:00:00. > :00:11.Hello. Welcome to a new series of Inside Out. I hope you had a lovely
:00:12. > :00:17.break. Tonight were putting health care under the spotlight. As budgets
:00:18. > :00:20.tighten and patient numbers rocket the NHS is being forced to ration
:00:21. > :00:26.different treatments depending on where you live. So we ask, do we
:00:27. > :00:35.still have a truly national health. It's now a local health service. It
:00:36. > :00:39.leads to inequality in health care. Some people will get health care for
:00:40. > :00:44.free and some won't. With NHS hospitals are learning more from
:00:45. > :00:53.Private treatments is a two tier system becoming a reality? It means
:00:54. > :00:57.NHS beds, services, staff once devoted to NHS patients are now
:00:58. > :01:02.being diverted to private care. And could your local pharmacy be under
:01:03. > :01:15.threat? Everything is going. We don't need the pharmacy to go.
:01:16. > :01:22.As many recent headlines have shown, the NHS is under colossal pressure
:01:23. > :01:26.at the moment. A combination of soaring demand and limited
:01:27. > :01:31.resources. The fallout from this is that increasingly treatment is being
:01:32. > :01:34.rationed regionally. But if the care available to patients depends more
:01:35. > :01:38.than ever on where we happen to live, can we still claim to have a
:01:39. > :01:47.truly national health? Chris Jackson investigates.
:01:48. > :01:52.The NHS is facing the most significant challenge in its
:01:53. > :01:57.history. There are fears the service we've grown up with is bidding to
:01:58. > :01:58.fragment. It is not a National Service. Absolutely there is a
:01:59. > :02:02.postcode lottery. This is the start -
:02:03. > :02:07.this is going to get worse. So, is the NHs in danger of ceasing
:02:08. > :02:10.to be a "National" service, where everyone is entitled
:02:11. > :02:13.to the same care? It's treating more patients,
:02:14. > :02:16.but is it becoming a postocde lottery, where access can
:02:17. > :02:23.depend on where you live? It feels like my bones
:02:24. > :02:36.are screaming at me at time. 33-year-old Ben Franklin
:02:37. > :02:37.has Hepatitis C. The virus can cause
:02:38. > :02:39.life-threatening liver damage. I could possibly lose
:02:40. > :02:50.the flat over my head. There are new drugs that could
:02:51. > :02:52.potentially cure Ben s Hepatitis. And just get absolutely
:02:53. > :03:06.wasted and ruin my liver, Buit I wouldbn't be surprised
:03:07. > :03:11.if somebody else would. The money is there for just
:03:12. > :03:14.over 10,000 treatments. It s claimed that means
:03:15. > :03:19.there are no queues in parts of the north, and long waits
:03:20. > :03:23.in places like London. Two people with exactly the same
:03:24. > :03:27.state of liver damage could present themselves in different
:03:28. > :03:30.parts of the country, and in one they'll be able to walk
:03:31. > :03:33.in and get Hepatitis C treatment immediately,
:03:34. > :03:34.and get cured. And in another part of the country,
:03:35. > :03:37.they may go there and be told, "Sorry, you're
:03:38. > :03:39.going to have to wait." NHS England told us it was regularly
:03:40. > :03:46.reallocating unused Hepatitis C treatments to places
:03:47. > :03:51.with waiting lists. The number of patients treated
:03:52. > :03:59.will increase by 25% next year. So Ben is taking the risk,
:04:00. > :04:09.of treating himself ? with cheaper The fact that I've had to pay
:04:10. > :04:28.for my treatment, it's criminal. Ben is hoping the generic drugs will
:04:29. > :04:52.kill him within a matter of weeks. -- cure him within a matter of
:04:53. > :04:58.weeks. The Hepatitis C Trust
:04:59. > :05:00.estimates that around 1,000 people in Britain may have
:05:01. > :05:03.bought the drugs abroad. If you go outside, there
:05:04. > :05:05.are halos around lights. Gloria McShane has
:05:06. > :05:12.cataracts in both eyes. Go up or down stairs
:05:13. > :05:18.with any kind of confidence. Cataracts are supposed
:05:19. > :05:21.to be treated within four Gloria, who lives in the north-east,
:05:22. > :05:29.says she s been waiting seven. It's too long, because there's such
:05:30. > :05:32.potential for accidents, and there's such a change
:05:33. > :05:37.in a person's mode. If Gloria had lived in Luton her
:05:38. > :05:40.wait could have been Absolutely there is
:05:41. > :05:48.a postcode lottery. It's not about clinical need,
:05:49. > :05:51.it's about some places in England having poor systems,
:05:52. > :05:56.having budgetary pressures and That doesn't feel too
:05:57. > :06:01."national" to me. Gloria expects to get her
:06:02. > :06:05.operation later this month. It really makes me angry
:06:06. > :06:08.because I think that it's almost Clinical Commissioning Groups,
:06:09. > :06:17.or CCGs, control health budgets. It s claimed some are delaying
:06:18. > :06:19.treatments like cataract surgery, Others are requiring patients
:06:20. > :06:25.to lose weight before getting Postponing an operation
:06:26. > :06:30.in the circumstances can And whilst the CCG's say it can be
:06:31. > :06:35."clinically justified", the Royal College of
:06:36. > :06:41.surgeons say it can't. There is very good evidence that
:06:42. > :06:44.people are now not getting elective operations simply because of
:06:45. > :06:51.financial restrictions. It is up to the clinicians
:06:52. > :06:54.to decide who should have what treatments, and therefore
:06:55. > :06:58.a bureaucratic system that produces a blanket
:06:59. > :07:03.ban is morally wrong. It s also claimed new systems
:07:04. > :07:06.for vetting appointments with specialists are another
:07:07. > :07:10.form of rationing. Why are they treating their patients
:07:11. > :07:15.with such contempt? Last month MPs complained
:07:16. > :07:17.about a private company being paid ?10 for every GP
:07:18. > :07:22.referral they stopped. This is rationing by the back door
:07:23. > :07:25.and has the potential to compromise The same private company oversees
:07:26. > :07:31.referrals in North Tyneside. We've spoken to doctors
:07:32. > :07:33.who say the system is The GPs who fear speaking out, have
:07:34. > :07:40.told us that cancer diagnoses are I tried to get a patient
:07:41. > :07:44.referred to a dermatologist. The referral management
:07:45. > :07:48.service said it was a It was a nasty,
:07:49. > :07:56.invasive skin cancer. They're putting up barriers,
:07:57. > :08:01.using delaying tactics. It's getting between the doctor
:08:02. > :08:08.and the specialist. In a statement, North Tyneside
:08:09. > :08:10.CCG said there was no evidence the system caused
:08:11. > :08:12.additional risk or delay. Cancer referrals do not go
:08:13. > :08:15.through the system and are made The number of referrals knocked back
:08:16. > :08:21.to GPs in England has risen You can see the details
:08:22. > :08:31.of our research online. The NHS is under an unprecedented
:08:32. > :08:34.level of pressure at the moment. If it doesn't get
:08:35. > :08:35.more funding, waiting times are going to get longer,
:08:36. > :08:38.the quality of patient So we will see different decisions
:08:39. > :08:42.taken in different parts of the country and different
:08:43. > :08:43.services being available So, is the NHS still
:08:44. > :08:49.a National Service? One of our most prominent
:08:50. > :08:52.medics is clear. I think it matters, because it leads
:08:53. > :09:00.to an equality in health care. Some people will get health care
:09:01. > :09:10.for free and others won't. It's a National Service
:09:11. > :09:14.with local variation In a statement, the Department of
:09:15. > :09:17.Health told us, far from rationing, more people than ever
:09:18. > :09:19.are getting prompt treatment. 3261 more cancer patients
:09:20. > :09:21.are being seen every day, We asked the Health Secretary and
:09:22. > :09:26.NHS England for an interview, both The people actually paying for NHS
:09:27. > :09:30.services, the typical commissioners, it
:09:31. > :09:33.did agree to speak. It's a National Service
:09:34. > :09:37.with local variation based on the needs of
:09:38. > :09:39.the Demographically, populations
:09:40. > :09:47.vary quite significantly We don't want to squander
:09:48. > :09:49.any money, we have limited resources,
:09:50. > :09:52.so it's really important that the very sources
:09:53. > :09:55.have we spent more effectively, getting the best value for our
:09:56. > :09:58.For those forced to take their own action rationing
:09:59. > :10:12.Still to come on tonight's show. We're talking of a cut of 12% in
:10:13. > :10:17.pharmacy budgets. For a lot of pharmacies that is a big hit. What
:10:18. > :10:18.you are going to see ultimately the Government doesn't change course is
:10:19. > :10:24.large-scale closures of pharmacies. An Inside Out London investigation
:10:25. > :10:28.has discovered that over the last five years,
:10:29. > :10:31.nearly all of the capital s NHS foundation hospitals have seen
:10:32. > :10:33.a significant rise in their income Many of us, it seems,
:10:34. > :10:37.are willing to pay ? often tens of thousands of pounds -
:10:38. > :10:40.to avoid long waiting lists or get Dr Ranj Singh asks if this
:10:41. > :10:45.is this a slippery slope towards a two-tier NHS,
:10:46. > :10:47.where less well-off patients When the NHS was first launched,
:10:48. > :10:57.back in 1948, it was founded on three core principles -
:10:58. > :11:02.that it met the needs of everyone, that it was free at the point
:11:03. > :11:05.of delivery, and that it was based on clinical need,
:11:06. > :11:09.not ability to pay. 69 years on, and campaigners warn
:11:10. > :11:13.that all three of those core principles are now under existential
:11:14. > :11:18.threat; in an NHS increasingly reliant on private services,
:11:19. > :11:23.private patients and private income. What people want to know
:11:24. > :11:26.is that you re going to get the services that you need,
:11:27. > :11:28.when you need them, free at the point of delivery
:11:29. > :11:32.because you ve paid for them, not that somebody is
:11:33. > :11:34.going to come and see You can have anything
:11:35. > :11:41.you want if you pay for it, But in a cash strapped NHS,
:11:42. > :11:47.do we really have the luxury of saying no to the profits
:11:48. > :11:50.of the private market? I don t think privatization needs
:11:51. > :11:54.to be something that is feared. Across the capital, income
:11:55. > :11:57.from private health care is booming, both in luxurious Harley Street
:11:58. > :12:00.clinics and, perhaps more surprisingly, within NHS
:12:01. > :12:07.hospitals themselves. The story really begins
:12:08. > :12:09.with the Health and Social Care Act 2012, which actually
:12:10. > :12:13.took away the duty form the Secretary of State to provide
:12:14. > :12:16.a national health service. The health and social care act,
:12:17. > :12:19.passed by the coalition Government, lifted a cap on non NHS income
:12:20. > :12:23.for foundation trusts from just 2% to 49%,
:12:24. > :12:33.effectively allowing some NHS hospitals to generate almost half
:12:34. > :12:35.of their incomes through private They are now incentivized,
:12:36. > :12:39.to say under their license we are going to actually cut,
:12:40. > :12:41.or delist the services Or we will reduce those
:12:42. > :12:47.services or we will reduce That then incentivises
:12:48. > :12:54.people to think, well, we better take out private health
:12:55. > :12:56.insurance or we better I understand the concerns that
:12:57. > :13:00.Allyson has, but the fact remains that the NHS is facing yet another
:13:01. > :13:03.year of massive pressures and as someone who works
:13:04. > :13:05.within the system every day, I can see how difficult it is
:13:06. > :13:09.becoming for patients and staff. So, is a revenue stream now
:13:10. > :13:14.generating almost 300 million pounds a year in London alone,
:13:15. > :13:16.actually an essential asset for an institution
:13:17. > :13:19.calling out for money? Or will it, as other fear,
:13:20. > :13:24.lead to a two tier system where those who can t pay
:13:25. > :13:27.are increasingly left behind? There is a sense amongst patients
:13:28. > :13:31.who can t afford to pay, of only if I had the money,
:13:32. > :13:34.I could jump the cue, We are not against private health
:13:35. > :13:40.care system, that is fine, the problem is our concern
:13:41. > :13:43.is for those who simply cannot begin to think
:13:44. > :13:48.of having private healthcare. Joe McKeever suffers
:13:49. > :13:51.from intense back pain, but the pain relief injections
:13:52. > :13:53.he used to receive, are no It s now got from three
:13:54. > :14:01.months, to six months, six months to nine months,
:14:02. > :14:05.now to a year between injections and OK for six months they work,
:14:06. > :14:09.and then after six months it starts People like me, who have been
:14:10. > :14:21.reliant on it for so long, all of a sudden stop,
:14:22. > :14:24.it's like taking someone's life Early last year Joe saw no options
:14:25. > :14:30.but to pay for a private It worked, but he says he can t
:14:31. > :14:33.afford to keep paying I was in pain, I needed some relief,
:14:34. > :14:38.and the only way to do You can have anything
:14:39. > :14:42.you want if you pay for it, I need it, I ve paid in my national
:14:43. > :14:52.insurance over the years, Our investigation discovered that
:14:53. > :14:58.over the past five years there has been a 22% increase in private
:14:59. > :15:01.patient numbers within NHS Foundation Trust hospital
:15:02. > :15:06.across the capital, over the last five years, and a 38% increase
:15:07. > :15:09.in private patient income. We showed Allyson some
:15:10. > :15:12.of these numbers. We looked at 14 foundation trust
:15:13. > :15:14.across London and looked at the amount of income
:15:15. > :15:17.they generate form private care within the NHS hospitals
:15:18. > :15:22.over five years. One that stands out,
:15:23. > :15:25.and this is only one example, is the Homerton Hospital,
:15:26. > :15:28.has increase its private income Now the caveat here is that it was
:15:29. > :15:38.half a million to start with, it s now ?1 million,
:15:39. > :15:40.so in absolute figures it might not be an huge amount,
:15:41. > :15:43.where as some other trust have increased it by tens
:15:44. > :15:45.of millions of pounds. And we can see this pattern
:15:46. > :15:47.now being replicated right across London,
:15:48. > :15:49.in varying proportions, but a huge increase,
:15:50. > :15:53.and this is what you going to expect to see over the next five to ten
:15:54. > :15:57.years, foundation trust will be looking to increase their income
:15:58. > :16:00.so that they are 49% private income and only 51%
:16:01. > :16:08.will be public patients. And that is very concerning,
:16:09. > :16:10.of course, because that means that NHS beds,
:16:11. > :16:12.services staffs, that were once dedicated to NHS patients,
:16:13. > :16:14.are now being diverted to private For some NHS trusts,
:16:15. > :16:18.private patient care has become so important,
:16:19. > :16:21.that they are opening up new multi million pound units both
:16:22. > :16:28.overseas and here in London. Just around the corner
:16:29. > :16:30.from here in the prestigious Harley Street area of London,
:16:31. > :16:32.is a brand new clinic that was opened late last year
:16:33. > :16:36.by the Royal Brompton, At the same time, the trust
:16:37. > :16:40.is facing remedial action, for missing NHS waiting list target
:16:41. > :16:45.at its main hospital site. Meanwhile the traditional private
:16:46. > :16:49.clinics around here are also seeing a significant rise in patient
:16:50. > :16:52.numbers, in part as a result It s inevitable that people
:16:53. > :17:00.are going to be let down by the NHS across a broad array of services,
:17:01. > :17:03.because the NHS can no longer provide all the things
:17:04. > :17:08.which the population had been led to have expectations that it
:17:09. > :17:16.might be able to do so. Across London, all NHS
:17:17. > :17:18.Foundation Trust hospitals now host separate private wings of their own,
:17:19. > :17:21.but Professor Ayliffe believes that traditional private clinics should
:17:22. > :17:26.welcome the emerging competition. Completion in the private sector
:17:27. > :17:33.is going to drive up standards, and improve care and I'm very
:17:34. > :17:37.pleased about that. I don't think privatization needs
:17:38. > :17:43.to be something that is feared. The private sector can be clever,
:17:44. > :17:46.it can be much more efficient at changing and adapting
:17:47. > :17:49.to different needs. That is the ability
:17:50. > :18:09.that the nationalized We are one of the richest countries
:18:10. > :18:14.in the world we can afford to pay for health service. We should be
:18:15. > :18:23.spending our money more wisely and not on all the Private for-profit
:18:24. > :18:27.companies. I've been a doctor for many years and I treat patients from
:18:28. > :18:31.allsorts of backgrounds. Some can afford to pay but many can't and I
:18:32. > :18:35.find myself increasingly conflicted. We are told that 100% of any surplus
:18:36. > :18:38.revenue generated from private patients at NHS foundation trusts,
:18:39. > :18:40.are reinvested back into the hospitals as a whole;
:18:41. > :18:42.hospitals that are facing a particular difficult
:18:43. > :18:43.financial environment. But I m not sure this
:18:44. > :18:46.is what the NHS is meant to be But I m not sure this is
:18:47. > :18:50.what the NHS is meant to be about - private patients subsidizing
:18:51. > :18:52.what would inevitably be But for me, perhaps the most
:18:53. > :18:58.frustrating thing of all is this, the people that run these hospitals
:18:59. > :19:00.and their private units across London, have all refused
:19:01. > :19:03.to talk to us.They have refused to argue their case for private
:19:04. > :19:06.patients, and it is this lack of transparency that raises so many
:19:07. > :19:09.suspicions and doubts. I believe when I was a kid the NHS
:19:10. > :19:13.for was a nonprofit organization, but now it's been turned
:19:14. > :19:33.into a multinational company. We all know how inundated with
:19:34. > :19:36.patient's GP's surgeries and any departments can get. That's why the
:19:37. > :19:40.Government is pushing for more of us to go to our local pharmacy form
:19:41. > :19:45.treatment of minor medical ailments. It makes sense. But some pharmacies,
:19:46. > :19:49.particularly those in the capital, are having to deal with huge cuts to
:19:50. > :19:56.their budgets, Poznan futures in jeopardy.
:19:57. > :19:58.This state of the art robot dispenses pills in this
:19:59. > :20:02.The machine maybe brand new, but this pharmacist has been
:20:03. > :20:06.here for 34 years and is one of the hubs of the community
:20:07. > :20:15.He listens and he has a kindly approach as well.
:20:16. > :20:18.He has always got a bit of a smile on his fizzog.
:20:19. > :20:21.Every time we need them they're here ready for us and sometimes
:20:22. > :20:23.there s a chance I don t even go to the GP.
:20:24. > :20:27.I say I got this or I got that - they help me out.
:20:28. > :20:30.My new born twins, one of them had quite a bad nappy rash
:20:31. > :20:32.and it was quite difficult to get a doctor's appointment.
:20:33. > :20:35.And the pharmacist we saw was quite useful at recommending something,
:20:36. > :20:41.so didn t need to see the GP, didn t need a prescription.
:20:42. > :20:44.We all know our GPs are completely overwhelmed and it can take days
:20:45. > :20:50.The Government is now trying to encourage more and more or us
:20:51. > :20:53.with simple illness such as coughs, colds and flu to go ands
:20:54. > :20:57.see a pharmacist before we bother our GP.
:20:58. > :21:00.Dilip Mehta is one such pharmacist trying to take some of the strain
:21:01. > :21:09.off local GPs by offering services that in the past only they could.
:21:10. > :21:17.where we sit down with the patients, discuss their medications.
:21:18. > :21:20.If there s any issues we send a report to the doctor
:21:21. > :21:28.When somebody s on a new medication, especially blood pressure medication
:21:29. > :21:32.or heart medication, we either call them in or we ring them up
:21:33. > :21:35.after a week or, if they need a blood pressure check,
:21:36. > :21:37.we tell them come and have a blood pressure check
:21:38. > :21:41.If it s a blood pressure medication we follow
:21:42. > :21:44.them up after a month, ask them if there s
:21:45. > :21:49.Can do that for you - are you registered
:21:50. > :21:52.Yes - in Chiswick, though, not round here.
:21:53. > :21:54.It's not a problem, though, we can do that for you.
:21:55. > :21:59.We have been doing flu service for the last few years - it has been
:22:00. > :22:04.They can come on a Saturday or thy can come whenever,
:22:05. > :22:09.This is what the customers like about it,
:22:10. > :22:13.so the uptake of flu services is quite high in pharmacies.
:22:14. > :22:15.Dillip's knowledge and awareness were vital when one woman
:22:16. > :22:24.He said, no, this is a serious matter.
:22:25. > :22:27.I don t want to scare you, I don t want to frighten
:22:28. > :22:31.She said yeah, yeah, I know, I made an appointment for two weeks.
:22:32. > :22:35.Please go to your GP and tell him urgent.
:22:36. > :22:41.to the GP and he said and he did give her when she told him the story
:22:42. > :22:45.Thank God Dr Warren saw her and she was referred
:22:46. > :22:48.to the hospital - a colonoscopy was done,
:22:49. > :22:56.You know, without this man maybe I die.
:22:57. > :23:01.He pushed me, he say, go away, take now -
:23:02. > :23:07.We thank God and we thank Mr Dilip for saving her life
:23:08. > :23:14.No wonder he is so well thought of in the local community
:23:15. > :23:19.but pharmacies cost us the tax payer over ?2.8 billion a year and now
:23:20. > :23:33.the Government is keen to reduce the bill and are making cuts.
:23:34. > :23:36.With around 90% of the income of pharmacies coming from the NHS
:23:37. > :23:40.many pharmacists say these cuts could put them out of business.
:23:41. > :23:47.Were talking of a cut of 12% in pharmacy budgets in the months
:23:48. > :23:52.December to March 2017 and more cuts to follow after that now for a lot
:23:53. > :24:01.What you will see ultimately if the Government doesn t change
:24:02. > :24:07.course could be large scale closures of pharmacies.
:24:08. > :24:11.Not all pharmacies will feel the full force of the cuts.
:24:12. > :24:13.You re offered some protection if you re the only chemist
:24:14. > :24:20.That means that the cuts could effect London very badly.
:24:21. > :24:26.Try travelling a mile in our busy metropolis
:24:27. > :24:29.Its not just the inner city that will be hit though,
:24:30. > :24:32.here in Hertfordshire this community pharmacy less than a mile
:24:33. > :24:37.from Harpenden is fighting to stay alive.
:24:38. > :24:40.This pharmacy and although it's the only pharmacy in the area and it
:24:41. > :24:42.serves the population of ten to 12 thousand people just
:24:43. > :24:50.because its marginally within the arbitrary one-mile limit
:24:51. > :24:52.of Harpenden, just short of a mile away
:24:53. > :24:57.will be subject to the full force of the cuts now that will leave
:24:58. > :24:59.the business non viable obviously I will not sign the lease
:25:00. > :25:03.on a business I know will not be able to pay its way
:25:04. > :25:11.and we will close in the next few months.
:25:12. > :25:15.This community we're serving here is 10,000 to 12,000 people.
:25:16. > :25:18.One of the things we know about a community that makes a micro
:25:19. > :25:21.economy work, you need a source of fresh food,
:25:22. > :25:30.a post office, and a source of health care.
:25:31. > :25:42.I would feel devastated because not only is it the pharmacy
:25:43. > :25:45.friends you know you build up a rapoor with people don t
:25:46. > :25:47.you everythings going we don t need the pharmacy to go.
:25:48. > :25:51.If I were to have to go to harpendon because this pharmacist had closed
:25:52. > :25:54.I would have to climb into my car and like many people and bear
:25:55. > :25:56.in mind that this pharmacist serves between 8,000 and 10,000
:25:57. > :25:59.people in the locality - you'd then have lots of car journeys
:26:00. > :26:01.into Harpendon that has an impact on the environment.
:26:02. > :26:05.It just seems strange to me that at a time when nhs funding is such
:26:06. > :26:08.a critical issue that pharmacist s who are able to provide expert
:26:09. > :26:15.advice on many many many issues maybe minor problems but if people
:26:16. > :26:18.don't get that advice in their local pharmacy, well,
:26:19. > :26:23.to their GP and that I would suggest is probably a much higher
:26:24. > :26:27.costly factor for the NHS than if they were getting
:26:28. > :26:30.over the counter advice from their local pharmacy.
:26:31. > :26:34.It doesn t make economic sense to me - it's quite absurd.
:26:35. > :26:37.So those local people are unsure of the effect on their daily life
:26:38. > :26:43.And it seems the Government are just as unsure.
:26:44. > :26:47.In a report signed off three months ago, by the under secretary of state
:26:48. > :26:49.for the Department of Health they said they couldn t estimate
:26:50. > :26:53.the economic cost to patients having to travel to pharmacies nor
:26:54. > :26:57.could they estimate the number of pharmacies that might have
:26:58. > :27:00.We asked them if they know knew what the effect
:27:01. > :27:06.They told us, "Our modernisation package will not jeopardise
:27:07. > :27:09.the quality of services provided but will protect patient access
:27:10. > :27:14.in areas where there are fewer pharmacies and higher health needs,
:27:15. > :27:17.meaning no area will be left without access
:27:18. > :27:24.You can't help but wonder what s going on here -
:27:25. > :27:27.one minute it's "use your local pharmacist" and the next
:27:28. > :27:32.but one thing is for certain - with our growing and ageing
:27:33. > :27:38.population, we are going to need our pharmacists more than ever before.
:27:39. > :27:40.So let's hope that some sensible and realistic decisions
:27:41. > :27:56.And that just about wraps up tonight 's health care special. Before we
:27:57. > :28:01.go, let's look at what is coming up on next week's programme. We
:28:02. > :28:06.investigate why the West Ham stadium deal continues to be a burden on
:28:07. > :28:11.taxpayers. As far as I can see, there is no end to taxpayer's money
:28:12. > :28:17.being used to prop up this white elephant. How a high-speed rail link
:28:18. > :28:22.cutting across this oasis could damage wildlife. I hate what they're
:28:23. > :28:25.doing it. I'm so scared of the destruction of this perfect habitat.
:28:26. > :28:30.And we go behind-the-scenes at a London icon. If using the thousands
:28:31. > :28:34.of people who travel over the bridge and through the bridge and river
:28:35. > :28:40.every day. None of them are aware of this massive space that exists here.
:28:41. > :28:47.And that is all from this week's Inside Out. If you missed any after
:28:48. > :28:53.nights's show, head to our website. The address is on screen. Thank you
:28:54. > :29:04.for watching. We'll see you next week.
:29:05. > :29:07.Hello, I'm Louisa Preston with your 90 second update.
:29:08. > :29:09.30 British tourists shot dead in Tunisia in 2015.
:29:10. > :29:12.Today, an inquest was told that security forces
:29:13. > :29:17.Donald Trump provokes a mixed reaction.
:29:18. > :29:20.Downing Street welcomes the promise of a "quick and fair" trade deal.
:29:21. > :29:22.But foreign ministers are concerned by his comments
:29:23. > :29:29.It follows the collapse of the power-sharing Government.
:29:30. > :29:31.Sinn Fein refused to nominate a new deputy first minister.
:29:32. > :29:35.Martin McGuinness resigned in a dispute with the DUP.
:29:36. > :29:37.The former football coach Barry Bennell,
:29:38. > :29:41.who worked at Crew Alexandra, has pleaded not guilty to eight