0:00:03 > 0:00:04On
0:00:04 > 0:00:07On the front line in A&E.
0:00:07 > 0:00:09On the front line in A&E. Done.
0:00:09 > 0:00:10On the front line in A&E. Done. When you
0:00:10 > 0:00:11On the front line in A&E. Done. When you see what they do,
0:00:11 > 0:00:13On the front line in A&E. Done. When you see what they do, it's amazing.
0:00:13 > 0:00:14you see what they do, it's amazing. Jamie
0:00:14 > 0:00:15you see what they do, it's amazing. Jamie Coulson examines the pressures
0:00:15 > 0:00:16Jamie Coulson examines the pressures on A&E around
0:00:16 > 0:00:18Jamie Coulson examines the pressures on A&E around the country.
0:00:18 > 0:00:19Jamie Coulson examines the pressures on A&E around the country. We
0:00:19 > 0:00:20on A&E around the country. We are in the worst
0:00:20 > 0:00:21on A&E around the country. We are in the worst position we have ever
0:00:21 > 0:00:22the worst position we have ever been.
0:00:22 > 0:00:23the worst position we have ever been. We have a real
0:00:23 > 0:00:24been. We have a real crisis in recruiting people
0:00:24 > 0:00:28recruiting people into emergency medicine.
0:00:28 > 0:00:29recruiting people into emergency medicine. And as GPs
0:00:29 > 0:00:30recruiting people into emergency medicine. And as GPs now control the
0:00:30 > 0:00:31medicine. And as GPs now control the budget, what does that
0:00:31 > 0:00:32budget, what does that mean for us in Kent
0:00:32 > 0:00:35budget, what does that mean for us in Kent and Sussex?
0:00:35 > 0:00:36budget, what does that mean for us in Kent and Sussex? I
0:00:36 > 0:00:37in Kent and Sussex? I am here today because I
0:00:37 > 0:00:38in Kent and Sussex? I am here today because I am concerned about
0:00:38 > 0:00:39because I am concerned about the creeping privatisation
0:00:39 > 0:00:40creeping privatisation of the National Health
0:00:40 > 0:00:42creeping privatisation of the National Health Service.
0:00:42 > 0:00:43creeping privatisation of the National Health Service. I am
0:00:43 > 0:00:44National Health Service. I am Natalie Graham, with untold
0:00:44 > 0:00:46Natalie Graham, with untold stories closer to home.
0:00:46 > 0:00:47Natalie Graham, with untold stories closer to home. From all around
0:00:47 > 0:00:48closer to home. From all around the South East, this
0:00:48 > 0:00:53closer to home. From all around the South East, this is Inside Out.
0:01:04 > 0:01:05Hello.
0:01:05 > 0:01:06Hello. Tonight we have
0:01:06 > 0:01:07Hello. Tonight we have a special edition
0:01:07 > 0:01:08Hello. Tonight we have a special edition of Inside Out from
0:01:08 > 0:01:09edition of Inside Out from the Queen Elizabeth The
0:01:09 > 0:01:10edition of Inside Out from the Queen Elizabeth The Queen Mother Hospital
0:01:10 > 0:01:12Elizabeth The Queen Mother Hospital in Margate.
0:01:12 > 0:01:13Elizabeth The Queen Mother Hospital in Margate. We are here for
0:01:13 > 0:01:14Elizabeth The Queen Mother Hospital in Margate. We are here for a day in
0:01:14 > 0:01:15in Margate. We are here for a day in the life of A&E,
0:01:15 > 0:01:16in Margate. We are here for a day in the life of A&E, after a summer in
0:01:16 > 0:01:17the life of A&E, after a summer in which the NHS
0:01:17 > 0:01:18the life of A&E, after a summer in which the NHS hit the headlines on
0:01:18 > 0:01:24which the NHS hit the headlines on an almost daily basis.
0:01:33 > 0:01:34This A&E department
0:01:34 > 0:01:35This A&E department sees 70,000 patients every
0:01:35 > 0:01:37This A&E department sees 70,000 patients every year.
0:01:37 > 0:01:38This A&E department sees 70,000 patients every year. Today, we
0:01:38 > 0:01:39patients every year. Today, we are going to meet
0:01:39 > 0:01:42patients every year. Today, we are going to meet a few of them.
0:01:42 > 0:01:43patients every year. Today, we are going to meet a few of them. Sally
0:01:43 > 0:01:44going to meet a few of them. Sally Shirley from Whitstable
0:01:44 > 0:01:45Shirley from Whitstable has had an accident.
0:01:45 > 0:01:46Shirley from Whitstable has had an accident. Hello.
0:01:46 > 0:01:47Shirley from Whitstable has had an accident. Hello. Hello.
0:01:47 > 0:01:48accident. Hello. Hello. This is Sally.
0:01:48 > 0:01:49accident. Hello. Hello. This is Sally. This morning
0:01:49 > 0:01:50Sally. This morning she was washing her
0:01:50 > 0:01:51Sally. This morning she was washing her windows, stood on a
0:01:51 > 0:01:52her windows, stood on a stool, and fell
0:01:52 > 0:01:53her windows, stood on a stool, and fell off the chair onto
0:01:53 > 0:01:55fell off the chair onto her outstretched right hand.
0:01:55 > 0:01:56fell off the chair onto her outstretched right hand. How is the
0:01:56 > 0:01:57outstretched right hand. How is the pain at the moment?
0:01:57 > 0:01:59outstretched right hand. How is the pain at the moment? Coming alive.
0:01:59 > 0:02:00pain at the moment? Coming alive. I'm starting to feel
0:02:00 > 0:02:01pain at the moment? Coming alive. I'm starting to feel it now.
0:02:01 > 0:02:02I'm starting to feel it now. Take her
0:02:02 > 0:02:03I'm starting to feel it now. Take her down to this area
0:02:03 > 0:02:11I'm starting to feel it now. Take her down to this area here.
0:02:11 > 0:02:12I'm starting to feel it now. Take her down to this area here. What
0:02:12 > 0:02:13her down to this area here. What are you doing cleaning
0:02:13 > 0:02:14her down to this area here. What are you doing cleaning windows on a
0:02:14 > 0:02:15you doing cleaning windows on a Sunday morning? I don't
0:02:15 > 0:02:16Sunday morning? I don't know. But I was. And
0:02:16 > 0:02:17Sunday morning? I don't know. But I was. And you just
0:02:17 > 0:02:18was. And you just toppled over?I just went
0:02:18 > 0:02:19was. And you just toppled over?I just went and I fell
0:02:19 > 0:02:20was. And you just toppled over?I just went and I fell off the stool
0:02:20 > 0:02:21just went and I fell off the stool and I broke the
0:02:21 > 0:02:22just went and I fell off the stool and I broke the kitchen door and the
0:02:22 > 0:02:23and I broke the kitchen door and the unit as well,
0:02:23 > 0:02:24and I broke the kitchen door and the unit as well, as I went. Hello.
0:02:24 > 0:02:25unit as well, as I went. Hello. You still in a
0:02:25 > 0:02:26unit as well, as I went. Hello. You still in a lot of pain?
0:02:26 > 0:02:27still in a lot of pain? Yes.What I am
0:02:27 > 0:02:28still in a lot of pain? Yes.What I am going to
0:02:28 > 0:02:29am going to do is make you comfortable first,
0:02:29 > 0:02:30am going to do is make you comfortable first, and then we
0:02:30 > 0:02:31comfortable first, and then we are going to x—ray
0:02:31 > 0:02:32comfortable first, and then we are going to x—ray this to see what
0:02:32 > 0:02:33going to x—ray this to see what is going on,
0:02:33 > 0:02:34going to x—ray this to see what is going on, because it hasn't been
0:02:34 > 0:02:35going on, because it hasn't been x—rayed yet. The BBC
0:02:35 > 0:02:36going on, because it hasn't been x—rayed yet. The BBC filmed in ten
0:02:36 > 0:02:37x—rayed yet. The BBC filmed in ten A&E departments in hospitals
0:02:37 > 0:02:38A&E departments in hospitals across England on the
0:02:38 > 0:02:39A&E departments in hospitals across England on the same day, so
0:02:39 > 0:02:40England on the same day, so later we can compare
0:02:40 > 0:02:41England on the same day, so later we can compare what the picture is
0:02:41 > 0:02:42can compare what the picture is like across the
0:02:42 > 0:02:45can compare what the picture is like across the country.
0:02:45 > 0:02:46can compare what the picture is like across the country. The accident and
0:02:46 > 0:02:47across the country. The accident and emergency department at the
0:02:47 > 0:02:48emergency department at the QETQM in Margate today
0:02:48 > 0:02:49emergency department at the QETQM in Margate today is under the
0:02:49 > 0:02:50Margate today is under the control of Sister Anne
0:02:50 > 0:02:53Margate today is under the control of Sister Anne Payne.
0:02:53 > 0:02:54Margate today is under the control of Sister Anne Payne. It
0:02:54 > 0:02:55Margate today is under the control of Sister Anne Payne. It can be very
0:02:55 > 0:02:56of Sister Anne Payne. It can be very stressful, but being in
0:02:56 > 0:02:57stressful, but being in charge, you kind of
0:02:57 > 0:02:58stressful, but being in charge, you kind of learn to do
0:02:58 > 0:02:59stressful, but being in charge, you kind of learn to do bed moves — it's
0:02:59 > 0:03:00kind of learn to do bed moves — it's like a furniture
0:03:00 > 0:03:03kind of learn to do bed moves — it's like a furniture shop sometimes.
0:03:03 > 0:03:04like a furniture shop sometimes. You are
0:03:04 > 0:03:05like a furniture shop sometimes. You are trying to move everyone
0:03:05 > 0:03:06are trying to move everyone around in time to
0:03:06 > 0:03:07are trying to move everyone around in time to get patients to
0:03:07 > 0:03:08in time to get patients to the wards they need
0:03:08 > 0:03:09in time to get patients to the wards they need to be in, in
0:03:09 > 0:03:11they need to be in, in a timely manner.
0:03:11 > 0:03:12they need to be in, in a timely manner. We have
0:03:12 > 0:03:13they need to be in, in a timely manner. We have just been told
0:03:13 > 0:03:14manner. We have just been told that a man has
0:03:14 > 0:03:15manner. We have just been told that a man has been brought in who
0:03:15 > 0:03:16a man has been brought in who has been sleeping rough
0:03:16 > 0:03:17a man has been brought in who has been sleeping rough locally, so we
0:03:17 > 0:03:18been sleeping rough locally, so we are going to find
0:03:18 > 0:03:19been sleeping rough locally, so we are going to find out what is
0:03:19 > 0:03:20are going to find out what is going on. I am
0:03:20 > 0:03:21are going to find out what is going on. I am now going to take
0:03:21 > 0:03:22on. I am now going to take your sock off, so
0:03:22 > 0:03:23on. I am now going to take your sock off, so we can look
0:03:23 > 0:03:24on. I am now going to take your sock off, so we can look at the extent of
0:03:24 > 0:03:25off, so we can look at the extent of where the problems are.
0:03:25 > 0:03:26where the problems are. The staff discover that
0:03:26 > 0:03:27where the problems are. The staff discover that one of his
0:03:27 > 0:03:28discover that one of his feet has been infested
0:03:28 > 0:03:31discover that one of his feet has been infested with maggots.
0:03:31 > 0:03:32discover that one of his feet has been infested with maggots. We are
0:03:32 > 0:03:33been infested with maggots. We are going to get
0:03:33 > 0:03:34been infested with maggots. We are going to get some special stuff to
0:03:34 > 0:03:35going to get some special stuff to soak your foot in,
0:03:35 > 0:03:36going to get some special stuff to soak your foot in, and what I'm
0:03:36 > 0:03:37soak your foot in, and what I'm going to do
0:03:37 > 0:03:38soak your foot in, and what I'm going to do is try and remove this
0:03:38 > 0:03:39going to do is try and remove this from your foot
0:03:39 > 0:03:40going to do is try and remove this from your foot at the moment. OK.
0:03:40 > 0:03:41from your foot at the moment. OK. Steady! I'm steadying.They're
0:03:41 > 0:03:42Steady! I'm steadying.They're sore. Very sore.
0:03:42 > 0:03:43Steady! I'm steadying.They're sore. Very sore. The maggots are
0:03:43 > 0:03:44Very sore. The maggots are actually in the
0:03:44 > 0:03:45Very sore. The maggots are actually in the skin itself. His
0:03:45 > 0:03:46in the skin itself. His name is Phil Adams, and
0:03:46 > 0:03:47in the skin itself. His name is Phil Adams, and he is a
0:03:47 > 0:03:50in the skin itself. His name is Phil Adams, and he is a regular in A&E.
0:03:50 > 0:03:51Adams, and he is a regular in A&E. After he was
0:03:51 > 0:03:52Adams, and he is a regular in A&E. After he was cleaned up, I was
0:03:52 > 0:03:53After he was cleaned up, I was able to speak to
0:03:53 > 0:03:54After he was cleaned up, I was able to speak to him. I am
0:03:54 > 0:03:55After he was cleaned up, I was able to speak to him. I am in a lot of
0:03:55 > 0:03:56to speak to him. I am in a lot of pain with it. It
0:03:56 > 0:03:57to speak to him. I am in a lot of pain with it. It has just started
0:03:57 > 0:03:58pain with it. It has just started running down my leg
0:03:58 > 0:04:01pain with it. It has just started running down my leg as well.
0:04:01 > 0:04:02running down my leg as well. And I need help
0:04:02 > 0:04:03running down my leg as well. And I need help to get it sorted
0:04:03 > 0:04:05running down my leg as well. And I need help to get it sorted out.
0:04:05 > 0:04:06need help to get it sorted out. Can you tell
0:04:06 > 0:04:07need help to get it sorted out. Can you tell me where you slept
0:04:07 > 0:04:08you tell me where you slept last night?
0:04:08 > 0:04:09you tell me where you slept last night? Yeah,
0:04:09 > 0:04:10you tell me where you slept last night? Yeah, the top of
0:04:10 > 0:04:15night? Yeah, the top of a multistorey car park.
0:04:15 > 0:04:16night? Yeah, the top of a multistorey car park. Rhys is one
0:04:16 > 0:04:17multistorey car park. Rhys is one of the doctors on
0:04:17 > 0:04:18multistorey car park. Rhys is one of the doctors on duty. Today he
0:04:18 > 0:04:19the doctors on duty. Today he is doing a
0:04:19 > 0:04:20the doctors on duty. Today he is doing a 12—hour shift, seven until
0:04:20 > 0:04:22doing a 12—hour shift, seven until seven.
0:04:22 > 0:04:23doing a 12—hour shift, seven until seven. I
0:04:23 > 0:04:24doing a 12—hour shift, seven until seven. I suppose that is the
0:04:24 > 0:04:25seven. I suppose that is the thing about the nature
0:04:25 > 0:04:26seven. I suppose that is the thing about the nature of your job,
0:04:26 > 0:04:27about the nature of your job, you do not know
0:04:27 > 0:04:28about the nature of your job, you do not know until you get here
0:04:28 > 0:04:29not know until you get here and while you are
0:04:29 > 0:04:30not know until you get here and while you are here, you don't
0:04:30 > 0:04:31while you are here, you don't know what will happen
0:04:31 > 0:04:32while you are here, you don't know what will happen in the next
0:04:32 > 0:04:33what will happen in the next hour. They are very
0:04:33 > 0:04:34They are very much an unfiltered population, that
0:04:34 > 0:04:35They are very much an unfiltered population, that is partly why
0:04:35 > 0:04:36population, that is partly why I like the
0:04:36 > 0:04:37population, that is partly why I like the job, it is unpredictable,
0:04:37 > 0:04:38like the job, it is unpredictable, it is free of
0:04:38 > 0:04:39like the job, it is unpredictable, it is free of protocols, to a
0:04:39 > 0:04:40it is free of protocols, to a degree. And every individual
0:04:40 > 0:04:41degree. And every individual is different and every
0:04:41 > 0:04:44different and every patient is different.
0:04:44 > 0:04:45different and every patient is different. For instance,
0:04:45 > 0:04:46different. For instance, Jason from Ramsgate has
0:04:46 > 0:04:47different. For instance, Jason from Ramsgate has arrived with a
0:04:47 > 0:04:49Ramsgate has arrived with a partially collapsed lung.
0:04:49 > 0:04:50Ramsgate has arrived with a partially collapsed lung. We will
0:04:50 > 0:04:51partially collapsed lung. We will draw off the air,
0:04:51 > 0:04:52partially collapsed lung. We will draw off the air, hope that it stays
0:04:52 > 0:04:53draw off the air, hope that it stays up, x—ray you again
0:04:53 > 0:04:54draw off the air, hope that it stays up, x—ray you again and if you
0:04:54 > 0:04:55up, x—ray you again and if you are well enough, we
0:04:55 > 0:04:56up, x—ray you again and if you are well enough, we will let you go
0:04:56 > 0:04:58well enough, we will let you go home.
0:04:58 > 0:04:59well enough, we will let you go home. Sound
0:04:59 > 0:05:00well enough, we will let you go home. Sound like a plan? Go
0:05:00 > 0:05:01home. Sound like a plan? Go for it. You seem
0:05:01 > 0:05:02home. Sound like a plan? Go for it. You seem very relaxed. We
0:05:02 > 0:05:04You seem very relaxed. We like patients like you.
0:05:04 > 0:05:05You seem very relaxed. We like patients like you. Well done.
0:05:05 > 0:05:06patients like you. Well done. In another
0:05:06 > 0:05:07patients like you. Well done. In another part of A&E, Sally
0:05:07 > 0:05:08another part of A&E, Sally is about to find
0:05:08 > 0:05:09another part of A&E, Sally is about to find out if her
0:05:09 > 0:05:10another part of A&E, Sally is about to find out if her arm is broken.
0:05:10 > 0:05:11to find out if her arm is broken. Hello. Me
0:05:11 > 0:05:12to find out if her arm is broken. Hello. Me again. Right,
0:05:12 > 0:05:13Hello. Me again. Right, the x—ray is back and
0:05:13 > 0:05:14Hello. Me again. Right, the x—ray is back and it shows that
0:05:14 > 0:05:15Hello. Me again. Right, the x—ray is back and it shows that you have got
0:05:15 > 0:05:16back and it shows that you have got a fracture of your
0:05:16 > 0:05:17back and it shows that you have got a fracture of your distal radius.
0:05:17 > 0:05:18a fracture of your distal radius. It is displaced.
0:05:18 > 0:05:19a fracture of your distal radius. It is displaced. It has
0:05:19 > 0:05:20a fracture of your distal radius. It is displaced. It has moved out, it
0:05:20 > 0:05:21is displaced. It has moved out, it has fractured and it
0:05:21 > 0:05:22has fractured and it has impacted a bit
0:05:22 > 0:05:23has fractured and it has impacted a bit on it as
0:05:23 > 0:05:24has fractured and it has impacted a bit on it as well, so what we
0:05:24 > 0:05:25bit on it as well, so what we are going to have
0:05:25 > 0:05:26bit on it as well, so what we are going to have to do is
0:05:26 > 0:05:27going to have to do is pull that bone into
0:05:27 > 0:05:28going to have to do is pull that bone into a better position and
0:05:28 > 0:05:29bone into a better position and then re—plaster it to
0:05:29 > 0:05:30bone into a better position and then re—plaster it to hold it in
0:05:30 > 0:05:31re—plaster it to hold it in a good position. As
0:05:31 > 0:05:32re—plaster it to hold it in a good position. As Sally heads off
0:05:32 > 0:05:33position. As Sally heads off to see the surgeon,
0:05:33 > 0:05:34the surgeon, the A&E department starts to
0:05:34 > 0:05:37the surgeon, the A&E department starts to get busy.
0:05:37 > 0:05:38the surgeon, the A&E department starts to get busy. Stomach
0:05:38 > 0:05:39the surgeon, the A&E department starts to get busy. Stomach trouble.
0:05:39 > 0:05:40starts to get busy. Stomach trouble. I have been
0:05:40 > 0:05:41I have been having pains right there.
0:05:41 > 0:05:42I have been having pains right there. I have just lay
0:05:42 > 0:05:43I have been having pains right there. I have just lay down on the
0:05:43 > 0:05:44there. I have just lay down on the floor and that was
0:05:44 > 0:05:45there. I have just lay down on the floor and that was it.
0:05:45 > 0:05:46there. I have just lay down on the floor and that was it. It's
0:05:46 > 0:05:47floor and that was it. It's my jaw. I got
0:05:47 > 0:05:48floor and that was it. It's my jaw. I got pains in my
0:05:48 > 0:05:49floor and that was it. It's my jaw. I got pains in my chest when I stood
0:05:49 > 0:05:50I got pains in my chest when I stood in Tesco's.
0:05:50 > 0:05:51I got pains in my chest when I stood in Tesco's. The dog came along
0:05:51 > 0:05:52in Tesco's. The dog came along with the master
0:05:52 > 0:05:53in Tesco's. The dog came along with the master and just came straight
0:05:53 > 0:05:54the master and just came straight at me. And beat
0:05:54 > 0:05:55the master and just came straight at me. And beat you? I do
0:05:55 > 0:05:56the master and just came straight at me. And beat you? I do enjoy my job.
0:05:56 > 0:05:57me. And beat you? I do enjoy my job. I often feel
0:05:57 > 0:05:58me. And beat you? I do enjoy my job. I often feel I don't have
0:05:58 > 0:05:59I often feel I don't have the opportunity to do
0:05:59 > 0:06:04I often feel I don't have the opportunity to do my job.
0:06:04 > 0:06:05I often feel I don't have the opportunity to do my job. I
0:06:05 > 0:06:06opportunity to do my job. I certainly do not have
0:06:06 > 0:06:07certainly do not have enough time with my
0:06:07 > 0:06:08certainly do not have enough time with my patients, and some patients
0:06:08 > 0:06:09with my patients, and some patients need more time
0:06:09 > 0:06:10with my patients, and some patients need more time and sometimes I feel
0:06:10 > 0:06:11need more time and sometimes I feel a bit rushed.
0:06:11 > 0:06:12need more time and sometimes I feel a bit rushed. It is like a
0:06:12 > 0:06:13a bit rushed. It is like a second family here, you
0:06:13 > 0:06:14a bit rushed. It is like a second family here, you spend more time
0:06:14 > 0:06:15family here, you spend more time here sometimes than you
0:06:15 > 0:06:16family here, you spend more time here sometimes than you do at home.
0:06:16 > 0:06:17here sometimes than you do at home. Now Sally is
0:06:17 > 0:06:18here sometimes than you do at home. Now Sally is about to have her
0:06:18 > 0:06:20Now Sally is about to have her bone reset.
0:06:20 > 0:06:21Now Sally is about to have her bone reset. It will
0:06:21 > 0:06:22Now Sally is about to have her bone reset. It will be painful, because
0:06:22 > 0:06:23reset. It will be painful, because basically the surgeon is
0:06:23 > 0:06:24basically the surgeon is going to pull it
0:06:24 > 0:06:25basically the surgeon is going to pull it back into place.
0:06:25 > 0:06:26pull it back into place. We always have
0:06:26 > 0:06:27pull it back into place. We always have an idea about the
0:06:27 > 0:06:28have an idea about the force exerted to produce
0:06:28 > 0:06:31have an idea about the force exerted to produce the deformity.
0:06:31 > 0:06:32have an idea about the force exerted to produce the deformity. And our
0:06:32 > 0:06:33to produce the deformity. And our action is to counteract
0:06:33 > 0:06:34action is to counteract that force so we
0:06:34 > 0:06:35action is to counteract that force so we have to push
0:06:35 > 0:06:36so we have to push the bone the opposite
0:06:36 > 0:06:37so we have to push the bone the opposite way.
0:06:37 > 0:06:38so we have to push the bone the opposite way. Would you like
0:06:38 > 0:06:39opposite way. Would you like to have some gas
0:06:39 > 0:06:40opposite way. Would you like to have some gas and air?
0:06:40 > 0:06:41opposite way. Would you like to have some gas and air? Yes.
0:06:41 > 0:06:42opposite way. Would you like to have some gas and air? Yes. I like
0:06:42 > 0:06:43opposite way. Would you like to have some gas and air? Yes. I like that.
0:06:43 > 0:06:44some gas and air? Yes. I like that. You like that, do
0:06:44 > 0:06:45some gas and air? Yes. I like that. You like that, do you?
0:06:45 > 0:06:47You like that, do you? I did like that.
0:06:47 > 0:06:56You like that, do you? I did like that. Just relax.
0:06:56 > 0:07:01You like that, do you? I did like that. Just relax. That is better.
0:07:01 > 0:07:02that. Just relax. That is better. Are you OK?
0:07:02 > 0:07:03that. Just relax. That is better. Are you OK? Mr
0:07:03 > 0:07:04that. Just relax. That is better. Are you OK? Mr Tanani gives the nod
0:07:04 > 0:07:05Are you OK? Mr Tanani gives the nod to the junior sister
0:07:05 > 0:07:06Are you OK? Mr Tanani gives the nod to the junior sister to help him
0:07:06 > 0:07:11to the junior sister to help him pull Sally's arm.
0:07:16 > 0:07:19Done!
0:07:19 > 0:07:20Done! It's
0:07:20 > 0:07:21Done! It's quite an eye opener
0:07:21 > 0:07:22Done! It's quite an eye opener when you see
0:07:22 > 0:07:25Done! It's quite an eye opener when you see what they do.
0:07:25 > 0:07:26you see what they do. It is an amazing.
0:07:26 > 0:07:27you see what they do. It is an amazing. Now, when
0:07:27 > 0:07:28amazing. Now, when you have recovered from
0:07:28 > 0:07:29amazing. Now, when you have recovered from the gas, we
0:07:29 > 0:07:30recovered from the gas, we will send you for
0:07:30 > 0:07:32recovered from the gas, we will send you for the x—ray.
0:07:32 > 0:07:34recovered from the gas, we will send you for the x—ray. Thank you.
0:07:34 > 0:07:35you for the x—ray. Thank you. Well, we have
0:07:35 > 0:07:36you for the x—ray. Thank you. Well, we have been here for the
0:07:36 > 0:07:37we have been here for the whole day. The time
0:07:37 > 0:07:38we have been here for the whole day. The time has flown. We
0:07:38 > 0:07:39The time has flown. We have seen a wide range
0:07:39 > 0:07:40The time has flown. We have seen a wide range of patients, but
0:07:40 > 0:07:41wide range of patients, but how did the day
0:07:41 > 0:07:42wide range of patients, but how did the day go in numbers?
0:07:42 > 0:07:43wide range of patients, but how did the day go in numbers? On
0:07:43 > 0:07:44wide range of patients, but how did the day go in numbers? On the day we
0:07:44 > 0:07:45the day go in numbers? On the day we visited, there were 204
0:07:45 > 0:07:46the day go in numbers? On the day we visited, there were 204 patients.
0:07:46 > 0:07:47visited, there were 204 patients. The government
0:07:47 > 0:07:48The government guidelines say that on average
0:07:48 > 0:07:49The government guidelines say that on average at least 95%
0:07:49 > 0:07:50on average at least 95% of people should
0:07:50 > 0:07:51on average at least 95% of people should be dealt with within
0:07:51 > 0:07:53should be dealt with within four hours.
0:07:53 > 0:07:54should be dealt with within four hours. On the
0:07:54 > 0:07:55should be dealt with within four hours. On the day that we
0:07:55 > 0:07:56hours. On the day that we visited, the figure was
0:07:56 > 0:08:00hours. On the day that we visited, the figure was 95.1%.
0:08:00 > 0:08:01hours. On the day that we visited, the figure was 95.1%. From the point
0:08:01 > 0:08:02the figure was 95.1%. From the point of view of a
0:08:02 > 0:08:03the figure was 95.1%. From the point of view of a doctor, working in
0:08:03 > 0:08:04of view of a doctor, working in A&E is an unusual
0:08:04 > 0:08:05of view of a doctor, working in A&E is an unusual job. You
0:08:05 > 0:08:06is an unusual job. You only see your patients on
0:08:06 > 0:08:07is an unusual job. You only see your patients on one day, before
0:08:07 > 0:08:08patients on one day, before they are taken off
0:08:08 > 0:08:09patients on one day, before they are taken off your hands.
0:08:09 > 0:08:10patients on one day, before they are taken off your hands. I
0:08:10 > 0:08:11taken off your hands. I don't mind if I
0:08:11 > 0:08:12taken off your hands. I don't mind if I never see them
0:08:12 > 0:08:13if I never see them again, as long as
0:08:13 > 0:08:14if I never see them again, as long as they haven't died,
0:08:14 > 0:08:15as they haven't died, I've done well so that
0:08:15 > 0:08:18as they haven't died, I've done well so that is OK.
0:08:18 > 0:08:19as they haven't died, I've done well so that is OK. So that is
0:08:19 > 0:08:20so that is OK. So that is an average day in
0:08:20 > 0:08:22so that is OK. So that is an average day in A&E in Margate.
0:08:22 > 0:08:23day in A&E in Margate. And even Phil, the
0:08:23 > 0:08:24day in A&E in Margate. And even Phil, the homeless man, is keeping
0:08:24 > 0:08:25Phil, the homeless man, is keeping his chin up in
0:08:25 > 0:08:26Phil, the homeless man, is keeping his chin up in front of the
0:08:26 > 0:08:27his chin up in front of the camera. I hope
0:08:27 > 0:08:28his chin up in front of the camera. I hope you feel better,
0:08:28 > 0:08:29I hope you feel better, Philip. Hopefully. I
0:08:29 > 0:08:30I hope you feel better, Philip. Hopefully. I might become shy, you
0:08:30 > 0:08:33Hopefully. I might become shy, you never know!
0:08:33 > 0:08:39Hopefully. I might become shy, you never know! You never know.
0:08:39 > 0:08:40never know! You never know. And you can hear
0:08:40 > 0:08:41never know! You never know. And you can hear more on the state
0:08:41 > 0:08:42can hear more on the state of our A&E units
0:08:42 > 0:08:43can hear more on the state of our A&E units on The Mark Forrest can hear more on the state of our A&E units
0:08:43 > 0:08:49can hear more on the state of our A&E units on The Mark Forrest Show. can hear more on the state of our A&E units
0:08:49 > 0:08:50can hear more on the state of our A&E units on The Mark Just tune can hear more on the state of our A&E units
0:08:50 > 0:08:51A&E units on The Mark Just tune into Radio Kent or can hear more on the state of our A&E units
0:08:51 > 0:08:52A&E units on The Mark Just tune into Radio Kent or BBC Sussex after the can hear more on the state of our A&E units
0:08:53 > 0:08:54Radio Kent or BBC Sussex after the programme. Coming up, on Inside Out.
0:08:54 > 0:08:55Radio Kent or BBC Sussex after the programme. Coming up, on We are told
0:08:55 > 0:08:56programme. Coming up, on We are told all the time that
0:08:56 > 0:08:57all the time that competition is going to
0:08:57 > 0:08:58all the time that competition is going to be good for the
0:08:58 > 0:09:00going to be good for the health service.
0:09:00 > 0:09:01going to be good for the health service. However, we don't
0:09:01 > 0:09:02service. However, we don't hear it from people
0:09:02 > 0:09:03service. However, we don't hear it from people who are in the
0:09:03 > 0:09:04from people who are in the possession of any actual
0:09:04 > 0:09:05possession of any actual evidence to that effect,
0:09:05 > 0:09:06possession of any actual evidence to that effect, because there isn't
0:09:06 > 0:09:07that effect, because there isn't any. I think there
0:09:07 > 0:09:08that effect, because there isn't any. I think there is no doubt
0:09:08 > 0:09:09any. I think there is no doubt that competition can improve
0:09:09 > 0:09:10competition can improve health care, and competition
0:09:10 > 0:09:11competition can improve health care, and competition encourages people to
0:09:11 > 0:09:13and competition encourages people to try harder.
0:09:13 > 0:09:14try harder. Right across England, A&E departments
0:09:14 > 0:09:15try harder. Right across England, A&E departments are dealing with
0:09:15 > 0:09:16A&E departments are dealing with one million more
0:09:16 > 0:09:17A&E departments are dealing with one million more people every year than
0:09:17 > 0:09:18million more people every year than they were three years
0:09:18 > 0:09:19they were three years ago. Jamie Coulson now
0:09:19 > 0:09:20they were three years ago. Jamie Coulson now takes a look
0:09:20 > 0:09:25Coulson now takes a look at the bigger picture.
0:09:30 > 0:09:31The prospect
0:09:31 > 0:09:32The prospect of arriving here
0:09:32 > 0:09:33The prospect of arriving here at accident and emergency
0:09:33 > 0:09:34The prospect of arriving here at accident and emergency is never a
0:09:34 > 0:09:35accident and emergency is never a pleasant one. But what
0:09:35 > 0:09:36pleasant one. But what can make it seem even
0:09:36 > 0:09:37pleasant one. But what can make it seem even more daunting for
0:09:37 > 0:09:38seem even more daunting for people is the
0:09:38 > 0:09:39seem even more daunting for people is the length of time you
0:09:39 > 0:09:40is the length of time you may have to wait
0:09:40 > 0:09:41is the length of time you may have to wait to see a
0:09:41 > 0:09:42is the length of time you may have to wait to see a doctor.
0:09:42 > 0:09:43is the length of time you may have to wait to see a doctor. We are in
0:09:43 > 0:09:44to wait to see a doctor. We are in the worst position that
0:09:44 > 0:09:45the worst position that we have ever been.
0:09:45 > 0:09:46the worst position that we have ever been. We have a
0:09:46 > 0:09:47been. We have a real crisis in recruiting
0:09:47 > 0:09:50recruiting people into emergency medicine.
0:09:50 > 0:09:51recruiting people into emergency medicine. You just find yourself
0:09:51 > 0:09:52medicine. You just find yourself thinking "how long
0:09:52 > 0:09:53medicine. You just find yourself thinking "how long can we carry on
0:09:53 > 0:09:54thinking "how long can we carry on working like this?" There
0:09:54 > 0:09:55working like this?" There needs to be light
0:09:55 > 0:09:56working like this?" There needs to be light at the end
0:09:56 > 0:09:57be light at the end of the tunnel and
0:09:57 > 0:09:58be light at the end of the tunnel and at the moment there
0:09:58 > 0:09:59be light at the end of the tunnel and at the moment there isn't. So
0:09:59 > 0:10:00and at the moment there isn't. So how did such a
0:10:00 > 0:10:01and at the moment there isn't. So how did such a vital organ of the
0:10:01 > 0:10:02how did such a vital organ of the NHS become such a
0:10:02 > 0:10:03how did such a vital organ of the NHS become such a problem, and what
0:10:03 > 0:10:04NHS become such a problem, and what can be done to
0:10:04 > 0:10:06NHS become such a problem, and what can be done to fix it?
0:10:06 > 0:10:07NHS become such a problem, and what can be done to fix it? These
0:10:07 > 0:10:08can be done to fix it? These patients are seeing their
0:10:08 > 0:10:09patients are seeing their GP, all at the
0:10:09 > 0:10:11patients are seeing their GP, all at the same time.
0:10:11 > 0:10:12the same time. Maureen Lloyd was once very
0:10:12 > 0:10:13the same time. Maureen Lloyd was once very likely to have
0:10:13 > 0:10:14once very likely to have become a regular at
0:10:14 > 0:10:15once very likely to have become a regular at her local A&E
0:10:15 > 0:10:16once very likely to have become a regular at her local A&E department.
0:10:16 > 0:10:17regular at her local A&E department. Along with her
0:10:17 > 0:10:18regular at her local A&E department. Along with her fellow patients at
0:10:18 > 0:10:19Along with her fellow patients at risk of diabetes, she
0:10:19 > 0:10:20risk of diabetes, she faced a future of
0:10:20 > 0:10:22risk of diabetes, she faced a future of chronic health problems.
0:10:22 > 0:10:23of chronic health problems. But hopefully that
0:10:23 > 0:10:24of chronic health problems. But hopefully that is no longer
0:10:24 > 0:10:26hopefully that is no longer the case.
0:10:26 > 0:10:27hopefully that is no longer the case. I started
0:10:27 > 0:10:28case. I started watching my diet better.
0:10:28 > 0:10:29case. I started watching my diet better. And then from
0:10:29 > 0:10:30case. I started watching my diet better. And then from the practice I
0:10:30 > 0:10:31better. And then from the practice I was encouraged to try
0:10:31 > 0:10:37was encouraged to try exercise on prescription.
0:10:37 > 0:10:38was encouraged to try exercise on prescription. She has gone from
0:10:38 > 0:10:39prescription. She has gone from being a poorly
0:10:39 > 0:10:40being a poorly controlled diabetic to being
0:10:40 > 0:10:41being a poorly controlled diabetic to being no diabetes, in the
0:10:41 > 0:10:42to being no diabetes, in the pre—diabetes stage.
0:10:42 > 0:10:43to being no diabetes, in the pre—diabetes stage. Emergency
0:10:43 > 0:10:44pre—diabetes stage. Emergency hospital admissions from patients
0:10:44 > 0:10:45hospital admissions from patients with chronic illnesses here
0:10:45 > 0:10:46with chronic illnesses here at this GP's
0:10:46 > 0:10:47with chronic illnesses here at this GP's surgery in the West
0:10:47 > 0:10:48GP's surgery in the West Midlands are set to
0:10:48 > 0:10:49GP's surgery in the West Midlands are set to have reduced by
0:10:49 > 0:10:54are set to have reduced by 40% in 18 months.
0:10:54 > 0:10:55are set to have reduced by 40% in 18 months. I simply
0:10:55 > 0:10:56are set to have reduced by 40% in 18 months. I simply won't have an
0:10:56 > 0:10:57months. I simply won't have an hour or two hours
0:10:57 > 0:10:58months. I simply won't have an hour or two hours to spend with every
0:10:58 > 0:10:59or two hours to spend with every patient and that
0:10:59 > 0:11:00or two hours to spend with every patient and that is what they need.
0:11:00 > 0:11:01patient and that is what they need. Do you
0:11:01 > 0:11:02patient and that is what they need. Do you think you would
0:11:02 > 0:11:05Do you think you would have done this anyway?
0:11:05 > 0:11:07Do you think you would have done this anyway? I doubt it.
0:11:07 > 0:11:08this anyway? I doubt it. I don't think I
0:11:08 > 0:11:09this anyway? I doubt it. I don't think I would. What we
0:11:09 > 0:11:10think I would. What we have seen with Maureen
0:11:10 > 0:11:11think I would. What we have seen with Maureen is a bit unusual
0:11:11 > 0:11:12with Maureen is a bit unusual and a different approach,
0:11:12 > 0:11:13different approach, but ultimately it is
0:11:13 > 0:11:14different approach, but ultimately it is about trying to
0:11:14 > 0:11:15it is about trying to keep people out of
0:11:15 > 0:11:16it is about trying to keep people out of here. The patient,
0:11:16 > 0:11:17out of here. The patient, the person, has
0:11:17 > 0:11:18out of here. The patient, the person, has to manage themselves 24
0:11:18 > 0:11:19person, has to manage themselves 24 hours a day, so
0:11:19 > 0:11:20person, has to manage themselves 24 hours a day, so if we can
0:11:20 > 0:11:21hours a day, so if we can get people to understand
0:11:21 > 0:11:22hours a day, so if we can get people to understand their disease and look
0:11:22 > 0:11:23to understand their disease and look after themselves, it
0:11:23 > 0:11:25after themselves, it makes a huge difference.
0:11:25 > 0:11:26after themselves, it makes a huge difference. Generally
0:11:26 > 0:11:27difference. Generally speaking, where access to
0:11:27 > 0:11:28difference. Generally speaking, where access to GPs' surgeries are
0:11:28 > 0:11:29where access to GPs' surgeries are good, attendances at A&E
0:11:29 > 0:11:31good, attendances at A&E can be lower.
0:11:31 > 0:11:32good, attendances at A&E can be lower. So it seems
0:11:32 > 0:11:33lower. So it seems the family doctor can
0:11:33 > 0:11:34lower. So it seems the family doctor can play a role
0:11:34 > 0:11:36can play a role in reducing the pressure.
0:11:36 > 0:11:37can play a role in reducing the pressure. The last Department
0:11:37 > 0:11:38pressure. The last Department of Health figures show
0:11:38 > 0:11:39Health figures show that annually over one
0:11:39 > 0:11:40Health figures show that annually over one million more people
0:11:40 > 0:11:41over one million more people visited A&E, compared to
0:11:41 > 0:11:44over one million more people visited A&E, compared to three years ago.
0:11:44 > 0:11:45A&E, compared to three years ago. This recent report
0:11:45 > 0:11:46A&E, compared to three years ago. This recent report by A&E England
0:11:46 > 0:11:47This recent report by A&E England admits that A&E performance
0:11:47 > 0:11:53admits that A&E performance has deteriorated significantly.
0:11:53 > 0:11:54deteriorated significantly. —— recent report by
0:11:54 > 0:11:55recent report by NHS England. The number of
0:11:55 > 0:11:56recent report by NHS England. The number of hospitals failing to
0:11:56 > 0:11:57number of hospitals failing to treat and discharge 95%
0:11:57 > 0:11:58number of hospitals failing to treat and discharge 95% of patients within
0:11:58 > 0:11:59and discharge 95% of patients within four hours has doubled
0:11:59 > 0:12:02and discharge 95% of patients within four hours has doubled in 12 months.
0:12:02 > 0:12:03four hours has doubled in 12 months. Inside Out
0:12:03 > 0:12:04four hours has doubled in 12 months. Inside Out filmed at ten
0:12:04 > 0:12:05Inside Out filmed at ten A&Es across England on
0:12:05 > 0:12:06Inside Out filmed at ten A&Es across England on the same day.
0:12:06 > 0:12:07England on the same day. Five of those failed
0:12:07 > 0:12:08England on the same day. Five of those failed to reach the
0:12:08 > 0:12:09those failed to reach the government's waiting time target.
0:12:09 > 0:12:10government's waiting time target. Our figures
0:12:10 > 0:12:11government's waiting time target. Our figures are just a
0:12:11 > 0:12:12Our figures are just a snapshot, and hospital trusts
0:12:12 > 0:12:13Our figures are just a snapshot, and hospital trusts are measured weekly,
0:12:13 > 0:12:18hospital trusts are measured weekly, monthly and annually.
0:12:19 > 0:12:20Great
0:12:20 > 0:12:21Great Yarmouth in Norfolk.
0:12:21 > 0:12:22Great Yarmouth in Norfolk. A few miles
0:12:22 > 0:12:23Great Yarmouth in Norfolk. A few miles from the seafront, the
0:12:23 > 0:12:24miles from the seafront, the local A&E struggles to
0:12:24 > 0:12:25miles from the seafront, the local A&E struggles to cope with the
0:12:25 > 0:12:26A&E struggles to cope with the demands of the town's
0:12:26 > 0:12:27demands of the town's population, even before the
0:12:27 > 0:12:28demands of the town's population, even before the seasonal influx of
0:12:28 > 0:12:37even before the seasonal influx of tourists.
0:12:37 > 0:12:38even before the seasonal influx of tourists. This hospital is
0:12:38 > 0:12:39even before the seasonal influx of tourists. This hospital is in a part
0:12:39 > 0:12:41of England that really struggles to recruit
0:12:41 > 0:12:42of England that really struggles to recruit enough Accident and
0:12:42 > 0:12:44recruit enough Accident and Emergency doctors.
0:12:44 > 0:12:45recruit enough Accident and Emergency doctors. But there is
0:12:45 > 0:12:46Emergency doctors. But there is no respite with winter just
0:12:46 > 0:12:48respite with winter just around the corner.
0:12:48 > 0:12:49respite with winter just around the corner. Staff shortages
0:12:49 > 0:12:50corner. Staff shortages in Accident and Emergency
0:12:50 > 0:12:51corner. Staff shortages in Accident and Emergency have become a way
0:12:51 > 0:12:52and Emergency have become a way of life here
0:12:52 > 0:12:53and Emergency have become a way of life here at the James Paget
0:12:53 > 0:12:54life here at the James Paget Hospital.
0:12:54 > 0:12:55life here at the James Paget Hospital. We have
0:12:55 > 0:12:56Hospital. We have got eight posts filled out
0:12:56 > 0:12:57Hospital. We have got eight posts filled out of 42 posts
0:12:57 > 0:12:58filled out of 42 posts this year, which means
0:12:58 > 0:12:59filled out of 42 posts this year, which means 34 gaps on
0:12:59 > 0:13:00which means 34 gaps on the rotas across the
0:13:00 > 0:13:01which means 34 gaps on the rotas across the east of England,
0:13:01 > 0:13:02across the east of England, from Peterborough to Southend,
0:13:02 > 0:13:03Peterborough to Southend, including us.
0:13:03 > 0:13:04Peterborough to Southend, including us. Consultants are
0:13:04 > 0:13:05Peterborough to Southend, including us. Consultants are having to work
0:13:05 > 0:13:06us. Consultants are having to work a lot harder to
0:13:06 > 0:13:07us. Consultants are having to work a lot harder to fill those gaps so
0:13:07 > 0:13:08lot harder to fill those gaps so the junior doctors
0:13:08 > 0:13:09lot harder to fill those gaps so the junior doctors who are here as
0:13:09 > 0:13:10junior doctors who are here as part of their rotations
0:13:10 > 0:13:11of their rotations and they look at these
0:13:11 > 0:13:12of their rotations and they look at these guys who
0:13:12 > 0:13:13these guys who are working to breaking
0:13:13 > 0:13:14these guys who are working to breaking point to keep things
0:13:14 > 0:13:16breaking point to keep things ticking over.
0:13:16 > 0:13:17breaking point to keep things ticking over. They say, "I
0:13:17 > 0:13:18ticking over. They say, "I don't want to be
0:13:18 > 0:13:19ticking over. They say, "I don't want to be doing that for the
0:13:19 > 0:13:20want to be doing that for the rest of my
0:13:20 > 0:13:21want to be doing that for the rest of my career", so they find
0:13:21 > 0:13:22of my career", so they find themselves something that is
0:13:22 > 0:13:23themselves something that is less stressful.
0:13:23 > 0:13:24themselves something that is less stressful. At
0:13:24 > 0:13:25themselves something that is less stressful. At the College of
0:13:25 > 0:13:26Emergency Medicine's London headquarters, there
0:13:26 > 0:13:27Emergency Medicine's London headquarters, there is alarm about
0:13:27 > 0:13:28headquarters, there is alarm about the situation in
0:13:28 > 0:13:29the situation in A&E departments up and down
0:13:29 > 0:13:31the situation in A&E departments up and down the country.
0:13:31 > 0:13:32the situation in A&E departments up and down the country. How concerned
0:13:32 > 0:13:34and down the country. How concerned should patients be?
0:13:34 > 0:13:35and down the country. How concerned should patients be? We are coming
0:13:35 > 0:13:36should patients be? We are coming to the point where
0:13:36 > 0:13:37should patients be? We are coming to the point where the situation will
0:13:37 > 0:13:38the point where the situation will destabilise and there will
0:13:38 > 0:13:39destabilise and there will be episodes in which
0:13:39 > 0:13:40destabilise and there will be episodes in which patient safety is
0:13:40 > 0:13:41episodes in which patient safety is compromised due to a
0:13:41 > 0:13:42compromised due to a lack of emergency medicine
0:13:42 > 0:13:43compromised due to a lack of emergency medicine doctors.
0:13:43 > 0:13:44compromised due to a lack of emergency medicine doctors. I
0:13:44 > 0:13:45emergency medicine doctors. I can't move my wrist
0:13:45 > 0:13:46emergency medicine doctors. I can't move my wrist very well.
0:13:46 > 0:13:47emergency medicine doctors. I can't move my wrist very well. Dr
0:13:47 > 0:13:48move my wrist very well. Dr Tamer Okasha divides his
0:13:48 > 0:13:49Okasha divides his working week between
0:13:49 > 0:13:50Okasha divides his working week between shifts as an A&E
0:13:50 > 0:13:51between shifts as an A&E consultant at Great Yarmouth
0:13:51 > 0:13:52between shifts as an A&E consultant at Great Yarmouth and a GP
0:13:52 > 0:13:53at Great Yarmouth and a GP in Norwich, so he
0:13:53 > 0:13:54Norwich, so he simultaneously specialises in primary
0:13:54 > 0:13:58specialises in primary care and emergency medicine.
0:13:58 > 0:13:59specialises in primary care and emergency medicine. How
0:13:59 > 0:14:00emergency medicine. How many patients do
0:14:00 > 0:14:01emergency medicine. How many patients do you see here in
0:14:01 > 0:14:02patients do you see here in an A&E that perhaps
0:14:02 > 0:14:03patients do you see here in an A&E that perhaps you could have
0:14:03 > 0:14:04that perhaps you could have dealt with as a
0:14:04 > 0:14:06that perhaps you could have dealt with as a GP in practice?
0:14:06 > 0:14:07that perhaps you could have dealt with as a GP in practice? Up to
0:14:07 > 0:14:08with as a GP in practice? Up to 60% of any presentations
0:14:08 > 0:14:09with as a GP in practice? Up to 60% of any presentations could have been
0:14:09 > 0:14:10of any presentations could have been dealt with in primary
0:14:10 > 0:14:12of any presentations could have been dealt with in primary care.
0:14:12 > 0:14:13dealt with in primary care. Many patients who come to the
0:14:13 > 0:14:14patients who come to the emergency department simply don't need
0:14:14 > 0:14:15patients who come to the emergency department simply don't need to be
0:14:15 > 0:14:16department simply don't need to be here.
0:14:16 > 0:14:17department simply don't need to be here. A&Es were never
0:14:17 > 0:14:18here. A&Es were never designed to be the access
0:14:18 > 0:14:19here. A&Es were never designed to be the access point for
0:14:19 > 0:14:22the access point for every illness or injury.
0:14:22 > 0:14:23the access point for every illness or injury. The
0:14:23 > 0:14:24the access point for every illness or injury. The 111 phone line was
0:14:24 > 0:14:25or injury. The 111 phone line was introduced, in part, to
0:14:25 > 0:14:26introduced, in part, to filter out those patients but,
0:14:26 > 0:14:27introduced, in part, to filter out those patients but, in some
0:14:27 > 0:14:28those patients but, in some cases, it had the
0:14:28 > 0:14:30those patients but, in some cases, it had the opposite effect.
0:14:30 > 0:14:31those patients but, in some cases, it had the opposite effect. Call
0:14:31 > 0:14:32it had the opposite effect. Call centre staff with
0:14:32 > 0:14:33centre staff with minimal training ended up
0:14:33 > 0:14:36ended up despatching ambulances too readily.
0:14:36 > 0:14:37ended up despatching ambulances too readily. Make sure you don't
0:14:37 > 0:14:38readily. Make sure you don't use any medication that's
0:14:38 > 0:14:39medication that's been prescribed for anybody
0:14:39 > 0:14:41medication that's been prescribed for anybody else, OK?
0:14:41 > 0:14:42for anybody else, OK? In Derby, the new service
0:14:42 > 0:14:43for anybody else, OK? In Derby, the new service has been a
0:14:43 > 0:14:44for anybody else, OK? In Derby, the new service has been a success.
0:14:44 > 0:14:45new service has been a success. Nonclinical phone
0:14:45 > 0:14:46new service has been a success. Nonclinical phone handlers who have
0:14:46 > 0:14:47Nonclinical phone handlers who have received six weeks' training
0:14:47 > 0:14:48received six weeks' training have medical experts
0:14:48 > 0:14:49received six weeks' training have medical experts on hand to intervene
0:14:49 > 0:14:50medical experts on hand to intervene at any stage of
0:14:50 > 0:14:52medical experts on hand to intervene at any stage of a call.
0:14:52 > 0:14:53at any stage of a call. The 111 service has
0:14:53 > 0:14:54at any stage of a call. The 111 service has to be aware
0:14:54 > 0:14:55service has to be aware of the effect on the
0:14:55 > 0:14:56service has to be aware of the effect on the A&E departments and
0:14:56 > 0:14:57effect on the A&E departments and the effects on the
0:14:57 > 0:14:58the effects on the ambulance services and
0:14:58 > 0:15:00the effects on the ambulance services and work with them.
0:15:00 > 0:15:01services and work with them. The Secretary of State
0:15:01 > 0:15:02services and work with them. The Secretary of State for Health claims
0:15:02 > 0:15:03Secretary of State for Health claims that 111 is now
0:15:03 > 0:15:05Secretary of State for Health claims that 111 is now starting to work.
0:15:05 > 0:15:06that 111 is now starting to work. We did have some
0:15:06 > 0:15:07that 111 is now starting to work. We did have some teething problems with
0:15:07 > 0:15:08did have some teething problems with the 111 service, but
0:15:08 > 0:15:09did have some teething problems with the 111 service, but you are always
0:15:09 > 0:15:10the 111 service, but you are always going to have some
0:15:10 > 0:15:11going to have some people who are not doctors
0:15:11 > 0:15:12going to have some people who are not doctors and nurses who
0:15:12 > 0:15:13not doctors and nurses who will hand the call
0:15:13 > 0:15:14not doctors and nurses who will hand the call right at
0:15:14 > 0:15:15not doctors and nurses who will hand the call right at the very start of
0:15:15 > 0:15:17the call right at the very start of the process.
0:15:17 > 0:15:18the call right at the very start of the process. What we need to
0:15:18 > 0:15:19the process. What we need to do is make sure
0:15:19 > 0:15:20the process. What we need to do is make sure if you need
0:15:20 > 0:15:21the process. What we need to do is make sure if you need to speak to a
0:15:21 > 0:15:22make sure if you need to speak to a doctor or nurse,
0:15:22 > 0:15:23make sure if you need to speak to a doctor or nurse, you are put through
0:15:23 > 0:15:24doctor or nurse, you are put through to one of them
0:15:24 > 0:15:25doctor or nurse, you are put through to one of them very quickly.
0:15:25 > 0:15:26to one of them very quickly. A&E departments will be
0:15:26 > 0:15:27departments will be given an additional £500
0:15:27 > 0:15:28departments will be given an additional £500 million over the
0:15:28 > 0:15:29additional £500 million over the next two years to
0:15:29 > 0:15:31next two years to deal with seasonal pressures.
0:15:31 > 0:15:32next two years to deal with seasonal pressures. Jeremy Hunt recently
0:15:32 > 0:15:33pressures. Jeremy Hunt recently announced a short—term fix
0:15:33 > 0:15:34announced a short—term fix for A&E departments but
0:15:34 > 0:15:35announced a short—term fix for A&E departments but a report on
0:15:35 > 0:15:36departments but a report on the future shape of
0:15:36 > 0:15:37departments but a report on the future shape of urgent and emergency
0:15:37 > 0:15:38future shape of urgent and emergency care provision is due
0:15:38 > 0:15:39future shape of urgent and emergency care provision is due out soon.
0:15:39 > 0:15:40care provision is due out soon. This man is
0:15:40 > 0:15:41care provision is due out soon. This man is helping to redesign the
0:15:41 > 0:15:43man is helping to redesign the service across England.
0:15:43 > 0:15:44man is helping to redesign the service across England. What we have
0:15:44 > 0:15:45service across England. What we have to do with those
0:15:45 > 0:15:46service across England. What we have to do with those moneys that have
0:15:46 > 0:15:47to do with those moneys that have come is optimise this
0:15:47 > 0:15:48come is optimise this current model of care
0:15:48 > 0:15:49come is optimise this current model of care that we have
0:15:49 > 0:15:50of care that we have to reduce the pressures over
0:15:50 > 0:15:51of care that we have to reduce the pressures over the next two
0:15:51 > 0:15:54of care that we have to reduce the pressures over the next two years.
0:15:54 > 0:15:55pressures over the next two years. Are things
0:15:55 > 0:15:57pressures over the next two years. Are things safe at the moment?
0:15:57 > 0:15:58Are things safe at the moment? At the moment,
0:15:58 > 0:15:59Are things safe at the moment? At the moment, our figures for
0:15:59 > 0:16:00the moment, our figures for this summer period look
0:16:00 > 0:16:01the moment, our figures for this summer period look very good.
0:16:01 > 0:16:02the moment, our figures for this summer period look very good. We are
0:16:02 > 0:16:04summer period look very good. We are monitoring safety.
0:16:04 > 0:16:05summer period look very good. We are monitoring safety. I can't give
0:16:05 > 0:16:06monitoring safety. I can't give you a prediction of
0:16:06 > 0:16:07monitoring safety. I can't give you a prediction of what will happen.
0:16:07 > 0:16:08a prediction of what will happen. What
0:16:08 > 0:16:09a prediction of what will happen. What I can guarantee is
0:16:09 > 0:16:10What I can guarantee is that the local areas
0:16:10 > 0:16:11What I can guarantee is that the local areas are doing everything
0:16:11 > 0:16:12local areas are doing everything they can to create
0:16:12 > 0:16:13local areas are doing everything they can to create a system going
0:16:13 > 0:16:14they can to create a system going forward that has as
0:16:14 > 0:16:15forward that has as many safeguards in it
0:16:15 > 0:16:16forward that has as many safeguards in it as possible.
0:16:16 > 0:16:17forward that has as many safeguards in it as possible. The
0:16:17 > 0:16:18in it as possible. The report into the future
0:16:18 > 0:16:19in it as possible. The report into the future of emergency care
0:16:19 > 0:16:20the future of emergency care in England is
0:16:20 > 0:16:23the future of emergency care in England is due out this autumn.
0:16:28 > 0:16:29Jamie Coulson
0:16:29 > 0:16:30Jamie Coulson reporting.
0:16:30 > 0:16:31Jamie Coulson reporting. The
0:16:31 > 0:16:32Jamie Coulson reporting. The government's recent Health and
0:16:32 > 0:16:33government's recent Health and Social Care Act set
0:16:33 > 0:16:34government's recent Health and Social Care Act set off a massive
0:16:34 > 0:16:35Social Care Act set off a massive debate and brought with
0:16:35 > 0:16:36debate and brought with it far reaching
0:16:36 > 0:16:38reaching changes to the Health Service.
0:16:38 > 0:16:39reaching changes to the Health Service. The upshot
0:16:39 > 0:16:40reaching changes to the Health Service. The upshot is that GPs
0:16:40 > 0:16:41Service. The upshot is that GPs now manage the budgets,
0:16:41 > 0:16:42Service. The upshot is that GPs now manage the budgets, but what do
0:16:42 > 0:16:43manage the budgets, but what do these changes actually mean
0:16:43 > 0:16:44manage the budgets, but what do these changes actually mean for us?
0:16:44 > 0:16:45these changes actually mean for us? Emma
0:16:45 > 0:16:46these changes actually mean for us? Emma Thomas has been finding
0:16:46 > 0:16:48these changes actually mean for us? Emma Thomas has been finding out.
0:16:48 > 0:16:49Emma Thomas has been finding out. On July
0:16:49 > 0:16:50Emma Thomas has been finding out. On July 5th, the new
0:16:50 > 0:16:52On July 5th, the new National Health Service starts.
0:16:52 > 0:16:53Service starts. It's a
0:16:53 > 0:16:54Service starts. It's a comforting thought that
0:16:54 > 0:16:55It's a comforting thought that when you are sick,
0:16:55 > 0:16:56It's a comforting thought that when you are sick, your GP will
0:16:56 > 0:16:57you are sick, your GP will always be there to
0:16:57 > 0:16:59you are sick, your GP will always be there to look after you.
0:16:59 > 0:17:00there to look after you. It has been this way
0:17:00 > 0:17:01there to look after you. It has been this way since the NHS
0:17:01 > 0:17:04this way since the NHS was founded in 1948.
0:17:04 > 0:17:05this way since the NHS was founded in 1948. But now what your
0:17:05 > 0:17:06in 1948. But now what your GP actually does
0:17:06 > 0:17:07actually does has changed and worried patients
0:17:07 > 0:17:08actually does has changed and worried patients have taking to
0:17:08 > 0:17:09worried patients have taking to the streets in
0:17:09 > 0:17:11worried patients have taking to the streets in protest.
0:17:11 > 0:17:12worried patients have taking to the streets in protest. I
0:17:12 > 0:17:13worried patients have taking to the streets in protest. I am here today
0:17:13 > 0:17:14streets in protest. I am here today because I am concerned
0:17:14 > 0:17:15because I am concerned about the creeping privatisation
0:17:15 > 0:17:16creeping privatisation of the National Health
0:17:16 > 0:17:17creeping privatisation of the National Health Service.
0:17:17 > 0:17:18creeping privatisation of the National Health Service. It
0:17:18 > 0:17:19National Health Service. It affects everybody in Britain
0:17:19 > 0:17:20everybody in Britain and if everybody in
0:17:20 > 0:17:21everybody in Britain and if everybody in Britain does not
0:17:21 > 0:17:22everybody in Britain does not begin to take action
0:17:22 > 0:17:23everybody in Britain does not begin to take action about it, it will
0:17:23 > 0:17:24to take action about it, it will be far too
0:17:24 > 0:17:26to take action about it, it will be far too late.
0:17:26 > 0:17:27to take action about it, it will be far too late. The Health and
0:17:27 > 0:17:28far too late. The Health and Social Care Act which
0:17:28 > 0:17:29far too late. The Health and Social Care Act which came into force this
0:17:29 > 0:17:30Care Act which came into force this year has brought
0:17:30 > 0:17:31Care Act which came into force this year has brought one of the biggest
0:17:31 > 0:17:32year has brought one of the biggest changes to the NHS
0:17:32 > 0:17:36year has brought one of the biggest changes to the NHS in its history.
0:17:36 > 0:17:37changes to the NHS in its history. Some GPs like Dr
0:17:37 > 0:17:38changes to the NHS in its history. Some GPs like Dr Patel who works in
0:17:38 > 0:17:39Some GPs like Dr Patel who works in East Grinstead are
0:17:39 > 0:17:40Some GPs like Dr Patel who works in East Grinstead are now in control of
0:17:40 > 0:17:43East Grinstead are now in control of their own budgets.
0:17:43 > 0:17:44East Grinstead are now in control of their own budgets. The benefit is
0:17:44 > 0:17:45their own budgets. The benefit is that you have
0:17:45 > 0:17:46their own budgets. The benefit is that you have a membership of a
0:17:46 > 0:17:47that you have a membership of a very wide array of
0:17:47 > 0:17:48that you have a membership of a very wide array of GPs and other health
0:17:48 > 0:17:49wide array of GPs and other health professionals within the
0:17:49 > 0:17:50professionals within the community who are able
0:17:50 > 0:17:51professionals within the community who are able to use their clinical
0:17:51 > 0:17:52who are able to use their clinical knowledge and their experience
0:17:52 > 0:17:53knowledge and their experience to plan and
0:17:53 > 0:17:54knowledge and their experience to plan and improve service at a
0:17:54 > 0:17:55plan and improve service at a level that has
0:17:55 > 0:18:01plan and improve service at a level that has not existed before.
0:18:01 > 0:18:02plan and improve service at a level that has not existed before. We have
0:18:02 > 0:18:03that has not existed before. We have not had this level
0:18:03 > 0:18:04not had this level of clinical involvement and
0:18:04 > 0:18:05involvement and engagement in commissioning
0:18:05 > 0:18:09involvement and engagement in commissioning in the NHS ever.
0:18:09 > 0:18:10involvement and engagement in commissioning in the NHS ever. But
0:18:10 > 0:18:12commissioning in the NHS ever. But not everyone is happy.
0:18:12 > 0:18:13commissioning in the NHS ever. But not everyone is happy. Gareth
0:18:13 > 0:18:14not everyone is happy. Gareth Tomlinson is a
0:18:14 > 0:18:15not everyone is happy. Gareth Tomlinson is a member of an NHS
0:18:15 > 0:18:16Tomlinson is a member of an NHS patients group covering West
0:18:16 > 0:18:17patients group covering West Kent, who are
0:18:17 > 0:18:18patients group covering West Kent, who are there to keep an
0:18:18 > 0:18:19patients group covering West Kent, who are there to keep an eye on the
0:18:19 > 0:18:21who are there to keep an eye on the changes.
0:18:21 > 0:18:22who are there to keep an eye on the changes. I am being
0:18:22 > 0:18:23changes. I am being sold by the government the
0:18:23 > 0:18:24changes. I am being sold by the government the idea that this
0:18:24 > 0:18:25government the idea that this will actually improve
0:18:25 > 0:18:26actually improve patient choice and improve quality
0:18:26 > 0:18:27actually improve patient choice and improve quality of service and
0:18:27 > 0:18:28improve quality of service and bring down costs
0:18:28 > 0:18:30improve quality of service and bring down costs in the NHS.
0:18:30 > 0:18:31improve quality of service and bring down costs in the NHS. None of
0:18:31 > 0:18:32down costs in the NHS. None of which, I believe, is
0:18:32 > 0:18:34down costs in the NHS. None of which, I believe, is true.
0:18:34 > 0:18:35down costs in the NHS. None of which, I believe, is true. So what
0:18:35 > 0:18:36which, I believe, is true. So what does Gareth think is
0:18:36 > 0:18:37which, I believe, is true. So what does Gareth think is the problem?
0:18:37 > 0:18:38which, I believe, is true. So what does Gareth think is the problem? He
0:18:38 > 0:18:39does Gareth think is the problem? He thinks the most
0:18:39 > 0:18:40thinks the most worrying thing about the new
0:18:40 > 0:18:41thinks the most worrying thing about the new act is the
0:18:41 > 0:18:42thinks the most worrying thing about the new act is the new system of
0:18:42 > 0:18:44the new act is the new system of clinical commissioning groups.
0:18:44 > 0:18:45clinical commissioning groups. GPs and other
0:18:45 > 0:18:46and other health professionals have been
0:18:46 > 0:18:47and other health professionals have been organised into these CCGS,
0:18:47 > 0:18:48been organised into these CCGS, as they are
0:18:48 > 0:18:52been organised into these CCGS, as they are known.
0:18:52 > 0:18:53been organised into these CCGS, as they are known. They
0:18:53 > 0:18:54been organised into these CCGS, as they are known. They have access to
0:18:54 > 0:18:55they are known. They have access to money to buy some
0:18:55 > 0:18:56money to buy some services from private companies,
0:18:56 > 0:18:57private companies, services that could be
0:18:57 > 0:18:58private companies, services that could be provided within the
0:18:58 > 0:18:59private companies, services that could be provided within the NHS.
0:18:59 > 0:19:00could be provided within the NHS. Things like ambulances,
0:19:00 > 0:19:01Things like ambulances, hip operations and
0:19:01 > 0:19:02Things like ambulances, hip operations and district nurses, for
0:19:02 > 0:19:03operations and district nurses, for example.
0:19:03 > 0:19:04operations and district nurses, for example. Some health
0:19:04 > 0:19:05example. Some health experts like Roy Lilley
0:19:05 > 0:19:06example. Some health experts like Roy Lilley are not happy
0:19:06 > 0:19:07Roy Lilley are not happy with Section 75 of
0:19:07 > 0:19:09Roy Lilley are not happy with Section 75 of the new act.
0:19:09 > 0:19:10Roy Lilley are not happy with Section 75 of the new act. It is the
0:19:10 > 0:19:11Section 75 of the new act. It is the bit which lays out
0:19:11 > 0:19:12Section 75 of the new act. It is the bit which lays out exactly how CCGs
0:19:12 > 0:19:13bit which lays out exactly how CCGs should put services out
0:19:13 > 0:19:16bit which lays out exactly how CCGs should put services out to tender.
0:19:16 > 0:19:17should put services out to tender. If the cake was
0:19:17 > 0:19:18should put services out to tender. If the cake was the NHS, Section 75
0:19:18 > 0:19:19If the cake was the NHS, Section 75 is the knife, effectively,
0:19:19 > 0:19:20If the cake was the NHS, Section 75 is the knife, effectively, that
0:19:20 > 0:19:21is the knife, effectively, that allows it to be cut up and
0:19:21 > 0:19:24is the knife, effectively, that allows it to be cut up and sliced.
0:19:24 > 0:19:25allows it to be cut up and sliced. And Roy says slicing
0:19:25 > 0:19:26allows it to be cut up and sliced. And Roy says slicing up the cake
0:19:26 > 0:19:27And Roy says slicing up the cake and giving bits to
0:19:27 > 0:19:28And Roy says slicing up the cake and giving bits to the private sector is
0:19:28 > 0:19:30giving bits to the private sector is a bad idea.
0:19:30 > 0:19:31giving bits to the private sector is a bad idea. The NHS is
0:19:31 > 0:19:33giving bits to the private sector is a bad idea. The NHS is a whole cake.
0:19:33 > 0:19:34a bad idea. The NHS is a whole cake. It is
0:19:34 > 0:19:35a bad idea. The NHS is a whole cake. It is what we call
0:19:35 > 0:19:37It is what we call an integrated service.
0:19:37 > 0:19:38It is what we call an integrated service. It
0:19:38 > 0:19:40It is what we call an integrated service. It is a whole system.
0:19:40 > 0:19:41service. It is a whole system. You carve a
0:19:41 > 0:19:42service. It is a whole system. You carve a piece out of the
0:19:42 > 0:19:43carve a piece out of the cake, however tempting that
0:19:43 > 0:19:44carve a piece out of the cake, however tempting that is, you have
0:19:44 > 0:19:45however tempting that is, you have still got to put
0:19:45 > 0:19:46however tempting that is, you have still got to put it back in to
0:19:46 > 0:19:47still got to put it back in to make the whole
0:19:47 > 0:19:48still got to put it back in to make the whole system work.
0:19:48 > 0:19:49the whole system work. When you break them
0:19:49 > 0:19:50the whole system work. When you break them up and put
0:19:50 > 0:19:52break them up and put them in the hands
0:19:52 > 0:19:52hands of different operators, however good they are,
0:19:52 > 0:19:53hands of different operators, however good they are, you
0:19:53 > 0:19:54however good they are, you create more service
0:19:54 > 0:19:55however good they are, you create more service interfaces, more costs
0:19:55 > 0:19:56more service interfaces, more costs and more possibility for
0:19:56 > 0:19:58and more possibility for things to go wrong.
0:19:58 > 0:19:59and more possibility for things to go wrong. David Worksett runs an
0:19:59 > 0:20:00go wrong. David Worksett runs an alliance called the
0:20:00 > 0:20:01alliance called the NHS Confederation which represents
0:20:01 > 0:20:04Confederation which represents some private healthcare providers.
0:20:04 > 0:20:05private healthcare providers. He says there
0:20:05 > 0:20:06private healthcare providers. He says there won't be a problem
0:20:06 > 0:20:07says there won't be a problem with expensive administration
0:20:07 > 0:20:09expensive administration of the new system.
0:20:09 > 0:20:10expensive administration of the new system. That
0:20:10 > 0:20:11expensive administration of the new system. That is a very
0:20:11 > 0:20:12system. That is a very minor point and it
0:20:12 > 0:20:14system. That is a very minor point and it is largely irrelevant.
0:20:14 > 0:20:15and it is largely irrelevant. The interesting thing
0:20:15 > 0:20:16and it is largely irrelevant. The interesting thing about the NHS over
0:20:16 > 0:20:17interesting thing about the NHS over the last couple of
0:20:17 > 0:20:18interesting thing about the NHS over the last couple of decades is how
0:20:18 > 0:20:19the last couple of decades is how poor it has been
0:20:19 > 0:20:20poor it has been as an almost entirely
0:20:20 > 0:20:21poor it has been as an almost entirely state—run system.
0:20:21 > 0:20:22poor it has been as an almost entirely state—run system. Don't
0:20:22 > 0:20:23entirely state—run system. Don't forget, even with
0:20:23 > 0:20:24forget, even with these reform, the independent sector
0:20:24 > 0:20:25independent sector is only delivering 5%
0:20:25 > 0:20:26independent sector is only delivering 5% or 6% of
0:20:26 > 0:20:27delivering 5% or 6% of NHS services and that
0:20:27 > 0:20:28delivering 5% or 6% of NHS services and that is probably not
0:20:28 > 0:20:29and that is probably not even going to double
0:20:29 > 0:20:30and that is probably not even going to double over the next
0:20:30 > 0:20:31and that is probably not even going to double over the next decade.
0:20:31 > 0:20:32to double over the next decade. Let's keep this in
0:20:32 > 0:20:34to double over the next decade. Let's keep this in perspective.
0:20:34 > 0:20:35Let's keep this in perspective. The man
0:20:35 > 0:20:36Let's keep this in perspective. The man who is ultimately in
0:20:36 > 0:20:37man who is ultimately in charge of the NHS
0:20:37 > 0:20:38man who is ultimately in charge of the NHS is the Secretary
0:20:38 > 0:20:39the NHS is the Secretary of State for Health,
0:20:39 > 0:20:40the NHS is the Secretary of State for Health, Jeremy Hunt.
0:20:40 > 0:20:41the NHS is the Secretary of State for Health, Jeremy Hunt. What will
0:20:41 > 0:20:42for Health, Jeremy Hunt. What will the cost of
0:20:42 > 0:20:44for Health, Jeremy Hunt. What will the cost of the reorganisation be?
0:20:44 > 0:20:45the cost of the reorganisation be? And in terms of
0:20:45 > 0:20:46the cost of the reorganisation be? And in terms of admin, how much will
0:20:46 > 0:20:48And in terms of admin, how much will that cost?
0:20:48 > 0:20:49And in terms of admin, how much will that cost? Well, I can get
0:20:49 > 0:20:50that cost? Well, I can get you the exact figures
0:20:50 > 0:20:51that cost? Well, I can get you the exact figures but, net, that
0:20:51 > 0:20:52exact figures but, net, that reorganisation is saving £5.5
0:20:52 > 0:20:53reorganisation is saving £5.5 billion over the
0:20:53 > 0:20:54billion over the course of this Parliament and
0:20:54 > 0:20:55billion over the course of this Parliament and that means we
0:20:55 > 0:20:56Parliament and that means we are able to
0:20:56 > 0:20:57Parliament and that means we are able to employ more people on
0:20:57 > 0:20:58able to employ more people on the front line. 4,500
0:20:58 > 0:20:59front line. 4,500 more doctors, 400,000 more
0:20:59 > 0:21:00front line. 4,500 more doctors, 400,000 more operatiosn every year,
0:21:00 > 0:21:01400,000 more operatiosn every year, a million more people
0:21:01 > 0:21:05a million more people going through A&E.
0:21:05 > 0:21:06a million more people going through A&E. That is
0:21:06 > 0:21:07a million more people going through A&E. That is why I think they
0:21:07 > 0:21:09A&E. That is why I think they have been a success.
0:21:09 > 0:21:10A&E. That is why I think they have been a success. The NHS
0:21:10 > 0:21:11been a success. The NHS budget is worth billions
0:21:11 > 0:21:12been a success. The NHS budget is worth billions and the reforms
0:21:12 > 0:21:13worth billions and the reforms mean that private healthcare
0:21:13 > 0:21:14that private healthcare companies are going
0:21:14 > 0:21:15that private healthcare companies are going to be able to
0:21:15 > 0:21:16are going to be able to take a bigger slice
0:21:16 > 0:21:17are going to be able to take a bigger slice of it.
0:21:17 > 0:21:18are going to be able to take a bigger slice of it. But according
0:21:18 > 0:21:19bigger slice of it. But according to Roy
0:21:19 > 0:21:20bigger slice of it. But according to Roy Lilley, another problem is that
0:21:20 > 0:21:21Roy Lilley, another problem is that if GPs decide to
0:21:21 > 0:21:22Roy Lilley, another problem is that if GPs decide to buy a service
0:21:22 > 0:21:23if GPs decide to buy a service from a private supplier,
0:21:23 > 0:21:24if GPs decide to buy a service from a private supplier, the danger is
0:21:24 > 0:21:25a private supplier, the danger is that they will put
0:21:25 > 0:21:27that they will put profits ahead of patients.
0:21:27 > 0:21:28that they will put profits ahead of patients. So
0:21:28 > 0:21:29that they will put profits ahead of patients. So this is a
0:21:29 > 0:21:30patients. So this is a piece of cake that
0:21:30 > 0:21:31patients. So this is a piece of cake that represents a private company
0:21:31 > 0:21:32that represents a private company that has taken
0:21:32 > 0:21:33that represents a private company that has taken over.
0:21:33 > 0:21:34that has taken over. What is the problem with
0:21:34 > 0:21:35that has taken over. What is the problem with that?
0:21:35 > 0:21:36that has taken over. What is the problem with that? If this is
0:21:36 > 0:21:37problem with that? If this is the value of
0:21:37 > 0:21:38problem with that? If this is the value of the contract, the problem
0:21:38 > 0:21:39value of the contract, the problem they will find
0:21:39 > 0:21:40value of the contract, the problem they will find is that they won't
0:21:40 > 0:21:41they will find is that they won't be able to make
0:21:41 > 0:21:42they will find is that they won't be able to make a profit and operate
0:21:42 > 0:21:43able to make a profit and operate safely.
0:21:43 > 0:21:44able to make a profit and operate safely. They will start slicing
0:21:44 > 0:21:46safely. They will start slicing staffing costs.
0:21:46 > 0:21:47safely. They will start slicing staffing costs. They will start
0:21:47 > 0:21:49staffing costs. They will start slicing administration costs.
0:21:49 > 0:21:50slicing administration costs. They will start
0:21:50 > 0:21:51will start taking our operating costs, because
0:21:51 > 0:21:52will start taking our operating costs, because they will have
0:21:52 > 0:21:53costs, because they will have to reduce their costs
0:21:53 > 0:21:54costs, because they will have to reduce their costs in order to
0:21:54 > 0:21:55reduce their costs in order to create some wiggle room
0:21:55 > 0:21:56create some wiggle room to create enough of
0:21:56 > 0:21:57create some wiggle room to create enough of the cake to
0:21:57 > 0:21:58create some wiggle room to create enough of the cake to make a profit.
0:21:58 > 0:21:59enough of the cake to make a profit. I think
0:21:59 > 0:22:00enough of the cake to make a profit. I think that is an
0:22:00 > 0:22:01I think that is an old chestnut which is
0:22:01 > 0:22:03I think that is an old chestnut which is fairly easily dismissed.
0:22:03 > 0:22:04which is fairly easily dismissed. One of
0:22:04 > 0:22:05which is fairly easily dismissed. One of the interesting things, it
0:22:05 > 0:22:06One of the interesting things, it does not matter
0:22:06 > 0:22:07One of the interesting things, it does not matter if it is private
0:22:07 > 0:22:08does not matter if it is private companies or charities who
0:22:08 > 0:22:09companies or charities who deliver healthcare, if they
0:22:09 > 0:22:10companies or charities who deliver healthcare, if they fail to look
0:22:10 > 0:22:11healthcare, if they fail to look after their patients
0:22:11 > 0:22:12healthcare, if they fail to look do go out
0:22:12 > 0:22:14healthcare, if they fail to look do go out of business.
0:22:14 > 0:22:15do go out of business. Of course, the
0:22:15 > 0:22:16do go out of business. Of course, the reason GPs are being
0:22:16 > 0:22:17the reason GPs are being given these powers to
0:22:17 > 0:22:18the reason GPs are being given these powers to buy services is
0:22:18 > 0:22:19powers to buy services is to increase competition.
0:22:19 > 0:22:20powers to buy services is to increase competition. If
0:22:20 > 0:22:21increase competition. If the doctors offer a
0:22:21 > 0:22:22increase competition. If the doctors offer a contract for a service,
0:22:22 > 0:22:23offer a contract for a service, they will be
0:22:23 > 0:22:24offer a contract for a service, they will be able to choose which
0:22:24 > 0:22:25will be able to choose which provider does the
0:22:25 > 0:22:26will be able to choose which provider does the best job for the
0:22:26 > 0:22:28provider does the best job for the best
0:22:28 > 0:22:29provider does the best job for the best price. That would appear to be
0:22:29 > 0:22:31best price. That would appear to be a good thing.
0:22:31 > 0:22:32best price. That would appear to be a good thing. But
0:22:32 > 0:22:33a good thing. But some academics like
0:22:33 > 0:22:34a good thing. But some academics like Lucy Reynolds disagree.
0:22:34 > 0:22:35a good thing. But some academics like Lucy Reynolds disagree. We do
0:22:35 > 0:22:36like Lucy Reynolds disagree. We do hear all the time
0:22:36 > 0:22:37hear all the time that competition is
0:22:37 > 0:22:38hear all the time that competition is going to be good
0:22:38 > 0:22:39is going to be good for the Health Service.
0:22:39 > 0:22:40is going to be good for the Health Service. However,
0:22:40 > 0:22:41is going to be good for the Health Service. However, we don't hear it
0:22:41 > 0:22:42Service. However, we don't hear it from people who are
0:22:42 > 0:22:43from people who are in the possession
0:22:43 > 0:22:44from people who are in the possession of any actual evidence
0:22:44 > 0:22:45possession of any actual evidence to that effect because
0:22:45 > 0:22:46possession of any actual evidence to that effect because there isn't any.
0:22:46 > 0:22:47that effect because there isn't any. I think
0:22:47 > 0:22:48that effect because there isn't any. I think there is no doubt
0:22:48 > 0:22:49I think there is no doubt that competition can
0:22:49 > 0:22:50I think there is no doubt that competition can improve healthcare.
0:22:50 > 0:22:51competition can improve healthcare. People talk about
0:22:51 > 0:22:52People talk about healthcare being different
0:22:52 > 0:22:53People talk about healthcare being different to other sectors and,
0:22:53 > 0:22:54different to other sectors and, in certain key respects it is
0:22:54 > 0:22:55different to other sectors and, in certain key respects it is very
0:22:55 > 0:22:56certain key respects it is very different, but in others,
0:22:56 > 0:22:57different, but in others, the same things we
0:22:57 > 0:22:58different, but in others, the same things we all know in
0:22:58 > 0:22:59things we all know in our everyday lives still
0:22:59 > 0:23:00things we all know in our everyday lives still apply and competition
0:23:00 > 0:23:01lives still apply and competition encourages people to try
0:23:01 > 0:23:03encourages people to try harder, it encourages
0:23:03 > 0:23:04encourages people to come up with innovation.
0:23:04 > 0:23:05encourages people to come up with innovation. In
0:23:05 > 0:23:06encourages people to come up with innovation. In terms of the academic
0:23:06 > 0:23:07innovation. In terms of the academic evidence and indeed
0:23:07 > 0:23:08evidence and indeed the practical evidence, the
0:23:08 > 0:23:09evidence, the evidence that isn't inconclusive
0:23:09 > 0:23:10evidence, the evidence that isn't inconclusive about it, which
0:23:10 > 0:23:11inconclusive about it, which is some, is overwhelmingly
0:23:11 > 0:23:12inconclusive about it, which is some, is overwhelmingly negative.
0:23:12 > 0:23:13some, is overwhelmingly negative. There
0:23:13 > 0:23:14some, is overwhelmingly negative. There are both theoretical reasons
0:23:14 > 0:23:15There are both theoretical reasons and a mountain
0:23:15 > 0:23:16There are both theoretical reasons and a mountain of practical evidence
0:23:16 > 0:23:17and a mountain of practical evidence that competition is bad
0:23:17 > 0:23:19that competition is bad for healthcare.
0:23:19 > 0:23:20that competition is bad for healthcare. I have nothing against
0:23:20 > 0:23:21healthcare. I have nothing against the idea of working
0:23:21 > 0:23:22healthcare. I have nothing against the idea of working with the private
0:23:22 > 0:23:23the idea of working with the private sector, and many hospitals
0:23:23 > 0:23:25sector, and many hospitals do it very successfully.
0:23:25 > 0:23:26sector, and many hospitals do it very successfully. But to
0:23:26 > 0:23:27very successfully. But to open up the NHS
0:23:27 > 0:23:28very successfully. But to open up the NHS broadly to competition
0:23:28 > 0:23:29the NHS broadly to competition in all aspects of
0:23:29 > 0:23:30the NHS broadly to competition in all aspects of what it does, I
0:23:30 > 0:23:32the NHS broadly to competition in all aspects of what it does, I do
0:23:32 > 0:23:32understand the enthusiasts who say it will improve quality and
0:23:32 > 0:23:33understand the enthusiasts who say it will improve quality and it
0:23:33 > 0:23:34it will improve quality and it will cut
0:23:34 > 0:23:38it will improve quality and it will cut costs.
0:23:38 > 0:23:39it will improve quality and it will cut costs. But I don't think
0:23:39 > 0:23:40cut costs. But I don't think there is any
0:23:40 > 0:23:41cut costs. But I don't think there is any evidence of that.
0:23:41 > 0:23:42cut costs. But I don't think there is any evidence of that. Critics
0:23:42 > 0:23:43is any evidence of that. Critics say the government
0:23:43 > 0:23:44the government simply haven't thought it
0:23:44 > 0:23:45the government simply haven't thought it through.
0:23:45 > 0:23:46the government simply haven't thought it through. Is this a
0:23:46 > 0:23:47thought it through. Is this a badly thought out
0:23:47 > 0:23:49thought it through. Is this a badly thought out and ill researched bill?
0:23:49 > 0:23:50thought out and ill researched bill? I think you have
0:23:50 > 0:23:51thought out and ill researched bill? I think you have got to look
0:23:51 > 0:23:52I think you have got to look at the evidence as
0:23:52 > 0:23:53I think you have got to look at the evidence as to what the bill
0:23:53 > 0:23:54evidence as to what the bill has actually achieved.
0:23:54 > 0:23:55evidence as to what the bill has actually achieved. The
0:23:55 > 0:23:56actually achieved. The NHS is holding up
0:23:56 > 0:23:57actually achieved. The NHS is holding up under a great
0:23:57 > 0:23:58holding up under a great deal of pressure extremely
0:23:58 > 0:23:59pressure extremely well and the reforms
0:23:59 > 0:24:00pressure extremely well and the reforms have helped to
0:24:00 > 0:24:01reforms have helped to make that possible because
0:24:01 > 0:24:02reforms have helped to make that possible because they have meant we
0:24:02 > 0:24:03possible because they have meant we are spending less
0:24:03 > 0:24:04are spending less money on bureaucracy and
0:24:04 > 0:24:05are spending less money on bureaucracy and the back office and
0:24:05 > 0:24:06bureaucracy and the back office and more money on frontline
0:24:06 > 0:24:07bureaucracy and the back office and more money on frontline staff.
0:24:07 > 0:24:08more money on frontline staff. The NHS
0:24:08 > 0:24:09more money on frontline staff. The NHS is certainly a world—renowned
0:24:09 > 0:24:10NHS is certainly a world—renowned state—run asset, but some
0:24:10 > 0:24:11state—run asset, but some critics say the
0:24:11 > 0:24:12state—run asset, but some critics say the Health and Social Care
0:24:12 > 0:24:13say the Health and Social Care Act is privatisation by
0:24:13 > 0:24:16say the Health and Social Care Act is privatisation by the back door.
0:24:16 > 0:24:17is privatisation by the back door. Section 75 of the
0:24:17 > 0:24:18is privatisation by the back door. Section 75 of the act allows GPs in
0:24:18 > 0:24:19Section 75 of the act allows GPs in the form of
0:24:19 > 0:24:20Section 75 of the act allows GPs in the form of CCGs to buy in
0:24:20 > 0:24:21the form of CCGs to buy in private companies to do
0:24:21 > 0:24:22the form of CCGs to buy in private companies to do various jobs, but
0:24:22 > 0:24:23companies to do various jobs, but it is
0:24:23 > 0:24:25companies to do various jobs, but it is feared some GPs will have
0:24:25 > 0:24:26companies to do various jobs, but it is feared some GPs will have to
0:24:26 > 0:24:30is feared some GPs will have to do that, whether they like it or not.
0:24:30 > 0:24:31that, whether they like it or not. If a CCG
0:24:31 > 0:24:32that, whether they like it or not. If a CCG does not put a
0:24:32 > 0:24:33If a CCG does not put a service out to tender,
0:24:33 > 0:24:34If a CCG does not put a service out to tender, for example, and
0:24:34 > 0:24:35to tender, for example, and let's say a private
0:24:35 > 0:24:36to tender, for example, and let's say a private company says, "I think
0:24:36 > 0:24:37say a private company says, "I think I could provide
0:24:37 > 0:24:38say a private company says, "I think I could provide that service just as
0:24:38 > 0:24:39I could provide that service just as well and probably at a
0:24:39 > 0:24:40I could provide that service just as well and probably at a better price,
0:24:40 > 0:24:41well and probably at a better price, I want to tender
0:24:41 > 0:24:42well and probably at a better price, I want to tender for it", if the
0:24:42 > 0:24:43I want to tender for it", if the CCG have not done
0:24:43 > 0:24:44I want to tender for it", if the CCG have not done that, it is
0:24:44 > 0:24:45have not done that, it is possible for that company
0:24:45 > 0:24:46have not done that, it is possible for that company to go to the
0:24:46 > 0:24:47for that company to go to the Competition Commission and
0:24:47 > 0:24:48Competition Commission and complain and, at the
0:24:48 > 0:24:49Competition Commission and complain and, at the end of the day,
0:24:49 > 0:24:50Competition Commission and complain and, at the end of the day, it is
0:24:50 > 0:24:51and, at the end of the day, it is possible for them to go
0:24:51 > 0:24:52and, at the end of the day, it is possible for them to go to court and
0:24:52 > 0:24:53possible for them to go to court and ask for a judicial
0:24:53 > 0:24:58possible for them to go to court and ask for a judicial review.
0:24:58 > 0:24:59ask for a judicial review. There are a lot
0:24:59 > 0:25:00ask for a judicial review. There are a lot of people who
0:25:00 > 0:25:01ask for a judicial review. There are a lot of people who are saying now
0:25:01 > 0:25:02a lot of people who are saying now the NHS is going to end
0:25:02 > 0:25:03a lot of people who are saying now the NHS is going to end up being
0:25:03 > 0:25:04the NHS is going to end up being run by the lawyers
0:25:04 > 0:25:05the NHS is going to end up being run by the lawyers and not by
0:25:05 > 0:25:09the NHS is going to end up being run by the lawyers and not by doctors.
0:25:09 > 0:25:10by the lawyers and not by doctors. Mike O'Brien QC is a former
0:25:10 > 0:25:11by the lawyers and not by doctors. Mike O'Brien QC is a former Labour
0:25:11 > 0:25:12Mike O'Brien QC is a former Labour Health Minister and is
0:25:12 > 0:25:13Health Minister and is now a barrister
0:25:13 > 0:25:16barrister specialising in procurement.
0:25:16 > 0:25:17barrister specialising in procurement. He says
0:25:17 > 0:25:18procurement. He says Section 75 regulations are confusing and
0:25:18 > 0:25:19regulations are confusing and could open the
0:25:19 > 0:25:20regulations are confusing and could open the door to private
0:25:20 > 0:25:21open the door to private services against a doctor's
0:25:21 > 0:25:24open the door to private services against a doctor's wishes.
0:25:24 > 0:25:25open the door to private services against a doctor's wishes. You have
0:25:25 > 0:25:26against a doctor's wishes. You have got this sort
0:25:26 > 0:25:27got this sort of conflict between what
0:25:27 > 0:25:28got this sort of conflict between what the Minister says the
0:25:28 > 0:25:29what the Minister says the clause means and what the
0:25:29 > 0:25:30what the Minister says the clause means and what the words within
0:25:30 > 0:25:34means and what the words within the clause say.
0:25:34 > 0:25:35means and what the words within the clause say. What they
0:25:35 > 0:25:36clause say. What they say is that pretty much
0:25:36 > 0:25:37clause say. What they say is that pretty much everything except
0:25:37 > 0:25:38pretty much everything except where you have got
0:25:38 > 0:25:39you have got one provider of something, so
0:25:39 > 0:25:41you have got one provider of something, so you have
0:25:41 > 0:25:41something, so you have got a product which will only be
0:25:41 > 0:25:42something, so you have got a product which will only be provided
0:25:42 > 0:25:43which will only be provided by one business, everything
0:25:43 > 0:25:44business, everything else, pretty much, has
0:25:44 > 0:25:45business, everything else, pretty much, has got to go
0:25:45 > 0:25:46business, everything else, pretty much, has got to go out to
0:25:46 > 0:25:48much, has got to go out to competition.
0:25:48 > 0:25:49much, has got to go out to competition. The government says
0:25:49 > 0:25:50competition. The government says that is not what
0:25:50 > 0:25:51competition. The government says that is not what it means.
0:25:51 > 0:25:52competition. The government says that is not what it means. It may
0:25:52 > 0:25:53that is not what it means. It may say that, but that
0:25:53 > 0:25:54that is not what it means. It may say that, but that is not what it
0:25:54 > 0:25:55say that, but that is not what it means.
0:25:55 > 0:25:56say that, but that is not what it means. The lawyers are
0:25:56 > 0:25:57means. The lawyers are saying, if this goes
0:25:57 > 0:25:58means. The lawyers are saying, if this goes to court, the judge
0:25:58 > 0:25:59this goes to court, the judge will have to
0:25:59 > 0:26:00this goes to court, the judge will have to look at the words
0:26:00 > 0:26:01have to look at the words in the regulations and
0:26:01 > 0:26:02have to look at the words in the regulations and they will have
0:26:02 > 0:26:03regulations and they will have to say, "We will
0:26:03 > 0:26:04say, "We will apply that because that is
0:26:04 > 0:26:06say, "We will apply that because that is the law".
0:26:06 > 0:26:07say, "We will apply that because that is the law". But
0:26:07 > 0:26:08that is the law". But Jeremy Hunt insists this
0:26:08 > 0:26:09that is the law". But Jeremy Hunt insists this is not the
0:26:09 > 0:26:10that is the law". But Jeremy Hunt insists this is not the case.
0:26:10 > 0:26:11that is the law". But Jeremy Hunt insists this is not the case. I
0:26:11 > 0:26:12insists this is not the case. I think there are
0:26:12 > 0:26:13insists this is not the case. I think there are a lot of myths
0:26:13 > 0:26:14think there are a lot of myths around Section 75 regulations
0:26:14 > 0:26:15around Section 75 regulations but let's be
0:26:15 > 0:26:16around Section 75 regulations but let's be absolutely clear, local GPs
0:26:16 > 0:26:17let's be absolutely clear, local GPs do not have to
0:26:17 > 0:26:18let's be absolutely clear, local GPs do not have to tender out
0:26:18 > 0:26:20do not have to tender out every service.
0:26:20 > 0:26:21do not have to tender out every service. They only have to
0:26:21 > 0:26:22do not have to tender out every service. They only have to do it if
0:26:22 > 0:26:23service. They only have to do it if it is in the
0:26:23 > 0:26:25service. They only have to do it if it is in the interests of patients.
0:26:25 > 0:26:26it is in the interests of patients. If they judge the
0:26:26 > 0:26:27If they judge the interests of patients are
0:26:27 > 0:26:28If they judge the interests of patients are to have
0:26:28 > 0:26:29patients are to have a joined up service, an integrated
0:26:29 > 0:26:30patients are to have a joined up service, an integrated service, they
0:26:30 > 0:26:31service, an integrated service, they don't have to put
0:26:31 > 0:26:32don't have to put those services out to
0:26:32 > 0:26:33don't have to put those services out to tender and that is
0:26:33 > 0:26:34to tender and that is really important because
0:26:34 > 0:26:35important because we need integrated joined
0:26:35 > 0:26:37important because we need integrated joined up services.
0:26:37 > 0:26:38joined up services. Gareth Tomlinson from the
0:26:38 > 0:26:39joined up services. Gareth Tomlinson from the patients' group
0:26:39 > 0:26:40from the patients' group in Kent knows exactly what he
0:26:40 > 0:26:41from the patients' group in Kent knows exactly what he wants from his
0:26:41 > 0:26:44knows exactly what he wants from his GP.
0:26:44 > 0:26:45knows exactly what he wants from his GP. As a patient, I
0:26:45 > 0:26:46knows exactly what he wants from his GP. As a patient, I go to my
0:26:46 > 0:26:47GP. As a patient, I go to my doctor for a treatment
0:26:47 > 0:26:48GP. As a patient, I go to my doctor for a treatment and I rely on
0:26:48 > 0:26:49for a treatment and I rely on my doctor to
0:26:49 > 0:26:50for a treatment and I rely on my doctor to provide me with the
0:26:50 > 0:26:51doctor to provide me with the best treatment possible.
0:26:51 > 0:26:52doctor to provide me with the best treatment possible. I
0:26:52 > 0:26:53doctor to provide me with the best treatment possible. I don't go there
0:26:53 > 0:26:55treatment possible. I don't go there to purchase a product.
0:26:55 > 0:26:56treatment possible. I don't go there to purchase a product. The people
0:26:56 > 0:26:57to purchase a product. The people who matter are
0:26:57 > 0:26:58to purchase a product. The people who matter are patients.
0:26:58 > 0:26:59who matter are patients. The best people
0:26:59 > 0:27:00who matter are patients. The best people to make the right
0:27:00 > 0:27:01people to make the right decisions for patients
0:27:01 > 0:27:02people to make the right decisions for patients are doctors, so what
0:27:02 > 0:27:03for patients are doctors, so what these reforms do is
0:27:03 > 0:27:04these reforms do is put those budgets in
0:27:04 > 0:27:05these reforms do is put those budgets in the hands of
0:27:05 > 0:27:06budgets in the hands of local doctors.
0:27:06 > 0:27:07budgets in the hands of local doctors. It
0:27:07 > 0:27:08budgets in the hands of local doctors. It is a mess.
0:27:08 > 0:27:09budgets in the hands of local doctors. It is a mess. Section 75
0:27:09 > 0:27:10doctors. It is a mess. Section 75 does need to be
0:27:10 > 0:27:11doctors. It is a mess. Section 75 does need to be repealed and we need
0:27:11 > 0:27:12does need to be repealed and we need some clarification from ministers
0:27:12 > 0:27:13some clarification from ministers in the law
0:27:13 > 0:27:14some clarification from ministers in the law itself about what they
0:27:14 > 0:27:17the law itself about what they intend here.
0:27:17 > 0:27:18the law itself about what they intend here. Do they
0:27:18 > 0:27:19intend here. Do they intend substantial privatisation, which
0:27:19 > 0:27:20substantial privatisation, which I think most of
0:27:20 > 0:27:21substantial privatisation, which I think most of the public would
0:27:21 > 0:27:22think most of the public would would be a bad
0:27:22 > 0:27:23think most of the public would would be a bad thing, or do they
0:27:23 > 0:27:24think most of the public would would be a bad thing, or do they not?
0:27:24 > 0:27:25be a bad thing, or do they not? Things have
0:27:25 > 0:27:26Things have certainly changed since 1948,
0:27:26 > 0:27:27Things have certainly changed since 1948, but who knows
0:27:27 > 0:27:28Things have certainly changed since 1948, but who knows what the future
0:27:28 > 0:27:291948, but who knows what the future will hold for the health
0:27:29 > 0:27:30will hold for the health of the nation
0:27:30 > 0:27:31will hold for the health of the nation and what the NHS
0:27:31 > 0:27:32nation and what the NHS will look like in
0:27:32 > 0:27:33nation and what the NHS will look like in a few years'
0:27:33 > 0:27:36nation and what the NHS will look like in a few years' time?
0:27:41 > 0:27:42For more
0:27:42 > 0:27:43For more information about tonight's
0:27:43 > 0:27:44For more information about tonight's show, you can visit
0:27:44 > 0:27:45For more information about tonight's show, you can visit our Kent and
0:27:45 > 0:27:46show, you can visit our Kent and Sussex website.
0:27:46 > 0:27:47show, you can visit our Kent and Sussex website. You can
0:27:47 > 0:27:48Sussex website. You can even watch the whole
0:27:48 > 0:27:49Sussex website. You can even watch the whole show again on
0:27:49 > 0:27:50Sussex website. You can even watch the whole show again on iPlayer.
0:27:50 > 0:27:53the whole show again on iPlayer. Go to bbc.co.uk/insideout.
0:27:53 > 0:27:54the whole show again on iPlayer. Go to bbc.co.uk/insideout. Coming
0:27:54 > 0:27:55the whole show again on iPlayer. Go to bbc.co.uk/insideout. Coming up
0:27:55 > 0:27:57to bbc.co.uk/insideout. Coming up next week.
0:27:57 > 0:27:58next week. Behind the scenes in
0:27:58 > 0:27:59next week. Behind the scenes in the battle for
0:27:59 > 0:28:00Behind the scenes in the battle for dreamland.
0:28:00 > 0:28:01Behind the scenes in the battle for dreamland. Our key
0:28:01 > 0:28:02dreamland. Our key objective was to bring the
0:28:02 > 0:28:03dreamland. Our key objective was to bring the site back into
0:28:03 > 0:28:04dreamland. Our key objective was to bring the site back into use and to
0:28:04 > 0:28:05bring the site back into use and to be an attraction instead
0:28:05 > 0:28:06be an attraction instead of a blight.
0:28:06 > 0:28:07be an attraction instead of a blight. Their
0:28:07 > 0:28:08be an attraction instead of a blight. Their park will aspire
0:28:08 > 0:28:09be an attraction instead of a blight. Their park will aspire more
0:28:09 > 0:28:10blight. Their park will aspire more to Margate over the last 10 or 15
0:28:10 > 0:28:11to Margate over the last 10 or 15 years than
0:28:11 > 0:28:17years than a Margate looking forward.
0:28:17 > 0:28:18forward. And helping the
0:28:18 > 0:28:19forward. And helping the children who need
0:28:19 > 0:28:21And helping the children who need help at school.
0:28:21 > 0:28:22And helping the children who need help at school. When I
0:28:22 > 0:28:23help at school. When I went there all the time, I
0:28:23 > 0:28:24help at school. When I went there all the time, I was
0:28:24 > 0:28:25help at school. When I went there all the time, I was not very good.
0:28:25 > 0:28:26all the time, I was not very good. Everyone
0:28:26 > 0:28:27all the time, I was not very good. Everyone kept on making me
0:28:27 > 0:28:28all the time, I was not very good. Everyone kept on making me angry.
0:28:28 > 0:28:29Everyone kept on making me angry. Children need
0:28:29 > 0:28:30Everyone kept on making me angry. Children need to learn social
0:28:30 > 0:28:31Children need to learn social skills, they need to
0:28:31 > 0:28:32skills, they need to recognise their rights, but
0:28:32 > 0:28:33skills, they need to recognise their rights, but equally they need
0:28:33 > 0:28:35rights, but equally they need to accept their responsibilities.
0:28:35 > 0:28:37accept their responsibilities. Good morning, children.
0:28:37 > 0:28:38accept their responsibilities. Good morning, children. ALL:
0:28:38 > 0:28:41morning, children. ALL: Good morning.
0:28:46 > 0:28:47That's it from
0:28:47 > 0:28:48That's it from us for tonight
0:28:48 > 0:28:49That's it from us for tonight from the Queen Elizabeth
0:28:49 > 0:28:50the Queen Elizabeth the Queen Mother Hospital in
0:28:50 > 0:28:51the Queen Elizabeth the Queen Mother Hospital in Margate.
0:28:51 > 0:28:52the Queen Elizabeth the Queen Mother Hospital in Margate. Many
0:28:52 > 0:28:53Hospital in Margate. Many thanks to mall the
0:28:53 > 0:28:54Hospital in Margate. Many thanks to mall the staff
0:28:54 > 0:28:55mall the staff here who let us in for
0:28:55 > 0:28:56mall the staff here who let us in for the day. See
0:28:56 > 0:28:57for the day. See you next week. Subtitles by
0:28:57 > 0:28:58for the day. See you next week. Subtitles by Red Bee Media
0:28:58 > 0:28:59for the day. See you next week. Subtitles by Red Bee Media Ltd.