it's influence in the asia pacific region on television and online the stream continues to tap into the extraordinary potential of social media to disseminate news the presidents of russia turkey and iran will meet in teheran for another summit seeking an end to the war in syria we'll have extensive coverage people in power continues to examine the use and abuse of power around the world the united nations general assembly holds a seventy third session what action will it take on atrocities in me and maher and yemen we'll bring you all the news it's september on al-jazeera. primary health care is the cornerstone of the u.k.'s national health service funded by the taxpayer it's a model for countries wanting more accessible and affordable health systems and it all hinges on a network of local doctors i really find it interesting meeting people you get to

me always interesting people and you get to ask them personal questions about their lives and find out whether there will be a better job and you want to help and sometimes you can't the general practices have always been small independent businesses contracted and paid for by the government is a complex business. there are about ten different ways to get paid some of it's to do with number of patients we have some quality some students report writing some bits through the education on the student politics some bits to do with training so it's crazy complicated which is exactly why we need a practice manager and an accountant to look after those side of things but ultimately the responsibility for success and failure is down to us so so that. it's the annual financial meeting and the doctors are hoping for a clean bill of health. if you go. because it is optional if you will. this impact that it will.

each practice gets paid one hundred seventeen dollars pair patient pair year from the government. with additional funding streams like those for meeting health targets killick street gets an annual income of two point eight million dollars. to . improve the bill. is needed isn't growth it's about on the. top of the prophecy of the fall because at last it was significantly down only before but now we're back where we were all. i said that we were this year. we go out so we've only gone up you're not actually a tiny bit so this this look of being great is not great it's just like it like it yes we've recovered from about. recent changes to government funding mean that inner city practices with a number of relatively senior g.p.'s like killick street are set to lose money.

if we lose they. say oh you're. not open to lean towards those duties. because you're spending on primary care as a proportion of the health budget declined from eleven percent in two thousand and five to eight point five percent in two thousand and fourteen now it's less for doing more. of a total annual budget of one hundred fifty one billion dollars only thirteen billion dollars is spent on primary care. in this changes the bureaucracy every sorry ten round their change something that changed the point so they've changed the system when asked to stop treating the n.h.s. like a political football and changing the rules a good over time the government changes all wore off.

in the u.k. general practice doctors train for ten years almost as long as hospital consultants and can be paid an equivalent salary of around one hundred forty thousand dollars a year yet they are on the frontline of identifying dangerous symptoms from harmless ones who have to be only and missing cancers are another thing we always worry about risk some some can't has it obvious when they're present but many times the first symptoms are quite mild. fashion journalist pepe has been a patient of killick st health center ever since is. dr field to send him for clinical tests. i mean you don't want to work for the side in my disease pulitzer or giving you my phone which is wrong. two thousand and seven i not feeling well and i had constant headache schools in iraq they went to my g.p.

just dismissed markets and told me you have a headache you have to take a kilo it's not comes out. and she would not refer me to a specialist the uki lags behind the rest of europe and cancer survival rates which some have picked and the fact that people can't go directly to a hospital specialist their general practitioners must affair them first i decided to go to a new health care is killing st i was able to go to the nose and throat specialist where i was told that i had cancer. dr trevor yellen has had to support pay pay through three bites of cancer. very hard i'm ok with the a.n.c. so where are you in the process of treatment of fish. first of all and. nine zero zero zero. tell me

all it's well different it's a big worry for him comes from a is that he will get a recurrence of cancer as you already have three that's more than enough for any person in their lifetime probably maginot stressful is for him to be thinking about that. since the birth of the n.h.s. the work of the g.p. has changed and increased they are never of aging more key here that used to be given in hospitals we do our own investigations blood tests x. rays scans we have people in this building who can look after your feet. pregnant see your psychological how yeah if you've got alcohol problems that you got drug problems we've got workers who will help you with that. apple isn't is a big problem in the u.k. and in this lenten i've got a handful of patients who are. unaware have alcohol problems and

drink too much alcohol or alcohol this is something they used to cope with a difficult situation right come have a state reason have an alcohol counselor is because there's good evidence that some of that can help intervene with patients like michael ok so we haven't met before not a selector saratoga one of the nurses here and one of your doctors who asked you to come and see me just to talk about your article or used to how much would you say you're drinking at the moment mark but just a lot of family just a lot. yesterday for instance yesterday i checked and ok so averages about six counts a day. well definitely i'd like for you actually be honest all right so what's an average day which is a false report. ok. and how long has it been like that for which you say. back now for about. six months what would you like to do right deal is what we need

to work out i just want to get help to get out of the health of so what do you think is a realistic level of what would you like to get back to zero two or three drinks. even though now not in the bottom drinking. drinking in each culture in a day basically so you what we say physically dependent really you know and it's quite dangerous for me to tell you to stop drinking immediately today may be the wrong advice there are things you crash ok if you want to stop drinking altogether we can do it we're required detox the other is what we call a community detox you agree there are a breathalyzer in the morning to make sure you're a safe level and then give you a tablet to stop the shakes and that sort of thing or we can just try cutting down bit by bit. that for me thanks for coming you often find yourself going to see you next week. cotton down stopping golf and quite

difficult because of. that has become part of me down drinking quiet. i've always done have always done well in my short of but sometimes that's my only companion. my partner passed right. five years ago to start realizing. how long i were. on. the start. in a polygon. book i know it's someone that needs really addressing very seriously and trying to do that. often of god good man and john to help me along with. i like being busy. not so all i can open thinking i need to count to be.

an increasing aging population is adding to the workload of primary care. by twenty fifty one in four people in england will be over the age of sixty five but you know the same newspaper. to a poll of the best. so that's how we got to the trouble illness doesn't just have physical consequences it affects all aspects of a person's life i was walking from one thing. and i can now fast and i sometimes slipped on a weekly if. i hadn't it was about a severe stroke. that changed our life. when i'm having drinking again on smoking which is what if you always think of not only stress it was just there if

you or. i carried on working while talking to the time that she was a stroke of a fault or a stroke sufferers. recently william was admitted to hospital because of a nasty chest infection and has just returned to dr ben smith care. william was very sprightly for his age physically he was able to push his wife up and down hills and get her in out of the car and i you know for his age he was pretty good and he's gone relatively quickly to being worse than average i think for his age in terms of his breathing and what he can do physically he certainly someone's on my radar the moment because he's got a cute things going on that side if you are fully on top of a lot of that is about getting him to as good a state as possible so he can look after his wife which is so important for both of

them and one that morning how are you. now things going. i was coming here to oscar. we were going to things. as you. haven't just been in hospital and now. believed. go through. i would be back. to be able to look after him. she's. been stove. on and the time short breath i want to watch. for him to move on. and i just think you're reading they see what sounds like older patients like william visit their general practitioners twice as often as the rest of the population. i mean i don't think i can form

a miracle right now unfortunately. the lots of things going on here if this is all truth or infection we infection the treatable so if we can get rid of the infection then your body will take a few weeks to recover and as a reason you can't get back to how you were. if there's a progression of the underlying project to say this or the longest collapsed a bit more or whatever the scam will show is that it's less easy belt to be to try to predict what's going on so i wouldn't want to give you an hour to read the words that i want to mislead you will give you false hope but incredible would have no hope because we know that you know a lot of the infection all right but what about where most of. the older pairs and gets the more likely they are to develop more than one condition. increasingly managing these complex co-morbidities or in the hands of the doctors and nurses in primary care. their job is to ensure patients stay out of hospital. what we're

checking is the thickness of the blood gentleman's taken tap a cold war for a much deliberately things very differently because it can be affected by things in your diet we have to make sure that the blood stays within a therapeutic range from one point four delegates down again. so let's see if we can find some sort trend what's going on has there been a time when because of eyes even away or not that you're eating has changed other you've been eating more that oppose or less vegetables or drinking more or drinking less i entirely run the clinic on my own i have complete control of what happens to the patients and keeping them within range the thing about the wolfen is it's about making the blood thinner but if it gets too thin the patients have a whisk of having major plates which could be life threatening and if it's not finished off then but to think you are at risk from both this. saw so heart attacks

mists of taka and just trying to find a way that we can or i did or not but an underlying reason why it's swinging around so much when you get down to the taliban we can't retrieve it exactly the same age here and you have what we call similar type of vegetables every day of your life not every garden moment shared more one more fight with mashed potatoes and i'm not looking to start she said some looking at actual green vegetables but really very bad poll says or of more have been one week. on their run of being. on their. order or brought in but not every day. because if you have dish every dish i recorded will have regarded a bit boring i wonder what brought them your risk of clotting so we've got to increase your medication getting patients to take responsibility for their own

health is the new challenge facing health professionals in the u.k. it's the patient's responsibility to give us information before gauge things down but you do have a responsibility for making sure that my practice is the safest possible otherwise we can be held liable in a court of law after change medications to see within a week so if you want to show you. for the watchtower now i need to see in a week's time i'm on up to that. or should be but of course. if you want to show me show you monday then on the thing would call me back or sunday show we won't be going away that monday.