the covid backlog. nearly five million people are now waiting for hospital treatment in england. waiting lists have reached a record high, after routine work was put on hold because of the pandemic. what they did say is you would normally be on a table in the next few weeks but we haven't got one, we haven't got a surgeon, we haven't got a table. we are live at st thomas' hospital in london to find out exactly how they are catching up on their waiting list backlog. we'll hear more about patients who've been affected and how the nhs can tackle the backlog. also this lunchtime: explosions. world leaders appeal for calm after continued clashes between israelis and palestinians,

more than 70 people have been killed in recent days. new data suggests covid cases in england are at their lowest since august. but there are concerns about a variant first identified in india. the largest tunnelling machine used in a uk rail project starts work under the chiltern hills — on the h52 high—speed link. jazz music. and, the power of music that is changing the lives of some people living with dementia. and coming up in the sport later in the hour on the bbc news channel. 12,000 manchester city and chelsea fans will be heading to portugal later this month as porto is confirmed for champions league final.

good afternoon and welcome to the bbc news at 0ne. new figures have laid bare the effect of the coronavirus pandemic on the nhs in england. the number of people waiting for routine hospital treatment has hit nearly five million — the highest since records began. as the nhs concentrated on tackling covid, the numbers waiting for treatment for other illnesses soared. than a year. that figure now stands at 436,000 people. let's cross to my colleague, victoria derbyshire at st thomas' hospital in london. thank you. nhs trusts up and down the country are having to come up with innovative novel ways of getting the waiting list backlog

down. we had been at st thomas' hospital in london where the prime minister was brought when he had covid finding out how they are doing and will talk to the boss. first our health correspondent has been talking to some of the patients affected. they said it's not good news and they said i had cancer. two months ago, doctors told elaine walsh she had womb cancer. what they did say is you would normally be on a table in the next few weeks but we haven't got one. we haven't got a surgeon, we haven't got a table and obviously i was aware every day that i'm not on a surgical operating table, it is more risk. in the past year the nhs has treated hundreds of thousands of covid patients and rolled out a mass vaccination programme. your tummy is hurting? vaccination programme. yourtumm is hurtinu? , your tummy is hurting? this has come at a cost disrupting _ your tummy is hurting? this has come at a cost disrupting nonurgent - your tummy is hurting? this has come at a cost disrupting nonurgent care - at a cost disrupting nonurgent care for many patients like zen. new figures from nhs england shows

436,000 people were waiting over a yearfor hospital 436,000 people were waiting over a year for hospital treatment in march, up from just i600 year for hospital treatment in march, up from just 1600 before the pandemic took hold. while there is more positive news in cancer care with a record number of referrals made by gps taking place in march the backlog is a serious concern. the biggest problem is on current trajectories they are saying it could — trajectories they are saying it could take them between three and five years— could take them between three and five years to recover this backlog. everyone — five years to recover this backlog. everyone knows that is simply not good _ everyone knows that is simply not good enough. nhs england has announced a £160 million initiative which will consider innovative ways to tackle waiting lists. we have a great, great national in student that has proved itself capable of rising to the most phenomenal challenges, it was never overwhelmed by covid, hasn't been so far, i know it can cope with the backlog and we will invest, we are

already investing massively. but could something like this help cut waiting times? here is a mobile surgical theatre. passionate — here is a mobile surgical theatre. passionate about helping the nhs, these two doctors have created and raised the funds for a surgical unit to be set up in car parks and ready to be set up in car parks and ready to use within two hours of arrival. you need to use your imagination. where we are standing is the entrance. it has a reception and a surgical theatre. what kind of patience will you treat here? it is the low risk surgery that frees up the main theatres in hospitals for the bigger presidents, anaesthetics, hips and knees. patients would exit out the back, it is hoped this one—way system will simplify the flow of people. we can see there is a scope to improve patient numbers not necessarily reliant on the bricks

and mortar is of large hospitals but more delivery in the community which is both easierfor more delivery in the community which is both easier for patients, more delivery in the community which is both easierfor patients, more cost effective and achievable. some health officials say calling upon the private sector is another way to increase capacity which has happened with elaine who is due to be treated at a private hospital tomorrow. sociable and outgoing, elaine longs for her old life. the prolonged wait for her old life. the prolonged wait for treatment has been made even more painful because she has had to isolate on her own. nobody realises the stress of going through this in covid come in the pandemic, and what it means to be isolated, and going through what you would normally have a huge support network. i mean i do have a network, but they cannot be with me, no one

can be with me. i can do it myself, i know i can, i am just lucky. but it is hard. let's take a closer look now at the waiting times in england. 0ur correspondent nick triggle has this assessment. covid has had a huge impact on the nhs. more than 400,000 patients have been treated in hospitalfor the virus during the pandemic. the average length of stay has been nine days — that's twice as long as patients admitted for other conditions would normally stay. thankfully cases have now dropped to a really low level but the scale of the disruption caused to hospitals is becoming clear. a report from the institute for fiscal studies shows the number of non—covid emergency admissions dropped by a fifth last year. 0utpatient appointments including support such as physiotherapy fell by a fifth too.

the number of people admitted for planned care like knee and hip operations dropped by even more. they are down a third on 2019. this fall in activity has had an impact on waits. the number of people on a waiting list in england is at its highest level since records began in 2007. one in 11 people are now waiting for treatment. the numbers are even higher in wales and northern ireland per head and this has happened despite a drop in people coming forward for care in the first place. the numbers referred on to a waiting list dropped by six million in 2020. ifjust a fraction of these seek help now it would increase the waiting list significantly. then there's cancer care. these services have been prioritised throughout the pandemic but waiting times have still worsened. some trusts are struggling to see even half of their patients in the target time of two months.

this has happened despite fewer being treated. the numbers are down 45,000 across the uk as referrals in from gps and via screening have dropped, although the numbers are now starting to rise again. experts are concerned this will mean more cancers will be spotted at a later stage, reducing the chances of survival. it's clear addressing these problems will take a monumental effort. with me now isjon findlay, chief operating officer of guy's and st thomas' hospital. good afternoon. what is the scale of the problem when you are talking about waiting lists? it is enormous. it is bigger than anything we have dealt with previously. we have 70,000 people on our waiting list currently. 70,000 people, all of those patients have

had to be reviewed and prioritised and we are obviously treating the most urgent patients first. we also have 4000 patients who have already waited over a year for treatment, and that is many, many times more than the case before the pandemic where we had less than 100 patients in that category. so the task is enormous notjust here but across the country. what are you doing to bring down the size of the waiting list? there are a huge number of initiatives, we are working closely with partners across our immediate sector and across london, we are working with partners in the independent sector, we have contracts with a local hospital, local hospitals for additional operating theatre capacitor, a mobile mri scanner in the car park here, additional operating robots. we are using technology to do some of our consultations virtually. we have got four large marquees across

the site for our vaccination programme, we have done a quarter of a million covid vaccines since early september. a massive impact on your staff. and people are working hard so we are putting on extra sessions at the weekend, we are doing longer operating during the day, and employing more staff, we are recruiting and it is pleasing there are more people interested in joining the nhs so we are increasing our workforce, joining the nhs so we are increasing ourworkforce, buy joining the nhs so we are increasing our workforce, buy new equipment, increasing capacity elsewhere. good luck, thank you for talking to us. so how other health services doing the uk. in a moment we'll hear from our correspondent in wales, 0wain clarke. and in northern ireland, marie—louise connolly. but first, lisa summers reports from scotland. here in scotland, just like everywhere else, people were waiting too long for routine treatment before the pandemic and it's only gotten worse. the scottish government had set aside £750 million to tackle waiting times.

nine years ago they set legislation that said that everybody should start treatment within 12 weeks of it being agreed. it's a target that's never been met. the latest data for scotland's not due out until later this month, but the most recent figures show 86,000 people were waiting to start treatment, 15,000 of them had been waiting over a year. it's also been a big election issue, how to tackle the backlog, and i spoke to one woman who'd been told that she'd have to wait six years to have both her hips replaced. the government says it is going to set up regional centres of excellence and is going to increase capacity for routine work by 10%. but with a lot of vacancies in specialist areas, it is going to be a big ask. in wales, the head of the nhs here has warned it could take five years to get waiting times back to pre—pandemic levels, and that wider impact of covid—19 is the biggest issue facing the new welsh labour government, which was elected last week.

now, the latest figures show over 500,000 people are waiting for their hospital treatment to start. that's equivalent to more than one in six of the welsh population being on a waiting list, and there are significant increases in waiting times for cardiology, neurology and for specialist treatments, such as restorative dentistry. the chances are if you are on a waiting list now, you're going to face a significantly longer wait compared to what you would've done last february. now, to get on top of this, to bring those waiting times down, the welsh nhs is likely to turn to the private sector for some help and may even look to use facilities, hospitals over the border in england too. it is a worrying time for patients and for theirfamilies, but also for staff who are working in the nhs who may feel overwhelmed by the challenge, having just spent a year ferociously tackling the pandemic in wales. here in northern ireland, hospital waiting lists have been described as a national scandal. hospital waiting lists have been

they're the worst in the uk. hospital waiting lists have been a report by the independent think tank, the nuffield trust, also concludes that the political deadlock here and the top—down management approach are frustrating efforts to help very sick people. in fact, a woman who's been waiting almost four years for a neurology appointment has been granted leave for a judicial review. it's the first case of its kind in the uk and centres on claims that the health authorities have a statutory duty to provide effective health care in realistic time. so, what's the forecast? last month, when new figures revealed that over 320,000 people are waiting over a year to see a consultant, the health minister said it would take almost a decade to tackle current waits. he has called for multi—year budgets, also that politics are set aside so that they can tackle health reform.

there will be a special programme on the news channel tonight at 8.30 to analyse the legacy of coronavirus for the nhs, and what the health service needs to do to reduce its backlog of patients. do you tune in if you can tonight. the time is 1:15. our top story this lunchtime: nhs waiting lists in england have reached a record high — with almost five million people waiting for treatment. and coming up: how music is changing the lives of some people with dementia. coming up in the sport in the next 15 minutes on the bbc news channel: the premier league have rolled over their uk broadcasting deal for another three years. they've been given government approval to bypass the usual bidding process.

israeli ground troops are massing on the border with gaza after another night of violence. palestinian militants have fired dozens more rockets into israel, while israeli air strikes have targeted senior commanders in gaza and brought down another tower block. there have also been further street clashes between israeli arabs and dues. can ——jews. health officials say more than 80 palestinians have died since monday, and seven israelis have been killed. paul adams reports from jerusalem. a conflict taking a dangerous new turn. 0n the mixed streets of israel, jews and arabs attacking each other, the country's president calling it a senseless civil war. in bat yam, south of tel aviv, an arab driver was pulled from his car and badly beaten. some of the images are too graphic to show. in the mixed city of lod,

gangs ofjewish youths roam the streets, scenes increasingly commonplace in recent weeks. there is a violence from the other side too. jews set upon, a synagogue torched, communities living in fear. translation: they heard i that my accent was not arab, ran up to my car and they started throwing stones. i was lucky there were no cars behind so i reversed. i almost ran into people and cars. i didn't see anything. israel's uneasy social compact is coming apart at the seams, on streets werejews and arabs live side by side. the prime minister accused of sowing division in the past, now condemning both sides. translation: nothing can 'ustify a lynching of jews by arabs h and nothing canjustify a lynching of arabs byjews. we will not accept this. nor are there any signs to an end

to the violence between israel and hamas. the militant organisation continues to fire rockets deep into israel. they are indiscriminate, civilians invariably pay the price. israel's air strikes on gaza are more precise but they are relentless and in this densely packed place, the civilian death toll continues to rise. translation: we had people shouting in the streets telling us _ to lead our house. the apartment building next to us was about to be bombed. we decided to leave everything behind and just flee. we ran out into the street. this conflict is not raging on several fronts. rarely in recent years has intercommunal violence erupted on the streets of israel at the same time as fighting between israel and the palestinians. it's an alarming development. after speaking to israel's prime minister, joe biden sounded optimistic. my expectation and hope is that this will be... ..closing down sooner than later, but israel has a right to defend itself when you have thousands of rockets flying into your territory. it's not clear what

president biden means. israel is warning of a possible ground operation, with troops massing along gaza's border. if it happens, the conflict will get much bloodier before it ends. and pauljoins us live from jerusalem now. we continually hear appeals for calm from the international community but really that is not a message that cuts through, it seems? ida. really that is not a message that cuts through, it seems? no, not so far. the dynamics _ cuts through, it seems? no, not so far. the dynamics all— cuts through, it seems? no, not so far. the dynamics all point - cuts through, it seems? no, not so far. the dynamics all point in - cuts through, it seems? no, not so far. the dynamics all point in one i far. the dynamics all point in one direction at the moment, which is towards further conflict. in the last half an hour or so, more reports of hamas rockets falling, being heard and falling in the tel aviv area. no civilian casualties as far as we know. we think most of the rockets were intercepted. there were even reports a rocket was fired to the southern port, where some international flights have been directed to. that is a very, very long way from the gaza strip and

that would be something of a departure if hamas were able to fire a a rocket that file. unconfirmed so far. we have the spectacle now with israeli ground troops being prepared for a possible ground operation. the last time that happened in 2014 and israel sent in troops on the ground, thousands of people ended up dead and that is what will happen if it happens again this time. it is impossible to conduct military operations in the densely packed gaza strip without inflicting appalling casualties. so that is the prospect being weighed up now as the israeli government looks at what hamas is doing and tries to figure out how much damage it is determined to inflict on the militants because if they decide they want to go the extra mile, then there conflict which looks bad enough at the moment could get a whole lot worse. so a lot for the international envoys who

may be thinking about coming here. we thinkjoe biden�*s envoy may be arriving, possibly even as early as today. the fact there is some diplomatic effort under way at all at their still relatively early stage in the conflict is perhaps a promising sign. we are not privy to much of it. a lot is going on behind closed doors and involves egypt and qatar and other countries, whether any of it is capable of preventing a further escalation, we do not know yet. further escalation, we do not know et. . ~' , ., further escalation, we do not know et. . ~ i., ., further escalation, we do not know et. . ., �*., , yet. thank you. pauladams in jerusalem- _ new data suggests the prevalence of coronavirus cases in england is at its lowest point since last august, despite the relaxation of the lockdown. but borisjohnson says the government is concerned about a variant of covid first identified in india, which is now spreading here. 0ur health correspondent, catherine burns, is with me. let's start with the latest data. this is the good news. this study has looked at infection levels and

found they have dropped by 50% between march and the start of this month. this takes us down to the lowest level since last august. that is the good news. but as you say, there is ever growing concern about that indian variant. the prime minister was asked about it today and the word he used was anxious. he said the government will take all be cautious steps that it needs to end he refused to rule anything out. that is a real change in tone from just a few days ago, on monday, when he announced that england would go ahead with the next age of opening up ahead with the next age of opening up from lockdown next week. that is uuite a up from lockdown next week. that is quite a striking _ up from lockdown next week. that is quite a striking ship, _ up from lockdown next week. that is quite a striking ship, actually. - up from lockdown next week. that is quite a striking ship, actually. how l quite a striking ship, actually. how much more do we know about why we have seen that shift in just a few days? have seen that shift in 'ust a few da s? ~ ., ~ ., have seen that shift in 'ust a few das? ., have seen that shift in 'ust a few da s? ~ ., ~ ., , ., days? we do know there has been a series of high-level— days? we do know there has been a series of high-level meetings - series of high—level meetings between government officials and scientists at this indian variant has been one of the main topics of conversation, especially after a spate of cases in places like bolton in places like bolton are three

things we greater manchester. there are three things we need to does not seem to be the case with the sun. 0ne, seem to be the case with the sun. one, does it cause more severe disease? that does not seem to be the case with this one. is does it is does it have any kind of... can it fight harder against vaccines? it is really early days and there might be some small impact but we don't know for certain. there are signs to be optimistic. the third one and i think it is key right now, is it more infectious, how does it spread? we know it spreads at least as quickly as the kent variant which has become the dominant one in the uk and it seems it could spread considerably faster. but what most people will want to know is will this affect opening up, will we still be able to do the things we were told we could do? it seems the answer is on monday, the next stage of reopening in england, things should be going ahead. more of the question about the stage after that which is june question about the stage after that which isjune 21 because at each stage, the government has four tests they set for themselves and one is, is there a variant that is causing worries and risks about raising the risk level? we don't have that

information yet. we don't know enough about that but we know the government says they want to make these decisions based on data are not dates. right now, the data is not dates. right now, the data is not there to is for 0k, thank you. a 21—year—old man has appeared at maidstone crown court charged with the murder of the police community support 0fficer, julia james, last month. callum wheeler, from aylesham in kent, was remanded in custody and will stand trial in november. high speed trains which were found to have cracks, causing disruption on some of britain's busiest routes, are expected to re—enter service shortly, after inspectors said they are safe. services on large parts of the network have been disrupted since saturday, after cracks were discovered on the chassis of several trains. work is beginning on a 10 mile tunnel under the chiltern hills, to form part of the h52 rail line between london and birmingham. it will take more than three years to drill, and will involve the largest tunnelling machine ever used in the uk on a rail project.

theo leggett reports. if you want to make a large tunnel, you need a giant drill and they don't come any bigger than this. florence, as she's known, is the tunnel boring machine, or tbm. so, this machine itself is 170 metres long. it contains all the processes, all the pipes, all the welfare, all the canteen, all the facilities for the guys to be on the machine for such a long duration. it's 10.26 metres in diameter, so i like to say it's roughly the height of two giraffes stood one on top of each other. it's a big bit of kit. florence, and a sister machine called cecilia, will be used to build a ten mile twin bore tunnel between —— beneath the chiltern hills. so, right now, we're walking through the centre of the tbm. this is where all the segments will be transferred up through, through the underside of the gantries, to deliver the segments to the front of the tbm. more than 100,000 concrete slabs will be needed to line the tunnel and they're all made on site.

these segments, which are concrete, steel fibre reinforced, are needed to support the ground in the tunnel. so, they're erected by the tbm machine while the tbm is driving. it's very important, it's crucial to the project, so that the tbm can keep going and keep installing the segments and therefore producing the tunnel. people here are deeply worried the work will fracture the fragile rocks surrounding the tunnel, causing water to simply drain away from rare chalk streams, like the river misbourne, destroying habitats and threatening drinking water supplies. i don't want to be the person that says we told you so. _ water goes downhill, i chalk is porous, you're not listening, guys, this is dangerous. l but the boss of h52 insists that isn't the case. we've done everything we can, that's why we're building a tunnel in the first place, so we stay underneath this chilterns area of natural beauty. we've already planted some 700,000 trees and bushes. 16,000 jobs now have been created

by this project and that number will nearly double in the next few years as we get to peak activity. in total, hs2 will be using ten of the giant machines to build 64 miles of tunnel between london and the west midlands. florence, meanwhile, has onlyjust begun herjourney. it will be another three and a half years before she sees daylight again. theo leggett, bbc news. the all—english champions league final will be played later this month in porto. the game between manchester city and chelsea has been moved from istanbul, to allow 6,000 fans from each club to attend after turkey was placed on the government's travel red—list. the power of music to transform the lives of people with dementia was underlined last year, when a former music teacher saw his composition become a viral hit on social media. paul harvey's joy at playing

the piano inspired one of scotland's wealthiest men to donate £1 million to charity, to give more people the chance to hear and take part in live music. graham satchell has been finding out more. jazz music plays. if you ever wondered about the extraordinary power of music — look at this! jazz music plays. care home residents, smiling, singing, dancing. this, a regular music therapy session by the jazz quartet, spitz. # i said hold it right there, baby, please don't go...# just because you've got dementia, for example, doesn't mean that there isn't, like, a whole world in someone's mind, there's a whole person, like, a whole view of life, and a whole experience of richness. the transformative effect of music can be remarkable. takejohn, for example, who has vascular dementia. members of spitz worked closely with john. gave him a guitar, changed his life.

through music, we've got to know john's life history. we've got to know whojohn is, and now, he's the centre of attention. he loves music, he's such a fun person to be around. and, hey ho! it's four years on now, he's here with us and i think we're going to get many more years to come withjohn. i like music, and i like country and western — a lot. _ john will carry on having music therapy because spitz is now getting extra funding from an unexpected source. when paul harvey was given four notes by his son nick to improvise a tune, no—one could have guessed what would happen next. the tune went viral online, and then was orchestrated by the bbc philharmonic.

if he's having a bad day, playing the right piece of music at the right time can be absolutely transformational. and if i manage to get him up to play the piano — magic happens. paul's story was seen by a scottish philanthropist, sir tom hunter, who gave £1 million to two charities. one of them, music for dementia, is distributing that money today. it's going to do good, and that's all that matters. i didn't do very little, exceptjust play four notes. music continues where the printed word stops, and it continues in a way that is magical, you know?

paul is a remarkably gifted man, whose love of music will now help