:00:05. > :00:12.Hello. What's the future for our NHS? Tonight, Inside Out East
:00:12. > :00:15.Midlands puts the health service under the microscope. We take blood
:00:15. > :00:19.pressure, we do defibrillation if you collapse in front of us. It's
:00:19. > :00:24.all free, free on the NHS. With huge changes ahead what does it all
:00:24. > :00:27.mean for doctors and patients? is what the biggest shake-up in the
:00:27. > :00:32.history of NHS is all about, giving local doctors, nurses and patients
:00:32. > :00:36.the chance to call the shots and shop around for the best care.
:00:36. > :00:41.with so much choice on offer what difference will it make to us here
:00:41. > :00:44.in the East Midlands? If we get this wrong, it will lead to serious
:00:44. > :00:50.problems. If we get it right, it will give us a much more positive
:00:50. > :01:00.future for the next 10 to 15 years. Plus fun and friendship on the open
:01:00. > :01:14.
:01:14. > :01:17.The Queen's Medical Centre in Nottingham was the country's first
:01:17. > :01:21.purpose built teaching hospital and is one of the biggest in Europe.
:01:21. > :01:25.For the last 65 years, the National Health Service has been there to
:01:25. > :01:30.look after us when we're ill. But in just ten weeks' time the NHS
:01:30. > :01:36.will undergo the biggest re- organisation in its history. So
:01:36. > :01:44.what will it mean for all of us? We asked TV doctor and comedian Phil
:01:44. > :01:50.This is lovely, madam. This inhaler will go well with your coat. Do you
:01:50. > :01:56.want to come here and cough, sir? I can give you those half price, plus
:01:56. > :02:00.something for your water retention. What do you reckon? I'm a GP and
:02:00. > :02:04.today, I'm taking health care into the community, where it is needed.
:02:04. > :02:07.All the sample bottles you could ever need and I will throw in a
:02:08. > :02:11.crutch. It's all free, all paid for. This is what the biggest shake-up
:02:11. > :02:14.in the history of the NHS is all about, giving local doctors, nurses
:02:14. > :02:21.and patients the chance to call the shots and shop around for the best
:02:21. > :02:24.care. At least that is the Government's plan. But many doctors
:02:24. > :02:29.think the reforms are untested, expensive and over complicated - a
:02:29. > :02:33.view I shared with a former health secretary Andrew Lansley. The
:02:33. > :02:40.difficulty is it is 353 pages of wonk. It's absolutely impossible to
:02:40. > :02:43.understand it. I choose my words carefully. It's wonk. But I have
:02:43. > :02:46.been waiting through the jargon and it is clear the reforms will affect
:02:46. > :02:50.us all so it's vital we put politics aside and try to
:02:50. > :02:54.understand exactly what they will mean for patients. Until now, the
:02:54. > :03:00.NHS has been like a big supermarket chain that only sells its own
:03:00. > :03:04.brands. It is a one-stop-shop where all the tricky decisions are made
:03:04. > :03:07.for you. In theory, you should get the same high quality care whether
:03:07. > :03:16.you live in Scunthorpe or Southend but like any monopoly, it's far
:03:16. > :03:18.from perfect. So, the government is bringing in the marketplace model
:03:18. > :03:28.instead, introducing more choice and competition and putting local
:03:28. > :03:29.
:03:30. > :03:39.GPs in charge instead of civil servants. Will it work? If I check
:03:39. > :03:43.your eyes... I can confirm you have two eyes. Doing two X-rays for the
:03:43. > :03:46.price of one and I can throw in a free brain scan. One change we're
:03:46. > :03:48.told patients should notice is care much closer to home. Hospitals and
:03:48. > :03:51.GPs will have more freedom to bring in innovative ideas. Technology
:03:51. > :03:54.might monitor your health at home and routine surgery could be done
:03:54. > :03:57.at high street clinics. Hospitals in Gloucestershire have already
:03:57. > :04:02.teamed up with a charity to send this mobile chemotherapy unit into
:04:02. > :04:07.rural communities. For cancer patients like Graham, it is a
:04:07. > :04:10.lifeline. The concept is great. Moving the treatment closer to the
:04:10. > :04:15.person because you suffer from trauma with the chemotherapy and
:04:16. > :04:25.the travelling. Bringing the treatment closer to the person is a
:04:26. > :04:28.
:04:28. > :04:32.lot better and you do feel a little bit better. But could this shift
:04:32. > :04:35.towards more localised care mean hospitals will have to close? To
:04:35. > :04:42.find out, I've come to London, to one of the world's best respected
:04:42. > :04:45.independent health think-tanks on health policy, the King's Fund.
:04:45. > :04:49.don't think you'll see many hospitals closing as as a result of
:04:49. > :04:51.care coming closer to home. It will mean hospitals changing their roles.
:04:51. > :04:54.That's few accident and emergency departments, fewer services
:04:54. > :04:58.provided but that could be to the benefit of the patients if we are
:04:58. > :05:06.able to plan that in an appropriate way and get better outcomes by
:05:06. > :05:11.concentrating those services in fewer hospitals. You might not be
:05:11. > :05:17.keen if it is your A&E which is closing. The second thing patients
:05:17. > :05:24.should notice is more choice. tomatoes... Three inhalers for the
:05:24. > :05:30.prize of two. A separate queue here. Competition in the NHS is not new
:05:30. > :05:36.but the reforms step it up a notch. The NHS will become a market place
:05:36. > :05:40.with private companies competing with the NHS for business. So, when
:05:40. > :05:47.your GP says you need a scan, your options may look less like this and
:05:47. > :05:54.more like this. But it should be quality, not price, which should
:05:54. > :05:57.decide which are allowed to offer care. It is already happening on
:05:57. > :06:06.the High Street, where Specsavers are treating NHS patients in 218 of
:06:06. > :06:13.its hearing centres. When I came to Specsavers, they do private and NHS,
:06:13. > :06:17.which I find is better than going to the hospital. You go to the
:06:17. > :06:24.hospital and there is a lot of travelling. I don't think you get
:06:24. > :06:27.such a personal attention, so this is much, much better. The plan is
:06:27. > :06:32.for patients like Doreen choose their provider, by looking at new
:06:32. > :06:38.performance league tables. But companies must play by the rules
:06:38. > :06:41.and cannot encourage NHS patients to go private. Ultimately,
:06:41. > :06:47.Specsavers want to protect the NHS work that we've managed to gain
:06:47. > :06:51.here. We don't want to do anything to try and jeopardise that so we
:06:51. > :06:55.are not going to try and sell a hearing aid or upsell a patient at
:06:55. > :06:57.all during that time. Market competition could drive up
:06:57. > :07:02.standards and lower costs but if profits slip, companies could pull
:07:02. > :07:06.out or even go under, leaving patients in the lurch. Remember the
:07:06. > :07:13.collapse of Northern Rock? Imagine if customers had been queuing not
:07:13. > :07:16.for their life savings but for life-saving surgery. If there is
:07:16. > :07:18.going to be a bigger role for private companies in delivering
:07:18. > :07:21.care to patients, there is always the possibility, however remote,
:07:21. > :07:24.the company will not be successful, that we will see something like
:07:24. > :07:28.Northern Rock in health care. The Government is anticipating that and
:07:28. > :07:30.is putting in place what is called a failure regime so the regulator
:07:30. > :07:38.can intervene and ensure continuity of services, even if the
:07:38. > :07:41.organisations are not providing care to the right standard.
:07:41. > :07:46.third thing patients may notice is a shift in their relationship with
:07:46. > :07:55.their GP. If I said trust me, I know the best place for you to go
:07:55. > :07:59.to get heart surgery, would you say yeah, you're the doctor? Have you
:07:59. > :08:03.chosen your family doctor? Since the birth of the NHS, doctors have
:08:03. > :08:05.taken the trust of patients for granted but as GPs offer more and
:08:05. > :08:09.more treatments, they could find themselves referring patients to
:08:09. > :08:13.their own services. Add private companies into the mix and there is
:08:13. > :08:20.real scope for a conflict of interest. Should we really be
:08:20. > :08:26.worried? In Bath, Jasmin Bishop is seeing a GP on the NHS but believe
:08:26. > :08:28.it or not, he actually works for Virgin. Yes, they're of planes,
:08:28. > :08:32.trains and super-fast broadband fame also run this walk-in centre,
:08:32. > :08:40.along with 170 other NHS services, although you would not know it from
:08:40. > :08:43.the branding. As Virgin take over more NHS services what is to stop
:08:43. > :08:46.you referring patients on to another Virgin service to make
:08:46. > :08:49.money for the company rather than in the best interests of the
:08:49. > :08:52.patient? Well, all of our GPs, like any GPs in the country, have to
:08:52. > :09:01.offer patients a choice when they are being referred for other
:09:01. > :09:04.services. In the end, it's down to the patient to choose where they go.
:09:04. > :09:07.Of course, GPs and other clinical staff of a professional
:09:07. > :09:15.responsibility too, to make sure they are finding the best care for
:09:15. > :09:19.their patients. That doesn't differ because GPs are employed by us.
:09:19. > :09:24.have to ask if patients remind who provides their care. Which of the
:09:24. > :09:29.sample bottles will you like? The bottom line is if you have a good
:09:29. > :09:34.idea to improve your care, tell your GP. If he or she can make it
:09:34. > :09:38.happen, we know the reforms are working. It has been a huge
:09:38. > :09:48.upheaval just get the NHS to listen to patients and I hope for all our
:09:48. > :09:54.
:09:54. > :10:00.sakes, it works. This has to go Well, to some, all this change is
:10:00. > :10:03.brave, bold and badly needed - just the medicine the NHS needs. Others
:10:03. > :10:06.see it as a reckless gamble. As BBC Health Correspondent Rob Sissons
:10:06. > :10:11.reports, control of the purse strings has already been shifting
:10:11. > :10:21.to GPs as the reforms are phased in. And here in the East Midlands some
:10:21. > :10:32.
:10:32. > :10:36.of the changes are proving She's not too sure where it' s
:10:36. > :10:44.going but Shirley knows where the NHS journey began. She's one of the
:10:44. > :10:47.few people born the very same day as the NHS, here in Leicester.
:10:47. > :10:50.is what was called Fielding Johnson Hospital, which was a private
:10:50. > :11:00.hospital, and it is where I was born on the 5th July 1948, at
:11:00. > :11:07.approximately 1.30 in the afternoon. I bet it wasn't snowing then!
:11:07. > :11:12.don't think so, no. On July 5th, the new National Health Service
:11:12. > :11:16.starts. Before the NHS, heathcare had been a luxury only some could
:11:16. > :11:22.afford. It was seen as the answer to chronic illness and premature
:11:22. > :11:27.death from disease. We are out to improve the health of every family
:11:27. > :11:30.and whole nation. And what did your mum say about it? Well, she thought
:11:30. > :11:35.it was great? And she said they didn't pay the bill because it was
:11:35. > :11:40.the first day that the NHS was introduced. These days Shirley just
:11:40. > :11:45.has questions. I don't think the system can carry on as it is. Can
:11:45. > :11:51.it maintain or will services suffer? Dr Callum McLean in Derby
:11:51. > :11:54.is one of the GP'snow leading change. That's much better than I
:11:54. > :11:57.thought. I will get your prescription sorted. It's another
:11:57. > :12:00.busy day here at his surgery in Sinfin. He's convinced the NHS
:12:00. > :12:04.could be so much better so he's taken another role alongside this
:12:04. > :12:10.frontline work and it takes him to the very heart of new NHS decision
:12:10. > :12:15.making. I am enthusiastic but also I realise it is essential. If we
:12:15. > :12:17.get this wrong it will lead us into serious problems. He's part of the
:12:17. > :12:20.new GP led Southern Derbyshire clinical commissioning group. One
:12:20. > :12:23.19 across the East Midlands officially they take over the purse
:12:23. > :12:29.strings from April.But somehave been making more and more decisions
:12:29. > :12:32.for months supervised by the soon to be scrapped primary care trusts.
:12:32. > :12:41.I watched as they put detecting dementia cases at the top of the
:12:41. > :12:46.agenda. It's on going work. It's not something we are ignoring or
:12:46. > :12:50.belittling it's just that we want to get it right. Earlier diagnosis
:12:50. > :12:57.is music to the ears of Norman Lewis. It's now too late for his
:12:57. > :13:00.wife Beryl. Here she was in the later stages of Alzheimer's disease.
:13:00. > :13:06.Now he wants to see improved care for others. She would hide money.
:13:06. > :13:13.She would forget how long things had been cooking. There's a host of
:13:13. > :13:16.little things that were all going completely wrong. Today he grieves.
:13:16. > :13:23.Beryl died last october. They'd fallen in love as teenagers and
:13:23. > :13:26.Norman says it took a long five years to diagnose her. In the early
:13:26. > :13:30.stages when I first consulted with her GP about Beryl's state of mind
:13:30. > :13:35.and the way she wasbehaving, his comment was well do you really want
:13:35. > :13:37.to know? He says the NHS must move away from any lingering old
:13:37. > :13:46.fashioned attitudes to dementia with new drug treatments
:13:46. > :13:53.aroundthese days like Aricept. administered Aricept and it brought
:13:53. > :13:56.her back. So maybe if the Aricept had been administered earlier, then
:13:56. > :14:04.perhaps our quality of life would have been better for a longer
:14:04. > :14:12.period. Looking at the GP's promise to improve dementia care Norman
:14:12. > :14:15.hopes they can and will deliver. Dr McLean says the money has to go
:14:15. > :14:22.further. His job to juggle competing priorities and continue
:14:22. > :14:26.to move away from the heavy reliance on hospitals. The idea is
:14:26. > :14:32.to keep people well and in their own homes and that's the challenge
:14:32. > :14:37.for the NHS over the next five, ten years. Hiya, you all right? OK. Hi
:14:37. > :14:40.Michael. How are you doing? Good. Here in Leicestershire it seems the
:14:40. > :14:45.challenge is already being met. The doctors called into see Michael who
:14:45. > :14:47.has multiple sclerosis. He was forever in and out of hospital.
:14:47. > :14:57.Until the GP's have put extra investment supporting patients'
:14:57. > :15:04.
:15:04. > :15:07.complex needs at home. How what things going with the feeding?
:15:07. > :15:12.Michael gets quite stressed when he goes into hospital and we know he
:15:12. > :15:16.is not happy. There is a knock-on effect within the family. We become
:15:16. > :15:22.quite worried. All he wants to do is be at home in his own bed,
:15:22. > :15:32.looking out of his window. The sun is going down on the old NHS but
:15:32. > :15:36.
:15:36. > :15:41.Dr Holden is a doctors' leader in Matlock. He is critical of radical
:15:41. > :15:45.change and questions whether it is the right prescription. I think the
:15:45. > :15:50.government has taken a massive risk. They have thrown the cards up in
:15:50. > :15:54.the air without knowing where they will fall. It is a major risk and
:15:54. > :15:58.it is not for nothing that the government has refused to reveal
:15:58. > :16:06.the risk analysis that they were compelled to do by law on these
:16:06. > :16:11.reforms. And Shirley senses the risks. Having been born on the same
:16:11. > :16:16.day as the National Health Service, she looks at it with affection. It
:16:16. > :16:26.has always been there for her. had a first operation in my
:16:26. > :16:27.
:16:27. > :16:32.twenties. I had a second thyroid operation only 12 years ago.
:16:32. > :16:35.Shirley sees now is a service under mounting pressure. I wonder how
:16:35. > :16:42.they are managed hat -- how well they managed to afford it in the
:16:42. > :16:49.future. Demand is going up, we are living longer, treatment costs keep
:16:49. > :16:58.going up. GPs are being told they have to make money go further.
:16:58. > :17:03.Doctors will be involved in tough choices. In Grantham, these mothers
:17:03. > :17:08.are worried about the future of the local birthing unit. Some argue it
:17:08. > :17:13.is no longer viable. He it is a really nice relaxed place to be. It
:17:13. > :17:18.would be a shame for Grantham, it is a growing town. They say not
:17:18. > :17:23.many people are using it. They put the bar so high, that not many
:17:23. > :17:30.people can use it. As the campaign to save the birthing unit gains
:17:30. > :17:33.momentum, could the GPs involved in the decision-making lose support?
:17:33. > :17:37.You have to start asking as a patient how your doctor is
:17:37. > :17:43.representing your? Are they are recommending a course of action
:17:43. > :17:48.which could make you suffer and it could ultimately in danger your
:17:48. > :17:53.baby's life? Back in Derby, I wondered if Dr McClean was ready to
:17:53. > :17:59.make the difficult choices. Do you know what to have left just -- let
:17:59. > :18:04.yourself in for? Money is tight. Money is flat, there are no
:18:04. > :18:09.increases. Is there a danger you will be seen as rationing care.
:18:09. > :18:16.will be seen as rationing care but it is our job to explain why. And
:18:16. > :18:20.to do it in a transparent way. hearing lots of uncertainty. The
:18:20. > :18:29.government tells us the eventual prize will be a much better health
:18:29. > :18:33.service. It is clear that reform is not everyone's cup of tea. Day-in,
:18:33. > :18:42.day-out, I have read about the controversy. Some predict a rough
:18:42. > :18:46.road ahead. -- day-in, day-out. public need to understand that she
:18:46. > :18:52.will be to do this journey in a Ford Mondeo, not a Rolls-Royce.
:18:52. > :18:58.we get it right, we will have a much more positive future.
:18:58. > :19:03.those embracing change, now the pressure is really on to deliver.
:19:03. > :19:09.For Shirley, the NHS was there from the cradle and she hopes it will be
:19:09. > :19:13.offering good care right to her grave. I want it to survive. I
:19:13. > :19:23.think it is an excellent system. But I am worried about the future
:19:23. > :19:27.
:19:27. > :19:31.So huge change ahead. Thanks to the patients and doctors.
:19:31. > :19:34.Now a complete gear change! We meet the born-again bikers back on the
:19:34. > :19:36.roads in bigger numbers than ever before. They're not boy racers. As
:19:36. > :19:40.Ben Jackson's been finding out, for these middle-aged motorbikers, it's
:19:40. > :19:44.more about fun and friendship than silly speeds!
:19:44. > :19:47.Now we all have our own idea of relaxation, but for me, it's all
:19:47. > :19:52.about gathering a group of friends, firing up the bikes, and breaking
:19:52. > :20:02.out into the beautiful Leicestershire countryside. And
:20:02. > :20:03.
:20:03. > :20:06.taking to the open road on two I had my first biking experience in
:20:06. > :20:10.my 30s. I wanted to do something exciting, so I rode from Leicester
:20:11. > :20:15.to John O'Groats. It was thrilling, an experience I've never looked
:20:15. > :20:19.back from. But I'm not alone in discovering the excitment of biking
:20:19. > :20:29.in later life. It seems that more and more middle-aged people are
:20:29. > :20:36.
:20:36. > :20:40.returning to it, or taking it up for the first time. I've still got
:20:40. > :20:44.that bike provided the journey on five years ago, and I still love it.
:20:44. > :20:54.But there are days when biking is not as much fun as you would like.
:20:54. > :20:55.
:20:55. > :21:04.I would like to throw it into a ditch at the moment. Come on!
:21:04. > :21:07.Mechanical problems aside, motorbiking is fun and sociable.
:21:07. > :21:16.Although everyday life seems to stop me going to most big bike
:21:16. > :21:21.gatherings, I try not to miss Ashby Folville. For the most part, Ashby
:21:21. > :21:24.Folville is a sleepy little place. But once a month, this field and
:21:24. > :21:34.the rest of the village becomes a place where bikers come together to
:21:34. > :21:37.
:21:37. > :21:41.show off their machines in one of the biggest meets in the country.
:21:41. > :21:51.You'll find everyone from novices to biking royalty. And it's all
:21:51. > :21:59.
:21:59. > :22:05.about the look. OK, so I'm not When I first came here a few years
:22:05. > :22:15.ago, it was just a few vintage cars behind a pub. Now look at it. There
:22:15. > :22:26.
:22:26. > :22:31.And whatever walk of life you come from, you'll find them here. The
:22:31. > :22:37.pups are not bothered because be taking megabucks. What do you love
:22:37. > :22:42.about biking? Everything. I have been doing it since I was 13.
:22:42. > :22:48.he had a break from it? Only one I have been smashed up. A wide you
:22:48. > :22:55.carry on? The adrenalin, it is a lifestyle. There are all ages, from
:22:55. > :22:58.little tops to pensioners. I am old, and I still enjoy it. Motorbikers
:22:58. > :23:06.are predominantly older people. And there's a reason why we don't want
:23:06. > :23:16.to give it up. The excitement is a feeling you can't beat. And for
:23:16. > :23:18.
:23:18. > :23:24.most of us, it's pure escapism. But the sale of large-capacity bikes in
:23:24. > :23:26.the UK has reduced by 10% in the last 12 months. So why is that?
:23:26. > :23:35.Gary Knowles at Triumph in Leicester knows the biking
:23:35. > :23:40.community well. I think it's not a case of people not buying bikes any
:23:40. > :23:44.more. You are seeing a shift in the kind of bike they are buying. When
:23:44. > :23:49.you get to my age, it's not particularly comfortable and it is
:23:49. > :23:55.nice to be in a sitting position. You also seeing a reduction in
:23:55. > :24:00.sports bikes riding. You are seeing a major transfer on to the
:24:00. > :24:05.adventure market. The cruiser market. It's not all about speed on
:24:05. > :24:09.bikes. You can enjoy it just as much at 50 miles an hour as you can
:24:09. > :24:12.at silly speeds. But for all the joys biking brings there's also a
:24:12. > :24:16.tragic side to it. Last year, 362 people were killed in motorbike
:24:16. > :24:26.accidents in Britain. 41 of these fatalities were on East Midlands
:24:26. > :24:34.
:24:34. > :24:41.roads. Slowdown! 53 miles per hour. That was a scooter, so you probably
:24:41. > :24:44.was back there. PC Dave Johnson is a biker as well as a traffic
:24:44. > :24:47.officer. He's trying to curb speeding and to reduce the biker
:24:47. > :24:51.death toll by targeting the bikers who insist on breaking the speed
:24:51. > :25:01.limit. But it's not just dual carriageways that bikers want to
:25:01. > :25:01.
:25:02. > :25:07.open up on. Often, it's residential streets. Tyres are good. What we
:25:07. > :25:17.are doing at the moment is checks on this road. Even here the
:25:17. > :25:17.
:25:17. > :25:22.racetrack in the background. can biking be so dangerous?
:25:22. > :25:26.anybody wants to exceed speed limits, or get than rush of
:25:26. > :25:32.adrenaline from high speeds, to do high speeds in a motor car, you
:25:32. > :25:38.have to spend a lot of money. For �2,000, you can buy a motorcycle
:25:38. > :25:41.and be out here exceeding 140 mph. Leicestershire Police run Bike Safe,
:25:41. > :25:45.a course that any biker can go on. It's designed to give bikers
:25:45. > :25:55.confidence. Andy recently passed his motorbike test and is taking
:25:55. > :26:14.
:26:14. > :26:20.the course for the first time. I Can I say that having a police
:26:20. > :26:25.officer right behind you, every time I look round I jump. We are
:26:25. > :26:31.not instruct us, we are assessors. We have an in-depth course which
:26:31. > :26:37.brings us to a set standard. We tried to pass that on to your cells.
:26:37. > :26:44.We show you that you -- that it is not all about speed, you can go out
:26:44. > :26:54.and ride and go to the speed limits and have some fun. I'm going to
:26:54. > :26:56.
:26:56. > :27:00.have a word. I have had an absolute blast. How has it been for you?
:27:00. > :27:07.have been so much more relaxed, being able to ride with that
:27:07. > :27:11.ability to see what's going on and feel safe. I mostly ride alone but
:27:11. > :27:14.riding with friends is definitely the best way to go as it gives the
:27:14. > :27:24.whole thing a kind of purpose. And where better to end than my local
:27:24. > :27:28.
:27:28. > :27:35.bikers' pub. He is a great life, great way to spend time. You go out
:27:35. > :27:43.and meet people, it's brilliant. the biker era in the 50s and 60s,
:27:43. > :27:51.Marlon Brando is my hero. You could be a man of the cloth! What has a
:27:51. > :27:55.sale and a registration? For it says, get thee behind me, Satan.
:27:55. > :27:59.And before we go, I've even got the honour of signing the bikers' wall
:27:59. > :28:06.of fame! We have some exciting country roads here, that give you
:28:06. > :28:16.an almost spiritual sense of freedom. And as they say in Easy
:28:16. > :28:24.
:28:24. > :28:28.I think I'll take your word for it, Ben. Bassett from outside the
:28:28. > :28:32.Queen's Medical Centre in Nottingham. Thank you for watching.
:28:32. > :28:37.Next week, why the East Midlands has some of the worst air pollution