16/01/2017 Inside Out South


16/01/2017

Jon Cuthill investigates the NHS funding gap as services in the south look to save over £2 billion in just five years.


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Transcript


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Hello. With pushing our health service to the limit and it's

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starting to show. Services within the hospital and within our

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community are under particular pressure. If it doesn't get more

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funding, waiting times are going to get longer.

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The quality of patient care is going to stuff. The fact that I've had to

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pay for my treatment is criminal. It is absolutely criminal. I'm sorry.

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Change is coming. But what's being prescribed? We seeing hospitals

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close. We're seeing A emerged. Some of these changes are so

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dramatic, people will oppose them to the death. The change is not easy.

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Inside Out is back. The doctor will see you now - probably!

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Thirsty dart things were addicted to in this country - caffeine and the

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NHS. We expected to be there where ever we are and whenever we wanted.

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But with more of us living longer, it means that costs are rising at an

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alarming rate. And that means NHS bosses here in the south facing some

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tough decisions about which services to cut and which services to keep.

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The NHS has a huge problem - us. There are more of us, and we are

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living longer. The average of 55-year-old costs the health service

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twice as much as a 20-year-old. And over 85s cost three times as much

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again. Members of the Bournemouth Swimming Club are doing their bit to

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stay healthy - even when it's 5 degrees outside. It's amazing. I

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cannot feel my body! After you done this, nothing else in the week seems

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too bad, really. It gives a real boost the immune system. It's good

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for the body. But even hardy folk like these need to call on the NHS

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from time to time. I've been diabetic for about 33 years. I am

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grateful for the NHS because if it wasn't for them, you know, well, I

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wouldn't be here. As an ex-nurse, I've seen it's all. When they come

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into hospital with a bag full of pills. You just don't think about

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how much it's costing, I guess. But I'm a working man so I guess I'm

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entitled to that. Here's the thing. The amount of money the NHS has been

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getting has been going up over time. But the amount of money the NHS

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actually needs to keep us all fit and healthy has been going up like

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this. And by 2020 it is estimated there will be a funding difference

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of ?22 billion. Here in the south, our share of the

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shortfall adds up to ?2.2 billion a year. In the entire health budget

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for the Isle of Wight is only 215 million. The meeting the soaring

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costs of health care in the south would require cutting the island's

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health services more than ten times over. The island's well aware of the

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cost of caring for an ageing population. A quarter of its

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residents are pensioners. The NHS here faces a ?52 million shortfall

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by 2020. So they're trying to make some radical changes.

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We've had the phone call through the 111 service, and they've asked us to

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come out and see you. Lousi leads the Isle of Wight crisis

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response team. To keep hospital admission down, they're bringing the

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NHS to your door. These three are practically dead

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now. It started on that hand as well.

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90-year-old Joan has severe arthritis, which means caring for

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her 94-year-old husband is a struggle. Their house also poses

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some risks. Oh, yes. I see. When was the last

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fall that your husband had? Actually, he had won about three

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days ago. I had to call the neighbour.

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Our job is to keep people out of hospital safely and independently in

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their rain residence. I'm just going to pop it in your

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ear, take your temperature. We have nurses, occupational therapists and

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We have the luxury of having more We have the luxury of having more

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time in the emergency services and GPs have got, so we can go in and

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look at keeping these people at home.

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Lousi provides a carer to come and help with the morning and a builder

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to sort out the back step. The local council will pick up the tab on the

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basis that prevention is better and cheaper than cure.

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We can get that all sorted out for you, can't we? Thank you. We can get

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people so you're not struggling on your own, all right?

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The island's health services reviewing everything it does to be

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cost-effective. And you keep people healthy and out of Saint Mary's

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Hospital, the only one on the island. Lucy's office as part of the

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process. It's now an integrated care hub. It's home to council workers

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and charity staff, as well as the NHS.

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The 999 and 111 calls coming to this centre here on the island, and we

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have generically trained staff who are able to answer both sets of

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calls. Have you ever had a leg ulcer?

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Solar putting everyone in the same room so they can talk face-to-face?

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So they can actually talk to each other.

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The district nurse said she is bleeding from her right ear. When

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the call comes into here, we decide on what services need to actually

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attend that. When you think an ambulance call costs ?202 per call,

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here on the island we have saved over 1000 of those Popa. The IM's

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NHS says it joined up approach of saving money. But money isn't the

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only problem. The hospital is full. Saint Mary's

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is on black alert. That means there's no room for new patients.

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They're going to tell us he's got increased wounds.

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It's a serious incident, and it's worryingly common. Last year, the

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alert. alert.

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It's a surge of services within the trust, within the hospital and

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within our community services. They're under particular pressure.

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Hospitals should have enough spare beds to cope.

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But in Saint Mary 's, they sometimes don't. Patients who could be at home

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get stuck in hospital, because community care services already at

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capacity. We are in difficulty. We have had to

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slow down access to planned care, so two operations, to enable us to

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manage the flow through our emergency department.

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Lack of beds meant 400 cancelled operations last year. The hospital

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was ?4 million overspend. Tough times for chief executive Karen

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Baker. You've innovated, you're trying

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different things, and here we are on black alert. Absolutely we are. And

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I guess that's the pressure - that's the pressure in the system. We know

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at the moment that we're not looking after people in the community as

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well as we could be. When there was people are not accessing different

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going to see their pharmacist, being going to see their pharmacist, being

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cared for by the community teams. All of those things are available

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and we need to make sure people are unaware and ultimately that will

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save money in the system. But the worry is the pressures are

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increasing faster than the solutions that can be found for it. They're

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still a queue at both doors. You're absolutely right. The answer is we

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continue to work on those solution. Pub managers here believe it of

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working methods can bridge the financial gap. But across the whole

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of the self, ?2.2 billion needs to be found by 2020. -- health managers

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here. Some health analysts like Roy Lilley, himself a former Trust

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chairman, so the changes needed will be radical and unpopular.

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If we want to save 2.2 billion, with God to stop doing things. We will

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seem hospitals closed, we will see A merged. GPs surgeries will have

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to be merged and put together. The Public were like that. The real

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solutions are the ones that are really painful. -- the public won't

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like that. The Isle of Wight faces a challenge

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because of its older proportion of older residents, but it's a crystal

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ball for the rest of the South. In ball for the rest of the South. In

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the rapidly ageing population, in 20 years' time the region's age profile

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is set to match the island's. So to help the NHS, we all need to do our

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bit. If I had a message for the public,

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it would be there's a lot. If you smoke, that they daft idea because

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that costs the NHS a fortune. If you're overweight, lose weight

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because that leads to obesity and cardiac problems. But we know these

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messages. I'm not telling you anything that we all don't know. How

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do we make people do? I don't know, but we really have got to take

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better care of ourselves. Back in Bournemouth, the Spartan

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swimmers are doing just that. A year ago, I was crippled with

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depression. And in the last six or seven weeks I've made leaps and

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bounds. And a lot of it is in part of this. There were fireworks going

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off in your brain. It makes you feel amazing, it really does. It makes

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you feel alive. You know, and I you feel alive. You know, and I

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encourage anybody to give it a try. Still to come, how we can help get

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the NHS back on its feet. Walking is the single most important

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thing that everyone can do for their health.

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As ever, I'd love to hear what you think. You can always drop me an

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e-mail at the below address. Next, does where you live matter more than

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ever now when it comes to the provision of health care? Chris

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Jackson has been investigating. The NHS is facing the most

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significant financial challenge in its history. There are fears the

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service were growing up with is beginning to fragment.

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It's not a National Service. Absolutely, there is a postcode

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lottery. It's criminal. It is absolutely

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criminal. This is the start. It's going to get

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worse. So, it is the NHS in danger of

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ceasing to be a National Service where everyone is entitled to the

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same care? It is treating more patients, but is it becoming a

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postcode lottery where access can depend on where you live? Were going

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to put that to the test. On a bad day, it ruins your life.

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The muscle pain, it feels like my bones are screaming at me at times.

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33-year-old Ben Franklin has Hepatitis C.

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The virus can cause life-threatening liver damage.

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I'm about to lose my job. I haven't been at work since April, I've been

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off sick. And I could possibly lose my flat.

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There are new drugs that could potentially cure Ben's Hepatitis,

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All I got was, you have two worried - basically because my liver wasn't

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bad enough. That made me want to go out and get absolutely wasted and

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when my brother just so that they would treat me. I wouldn't do that,

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but I wouldn't be surprised if nobody else would.

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The money is there for just over 10,000 treatments.

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It's claimed that means there are no queues in parts

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of the North ? and long waits in places like London.

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Two people will exactly the same state of liver damage could present

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themselves in different parts of the country, and in one watt able to

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walk in, get hepatitis C treatment immediately, get to it. In another

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part of the country they will be told, I'm sorry, you're going to

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have to do it. This is inherently unfair.

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NHS England told us it was regularly reallocating unused Hepatitis C

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treatments to places with waiting lists.

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The number of patients treated will increase by 25% next year.

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The fact that it's down to money, that upsets me the most. It's just

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money. So Ben is taking the risk

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of treating himself with cheaper How much have you spent on that box?

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?1300. ?1300 but I don't really have. The fact that I've had to pay

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for my treatment, it's criminal. It is absolutely criminal. I'm sorry.

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I'm just tired of being tired. Ben is hoping the generic drugs will

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cure him within a matter of weeks, and he's not alone. The hepatitis C

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Trust estimates around 1000 people in Britain may have bought the drugs

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abroad. If you go outside, there's halos

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around the lights. Lights and around the lights. Lights and

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shadows. It's often hard to see things, they're a bit distorted.

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Gloria McShane has cataracts in both eyes.

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I can't take stairs, go up or down stairs with any kind of confidence.

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Cataracts are supposed to be treated within four

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Gloria, who lives in the North East, says she's been waiting seven.

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It's too long because there is such potential for accidents, and there

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is such a change in a person's mood. If Gloria had lived in Luton,

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her wait could have been Absolutely, there is a postcode

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lottery. It's not about the clinical need. It's about some places in

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England having poor systems, having budget pressures, and deep

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prioritising cataract surgery. That doesn't feel too national to me.

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Gloria expects to get her operation later this month.

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It really makes me angry because I think it's almost like survival of

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the fittest. Clinical Commissioning Groups,

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

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treatments like cataract surgery Others are requiring patients

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to lose weight before getting Postponing an operation in these

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circumstances can save money in the short term. And most of the CCG say

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can be clinically justified, the Royal College of surgeons say it

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can't. There is a vague evidence that

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people are now not getting elective operations, which they desperately

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sometimes require. -- there is very good evidence. Simply because the

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financial restrictions. It is up to the clinicians to decide who should

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have what treatments, and therefore a bureaucratic system which produces

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a blanket ban, we think, is morally wrong.

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It's also claimed new systems for vetting appointments

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with specialists are another form of rationing.

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Why are they treating their patients with such contempt?

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Last month, MPs complained about a private company

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being paid ?10 for every GP referral they stopped.

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This is rationing by the back door. And it has the potential to patient

:16:32.:16:34.

safety. The same private company oversees

:16:35.:16:36.

referrals in North Tyneside. We've spoken to doctors who say the

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system is putting patients at risk. The GPs, who fear speaking out, have

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told us that cancer diagnosis are being held up.

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In a statement, North Tyneside CCG said there was no evidence the

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system course additional risk or delay. Cancer referrals do not go

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through the system and are made directly to hospital. The number of

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referrals knocked back to GPs in England has risen by about 30% in

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the last two years. You can see the details

:17:31.:17:32.

of our research online. Shortage and regional difference

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

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could get much worse. The NHS is under an unprecedented

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

:17:51.:17:54.

times will get longer and the quality of patient care is going to

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suffer. So we will see different decisions taken in different parts

:17:59.:18:00.

of the country, and different of the country, and different

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services being available to patients.

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So, is the NHS still a national service?

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One of our most prominent medics is clear.

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No, it's not a National Service. It is now a local health service. It

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matters because it leads to an inequality in health care. Somebody

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will get health care for free, and others won't.

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In a statement, the Department of Health told us that far from

:18:26.:18:28.

getting prompt treatment. 3261 more getting prompt treatment. 3261 more

:18:29.:18:34.

cancer patients are being seen every day, and standards of care an

:18:35.:18:38.

improving. We asked the Health Secretary and NHS England for an

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interview. Both declined. The people actually paying for NHS

:18:44.:18:46.

the clinical commissioners, did the clinical commissioners, did

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agree to speak. It's a National Service with local

:18:50.:18:54.

variation based on the need of the population. Demographically, the

:18:55.:18:58.

populations vary quite significantly from town, to rubble, to county.

:18:59.:19:02.

It's really important that we respond to that population on a

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local basis. -- from town, to rural. We don't want to squander any money.

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We have limited resources. It's really important that we most

:19:13.:19:17.

effectively and get the best value for our population.

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For those forced to take their own action, rationing appears all too

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real. Chris Jackson reporting. Don't

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forget, where one Twitter. You can find out more about the show and see

:19:31.:19:35.

behind the scenes - Paul Dunne - at...

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-- hold on. Now, it's not all doom and gloom. There are some things we

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can do to help the NHS. One of them doesn't cost a penny and involves

:19:46.:19:48.

the ancient art of putting this foot in front of this foot.

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Human beings were designed to sit down all day. We evolved to walk.

:19:59.:20:03.

But modern life means few of us are working enough, and it's making us

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all. Everyone at South Central Ambulance Service is in the business

:20:10.:20:13.

of saving lives. Tanya speaking, how can I help quiz? I name is Tanya and

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I been with the service for ten years. I've save five lives. My name

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is David. I'm 25 years old. I been working here for two years.

:20:29.:20:33.

Whether the patient live? Sitting down a day, like so many of

:20:34.:20:37.

us too, means Tanya and Dave are putting their own health at risk.

:20:38.:20:42.

You get half an hour meal break, but we are supposed to leave the screen

:20:43.:20:45.

every hour for five minutes. But I don't.

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Walking is the single most important thing everyone can do for their

:20:54.:20:58.

health. Both in the short term and long term. I believe health care is

:20:59.:21:06.

what we do for ourselves, and what I'm prescribing doesn't cost a

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penny. Sitting at work means you lose fitness, strength, stamina,

:21:12.:21:17.

suppleness and skill. So you've got to build walking into the working

:21:18.:21:20.

day. Have you got your patient's NHS

:21:21.:21:23.

number? It is a secret that many of our

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health problems are caused by not doing enough exercise.

:21:27.:21:33.

I've got to have a flutter, which I got on the 18th of March 20 13. --

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arterial flutter. The first one happened here. I was diagnosed as a

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diabetic. Type II. It's quite good at the moment. I'm

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keeping in check with good eating, as much exercise as I can. I've got

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a few problems with my back. It's manageable if I try not to think

:21:59.:22:02.

about! One in four women and one in

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men do less than half an hour of men do less than half an hour of

:22:05.:22:08.

even moderate activity in whole week. We start ageing from the age

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of 20. So keeping moving is crucial. Whatever your lifestyle, whether

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it's 2000 steps a day or 10,000 steps a day, if you walk 3000 extra

:22:21.:22:26.

vital steps a day, you'll transform the way you feel now and reduce your

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risk of death, disease, disability and dementia. So I've set Tanya and

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Dave a challenge. Record their daily step count and then up it.

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So far today I've done... 1065 steps. The time is just after ten.

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Just after 10:10. On this one, I've done 1470 steps.

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It took me an hour just to get into work this morning, so that was a lot

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of it. At this rate, they're going to struggle to clock up the extra

:23:10.:23:15.

3000 steps which I call my Walking Cure. 3000 sounds a lot. It's 30

:23:16.:23:20.

minutes. But we now know it's just as good as three ten minute 1000

:23:21.:23:28.

steps episode. So on the way to work, get off the bus early.

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Lunchtime, got to get out and do 1000. Then on the way home, do

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another 1000. That's the way to build it into your lifestyle. Before

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I challenge Tanya to walk more, lunchtime often involves no more

:23:43.:23:45.

than a few steps to the call centre's kitchen. Those also, like

:23:46.:23:52.

many others, would simply eat a sandwich at his desk. But today he

:23:53.:23:57.

spends of his break out walking. Good on you, Dave. That's perfect.

:23:58.:24:03.

As well as the ten minute additions, in your working day there are things

:24:04.:24:06.

you can do. Obviously, Tanya and David can't stand and walk about.

:24:07.:24:11.

Although I will be speaking to the call standing desks. -- I'll be

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speaking to the call centres about standing desks. How is this likely

:24:20.:24:25.

to revolutionise - one meetings work very well, particularly if you have

:24:26.:24:32.

something tough to say. I blew to eyeball is not necessarily as good

:24:33.:24:36.

as shoulder to shoulder. -- working meetings. Research things that in an

:24:37.:24:40.

hour, fit for no more than 20 minutes. Stand for eight. And

:24:41.:24:46.

walkabout for two. So if you're busy and have a telephone call to make,

:24:47.:24:53.

why not make it while walking? Hi, I've got ten minutes, so we can

:24:54.:24:57.

catch up. Really nice to speak to you. Where are you? Walking, I hope.

:24:58.:25:03.

I'm convinced there's no easy way to improve our general health than

:25:04.:25:05.

through this. The simplest of activities. OK, that's it. Ten

:25:06.:25:12.

minutes on the phone, ten minutes walking. That's 1000 steps. That's a

:25:13.:25:17.

kilometre. And we're both better off for it. Back at the call centre,

:25:18.:25:22.

after sitting down for almost seven hours solid, it's clocking off time.

:25:23.:25:26.

So how many steps have Tanya and Dave clocked up? Today's abysmal.

:25:27.:25:31.

2186. That is dismal. 2186. That is dismal.

:25:32.:25:43.

3275 steps. I didn't like the 2000 steps.

:25:44.:25:48.

Especially if you're supposed to 10,000 a day, I'm way behind.

:25:49.:25:59.

one of us making the effort with one of us making the effort with

:26:00.:26:04.

more active day to day life, and losing our terrible habit of sitting

:26:05.:26:08.

for long periods of time. Obviously, if you've a heart condition or other

:26:09.:26:12.

underlying health conditions and check with your doctor first before

:26:13.:26:14.

stepping up the pace. I suppose stepping up the pace. I suppose

:26:15.:26:19.

you've got lots of things wrong with you, but if you can do 100 steps

:26:20.:26:23.

more to start wrong with you, start with that. You'll feel better and

:26:24.:26:30.

reduce your risk of disease, disability and dementia. That's the

:26:31.:26:34.

bottom line. When we first met Tanya and Dave at

:26:35.:26:38.

the call centre, they were doing just 3000 or so steps a day. How are

:26:39.:26:44.

they doing now? It's been two weeks since the challenge. My best score

:26:45.:26:48.

is just over 6000 but through the day. I have to go by what my

:26:49.:26:52.

daughter once, because I've got no one else there helping me as a

:26:53.:26:58.

single dad. It can be difficult, but it's good fun as well.

:26:59.:27:02.

I've opted mainly at the weekends. Not while I'm working because of

:27:03.:27:06.

having to sit down and answer the telephone. -- I have upped it. The

:27:07.:27:11.

last few days have been in the seven thousands. I would like to be in the

:27:12.:27:16.

10,000, but I will get there slowly. Here is the bottom line - no matter

:27:17.:27:20.

your age, no matter what long-term condition or disease you've got,

:27:21.:27:25.

walking more is the single best thing that you can do. And talking

:27:26.:27:31.

of bottom lines, Tanya and Dave, and little Edie, are at the foot of

:27:32.:27:37.

of Winchester, contemplating whether of Winchester, contemplating whether

:27:38.:27:39.

to take their step count to new heights. I could give some of it a

:27:40.:27:48.

go, yeah. Coming down will be easy! Go through the gate first. This is a

:27:49.:27:55.

steep bit. Oh, I'll wait here. Tanya gets most of the way and vows

:27:56.:28:00.

to return to Congress Saint Catherine's another day. But Dave's

:28:01.:28:08.

pushing on. -- return to conquer Saint Catherine's.

:28:09.:28:13.

top! Yay! I could quite happily top! Yay! I could quite happily

:28:14.:28:22.

liver pate, e.g.. Couldn't you? -- I could quite happily live up here.

:28:23.:28:27.

Well done, Dave and Tanya. Good effort. That's it for now. Don't

:28:28.:28:31.

forget the e-mail. I'd better get walking, see you.

:28:32.:28:39.

Next week... They just moved out onto the right,

:28:40.:28:44.

and she's almost overcompensating. The junior doctors at risk driving

:28:45.:28:47.

home after their night shifts. She getting quite bad now. That's

:28:48.:28:52.

terrifying. That's really, really scary.

:28:53.:29:06.

Hello, I'm Louisa Preston with your 90 second update.

:29:07.:29:09.

30 British tourists shot dead in Tunisia in 2015.

:29:10.:29:12.

Today, an inquest was told that security forces

:29:13.:29:15.

New Series. Jon Cuthill investigates the NHS funding gap as services in the south look to save over £2 billion in just five years, while Oxford professor Sir Muir Gray reflects on the sedentary lifestyle he blames for many of our health problems.


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