24/10/2016 Inside Out South


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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,


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