:00:00. > :00:07.We are on the rounds with the Cumbrian consultant trying
:00:08. > :00:11.to find a cure for the doctor shortage.
:00:12. > :00:14.One thing we have to do is ask all the doctors I meet
:00:15. > :00:17.whether they are willing to work extra hours this weekend.
:00:18. > :00:20.I have to be aware of the stress they are under as well.
:00:21. > :00:24.I have asked somebody that and they burst into tears.
:00:25. > :00:27.But if we look abroad for the fix, who is left to treat
:00:28. > :00:39.Also tonight - the anguish when a loved one disappears.
:00:40. > :00:44.We follow one Tyneside father's quest to find his missing son.
:00:45. > :00:53.Looking out this window, I am thinking, where is Michael?
:00:54. > :01:06.I am Chris Jackson and this is Inside Out.
:01:07. > :01:09.Hospitals across the North are reporting a major shortage
:01:10. > :01:15.A survey for Inside Out suggests one of the biggest crises
:01:16. > :01:19.is that of the North Cumbria Trust, where almost a quarter of posts
:01:20. > :01:25.For those that are there, that brings added pressure,
:01:26. > :01:28.and this is the story of one consultant working across four wards
:01:29. > :01:40.Joanna Cox has been an elderly care consultant here
:01:41. > :01:48.I am a bit tired but it is Friday so that is a really good thing.
:01:49. > :01:51.Staff shortages mean Joanna will look after her elderly patients
:01:52. > :01:57.and also work in another three departments today.
:01:58. > :02:01.The rota here for the medical staff at all grades is quite fragile
:02:02. > :02:04.because of our dependence on locums, so we tend
:02:05. > :02:09.A survey for Inside Out last December showed that
:02:10. > :02:14.across the North almost 7% of posts for doctors and nurses were vacant.
:02:15. > :02:23...where it was 24% for doctors and 45% for consultants
:02:24. > :02:30.Today, those shortages will pass Joanna's skills and her fitness.
:02:31. > :02:33.One porter claimed to have done 11 miles in a shift.
:02:34. > :02:38.I don't have time to go to the gym so it is good to keep running about.
:02:39. > :02:40.Now, handover at the Emergency Assessment Unit.
:02:41. > :02:42.He was sick as a chick yesterday, profoundly hypertensive,
:02:43. > :02:46.and he looked like he was in failure with ongoing chest pain...
:02:47. > :02:52.Joanna gets a call to her Elderly Care ward,
:02:53. > :02:59.Morning. You all right?
:03:00. > :03:01.We have been a bit worried about you.
:03:02. > :03:06.I like you. Bless you.
:03:07. > :03:11.I do. Oh, bless you.
:03:12. > :03:15.That's a very frail lady who seemed to improve but then has
:03:16. > :03:20.We have checked all the obvious treatable causes of that and have
:03:21. > :03:33.I think we need to sit tight and see how she goes.
:03:34. > :03:34.There are more patients here to assess.
:03:35. > :03:40.because I think right now I am going to have the time
:03:41. > :03:42.that I need to assess this lady.
:03:43. > :03:45.Yesterday I felt much less in control.
:03:46. > :03:47.How does the breathing feel just now?
:03:48. > :03:50.You're not coughing up any horrible stuff?
:03:51. > :03:55.I was planning to see four people on that ward.
:03:56. > :03:58.I have seen three but they have called me to
:03:59. > :04:07.So, pain in the chest, is that right, yeah?
:04:08. > :04:14.OK, and have you had chest infection symptoms?
:04:15. > :04:15.Cold symptoms? No, OK.
:04:16. > :04:22.Right, the question is whether this could be a blood clot on the lung.
:04:23. > :04:26.So the question is whether we need to get a scan of your lungs to make
:04:27. > :04:34.In emergency admissions, they have a staffing problem.
:04:35. > :04:38.I can't do Sunday day but through the week...
:04:39. > :04:41.We have had staffing shortages and difficulty recruiting
:04:42. > :04:47.Unfortunately, we have just got to try and do what we are doing now
:04:48. > :04:52.We are a long way from the cities, and places where people
:04:53. > :05:01.want to build their lives, and too many of our consultant
:05:02. > :05:03.workforce are locums, and the trainee doctors,
:05:04. > :05:04.can only be supervised by certified consultants,
:05:05. > :05:09.The trust also has a history and that is a major cause
:05:10. > :05:14.Staff told Inside Out last year that transferring services to Carlisle
:05:15. > :05:20.was hard on patients - a claim that the trust denies.
:05:21. > :05:24.North Cumbria is one of three areas targeted by the NHS success regime.
:05:25. > :05:30.If you have a reputation issue then some doctors won't want to
:05:31. > :05:34.If they don't come and work here, then you have a difficulty
:05:35. > :05:38.What are you actually doing to the process?
:05:39. > :05:41.The first thing is trying to create a new partnership with doctors
:05:42. > :05:46.So that when there is a place in difficulty, doctors will come
:05:47. > :05:52.from different parts of the NHS instead of locums.
:05:53. > :05:55.We need to build a reputation that this is the right place to come
:05:56. > :06:03.This is the right place to pursue a special interest.
:06:04. > :06:06.It is nearly 12 now and I am now back to the unit that I started
:06:07. > :06:12.Right, so I have got for people to see here,
:06:13. > :06:18.Our worry is that this pancreas problem is lingering.
:06:19. > :06:26.We need to decide whether we just battle on the antibiotics,
:06:27. > :06:29.which might well be what we do, or whether actually we need to think
:06:30. > :06:36.I don't think they are letting it show, being under pressure.
:06:37. > :06:41.They are just trying to get on with it.
:06:42. > :06:45.I've got about four patients I already know I need
:06:46. > :06:49.I am going to get some lunch, which is good, because yesterday
:06:50. > :06:59.We are very short on nursing staff in the ward so one thing to do is go
:07:00. > :07:01.round this afternoon and ask all the doctors I meet
:07:02. > :07:05.whether they are willing to work extra hours this weekend.
:07:06. > :07:08.I need to check who is already scheduled to work because it
:07:09. > :07:11.will just annoy them if I go, can you work an extra shift?
:07:12. > :07:17.You don't want to work extra hours this weekend, do you?
:07:18. > :07:24.Yes, that is OK, or any hours, 95 or...
:07:25. > :07:32.Great, so that was the second person I asked.
:07:33. > :07:37.The stress that they are under as well.
:07:38. > :07:42.So it has happened that I have asked somebody that then burst into tears.
:07:43. > :07:57.So far, Joanna has covered three different departments.
:07:58. > :08:02.Now she is called to a surgical ward.
:08:03. > :08:05.There is not a junior doctor present so it is the consultant practitioner
:08:06. > :08:08.who is looking after the patient on this ward.
:08:09. > :08:11.I think we are thinking at the stairs might be a bit
:08:12. > :08:14.of a worry for you at home so I think that is what we will do
:08:15. > :08:18.Think about a bed downstairs and then we will get you home.
:08:19. > :08:22.I was going to say, it will have to...
:08:23. > :08:25.They do work very, very hard, all of them.
:08:26. > :08:31.They are always happy to do things for you.
:08:32. > :08:36.I think everybody is working very hard.
:08:37. > :08:40.I work with people I respect and trust and I also really
:08:41. > :08:43.like them, so people are vigilant for signs of stress in each other
:08:44. > :08:52.But high-pressure work like this could put job applicants.
:08:53. > :08:58.Is it not a fact that Cumbria is on regrettable now?
:08:59. > :09:01.There are junior doctors coming to work here.
:09:02. > :09:04.All the services are under review to make sure that there
:09:05. > :09:07.is a contingency plan, and to make sure that we can cope.
:09:08. > :09:09.In the meantime, there are lots of locums in place.
:09:10. > :09:18.We are finding a way of making the services work safely.
:09:19. > :09:21.North Cumbria may be top of the list when it comes to vacancies
:09:22. > :09:24.but our survey shows that other trusts are having problems.
:09:25. > :09:26.County Durham and Darlington trust, have had 13% of doctors posts
:09:27. > :09:34.At York Teaching Hospital, it was 11%, and at South Tyneside
:09:35. > :09:39.After checking more patients, Joanna heads back to the office.
:09:40. > :09:48.Yay! Good.
:09:49. > :09:55.An afternoon's worth of e-mails need processing.
:09:56. > :09:57.We are running at close to personal capacity for working.
:09:58. > :09:59.The really bad days, I have snapped at staff,
:10:00. > :10:03.6.20pm, and Joanna's working day ends.
:10:04. > :10:07.I did everything that I wanted to do to day.
:10:08. > :10:09.I had lunch today so that is brilliant.
:10:10. > :10:11.I will go home, Friday evening, possibly have a glass
:10:12. > :10:23.That survey suggested that almost three quarters of trusts
:10:24. > :10:25.across England will try to fix that serious shortage in medical staff
:10:26. > :10:35.But, by luring foreign doctors here, is the NHS simply creating
:10:36. > :10:42.I have been to one Eastern European country to ask if we are getting
:10:43. > :10:43.their doctors on the cheap, without any regard
:10:44. > :11:09.Did your tummy get bigger, basically?
:11:10. > :11:13.It is a world-class health system, the NHS.
:11:14. > :11:17.I get an opportunity to learn something new and not worry
:11:18. > :11:26.Leon Danaila practices brain surgery back in Romania.
:11:27. > :11:28.TRANSLATION: I don't have a large fortune.
:11:29. > :11:34.I think I am the poorest doctor in the world.
:11:35. > :11:40.The rich, the NHS, sucks in talent from around the world at the expense
:11:41. > :11:56.Leon Danaila is removing a brain tumour.
:11:57. > :12:04.TRANSLATION: If the doctor is in good health, it is good
:12:05. > :12:20.He is one of thousands who could not retire even if they wanted to.
:12:21. > :12:30.It means medicine in Romania is increasingly becoming
:12:31. > :12:37.Last year, there were more than 8500 doctors over the age of 60.
:12:38. > :12:46.Compare that with 1,300 under the age of 30.
:12:47. > :12:50.Across Bucharest, students from the Carol Davila medical school.
:12:51. > :12:55.In Britain, it costs just under ?200,000 to train a medic.
:12:56. > :12:59.But it costs next to nothing to take one ready trained from here.
:13:00. > :13:04.So, in effect, Romania is subsidising our health service.
:13:05. > :13:16.The United Kingdom is on top of my list.
:13:17. > :13:21.My first and, technically, only choice, is the UK.
:13:22. > :13:25.They will join around 2,000 Romanians practising in Britain.
:13:26. > :13:30.They can earn ten times what they get here.
:13:31. > :13:35.The high wage is really the main reason I would go abroad.
:13:36. > :13:39.And there is another way that Romania subsidises the NHS.
:13:40. > :13:43.Believe it or not, there are British students training here in Bucharest.
:13:44. > :13:45.Britain limits its medical school places.
:13:46. > :13:48.It even cut than three years ago, because the Government thought
:13:49. > :13:52.there would be too many hospital doctors in future.
:13:53. > :13:54.So, British students rejected by our medical schools come
:13:55. > :13:56.to countries like Romania instead.
:13:57. > :14:02.Once they are qualified, we snapped them up, despite seeing
:14:03. > :14:06.Like Arran Williamson, who has been studying
:14:07. > :14:13.And Anil Velivela who has been here for three.
:14:14. > :14:16.I didn't get a place at a UK university and I read
:14:17. > :14:19.about the opportunities to study abroad.
:14:20. > :14:20.The classes themselves are in English.
:14:21. > :14:28.I will be fully qualified to do the job.
:14:29. > :14:31.It is a little loophole and I was very surprised when I read
:14:32. > :14:34.about it but it benefits me so I am happy about it.
:14:35. > :14:36.Like the Romanians, they have training which also costs
:14:37. > :14:45.Back with our doctors, Leon and Luisa.
:14:46. > :14:59.Both are concerned about the exodus of medics to countries like Britain.
:15:00. > :15:02.TRANSLATION: Yes, they are a loss to the Romanian health system.
:15:03. > :15:09.We are not encouraging enough junior doctors to stay and it is not only
:15:10. > :15:14.about the pay, it is about investing in the hospitals.
:15:15. > :15:22.Proper services to support the patients.
:15:23. > :15:24.Our hospitals scour the world with shopping lists of doctors.
:15:25. > :15:27.Mark has made it his business to supply them with talent.
:15:28. > :15:34.There are hundreds and thousands of agencies who are
:15:35. > :15:38.The most sought after specialties are acute medicine, accident
:15:39. > :15:39.and emergency, anesthesia, intensive care, paediatrics,
:15:40. > :15:51.Across Bucharest, 87-year-old cardiologist Leonida Gherasim.
:15:52. > :15:57.It is claimed that poaching the young is making health care
:15:58. > :15:59.dangerous. He not only lose individuals,
:16:00. > :16:02.you lose their capacity In great towns, maybe
:16:03. > :16:08.there are enough doctors, but in important towns with more
:16:09. > :16:11.than 100,000 inhabitants, the medicine in these places
:16:12. > :16:18.is done with danger. That is because specialists have
:16:19. > :16:22.to work in areas they know little about - for example,
:16:23. > :16:24.cardiologists could be required Short and medium-term,
:16:25. > :16:37.I want to train and to I will give a phone call
:16:38. > :16:45.to your wife to tell her It is a privilege to help my
:16:46. > :16:49.patients and to be It is both a duty
:16:50. > :16:56.and a pleasure, yes. In Bucharest, Leon's patient has
:16:57. > :17:00.regained consciousness. Tes, certain illnesses or situations
:17:01. > :17:21.could make me step aside. With the present trend,
:17:22. > :17:32.many of the doctors we will meet over the next decade will no doubt
:17:33. > :17:36.come from places like Romania. The question is, should Britain
:17:37. > :17:41.expand its medical schools or is it just cheaper and easier to rely
:17:42. > :17:43.on poorer countries like Romania Doctors have always supported
:17:44. > :17:50.free movement of labour. The British Medical Association
:17:51. > :17:52.is concerned about the effect Overseas doctors have always been
:17:53. > :18:01.the backbone of the National Health I do get worried when I hear
:18:02. > :18:06.about the way in which we can go abroad and deliberately recruit too
:18:07. > :18:09.many people to the extent that there are some countries
:18:10. > :18:11.where a substantial proportion of their doctors are coming to work
:18:12. > :18:13.in the United Kingdom. It could be worrying, I think,
:18:14. > :18:15.for those countries, because we're not
:18:16. > :18:18.doing them a service. Early last December, we ask
:18:19. > :18:21.the Health Secretary Jeremy Hunt for an interview to discuss
:18:22. > :18:24.the issues raised here. A month and a half
:18:25. > :18:27.later, he declined. So, we asked the Health
:18:28. > :18:29.Minister Ben Gummer, and last week, almost
:18:30. > :18:33.a month later, he declined. We wanted to ask them
:18:34. > :18:36.on your behalf, why we can't train Would the system collapse
:18:37. > :18:42.without the foreign staff? And is it wrong to exploit
:18:43. > :18:44.the health systems The Department of Health did issue
:18:45. > :18:53.a statement which said staffing was a priority and there are now
:18:54. > :18:56.more than 10,700 additional And more than 55,000
:18:57. > :19:00.doctors in training. Overseas staff are crucial
:19:01. > :19:04.to the NHS but we must also train Experts were reviewing the number
:19:05. > :19:12.of medical degree places. It is pretty clear that in places
:19:13. > :19:14.like Romania that review Whether by Twitter or e-mail,
:19:15. > :19:24.that we know what you think about how the NHS is trying to cope
:19:25. > :19:27.with the doctor shortage. All my contact details
:19:28. > :19:37.are on screen now. Hardly a week goes by without a news
:19:38. > :19:40.story about someone Police investigated thousands
:19:41. > :19:45.of cases across the Northeast Most are found within a matter
:19:46. > :19:50.of days but for some the agonising As we discovered when we follow one
:19:51. > :19:57.Tyneside father who is desperate Every two minutes,
:19:58. > :20:08.someone in Britain disappears. Most will be found but, every year,
:20:09. > :20:11.2,000 people who go missing This is Michael's home and he lived
:20:12. > :20:35.here until he was last seen He was just staying up most nights
:20:36. > :20:48.and listening to music. I lent him this Fleetwood Mac album
:20:49. > :20:54.and I had had a bit of bother trying Whenever I left here
:20:55. > :21:06.it was, love you, dad. When I think about it,
:21:07. > :21:09.it is a bit upsetting, but that was just the sort
:21:10. > :21:12.of person he was. I never told him but
:21:13. > :21:26.I should have done. When he was 17 years old,
:21:27. > :21:29.his mother died in his And I think a traumatic experience
:21:30. > :21:37.like that can affect anybody. He suffered what they call
:21:38. > :21:40.a psychosis, which I was ignorant This is the last sighting of Michael
:21:41. > :21:51.on CCTV three months ago. Paul believes his son
:21:52. > :21:55.could be anywhere in the UK. We did set up a Facebook account
:21:56. > :22:00.called Help Find Michael Whinham. We have had a fantastic response
:22:01. > :22:05.throughout the country. A message has been posted which says
:22:06. > :22:08.that a man looking like his son has been spotted in the
:22:09. > :22:11.North of Scotland. And the lady in Elgin said
:22:12. > :22:16.on the Thursday she was shopping and she said she recognised
:22:17. > :22:22.Michael's face. He's my son and obviously he has got
:22:23. > :22:32.a problem and I don't know what that problem is so,
:22:33. > :22:34.being a father, I would go In Elgin, Paul puts up posters
:22:35. > :22:46.and talks to locals but there is Without any fresh leads,
:22:47. > :22:53.Paul has come to Northumbria Police to talk to the officer
:22:54. > :22:56.handling the case. More recently, we have had
:22:57. > :22:59.a sighting in the Metro In general, obviously,
:23:00. > :23:06.we are keeping our mind open The thing that has got everybody
:23:07. > :23:12.mystified is the fact that, When there is money going
:23:13. > :23:16.into the bank account? From our point of view,
:23:17. > :23:19.we need people to come forward if they have got a sighting or any
:23:20. > :23:21.relevant information, to bring that forward to us,
:23:22. > :23:25.so we can act upon that. When does it come to a point that
:23:26. > :23:28.you think you have done enough? If we get information and that
:23:29. > :23:31.comes in, we will follow If it comes a point where that
:23:32. > :23:34.information is drying up, then we haven't got very much
:23:35. > :23:37.that we can act upon, but we do have a process in place
:23:38. > :23:40.where we reviewed them monthly, and then yearly after that,
:23:41. > :23:45.but we always keep them open. Michael is just one of the 40
:23:46. > :23:48.long-term missing people that Helen It is really difficult
:23:49. > :23:54.for the family, day in, day out, not knowing what has happened
:23:55. > :23:56.to their loved one. Paul is regularly on the telephone
:23:57. > :23:59.to us, on a weekly basis, daily basis, just going over things
:24:00. > :24:02.that have happened or It is frustrating, from one point
:24:03. > :24:10.of view, that there has been no progress, but sometimes
:24:11. > :24:19.no news is good news. Because if anything seems to be
:24:20. > :24:21.wrong happened to Michael, The more time passes,
:24:22. > :24:25.the longer the torment. Paul is having to face up
:24:26. > :24:28.to the possibility it may take Today, he is meeting
:24:29. > :24:33.Sandra Flintoff. Her son Craig went missing
:24:34. > :24:37.in Loughborough in 2003. I still get very tearful and I can
:24:38. > :24:47.still become very upset. Basically, it is affecting
:24:48. > :24:51.your whole life, really. Absolutely, your full life
:24:52. > :24:53.is turned upside down. But in my heart, I know that my boy
:24:54. > :24:56.would not want to hurt us And if Craig is out there,
:24:57. > :25:00.I think he will be very surprised at just how distressed
:25:01. > :25:02.and hurt we have been. Because, you know,
:25:03. > :25:04.they are your children, and it doesn't matter how
:25:05. > :25:11.old they get, you do not When you haven't got a final answer,
:25:12. > :25:20.your mind works double overtime and you start thinking of the bad
:25:21. > :25:23.things that they could have possibly
:25:24. > :25:24.happened... I have been to the negatives
:25:25. > :25:28.and you go through some terrible, terrible times, if your son
:25:29. > :25:31.is in fine, and I hope You feel as if you can't
:25:32. > :25:35.start living again. Life has to go on and 13 years down
:25:36. > :25:40.the line we are still here. Someone once said to me,
:25:41. > :25:46.it is like a prodigal son And I just looked at this person
:25:47. > :25:53.and said, I would open my arms My advice to you is,
:25:54. > :25:59.just let people help you. Because you can't do it
:26:00. > :26:03.all by yourself. That was a really, really helpful
:26:04. > :26:05.experience with Sandra, because Michael, although he has
:26:06. > :26:10.been missing three months, and it seems a long time,
:26:11. > :26:13.but when Craig has been missing 13 years, Sandra is still thinking
:26:14. > :26:16.positively, and it gives me Paul is determined to leave no stone
:26:17. > :26:27.unturned on the hunt for his son. Looking out this window,
:26:28. > :26:34.thinking, where is Michael? He has travelled to London,
:26:35. > :26:41.the base for the country's only charity aimed at reuniting
:26:42. > :26:44.missing people and their families. We are here for you and the family
:26:45. > :26:51.of anyone who has gone We can produce publicity,
:26:52. > :26:57.with the police, where we create a poster of Michael and we can then
:26:58. > :27:05.distribute that across the country. Publicity really is there to reach
:27:06. > :27:08.out to this person themselves. The messaging on the poster
:27:09. > :27:11.is directed to the missing person, to say, we are here for
:27:12. > :27:15.you if you need help, Obviously, my first priority
:27:16. > :27:21.is to find out if my son He might not want to come home,
:27:22. > :27:25.which is his choice. That is where our
:27:26. > :27:28.helplines come into it. If they want to let their family
:27:29. > :27:31.know they are OK, we can take a message and we can pass that
:27:32. > :27:34.onto the family member So, just before we go, we have got,
:27:35. > :27:39.hot off the presses, this is the poster we have
:27:40. > :27:41.created for Michael. We have done a few of them,
:27:42. > :27:44.so you can take some with you. People can also download this
:27:45. > :27:47.from the website as well, so if you have got family
:27:48. > :27:49.and friends who want to, they can, and we will also show
:27:50. > :27:52.that on social media, Paul is finding it hard to come
:27:53. > :28:07.to terms with the chance that he may I think he has just got something
:28:08. > :28:14.to do with his head and things have I don't know what the state
:28:15. > :28:22.of his mental health is at the moment but I sincerely
:28:23. > :28:25.believe you still alive. Until we have a body,
:28:26. > :28:28.as far as I am concerned, And, of course, if Michael is found,
:28:29. > :28:39.we will be sure to let you know,