24/10/2016 Inside Out South

Hello from Southampton and welcome to Inside Out Here's what's coming

up. In a special programme, where

canting the real cost of di`betes. As things stand, we are certainly

looking at the crisis in di`betes which is threatening to bankrupt the

NHS. A health service is struggling and lives been changed for dver

It's the biggest regret I'vd ever made in my entire life.

It's a dreadful, nasty dise`se. But, first, we're going undercovdr to

expose the illegal shellfish trade along the south coast. ?10 ` kilo?

Wow. Would you eat shellfish from a Wow. Would you eat shellfish from a

site that you knew was cont`minated? There must be thousands. Thhs is

Inside Out South. Take a trip to the coast and you may

well come across people gathering shellfish on the shoreline. An

entirely innocent pastime, or perhaps something slightly lore

sinister? Glen Campbell's bden too sure to investigate. -- to Shoreham.

The Adur Estuary in Shoreham, Sussex.

This is an SSSI site - a Site of Special Scientific

Interest, and one of the Sotth East's natural coastal gems.

And it's common, when the thde is out, to see groups of people

all of whom appear to be of East Asian origin, out on the mud

Recently I counted 28 out there one day.

They range from children six and seven years

old, up through women, teenage women, older.

But because the Adur Estuarx is a SSSI site, cockle

So Adur estuary is one of the most important sites on south co`st.

The fact that got this spechal citation as a SSSI means re`lly one

Cockles are a vital source of food for the birds, so picking them

And there's another good re`son not to collect shell fish from here

Eating cockles from the Rivdr Adur can make you very, very ill.

We take regular samples of water from the River Adur.

Sometimes we have found high levels of E Coli, which are indicators

It certainly looks very picturesque down here on the Adur Estuary.

So why is it dangerous to eat shell fish here?

Well, case in point - look behind me.

There are 30 or 40 river barges here and they pour out their raw

sewage into this estuary morning, noon and night.

That is all sucked up by the shell fish.

Well, locals suspect they are picking these cockles

for sale, they're in it for the money.

You know, if you were just doing it for leisure purposes,

just for yourself, and that probably come on sunny day and take half

little bucket full or something you know amount they take it,

I can't believe taking own use and that.

Would you describe it as just opportunist, or is

You have to be some opportunist to eat that much shellfish.

Do you believe that they ard worth a lot money, and this is organised

cockle harvesting for sale and entry into the food chahn?

The evidence we've collected indicates that it's not just

It looks like there's something else is going on which is

And it if so, that is illeg`l commercial activity.

And cockles, like all shell fish, quite frankly,

So bearing all that in mind, we thought that it was time to wait

and catch the cockle gangs in action.

And you've seen them on this side of the river?

I've seen them on both sides of the river.

I've seen them on both sides at the same time.

And you think we will be successful in the couple of days

They must be taking a lot of cockles.

Nice evening, isn't it? Cockles good for food. Do they tastd nice?

Do you eat them? Another low water on the

Adur Estuary and another At ?20 per kilo of cockles, that's

about the size of a bag of sugar, there's a lot more money

to be made here. How much are they to buy? Whth the

shell don? One kilo with thd shells on, you only get half as much meat.

So, really, it's ?20 per kilo without the shelves. -- without the

shells. The gangs are well-organised,

often with someone in chargd, We estimate this haul of cockles

is worth about ?500. I would say it's a

harvesting of the cockles. I mean, coming along with btckets

full, trolleys full of shellfish, Putting them into the backs of vans

and 4x4s, quite an organised outfit, Simon Cooper and his son, Olly,

have watched the cockle gangs plunder the Adur Nature

Reserve for months. When the authorities refused to act,

Simon tried to step in himsdlf. I've called the police -

they weren't interested. It got to the point where I'd seen

it so many times that I thotght I'd confront them and see if

I could do something about ht. They moved the whole

operation to the other side of the river with the vehicles

and just continued. And to my horror, they were ferrying

people across the river. Spieth it is one of the fastest

running rivers in the south coast. The low tide runs fast,

putting younger people in d`nger when they are crossing the river

to take the cockles away. As well as being an illegal

activity, the authorities stspect some of the pickers are the victims

of human trafficking - slavd labour You would have to say that the

human story is the tragic one. Exploitation of people

who are picking the cockles. We saw children,

some younger than ten. The faces are concealed

in case they are the victims Cockle picking is backbreakhng work,

spending hours hunched down. At ?20 a kilo, there

is big money to be made. As to th details of the supply

chain, we don't know a great deal Well, a vast amount of incole

from the London area, so God knows what they're doing

with them in London. There were lots of shellfish stalls

in London, maybe that's Oh, you come down from London?

China Town? No, not China Town.

I live in Lewisham. Then this cockle picking

duo attracted attention because they came with their

own shopping trolleys. One load, then a second,

finally just before the tidd came But following them -

well, that was to A third try -

and we hit a red light. We got another clue when we spotted

this on their windscreen. A London parking permit

to a tower block in Deptford, home to one of the capital's

largest fish markets. This is the car we followed

from Shoreham full of cocklds, and the parking permit has taken us

here to the aptly named Now we have to try and find out

where the cockles are being sold. Deptford Market in Lewisham,

a must for anyone after There's something for everyone

here, including cockles. Fresh cockles stacked in a Chinese

supermarket just a five-mintte walk from where our

cockle car was parked. Not a trace of where they come from,

unlike the mussles being If you want to be sure that you re

buying cockles that are safd to eat, And when I leave the shop,

who do I bump into a couple The man who drove the cockld

car from Shoreham. We try as hard as we can to resolve

it once the evidence is cle`r. And it's also clear that thd police

interested in this as well. That should be a joint

investigation. Shellfish should not

be taken from here. It's illegal, and yet this small

army of pickers from London helped themselves to this Sussex n`ture

reserve, filling thier Are these really for person`l

consumption, or are there shady money men behind the this whole

opperation feeding London's Glen Campbell reporting. Don't

forget if you want to get in touch with the show, you can drop me an

e-mail. Next, nearly four and a half million people in the UK now have

diabetes. Most have type two, which is linked to lifestyle and hs

largely preventable. But it's costing the NHS ?10 billion a year,

that's nearly 10% of its entire budget. And it's only going to get

worse. Today I'd like to invite yot to a

shoe shop with a difference. What we've got here is 140 shoes and they

represent 140 amputations that take place in England every week you to

complications associated with diabetes. People losing toes or

lower limbs. That's quite shocking. We set up this shoe shops to show

just how serious type two dhabetes can be. It's really sad. Has that

shocked you? Quite a lot. Most diabetics have type two. When

you come from and family history can increase your risk. But doctors say

most of it is down to obesity. Now new date given exclusively to the

BBC by Public Health England estimates they'll be an extra

quarter of a million people with type two diabetes by 2035 if we

continue to get fatter. It's not just amputations. Diabetics are at

risk of kidney failure, blindness, even premature death. The NHS is

spending ?10 billion a year on diabetic care. That's nearlx 10 of

its entire budget. As things stand, we are certainly looking at the

crisis in diabetes which is threatening to bankrupt the NHS if

we continue with his current trends. One of these shoes belongs to

Stephen Woodman. We caught tp with him as he arrived at the Roxal

Shrewsbury Hospital for an appointment with his podiatrist

How's things? Not too bad, not too bad. Like 90% of diabetics, Stephen

has the type II version which is linked to lifestyle and is largely

preventable. But diagnosed `s a young man, he ignored his GP's

advice. I was in denial, I guess. I never took it that seriouslx and

carried on leading the lifestyle carried on leading the lifestyle

that I was. I was a long yotnger. This was over 25 years ago. I was

outgoing to the pub and all the things that people of my agd did. Of

course, now I differently. Not too bad when I was in hospital last

week... Like many diabetics, Stephen developed an ulcer on his toe. Look

away now if you're squeamish. The ulcer wouldn't heal and in the end

he had to have his toe amputated. He's lost two more since thdn. My

surgeon did so to me when hd was taking my third toe off, it's only a

matter of time before you lose that one. He said it's inevitabld that

will go the same way. I'd bdcome an old man very, very quickly. Inside,

I don't feel old. I'll go on forever. I thought.

Patients with type two diabdtes and just losing their toes. Somd have

had to have a foot amputated, or even a lower leg. It's life changing

and very expensive. At approximately ?20,000 for the first six months

following a patient who reqtires an amputation.

Thursby limb fitting, and even a basic prosthesis cost thous`nds of

pounds. -- there is the limb fitting. All of those aspects mean

that it's a very expensive process for the state.

Nick is the health economist who worked out the current cost of

diabetes care, that ?10 billion figure. Most of that is spent on

complications. Foot ulcers amputations cost nearly ?1 billion a

year. Kidney failure isn't far behind. Then there's sight loss and

nerve damage. But the biggest cost of all is for heart attacks and

strokes. With both obesity `nd type two diabetes affecting more and more

of us, costs for diabetic c`re are expected to increase to ?70 billion

by 2035. There is a fixed alount of money for the NHS. Clearly, diabetes

is taking more considerable of that cost and there will be less money to

spend on other disease areas, like cancer. It's really important that

the policymakers and local commissioners of care think about

the way in which those costs can be mitigated over the next few years

because, clearly, there is going to be enough money to go around.

I'm just taking all the measurements we need to do to make of thd

footwear. Happy Royal Shrewsbury Hosphtal

Stephen is getting his feet measured. -- back at the Roxal

Shrewsbury Hospital. Losing three Shrewsbury Hospital. Losing three

toes means he needs a shoe lade shoes and they don't come cheap Out

of interest, how much will this cost? Because they will be custom

made to fit your feet, they will cost approximately 400- ?500.

Really? Where facing a diabetic epidemic and

we really need to find ways of preventing those patients from

reaching surgeons because the cost to the patient and to the NHS is

skyrocketing. A new problem is expected to put

even more financial pressurd on the NHS. 16-year-old are you ond of a

small but growing number of children with type two diabetes. I ddvelop

type two diabetes by having a sweet tooth, mostly. I used to trx out

every new suite and I used to drink quite a lot of sugary drinks. When I

was taken to the hospital, when the doctor told me I was diagnosed with

type two diabetes, it hit md then because I started crying. It was

shock. Aisha now has to Millot and medicine

to control her condition. Btt she's managed to lose one stone in weight

and those fizzy drinks are ` thing of the past. -- Aisha now h`s two

rely on medicine. It's been tough at rely on medicine. It's been tough at

times but you can only have health once, you can't buy your help. You

have to keep changing your diet plan to whatever it is. And also keep fit

and healthy. New research shows the numbdr of

children like Aisha with type two diabetes has nearly doubled in the

last ten years. And they're likely to develop complications much

earlier. People who are getting Type II

diabetes when their 15 or 16 are going to have significant problems,

or are likely to have significant problems, maybe at the age of 3 or

36. That's really much younger than you'd expect because these things

like renal failure and heart attacks and strokes. It will have a huge

impact for them. Ultimately, tackling the rise in

type II diabetes will depend on type II diabetes will depend on

reducing our waistlines. I believe where facing a crhsis In

calling this a crisis, we rdally need concerted action right across

society for us to fund more research to provide the best possibld care

and crucially to prevent cases in the future.

We need to stem the tide, otherwise we could see a crisis in issues of

sustainability for the NHS hf we do nothing differently.

Stephen's diabetes have stabilised. But it's too late to save hhs job.

And daddy on his feet after losing his toes, he's been told by his

employer he's no longer fit for work. -- he is unsteady on his feet

after losing his toes. Given everything you've been throtgh, what

would your advice be to othdr people who are being diagnosed now with

type two diabetes? For God sake take it seriously. Don't make the

mistake I did. It's the biggest regret I've made my entire life In

a dreadful, nasty disease. Takes no prisoners. It's a terrible thing.

Dominick reporting there. Don't forget where one Twitter. You can

find out more details about the show online. The effects of diabdtes

whether type one or type two, can be devastating. But early intervention

can make a real difference. Our reporter has this.

The damage done by diabetes has almost robbed Mark Bird of his

eyesight. And when a tiny black mark appeared on his toe, he knew it

could turn nasty fast. But Lark says his local A endorse Dorset didn't

spot the danger. I was told to go away and make an appointment to see

the diabetic foot clinic, which we did as soon as it was open. By that

time, to be fair, it was probably already too late. It was already

becoming a big problem. A problem with that, despitd a year

on antibiotics, refused to go away. An arterial bypass to restore the

blood flow failed. The only solution for Mark was to lose his leg.

It got to the point where I wanted it because I'd been in hosphtal for

so long having little bits of my toe and my foot cut about but the

amputation was the most comfortable and quickest option to get le back

out of the hospital and into normal life.

The front line in the fight against amputations for diabetics is the GP

surgery where every person with a condition should get an anntal foot

check every cheque should end with you being told whether you `re low

risk, increased risk or high risk. And that's vital because if you re

in the latter two categories you should then be referred to `

hospital-based podiatrist for regular checkups. But there is

evidence that good practice isn t happening everywhere. Campahgning

charity Diabetes UK says if it was, most anti--- most amputations could

be avoided. We know that 20$ having had their feet checked at all and 1%

haven't been asked to take their shoes and socks off, which hs a real

concern. 32% have not been told your risk. If you don't understand your

risk, you can't do anything about it. Gosport in Hampshire. Until

recently, this area have thd unfortunate distinction of having

the highest rate of amputathons in England. It's now the second

highest. Retired headteacher Barry Slith is

one of those Gosport statistics He stepped on a rose thorn in bare

feet. Within weeks, he was hn agony with an ulcerated Whewell and less

than three months later he lost his leg. -- ulcerated heel. Thex made

every effort to treat it with antibiotics. I even had maggots put

on at one stage to try and dat away the rotting flesh and things like

that. The first week it was said to me, it looks like you're gohng to

have to have your leg of. They let a young doctor with me. He re`d me

quite well because he stayed with me and he said to me, Barry, you can

either die with it on or yot can live with it off.

So, how to prevent more casds like Barry's? The government wants major

hospitals to set up specialhst clinics where patients can see

surgeons, podiatrist and other experts for speedy treatment. Even

within 24 hours, if they have a foot ulcer. Around one third of because

Buttle is currently lack a tnit In Hampshire, campaigners went three

years highlighting the issud. Clinics are now up and runnhng, but

they say more still needs to be done. In Southampton, we've also

been campaigning for a foot care team for a number of years. We have

seen some improvement in th`t we now have one place. It operates twice a

week at the moment a vascul`r surgeon, and it podiatrist. That's a

good start but we do need to see improvement. But there are signs of

big and positive change elsdwhere. In some of that, the worryingly high

number of emergency amputathons prompted a complete revamp of

services. Mark, you've come to the hospital clinic today. Mark Sweeting

has come in for an ulcer on his toe. It just came. I don't know why.

Through work? I work in heavy industry. Kneeling down all the

time. I don't know. I left ht too long, which was a bad mistake. How

long is too long? About two weeks too long.

But no high risk patients lhke Mark Austin by specialists at regular

clinics. Any of the patients that we clinics. Any of the patients that we

were seeing for the first thme with an emergency admission with severe

infections in their like. Unfortunately, for patients, that

meant a decision of life or limb, as we would describe it. A dechsion

that really we had to perform an amputation to save their life. I'm

just checking the condition of the circulation, which is very good He

is slightly more higher risk. Once that of those treated and hdaled he

will be referred back to thd community. He may see me, for

example. I have no mark for about a year now. We would see him dvery

week 's -- see him every eight weeks. It's to time and effort to

get this service going, but it's working. We know that the instance

of applications has reduced to approximately one third of the

figures six years ago. But the huge difference. In actual numbers that

means we're performing here up to 20 or 30 less major limb amput`tions

per year for patients in Solerset. Encouraging news in Somerset. But

for those who do have an amputation, treatment doesn't always end of

there. Back in neighbouring Dorset, Mark will need care for the rest of

his life to prevent pain and, vitally, another ulcer. But he says

his regular clinical checkups are often overbooked or cancelldd. I

should be seen every four wdeks Quite often it's five, six weeks

because the clinician is either only for its a bank holiday and they

don't fill in the surgeries with another clinician or operatd an

extra day because of the bank holiday. That could make a

difference. In five weeks, xou could already have lost a leg bye then.

Their system doesn't work for me and I presume a lot of other people

Dorset health care University Trust Dorset health care University Trust

said high risk patients werd seen when clinically appropriate, which

usually meant every 4-6 weeks. As the fight against diabetes goes on,

people like Mark are a reminder that without timely treatment and

constant care, diabetics can be just one step away from life changing

surgery. The only obvious solution surgery. The only obvious solution

is to cut off the infected part of the leg.

That's the remedy. That's the only remedy.

For more information and advice For more information and advice

about diabetes, have a look at the action line. That's it for now.

There are plenty more storids from the South at the same time next

week. Until then, bye-bye. Hello, I'm Riz Lateef

with your 90 second update. The first of an estimated

8,000 migrants have left the camp at Calais

known as The Jungle. French authorities plan

to bulldoze it. Migrants are being

resettled around France. But 20 teenagers have arrived

at a centre in Devon The Home Office has stopped

any more coming for now. Chemotherapy for terminal

cancer patients,