29/02/2016 Inside Out North East and Cumbria


29/02/2016

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Transcript


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We are on the rounds with the Cumbrian consultant trying

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to find a cure for the doctor shortage.

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One thing we have to do is ask all the doctors I meet

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whether they are willing to work extra hours this weekend.

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I have to be aware of the stress they are under as well.

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I have asked somebody that and they burst into tears.

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But if we look abroad for the fix, who is left to treat

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Also tonight - the anguish when a loved one disappears.

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We follow one Tyneside father's quest to find his missing son.

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Looking out this window, I am thinking, where is Michael?

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I am Chris Jackson and this is Inside Out.

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Hospitals across the North are reporting a major shortage

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A survey for Inside Out suggests one of the biggest crises

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is that of the North Cumbria Trust, where almost a quarter of posts

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For those that are there, that brings added pressure,

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and this is the story of one consultant working across four wards

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Joanna Cox has been an elderly care consultant here

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I am a bit tired but it is Friday so that is a really good thing.

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Staff shortages mean Joanna will look after her elderly patients

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and also work in another three departments today.

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The rota here for the medical staff at all grades is quite fragile

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because of our dependence on locums, so we tend

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A survey for Inside Out last December showed that

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across the North almost 7% of posts for doctors and nurses were vacant.

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..where it was 24% for doctors and 45% for consultants

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Today, those shortages will pass Joanna's skills and her fitness.

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One porter claimed to have done 11 miles in a shift.

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I don't have time to go to the gym so it is good to keep running about.

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Now, handover at the Emergency Assessment Unit.

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He was sick as a chick yesterday, profoundly hypertensive,

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and he looked like he was in failure with ongoing chest pain...

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Joanna gets a call to her Elderly Care ward,

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Morning. You all right?

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We have been a bit worried about you.

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I like you. Bless you.

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I do. Oh, bless you.

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That's a very frail lady who seemed to improve but then has

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We have checked all the obvious treatable causes of that and have

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I think we need to sit tight and see how she goes.

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There are more patients here to assess.

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because I think right now I am going to have the time

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that I need to assess this lady.

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Yesterday I felt much less in control.

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How does the breathing feel just now?

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You're not coughing up any horrible stuff?

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I was planning to see four people on that ward.

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I have seen three but they have called me to

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So, pain in the chest, is that right, yeah?

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OK, and have you had chest infection symptoms?

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Cold symptoms? No, OK.

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Right, the question is whether this could be a blood clot on the lung.

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So the question is whether we need to get a scan of your lungs to make

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In emergency admissions, they have a staffing problem.

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I can't do Sunday day but through the week...

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We have had staffing shortages and difficulty recruiting

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Unfortunately, we have just got to try and do what we are doing now

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We are a long way from the cities, and places where people

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want to build their lives, and too many of our consultant

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workforce are locums, and the trainee doctors,

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can only be supervised by certified consultants,

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The trust also has a history and that is a major cause

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Staff told Inside Out last year that transferring services to Carlisle

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was hard on patients - a claim that the trust denies.

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North Cumbria is one of three areas targeted by the NHS success regime.

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If you have a reputation issue then some doctors won't want to

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If they don't come and work here, then you have a difficulty

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What are you actually doing to the process?

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The first thing is trying to create a new partnership with doctors

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So that when there is a place in difficulty, doctors will come

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from different parts of the NHS instead of locums.

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We need to build a reputation that this is the right place to come

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This is the right place to pursue a special interest.

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It is nearly 12 now and I am now back to the unit that I started

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Right, so I have got for people to see here,

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Our worry is that this pancreas problem is lingering.

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We need to decide whether we just battle on the antibiotics,

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which might well be what we do, or whether actually we need to think

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I don't think they are letting it show, being under pressure.

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They are just trying to get on with it.

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I've got about four patients I already know I need

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I am going to get some lunch, which is good, because yesterday

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We are very short on nursing staff in the ward so one thing to do is go

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round this afternoon and ask all the doctors I meet

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whether they are willing to work extra hours this weekend.

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I need to check who is already scheduled to work because it

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will just annoy them if I go, can you work an extra shift?

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You don't want to work extra hours this weekend, do you?

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Yes, that is OK, or any hours, 95 or...

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Great, so that was the second person I asked.

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The stress that they are under as well.

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So it has happened that I have asked somebody that then burst into tears.

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So far, Joanna has covered three different departments.

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Now she is called to a surgical ward.

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There is not a junior doctor present so it is the consultant practitioner

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who is looking after the patient on this ward.

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I think we are thinking at the stairs might be a bit

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of a worry for you at home so I think that is what we will do

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Think about a bed downstairs and then we will get you home.

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I was going to say, it will have to...

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They do work very, very hard, all of them.

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They are always happy to do things for you.

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I think everybody is working very hard.

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I work with people I respect and trust and I also really

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like them, so people are vigilant for signs of stress in each other

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But high-pressure work like this could put job applicants.

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Is it not a fact that Cumbria is on regrettable now?

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There are junior doctors coming to work here.

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All the services are under review to make sure that there

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is a contingency plan, and to make sure that we can cope.

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In the meantime, there are lots of locums in place.

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We are finding a way of making the services work safely.

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North Cumbria may be top of the list when it comes to vacancies

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but our survey shows that other trusts are having problems.

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County Durham and Darlington trust, have had 13% of doctors posts

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At York Teaching Hospital, it was 11%, and at South Tyneside

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After checking more patients, Joanna heads back to the office.

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Yay! Good.

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An afternoon's worth of e-mails need processing.

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We are running at close to personal capacity for working.

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The really bad days, I have snapped at staff,

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6.20pm, and Joanna's working day ends.

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I did everything that I wanted to do to day.

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I had lunch today so that is brilliant.

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I will go home, Friday evening, possibly have a glass

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That survey suggested that almost three quarters of trusts

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across England will try to fix that serious shortage in medical staff

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But, by luring foreign doctors here, is the NHS simply creating

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I have been to one Eastern European country to ask if we are getting

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their doctors on the cheap, without any regard

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Did your tummy get bigger, basically?

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It is a world-class health system, the NHS.

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I get an opportunity to learn something new and not worry

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Leon Danaila practices brain surgery back in Romania.

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TRANSLATION: I don't have a large fortune.

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I think I am the poorest doctor in the world.

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The rich, the NHS, sucks in talent from around the world at the expense

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Leon Danaila is removing a brain tumour.

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TRANSLATION: If the doctor is in good health, it is good

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He is one of thousands who could not retire even if they wanted to.

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It means medicine in Romania is increasingly becoming

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Last year, there were more than 8500 doctors over the age of 60.

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Compare that with 1,300 under the age of 30.

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Across Bucharest, students from the Carol Davila medical school.

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In Britain, it costs just under ?200,000 to train a medic.

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But it costs next to nothing to take one ready trained from here.

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So, in effect, Romania is subsidising our health service.

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The United Kingdom is on top of my list.

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My first and, technically, only choice, is the UK.

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They will join around 2,000 Romanians practising in Britain.

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They can earn ten times what they get here.

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The high wage is really the main reason I would go abroad.

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And there is another way that Romania subsidises the NHS.

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Believe it or not, there are British students training here in Bucharest.

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Britain limits its medical school places.

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It even cut than three years ago, because the Government thought

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there would be too many hospital doctors in future.

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So, British students rejected by our medical schools come

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to countries like Romania instead.

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Once they are qualified, we snapped them up, despite seeing

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Like Arran Williamson, who has been studying

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And Anil Velivela who has been here for three.

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I didn't get a place at a UK university and I read

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about the opportunities to study abroad.

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The classes themselves are in English.

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I will be fully qualified to do the job.

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It is a little loophole and I was very surprised when I read

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about it but it benefits me so I am happy about it.

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Like the Romanians, they have training which also costs

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Back with our doctors, Leon and Luisa.

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Both are concerned about the exodus of medics to countries like Britain.

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TRANSLATION: Yes, they are a loss to the Romanian health system.

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We are not encouraging enough junior doctors to stay and it is not only

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about the pay, it is about investing in the hospitals.

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Proper services to support the patients.

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Our hospitals scour the world with shopping lists of doctors.

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Mark has made it his business to supply them with talent.

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There are hundreds and thousands of agencies who are

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The most sought after specialties are acute medicine, accident

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and emergency, anesthesia, intensive care, paediatrics,

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Across Bucharest, 87-year-old cardiologist Leonida Gherasim.

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It is claimed that poaching the young is making health care

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dangerous. He not only lose individuals,

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you lose their capacity In great towns, maybe

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there are enough doctors, but in important towns with more

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than 100,000 inhabitants, the medicine in these places

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is done with danger. That is because specialists have

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to work in areas they know little about - for example,

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cardiologists could be required Short and medium-term,

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I want to train and to I will give a phone call

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to your wife to tell her It is a privilege to help my

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patients and to be It is both a duty

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and a pleasure, yes. In Bucharest, Leon's patient has

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regained consciousness. Tes, certain illnesses or situations

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could make me step aside. With the present trend,

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many of the doctors we will meet over the next decade will no doubt

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come from places like Romania. The question is, should Britain

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expand its medical schools or is it just cheaper and easier to rely

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on poorer countries like Romania Doctors have always supported

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free movement of labour. The British Medical Association

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is concerned about the effect Overseas doctors have always been

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the backbone of the National Health I do get worried when I hear

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about the way in which we can go abroad and deliberately recruit too

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many people to the extent that there are some countries

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where a substantial proportion of their doctors are coming to work

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in the United Kingdom. It could be worrying, I think,

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for those countries, because we're not

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doing them a service. Early last December, we ask

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the Health Secretary Jeremy Hunt for an interview to discuss

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the issues raised here. A month and a half

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later, he declined. So, we asked the Health

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Minister Ben Gummer, and last week, almost

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a month later, he declined. We wanted to ask them

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on your behalf, why we can't train Would the system collapse

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without the foreign staff? And is it wrong to exploit

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the health systems The Department of Health did issue

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a statement which said staffing was a priority and there are now

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more than 10,700 additional And more than 55,000

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doctors in training. Overseas staff are crucial

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to the NHS but we must also train Experts were reviewing the number

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of medical degree places. It is pretty clear that in places

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like Romania that review Whether by Twitter or e-mail,

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that we know what you think about how the NHS is trying to cope

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with the doctor shortage. All my contact details

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are on screen now. Hardly a week goes by without a news

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story about someone Police investigated thousands

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of cases across the Northeast Most are found within a matter

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of days but for some the agonising As we discovered when we follow one

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Tyneside father who is desperate Every two minutes,

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someone in Britain disappears. Most will be found but, every year,

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2,000 people who go missing This is Michael's home and he lived

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here until he was last seen He was just staying up most nights

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and listening to music. I lent him this Fleetwood Mac album

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and I had had a bit of bother trying Whenever I left here

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it was, love you, dad. When I think about it,

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it is a bit upsetting, but that was just the sort

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of person he was. I never told him but

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I should have done. When he was 17 years old,

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his mother died in his And I think a traumatic experience

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like that can affect anybody. He suffered what they call

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a psychosis, which I was ignorant This is the last sighting of Michael

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on CCTV three months ago. Paul believes his son

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could be anywhere in the UK. We did set up a Facebook account

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called Help Find Michael Whinham. We have had a fantastic response

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throughout the country. A message has been posted which says

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that a man looking like his son has been spotted in the

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North of Scotland. And the lady in Elgin said

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on the Thursday she was shopping and she said she recognised

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Michael's face. He's my son and obviously he has got

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a problem and I don't know what that problem is so,

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being a father, I would go In Elgin, Paul puts up posters

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and talks to locals but there is Without any fresh leads,

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Paul has come to Northumbria Police to talk to the officer

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handling the case. More recently, we have had

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a sighting in the Metro In general, obviously,

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we are keeping our mind open The thing that has got everybody

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mystified is the fact that, When there is money going

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into the bank account? From our point of view,

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we need people to come forward if they have got a sighting or any

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relevant information, to bring that forward to us,

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so we can act upon that. When does it come to a point that

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you think you have done enough? If we get information and that

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comes in, we will follow If it comes a point where that

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information is drying up, then we haven't got very much

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that we can act upon, but we do have a process in place

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where we reviewed them monthly, and then yearly after that,

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but we always keep them open. Michael is just one of the 40

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long-term missing people that Helen It is really difficult

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for the family, day in, day out, not knowing what has happened

:23:49.:23:54.

to their loved one. Paul is regularly on the telephone

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to us, on a weekly basis, daily basis, just going over things

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that have happened or It is frustrating, from one point

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of view, that there has been no progress, but sometimes

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no news is good news. Because if anything seems to be

:24:11.:24:19.

wrong happened to Michael, The more time passes,

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the longer the torment. Paul is having to face up

:24:22.:24:25.

to the possibility it may take Today, he is meeting

:24:26.:24:28.

Sandra Flintoff. Her son Craig went missing

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in Loughborough in 2003. I still get very tearful and I can

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still become very upset. Basically, it is affecting

:24:38.:24:47.

your whole life, really. Absolutely, your full life

:24:48.:24:51.

is turned upside down. But in my heart, I know that my boy

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would not want to hurt us And if Craig is out there,

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I think he will be very surprised at just how distressed

:24:57.:25:00.

and hurt we have been. Because, you know,

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they are your children, and it doesn't matter how

:25:03.:25:04.

old they get, you do not When you haven't got a final answer,

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your mind works double overtime and you start thinking of the bad

:25:12.:25:20.

things that they could have possibly

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happened... I have been to the negatives

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and you go through some terrible, terrible times, if your son

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is in fine, and I hope You feel as if you can't

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start living again. Life has to go on and 13 years down

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the line we are still here. Someone once said to me,

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it is like a prodigal son And I just looked at this person

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and said, I would open my arms My advice to you is,

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just let people help you. Because you can't do it

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all by yourself. That was a really, really helpful

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experience with Sandra, because Michael, although he has

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been missing three months, and it seems a long time,

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but when Craig has been missing 13 years, Sandra is still thinking

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positively, and it gives me Paul is determined to leave no stone

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unturned on the hunt for his son. Looking out this window,

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thinking, where is Michael? He has travelled to London,

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the base for the country's only charity aimed at reuniting

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missing people and their families. We are here for you and the family

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of anyone who has gone We can produce publicity,

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with the police, where we create a poster of Michael and we can then

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distribute that across the country. Publicity really is there to reach

:26:58.:27:05.

out to this person themselves. The messaging on the poster

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is directed to the missing person, to say, we are here for

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you if you need help, Obviously, my first priority

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is to find out if my son He might not want to come home,

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which is his choice. That is where our

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helplines come into it. If they want to let their family

:27:26.:27:28.

know they are OK, we can take a message and we can pass that

:27:29.:27:31.

onto the family member So, just before we go, we have got,

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hot off the presses, this is the poster we have

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created for Michael. We have done a few of them,

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so you can take some with you. People can also download this

:27:42.:27:44.

from the website as well, so if you have got family

:27:45.:27:47.

and friends who want to, they can, and we will also show

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that on social media, Paul is finding it hard to come

:27:50.:27:52.

to terms with the chance that he may I think he has just got something

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to do with his head and things have I don't know what the state

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of his mental health is at the moment but I sincerely

:28:15.:28:22.

believe you still alive. Until we have a body,

:28:23.:28:25.

as far as I am concerned, And, of course, if Michael is found,

:28:26.:28:28.

we will be sure to let you know,

:28:29.:28:39.

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