16/01/2017 Inside Out East Midlands


16/01/2017

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Transcript


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Hello and welcome to Alport Heights in Derbyshire

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

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Medicines and money. Our cameras catch patients

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Do we still have a National Health Service?

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Professor Robert Winston does not think so.

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And is it time to ration fertility treatment?

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What happens when the cost of starting a family

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When somebody can have three goes and someone else none,

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

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First tonight, our hospitals are facing one of their

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busiest winters ever. The wards are full.

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And the budgets are under enormous pressure.

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

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

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

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Jonathan Gibson has been investigating.

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And funding the health service does not come cheap.

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

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Many of those are repeat prescriptions.

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

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

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

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That is what I am worried is happening in some

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We are all familiar with auction websites like eBay.

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

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

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It is a prescription-only drug for treating depression.

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

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

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

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It is a drug for treating erectile dysfunction.

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

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

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as well as some other prescription-only

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This is caverject and it comes in the form of this

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So, you need to know what you are doing.

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

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through this - his repeat prescription.

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It looks like his doctor is prescribing these to him on

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the NHS and he is just selling them on.

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The guy selling his NHS prescription lives in Nottinghamshire and,

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with it being Friday, I have come up with

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the perfect reason for coming calling around.

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I am after something for the weekend.

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

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I am hardly through the door and he is

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Right, but you still get the prescription,

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

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

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

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Each containing an injection, a complete kit.

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

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

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NHS prescription I am being offered for sale.

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

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

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at a service station car park on the motorway.

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

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

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

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

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The drug he is selling is used to treat arthritis.

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It can only be prescribed by a hospital specialist.

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He gets prescribed a box every four weeks.

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

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And if I want more, that is no problem.

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

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OK, target number two and drug number two.

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The community pharmacist says what they are doing is

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These are prescription-only medicines which have been

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prescribed for an individual, for their individual condition.

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

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

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And it is actually an illegal thing to do.

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It could also lead to a prison sentence.

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

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From prescription toothpaste to antidepressants.

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

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Patients like the man selling his NHS impotence injection.

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

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

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

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

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

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

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

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

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

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

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and pocketing the proceeds. Why are you doing that?

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But moments later, he gives me a call.

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So you will not be selling NHS prescriptions any more?

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

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We may have closed the door on one fraudster's

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

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Well, eBay has told us that its sellers must comply

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

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They say they work in liason with the regulatory agency

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

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The pressure on NHS staff and budgets is

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

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Inside Out has discovered that the medical treatment

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

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So, is the NHS still a national health service?

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Chris Jackson has been investigating.

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The NHS is facing the most significant financial challenge

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There are fears that the service we grew up

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Absolutely, there is a postcode lottery.

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It is criminal. It is absolutely criminal.

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

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

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service, where everyone is entitled to the same care?

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It is treating more patients, but is it becoming

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

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We are going to put that to the test.

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It feels like my bones are actually screaming at me.

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33-year-old Ben Franklin has Hepatitis C.

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The virus can cause life-threatening liver damage.

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

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I could also maybe lose the flat over my head.

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There are new drugs that could potentially cure

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

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

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

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I would not do that, but would not be surprised

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

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

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north and long waits in places like London.

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Two people with exactly the same state of liver damage can

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present themselves in different parts of the country.

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

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hepatitis C treatment immediately, get cured.

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

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NHS England said they were regularly reallocating unused hepatitis C

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treatments to places with waiting lists.

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

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

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So, Ben is taking the risk of treating himself,

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with cheaper copies of the new drugs.

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

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

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

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

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

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

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

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

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

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

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as little as 15 days. A postcode lottery?

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Absolutely there is a postcode lottery.

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It is about some places in England having poor

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systems, having budgetary pressures and deprioritising cataract surgery.

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That does not feel too national to me.

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Gloria expects to get her operation later this month.

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

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almost like the survival of the fittest.

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It is claimed some are delaying treatments like cataract surgery

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Others are requiring patients to lose weight

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before getting operations like hip replacements.

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Postponing an operation in these circumstances

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While the CCGs say that can be clinically justified, the

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Royal College of Surgeons says it cannot.

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There's very good evidence that people are now not

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getting elective operations, which they sometimes

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desperately require, simply because of

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

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Therefore, a bureaucratic system which produces a

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blanket ban, we think, is morally wrong.

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It is also claimed that new systems for vetting appointments

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for specialists are another form of rationing.

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Why are they treating their patients with such contempt?

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Last month, MPs complained about a private company

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being paid ?10 for every GP referral they stopped.

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This is rationing by the back door and has

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the potential to compromise patient safety.

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The same private company overseas referrals in North Tyneside.

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

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

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In a statement, North Tyneside CCG said

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there was no evidence that the system caused

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They said cancer referrals do not go through the

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system and are made directly to hospital.

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The number of referrals knocked back to GPs in England

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You can see the details of our research online.

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Shortage and regional difference have always been

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Today, the differences could get much worse.

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

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If it does not get more funding, waiting times are

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

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

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the country and different services being available to patients.

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So, is the NHS still a national service?

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One of our most prominent medics is clear.

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

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

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

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

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

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

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

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The people actually paying for NHS services,

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the clinical commissioners, did agree to speak to us.

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variations, based on the need of the population.

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Demographically, the population varies quite significantly,

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from town to rural and county to county.

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It is really important that we commission and respond to the

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needs of that population on a local basis.

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It is all about making sure that pathway is correct.

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We do not want to squander any money.

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We have limited resources so it is really

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important we spend most effectively and get the best value for

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For those forced into taking their own action, rationing

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Now, the decision of what the NHS can

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

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

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Health bosses say IVF is low priority and insist

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But as Rob Sissons has been finding out,

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

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There is never a dull moment in this family.

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

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Most parents think their children are priceless, of course,

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

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Kelly is infertile and they had to pay for IVF fertility

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treatment because of where they live.

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

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

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If it could've happened naturally, we would

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definitely have had two or three children.

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

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

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

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different story for a different pair of parents.

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Their son Matthew did not cost them a penny.

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And we were extremely happy that it worked first time.

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I think it is strange that there is a lack

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We have been looking on this website this morning and

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

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The couple know they are lucky, but are

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

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

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

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

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

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

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If Tim and Kelly had moved from Staffordshire

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to the neighbouring county of Derbyshire, their

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first IVF baby would have been paid for.

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It is something which baffles couples.

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It also some irritates fertility experts.

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

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

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

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

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Live birth rates here have increased enormously, really, when

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

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Today, the national average is double that.

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So, techniques are moving forward, but

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the doctor fears funding is going backwards.

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Controversially, health bosses in parts of Notts are now proposing

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proposing to scrap IVF treatment on the NHS.

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

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I think it matters because there are knock-on effects

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up and down the country for decisions which are made.

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

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Her IVF journey starts in the kitchen.

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The hormone injections are designed to stimulate production of

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They are back at Care Fertility in Nottingham.

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

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

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

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can be some side effects. An ultrasound scans suggest the

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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know if she is pregnant in a few weeks.

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

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

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

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

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

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

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

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

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

:27:53.:28:00.

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

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

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

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

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

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week. On the next Inside Out East

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

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children was an appalling You just stop living,

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

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

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with your 90 second update. 30 British tourists shot

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dead in Tunisia in 2015.

:29:09.:29:11.

Is the NHS still a national service - or does where you live matter most when it comes to being treated? Inside Out talks to patients and clinicians who say rationing is fracturing the NHS, as local decision-makers struggle to balance the books.


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