16/01/2017 Inside Out East Midlands

Hello and welcome to Alport Heights in Derbyshire

In our special programme tonight, we are checking up on the health

Medicines and money. Our cameras catch patients

Do we still have a National Health Service?

Professor Robert Winston does not think so.

And is it time to ration fertility treatment?

What happens when the cost of starting a family

When somebody can have three goes and someone else none,

I'm Lukwesa Burak and this is Inside Out for the East Midlands.

First tonight, our hospitals are facing one of their

busiest winters ever. The wards are full.

And the budgets are under enormous pressure.

So, the last thing the NHS needs is to be throwing away money.

But that is exactly what appears to be happening, as patients sell

on the drugs prescribed to them by their GPs or specialists.

Jonathan Gibson has been investigating.

And funding the health service does not come cheap.

In 2015, they cost the NHS in England more than ?9.2 billion.

Many of those are repeat prescriptions.

If you do not need an item, it is your duty to protect

the NHS and, actually, if I do not need it,

But a system which relies on honesty is also open to abuse.

That is what I am worried is happening in some

We are all familiar with auction websites like eBay.

It means you can virtually buy and sell anything these days.

I am worried that that is exactly what some people are doing.

It is a prescription-only drug for treating depression.

This guy selling venlafaxine says it was prescribed for his wife.

She does not need it, so they have decided to sell it on.

But it is not just drugs to treat depression or improve your teeth.

It is a drug for treating erectile dysfunction.

So why has this guy got eight for sale on eBay?

I have ordered a couple through the post, to find out,

as well as some other prescription-only

This is caverject and it comes in the form of this

So, you need to know what you are doing.

I asked for proof that these products were genuine and he sent me

through this - his repeat prescription.

It looks like his doctor is prescribing these to him on

the NHS and he is just selling them on.

The guy selling his NHS prescription lives in Nottinghamshire and,

with it being Friday, I have come up with

the perfect reason for coming calling around.

I am after something for the weekend.

So, secret camera running, I have parked up some distance away.

I am hardly through the door and he is

Right, but you still get the prescription,

I take it you don't pay for your prescriptions?

So, the NHS looks after him and he, well, looks after himself.

That is 48 boxes a year, costing the NHS about ?500.

Each containing an injection, a complete kit.

He gets the money and you and I pick up the bill.

But ?500 is small change compared to the cost of another

NHS prescription I am being offered for sale.

I am on my way to meet a man whose prescription drug costs

It is a cold Thursday night and he has asked to meet me

at a service station car park on the motorway.

He's here all right, but he is on the other side of

My cameraman is watching my back, as I head across the

I thought he would go straight for the cash, but he is covering

But it does not take him long to get down to business.

The drug he is selling is used to treat arthritis.

It can only be prescribed by a hospital specialist.

He gets prescribed a box every four weeks.

He is also breaking the rules of eBay by listing it.

And if I want more, that is no problem.

After all, the NHS gives him almost ?10,000 worth

OK, target number two and drug number two.

The community pharmacist says what they are doing is

These are prescription-only medicines which have been

prescribed for an individual, for their individual condition.

But then, to sell them, for a financial gain for themselves,

It is defrauding everybody, because the NHS is for all of us.

And it is actually an illegal thing to do.

It could also lead to a prison sentence.

These are just a few of the prescriptions I have purchased.

From prescription toothpaste to antidepressants.

Prescribed in good faith by the NHS to patients who are illegally

Patients like the man selling his NHS impotence injection.

Instead, I got an e-mail from his wife.

Yes, she says, we know what we're doing is wrong,

but we're just trying to help people out we're

not and we're not making much money out of it, anyway.

Barely enough, she says, to buy a packet of fags.

Do you ever get the feeling someone is missing the point?

I have told him I want to buy more of his drugs, but

this time, I am not bringing cash, just cameras.

I am not really called Steve. I am a reporter for the BBC.

I am trying to find out why you are selling NHS prescriptions

and pocketing the proceeds. Why are you doing that?

But moments later, he gives me a call.

So you will not be selling NHS prescriptions any more?

Whether or not that is true, I do not know.

We may have closed the door on one fraudster's

activities, but it is clear he is not the only patient willing

Well, eBay has told us that its sellers must comply

with the law and they are prohibited from listing prescribed drugs.

They say they work in liason with the regulatory agency

to remove any such items from sale as soon as they are reported.

The pressure on NHS staff and budgets is

very much in the headlines, but it is not just about A

Inside Out has discovered that the medical treatment

you are offered can very much depend on where you live.

So, is the NHS still a national health service?

Chris Jackson has been investigating.

The NHS is facing the most significant financial challenge

There are fears that the service we grew up

Absolutely, there is a postcode lottery.

It is criminal. It is absolutely criminal.

This is the start. This is going to get worse.

So, is the NHS in danger of ceasing to be a national

service, where everyone is entitled to the same care?

It is treating more patients, but is it becoming

a postcode lottery, where access can depend on where you live?

We are going to put that to the test.

It feels like my bones are actually screaming at me.

33-year-old Ben Franklin has Hepatitis C.

The virus can cause life-threatening liver damage.

I have been off work since April, I have been off sick.

I could also maybe lose the flat over my head.

There are new drugs that could potentially cure

But they are expensive and rationed. Ben has been denied them.

All I got was told to wait, because basically my liver

That made me want to go out and get absolutely wasted and ruin my liver,

I would not do that, but would not be surprised

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

It is claimed that means there are no queues in parts of the

north and long waits in places like London.

Two people with exactly the same state of liver damage can

present themselves in different parts of the country.

In one, they will be able to walk in and get

hepatitis C treatment immediately, get cured.

In another part of the country they may be told sorry,

NHS England said they were regularly reallocating unused hepatitis C

treatments to places with waiting lists.

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

The fact that it is down to money upsets me the most.

So, Ben is taking the risk of treating himself,

with cheaper copies of the new drugs.

The fact that I have had to pay for my treatment, it is criminal.

Ben is hoping the generic drugs will cure him within a matter of weeks.

around 1,000 people in Britain may have bought the drugs abroad.

If you go outside, there is halos around the lights.

I cannot go up or down stairs with any kind of confidence.

Cataracts are meant to be treated within four months of referral.

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

It is too long, because there is such potential for accidents.

And there is such a change in the person's mood.

If Gloria has lived in Luton, her wait could have been

as little as 15 days. A postcode lottery?

Absolutely there is a postcode lottery.

It is about some places in England having poor

systems, having budgetary pressures and deprioritising cataract surgery.

That does not feel too national to me.

Gloria expects to get her operation later this month.

It really makes me angry, because I think that it is

almost like the survival of the fittest.

It is claimed some are delaying treatments like cataract surgery

Others are requiring patients to lose weight

before getting operations like hip replacements.

Postponing an operation in these circumstances

While the CCGs say that can be clinically justified, the

Royal College of Surgeons says it cannot.

There's very good evidence that people are now not

getting elective operations, which they sometimes

desperately require, simply because of

It is up to the clinicians to decide who should get what treatment.

Therefore, a bureaucratic system which produces a

blanket ban, we think, is morally wrong.

It is also claimed that new systems for vetting appointments

for specialists are another form of rationing.

Why are they treating their patients with such contempt?

Last month, MPs complained about a private company

being paid ?10 for every GP referral they stopped.

This is rationing by the back door and has

the potential to compromise patient safety.

The same private company overseas referrals in North Tyneside.

We have spoken to doctors who say the system is putting patients

The GPs, who fear speaking out, have told us that cancer

In a statement, North Tyneside CCG said

there was no evidence that the system caused

They said cancer referrals do not go through the

system and are made directly to hospital.

The number of referrals knocked back to GPs in England

You can see the details of our research online.

Shortage and regional difference have always been

Today, the differences could get much worse.

The NHS is under an unprecedented level of pressure at the moment.

If it does not get more funding, waiting times are

going to get longer and the quality of patient care is going to suffer.

So, we will see different decisions getting taken in different parts of

the country and different services being available to patients.

So, is the NHS still a national service?

One of our most prominent medics is clear.

No, it is not a national service. It is now a local health service.

I think it matters because leads to inequality in health care.

So, some people will get health care free and others will not.

In a statement, the Department of Health told us...

Far from rationing, more people than ever are getting treatment.

3,261 more cancer patients are being seen every day.

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

The people actually paying for NHS services,

the clinical commissioners, did agree to speak to us.

variations, based on the need of the population.

Demographically, the population varies quite significantly,

from town to rural and county to county.

It is really important that we commission and respond to the

needs of that population on a local basis.

It is all about making sure that pathway is correct.

We do not want to squander any money.

We have limited resources so it is really

important we spend most effectively and get the best value for

For those forced into taking their own action, rationing

Now, the decision of what the NHS can

Parts of Nottinghamshire are likely to become the first in the East

Midlands to stop funding so-called test-tube babies.

Health bosses say IVF is low priority and insist

But as Rob Sissons has been finding out,

that is not how couples who have benefited from one of the miracles

There is never a dull moment in this family.

She is the child that Kelly and Tim thought they would never have.

Most parents think their children are priceless, of course,

but if you wanted to put a price on Imogen, you could.

Kelly is infertile and they had to pay for IVF fertility

treatment because of where they live.

When you are a young couple, you do not have the sort of money.

They had to remortgage and now face going into even more debt.

If it could've happened naturally, we would

definitely have had two or three children.

So, we bit the bullet and decided to go for it again.

We will be following the couple through the latest round of IVF.

A few miles away in Nottingham, parents it's been a very

different story for a different pair of parents.

Their son Matthew did not cost them a penny.

And we were extremely happy that it worked first time.

I think it is strange that there is a lack

We have been looking on this website this morning and

there are some areas where you have three cycles, but in the East

The couple know they are lucky, but are

worried that others may feel cheated by the so-called postcode lottery.

It gets to a stage, with the subset of people who cannot conceive

naturally, that only the really rich will be able to have children.

If somebody can have three goes and someone else has no goas,

If everybody had one go, that would be more sensible.

It is clear that whether you get NHS funding or not very much depends on

If Tim and Kelly had moved from Staffordshire

to the neighbouring county of Derbyshire, their

first IVF baby would have been paid for.

It is something which baffles couples.

It also some irritates fertility experts.

One of them is Simon, a doctor at Care in Nottingham.

who worked alongside the team which created the first IVF baby,

Since then, more than 250,000 IVF babies have been born in

We have an understanding of the medical condition that we did not

Live birth rates here have increased enormously, really, when

In 1991, it was about 14% live birth rate.

Today, the national average is double that.

So, techniques are moving forward, but

the doctor fears funding is going backwards.

Controversially, health bosses in parts of Notts are now proposing

proposing to scrap IVF treatment on the NHS.

We think there should be one of two treatment cycles for everybody.

I think it matters because there are knock-on effects

up and down the country for decisions which are made.

Once it affects patients, I think it is a real worry.

Her IVF journey starts in the kitchen.

The hormone injections are designed to stimulate production of

They are back at Care Fertility in Nottingham.

It is just the unknown. You do not know the answer. You do not know

what is going to happen. You have started these stimulation drugs. How

is that going? We know about nor this time about how it is going. It

can be some side effects. An ultrasound scans suggest the

injections are working. This is one of the follicles. So far, so good.

The treatment costs about ?3000 for every cycle. Health bosses in this

part of the world are trying to save ?20 million. Scrapping IVF funding

could save ?300,000 a year. We have to think about how we use of rate

poems we are budgeted. You could be denying people the chance who have

the chance of conceiving only IVF through. That is what makes things

more difficult. The couple have returned to the fertility clinic.

The other removing eggs. The wiggle. One more follicle and we are done.

You have done really well. We have got six eggs. I am over the moon.

Everything is going really well. At the end of the day, it is not about

numbers, but about quality. I have had patients with 20 eggs who have

not had a baby and other patients who have had just won and they have

had their baby. Next, the moment of fertilisation. If the eggs meet

200,000 of his spear. 24-hour Slater, the report for good quality

eggs. One is implanted than the other three are frozen. She will

know if she is pregnant in a few weeks.

The proposals to cut funding IVF for will affect couples around the

region. A few weeks into the consultation, water is getting round

and not everyone thinks it is a bad idea. I do not think we should be

funding it at the moment. We have got such financial difficulties. We

could not of children had to adopt. If you want to have IVF, I do not

think why we should have to pay for it. I think they should fund it. I

do not think it is very good. Health bosses say they want to hear what

everyone has two C before making a final decision. -- to see. The

anxious wait is over, but it is bad news. Unfortunately, we did not get

to the point where we had to take a pregnancy test. It did not work this

time. But with the frozen embryos, they still have a chance. We will

keep trying. We have got three more. We will keep going for it. They are

going to have a break before they have another go at IVF.

That decision is expected next month. That is all from us this

week. On the next Inside Out East

Midlands, the Derbyshire couple who claim the adoption of their two

children was an appalling You just stop living,

because you are ripped apart. Inside Out East Midlands at 7:30pm

on Monday on BBC One. Hello, I'm Louisa Preston

with your 90 second update. 30 British tourists shot

dead in Tunisia in 2015.