16/01/2017 Inside Out North East and Cumbria

Hello and welcome to a brand new series.

Tonight: A close up look at health care.

We're on the rounds with a local GP fighting financial pressure

I want to do what I'm trained to do, not be some clinical accountant.

We need a health service to fit patients not patients

We ask: Do we still have a national health service, or does

where you live increasingly affect your care?

The fact that had to pay for my trip but is criminal. It is absolutely

cruel. Sorry. Should a lesson in

life-saving be compulsory? She was lying there on the sofa

totally unconscious If I hadn't done CPR my mother

wouldn't have survived today. I'm Chris Jackson and

this is Inside Out. Tonight, in a special programme,

we look at increasing As budgets tighten and the number

of patients arriving in the doctor's surgery rockets,

GPs are under increasing pressure We followed one doctor from Tyneside

to find out first-hand how Mike Scott has been a GP

at Newburn Surgery in Newcastle The NHS is under huge

financial pressure. GPs like Mike are at the sharp

end, making decisions The surgery has more than five

and a half thousand patients. Donna has back problems

and suffers from depression. I got to the stage where

I didn't want to be here. When they said I was useless

I thought what is the point? The drug that works

for Donna is being rationed, We're being strongly encouraged

by the people who run our health I think the plan is probably

for the next four weeks is keeping If I'm struck off it'll

take a few years. I'm going to be retired soon

anyway, so we don't need After losing eight and a half

stone Donna needs surgery I can't get anything

for that on the NHS. Almost for devilment I think I'll

put in an application, because you've just told me

you felt suicidal. But I'll have to fill

in a thing called an IFR, I want to do what I'm trained

for, not be some sort We need to configure the health

service to fit the patients, not the patients to fit the design

of the services. In 2016 Newburn issued more

than 35,000 prescriptions. The push is not to prescribe

antibiotics for colds and flu. It's costly and risks

developing superbugs. Ok, well that's all sore

and red and septic. I think we'll rely on mother nature

to sort this one out. I'm afraid there'll be

a wait for Dr Scott. There's a patient at Waverley Lodge

who has had three seizures So would you mind looking at this

as soon as possible, please? Deprivation, unemployment

and child poverty in Newburn are all "significantly worse"

than the national average. More than 300 of the surgery's

patients are registered as diabetic. You've near as cured your diabetes

with losing that two stone. Dorothy has a severe muscle wasting

disease, and has developed If the nurse hadn't been

in would you have been Dorothy has had the muscle wasting

disease for fifteen years. I've had it specially refrigerated

to give you a thrill. Dorothy used to have a driver

who got her out of the house. Sometimes I can sit in the house

for three weeks doing nothing. Often, patients have already

diagnosed their illness Don't worry, we'll

preserve your modesty. I'm not bothered, when

you get to nearly 83. Right, go on, give us

a couple of deep breaths. Yeah, you're sounding

like a bag of weasels here. I think your vest's tucked

into your socks here, or something. It's a bit more than

a cold, certainly. You've got a flare up

of the bronchitis. Newburn has five part

time GPs, earning less If I had 15 minutes to see

all my complex patients, with half a dozen different medical

problems, I'm sure I could improve But you basically have

to do what's feasible. The average waiting time in England

for a routine appointment I can understand when people are

poorly they really want to be seen. It's hard if you try to say there's

no appointments left. There's all sorts of

squeeks and rattles. You know i don't like steroids,

but I don't mind a period of them. OK doctor, I'll go

on your recommendation. The Commissioning Group that funds

hospital services recently began paying GPs to reduce the number

of referrals they make Inevitably people who should have

been referred will not be referred. If your practice is signed up

for that, don't trust your doctor anymore, because when he tells

you I don't think you need to go to hospital, he could be saying

I honestly don't think you need to go to hospital, or he could be

thinking I need to save up for my foreign holiday

and if I don't refer this patient it'll cover some of the cash flow

we missed from last year. If I'm honest I don't think

anybody's going to be saying that, but it puts

you in an invidious situation. Newcastle Gateshead Clinical

Commissioning Group said in a statement the aim

was to improve quality, get the best service,

and make best use of resources. There are other schemes in other

areas where after you've made a referral another doctor,

who doesn't know the patient, looks at the referral letter

and says no you can't If somebody who doesn't know me

and doesn't know them says "no", I just don't accept that and I'll do

everything to circumvent that. Newburn made almost two

and a half thousand referrals For operations like removing tonsils

there are many hurdles to overcome. Seven or more well documented

clinically significant adequately treated sore throats

in the previous year. Seven episodes of disabling

tonsilitis in a year! That to me is just

a rationing criteria. I think that bar

is set far too high. Mike has more telephone

consultations. A seriously ill patient is deemed

fit for work by the Department Hello, it's Dr Scott

from the surgery here. I haven't got a clue,

my nerves are shattered. I find it mind boggling that someone

who has never met you in their life He has very severe arthritis

and a very severe depression. I think my opinion as to

whether he's capable of working is worth a whole lot more

than the other guy, who is doing a tick box exercise

for a private company contracted But there are three home

visits still to do. I was fine, then this gripping pain

started again, and then I vomited. OK, so what you need from me tonight

is pain relief and not vomiting. Home visits are costly

in time terms, but can That lady there I think as a result

of visiting her this evening we can keep her out of hospital,

whereas, if we hadn't seen her tonight she could have been

in hospital by midnight. I give myself a day off each week,

as well as the weekend. I'm going to go home and I may pour

myself a nice cold beer and watch something that involves no mental

effort at all on the telly. While Dr Mike is facing

the squeeze on the front line, others are looking at the wider

picture and asking, is the NHS Does where you live now matter more

than ever when it comes The NHS is facing the most

significant financial There are fears the service

we have grown up with is There is a postcode lottery. It is

absolutely criminal. This is going to get worse.

So, is the NHS in danger of ceasing to be a "national" service,

where everyone is entitled to the same care?

It's treating more patients but is it becoming a postcode

lottery, where access can depend on where you live?

On a bad day ruined your life. It feels like my bones are screaming at

me at times. 33-year-old Ben Franklin

has Hepatitis C. The virus can cause

life-threatening liver damage. I am about to lose my job. I have

been of work six since April and they could possibly lose the flat

over my head. There are new drugs that could

potentially cure Ben's Hepatitis. That made me want to go out and just

get absolutely wasted and ruin my liver just

so they would treat me. I wouldn't do that but I wouldn't be

surprised if somebody else would. The money is there for just

over 10,000 treatments. It's claimed that means

there are no queues in parts of the North and long waits

in places like London. Two people with exactly the same

state of liver damage could present themselves in different parts

of the country and in one they'll be able to walk in and get Hepatitis C

treatment immediately, and get cured, and in another part

of the country they may go there and be told "Sorry you're

going to have to wait". NHS England told us it was regularly

reallocating unused Hepatitis C treatments to places

with waiting lists. The number of patients treated

will increase by 25% next year. So Ben is taking the risk

of treating himself with cheaper The fact that I've had to pay

for my treatment, it's criminal. Ben is hoping the generic drugs will

cure him within a matter of weeks. The Hepatitis C trust estimates that

around 1,000 people in Britain may If you go outside there

are halos around lights. Lights and shadows,

it's hard to see things. Gloria McShane has

cataracts in both eyes. Go up or down stairs

with any kind of confidence. Cataracts are supposed

to be treated within four Gloria, who lives in the North East,

says she's been waiting seven. It's too long because there's such

potential for accidents, and there's such a change

in a person's mood. If Gloria had lived in Luton her

wait could have been Absolutely, there is

a postcode lottery. It's not about clinical need,

it's about some places in England having poor systems,

having budgetary pressures and That doesn't feel

too national to me. Gloria expects to get her

operation later this month. It really makes me angry,

because I think that it's almost Clinical Commissioning Groups,

or CCGs, control health budgets. It's claimed some are delaying

treatments like cataract surgery Others are requiring patients

to lose weight before getting Postponing an operation

in these circumstances can And whilst the CCGs say it can be

"clinically justified", the Royal College of Surgeons

say it can't. There's very good evidence that

people are now not getting elective operations simply

because of financial restrictions. It is up to the clinicians to decide

who should have what treatments and therefore a bureaucratic system

that produces a blanket It's also claimed new systems

for vetting appointments with specialists are another

form of rationing. Why are they treating their patients

with such contempt? Last month, MPs complained

about a private company being paid ?10 for every GP

referral they stopped. This is rationing by the back door

and has the potential The same private company oversees

referrals in North Tyneside. We've spoken to doctors

who say the system is The GPs, who fear speaking out,

have told us that cancer I tried to get a patient

referred to a dermatologist. The referral management

service said it was a skin They're putting up barriers,

using delaying tactics. It's getting between the doctor

and the specialist. In a statement, North Tyneside CCG

said there was No evidence the system caused additional

risk or delay. Cancer referrals do not go

through the system and are made The number of referrals knocked back

to GPs in England has risen You can see the details

of our research online. Shortage and regional difference

have always been part of the NHS. Today, the differences

could get much worse. The NHS is under an unprecedented

level of pressure at the moment. If it doesn't get more funding,

waiting times are going to get longer, the quality of patient care

is going to suffer. So we will see different decisions

taken in different parts of the country and different

services being So, is the NHS still

a national service? One of our most prominent

medics is clear. I think it matters, because it leads

to inequality in healthcare. Some people will get health care

for free and others won't. We asked the Health Secretary

and NHS England for an interview. The people actually

paying for NHS services, the clinical commissioners,

did agree to speak. It's a national service

with local variation based Demographically, populations

vary quite significantly It's really important

that we commission and respond to the needs of that population

on a local basis. It's about making sure

that the pathway is correct. We don't want to squander any money,

we have limited resources, so it's really important

that the resources we have we spend more effectively,

getting the best value For those forced to take

their own action, rationing Have local decisions about the care

available made a difference to you? You'll find me on twitter,

my hashtag is insideoutcj. Or e-mail me at

[email protected]. In the UK there are over 30,000

cardiac arrests every year But just one in 10 Brits

know how to give CPR. Campaigners say resuscitation should

be taught in schools. We met one Newcastle teenager

who understands more than most just how important this life

saving skill is. I raise money for a charity that

places defibrillators in primary schools and public places and raises

awareness of CPR. I started fundraising

in 2014 when I lost my best Michael was just 14

when he had a cardiac arrest. It was triggered

by an asthma attack. You know when you just know

something bad has happened. It was just such a shock,

you didn't expect it to happen. It was the most

horrible feeling ever. She was absolutely devastated,

totally broken-hearted. As a mother it was hard

watching her go through it because I couldn't do anything

to make it better. She cried all the time,

played the same music Bobbi has now raised over ?10,000

and funded her own CPR But after what happened

to her friend, she wants everyone to know just how important

it is to know lifesaving skills. If you don't act fast and do CPR

you've got so much less I think it's something

when you get to a certain age you should be trained

in because anything could happen. But if Bobbi lived in Denmark,

she and her peers would Resuscitation skills, CPR,

has been a compulsory part of the school curriculum

here for the last 10 years. In a Copenhagen classroom,

11 and 12-year-olds are being challenged

to make their own films Each film will be a campaign film

telling me and you how to act if you see a person dropping dead

on the streets. The aim is that the children

have a fun and creative day. By making films about it,

they will obtain knowledge and the idea that it's a good

thing to help. It's always interesting to see

the children's perspective on these quite difficult issues

about life and death. 20-year-old Rasmus knows more

than most people just how Two years ago he was at

home alone with his mum She was lying there on the sofa

totally unconscious. The only thing that kept me

going was I could hear her breathe If I hadn't done CPR my mother

wouldn't have survived today. It is a very, very

good thing to know. You never know when

it's going to happen. It could happen all of

a sudden, like for me. My mum, of course

she is very grateful. The first thing she told me

when she could speak again was, I didn't know how to respond

to that but, I guess I did. Now nearly 70% of people

in Denmark know CPR. That's compared to just 10%

in the UK and the survival rate This is the emergency dispatch

centre in Copenhagen. It is about changing the attitude

that you can do something and you cannot do anything wrong,

to take a social responsibility. It does have an impact

on survival, it does have an impact on the new future

generation of lifesavers. Give me just one reason not to teach

children CPR in school. It's just one hour,

it's cost effective, Back in the classroom,

the 6th grade students are finishing It's about this boy

who when he's smaller he learns Then he comes out in real life

where this accident actually happened and he ended

up helping him. So my role is the person

who saves Theodor's life. You can save lives,

everybody can save lives. But the more you hesitate,

the chances of surviving get That's what one paramedic

wants to teach children This class is for five

and six-year-olds in South Shields. Little ones are

absolutely like sponges. I've been completely shocked

at how much they can, not only take on board but retain

and then deliver down the line. I think the characters really help,

they always want to get involved with the characters

and the activities we run. It's not compulsory

but I absolutely think it should be because personally I think it's one

of the most important life So are we any closer to making this

the norm in UK classrooms, The Department of Education told us:

"We have given head teachers more freedom than ever to shape

the curriculum to the We would also encourage teachers

to draw upon high-quality resources in the classroom,

including guidance on first We're way behind the curve

here and we're failing our population because people

are dying prematurely unnecessarily. It makes me really sad because it's

such a simple thing to introduce. It doesn't cost much

and the benefits would be so huge. A North East MP says

she is lobbying her government. There is so much evidence that

having those skills throughout the population can make

a substantial difference in life That's our challenge as campaigners

to persuade them there is a strong evidential base to the government

saying we want to invest in this In Newcastle, it's a special day

for 15-year-old Bobbi. Overall I've bought 10

defibrillators and they've been placed in the areas where me

and Michael lived. Now our area's heart safe

and I just want to get as many We're still really close

to Michael's family. We're just keeping his memory alive

and hoping that nobody else has The winner of the Young Role Model

award goes to Bobbi Potts. Amazing, I'm so happy,

I can't believe it to be Everyone in this room will know that

Michael had a cardiac arrest. He'd be over the moon,

he really would be. Next week: The County Durham vet

who has transformed the lives of neglected street dogs

in Sri Lanka and how Until then, from

Tyneside, good night. Hello, I'm Louisa Preston

with your 90 second update. 30 British tourists shot

dead in Tunisia in 2015.