21/01/2013 Inside Out East Midlands

Hello. What's the future for our NHS? Tonight, Inside Out East

Midlands puts the health service under the microscope. We take blood

pressure, we do defibrillation if you collapse in front of us. It's

all free, free on the NHS. With huge changes ahead what does it all

mean for doctors and patients? is what the biggest shake-up in the

history of NHS is all about, giving local doctors, nurses and patients

the chance to call the shots and shop around for the best care.

with so much choice on offer what difference will it make to us here

in the East Midlands? If we get this wrong, it will lead to serious

problems. If we get it right, it will give us a much more positive

future for the next 10 to 15 years. Plus fun and friendship on the open

The Queen's Medical Centre in Nottingham was the country's first

purpose built teaching hospital and is one of the biggest in Europe.

For the last 65 years, the National Health Service has been there to

look after us when we're ill. But in just ten weeks' time the NHS

will undergo the biggest re- organisation in its history. So

what will it mean for all of us? We asked TV doctor and comedian Phil

This is lovely, madam. This inhaler will go well with your coat. Do you

want to come here and cough, sir? I can give you those half price, plus

something for your water retention. What do you reckon? I'm a GP and

today, I'm taking health care into the community, where it is needed.

All the sample bottles you could ever need and I will throw in a

crutch. It's all free, all paid for. This is what the biggest shake-up

in the history of the NHS is all about, giving local doctors, nurses

and patients the chance to call the shots and shop around for the best

care. At least that is the Government's plan. But many doctors

think the reforms are untested, expensive and over complicated - a

view I shared with a former health secretary Andrew Lansley. The

difficulty is it is 353 pages of wonk. It's absolutely impossible to

understand it. I choose my words carefully. It's wonk. But I have

been waiting through the jargon and it is clear the reforms will affect

us all so it's vital we put politics aside and try to

understand exactly what they will mean for patients. Until now, the

NHS has been like a big supermarket chain that only sells its own

brands. It is a one-stop-shop where all the tricky decisions are made

for you. In theory, you should get the same high quality care whether

you live in Scunthorpe or Southend but like any monopoly, it's far

from perfect. So, the government is bringing in the marketplace model

instead, introducing more choice and competition and putting local

GPs in charge instead of civil servants. Will it work? If I check

your eyes... I can confirm you have two eyes. Doing two X-rays for the

price of one and I can throw in a free brain scan. One change we're

told patients should notice is care much closer to home. Hospitals and

GPs will have more freedom to bring in innovative ideas. Technology

might monitor your health at home and routine surgery could be done

at high street clinics. Hospitals in Gloucestershire have already

teamed up with a charity to send this mobile chemotherapy unit into

rural communities. For cancer patients like Graham, it is a

lifeline. The concept is great. Moving the treatment closer to the

person because you suffer from trauma with the chemotherapy and

the travelling. Bringing the treatment closer to the person is a

lot better and you do feel a little bit better. But could this shift

towards more localised care mean hospitals will have to close? To

find out, I've come to London, to one of the world's best respected

independent health think-tanks on health policy, the King's Fund.

don't think you'll see many hospitals closing as as a result of

care coming closer to home. It will mean hospitals changing their roles.

That's few accident and emergency departments, fewer services

provided but that could be to the benefit of the patients if we are

able to plan that in an appropriate way and get better outcomes by

concentrating those services in fewer hospitals. You might not be

keen if it is your A&E which is closing. The second thing patients

should notice is more choice. tomatoes... Three inhalers for the

prize of two. A separate queue here. Competition in the NHS is not new

but the reforms step it up a notch. The NHS will become a market place

with private companies competing with the NHS for business. So, when

your GP says you need a scan, your options may look less like this and

more like this. But it should be quality, not price, which should

decide which are allowed to offer care. It is already happening on

the High Street, where Specsavers are treating NHS patients in 218 of

its hearing centres. When I came to Specsavers, they do private and NHS,

which I find is better than going to the hospital. You go to the

hospital and there is a lot of travelling. I don't think you get

such a personal attention, so this is much, much better. The plan is

for patients like Doreen choose their provider, by looking at new

performance league tables. But companies must play by the rules

and cannot encourage NHS patients to go private. Ultimately,

Specsavers want to protect the NHS work that we've managed to gain

here. We don't want to do anything to try and jeopardise that so we

are not going to try and sell a hearing aid or upsell a patient at

all during that time. Market competition could drive up

standards and lower costs but if profits slip, companies could pull

out or even go under, leaving patients in the lurch. Remember the

collapse of Northern Rock? Imagine if customers had been queuing not

for their life savings but for life-saving surgery. If there is

going to be a bigger role for private companies in delivering

care to patients, there is always the possibility, however remote,

the company will not be successful, that we will see something like

Northern Rock in health care. The Government is anticipating that and

is putting in place what is called a failure regime so the regulator

can intervene and ensure continuity of services, even if the

organisations are not providing care to the right standard.

third thing patients may notice is a shift in their relationship with

their GP. If I said trust me, I know the best place for you to go

to get heart surgery, would you say yeah, you're the doctor? Have you

chosen your family doctor? Since the birth of the NHS, doctors have

taken the trust of patients for granted but as GPs offer more and

more treatments, they could find themselves referring patients to

their own services. Add private companies into the mix and there is

real scope for a conflict of interest. Should we really be

worried? In Bath, Jasmin Bishop is seeing a GP on the NHS but believe

it or not, he actually works for Virgin. Yes, they're of planes,

trains and super-fast broadband fame also run this walk-in centre,

along with 170 other NHS services, although you would not know it from

the branding. As Virgin take over more NHS services what is to stop

you referring patients on to another Virgin service to make

money for the company rather than in the best interests of the

patient? Well, all of our GPs, like any GPs in the country, have to

offer patients a choice when they are being referred for other

services. In the end, it's down to the patient to choose where they go.

Of course, GPs and other clinical staff of a professional

responsibility too, to make sure they are finding the best care for

their patients. That doesn't differ because GPs are employed by us.

have to ask if patients remind who provides their care. Which of the

sample bottles will you like? The bottom line is if you have a good

idea to improve your care, tell your GP. If he or she can make it

happen, we know the reforms are working. It has been a huge

upheaval just get the NHS to listen to patients and I hope for all our

sakes, it works. This has to go Well, to some, all this change is

brave, bold and badly needed - just the medicine the NHS needs. Others

see it as a reckless gamble. As BBC Health Correspondent Rob Sissons

reports, control of the purse strings has already been shifting

to GPs as the reforms are phased in. And here in the East Midlands some

of the changes are proving She's not too sure where it' s

going but Shirley knows where the NHS journey began. She's one of the

few people born the very same day as the NHS, here in Leicester.

is what was called Fielding Johnson Hospital, which was a private

hospital, and it is where I was born on the 5th July 1948, at

approximately 1.30 in the afternoon. I bet it wasn't snowing then!

don't think so, no. On July 5th, the new National Health Service

starts. Before the NHS, heathcare had been a luxury only some could

afford. It was seen as the answer to chronic illness and premature

death from disease. We are out to improve the health of every family

and whole nation. And what did your mum say about it? Well, she thought

it was great? And she said they didn't pay the bill because it was

the first day that the NHS was introduced. These days Shirley just

has questions. I don't think the system can carry on as it is. Can

it maintain or will services suffer? Dr Callum McLean in Derby

is one of the GP'snow leading change. That's much better than I

thought. I will get your prescription sorted. It's another

busy day here at his surgery in Sinfin. He's convinced the NHS

could be so much better so he's taken another role alongside this

frontline work and it takes him to the very heart of new NHS decision

making. I am enthusiastic but also I realise it is essential. If we

get this wrong it will lead us into serious problems. He's part of the

new GP led Southern Derbyshire clinical commissioning group. One

19 across the East Midlands officially they take over the purse

strings from April.But somehave been making more and more decisions

for months supervised by the soon to be scrapped primary care trusts.

I watched as they put detecting dementia cases at the top of the

agenda. It's on going work. It's not something we are ignoring or

belittling it's just that we want to get it right. Earlier diagnosis

is music to the ears of Norman Lewis. It's now too late for his

wife Beryl. Here she was in the later stages of Alzheimer's disease.

Now he wants to see improved care for others. She would hide money.

She would forget how long things had been cooking. There's a host of

little things that were all going completely wrong. Today he grieves.

Beryl died last october. They'd fallen in love as teenagers and

Norman says it took a long five years to diagnose her. In the early

stages when I first consulted with her GP about Beryl's state of mind

and the way she wasbehaving, his comment was well do you really want

to know? He says the NHS must move away from any lingering old

fashioned attitudes to dementia with new drug treatments

aroundthese days like Aricept. administered Aricept and it brought

her back. So maybe if the Aricept had been administered earlier, then

perhaps our quality of life would have been better for a longer

period. Looking at the GP's promise to improve dementia care Norman

hopes they can and will deliver. Dr McLean says the money has to go

further. His job to juggle competing priorities and continue

to move away from the heavy reliance on hospitals. The idea is

to keep people well and in their own homes and that's the challenge

for the NHS over the next five, ten years. Hiya, you all right? OK. Hi

Michael. How are you doing? Good. Here in Leicestershire it seems the

challenge is already being met. The doctors called into see Michael who

has multiple sclerosis. He was forever in and out of hospital.

Until the GP's have put extra investment supporting patients'

complex needs at home. How what things going with the feeding?

Michael gets quite stressed when he goes into hospital and we know he

is not happy. There is a knock-on effect within the family. We become

quite worried. All he wants to do is be at home in his own bed,

looking out of his window. The sun is going down on the old NHS but

Dr Holden is a doctors' leader in Matlock. He is critical of radical

change and questions whether it is the right prescription. I think the

government has taken a massive risk. They have thrown the cards up in

the air without knowing where they will fall. It is a major risk and

it is not for nothing that the government has refused to reveal

the risk analysis that they were compelled to do by law on these

reforms. And Shirley senses the risks. Having been born on the same

day as the National Health Service, she looks at it with affection. It

has always been there for her. had a first operation in my

twenties. I had a second thyroid operation only 12 years ago.

Shirley sees now is a service under mounting pressure. I wonder how

they are managed hat -- how well they managed to afford it in the

future. Demand is going up, we are living longer, treatment costs keep

going up. GPs are being told they have to make money go further.

Doctors will be involved in tough choices. In Grantham, these mothers

are worried about the future of the local birthing unit. Some argue it

is no longer viable. He it is a really nice relaxed place to be. It

would be a shame for Grantham, it is a growing town. They say not

many people are using it. They put the bar so high, that not many

people can use it. As the campaign to save the birthing unit gains

momentum, could the GPs involved in the decision-making lose support?

You have to start asking as a patient how your doctor is

representing your? Are they are recommending a course of action

which could make you suffer and it could ultimately in danger your

baby's life? Back in Derby, I wondered if Dr McClean was ready to

make the difficult choices. Do you know what to have left just -- let

yourself in for? Money is tight. Money is flat, there are no

increases. Is there a danger you will be seen as rationing care.

will be seen as rationing care but it is our job to explain why. And

to do it in a transparent way. hearing lots of uncertainty. The

government tells us the eventual prize will be a much better health

service. It is clear that reform is not everyone's cup of tea. Day-in,

day-out, I have read about the controversy. Some predict a rough

road ahead. -- day-in, day-out. public need to understand that she

will be to do this journey in a Ford Mondeo, not a Rolls-Royce.

we get it right, we will have a much more positive future.

those embracing change, now the pressure is really on to deliver.

For Shirley, the NHS was there from the cradle and she hopes it will be

offering good care right to her grave. I want it to survive. I

think it is an excellent system. But I am worried about the future

So huge change ahead. Thanks to the patients and doctors.

Now a complete gear change! We meet the born-again bikers back on the

roads in bigger numbers than ever before. They're not boy racers. As

Ben Jackson's been finding out, for these middle-aged motorbikers, it's

more about fun and friendship than silly speeds!

Now we all have our own idea of relaxation, but for me, it's all

about gathering a group of friends, firing up the bikes, and breaking

out into the beautiful Leicestershire countryside. And

taking to the open road on two I had my first biking experience in

my 30s. I wanted to do something exciting, so I rode from Leicester

to John O'Groats. It was thrilling, an experience I've never looked

back from. But I'm not alone in discovering the excitment of biking

in later life. It seems that more and more middle-aged people are

returning to it, or taking it up for the first time. I've still got

that bike provided the journey on five years ago, and I still love it.

But there are days when biking is not as much fun as you would like.

I would like to throw it into a ditch at the moment. Come on!

Mechanical problems aside, motorbiking is fun and sociable.

Although everyday life seems to stop me going to most big bike

gatherings, I try not to miss Ashby Folville. For the most part, Ashby

Folville is a sleepy little place. But once a month, this field and

the rest of the village becomes a place where bikers come together to

show off their machines in one of the biggest meets in the country.

You'll find everyone from novices to biking royalty. And it's all

about the look. OK, so I'm not When I first came here a few years

ago, it was just a few vintage cars behind a pub. Now look at it. There

And whatever walk of life you come from, you'll find them here. The

pups are not bothered because be taking megabucks. What do you love

about biking? Everything. I have been doing it since I was 13.

he had a break from it? Only one I have been smashed up. A wide you

carry on? The adrenalin, it is a lifestyle. There are all ages, from

little tops to pensioners. I am old, and I still enjoy it. Motorbikers

are predominantly older people. And there's a reason why we don't want

to give it up. The excitement is a feeling you can't beat. And for

most of us, it's pure escapism. But the sale of large-capacity bikes in

the UK has reduced by 10% in the last 12 months. So why is that?

Gary Knowles at Triumph in Leicester knows the biking

community well. I think it's not a case of people not buying bikes any

more. You are seeing a shift in the kind of bike they are buying. When

you get to my age, it's not particularly comfortable and it is

nice to be in a sitting position. You also seeing a reduction in

sports bikes riding. You are seeing a major transfer on to the

adventure market. The cruiser market. It's not all about speed on

bikes. You can enjoy it just as much at 50 miles an hour as you can

at silly speeds. But for all the joys biking brings there's also a

tragic side to it. Last year, 362 people were killed in motorbike

accidents in Britain. 41 of these fatalities were on East Midlands

roads. Slowdown! 53 miles per hour. That was a scooter, so you probably

was back there. PC Dave Johnson is a biker as well as a traffic

officer. He's trying to curb speeding and to reduce the biker

death toll by targeting the bikers who insist on breaking the speed

limit. But it's not just dual carriageways that bikers want to

open up on. Often, it's residential streets. Tyres are good. What we

are doing at the moment is checks on this road. Even here the

racetrack in the background. can biking be so dangerous?

anybody wants to exceed speed limits, or get than rush of

adrenaline from high speeds, to do high speeds in a motor car, you

have to spend a lot of money. For �2,000, you can buy a motorcycle

and be out here exceeding 140 mph. Leicestershire Police run Bike Safe,

a course that any biker can go on. It's designed to give bikers

confidence. Andy recently passed his motorbike test and is taking

the course for the first time. I Can I say that having a police

officer right behind you, every time I look round I jump. We are

not instruct us, we are assessors. We have an in-depth course which

brings us to a set standard. We tried to pass that on to your cells.

We show you that you -- that it is not all about speed, you can go out

and ride and go to the speed limits and have some fun. I'm going to

have a word. I have had an absolute blast. How has it been for you?

have been so much more relaxed, being able to ride with that

ability to see what's going on and feel safe. I mostly ride alone but

riding with friends is definitely the best way to go as it gives the

whole thing a kind of purpose. And where better to end than my local

bikers' pub. He is a great life, great way to spend time. You go out

and meet people, it's brilliant. the biker era in the 50s and 60s,

Marlon Brando is my hero. You could be a man of the cloth! What has a

sale and a registration? For it says, get thee behind me, Satan.

And before we go, I've even got the honour of signing the bikers' wall

of fame! We have some exciting country roads here, that give you

an almost spiritual sense of freedom. And as they say in Easy

I think I'll take your word for it, Ben. Bassett from outside the

Queen's Medical Centre in Nottingham. Thank you for watching.

Next week, why the East Midlands has some of the worst air pollution