Browse content similar to 16/01/2017. Check below for episodes and series from the same categories and more!
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Is the NHS still a National Service? | 0:00:06 | 0:00:09 | |
Do I think my health is more important than ?400 a year | 0:00:09 | 0:00:12 | |
which is half the cost of a holiday? | 0:00:12 | 0:00:14 | |
The answer is my health is more important. | 0:00:14 | 0:00:18 | |
As NHS budgets get tighter, we meet the people prepared | 0:00:18 | 0:00:20 | |
to pay to see their doctor and compare our GP services | 0:00:20 | 0:00:23 | |
with our friends in Ireland. | 0:00:23 | 0:00:27 | |
If a patient rings up, you can be seen today | 0:00:27 | 0:00:31 | |
or tomorrow and in the NHS there are waiting lists. | 0:00:31 | 0:00:35 | |
We investigate whether NHS treatments are different | 0:00:35 | 0:00:37 | |
depending on where you live. | 0:00:37 | 0:00:40 | |
We will see different decisions taken in different parts | 0:00:40 | 0:00:42 | |
of the country and different services being | 0:00:42 | 0:00:44 | |
available to patients. | 0:00:44 | 0:00:48 | |
And the Suffolk hospital trying to do more with less money. | 0:00:48 | 0:00:51 | |
I have been seen straightaway here. | 0:00:51 | 0:00:52 | |
Wheeled in and nurses and doctors all around me. | 0:00:52 | 0:00:54 | |
Very good. | 0:00:54 | 0:00:55 | |
Revealing the stories that matter closer to home. | 0:00:55 | 0:00:57 | |
Inside Out is back. | 0:00:57 | 0:01:07 | |
Hello, this is the start of the new series of | 0:01:16 | 0:01:18 | |
Inside Out here on BBC One. | 0:01:18 | 0:01:22 | |
I am in Jaywick on the Essex coast and we have a special programme | 0:01:22 | 0:01:25 | |
that is all about health care. | 0:01:25 | 0:01:27 | |
Finding a GP is getting harder in many places | 0:01:27 | 0:01:29 | |
in the east of England. | 0:01:29 | 0:01:31 | |
In Essex we found 10% of surgeries, 10%, are now not accepting | 0:01:31 | 0:01:34 | |
new patients and some people are choosing to pay to see a private | 0:01:34 | 0:01:37 | |
GP instead of waiting. | 0:01:37 | 0:01:45 | |
When we visit an NHS GP, we expect them to deliver expert | 0:01:45 | 0:01:48 | |
care without having to pay. | 0:01:48 | 0:01:52 | |
But like a lot of modern life, things are changing. | 0:01:52 | 0:01:56 | |
Perhaps in the future, if we want free minutes, | 0:01:56 | 0:02:01 | |
we ll need to take out a contract with our service provider. | 0:02:01 | 0:02:04 | |
Not so unlike shopping for a new phone - one that offers | 0:02:04 | 0:02:07 | |
the best deal to meet your needs. | 0:02:07 | 0:02:09 | |
But why? | 0:02:09 | 0:02:12 | |
Later, we meet one man who says going private is the only option. | 0:02:12 | 0:02:18 | |
Do I think my health is more important than ?400 a year | 0:02:18 | 0:02:23 | |
which is half the cost of a holiday and the answer is my | 0:02:23 | 0:02:26 | |
health is more important. | 0:02:26 | 0:02:29 | |
NHS GP practice is under more pressure than ever before ? | 0:02:29 | 0:02:31 | |
and excessive workloads have forced some surgeries to | 0:02:31 | 0:02:34 | |
take drastic action. | 0:02:34 | 0:02:40 | |
In Essex, 26 surgeries, that s 10%, are refusing to take on new patients | 0:02:40 | 0:02:46 | |
? leaving them to seek a doctor elsewhere. | 0:02:46 | 0:02:48 | |
Other practices are struggling to keep up with demand. | 0:02:48 | 0:02:50 | |
Take Jaywick. | 0:02:50 | 0:02:52 | |
Here, a combination of an ageing population, doctors retiring | 0:02:52 | 0:02:56 | |
and problems recruiting has put huge strain on the local GP surgery. | 0:02:56 | 0:03:04 | |
Dr Peter Skew joined The Green Elms Medical Practice five | 0:03:04 | 0:03:07 | |
years ago ? his aim? | 0:03:07 | 0:03:10 | |
To turn around a failing practice. | 0:03:10 | 0:03:15 | |
The practice population is in and from the most deprived | 0:03:15 | 0:03:17 | |
ward in the whole of England. | 0:03:17 | 0:03:22 | |
The practice had not had a regular doctor for two or three years. | 0:03:22 | 0:03:27 | |
The patients were fed up of seeing repeatedly different doctors. | 0:03:27 | 0:03:30 | |
Dr Skew concentrated his effort on recruitment ? offering terms | 0:03:30 | 0:03:34 | |
such as defined hours, to attract GPs to the practice. | 0:03:34 | 0:03:39 | |
Now the surgery has five regular GPs and one long term locum. | 0:03:39 | 0:03:44 | |
The philosophy of this practice is to problem-solve. | 0:03:44 | 0:03:48 | |
And because we know the patient is going to come back to us | 0:03:48 | 0:03:51 | |
if we don t get it right, we have a much stronger driver | 0:03:51 | 0:03:54 | |
to get it right, to problem-solve. | 0:03:54 | 0:03:59 | |
I hate to say this, but locums do not have that | 0:03:59 | 0:04:02 | |
ongoing responsibility. | 0:04:02 | 0:04:03 | |
So, what do the patients think? | 0:04:03 | 0:04:05 | |
It s an excellent surgery compared with what it was 15/20 years ago. | 0:04:05 | 0:04:13 | |
It s far better now than it was when we were mostly locums. | 0:04:13 | 0:04:16 | |
But you know, now I ve got no complaints whatsoever. | 0:04:16 | 0:04:21 | |
Dr Skew has turned his surgery around, so what s to stop other NHS | 0:04:21 | 0:04:24 | |
practices doing the same? | 0:04:24 | 0:04:30 | |
At the moment General Practice is under a huge amount of pressure. | 0:04:30 | 0:04:35 | |
The situation is the worst it has been and surveys of GPs | 0:04:35 | 0:04:43 | |
which look at work load and stress suggest it is becoming, | 0:04:43 | 0:04:47 | |
the workload issues is becoming a crisis and that plays | 0:04:47 | 0:04:49 | |
into your ability to recruit and retain GPs. | 0:04:49 | 0:04:59 | |
A world away from Jaywick is the affluence city of Chelmsford. | 0:04:59 | 0:05:05 | |
Here unemployment is low and living standards are high. | 0:05:05 | 0:05:07 | |
You can tell by the variety of shops. | 0:05:07 | 0:05:12 | |
And when it comes to picking a GP, here it is a bit like shopping. | 0:05:12 | 0:05:17 | |
And each GP service offers a different deal. | 0:05:17 | 0:05:21 | |
So, for instance, if a regular GP-run practice is not for you ? how | 0:05:21 | 0:05:25 | |
about an NHS surgery run by an external operator? | 0:05:25 | 0:05:30 | |
As of July last year, Sutherland Lodge Surgery | 0:05:30 | 0:05:34 | |
is run by Virgin Care. | 0:05:34 | 0:05:37 | |
It s one of five NHS medical centres run by Virgin in Essex. | 0:05:37 | 0:05:44 | |
Now you d be forgiven for thinking the medical centre was failing | 0:05:44 | 0:05:49 | |
was handed to the private sector to sort out. | 0:05:49 | 0:05:50 | |
But no. | 0:05:50 | 0:05:51 | |
Only recently it was rated outstanding by the Care | 0:05:51 | 0:05:54 | |
Quality Commission. | 0:05:54 | 0:05:56 | |
The surgery then had its funding cut back. | 0:05:56 | 0:06:01 | |
The GPs at Sutherland Lodge decided they d had enough ? and so they took | 0:06:01 | 0:06:05 | |
the drastic decision to close the practice. | 0:06:05 | 0:06:09 | |
This is astounding. | 0:06:09 | 0:06:11 | |
Shirley-Anne Hall has been a patient at Sutherland Lodge | 0:06:11 | 0:06:17 | |
for over 70 years. | 0:06:17 | 0:06:20 | |
Virgin Care Services has been identified as the preferred bidder | 0:06:20 | 0:06:23 | |
to take on the running of Sutherland Lodge Surgery. | 0:06:23 | 0:06:25 | |
It s like you should be grateful that this is now happening. | 0:06:25 | 0:06:28 | |
Well, I guess we are grateful because otherwise | 0:06:28 | 0:06:29 | |
what were we going to have? | 0:06:30 | 0:06:31 | |
Nothing? | 0:06:31 | 0:06:32 | |
And no other doctor s surgery in the area can take on more | 0:06:32 | 0:06:35 | |
patients ? they ve said so. | 0:06:35 | 0:06:37 | |
What s it like now? | 0:06:37 | 0:06:37 | |
It just seems to be locums. | 0:06:37 | 0:06:41 | |
So, you wonder if things carry on ? or if I had something | 0:06:41 | 0:06:45 | |
seriously wrong with me, would I be seen by the same person | 0:06:45 | 0:06:47 | |
or just a continuation of different people? | 0:06:47 | 0:06:52 | |
That doesn t make me feel very happy. | 0:06:52 | 0:06:58 | |
A spokesperson for Virgin Care said: | 0:06:58 | 0:07:03 | |
But if you re one of those patients | 0:07:15 | 0:07:16 | |
no longer registered with Sutherland Lodge | 0:07:16 | 0:07:18 | |
? or you want to look elsewhere, what can you do? | 0:07:18 | 0:07:23 | |
Maybe find another NHS doctor ? stick with the tried | 0:07:23 | 0:07:25 | |
and tested older model. | 0:07:25 | 0:07:28 | |
Or as some websites claim ? help ease the pressure | 0:07:28 | 0:07:31 | |
and save the NHS money, by upgrading to a private GP | 0:07:31 | 0:07:36 | |
for a faster, maybe better, service. | 0:07:36 | 0:07:40 | |
And if you re shopping in Chelmsford and you can afford it, | 0:07:40 | 0:07:43 | |
it won t take long to find a private GP to suit your needs. | 0:07:43 | 0:07:48 | |
Private GP Services was set up by Dr Anne Squire 16 years ago. | 0:07:48 | 0:07:55 | |
We see a very wide social mix. | 0:07:55 | 0:07:57 | |
You have to remember that what we charge for an appointment | 0:07:57 | 0:08:00 | |
is less than most people pay at the vets. | 0:08:00 | 0:08:02 | |
It s a pay as you go service ? you don t have to sign up to keep | 0:08:02 | 0:08:06 | |
coming back to us in any way. | 0:08:06 | 0:08:09 | |
So you're benefiting from the very fact that the NHS | 0:08:09 | 0:08:11 | |
is buckling under the strain? | 0:08:11 | 0:08:16 | |
I think in the last two years, 18 months to two years, | 0:08:16 | 0:08:21 | |
we are seeing an increasing number of new patients, who are here | 0:08:21 | 0:08:24 | |
because they cannot get an appointment with their NHS GP. | 0:08:24 | 0:08:26 | |
And it really isn t that people are discontented with their own GP, | 0:08:26 | 0:08:32 | |
but they re discontented with the time it takes to see them. | 0:08:32 | 0:08:37 | |
Tim Wood registered with the Private GP Services ten years ago. | 0:08:37 | 0:08:43 | |
Do you think that people like yourself will move more | 0:08:43 | 0:08:45 | |
into paying for their treatment? | 0:08:45 | 0:08:49 | |
I had this discussion with couple of mates about this. | 0:08:49 | 0:08:53 | |
One said, why should I go near a GP, it should be means tested. | 0:08:53 | 0:08:58 | |
I should not be allowed near a GP. | 0:08:59 | 0:09:04 | |
The GP, the NHS should be people that cannot afford to come | 0:09:04 | 0:09:07 | |
to places like this. | 0:09:07 | 0:09:08 | |
If you decide to go private, pay-as-you-go single | 0:09:08 | 0:09:10 | |
consultations start from ?80. | 0:09:10 | 0:09:15 | |
But what s the impact on the NHS GP services? | 0:09:15 | 0:09:18 | |
If you can t get access, then the private sector is very good | 0:09:18 | 0:09:21 | |
at then expanding to soak that up. | 0:09:21 | 0:09:26 | |
As services improve, what happens is the private sector | 0:09:26 | 0:09:28 | |
tends to contract again ? because people go back | 0:09:28 | 0:09:31 | |
to the public service. | 0:09:31 | 0:09:35 | |
If GP practice is struggling in England, it's perhaps worth | 0:09:35 | 0:09:39 | |
looking at how GP services are delivered elsewhere in Europe. | 0:09:39 | 0:09:42 | |
I ve come to Ireland - to Dublin. | 0:09:42 | 0:09:45 | |
Everyone in Ireland is entitled to receive medical care | 0:09:45 | 0:09:47 | |
through the public health system. | 0:09:47 | 0:09:50 | |
The service, however, is means-tested - those on benefits | 0:09:50 | 0:09:54 | |
or low incomes get a medical card entitling them to free treatment. | 0:09:54 | 0:10:01 | |
The remainder of the population either has private insurance or pays | 0:10:01 | 0:10:03 | |
on a treatment-by-treatment basis ? so back to pay as you go. | 0:10:03 | 0:10:09 | |
Could this be the future for the NHS? | 0:10:09 | 0:10:12 | |
Dr Mark Murphy is a GP and chair of communications | 0:10:12 | 0:10:15 | |
for the Irish College of General Practitioners. | 0:10:15 | 0:10:21 | |
Only 40% of the population can receive free at | 0:10:21 | 0:10:23 | |
the point of contact care. | 0:10:23 | 0:10:26 | |
So the other 60% of the population have to pay the market | 0:10:26 | 0:10:29 | |
price to see a GP. | 0:10:29 | 0:10:31 | |
That could be 50 euros, it could be 60 euros. | 0:10:31 | 0:10:34 | |
There is this squeezed middle. | 0:10:34 | 0:10:36 | |
So about 20% of the population in Ireland neither have a medical | 0:10:36 | 0:10:39 | |
card, so they have to pay to see me as a GP. | 0:10:39 | 0:10:43 | |
But they don t have private health insurance either and unfortunately | 0:10:43 | 0:10:46 | |
they can face catastrophic out-of-pocket payments | 0:10:46 | 0:10:51 | |
when they re unwell ? and that really is not the norm | 0:10:51 | 0:10:53 | |
in most developed countries. | 0:10:53 | 0:10:56 | |
Is it frustrating as a GP to work within these | 0:10:56 | 0:10:58 | |
constructing parameters? | 0:10:58 | 0:11:00 | |
I suppose the one advantage of the Irish health care system | 0:11:00 | 0:11:03 | |
from a General Practice perspective above the NHS, is that we generally | 0:11:03 | 0:11:07 | |
have ? if a patient rings up, they can be seen today or tomorrow ? | 0:11:07 | 0:11:10 | |
and I know in the NHS there are waiting lists. | 0:11:10 | 0:11:12 | |
If you want to see a specific GP you may have to wait | 0:11:12 | 0:11:16 | |
two or three weeks. | 0:11:16 | 0:11:17 | |
The Irish system works well for those who can afford it. | 0:11:17 | 0:11:25 | |
But asking people here in England to pay to see their NHS GP would be | 0:11:25 | 0:11:29 | |
politically unpalatable. | 0:11:29 | 0:11:30 | |
So what s to be done? | 0:11:30 | 0:11:31 | |
Across the region, GPs are looking at ways to maintain local services, | 0:11:31 | 0:11:34 | |
while at the same time working with other practices | 0:11:34 | 0:11:36 | |
to share certain costs. | 0:11:36 | 0:11:37 | |
And the Government says it s committed to spending | 0:11:37 | 0:11:39 | |
more on GP practice. | 0:11:39 | 0:11:44 | |
There s no doubt that many doctors and patients remain committed | 0:11:44 | 0:11:46 | |
to the NHS but without better funding, some surgeries may be | 0:11:46 | 0:11:49 | |
forced to reduce services or worse, close down altogether. | 0:11:49 | 0:11:56 | |
I think that if people have to pay to get the right care, | 0:11:56 | 0:12:00 | |
the whole of society has failed somewhere. | 0:12:00 | 0:12:04 | |
It s not just the NHS ? it s what does society want | 0:12:04 | 0:12:08 | |
from their health care providers? | 0:12:08 | 0:12:11 | |
And if they only get it privately, we ve failed. | 0:12:11 | 0:12:17 | |
Now we are back on air, it is great to hear | 0:12:17 | 0:12:20 | |
from you if there is something you think we should be looking into. | 0:12:20 | 0:12:23 | |
Get in touch with me on Twitter... | 0:12:23 | 0:12:25 | |
Or you can e-mail... | 0:12:25 | 0:12:31 | |
You are watching Inside Out for the East of England here on BBC One. | 0:12:31 | 0:12:35 | |
Later, the hospital that hopes to be a blueprint for the region. | 0:12:35 | 0:12:38 | |
Pleasure to meet you, sir. | 0:12:38 | 0:12:40 | |
You will get better soon. | 0:12:40 | 0:12:42 | |
I'm going home to see my cat. | 0:12:42 | 0:12:48 | |
As budgets get smaller, patient numbers go up. | 0:12:49 | 0:12:52 | |
We are looking at the pressure to ration treatments so is the NHS | 0:12:52 | 0:12:56 | |
still a National Service and does where you live matter more | 0:12:56 | 0:12:58 | |
than ever when it comes to the treatment on offer to you? | 0:12:58 | 0:13:03 | |
Chris Jackson has been investigating. | 0:13:03 | 0:13:08 | |
The NHS is facing the most significant financial | 0:13:08 | 0:13:10 | |
challenge in its history. | 0:13:10 | 0:13:15 | |
There are fears the service we have grown up with is | 0:13:15 | 0:13:17 | |
beginning to fragment. | 0:13:17 | 0:13:20 | |
It is not a National Service. | 0:13:20 | 0:13:22 | |
Absolutely there is a postcode lottery. | 0:13:22 | 0:13:25 | |
It is criminal. | 0:13:25 | 0:13:27 | |
It is absolutely criminal. | 0:13:27 | 0:13:30 | |
This is the start, this is going to get worse. | 0:13:30 | 0:13:36 | |
So, is the NHS in danger of ceasing to be a National Service | 0:13:36 | 0:13:39 | |
where everyone is entitled to the same care? | 0:13:39 | 0:13:44 | |
It is treating more patients but is it becoming a postcode | 0:13:44 | 0:13:46 | |
lottery where access depends on where you live? | 0:13:46 | 0:13:49 | |
We are going to put that to the test. | 0:13:49 | 0:13:57 | |
On a bad day, it ruins your life. | 0:13:57 | 0:14:01 | |
Muscle pains, it feels like my bones are screaming at me at times. | 0:14:01 | 0:14:09 | |
33-year-old Ben Franklin has hepatitis C, the virus can cause | 0:14:09 | 0:14:11 | |
life-threatening liver damage. | 0:14:11 | 0:14:13 | |
I am about to lose my job, I have not been at work since April, | 0:14:13 | 0:14:16 | |
I've been off sick. | 0:14:16 | 0:14:18 | |
And I could lose the flat over my head. | 0:14:18 | 0:14:21 | |
There are new drugs that can potentially cure the hepatitis | 0:14:21 | 0:14:24 | |
but they are expensive and rationed. | 0:14:24 | 0:14:27 | |
Ben has been denied them. | 0:14:27 | 0:14:35 | |
All I got was wait, because my liver was not bad enough and that made me | 0:14:35 | 0:14:38 | |
want to go out and get wasted and ruin my liver | 0:14:38 | 0:14:41 | |
just so they would treat me. | 0:14:41 | 0:14:42 | |
I wouldn't do that but I wouldn't be surprised if anyone else wouldn't. | 0:14:42 | 0:14:46 | |
The money is there for 10,000 treatments each area | 0:14:46 | 0:14:50 | |
has a target to meet, it is claimed that means | 0:14:50 | 0:14:53 | |
there are no queues in part of the North and long waits | 0:14:53 | 0:14:56 | |
in places like London. | 0:14:56 | 0:14:59 | |
Two people with the same state of liver damage could present | 0:14:59 | 0:15:03 | |
themselves in different parts of the country and in one | 0:15:03 | 0:15:05 | |
they will walk in, get hepatitis C treatment immediately, | 0:15:05 | 0:15:07 | |
get cured and in another part of the country they may go and be | 0:15:07 | 0:15:11 | |
told you will have to wait. | 0:15:11 | 0:15:14 | |
This is inherently unfair. | 0:15:14 | 0:15:18 | |
NHS England told us it was regularly reallocating and used hepatitis C | 0:15:18 | 0:15:23 | |
treatments to places with waiting lists. | 0:15:23 | 0:15:29 | |
The number of patients treated will increase by 25% next year. | 0:15:29 | 0:15:34 | |
The fact it is down to money that upsets me the most. | 0:15:34 | 0:15:38 | |
It is just money. | 0:15:38 | 0:15:41 | |
So, Ben is taking the risk of treating himself with cheaper | 0:15:41 | 0:15:43 | |
copies of the new drugs. | 0:15:44 | 0:15:51 | |
How much have you spent on that box? | 0:15:51 | 0:15:53 | |
?1300. | 0:15:53 | 0:15:54 | |
?1300 that I don't really have. | 0:15:54 | 0:15:57 | |
The fact I have had to pay for my treatment and... | 0:15:57 | 0:16:01 | |
It is criminal. | 0:16:01 | 0:16:02 | |
It is absolutely criminal. | 0:16:02 | 0:16:05 | |
Sorry. | 0:16:05 | 0:16:08 | |
I'm just tired of being tired. | 0:16:08 | 0:16:12 | |
Basically. | 0:16:12 | 0:16:19 | |
Ben is hoping the generic drugs will cure him within a matter | 0:16:19 | 0:16:22 | |
of weeks and he is not alone. | 0:16:22 | 0:16:26 | |
The hepatitis C trust estimates around 1000 people in Britain may | 0:16:26 | 0:16:30 | |
have brought the drugs abroad. | 0:16:30 | 0:16:37 | |
If you go outside, there are halos around the lights, | 0:16:37 | 0:16:42 | |
lights and shadows, it is hard to see things which are distorted. | 0:16:42 | 0:16:45 | |
Gloria has cataracts in both eyes. | 0:16:45 | 0:16:50 | |
I can't take stairs, go up or down stairs | 0:16:50 | 0:16:52 | |
with any kind of confidence. | 0:16:52 | 0:16:55 | |
Cataracts are supposed to be treated within four points | 0:16:55 | 0:16:58 | |
five months of referral. | 0:16:58 | 0:17:00 | |
Gloria, who lives in the Northeast says she has been waiting seven. | 0:17:00 | 0:17:03 | |
Is too long because there is such potential for accidents | 0:17:03 | 0:17:09 | |
and there is such a change in a person s mood. | 0:17:09 | 0:17:16 | |
If Gloria had lived in Luton, her wait could have been 15 days. | 0:17:16 | 0:17:19 | |
The postcode lottery. | 0:17:19 | 0:17:21 | |
Absolutely there is a postcode lottery. | 0:17:21 | 0:17:23 | |
It is not about clinical need, it is about some places in England | 0:17:23 | 0:17:29 | |
having poor systems, budgetary pressures and deep | 0:17:29 | 0:17:31 | |
prioritising cataract surgery. | 0:17:31 | 0:17:37 | |
That does not feel too national to me. | 0:17:37 | 0:17:41 | |
Gloria expects an operation later this month. | 0:17:41 | 0:17:42 | |
It makes me angry because I think it is almost | 0:17:42 | 0:17:45 | |
like a survival of the fittest. | 0:17:45 | 0:17:49 | |
Clinical commissioning groups control health budgets. | 0:17:49 | 0:17:57 | |
It is claimed some are delaying treatment is like cataract surgery | 0:17:57 | 0:18:00 | |
by slowing down referrals. | 0:18:00 | 0:18:01 | |
Others are requiring patients to lose weight before getting | 0:18:01 | 0:18:03 | |
operations like hip replacements. | 0:18:03 | 0:18:08 | |
Postponing an operation in these circumstances can save money | 0:18:08 | 0:18:11 | |
in the short term and whilst the CCG say they can be | 0:18:11 | 0:18:19 | |
clinically justified, the Royal College | 0:18:19 | 0:18:20 | |
of surgeons says not. | 0:18:20 | 0:18:22 | |
There is good evidence people are now not getting elective | 0:18:22 | 0:18:25 | |
operations which they desperately sometimes require simply | 0:18:25 | 0:18:26 | |
because of financial restrictions. | 0:18:26 | 0:18:29 | |
It is up to the clinicians to decide who should have what treatments. | 0:18:29 | 0:18:35 | |
And therefore a bureaucratic system which produces a blanket | 0:18:35 | 0:18:38 | |
ban is morally wrong. | 0:18:38 | 0:18:42 | |
It is claimed new systems for vetting appointments | 0:18:42 | 0:18:44 | |
with specialists are another form of rationing. | 0:18:44 | 0:18:47 | |
Why are they treating their patients with such contempt? | 0:18:47 | 0:18:52 | |
Last month, MPs complained about a private company | 0:18:52 | 0:18:58 | |
being paid ?10 for every GP referral they stopped. | 0:18:58 | 0:19:00 | |
This is rationing by the back door and has the potential | 0:19:00 | 0:19:03 | |
to compromise patient safety. | 0:19:03 | 0:19:05 | |
The same private company overseas referrals in North Tyneside. | 0:19:05 | 0:19:07 | |
We have spoken to doctors who say the system is | 0:19:07 | 0:19:10 | |
putting patients at risk. | 0:19:10 | 0:19:16 | |
The GPs who fear speaking out have told us cancer | 0:19:16 | 0:19:19 | |
diagnoses are being held up. | 0:19:19 | 0:19:21 | |
In a statement, North Tyneside CCG said there was no evidence | 0:19:41 | 0:19:43 | |
the system caused additional risk or delay. | 0:19:43 | 0:19:50 | |
Cancer referrals do not go through the system and are made | 0:19:50 | 0:19:53 | |
directly to hospital. | 0:19:53 | 0:19:56 | |
The number of referrals knocked back to GPs in England has risen by 30% | 0:19:56 | 0:20:00 | |
in the last two years. | 0:20:00 | 0:20:05 | |
You can see the details of the research online. | 0:20:05 | 0:20:07 | |
Shortage and regional difference have always been part of the NHS. | 0:20:07 | 0:20:10 | |
Today, the differences could get much worse. | 0:20:10 | 0:20:14 | |
The NHS is under an unprecedented level of pressure at the moment. | 0:20:14 | 0:20:17 | |
If it doesn't get more funding, waiting times are going to get | 0:20:17 | 0:20:20 | |
longer and the quality of patient care is going to suffer. | 0:20:20 | 0:20:27 | |
We will see different decisions taken in different parts | 0:20:27 | 0:20:29 | |
of the country and different services being | 0:20:29 | 0:20:31 | |
available to patients. | 0:20:31 | 0:20:34 | |
So, is the NHS still a National Service? | 0:20:34 | 0:20:36 | |
One of our most prominent medics is clear. | 0:20:36 | 0:20:38 | |
No, it is not a National Service. | 0:20:38 | 0:20:40 | |
It is a local health service. | 0:20:40 | 0:20:42 | |
It matters because it leads to inequality in health care, | 0:20:42 | 0:20:45 | |
that is the problem so some people will get health care | 0:20:45 | 0:20:47 | |
for free and others won't. | 0:20:47 | 0:20:49 | |
In a statement, the Department of Health told us far | 0:20:49 | 0:20:52 | |
from rationing, more people than ever are getting | 0:20:52 | 0:20:54 | |
prompt treatment. | 0:20:54 | 0:20:58 | |
standards of care are improving. | 0:21:07 | 0:21:08 | |
We asked the health secretary and NHS England | 0:21:08 | 0:21:10 | |
for an interview but both declined. | 0:21:10 | 0:21:12 | |
The people paying for NHS services, the clinical commissioners, | 0:21:12 | 0:21:14 | |
did agree to speak. | 0:21:14 | 0:21:15 | |
It is a National Service with local variation based | 0:21:15 | 0:21:17 | |
on the need of the population. | 0:21:17 | 0:21:21 | |
Demographically, populations vary quite significantly from town | 0:21:21 | 0:21:23 | |
to rural, county to county. | 0:21:23 | 0:21:30 | |
It is really important we commission and respond to the needs | 0:21:30 | 0:21:32 | |
of the population on a local basis. | 0:21:32 | 0:21:34 | |
It is about making sure the pathway is correct, | 0:21:34 | 0:21:36 | |
we don't want to squander any money. | 0:21:36 | 0:21:38 | |
We have limited resources so it's important we spend most effectively | 0:21:38 | 0:21:41 | |
and get the best value for the population. | 0:21:41 | 0:21:44 | |
For those forced to take their own action, rationing | 0:21:44 | 0:21:46 | |
appears all too real. | 0:21:46 | 0:21:53 | |
Our hospitals are also facing cuts. | 0:21:53 | 0:21:55 | |
They have been asked to make plans to be more efficient. | 0:21:55 | 0:21:59 | |
Our health reporter Nicki Fox has been to Bury St Edmunds to see how | 0:21:59 | 0:22:02 | |
the West Suffolk Hospital is trying to offer better care | 0:22:02 | 0:22:05 | |
with less money. | 0:22:05 | 0:22:14 | |
This leaflet is coming through your letterbox one day soon. | 0:22:14 | 0:22:17 | |
The NHS as it was when it was set-up in 1948. | 0:22:17 | 0:22:22 | |
How different it is today. | 0:22:22 | 0:22:25 | |
With 22 billion to save and not enough hospital beds | 0:22:25 | 0:22:32 | |
there is a new plan for the NHS. | 0:22:32 | 0:22:37 | |
And this means keeping more people out of A | 0:22:37 | 0:22:39 | |
and discharging patients quicker. | 0:22:39 | 0:22:40 | |
I have come to West Suffolk Hospital to see what it is like | 0:22:40 | 0:22:43 | |
on a typical shift. | 0:22:43 | 0:22:44 | |
Here it is about reducing the number of people stepping | 0:22:44 | 0:22:47 | |
through these doors. | 0:22:47 | 0:22:48 | |
The big struggle for this hospital is to find beds for those patients | 0:22:48 | 0:22:51 | |
who need to be admitted and that s because it s harder to release those | 0:22:51 | 0:22:55 | |
who need to go home. | 0:22:55 | 0:22:59 | |
We have got a very rural population, an ageing population. | 0:22:59 | 0:23:03 | |
we have to make sure local services are tailored to meet that need. | 0:23:03 | 0:23:07 | |
Bill Pleasance was rushed to A the night before. | 0:23:07 | 0:23:11 | |
I woke up and had a slight sort of discomfort. | 0:23:11 | 0:23:13 | |
anyway I put it down to indigestion. | 0:23:14 | 0:23:17 | |
It got worse, that frightened me and as it got worse in the end | 0:23:17 | 0:23:23 | |
I pressed my life line alarm and the paramedics came | 0:23:23 | 0:23:29 | |
within a very few minutes and decided it was not a heart | 0:23:29 | 0:23:33 | |
attack or they didn t think it was but they wanted me to come | 0:23:33 | 0:23:37 | |
into A and be checked over. | 0:23:37 | 0:23:46 | |
They are wonderful what they have done so far. | 0:23:46 | 0:23:48 | |
Really wonderful. | 0:23:48 | 0:23:49 | |
He is being fast tracked to get him home as soon as possible. | 0:23:49 | 0:23:53 | |
As Bill waits to hear if he is going home, | 0:23:53 | 0:23:55 | |
Rosemary McNeil has just been rushed in. | 0:23:55 | 0:24:00 | |
Your heart is beating so fast. | 0:24:00 | 0:24:04 | |
She has a history of heart problems. | 0:24:04 | 0:24:07 | |
Were you having palpitations? | 0:24:07 | 0:24:15 | |
It is unlikely she will go home today. | 0:24:15 | 0:24:20 | |
They had to shock my heart several times now. | 0:24:20 | 0:24:27 | |
I have been seen straightaway here - wheeled in and nurses | 0:24:27 | 0:24:29 | |
and doctor all around me. | 0:24:29 | 0:24:30 | |
Very good. | 0:24:30 | 0:24:31 | |
This hospital wants to lead the way by making sure that the care | 0:24:31 | 0:24:35 | |
is in place at home so patients can be discharged quickly, | 0:24:35 | 0:24:37 | |
this helps prevents bed blocking. | 0:24:37 | 0:24:41 | |
It is late morning and Bill gets a visit from a care practitioner. | 0:24:41 | 0:24:44 | |
My name is Sue. | 0:24:44 | 0:24:46 | |
I work for the early intervention team. | 0:24:46 | 0:24:51 | |
My role is to keep you as independent as possible. | 0:24:51 | 0:24:53 | |
I don t want to take that away from you so we need just tweak very | 0:24:53 | 0:24:58 | |
slightly the care you have got which will enable you | 0:24:58 | 0:25:00 | |
to return home safely. | 0:25:00 | 0:25:03 | |
Yes, yes. | 0:25:03 | 0:25:05 | |
That will be fine. | 0:25:05 | 0:25:10 | |
It turns out the tweaking is sorting out lunch | 0:25:10 | 0:25:12 | |
on a regular basis for Bill. | 0:25:12 | 0:25:14 | |
That is all that is needed. | 0:25:14 | 0:25:16 | |
I will let the staff know on the ward that | 0:25:16 | 0:25:19 | |
you and I have spoken. | 0:25:19 | 0:25:22 | |
What we are going to put into place and then see how you're | 0:25:22 | 0:25:25 | |
are getting home today. | 0:25:25 | 0:25:26 | |
This part of the county has to make 50 million worth of savings, | 0:25:26 | 0:25:31 | |
hospitals cost a lot more than care in the community so more care out | 0:25:31 | 0:25:34 | |
of hospital is one way this Trust will save money. | 0:25:34 | 0:25:38 | |
Our vision for the future is we will only do in hospital | 0:25:38 | 0:25:42 | |
what needs to be done in hospital that means we will continue | 0:25:42 | 0:25:46 | |
to provide excellent surgery and getting people treated | 0:25:46 | 0:25:49 | |
in emergency care but we are also working in the community. | 0:25:49 | 0:25:56 | |
So these people will have the support they need | 0:25:56 | 0:25:58 | |
in their own homes they won t be told you can t come | 0:25:58 | 0:26:01 | |
to hospital and then not have the support they need. | 0:26:01 | 0:26:03 | |
Absolutely we are very committed to providing the same services | 0:26:03 | 0:26:06 | |
to local people but do it in a more joined up proactive way. | 0:26:06 | 0:26:11 | |
Until these changes happen this A remains under pressure | 0:26:11 | 0:26:15 | |
and is still the best place to get the most expert care | 0:26:15 | 0:26:18 | |
when things go wrong. | 0:26:18 | 0:26:20 | |
A three-day history of chest infection. | 0:26:20 | 0:26:22 | |
Not responded to antibiotics. | 0:26:22 | 0:26:25 | |
How difficult is it for everyone to judge whether a patient | 0:26:25 | 0:26:28 | |
like this should be coming into hospital or not? | 0:26:28 | 0:26:32 | |
I think everyone has a duty of care so it is really | 0:26:32 | 0:26:35 | |
difficult for you to make a decision out there. | 0:26:35 | 0:26:38 | |
I think the best place is to come to A and take it from there. | 0:26:38 | 0:26:42 | |
For these pre hospital guys it is so difficult | 0:26:42 | 0:26:44 | |
for them as they don t know. | 0:26:44 | 0:26:50 | |
If a mistake is made then there is an awful lot of trouble, | 0:26:50 | 0:26:55 | |
so if it s not a clear cut decision then the best place is to bring them | 0:26:55 | 0:26:59 | |
to A you get the clinical decision from doctors. | 0:26:59 | 0:27:08 | |
If you didn t have to come if you're came here | 0:27:08 | 0:27:10 | |
and you came and well that | 0:27:10 | 0:27:12 | |
not such a bad thing but on the other way | 0:27:12 | 0:27:17 | |
round you would want it to be the other way round. | 0:27:17 | 0:27:20 | |
Your lovely neighbour has made you some lunch. | 0:27:20 | 0:27:24 | |
But it is in cases like Bill's where pressure | 0:27:24 | 0:27:26 | |
on the hospital can be relieved - by late afternoon he gets the news | 0:27:26 | 0:27:29 | |
he has been hoping for. | 0:27:29 | 0:27:32 | |
Where I live is a cottage, and I would like to stop | 0:27:32 | 0:27:35 | |
there until they wheel me out! | 0:27:35 | 0:27:36 | |
There is no place like it. | 0:27:36 | 0:27:41 | |
I will be glad to go home and see my cat! | 0:27:41 | 0:27:45 | |
And the hospital is able to free up another bed. | 0:27:45 | 0:27:49 | |
It is busy and demand is high. | 0:27:49 | 0:27:53 | |
The big plan for the NHS is the type of care being offered is changing. | 0:27:53 | 0:27:57 | |
This hospital wants to be a blue print for other hospitals to follow | 0:27:57 | 0:28:00 | |
what is clear from my time here is that the West | 0:28:00 | 0:28:05 | |
Suffolk is changing. | 0:28:05 | 0:28:08 | |
That is it. | 0:28:08 | 0:28:09 | |
Next week we investigate the rise in scams conning the elderly out | 0:28:09 | 0:28:12 | |
of billions every year. | 0:28:12 | 0:28:13 | |
Get in touch on Twitter or e-mail. | 0:28:13 | 0:28:23 | |
From a bitterly cold Jaywick on the east coast, see next week. | 0:28:25 | 0:28:32 | |
Also, the big vision, Milton Keynes 50 years | 0:28:32 | 0:28:35 | |
on, is it a success? | 0:28:35 | 0:28:41 | |
And what is the way forward to protect our coastal communities? | 0:28:41 | 0:28:44 | |
People have been campaigning for years to have proper sea | 0:28:44 | 0:28:46 | |
defences and they say whenever there is a storm surge they will go | 0:28:46 | 0:28:49 | |
to bed fearing the worst. | 0:28:49 | 0:28:53 | |
Inside Out next Monday at 7:30pm. | 0:28:53 | 0:28:57 | |
Hello, I'm Louisa Preston with your 90 second update. | 0:29:09 | 0:29:12 | |
30 British tourists shot dead in Tunisia in 2015. | 0:29:12 | 0:29:14 | |
Murdered by an Islamist gunman. | 0:29:14 | 0:29:15 | |
Today, an inquest was told that security forces | 0:29:15 | 0:29:17 | |
were deliberately slow to respond. | 0:29:17 | 0:29:20 | |
Donald Trump provokes a mixed reaction. | 0:29:20 | 0:29:22 | |
Downing Street welcomes the promise of a "quick and fair" trade deal. | 0:29:22 | 0:29:25 | |
But foreign ministers are concerned by his comments | 0:29:25 | 0:29:27 | |
that Nato is obsolete. | 0:29:27 | 0:29:29 | |
A snap election in Northern Ireland. | 0:29:29 | 0:29:32 | |
It follows the collapse of the power-sharing Government. | 0:29:32 | 0:29:34 | |
Sinn Fein refused to nominate a new deputy first minister. | 0:29:34 | 0:29:36 | |
Martin McGuinness resigned in a dispute with the DUP. | 0:29:36 | 0:29:40 | |
The former football coach Barry Bennell, | 0:29:40 | 0:29:42 |