Transcripts For BBCNEWS Victoria Derbyshire 20170206

Little money, very little resources, and to be honest, it is quite demoralising. I am a patient in the nhs. I had great care before my operation, but afterwards it has gone downhill. The staff are demoralised and tired and it affects us as demoralised and tired and it affects us as patients. My mum was diagnosed with cancer not long ago. I think the nhs is absolutely fantastic. The Ca Re The Nhs is absolutely fantastic. The care is amazing. I would fight to keep it. With us this morning is an audience of around 80 people who we re audience of around 80 people who were all either work for the nhs or have direct experience of it as a patient. You can share your experiences. Here is how to get in touch welcome to the programme. We are live until 11. Later, we will talk about some of the really difficult decisions the nhs may need to make in the future. Should it begin to charge for more services . Should we pay more in National Insurance fund the nhs . Your views are welcome. Nhs hospitals in england will have a legal duty to charge overseas patients upfront for Nonurgent Care if they are not eligible for free treatment. From april, so called Health Tourists could be refused operations unless they cover their costs in advance. Emergency care would still be provided immediately and charged later. Hospitals are already supposed to charge those foreign patients who dont qualify for free non urgent care, but a report by the National Audit office found that money raised next year would fall far short of a £500 million target set by the government. Ministers have announced that, from april, nhs trusts in england will have a legal duty to charge upfront for non Emergency Care, rather than send invoices after the event. Its not clear how this would be enforced. A uk wide poll ofjust over 1000 adults by ipsos mori for the bbc shows that 74 of respondents support increasing charges for visitors from outside the uk to help fund the nhs. 40 said raising income tax to finance the nhs would be acceptable. 37 said it would be acceptable for uk citizens to pay for some Health Services which are currently free. You were on the phone to the Department Of Health up to the start of the programme what does this mean in practical terms . |j of the programme what does this mean in practicalterms . I asked if it means new legislation, and the a nswer it means new legislation, and the answer was no. We are told it will involve so called secondary regulation, things that have already there, trying to make hospitals do more to charge people upfront who come from outside the uk and dont qualify for free care. No detail on how this will actually work. We are told it will be aimed at supporting hospitals to chase up the money. Some hospitals already do it quite effectively. Some ask for id. When you go in, that shows whether you are eligible for care or not. The government and what it can do remains unclear. It has been criticised for not raising the £500 million per year they said they would next year. It has fallen far short so far, according to the National Audit office. Will it affect eu nationals . If you come from another eu country to the uk and you need health care, you have the card that everyone is familiar with. Hospitals should take the details, send them to the Department Of Health, who then chase up the government of the country from which the visitor has come to get the money back. The Department Of Health have not been good at pursuing that, so have not been good at pursuing that, so there is inefficiency there. Some will say that this is a couple of hundred Million Pounds a year, and the nhs in england spends more than £100 billion per year, and it is about finding more funding generally. I view from croydon says should the uk taxpayer paid for the incompetence of other nations, often because of corruption . 0verseas players should pay, but how is the challenge. Another view says the uk isa challenge. Another view says the uk is a soft touch and we need Compulsory Health insurance for visitors. We will talk about this issue this morning. The rest of the mornings news now. An nhs trust has begun a formal inquiry into the case of an 89 year old woman who was kept in hospitalfor six months despite being well enough to be discharged. Iris sibley was taken to the bristol Royal Infirmary after a fall at her Residential Care home last summer. She recovered but no suitable nursing home place was found for her until last month. The cost of keeping her in hospital is estimated at £90,000. The trust has apologised. The number of unexpected deaths of Mental Health patients has risen by almost 50 in three years. Thats according to new figures obtained by the bbcs panorama programme. The findings are based on data from more than half of englands Mental Health trusts. The government says the increase was expected, because of changes to the way deaths were recorded. Thousands of low income families who were stripped of their tax credits after a mistake by the us out sourcing Firm Concentrix will have their cases reviewed. A committee of mps says that her majestys revenue and customs has accepted their recommendations to review up to 23,000 new cases. The company, concentrix, was sacked by Hmrc In September following an investigation by this programme. Mps will have the chance to amend the governments legislation on brexit when it returns to the commons for three more days of debate. A number of pro remain Conservative Mps are understood to be considering voting with labour and the snp to try and give mps more of a say over what happens at the end of the Negotiating Process, although Downing Street is understood to be confident the bill will be approved. President trump has stepped up his attacks on the judge who blocked his travel ban on seven muslim majority nations. In a series of tweets, he said the American People should blame the judge if anything happened to threaten National Security and that the courts were making his job very difficult. The white house is expected to pursue its appeal against the ruling later today. Prince william might be closer to the throne, but it was prince harry who on this occasion crossed the finishing line ahead of his brother. Harry, william and the duchess of cambridge raced against each other in a 50 metre sprint at the Queen Elizabeth 0lympic park, during a Mental Health charity event. Cheered by track stars and amateur runners training for aprils london marathon, harry crossed the line a stride ahead of his elder brother. Thats a summary of the latest bbc news. More at 9. 30am. Now the sport news withjohn watson. Good morning. The new England Patriots produced the greatest comeback in super bowl history to beat the Atlanta Falcons 34 28 in overtime. The falcons were in complete control having scored three touchdowns before half time. They were 25 points ahead before the spectacular fightback. No team has come form that far behind before. The Patriots Drew Level at 28 all with less than a minute left of regulation time remaining. And then, in overtime, a touchdown from james white completed the comeback to take the title. Quarterback tom brady named the Most Valuable Player for a record fourth time its a fifth title for the patriots. As we know the half time show as big as the game itself. And this year it was lady gagas turn to dazzle the crowds as she leapt into the stadium, lowered 79 metres to the stage below. Just the two costume changes in her 12 minute set. Her next big moment came when she dropped her mic at the end of the set, caught a glittery ball and then leapt off stage. An impressive entrance and exit. There was an astonishing finish to great britains davis cup tie when canadas Denis Shapovolov was disqualified after smashing a tennis ball at the match umpire, handing the tie and a place in the Quarter Finals to gb. Kyle edmund was two sets up in the decider. And the canadian in red after losing his serve, smashed a ball away. And it struck the Umpire Square in the face. It was a Freak Accident but still saw canada default the match. Great britain will face france next in april. Its a shame it has happened that way, and i feel for the its a shame it has happened that way, and ifeel for the young lad. He isa way, and ifeel for the young lad. He is a great talent and he has learned a harsh lesson today. What i would say is, i thought kyle, from what we saw on friday, he was absolutely fantastic. Is not the result or the outcome of anyone was expecting. Good morning. This morning were talking about the state of the nhs with you, and with an audience of 80 nhs staff and patients. The nhs is one of those institutions that most of us cherish, but are the pressures on its resources at Breaking Point . In recent weeks weve heard claims that its facing a humanitarian disaster, hospitals on major alert status, visits to some a e departments being up 30 on last year, patients being treated in Hospital Corridors because of lack of beds, and so on and so on. A bbc ipsos mori survey out today suggests over half of you think the nhs in england has got worse in the last six months just 8 think things have got better. Is that a fair reflection . You are very welcome to get in touch with us. Good morning. You are very welcome to get in touch with us. Good morninglj you are very welcome to get in touch with us. Good morning. I absolutely support what my colleagues are saying, the nhs is in a devastating position. However, iam here because of the commitment of the front line staff. The commitment remains, and it is not done to them, the state of the nhs. What is yourjob . I have been chief nurse in three acute hospitals, i have inspected hospitals. Even the hospitals that go into special measures, they are absolutely packed with incredible nurses, doctors, physiotherapist, radiologists. What is going wrong . There are not many politicians here, but there is something fundamentally going wrong and it is not with the clinicians. What is it, in your view . A number of things. Funding has gone wrong, there is not enough, and what is going in the wrong places. We will talk about social ca re places. We will talk about social care later, but there is an issue with funding, access, inequality, it is different across the country. There are issues in london, up north. Who agrees . My name is emma. I trained as a nurse back in 1985. I have worked as a Hospital Manager of a good few years. I run a First Aid Training business, recruiting and benefiting from the demoralisation in Ambulance Staff, because Paramedics Want to be treated better. The nhs must be managed by people that have been within the syste m people that have been within the system and to know the system and who understand it. Is that what is going wrong, poor managers . Incompetent managers, managers who are snowed under completely . Incompetent managers, managers who are snowed under completely7m incompetent managers, managers who are snowed under completely . It is a horrendousjob. As are snowed under completely . It is a horrendous job. As a are snowed under completely . It is a horrendousjob. As a Hospital Manager, we had a lot of external consultants coming in with Amazing Solutions thatjust consultants coming in with Amazing Solutions that just dont work in a very oversubscribed situation. Your own experiences . I am a patient. I was diagnosed with cancer during pregnancy. I underwent chemotherapy, had my baby. She is fine. I had a mastectomy in my care was fantastic throughout. My problem is that after all of that, i was told the drugs i would need are not funded by the nhs in wales. They are currently funded in england, but they are being withdrawn there too. How much money do you need to raise drugs . My target is £150,000. Thats for one year on different drugs. Wow. The ca re year on different drugs. Wow. The care has been brilliant and i cant complain, but to get to the end of that process and reach a point where you think you had the worst news possible and to the told you have incurable cancer and then discover that the drugs that are available, that the drugs that are available, that are proven to be effective, you are not going to be given access to them. Because they are too expensive. What is your frame of mind about this situation . |j expensive. What is your frame of mind about this situation . I dont know who to be angry with about this. I cant blame the nhs. Its not their fault. They are working within ridiculous budgets. I can only lay the blame with the government. We have a Conservative Mp here. We will talk to him in a moment. We asked englands Health Secretary jeremy hunt to join us. Asked englands Health Secretary jeremy hunt tojoin us. He asked englands Health Secretary jeremy hunt to join us. He wasnt availablement hello sir. Im a patient. Steve, bring that microphone closer to your mouth. Im a patient and lastjuly i was diagnosed with an enlarged prostate. As of todays date, i dont know why the prostate is enlarged. Im waiting for a different diagnosis, is it cancerous, if it isnt. Why do you think about that . If it is cancerous, i would like the treatment to start soon. It cant be for the number of people to trying to find out . I have had a number of non invasive tests. The next test is the biopsy. Thank you, steve. Hello. Were going to pause forjust a moment to look at the overall Information Budget and the pressures on it. Have a look at this. The nhs is the second biggest area of Public Spending in the uk behind welfare. But exactly how big is it . Well, heres how Health Expenditure in england has changed over the years. In 20152016, it stood at around £117 billion. Its set to rise in the coming years, but, taking account of inflation, at a less impressive rate. Its also worth noting that the uk population has increased by five million in ten years. And its an Ageing Population, too, putting extra stress on the system. If we take the Health Budget in england in 2015 2016, we can see how it breaks down. The biggest expenditure was on hospitals and ambulances. Many experts say the budgets for mental Health Services and care in the community are not great enough. In 2010 2011, nhs trusts in england overall had £458 million left overfrom their budget. That figure rose in successive years, but since then trusts have rapidly fallen into deficit, which means they spend more than their budget. And in 2015 2016 the deficit stood atjust under £2. 5 billion. With us is our Health Editor hugh pym, jeremy lefroy, a Conservative Mp for stafford, jon ashworth, a labour mp who is their spokesperson on health. The president of the Royal College of paediatrics and child health, professor neena modi. The chair of the Royal College of gps helen stokes lampard. Dr Chaand Nagpaul from the british medical association. We asked englands Health Secretary jeremy hunt and other ministers from the Department Of Health to take part in the programme. They said no, but did tell us, across the country we know the nhs is very busy, but hospitals are performing well why the laughter . Why the laughter . It is obvious the nhs is to busy. It seems like a ridiculous statement from the Ministry Of Health to have to tell us Ministry Of Health to have to tell us that. It goes on. But hospitals are per fortunatelying well with steps in place to cope with the extra demands winter brings, supported by an extra £400 million worth of funding. It sounds like a lot of money, hugh. Well, if you think the overall budget for the nhs is more than £100 billion a year in england it puts it into prospective. Im not totally clear about the £400 million, i think it is recurring money thats spent every yearfor think it is recurring money thats spent every year for winter rather than being something extra this year. And what we have been told is the nhs was allocated extra money in successive the nhs was allocated extra money in Su Ccess Ive Yea Rs the nhs was allocated extra money in successive years by this government and it basically needs to get on with what it has got even though it had to cope with extremely high Patient Demand as weve heard, but there is a big question which im sure we will be talking about throughout the programme, does the nhs need more money, if so, where does it come from . Are people prepared to pay more tax . There needs to be a debate about health and social care and whether they should be more integrated in england. Social care paid for by local authorities, how do you deal with that . There is some Big Questions about the future here. Hello, sir. Introduce yourself . Im simon. Im a cln i in the nhs. No one disagrees with hugh, the nhs does need more money, always has needed more money and i think we live in this world now the prost trump world with alternative facts, sometimes i wonder if the dh comes up sometimes i wonder if the dh comes up with alternative facts on their funding and how much theyre given. I would like like to say also successive governments, one can blame this government now, but successive governments because of the tax burden that is the nhs, they bring in so called Efficiency Measures and every time there is efficiency measure ultimately that means money has to be removed from the budget. There is nothing efficient about treating anybody. That lady who has the cancer, there is nothing efficient about treating that lady. She needs the money. We should be able to give t im sure she gave taxes for the nhs. Applause thank you. What i didnt mention is that i am not unique. Im not even unusual. There are a lot of women who are fund raising and men presumably fund raising for cancer drugs in this country and just this week on the bbc it was reported that there has been a seven fold increase from 2015 to 2016 in people on fund raising sites who are raising money for life saving or life extending treatments and i think thats a ridiculous situation to be in. We can afford this. We have the money available, but the money is being spent in ways that we dont wa nt being spent in ways that we dont want it to be spent. Applause well, i was just saying we have got two ministers here, one Shadow Minister and a very brave member from the Conservative Party from stafford. Would they like to make some comments . I would like them not to say if we were in power we would give more money or we have given more money to the nhs. Everyone in this room likes the nhs. They want to keep the nhs. They want the nhs properly funded. What would they say to us who have come here today to ask you that question specifically . Applause asa applause as a Conservative Mp, conservative government, what are you going to say to that . I agree. I have been, i declare an interest in that my wife isa gp, declare an interest in that my wife is a gp, my daughter is a medical student. As a family we are extremely committed to the National Health service. I have been saying since as you rightly say, my, what was the mid staffordshire trust is in my constituency. I have to say that there have been great improvements there thanks to the dedication of the staff, it is now pa rt dedication of the staff, it is now part of the University Hospitals of the north midlands. Still a great deal of pressure there. There is no doubt if you look at the amount that we asa doubt if you look at the amount that we as a nation spend on health, it is probably about 2 of gdp less than say in france and germany. And frankly unless we are prepared and i heard people behind say they were prepared to do this and certainly when i talk to my constituents, u nless when i talk to my constituents, unless youre prepared to say we will up the amount that we spend, which means, higher taxes, will up the amount that we spend, which means, highertaxes, iam afraid, there isnt anywhere else to go. If were going to have a system funded based on need and from a progressive source of income, thats the only way to go. And its interesting that i think people are beginning to see that. I have been saying that for the last three or four years. Ive written about it. We have seen cross party work done in the last few weeks. Can you see a Conservative Governmentjust before the 2020 election. We have got a Microphone Orfader the 2020 election. We have got a microphone or fader open. We will ignore that. Promising in a ma nifesto, ignore that. Promising in a manifesto, we will put your taxes up in order to fund properly the nhs . The answer is i dont know. I would hope that we would have, weve got this. Thats yourjob. Yourjob is to advocate for us. Youre representing the people of this country. Im a patient. Turn around and look at the lady wh who is talking to you. Sorry, i still cant see you. I want to look at your eyes. Yourjob is to advocate for us. Thats yourjob as our mp. 0ne for us. Thats yourjob as our mp. One of the mps in this government at the moment. And if were saying and a lot of people are, i have seen lots of question time, it is the only programme i watch, we are willing to pay the extra two pence on the tax, why not . Forget the eye eology of low tax. Let us have our nhs free at the point of delivery so we can stay alive. Applause My Name Is Gaye Lee and i have been a nurse for 37 years. I work in a hospice. There is no great mystery why hospices work. They have enough staff. The funding for the nhs, by the way im sorry to see there are no Nurse Leaders here, i wish the Royal College of nursing had been invited. The funding sources, my area in South East London spent £5. 3 million in the last three years on external Management Consultants to advice how to reorganise services in our area advice how to reorganise services in ourarea and the advice how to reorganise services in our area and the second thing is that. Lets stay on the money issueif that. Lets stay on the money issue if we may. The admin costs have gone up by 10 over the last 20 years since the nhs became a Market Commissioning and provision of service separated. Go ahead. Im ben harris. Ben, can you move that microphone closer. Im glad sir you said you wanted more a nswe rs glad sir you said you wanted more answers than just throw more money at it. This debate rarely gets beyond that because labour say the a nswer beyond that because labour say the answer is throw more money at it. Im not saying the nhs doesnt need funding, but it is extraordinary, isnt it, that jeremy funding, but it is extraordinary, isnt it, Thatjeremy Hunt is one of the longest serving health secretaries. He has been in post for just four years and really the problem with the nhs or indeed a big problem with the nhs or indeed a big problem with the nhs or indeed a big problem with the nhs is the fact that this country for at least the last 20 years has been governed on the basis of winning an election, not on the basis of Long Term Planning. To the point about the. Applause the percentage of gdp spending, japan spends 1 less than we do on its healthcare and has better Healthcare Outcomes and thats because they have a different approach. So, whilst im not here to say we need to cut funding to the nhs, absolutely not. That can only ever be part of the solution. Lets hear what a Labour Representative has to say. John ashworth, i dont know Whatjeremy Corbyn will promise in his manifesto before 2020 if hes still the leader, will it be more money or yeah, well put your taxes up money or yeah, well put your taxes up two pence in the pound, what . Certainly the nhs needs more money. Imean it certainly the nhs needs more money. I mean it is going through the largest financial squeeze in its history and head for head next year nhs investment will actually be cut in england. So youre right, sir, to say it is notjust about money, but we cannot ignore the reality that this huge financial squeeze is putting this incredible burden and pressure on the system at every level now so we cant just dismiss that out of hand. Firstly, how do you account for the fa ct firstly, how do you account for the fact that japan has better Healthcare Outcomes by spending less money . Are you willing to acknowledge as many of your collea g u es acknowledge as many of your colleagues at least have, that this country is out of money. Were told we have an Austerity Budget in place. No, im afraid it is. Were told we have an Austerity Budget in place. This government is borrowing £70 billion more than it is taking into the ex trekker. We are £1. 5 trillion in debt. When there is another recession we will be in big, big trouble. The kind of trouble greece has been in. I work in a coastal nhs. Im afraid thats rubbish. We are the sixth richest country in the world. Let me finish my point. Im afraid the government gave and it is tories and liberals and the labour, gave when the bankers bail out 109, not million, not billion, but trillion pounds, that could have funded the social ca re that could have funded the social care for 100 years and done the nhs for 50 years. It is all about ideology and the fact that the tory government dont want to do it and we should stand up against it. We didnt spend £109 billion bailing out the banks. We didnt spend £109 trillion. No, no, sorry sir, we didnt spend £109 trillion. This government has found billions to cut tax for big corporations, has found billions to cut Share Transaction tax and in the recent november budget it found millions to build new Grammar Schools and not an extra penny for the nhs. So what would labourdo . Penny for the nhs. So what would labour do . To say there is no money available is a nonsense. We need to put investment. Please. Please. If you dont have a microphone, dont speak. Government is about choices. It doesnt need to choose to cut Corporation Tax for billions. It doesnt need to choose to put millions into building new Grammar Schools. What would labour do . We would put more investment into the nhs. I have outlined suggestions about what the government doesnt need to be doing, but i think the country needs to engage ina but i think the country needs to engage in a big debate about the future financing of the nhs, because as we get older as our population, with more complex needs, which is a good thing that we are living longer, and we have more expectations on the nhs, we will have to debate and face up to some Big Questions about how we fund it, but lets not go for the nonsense and believe that the nhs Cannot Have Extra Investment now. It could if the government took a different set of decisions. I am an Orthopaedic Surgeon in my last year of training, soi surgeon in my last year of training, so i have been privy to budgets and cuts over the last few years from a front line point of view. The gentleman from the conservative think tank, bravo, you argued your alternative facts very vehemently and presented a convincing case, but the fact of the matter is, you are talking about not putting in extra funding. This is a political decision. It is the cuts you are making every single day. The purpose of the nhs is like a bucket with holes in it, and the holes are increasing daily. We see money being siphoned off to private Finance Initiatives. £80 billion for private Finance Initiatives for buildings that were supposed to cost £11 billion. That was the previous government. I am not talking about funding but about loss. You can keep putting water into a bucket, but if you put holes in it and you are siphoning off money, since this health and social at health and social care act, hospitals were forced into private initiatives, and money is being lost through ridiculous means every single day. I see this as a doctor, because were having to ration services. Like what . For example, certain people can be offered certain people can no longer be offered hip and Knee Replacements who could have got them five years ago. We heard the story about drugs available for cancer. The next thing will be that people who are obese should not be allowed certain treatments, smokers shouldnt be allowed certain treatments. It will go on and on. Private companies are looking at profits, and they are beholden to shareholders before the public. Compared to the whole, the propulsion of private companies is not that much. I dont think that more money is necessarilyjust the way forward. We are spending a 0. 9 increase. But we are seeing a real cut every year. On the figure about banks. There are various reports, but it is round but it is around £1 trillion. Not 109 trillion. It is around £1 trillion. I am a co nsulta nt around £1 trillion. I am a Consultant Anaesthetist and i want to make a couple of points. People talk about absolute numbers. I am not a health academic, but you need to talk about the percentage of gdp, the head to head spend, the fact that we are accommodating and increasing, Ageing Population, there are more sick people around. If you give me numbers, i dont know what that means. In yourjob, you said you were making dangerous decisions what do you mean . You were making dangerous decisions what do you mean . I speak on behalf of every consultant and gp, and we have written an open letter to the Prime Minister, signed by around 2000 consultants and gps from around 2000 consultants and gps from around the country. It says that, first, we are in a crisis. It is not a seasonal pinch. We have never been in such dangerous territory. The decisions we have to make are unfathomable. Give an example. We are run black alert every day. I dont know what that means any more. It isa dont know what that means any more. It is a permanent fixture. I have to tell people daily that their operation for Stomach Cancer is cancelled for the third time because there is bed blocking due to medically fit patients who Cannot Access Social Services and because there are more sick people in the acute services. Gps are at us in point, as our acute services. The real worry is the brain drain. Nurses and doctors are starting to leave. Sorry to interrupt. The dangerous decision is, it saying to a patient that they cannot have an operation because there is nowhere to put them, and that is dangerous. You like it is dangerous and heartbreaking for me. I didnt train to do that. Secondly, the fact that there are fewer doctors and nurses. The doctor and nurse patient ratio, you cannot imagine the stresses. We are looking after patients who are very sick in unsafe areas of the hospital. You hear about trolleys. We make decisions where we go home at night and frankly we dont sleep. Did i do the right thing . Did i discharge that patient to hourly . My Junior Doctors are acting as nurses and doctors at the same time because there are not enough staff. Bid i discharge that patient too early . Staff are talking about going to do buy, to canada. That never happened before. I agree with anita. I am a Front Line Nurse and i have seen Services Getting increasingly more pressured, increasingly more dangerous situations where we are having to make life changing decisions for patients. It also feels really demoralising as a memberof feels really demoralising as a member of staff to be tell continuously byjeremy member of staff to be tell continuously by jeremy hunt member of staff to be tell continuously Byjeremy Hunt and the Department Of Health that they are putting more money into the nhs when in reality it is a £22 billion cut to services. We are not stupid. Stay there. The gentleman here, dojoin us. I am there. The gentleman here, dojoin us. Iama there. The gentleman here, dojoin us. Iam a gp there. The gentleman here, dojoin us. I am a gp from doncaster and i wa nt us. I am a gp from doncaster and i want to echo what my colleague in the hospital is saying. It is similar in General Practice there are not enough doctors. Patients are getting more sick, living longer, and there are more of them. I go to work at 7 30am, and there will be 100 pieces of paper work to do before patients start phoning at 8 30am. Between 8 30am and lunchtime, i can consult with approximately 50 patients. There might be another 25 30 patients for the rest of the day. By 10 30am, my brain is fried and i cant think any more. I advise them at 11am, you know youre not getting the best of me any more. It is dangerous to phone from here on in. I dont know what to do because there are not enough staff for the number of patients. That would be my other point. What have we been doing about Workforce Planning for the future . By Workforce Planning for the future . By2020, Workforce Planning for the future . By 2020, we will have a complete shortage of nurses, unable to cope with the demands we experienced on the public. In addition, the nhs bursaries have been cut for nursing, so were not recruiting them. This year alone, more than ever before, Moore Foundation doctors, Junior Doctors about to embark on a Career In Speciality training, have left. More than any other year. Personally, i am covering more gaps in the Junior Doctor wrote than i ever thought would be the case. I didnt think it was part of myjob plan, but there are holes. We come to work and there is not a medical registrar or a surgeon. Sue says i cant praise them enough, lets keep it, please. Jeff says there are ample funds in the nhs and it is about bad management and bad procurement practices. Another viewer says nurses and doctors are excellent. The problems are elsewhere. Too many chiefs, not enough beds. Another viewer says resources cannot keep up with demand. Should demand due to self indulgence, like obesity, be given a lower place in the queue . It is something we will definitely talk about through the morning. We are going to bring you the latest news and sport. Here isjoanna. The number of patients on Hospital Wards has been at unsafe levels in nine out of ten nhs trusts in england this winter, according to figures obtained by the bbc. A report by mps said the system for recovering costs was chaotic. Nhs improvement says it has to improve the way that money is collected. The number of patients on Hospital Wards has been at unsafe levels in nine out of ten nhs trusts in england this winter, according to figures obtained by the bbc. The results show some hospitals were operating at close to full capacity, putting increased pressure on the number of beds available. Nhs england says more beds would be freed up if there was greater focus on the link with social care providers. The number of unexpected deaths of Mental Health patients has risen by almost 50 in three years. Thats according to new figures obtained by the bbcs panorama programme. The findings are based on data from more than half of englands Mental Health trusts. The government says the increase was expected because of changes to the way deaths were recorded. Thousands of low income families who were stripped of their tax credits after a mistake by the us out sourcing Firm Concentrix will have their cases reviewed. A committee of mps says that her majestys revenue customs has accepted their recommendations to review up to 23,000 new cases. The company, concentrix, was sacked by Hmrc In September following an investigation by this programme. Thats a summary of the latest bbc news, more at 10. 00. Heresjohn watson with the sport. Good morning. Some Breaking News Alastair Cook has stood down as england captain. The england and Wales Cricket board has announced that. We will bring you more at 10am. A Bizarre Davis Cup victory for great britain. After canada are disqualified when one of their players, denis shapovalov, accidentally hits a ball straight into the eye of the umpire. It was the deciding match of the tie and sees gb reach the Quarter Finals. New England Patriots won a dramatic super bowl last night, as they came from 25 points behind to beat the atalanta falcons 34 28. No side has ever come from that far down. Its a fifth title for the patriots and a fourth for mvp tom brady. The quarter back instrumental in the comeback Manchester United Beat Leicester three nil, in what was another defeat for the champions who are now one point above the relegation zone. What a difference a season made. United remain on course for a top fourfinish. Wales beat italy in the last match of the Opening Weekend of rugby unions six nations. 33 7 it finished in rome. George north with his sides third try. Wales making a winning start but missed out on scoring a fourth try which would have earned them a bonus point victory. That is all the sport for now. Victoria, back to you. Welcome back. This morning were talking about the state of the nhs with you, and with an audience of 80 nhs workers and patients. For the next 15 mins or so were going to talk about social care and the impact that stretched resources there have on the nhs. Health care is provided by the nhs in doctors surgeries and hospitals. Social care is provided in the community to help people who need support due to illness, disability or old age. And because so many more people are living longer, its really putting pressure on the social care budget, which in 2016 stood atjust under £20 billion in england. The Social Care System is designed to provide care in the community for the elderly, sick and disabled. It encompasses anything from help in the home with washing and dressing to care homes, and has remained more or less unchanged since it was created after world war ii. Nowadays people live on average ten years longer and with more complex conditions that require additional care. But support is not rising its falling. The local Government Association estimates the gap between the care Budget Councils receive will be £4 billion short of whats needed by 2020. Some experts have called for the care system to be merged with the nhs, but its known the government has little appetite for more structural upheaval. The result is that councils are left to limp on. Many people with care needs are forced to pay for it themselves, rely on friends and family, or go without. The Prime Minister has, however, promised a long term sustainable system. By the end of this parliament, local authorities will have £3. 5 billion more to spend on social care, and of course were putting more money into the Health Service as well. The governments offered local authorities the opportunity to bring forward council tax rises to help cover social care costs, and money redistributed from the new homes bonus scheme. Over the next two years, the government says it could mean an extra £900 million is pumped into the Social Care System. But charities have called it a drop in the ocean. This morning an nhs trust has apologised after an elderly woman remained on a ward for six months at a cost of more than £80,000 despite being fit for discharge. 89 year old iris sibley was initially admitted to hospital after a fall at a care home injune. She and her family were left Distressed And Let Down after multiple attempts to move her into a nursing home failed, leaving her in isolation at the bristol Royal Infirmary. Is this an isolated incident . My name is barry. My mother had to go into social care through dementia which she was paying for. Through a nursing home, a care home . Care home. One saturday morning she had this bout of sickness and the home kept us informed through the day up until saturday evening, they said she is no worse. She will be fine. Shell get through the night. That was the last call we got until 7am Sunday Morning when the hospital phoned us to say she had passed away. She was discharged from hospital without any of her medical records. The hospital tried to phone the home and couldnt get any answer. The police went down and couldnt get any answer. When the Morning Shift came on at 7am, thats when the police got some response from the night staff. We found out that, you know, if we had been informed that my mother was in hospital, one of the family could have sat with her. She choked on her own vomit and died in a e. Oh, my goodness. We were paying for 24 hour care, but any member of the family would have willingly sat with her in a e. How does your family respond to what happened to your mum . What could you do . I got in touch with the solicitor to sue the home for negligence. He said forget it, youre not going to get anywhere with it. He gave me a figure of less than £1,000 wed get because were not dependant on her, but the thing was, we wanted to take it further to prevent it happening again, but he just said it would cost you thousands to prove a point and it wont get you any further. Yeah, yeah understood. My name is lindsey. Lama yeah understood. My name is lindsey. I am a home care support worker. I work with people who are discharged from hospital enabling them to remain in theirown from hospital enabling them to remain in their own homes following a period of illness. I work with a caring compassionate team who go Above And Beyond whats asked of them. Ithink Above And Beyond whats asked of them. I think our concerns are the shutting of the community hospitals, there is nowhere for these patients to go once they have left hospital, therefore due to bed blocking they are being discharged too soon and ending up in being re admitted to hospital. I wonder what needs to change . Hello. Im chair of the Royal College of gps, but i am a gp myself. This is bringing back examples that i have seen in my practise and i was there to late on friday and i will be there late this afternoon. People are trapped in hospital unable to go to a safe place because there arent the places there. The nhs is entirely dependant on social care. If you think of it as a three legged stool, you have got the Community Care and the social care and the Hospital Care. We have to Work Together and if the system isnt tunded and support, we all fall down, so were all in it together. It breaks my heart when i have a patient at home andl heart when i have a patient at home and i can see them deteriorating and needing care and i know with the right care package in place they wouldnt need to go to hospital. The ivy wouldnt need to go to hospital. The joy of being a gp, we can save people getting to hospital if we have the right support structures, we can conduct this orchestra of wonderful people, and family support, we can work miracles. I feel for you guys, but youve done amazing, amazing work. Applause whats your view when it comes to social care . I think this debate is about the health and Social Care System being part of a Single Organisation which is as weve heard before woefully under funded and coming back to the hard facts, the real facts, the truth coming back to the hard facts, the realfacts, the truth is coming back to the hard facts, the real facts, the truth is we have fewer Hospital Beds than any other european nation. Germany has three times as many Hospital Beds. Three times as many Hospital Beds. Three times as many Hospital Beds. Three times as many. We have the lowest number of doctors, social care funding has been cut year on year for the last six years and therefore, when you actually try and look after an older population with multiple Health Problems you simply cant deliver that whilst you have a Social Care System that is cutting costs year on year so there has to be this has to be addressed as a global issue about looking at the total resource. Well, i dont know about a global issue. Surrey county council is having a referendum amongst households to see if they would pay 15 extra on their bills to pay for social care . This is a National Health service. The minute we leave it to local areas to sort out a national problem, weve lost it. Good morning. Thank you very much, victoria. Im a frontline clinician, i look after sick newborn babies and last year 1,000 sick babies and last year 1,000 sick babies were transferred unnecessarily between hospitals because there were insufficient cots. Thatsjust one because there were insufficient cots. Thats just one fact that i wa nt cots. Thats just one fact that i want to put out there. But i also wa nt want to put out there. But i also want to put out there. But i also want to pick up on the point of the Ageing Population. Lets talk about the healthy Ageing Population because, of course, the burdens that are placed upon the Health Service has come because were having an Ageing Population with complex needs, but what is it that would help us all live long and healthy as opposed to unhealthy lifestyles . Tell us, please. It is about prevention, isnt it . It is about Healthy Eating and we have not yet spoken about the, we have only spoken about the, we have only spoken about the acute Health Services, we have not spoken about the terrible cuts that have been inflicted on Public Health. Most of which burden is i have to say being imposed upon children. 14 of the £200 million in Public Health cuts la st £200 million in Public Health cuts last year are falling directly upon childrens services, health visiting, is Sexual Health for young people, obesity prevention, antismoking. All these things are the things that will lead to chronic lung disease, obesity, dementia, many cancers further down the line. It would be really good to talk about prevention when we talk about the Health Services as well. John ashworth . Im pleased were having a debate about social care because you wont solve the problems and the pressures facing the nhs unless we solve the social care crisis in this country. Does that come from the top or do you think County Councils who are responsible or councils responsible for social care can make their own arrangements . It has to come from the top. 400,000 elderly and Vulnerable People are not getting the kind of Social Care Packages that they would have done. Thats putting huge pressures on the nhs itself. It has to come from the top. In the budget in march, the chancellor has to do what he failed to do in his mini budget in november, bring Forward Emergency Funding for social care because the way we treat elderly people is a disgrace in this country at the moment. Jeremy, as a Conservative Mp was it short sighted of the Coalition Government to make the kind of cuts they did to social care . I think we have seen this increase over the last couple of years when there has been a lot of pressure. Years when there has been a lot of pressure. Was it shortsighted then . Yes, i would say, it is short sighted. I think social care has always been the poor relation. Would you back mr ashworths call for your chancellor to bring Forward Emergency Funding to help councils pay for social care or are you happy to see councils put Council Tax Bills up as many will do . We do need emergency funding. I dont see a problem with councils putting their, weve had council tax freezes more about four or five years. I think it is important that those Council Tax Bills starting to up again in a measured way which is what they are doing in my county, but also i think we need some Emergency Social Care funding because what were seeing as everybody here has said is people staying far too long, i have seen that in Hospital Beds, i have seen that in Hospital Beds, i have seen that in Hospital Beds, i have seen that in my constituency surgeries and im sure every colleague in parliament has seen the same. When you say emergency funding, how much money are you asking that the chancellor put in . There is estimates about what is needed. They we re estimates about what is needed. They were talking about £2 billion, i have suggested there is an extra 700 million allocated in 2019, why not bring that forward . We need some money. Im going to ask you to pretend that you are residents of Surrey County council. They are having this referendum, theyre going to ask their own householders do you want to pay an extra 15 on your Council Tax Bill which will go to social care . Sorry residents, would you say yes, i will go for the 15 , if you would, put your hand in the air. The problem is with referendums and asking the question, putting questions to the public is were not given enough information. Were not educated enough to make a choice. There are people who put their hand up there are people who put their hand up to say there are people who put their hand 5, there are people who put their hand up to say yes, i would pay the extra 15 . How can you guarantee that that 1596 15 . How can you guarantee that that 15 is going to go to the Frontline Services . Yes, introduce yourself . Wendy preston head of Nursing Practise from the Royal College of nursing. It is the wrong question to ask. Theyre asking it whether we like it or not, theyre asking it. If we get the extra money, how are we going to spend it . How are we suddenly going to be able to have the services . Our members have been telling us this is not isolated incidents, they are telling us that day in and day out nurses and doctors are having to send patients home from hospitals into their home when there is not enough care and we know that there are, we have got Less Community nurses, there is a 40 drop in district nurses. We have got 24,000 Nurse Vacancies so we need some long term solutions. It is notjust need some long term solutions. It is not just about throwing money at this problem. Welcome. You said you would pay an extra 15 on your Council Tax Bill. I dont live in surrey, but i would, the problem is going to be poorer parts of the country, newcastle, middlesbrough,15 parts of the country, newcastle, middlesbrough, 15 is a significant amount of money. It is all very well in surrey from prosperity is higher, but it is not right for the government to push this problem on to local councils. It needs to be funded properly. You would pay that extra on your Council Tax Bill . No, im from the Taxpayers Alliance and surrey is an outrageous example. There are lots of councils who are coping with this far, far better than surrey. It is not a good example there are lots of councils who will increase bills . 15 is quite absurd and it is clear that some councils are better at this than others and some councils are better at keeping people in their homes and out of care homes than others. There does need to be a learning from best practise across councils because some are opening far, far better than others. Yes, hugh. This is a really Crucial Point here and it is interesting to see in Scotland Health and social ca re see in Scotland Health and social care is now integrated, but it will ta ke care is now integrated, but it will take time to actually get social ca re run take time to actually get social care run by local authorities and the nhs working closely together. So they started in scotland. It hasnt happened in england. It happened in Northern Ireland a while ago. But the big point thats being made here, how can you treat social care funded by local authorities as something very different from the nhs when you have a patient with dementia for example who lives in their own home and who needs care, but is mea ns tested their own home and who needs care, but is means tested for it, whereas your cancer ca re but is means tested for it, whereas your cancer care is paid for in a hospital . I think all the Big Questions are coming up. There are exa m ples questions are coming up. There are examples around england certainly that ive looked at where local authorities and local nhs gps are working now together to try to make the best of what theyve got which i think can be done, but ultimately, money is involved and is it right it should fall on Council Tax Payers in areas that maybe can afford it, whereas others cant raise council tax because their local population cant afford it . Does it need a bigger Long Term Plan to be drawn 7 imjune gray and 7 im june gray and i am a practise Nurse Working in east london. My father of 84 years of age passed away sometime ago and in the bed opposite to him on the ward was one of his best friends who unfortunately had had his leg amputated and had been in hospital for a year because he didnt figure in the local authority radar, he didnt have any housing, he had no income, except for his pension and his nearest relative lived in wales n swansea, but the authority there didnt want to take him on and couldnt find a nursing home that was suitable for him and so he spent virtually a year in hospital with people passing the buck and saying we dont want to fund this, we cant find a place for you. Eventually it was sorted out, but the difficulties for his family. The difficulties for him and the deterioration in his mental state through lying in hospital for all that amount of time and not getting the proper rehabilitation that he could have had. This is why it needs to be a national service, it is a three legged stool. When i was a district nurse, if i went into a home, and someone was deteriorating, i could say this person needs more help. We need more visits. When my father was deteriorating, and we said to the carers, can we get more help . We had to go back to the care co ordinator, they had to go to the agency. Let me read this message. Brendan texts, families need me read this message. Brendan texts, families need to me read this message. Brendan texts, families need to take far more responsible for their ablinging pa rents responsible for their ablinging parents and relatives. Great, fine, are you going to pay me to give up my full time job in order to look after my elderly relatives . Applause because thats the reality. My mother, who is in her 80s now and i we re mother, who is in her 80s now and i were having to look after my father and pick up the shortfall. My sisters helped where they could, but they live far away. Families are not unwilling to do this, but we cant alljust drop everything and be there. I work there. Iwork in there. I work in a care home and in the only past few weeks we have had residents sent home too early from hospital and then they have had to be re admitted. Karen says pay relatives to look after the relatives, it must be cheaper than ca re relatives, it must be cheaper than care homes. Good morning. Im the mum of two Junior Doctors. Whats your name . Leeash. The pressures on the nhs are also being increased because of cutbacks in the social sector, the social funding. Because of cutbacks in the social sector, the socialfunding. I have a brother who has spent an extra five weeks in hospital and an extra five weeks in hospital and an extra five weeks in hospital and an extra five weeks in a nursing home when he has got a home of his own. Hejust weeks in a nursing home when he has got a home of his own. He just needs his social care package to be able to go back to where he wants to be, backin to go back to where he wants to be, back in the home. It must be so frustrating. Very. The thing is, if they had betterfunding for the social side, these patients dont want to be in the hospital, where they can pick up more infections, they want to go back to their houses and have some dignity and care within their houses, which would release lots of beds. Thats the main thing i wanted to say. And the main thing i wanted to say. And the nhs is great. Thank you. The news and sport is on the way, then more discussion. Sally texted to say, remember that the elderly are the ones who have paid tax all their lives, so why should they be sidelined when it comes to treatment . Coming up, we will ask you paying for care will become inevitable. First, the weather. It has started chile, and the end of the week will be very cold indeed. We have a wet and windy interlude, which is on its way later on today. We have some fog patches lingering in central and eastern areas, but at west it is all change. Cloud is increasing and outbreaks of heavy rain are working in. A pretty poor rush hour in these areas, particularly in belfast. This evening and overnight, the wet and windy weather sweeps to the east. Snow on the high ground of scotland and Northern England, potentially some disruption to Trans Pennine routes. There could be icy stretches by the end of the night at west. A bright day tomorrow, but the chance of some hefty showers in the south west. The Weather Front never really moves through and there will be outbreaks of rain. Towards the end of the week, the cloud and rain continues to work its way to the west, bringing colder air with it. It is cloudy at the end of the week, and at times, some of us could see some snow flurries. Hello, its wednesday, its 10 oclock, im victoria derbyshire, good morning and welcome our programme. This morning, the governments announced that from april hospitals in england will have a legal duty to charge overseas patients who arent eligible for free nhs care. Well ask our audience here of nhs workers and patients whether the nhs should start charging for more treatments and procedures. Lets treatments and procedures. Get a quick snapshot. I think if you charge, it fundamentally alters the relationship between the doctors and patients. I agree with the gp over there that if you start charging, it isa there that if you start charging, it is a slippery slope. You are a final Year Medical Student. is a slippery slope. You are a final Year Medical Student. I have to agree with the other guys. Is there enough money to do that . I dont know if there is. You have been telling us your experiences of the state of the nhs this morning. We have never been in such dangerous territory. The decisions we have been asked to make our unfathomable. I was told the drugs i need are not funded in wales. They are being withdrawn from england too. I am having to raise funds to paper the drugs to keep me alive to be here for my children. Day in, day out, nurses and doctors are having to send patients home from hospitals to their home, weather is not enough care. We will also talk about Government Plans for a seven day nhs. Here is how you can get in touch. And wherever you are in the uk, do get in touch with your own experiences and well feed those into our conversatoin this morning. Heres how to get in touch. You can e mail us at victoria bbc. Co. Uk. Tweet us victoria live. Were on facebook, just search victoria derbyshire. 0r text on 61124. Texts will be charged at the Standard Network rate. Heresjoanna in the bbc newsroom with a summary of todays news. The number of patients on Hospital Wards has been at unsafe levels in nine out of ten nhs trusts in england this winter, according to figures obtained by the bbc. The results show some hospitals were operating at close to full capacity, putting increased pressure on the number of beds available. Nhs england says more beds would be freed up if there was greater focus on the link with social care providers. This programme has been debating the state of the nhs in england, which has been described by some as a humanitarian crisis. We need to engage in a big debate about the future financing of the nhs, because as we get older as a population, with more complex needs, and we have more expectations on the nhs, we will have to debate and face up to Big Questions about how we fund it. Lets not go to the nonsense and believe that the nhs could not have extra investment now. It could if this government took a different set of decisions. The Conservative Mp for stafford disagrees and thinks that extra tax should be raised. you look at the amount we spend on health, it is probably about 2 gdp less than in france and germany, and frankly, unless we are prepared, and i heard people behind say they were prepared to do this, and certainly when i talk to my constituents, unless we are prepared to say we will increase the amount we spend, which means higher taxes, im afraid, there isnt anywhere else to go if we are going to have a. Syste m go if we are going to have a. System funded based on need and from a progressive source of income, that is the only way to go. The Government Plans to impose a legal duty on hospitals in england to charge overseas patients up front if they are not eligible for free non urgent care on the nhs. Last week, a report by mps said the system for recovering costs from foreign visitors was chaotic. Nhs improvement, which oversees trusts, said the new approach would save hospitals having to chase money they are owed. Emergency treatment will continue to be provided immediately and invoiced later. Thousands of low income families who were stripped of their tax credits after a mistake by the us out sourcing Firm Concentrix will have their cases reviewed. A committee of mps says that her majestys revenue customs has accepted their recommendations to review up to 23,000 new cases. The company, concentrix, was sacked by Hmrc In September following an investigation by this programme. Mps will have the chance to amend the governments legislation on brexit when it returns to the commons for three more days of debate. A number of pro remain Conservative Mps are understood to be considering voting with labour and the snp to try and give mps more of a say over what happens at the end of the Negotiating Process although Downing Street is understood to be confident the bill will be approved. President trump has stepped up his attacks on the judge who blocked his travel ban on seven muslim majority nations. In a series of tweets, he said the American People should blame the judge if anything happened to threaten National Security and that the courts were making his job very difficult. The white house is expected to pursue its appeal against the ruling later today. Thats a summary of the latest bbc news. Now, john watson has the sport. Good morning. Were going to start with Breaking News from the last hour and the announcement that Alastair Cook has stepped down as england test captain. Cook was appointed nearly five years ago and has led england for a record 59 tests. He helped england To Two Ashes Series wins but leaves in the wake of a 4 0 series defeat to india. The 32 year old has told the ecb he wants to continue as a test player, but leaves england looking for a new test captain with a home series to come against south africa this summer. Ea rs ears very strong mentally, he knows his game, knows what he wants. He is stubborn at times. He has worked feverishly hard on his technique to improve it through the years, and he isa improve it through the years, and he is a fantastic test cricketer, the rock of englands batting for the last decade. There was an argument for cook to continue for another year, to get through this summer, get through the ashes, and then hand over to joe root. That get through the ashes, and then hand over tojoe root. That would get through the ashes, and then hand over to joe root. That would allow joe root to settle in as captain. It seems, after the discussion, that he has had enough. The new England Patriots produced the greatest comeback in super bowl history to beat the Atlanta Falcons 34 28 in overtime. The falcons were in complete control having scored three touchdowns before half time. They were 25 points ahead before the spectacular fight back no team has come form that far behind before. The Patriots Drew Level at 28 all with less than a minute left of regulation time remaining. And then, in overtime, a touchdown from james white completed the comeback to take the title. Quarter back tom brady named the Most Valuable Player for a record fourth time its a fifth title for the patriots. Thats all the sport. Back to you. The nhs was created after the Second World War with the Guiding Principle that it should be free to all and open to anyone at any point in their lives, that is, that it would look after you from cradle to grave. How many of those principles hold true nearly 70 years later . I got pain in the top of my legs, really bad. I had to ring 999. The ambulance came and took me to a e, and they told me i was in labour. Two hours later, i had a baby. I didnt know i was pregnant until i got into the delivery suite, so they were very supportive, helped me with baby clothes, because i had nothing, and just generally felt that home because of their support and how welcoming they were. My name is rachel, i live in london and ive had Mental Health problems for about three years since i had a breakdown in my last year at university. My experiences with nhs services have been really mixed. I have had some that were really helpful, but often, the right services arent there when you need them, so you can end up waiting a really long time, and that can mean things get really bad before you get any help. Im lisa stevenson, and in april2011, my life changed forever, when i was diagnosed Out Of The Blue with multiple myeloma, cancer of the blood plasma. The nhs, for me, is made up because of the incredible people who work within it the doctors, the nurses, the porters, the cleaners. Every interaction i have had has been absolutely amazing. My name isjo horton, and less than a year ago i was involved in an accident in a bus that resulted in me losing my leg, so i am an amputee. Thanks to the nhs, i am here, running my own business again, Teaching Judo in schools. I am a former olympian, and judo has been my life since i was eight years old. The nhs literally pieced me back together, physically, emotionally and mentally to get me back here on this journey. Everyone from the bottom to the top has made this journey possible for me. My name is leslie. My husband died in may 2014 from pancreatic cancer, and throughout that process, we were put through the Palliative Care route and support by the Palliative Care team. We went from him being 0k to suddenly dying overnight. Lots of the care along the way wasnt the way that we wanted it to be. It didnt really meet the kind of person centred agenda that the nhs talk about, people being at the centre of the decision making, so i am keen to share the story that seth and i went through to improve things for others and to create a compassionate legacy in seths name. Labour opened up the nhs to independent, private providers in 2002 in a system where money follows the patient. Ten years ago 2. 8 of the nhs budget was spent on independent providers. Now that figure stands at 7. 6 . Privatisation means opening the door to private providers. Its different to charging for some services which we already do for things like dentists, eye care and so on. But with a finite pot of money, a growing and Ageing Population meaning more pressure on services, is it time to start looking again at Charging Patients for more services . A bbc ipsos mori survey of over 1000 adults in the uk suggests that half of you think that would be unacceptable, but around a third think it would be acceptable. Lets get a snapshot of views in the audience. Put your hands up and keep them up, if you think it would be acceptable to see charges for some services . Im just going to net over here. spent 28 years in the ambulance sector. I would look at charging for people who choose to get drunk. They put a huge strain on services and theyd like bae nde they blight theyd like bae nde they blight the a e. Theyd like bae nde they blight the me. How much would you charge . In the united states, they are locked in a safe place, cared for, and the next day, there is a release fee. Who agrees or disagrees . Whats it called . The drunk recovery service. This is a trojan horse argument. The nhs has been. Tell the gentleman here. argument. The nhs has been. Tell the gentleman here. I will explain to him. They might seem like an easy target, but once you introduce the infrastructure for charging this will gradually be extended to other groups like overweight people, people who smoke, people who injure themselves through skiing, the immigrants are being used to introduce charging. Charging patients is classified as a zombie policy. It refuses to die and what our tory policy. It refuses to die and what ourtory mp policy. It refuses to die and what our tory mp should be telling us they are setting us up for an american style Insurance System either you american style Insurance System eitheryou can, american style Insurance System either you can, there american style Insurance System eitheryou can, there is american style Insurance System either you can, there is two ways to pay charges, you pay out of pocket or take out top up insurance and our politicians are afraid to tell us where theyre taking us. Im going to ask our Conservative Mp ina im going to ask our Conservative Mp in a second. I want you to argue the case for what you have talked about with this gentleman here. Whats your name and what do you do . Im dr bob gill and your name and what do you do . Im dr bob gillandl your name and what do you do . Im dr bob gill and i am a gp and im producing a documentary to explain this scam thats taking place. think it is demoralising for Ambulance Staff having to deal with drunk people on friday and saturday night. You ask about the morale of the nhs, they are having to deal with people because there is no disincentive for them to go out and get drunk . Is that something we want to put up with . I take your point about it being a trojan horse potentially, but thats a specific insta nce potentially, but thats a specific instance where it causes misery for nhs and money. I am not advocating that people get drunk and waste peoples time. Has anyone here had an ambulance called after having one too many or two too many or three too many or two too many or three too many . What thz is a spurious argument. We are having demonising of certain patients and this will be extended and were falling into a trap. My name is jess and i am an a e doctor. I stand on the frontline, im the person who gets assaulted and gets sexually assaulted and gets sexually assaulted in a e by drunk people. I was a medical student, you have seen us on tv, we go out and get drunk all the time, i us on tv, we go out and get drunk allthe time, i have never ended up in a e. None of us have ever ended up in a e. None of us have ever ended up in a e and ive never left my friends behind on the side of the road drunk which people do now. We should be charging them. It costs huge sums of money. It is £300 every time we spend las to go and pick somebody up off the side of the road and then the money you get charged, just talking into a e is £100 to register you, it is a waste of money and it is ridiculous. Can i ask you the nature of the assaults upon you . I have been punched in the face and held up against the wall, i have had nurses who are awesome dragging people off me. I had someone grab me by the breast in the waiting room and thats going to court and thats because i work on the frontline in a e and all of those people were drunk, none of them were mentally unwell, but all of those people were drunk and not in control of them sefrs, that doesnt make their behaviour acceptable in anyway. You would charge £400 . In cardiff they have a drunk time. The las who are highly trained professionals say, you are a drunk person. Go and lie on that bed and a matron will kick you out in two hours when you wa ke kick you out in two hours when you wake up and feel sorry for yourself. Wake up and feel sorry for yourself. Threequarters of people support the idea of Charging Visitors from outside the uk for health visitors. Who agrees with that . My name is joanne smith. Im a medical secretary in the hospital for 23 yea rs. Secretary in the hospital for 23 years. I have also been a patient over the last two years through breast cancer, chemo, radiotherapy, and two operations as well as supporting my dad with lung cancer and asa supporting my dad with lung cancer and as a family, the money that we have had out of the nhs and my brother broke his kneecap as well, we we re brother broke his kneecap as well, we were all in hospital at the same time at one point. All going to theatre. Me and me dad were on the cancer ward having chemo together. The money as a family that we have had out of the nhs, i would not like to know, but my dad is 70. He run his own company. He has worked every single day since he left school. The same with me and the same with my brother. And we owe our lives to the hospital. I work as a medical secretary. I give Above And Beyond. And you support this move thats been brought in . beyond. And you support this move thats been brought in . I support. A legal duty on staff to charge . thats been brought in . I support. A legal duty on staff to charge . I do, yes because. Who disagrees with that . Where is amber. Im oliver. To be honest i disagree that people who come to this country should have to pay to receive care if they fall ill. While theyre here theyre contributing to the economy, you know, theyre spending money, investing in the country, you never know when youre going to become ill. 50 i know when youre going to become ill. So i think, know when youre going to become ill. 50 i think, id know when youre going to become ill. So i think, id like to know when youre going to become ill. 50 i think, id like to think ifi ill. 50 i think, id like to think if i was in ill. 50 i think, id like to think ifiwas ina ill. 50 i think, id like to think if i was in a foreign country id receive. If i was in a foreign country id receive. What if i was in a foreign country id receive. What do we mean by non urgent care . Receive. What do we mean by Nonurgent Care . Nobody in government is proposing that if you come over from another country and you have to be picked up by an ambulance and taken to a e that you will be charged. This policy that developed today, we need it get more details, refers to routine and non urgent care. There is a bit of a grey area around that, but it is being interpreted if you go for an appointment which in a hospital, an Outpatient Appointment leading to some form of routine surgery, that would be something where theyd check your id and see if you are entitled to free nhs care. I dont think anybody wants to stop emergencies being treated whichever country you km from. But you get a bill afterwards under these plans. Jeremy lefroy might have more details. There was a plan to extend it so that if you went into a e and needed to stay a few nights and needed to stay a few nights and needed surgery as a result of that, would you have to pay for that, but jeremy hunt announced that was put on hold for now. Todays policy is all about dealing with the routine and non urgent care and whether hospitals are being effective at charging. You think thats a good idea. You disagree. You should only be able to get access to it if you put money into the system. My stepson came from america, he was charged £50 at a e when he hurt his arm. We didnt mind paying for it. Hes not paying into the system. You could afford it though . There are other things, you dont need to go to doctorfor other things, you dont need to go to doctor for everything. Sometimes the pharmacy can cover lots of things, you know, ithink the pharmacy can cover lots of things, you know, i think sometimes charging them might make them think twice do i really need to go . Urgency i understand. Lets ask the next question. Four in ten in england would support increasing income tax to fund the nhs. And more than half in the uk would support increasing National Insurance to fund the nhs. Stick your hand up if you agree with that and havent yet spoken. Hi, good morning. Good morning. Whats your names . James welling. I hopefully can speak for a lot of folks here. If we can get guarantees from the government that it would be ring fenced and it would be spent on extra staff, extra services, and not put into another department for helping with future wars, whatever else, if it is ring fenced i think people will be willing to pay extra. So would you, a penny on income tax . Yes. Five pence . But, but we need to know where it is going. Yes, ok. Thank you. Hi. Agree ordisagree . Thank you. Hi. Agree or disagree . Im mike foster and hi. Agree or disagree . Im Mike Fosterand im hi. Agree or disagree . Im mike foster and im from huddersfield. This is the wrong question again. Unfortunately we have the money in the nhs system. The government has a lot of money, the minister or the mp needs to answer the question thats been put to him, £22 billion more is going to be cut from the Nhs Budget By2020 going to be cut from the nhs budget by 2020 by this government. That money should be refunded. We have a £3 billion deficit and someone has talked about a pfi debt. We need to cancel all the pfi debts and then the nhs will be awash with money instead of us having to pay more. 0k. Hello. Do you agree or disagree, madam in terms of increasing income tax or National Insurance . madam in terms of increasing income tax or National Insurance . I agree with increasing income tax, but not National Insurance. Weve paid National Insurance. Weve paid National Insurance, the older people have throughout our worker years and we shouldnt have to do that again. Let me say, im chairman of the Lewisham Pensioners Forum and we we re Lewisham Pensioners Forum and we were instrumental in campaigning to save the nhs as well as to save lewisham hospital. I just save the nhs as well as to save lewisham hospital. Ijust had to get that one in. Well, you did it and you did it very well and we barely noticed i want to comment on what the gp said. We need more gps. We need more doctors. We need more funding. I mean, especially in my case, talking for older people, we shouldnt have to go and queue for half an hour or shouldnt have to go and queue for halfan houroran shouldnt have to go and queue for half an hour or an hour to get to see a gp. We would like consistency, stability, we dont want to be changing doctors every time we go to the surgery. We would like to see the surgery. We would like to see the same gp to get accustomed, to build confidence, feel comfortable with that gp rather than seeing different people every time that we go to the hospital. 0k. Do you agree or disagree in terms of putting up income tax, if it was ring fenced . Terms of putting up income tax, if it was ringfenced . Yes, agree with that as well. You would do it . You would vet for a party that had that in its manifesto at next general election . Yes and ill tell you why. I have been in an nhs patient for 39 yea rs. I have been in an nhs patient for 39 years. Im celebrating 21 years as a transplant patient. Applause thank you. The reason that i agree is because i owe my life to the nhs. I will owe my life to the Nhs For The Rest Of My Life to the Nhs For The Rest Of My Life to the Nhs For The Rest Of My Life and i will need another transplant one day. This wont last forever, i realise that. If you have ever been ill and ever known a Family Member thats been ill in my opinion, you will change your view on whether you think that it should be increased in income tax or anything else. In my view, the, you have to look at where the money is going. There is no good in pumping the money into the nhs if were going to be overcharged with managers getting six figure salaries, even the quality xharks, six figure salaries, theyre not dharg jobs correctly. We need to have people doing theirjobs correctly. Im lesley channon. I guess i really lf the nhs. It has helped me love the nhs. It has helped me. I had really severe postnatal depression andi really severe postnatal depression and i agree with raising taxes for everyone. Ive experienced the healthcare everyone. Ive experienced the healthca re system everyone. Ive experienced the Healthcare System in america where i had to pay 300 a month just to be insured. I had a Spinal Cord Injury and it ended up costing my insurance company, i was in hot a week, 150,000, i was in rehab for nine months, i didnt know if i was going to be able to have children. If i hadnt had insurance, i would have been responsible for that debt and George W Bush wrote into legislation that people cannot file bankruptcy on medical bills so people are losing their homes when they get sick. So i think as a society, this precious nhs that we have, we shouldnt be blaming one person because they get cancer or one person because they need a transplant. As a society we have agreed with this nhs to share the cost equally. 0k, thank you. Applause good morning. Im a gp from hackney. Ijustjust wa nt to im a gp from hackney. Ijustjust want to talk about charging and about where the money goes and it was interesting you quoted that figure of private involvement in the nhs. Thats a massive under estimate. The nhs spends millions and millions and millions of pounds every year on consultant managements, high fees for general managers within the nhs and also there is a lot of back Office Functions such as the csus, theyre kind of people that run the, i dont know, back Office Functions behind a lot of, theyre being amalgamated so there is more costs all the time and there is more costs all the time and the governments very sponse to chronic funding in the nhs is to say we need a complete upheaval called the sustainability and transformation programmes. The nhs is going to be divided up into 44 areas, my area has spent £7 million just on the reorganisation and nothing has happened yet it is not even a 1259try body. And these reorganisations are going to to lead to a disguise for cuts. The aim of this is to cut funding, close a es, close others is, not ill hospitals that are needed. Lets bring injeremy hospitals that are needed. Lets bring in jeremy lefroy, hospitals that are needed. Lets bring injeremy lefroy, the Conservative Mp. Speaking as a constituency mp, but it is your government, your party in government. Some people think the government. Some people think the government is on a secret part to eventually privatise the nhs, and this programme of Efficiency Savings, cuts, whatever term you wa nt to savings, cuts, whatever term you want to use, is a way of breaking the system so that when they reach the system so that when they reach the day when they go, were going to privatise everton, people will go, thank god for that because it is such a mess at the moment. Privatise everything. Is there any truth in that . Know is the answer. No is the answer. Absolutely not, and if there was, i wouldnt be a Conservative Mp, simple as that. The gentle man also spoke about the £22 billion. Where that figure has come from is that before the last election, the nhs produced its own plan saying we need an additional £30 billion in real terms over the coming five years, and the nhs itself, simon stephens, said, we will find Efficiency Savings of £22 billion, but we need an additional £8 billion in real terms to meet this target. That is where the figure comes from. It is not about cutting money, it is about additional money, but the increased pressures the nhs is facing meant that those savings had to be found. Personally, i think that the 2020 plan was ambitious. If i can just finished, we need to get into our heads that this £22 billion is not money that has some come as somehow come out of the nhs. Bee it is. I think hugh can explain that. It is. Where does the money come from . The government says it will chip in £8 billion, so the government has pledged more money, but the debate is over how you get to £30 billion. Does it need more government money does it need the nhs using the £22 billion more efficiently to close that gap . That is partly what the sustainability of Transformation Plan is about. Just pa rt of Transformation Plan is about. Just part of this is about treating more people in their local community rather than being people in their local community ratherthan being in people in their local community rather than being in hospital. Is there a better use of the money . That is the logic, but there is scepticism about whether anything like £22 billion can be found. Jeromy is absolutely right. If the conservatives privatise the nhs, they will be voted out of office. Jeromy is saying, as a Conservative Mp, if they privatise the nhs, i wont continue. Do you believe this Conservative Mp when he says that . No. I disagree with what you are saying, victoria. Use the leg mac you asked if they were privately trying to you asked if they we re trying to you asked if they were secretly trying to privatise, but it is not even secret any more. I work at the royal london, a major trauma centre, and we cannot cope with elective work any more because they have closed down a es. Who would vote for a party that would promise to privatise the nhs . They wont explicitly, but they will if they show the nhs is a service in failure. Then the whitewater privatisation comes in and says, actually, we have an alternative, then they will vote for it. We need to look at money is going. How many mps and consultants have links to the Conservative Party . The Care Quality Commission is made up of people with links. They are the wrong people. Youve got to look at where money is being lost. This is money being siphoned off. John as hford, money being siphoned off. John ashford, do you think there is a plan from the conservatives to slowly privatise the nhs . To be fair tojohn, he slowly privatise the nhs . To be fair to john, he is slowly privatise the nhs . To be fair tojohn, he is not a typical tory. We should not gang up on him. The health and social care rack which the conservatives brought in has put rocket boosters under the exercise. In durham, there is a private firm stepping in when gps have made a referral. The private firm checks whether the gp was correct or not to make that referral. It is absolutely disgraceful, isnt it . On the point about stps, there was an eloquent explanation on the economics of it, but the row letty is that across the country we will see beds cut, a e departments close. Maternity units will be closed, hospitals will be close. That is what this £22 billion is about huge cuts to local services. I want to ask the panel, what would you charge for, if anything . I represent doctors in the bma. I think this is completely the wrong question. Just answer the question and then say why you think it is wrong. I agree that charging is an unhealthy distraction. The amount of money we could reclaim is so small as to make a major distraction, because the people who would pay other people who are really struggling at the moment. Those who are unemployed and fully resourced through social care would not pay anything anyway. Those who are vulnerable, elderly, they would not pay. It is the people working and contributing via tax. People say to me, of these two drugs, which is most urgent . They cant afford prescription fee. Adding fees beyond that will make the sick even more set. Sick. That will make the sick even more set. Sick. Children have no voice andi set. Sick. Children have no voice and i speak for them. Set. Sick. Children have no voice and i speakfor them. This is a huge distraction. There is money in the system. Lets take the internal market, abolished in scotland and wales. It would free up around £5 billion per year. What about the external market . The Department Of Health was my own figures, £6. 6 billion going into profit making companies. Add that up and youve already got about £12 billion a year that could be getting into the nhs. Talking about charging for services, which is less than 0. 5 of the nhs budget, is a huge distraction. It is not a question we should be addressing. Right, we are going to have more stories. I want to hear from this lady. Good morning. My name is sylvia parks. I worshipped the nhs up until the 8th Of October 20 15. Before that, two of october 20 15. Before that, two of my daughters had twins and they we re of my daughters had twins and they were in the special care unit and the nurses were fabulous. On the 8th of october, my daughter, 26 years old, went into hospital to have her baby, and she died during childbirth. They wanted us to switch the machine off on the same day that my daughter died. The baby survived, she is 16 months. She has a great three brain injury and she is blind. Ijust want three brain injury and she is blind. I just want to three brain injury and she is blind. Ijust want to say three brain injury and she is blind. I just want to say that we three brain injury and she is blind. Ijust want to say that we didnt anticipate that happening. She walked into hospital. She went on the 7th Of October and was sent home. We were told that ever the leg mac if everyone came in when they were one centimetre dilator, they were one centimetre dilator, the hospital would be full. She had a problem that was seen on three scans and not acted upon because they were not sure what it was. That cost her her life. I would like to say, how many lives are going to go like my daughters before something is done about the nhs . We paid dearly, and we are still paying dearly, and we are still paying dearly, still having Problems Accessing Services for my granddaughter, of whom we have legal custody now. We were told the other day that they have to be careful how they spend public funds. The baby doesnt sleep at night. She sustained brain injury and doesnt sleep as a result. I am about to give up work. I am working my notice to take care of my granddaughter. Who is going to help us . Wow. We are so sorry, so sorry. I know this lady would like to talk to. Firstly, my sincere condolences. I know the pain of loss. I speak and write on perinatal Mental Health. I have done that for the last 12 years. I was very ill 20 years ago and could have been one of those very sad cases of a new mothers body found on a railway line. I survived, a new mothers body found on a railway line. Isurvived, thanks a new mothers body found on a railway line. I survived, thanks to the nhs and everyone who supports me. Now i speak on behalf of other ladies and families who had been left without a mother or father because of poor Mental Health care around childbirth. I spoke to midwives last week on a training day, and one lady said there are two midwives coping for 27 people at any one time. People. Midwives do an incredible job, one time. People. Midwives do an incrediblejob, i think one time. People. Midwives do an incredible job, i think they really do, and yet they are pressured. Our society is based on new lives. Mothers and fathers need supporting, andi mothers and fathers need supporting, and i think as a society we have forgotten and i think as a society we have fo rg otte n to and i think as a society we have forgotten to nurture our families. We are not remembering how precious new life is, especially when we have treatment of a loved one at the same time asjoy, we have to put more into perinatal head mental Health Services. Into perinatal mental Health Services. I am a big fan of the nhs. I had a stroke two years ago andl the nhs. I had a stroke two years ago and i can honestly say the support i got from the nhs was superb. In my recent role as a volunteer, i speak to a lot of stroke survivors, and a lot of them say they have not had that same experience, particularly when they are discharged from hospital. When we did a survey, 48 of stroke survivors felt alone and totally unconsidered after being discharged. It isa unconsidered after being discharged. It is a postcode lottery. Some areas are really good, other areas, you get nothing. There are 1. 2 million stroke survivors out there, and for so many of those, they end up with permanent, life changing differences. They need support, whether it be mental, physical, speech. A lot of the clinical commissioning groups, when they start looking at funding, they take away some of that funding. The stroke association, whom i help with, they go out and help support those survivors. That funding is slowly being ta ken those survivors. That funding is slowly being taken away, so they cant do that for that cancel any more. Thank you. Hello. My name is chris. Three years ago i was diagnosed with depression and anxiety, and the nhs couldnt do anything for me. I had to spend £4000 of my own money. If i had not, i dont know if i would be here today. The concept of charging is already happening. I paid a lot of money. 6000 people are killing themselves every year. We have got to start taking Mental Health more seriously and commit and spend the money we say we are going to come because were not doing it. For the last 15 minutes or so of the programme, we are going to talk about Government Plans for a seven day nhs. Should you be able to book an appointment at the gp surgery in the evening or at weekends . Should routine operations ta ke weekends . Should routine operations take place outside office hourss look at this. One of the governments most ambitious plans is to make the nhs in england a seven day service by 2020. It was a key pledge of former Prime Minister david cameron. With a future conservative government, we would have a truly seven day nhs. Now its been taken on by theresa may. The government envisages people having access to local gps seven days a week. It recently announced that gp surgeries that fail to open at evenings and on weekends could lose their funding. Patients, the government say, should also receive the same level of urgent and Emergency Care in hospitals in england at weekends as they do mondays to fridays. Chanting save our nhs, save our nhs this was at the centre of the Junior Doctors contract dispute last year. Junior doctors already work on weekends, and in fact represent the bulk of medical professionals on shift. Tweets targ1eted at Health Secretary last year using the hashtag im in work, jeremy were keen to prove this point. But while Emergency Care is available at weekends, Staffing Levels are much lower. Health secretaryjeremy hunt has caused controversy by suggesting a lack of staff was behind the higher weekend death rate. He said 6000 deaths a year were caused by a lack of a proper seven day service, citing an unpublished paper at the time. But e mails show one of its authors was unhappy with how the study was being used. Some experts believe other factors must be considered when analysing the higher death rate, such as how patients admitted at weekends tend to be sicker than those admitted during the week, and that theres no evidence to suggest extra staff would prevent so called excess deaths. Staffing concerns, however, havent been limited to england. The Public Services ombudsman in wales called for a systematic review of out of hours Hospital Care last year. While scotlands first minister Nicola Sturgeon announced in 2016 that minimum Staffing Levels in scotlands nhs will be enshrined in law. In may 2016 it was announced a deal had been struck with the government overJunior Doctors new contracts. But whether this will lead to a truly seven day nhs is unclear. Leaked department of Health Documents released in august last year worried that a lack of available gps, hospital consultants and other Health Professionals would mean the full vision would not be realised. Government sources said this was a normal risk assessment. Hugh pym our Health Editor is here. What does seven day a week mean in practical terms. People say we already have a seven day a week nhs . It has become a massively contentious issue. It was at the centre of the Junior Doctors dispute. Junior doctors were angry to be told there were changes in the contract, they were already working several weekends, well one in two, one in three or whatever. There was theissue one in three or whatever. There was the issue of getting more consul tonights. Consultants. There are talks on going with the bma about that. There is gps, thats proved controversial as well. Attempts to get more gp access after office hours during the week and at weekends when gps are saying well, were already doing that and we sometimes open at a weekend and offer appointments and nobody wants them. It is highly controversial, but there is a lot of different aspects to it. Hi. My name is dave. Im a staff nurse in a e. I think the government deliberately deflects from what the issue is. This issue ofa from what the issue is. This issue of a seven day nhs, i dont think the public really want an elective seven day nhs, what they want is a fully funded seven day emergency ca re fully funded seven day Emergency Care and five day lekive care. Elective care. Applause . The problem is we have been under funded for the last six years as one of our contributors said earlier, it used to be 4 to 4 added on every year to account for things like increase pharmacology costs, technology improving, and people getting older. And that was stopped in 2010. So we have been defunded for the last six years. What is going to come up is what has been said about this cliff edge of the stps, the 44 areas that, were not going to have an nhs in two or three years because what is happening were being divided up into 44 steps, mine is oxfordshire, we st into 44 steps, mine is oxfordshire, West Berkshire and buckinghamshire, where i am, theyre looking at cutting mental Health Services by £4 million. They are talking about cutting staffing which is most staff are nurses, so the majority of these cuts will come to nursing. £34 million in cuts. And thats going to significantly affect the number of beds we have. Social care, it is going to affect everything and were going to affect everything and were going to affect everything and were going to fall over. Are you a final Year Medical Student . going to fall over. Are you a final Year Medical Student . I am a final Year Medical Student . I am a final Year Medical Student . I am a final Year Medical Student. There is a couple of points. Firstly, in relation to that, the seven day nhs, what we need is more Health Professionals, radio ographers and pharmacist to have a fully staffed emergency cover seven day as week. What we dont need is people to have elective operations on a sunday. Give our audience an example of an elective operation . Carpel tunnel decompression. What . I a decompression. What . Ia hip decompression. What . I a hip replacement. This is kind of circular, we are saying there arent enough doctors, the morale is so low, you said two years ago you had a stroke and the care was excellent and people arent having that same level of care. When i started at medical school six years ago, the morale, the way it felt to be in the nhs was different and actually the first thing that goes is teaching because thats not urgent. So, were not getting, you see and Junior Doctors arent getting the same level of teaching which will have an impact for a long time. People are talking about leaving and many Junior Doctors time. People are talking about leaving and manyJunior Doctors and consultants say to us, get out. Get out. They say it to us every single day. What are you going to do . Im not sure if im going to leave the country and still be a doctor. Maybe management, maybe, you know, ive got friends who have taken years out to work in pharmaceutical companies. My friends who are Junior Doctors, they are working one in two weekends of the there is a seven day a week nhs and its exhausting. Whats your name again . Tall, a. Are you not bothered about a hip op at the weekend, you want the Emergency Care over the weekend . Decent Emergency Care, is that what. Yes. Hello. I used to work for the nhs, but u nfortu nately, used to work for the nhs, but unfortunately, i cant continue working for the nhs through the operation i had. I had an operation in 2004, after that, i am still having problems of locals yum, magnesium, potassium. Im in and out of hospital. I go to my gp today, my gp says i go to hospital to get the infusion. I go to the hospital and they say go to the infusion. I go to they say go to the infusion. I go to the gp, they say go to the hospital. I dont know what to do. My gp phoned me last week and said, can you go to hospital . I cant because im tired. Every week im in and out of hospital. My hands are hurting because of needles. It is now ten yea rs i have because of needles. It is now ten years i have been going through this. Really . Yes. This is my life. They say this is your life. I said can you arrange something, i dont mind having the infusion in my house, there is nothing new, i have got the drugs, they are giving me, i have got the injections and morphine, i have got it in my house, i wont kill myself, i wont do any harm to my children, why dont you send a nurse once a weekjust to do the infusion. I dont mind. Im going to a e and every time i go, i have tojoin the going to a e and every time i go, i have to join the queue in a e. Sometimes you spend two nights in a e on a trolley and the next day go home. Go home again. Go back to the hospital. Im like, why . Iwant home. Go home again. Go back to the hospital. Im like, why . I want to know, i mean, if they can do something to keep my like in one place. Whatever is happening . Last year they called me on 20th october saying when you were in hospital we did an mri scan and we found youve got a big lump, did an mri scan and we found youve gota big lump, your did an mri scan and we found youve got a big lump, your liver has got all this. Im 0k, fine. Go and see yourgp. All this. Im 0k, fine. Go and see your gp. This is a phone call. I went to my gp and i said this is the message i got from the hospital. My gp was like, i dont have any report. So it was like im going back and forth. When i was in my gps, one of the nurse called from my hospital. I talked to him, i dont know anything. Im appearing stupid in front of her because what youre saying is different. This case is really, really sad, unbelievably frustrating for this lady. Is that the kind of thing, that tooing and froing that youre seeing and do you have demand from your patients to see them on saturday and sunday . There are so many things in this case. First of all, the joined up working is something that we can all do better, but we need a better it infrastructure, there is no way we should be waiting for phone calls and faxes when we are trying to convey information in an efficient way. Thats a no brainer. It could be better with resources of the seven day argument is so powerful. Of course, in an ideal world we would love to have our Blood Pressure checked on a monday afternoon if we could. Im not sure im bothered about that . A lot of money has been put into opening gps surgeries on a sunday afternoon and people dont turn upment people want a livment there are some people who are working hard in the week who would like more routine access at the week, but if we cannot provide a safe, comprehensive in hour service, plus a comprehensive safe Emergency Service four our patients in the community and in hospitals, then the seven day argument for rue toon care is spurious and its a distraction. Routine care is spurious and its a distraction. You work for pulse magazine. What is the evidence . The evidence does show that it reduces peoples tendency to go to a e, but it doesnt reduce the more serious patients, the more serious patients will still end up in a e and if you look at the attendances on a sunday afternoon, lets be honest patients have Something Better to do than turn up at their gp surgery. And it costs twice as much than routine gp ca re costs twice as much than routine gp care and. What at the weekend . Yes, for the weekend care. So if you think about, weve looked at the numbers, it will cost £1. 5 billion for this policy by 2020. Think about, how that money could have been used during the five days during the week to reduce the waiting times for a routine gp appointment. There is a fallacy, the government says you will see your gp seven days a week, it is not your gp, it is a hub, often quite a distance away and that lady there that was talking about, she wants to see hergp, she that was talking about, she wants to see her gp, she wants to get the ca re see her gp, she wants to get the care from someone she knows, that, if we are talking about cost versus value it is better to see your gp, in the long run, you get better care and it will be cheaper in the long run. You have got 30 seconds because were coming to the end of the programme. Well, i have a longterm condition and i have been treated over the years by the nhs at christmas and at new year and we not only have a seven day nhs, we have a 365 day nhs, they will treat you all times of the year and the one last thing i wanted to say is that the charity that works on be of half of my condition, theyre really pushing for more specialist nurses for long term conditions which would help a lot of other people as well. Thank you very much. Thank you. At 12. 30 today, we will be taking your questions on so called Health Tourism and how we should handle pressures in the nhs. Do get in touch. Thank you very much all of you. Thank you. You have been magnificent. Plenty more on the state of the nhs across the day on bbc news. You can give yourself another round of applause actually. Good morning. The week has got off toa good morning. The week has got off to a chilly start. We had a widespread frost this morning. By the end of the week, it will feel cold again for all of us, but before we get there, we have a wet and windy interlude to get through and thats heading our way as we go on through today. Holding on to dry weather across central and eastern areas. Still the odd stubborn fog patch, but out west, things are changing. Increasingly strong winds as well. It could turn gusty for a time across Northern Ireland, the Western Isles of scotland. So a tricky rush hour this belfast. Through this evening and tonight the wet and windy weather sweeps eastwards and for the hills of Northern England and scotland, there could be significant snow and that could cause some travel problems and ice as well tuckly across scotland into tomorrow morning. Tomorrow, eastern most areas are likely to stay cloudy with patchy rain at times. Further west, brightness and sunshine. Hefty showers particularly in the south west. Six to ten celsius, for the end of the week it turns colder with a lot of cloud and some of us will see some snow flurries. This is bbc news, and these are the top stories developing at eleven the number of patients on Hospital Wards in england has been at unsafe levels at nine out of ten nhs trusts this winter, bbc analysis shows. Hospitals in england are told they will have a legal duty to ask overseas patients to pay for their nhs care upfront. The number of unexpected deaths among Mental Health patients in england rises by almost 50 in three years. Also this hour another twitter tirade President Trump uses social media to ramp up criticism of thejudge who set aside his travel ban on seven muslim majority countries. The queen breaks another royal record to become the first british monarch to have reigned for 65 years. And the england cricket captain, Alastair Cook, announces that hes stepping down after a record 59 tests in charge