16/01/2017 Inside Out North East and Cumbria


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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.


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