:00:00. > :00:00.Hello and welcome to Alport Heights in Derbyshire
:00:00. > :00:10.In our special programme tonight, we are checking up on the health
:00:11. > :00:15.Medicines and money. Our cameras catch patients
:00:16. > :00:29.Do we still have a National Health Service?
:00:30. > :00:34.Professor Robert Winston does not think so.
:00:35. > :00:39.And is it time to ration fertility treatment?
:00:40. > :00:41.What happens when the cost of starting a family
:00:42. > :00:45.When somebody can have three goes and someone else none,
:00:46. > :01:05.I'm Lukwesa Burak and this is Inside Out for the East Midlands.
:01:06. > :01:07.First tonight, our hospitals are facing one of their
:01:08. > :01:09.busiest winters ever. The wards are full.
:01:10. > :01:12.And the budgets are under enormous pressure.
:01:13. > :01:15.So, the last thing the NHS needs is to be throwing away money.
:01:16. > :01:18.But that is exactly what appears to be happening, as patients sell
:01:19. > :01:20.on the drugs prescribed to them by their GPs or specialists.
:01:21. > :01:29.Jonathan Gibson has been investigating.
:01:30. > :01:44.And funding the health service does not come cheap.
:01:45. > :01:51.In 2015, they cost the NHS in England more than ?9.2 billion.
:01:52. > :01:56.Many of those are repeat prescriptions.
:01:57. > :02:01.If you do not need an item, it is your duty to protect
:02:02. > :02:04.the NHS and, actually, if I do not need it,
:02:05. > :02:12.But a system which relies on honesty is also open to abuse.
:02:13. > :02:14.That is what I am worried is happening in some
:02:15. > :02:19.We are all familiar with auction websites like eBay.
:02:20. > :02:23.It means you can virtually buy and sell anything these days.
:02:24. > :02:28.I am worried that that is exactly what some people are doing.
:02:29. > :02:32.It is a prescription-only drug for treating depression.
:02:33. > :02:38.This guy selling venlafaxine says it was prescribed for his wife.
:02:39. > :02:42.She does not need it, so they have decided to sell it on.
:02:43. > :02:54.But it is not just drugs to treat depression or improve your teeth.
:02:55. > :03:01.It is a drug for treating erectile dysfunction.
:03:02. > :03:10.So why has this guy got eight for sale on eBay?
:03:11. > :03:15.I have ordered a couple through the post, to find out,
:03:16. > :03:16.as well as some other prescription-only
:03:17. > :03:24.This is caverject and it comes in the form of this
:03:25. > :03:28.So, you need to know what you are doing.
:03:29. > :03:34.I asked for proof that these products were genuine and he sent me
:03:35. > :03:42.through this - his repeat prescription.
:03:43. > :03:45.It looks like his doctor is prescribing these to him on
:03:46. > :03:47.the NHS and he is just selling them on.
:03:48. > :03:51.The guy selling his NHS prescription lives in Nottinghamshire and,
:03:52. > :03:53.with it being Friday, I have come up with
:03:54. > :03:55.the perfect reason for coming calling around.
:03:56. > :03:59.I am after something for the weekend.
:04:00. > :04:05.So, secret camera running, I have parked up some distance away.
:04:06. > :04:12.I am hardly through the door and he is
:04:13. > :04:30.Right, but you still get the prescription,
:04:31. > :04:33.I take it you don't pay for your prescriptions?
:04:34. > :04:39.So, the NHS looks after him and he, well, looks after himself.
:04:40. > :05:02.That is 48 boxes a year, costing the NHS about ?500.
:05:03. > :05:16.Each containing an injection, a complete kit.
:05:17. > :05:19.He gets the money and you and I pick up the bill.
:05:20. > :05:22.But ?500 is small change compared to the cost of another
:05:23. > :05:31.NHS prescription I am being offered for sale.
:05:32. > :05:34.I am on my way to meet a man whose prescription drug costs
:05:35. > :05:42.It is a cold Thursday night and he has asked to meet me
:05:43. > :05:48.at a service station car park on the motorway.
:05:49. > :06:06.He's here all right, but he is on the other side of
:06:07. > :06:10.My cameraman is watching my back, as I head across the
:06:11. > :06:26.I thought he would go straight for the cash, but he is covering
:06:27. > :06:39.But it does not take him long to get down to business.
:06:40. > :06:44.The drug he is selling is used to treat arthritis.
:06:45. > :06:47.It can only be prescribed by a hospital specialist.
:06:48. > :06:52.He gets prescribed a box every four weeks.
:06:53. > :07:09.He is also breaking the rules of eBay by listing it.
:07:10. > :07:31.And if I want more, that is no problem.
:07:32. > :07:33.After all, the NHS gives him almost ?10,000 worth
:07:34. > :07:38.OK, target number two and drug number two.
:07:39. > :07:51.The community pharmacist says what they are doing is
:07:52. > :07:56.These are prescription-only medicines which have been
:07:57. > :08:00.prescribed for an individual, for their individual condition.
:08:01. > :08:02.But then, to sell them, for a financial gain for themselves,
:08:03. > :08:08.It is defrauding everybody, because the NHS is for all of us.
:08:09. > :08:15.And it is actually an illegal thing to do.
:08:16. > :08:22.It could also lead to a prison sentence.
:08:23. > :08:25.These are just a few of the prescriptions I have purchased.
:08:26. > :08:26.From prescription toothpaste to antidepressants.
:08:27. > :08:32.Prescribed in good faith by the NHS to patients who are illegally
:08:33. > :08:38.Patients like the man selling his NHS impotence injection.
:08:39. > :08:42.Instead, I got an e-mail from his wife.
:08:43. > :08:45.Yes, she says, we know what we're doing is wrong,
:08:46. > :08:47.but we're just trying to help people out we're
:08:48. > :08:50.not and we're not making much money out of it, anyway.
:08:51. > :08:53.Barely enough, she says, to buy a packet of fags.
:08:54. > :08:58.Do you ever get the feeling someone is missing the point?
:08:59. > :09:04.I have told him I want to buy more of his drugs, but
:09:05. > :09:07.this time, I am not bringing cash, just cameras.
:09:08. > :09:10.I am not really called Steve. I am a reporter for the BBC.
:09:11. > :09:13.I am trying to find out why you are selling NHS prescriptions
:09:14. > :09:19.and pocketing the proceeds. Why are you doing that?
:09:20. > :09:36.But moments later, he gives me a call.
:09:37. > :09:47.So you will not be selling NHS prescriptions any more?
:09:48. > :09:54.Whether or not that is true, I do not know.
:09:55. > :10:05.We may have closed the door on one fraudster's
:10:06. > :10:08.activities, but it is clear he is not the only patient willing
:10:09. > :10:13.Well, eBay has told us that its sellers must comply
:10:14. > :10:16.with the law and they are prohibited from listing prescribed drugs.
:10:17. > :10:19.They say they work in liason with the regulatory agency
:10:20. > :10:26.to remove any such items from sale as soon as they are reported.
:10:27. > :10:29.The pressure on NHS staff and budgets is
:10:30. > :10:33.very much in the headlines, but it is not just about A
:10:34. > :10:38.Inside Out has discovered that the medical treatment
:10:39. > :10:40.you are offered can very much depend on where you live.
:10:41. > :10:42.So, is the NHS still a national health service?
:10:43. > :10:49.Chris Jackson has been investigating.
:10:50. > :10:51.The NHS is facing the most significant financial challenge
:10:52. > :10:57.There are fears that the service we grew up
:10:58. > :11:06.Absolutely, there is a postcode lottery.
:11:07. > :11:10.It is criminal. It is absolutely criminal.
:11:11. > :11:17.This is the start. This is going to get worse.
:11:18. > :11:20.So, is the NHS in danger of ceasing to be a national
:11:21. > :11:22.service, where everyone is entitled to the same care?
:11:23. > :11:25.It is treating more patients, but is it becoming
:11:26. > :11:28.a postcode lottery, where access can depend on where you live?
:11:29. > :11:38.We are going to put that to the test.
:11:39. > :11:46.It feels like my bones are actually screaming at me.
:11:47. > :11:49.33-year-old Ben Franklin has Hepatitis C.
:11:50. > :11:52.The virus can cause life-threatening liver damage.
:11:53. > :11:59.I have been off work since April, I have been off sick.
:12:00. > :12:02.I could also maybe lose the flat over my head.
:12:03. > :12:04.There are new drugs that could potentially cure
:12:05. > :12:12.But they are expensive and rationed. Ben has been denied them.
:12:13. > :12:15.All I got was told to wait, because basically my liver
:12:16. > :12:19.That made me want to go out and get absolutely wasted and ruin my liver,
:12:20. > :12:26.I would not do that, but would not be surprised
:12:27. > :12:29.The money is there for just over 10,000 treatments.
:12:30. > :12:36.It is claimed that means there are no queues in parts of the
:12:37. > :12:39.north and long waits in places like London.
:12:40. > :12:42.Two people with exactly the same state of liver damage can
:12:43. > :12:43.present themselves in different parts of the country.
:12:44. > :12:46.In one, they will be able to walk in and get
:12:47. > :12:49.hepatitis C treatment immediately, get cured.
:12:50. > :12:52.In another part of the country they may be told sorry,
:12:53. > :13:00.NHS England said they were regularly reallocating unused hepatitis C
:13:01. > :13:04.treatments to places with waiting lists.
:13:05. > :13:17.The number of patients treated will increase by 25% next year.
:13:18. > :13:20.The fact that it is down to money upsets me the most.
:13:21. > :13:24.So, Ben is taking the risk of treating himself,
:13:25. > :13:28.with cheaper copies of the new drugs.
:13:29. > :13:41.The fact that I have had to pay for my treatment, it is criminal.
:13:42. > :14:03.Ben is hoping the generic drugs will cure him within a matter of weeks.
:14:04. > :14:16.around 1,000 people in Britain may have bought the drugs abroad.
:14:17. > :14:18.If you go outside, there is halos around the lights.
:14:19. > :14:34.I cannot go up or down stairs with any kind of confidence.
:14:35. > :14:38.Cataracts are meant to be treated within four months of referral.
:14:39. > :14:43.Gloria, who lives in the North East, says she has been waiting seven.
:14:44. > :14:47.It is too long, because there is such potential for accidents.
:14:48. > :14:55.And there is such a change in the person's mood.
:14:56. > :14:57.If Gloria has lived in Luton, her wait could have been
:14:58. > :15:00.as little as 15 days. A postcode lottery?
:15:01. > :15:02.Absolutely there is a postcode lottery.
:15:03. > :15:07.It is about some places in England having poor
:15:08. > :15:09.systems, having budgetary pressures and deprioritising cataract surgery.
:15:10. > :15:22.That does not feel too national to me.
:15:23. > :15:24.Gloria expects to get her operation later this month.
:15:25. > :15:27.It really makes me angry, because I think that it is
:15:28. > :15:29.almost like the survival of the fittest.
:15:30. > :15:35.It is claimed some are delaying treatments like cataract surgery
:15:36. > :15:37.Others are requiring patients to lose weight
:15:38. > :15:43.before getting operations like hip replacements.
:15:44. > :15:45.Postponing an operation in these circumstances
:15:46. > :15:52.While the CCGs say that can be clinically justified, the
:15:53. > :15:56.Royal College of Surgeons says it cannot.
:15:57. > :15:58.There's very good evidence that people are now not
:15:59. > :16:03.getting elective operations, which they sometimes
:16:04. > :16:05.desperately require, simply because of
:16:06. > :16:12.It is up to the clinicians to decide who should get what treatment.
:16:13. > :16:14.Therefore, a bureaucratic system which produces a
:16:15. > :16:19.blanket ban, we think, is morally wrong.
:16:20. > :16:21.It is also claimed that new systems for vetting appointments
:16:22. > :16:26.for specialists are another form of rationing.
:16:27. > :16:30.Why are they treating their patients with such contempt?
:16:31. > :16:32.Last month, MPs complained about a private company
:16:33. > :16:37.being paid ?10 for every GP referral they stopped.
:16:38. > :16:39.This is rationing by the back door and has
:16:40. > :16:42.the potential to compromise patient safety.
:16:43. > :16:44.The same private company overseas referrals in North Tyneside.
:16:45. > :16:49.We have spoken to doctors who say the system is putting patients
:16:50. > :16:56.The GPs, who fear speaking out, have told us that cancer
:16:57. > :17:24.In a statement, North Tyneside CCG said
:17:25. > :17:26.there was no evidence that the system caused
:17:27. > :17:30.They said cancer referrals do not go through the
:17:31. > :17:35.system and are made directly to hospital.
:17:36. > :17:37.The number of referrals knocked back to GPs in England
:17:38. > :17:45.You can see the details of our research online.
:17:46. > :17:46.Shortage and regional difference have always been
:17:47. > :17:53.Today, the differences could get much worse.
:17:54. > :17:56.The NHS is under an unprecedented level of pressure at the moment.
:17:57. > :17:58.If it does not get more funding, waiting times are
:17:59. > :18:02.going to get longer and the quality of patient care is going to suffer.
:18:03. > :18:05.So, we will see different decisions getting taken in different parts of
:18:06. > :18:10.the country and different services being available to patients.
:18:11. > :18:12.So, is the NHS still a national service?
:18:13. > :18:19.One of our most prominent medics is clear.
:18:20. > :18:23.No, it is not a national service. It is now a local health service.
:18:24. > :18:25.I think it matters because leads to inequality in health care.
:18:26. > :18:29.So, some people will get health care free and others will not.
:18:30. > :18:31.In a statement, the Department of Health told us...
:18:32. > :18:42.Far from rationing, more people than ever are getting treatment.
:18:43. > :18:45.3,261 more cancer patients are being seen every day.
:18:46. > :18:48.We asked the Health Secretary and NHS England for an interview.
:18:49. > :18:51.The people actually paying for NHS services,
:18:52. > :18:54.the clinical commissioners, did agree to speak to us.
:18:55. > :18:58.variations, based on the need of the population.
:18:59. > :19:01.Demographically, the population varies quite significantly,
:19:02. > :19:03.from town to rural and county to county.
:19:04. > :19:06.It is really important that we commission and respond to the
:19:07. > :19:09.needs of that population on a local basis.
:19:10. > :19:14.It is all about making sure that pathway is correct.
:19:15. > :19:16.We do not want to squander any money.
:19:17. > :19:18.We have limited resources so it is really
:19:19. > :19:21.important we spend most effectively and get the best value for
:19:22. > :19:29.For those forced into taking their own action, rationing
:19:30. > :19:35.Now, the decision of what the NHS can
:19:36. > :19:43.Parts of Nottinghamshire are likely to become the first in the East
:19:44. > :19:49.Midlands to stop funding so-called test-tube babies.
:19:50. > :19:51.Health bosses say IVF is low priority and insist
:19:52. > :19:57.But as Rob Sissons has been finding out,
:19:58. > :20:00.that is not how couples who have benefited from one of the miracles
:20:01. > :20:11.There is never a dull moment in this family.
:20:12. > :20:17.She is the child that Kelly and Tim thought they would never have.
:20:18. > :20:19.Most parents think their children are priceless, of course,
:20:20. > :20:23.but if you wanted to put a price on Imogen, you could.
:20:24. > :20:28.Kelly is infertile and they had to pay for IVF fertility
:20:29. > :20:34.treatment because of where they live.
:20:35. > :20:37.When you are a young couple, you do not have the sort of money.
:20:38. > :20:46.They had to remortgage and now face going into even more debt.
:20:47. > :20:47.If it could've happened naturally, we would
:20:48. > :20:49.definitely have had two or three children.
:20:50. > :20:55.So, we bit the bullet and decided to go for it again.
:20:56. > :21:00.We will be following the couple through the latest round of IVF.
:21:01. > :21:02.A few miles away in Nottingham, parents it's been a very
:21:03. > :21:06.different story for a different pair of parents.
:21:07. > :21:09.Their son Matthew did not cost them a penny.
:21:10. > :21:21.And we were extremely happy that it worked first time.
:21:22. > :21:24.I think it is strange that there is a lack
:21:25. > :21:27.We have been looking on this website this morning and
:21:28. > :21:30.there are some areas where you have three cycles, but in the East
:21:31. > :21:40.The couple know they are lucky, but are
:21:41. > :21:49.worried that others may feel cheated by the so-called postcode lottery.
:21:50. > :21:52.It gets to a stage, with the subset of people who cannot conceive
:21:53. > :21:55.naturally, that only the really rich will be able to have children.
:21:56. > :21:58.If somebody can have three goes and someone else has no goas,
:21:59. > :22:03.If everybody had one go, that would be more sensible.
:22:04. > :22:07.It is clear that whether you get NHS funding or not very much depends on
:22:08. > :22:10.If Tim and Kelly had moved from Staffordshire
:22:11. > :22:11.to the neighbouring county of Derbyshire, their
:22:12. > :22:14.first IVF baby would have been paid for.
:22:15. > :22:19.It is something which baffles couples.
:22:20. > :22:24.It also some irritates fertility experts.
:22:25. > :22:30.One of them is Simon, a doctor at Care in Nottingham.
:22:31. > :22:32.who worked alongside the team which created the first IVF baby,
:22:33. > :22:40.Since then, more than 250,000 IVF babies have been born in
:22:41. > :22:49.We have an understanding of the medical condition that we did not
:22:50. > :22:56.Live birth rates here have increased enormously, really, when
:22:57. > :23:01.In 1991, it was about 14% live birth rate.
:23:02. > :23:09.Today, the national average is double that.
:23:10. > :23:11.So, techniques are moving forward, but
:23:12. > :23:13.the doctor fears funding is going backwards.
:23:14. > :23:15.Controversially, health bosses in parts of Notts are now proposing
:23:16. > :23:19.proposing to scrap IVF treatment on the NHS.
:23:20. > :23:23.We think there should be one of two treatment cycles for everybody.
:23:24. > :23:26.I think it matters because there are knock-on effects
:23:27. > :23:28.up and down the country for decisions which are made.
:23:29. > :23:34.Once it affects patients, I think it is a real worry.
:23:35. > :23:43.Her IVF journey starts in the kitchen.
:23:44. > :23:50.The hormone injections are designed to stimulate production of
:23:51. > :23:58.They are back at Care Fertility in Nottingham.
:23:59. > :24:27.It is just the unknown. You do not know the answer. You do not know
:24:28. > :24:34.what is going to happen. You have started these stimulation drugs. How
:24:35. > :24:43.is that going? We know about nor this time about how it is going. It
:24:44. > :24:49.can be some side effects. An ultrasound scans suggest the
:24:50. > :25:00.injections are working. This is one of the follicles. So far, so good.
:25:01. > :25:04.The treatment costs about ?3000 for every cycle. Health bosses in this
:25:05. > :25:15.part of the world are trying to save ?20 million. Scrapping IVF funding
:25:16. > :25:22.could save ?300,000 a year. We have to think about how we use of rate
:25:23. > :25:31.poems we are budgeted. You could be denying people the chance who have
:25:32. > :25:38.the chance of conceiving only IVF through. That is what makes things
:25:39. > :25:49.more difficult. The couple have returned to the fertility clinic.
:25:50. > :26:03.The other removing eggs. The wiggle. One more follicle and we are done.
:26:04. > :26:15.You have done really well. We have got six eggs. I am over the moon.
:26:16. > :26:24.Everything is going really well. At the end of the day, it is not about
:26:25. > :26:28.numbers, but about quality. I have had patients with 20 eggs who have
:26:29. > :26:33.not had a baby and other patients who have had just won and they have
:26:34. > :26:41.had their baby. Next, the moment of fertilisation. If the eggs meet
:26:42. > :26:47.200,000 of his spear. 24-hour Slater, the report for good quality
:26:48. > :26:50.eggs. One is implanted than the other three are frozen. She will
:26:51. > :26:55.know if she is pregnant in a few weeks.
:26:56. > :27:06.The proposals to cut funding IVF for will affect couples around the
:27:07. > :27:09.region. A few weeks into the consultation, water is getting round
:27:10. > :27:15.and not everyone thinks it is a bad idea. I do not think we should be
:27:16. > :27:22.funding it at the moment. We have got such financial difficulties. We
:27:23. > :27:29.could not of children had to adopt. If you want to have IVF, I do not
:27:30. > :27:39.think why we should have to pay for it. I think they should fund it. I
:27:40. > :27:43.do not think it is very good. Health bosses say they want to hear what
:27:44. > :27:52.everyone has two C before making a final decision. -- to see. The
:27:53. > :28:00.anxious wait is over, but it is bad news. Unfortunately, we did not get
:28:01. > :28:06.to the point where we had to take a pregnancy test. It did not work this
:28:07. > :28:12.time. But with the frozen embryos, they still have a chance. We will
:28:13. > :28:22.keep trying. We have got three more. We will keep going for it. They are
:28:23. > :28:30.going to have a break before they have another go at IVF.
:28:31. > :28:33.That decision is expected next month. That is all from us this
:28:34. > :28:37.week. On the next Inside Out East
:28:38. > :28:39.Midlands, the Derbyshire couple who claim the adoption of their two
:28:40. > :28:42.children was an appalling You just stop living,
:28:43. > :28:46.because you are ripped apart. Inside Out East Midlands at 7:30pm
:28:47. > :29:05.on Monday on BBC One. Hello, I'm Louisa Preston
:29:06. > :29:08.with your 90 second update. 30 British tourists shot
:29:09. > :29:11.dead in Tunisia in 2015.