. I want get out of this room, I have been in here all day.

0:48:42 > 0:48:45Over the last few days, the psychiatric team have been meeting

0:48:45 > 0:48:47to discuss Chris's progress.

0:48:49 > 0:48:50- Hi, Chris.- Hello, how are you?

0:48:50 > 0:48:56- I'm all right, and you? You know all of us in the room.- I do, yes. Hello.

0:48:56 > 0:48:58- Have a seat, Chris. - Thank you very much.

0:48:58 > 0:49:02Before you came into hospital, when you were unwell,

0:49:02 > 0:49:04what was going on in your mind?

0:49:04 > 0:49:08I guess I've never really fitted into regular society,

0:49:08 > 0:49:11though it's quite an impossibility.

0:49:11 > 0:49:13The National Health Service, to me,

0:49:13 > 0:49:18has always been a solace for when I am not so good.

0:49:18 > 0:49:21I am known to be a relative of Her Majesty, Her Royal Highness

0:49:21 > 0:49:25Queen Anne I, the sickly queen of childbirth,

0:49:25 > 0:49:31and people seem to think I am

0:49:31 > 0:49:34brassed gold sovereignty

0:49:34 > 0:49:36and it's just never really been that way.

0:49:36 > 0:49:40I get a lot of support from an awful lot of people,

0:49:40 > 0:49:42an awful lot of celebrities,

0:49:42 > 0:49:45even the Pope messages now and again,

0:49:45 > 0:49:48in his own way, so I am very, very blessed.

0:49:48 > 0:49:51You have done quite well in the unit

0:49:51 > 0:49:55and I am really pleased to hear from staff the progress you have made.

0:49:55 > 0:49:58The nursing staff are great but these are faces that

0:49:58 > 0:50:02I don't really want to see for ever. I need to go, I need to leave.

0:50:02 > 0:50:09One day, and hopefully it is soon, I'll be in my home.

0:50:09 > 0:50:14From this hospital environment, would you like to move to an accommodation

0:50:14 > 0:50:19where you've your own space, your own room, and staff to support you?

0:50:19 > 0:50:23I think until I find somewhere that I appreciate,

0:50:23 > 0:50:28I think it will be an ample home and a happy home life,

0:50:28 > 0:50:31a huge garden, with apple trees.

0:50:34 > 0:50:39My frustrations in the community are sometimes too out of control

0:50:39 > 0:50:42for support workers to deal with and, with that -

0:50:42 > 0:50:45it doesn't just stem from money,

0:50:45 > 0:50:48there's a lot of things, a lot of issues

0:50:48 > 0:50:51and I discuss them with my doctors and my nurses,

0:50:51 > 0:50:55though not into great detail like I should -

0:50:55 > 0:50:58I don't let out enough steam as I should.

0:50:58 > 0:51:04Here is solitude and it's where I can rest

0:51:04 > 0:51:09and feel reassured that no-one can get in and no-one can watch me

0:51:09 > 0:51:12and no-one can stalk me, if you will.

0:51:12 > 0:51:14I get a lot of that.

0:51:26 > 0:51:29This is also the culprit that makes your hair fall out.

0:51:29 > 0:51:33- So it just starts coming out in clumps?- Yes.- Yes.

0:51:33 > 0:51:35But it is entirely up to you, some ladies like to take it

0:51:35 > 0:51:38all off themselves and some like to just wait and see what happens.

0:51:38 > 0:51:42'I would be lying if I said it didn't affect me,

0:51:42 > 0:51:47'in the way that you take stuff home with you, and there is always

0:51:47 > 0:51:51'somebody that you carry home with you on a daily basis.'

0:51:51 > 0:51:53You know, you can't be sentimental all the time,

0:51:53 > 0:51:55you've got a job to do, you have to do it.

0:51:55 > 0:51:58'These people are expecting you to treat them

0:51:58 > 0:52:02'to make them better, to let them go home.'

0:52:02 > 0:52:04You know, we have 130 patients,

0:52:04 > 0:52:08that's 130 stories that are going to break your heart if you let it

0:52:08 > 0:52:11so you have got to just carry on, really.

0:52:14 > 0:52:18Eight years ago, Sandra was diagnosed with breast cancer.

0:52:19 > 0:52:23- Hats, hats.- Very stylish.- Yes.

0:52:23 > 0:52:25- She's the queen of hats.- Hats.

0:52:25 > 0:52:29Every time I come I have a different hat on, nearly,

0:52:29 > 0:52:32and everybody always comments on my hats.

0:52:32 > 0:52:34I do it to detract from everything else.

0:52:34 > 0:52:39Everybody is looking at my hat and not my steroid filled face.

0:52:39 > 0:52:43- Is that what it feels like?- Yes.

0:52:43 > 0:52:47Because my cancer is secondary cancers now, so I did have a bit of

0:52:47 > 0:52:53a reprieve after my initial diagnosis, and treatment,

0:52:53 > 0:52:57and chemo, and radiotherapy, and that seemed to do OK

0:52:57 > 0:53:03and I just went onto a daily chemo and...

0:53:03 > 0:53:08that stopped working and I wasn't feeling as well.

0:53:08 > 0:53:11I found a lump myself

0:53:11 > 0:53:15and then we knew it had turned into secondaries. So...

0:53:15 > 0:53:18You don't have as much chance with secondaries

0:53:18 > 0:53:22once you've got those. They've just kept reappearing and reappearing

0:53:22 > 0:53:27up until this year and I have brain tumours now,

0:53:27 > 0:53:29so it has spread to my brain now.

0:53:32 > 0:53:36This controls the pain, nothing controls the cancer now.

0:53:39 > 0:53:43- Really nice to meet you.- OK.- Really nice to meet you. All the very best.

0:53:47 > 0:53:49Health secretary Jeremy Hunt

0:53:49 > 0:53:53must oversee savings of up to £20 billion within the NHS by 2015.

0:53:55 > 0:53:58What we've got here is the very best in cancer care.

0:53:58 > 0:54:03It's very exciting to see the NHS offering

0:54:03 > 0:54:06really the very best in the world

0:54:06 > 0:54:10and talking to patients about what it was like to

0:54:10 > 0:54:14actually have their cancer care in a completely different environment

0:54:14 > 0:54:18where they are able to stay at a hotel that's run by the hospital

0:54:18 > 0:54:22and not feel that they are an inpatient.

0:54:22 > 0:54:25Those stories I think are very striking.

0:54:25 > 0:54:28But I've also had some pretty crunchy discussions

0:54:28 > 0:54:31about the challenges facing hospitals in London,

0:54:31 > 0:54:35and the fact that admissions to A&E are going up by 5% every year,

0:54:35 > 0:54:39the pressure that's putting on the system and...

0:54:39 > 0:54:42and I'm going to have some pretty big decisions to take

0:54:42 > 0:54:46in the spring and it's been very useful background for that.

0:54:46 > 0:54:49One of the interesting things I think for a politician is that

0:54:49 > 0:54:52the NHS is a political hot potato,

0:54:52 > 0:54:55but when you come inside a hospital, it's an ideology free zone -

0:54:55 > 0:54:58no-one's really interested in left or right,

0:54:58 > 0:55:01they just want to talk about what's better for the patients

0:55:01 > 0:55:04and I think that's incredibly motivating.

0:55:18 > 0:55:20Are you there?

0:55:25 > 0:55:27- Better.- Yes.

0:55:27 > 0:55:29Good.

0:55:31 > 0:55:33It's all over.

0:55:35 > 0:55:37Are you OK there, Rose? You did very well, OK.

0:55:44 > 0:55:48- LUDVIC:- 'Rose's operation would have cost around £18,000.

0:55:48 > 0:55:51'I think it would be a very sad day'

0:55:51 > 0:55:53if, as a country,

0:55:53 > 0:55:57we said we can't afford to do deep brain stimulation on the NHS.

0:55:57 > 0:56:00'I think it would be very sad for patients.

0:56:00 > 0:56:04'This is a condition which is seriously affecting Rose's life.'

0:56:04 > 0:56:06We have a very effective

0:56:06 > 0:56:09and cost-effective way of helping the tremor

0:56:09 > 0:56:15and so I can't see any reason why the NHS shouldn't offer surgery.

0:56:15 > 0:56:19- Hello.- How are you?- Very well. - You're showing off now.

0:56:21 > 0:56:25- Good.- We got there.- We did. Got a bit emotional there, at the end.

0:56:25 > 0:56:30- Yes.- Yes.- Yes. I suppose that was relief.

0:56:30 > 0:56:35- It is all over. Wasn't it?- Yes.

0:56:35 > 0:56:38- It is a big thing to go through. - Well, yes.

0:56:38 > 0:56:42- I wouldn't like to do it again. - I don't blame you.

0:56:42 > 0:56:44I got my cup of tea.

0:56:44 > 0:56:46- You did, did you?- I did.

0:56:46 > 0:56:50- I held him to it.- With three sugars. - Three sugars!

0:56:52 > 0:56:55- Very good. You were an absolute star today, well done.- Thank you.

0:56:55 > 0:56:58A lot of it goes over to you.

0:56:58 > 0:57:02- Goodbye.- Thank you very much. - Bye. See you.

0:57:04 > 0:57:07How much better can you have than that?

0:57:07 > 0:57:10You can't.

0:57:10 > 0:57:14No matter where you go, you won't get doctors like that. Lovely.

0:57:19 > 0:57:22'It's one of the problems, if you like, with healthcare,

0:57:22 > 0:57:24'is that in to some degree it's a bottomless pit.

0:57:24 > 0:57:27'But as Aneurin Bevan said so many years ago,'

0:57:27 > 0:57:29"You can tell how civilised a culture is

0:57:29 > 0:57:32"by how they look after their old and their sick."

0:57:32 > 0:57:36Once we stop looking after these people,

0:57:36 > 0:57:39then perhaps we have lost a little bit of humanity.

0:58:22 > 0:58:26To order your free copy of the Open University's booklet,

0:58:26 > 0:58:29Working To Save Lives, which accompanies this series,

0:58:29 > 0:58:33call this number:

0:58:33 > 0:58:36Or you can go to the website:

0:58:36 > 0:58:39Follow the links to the OU.

0:58:58 > 0:59:02Subtitles by Red Bee Media Ltd