:00:00. > :00:00.Welcome to a new series of Inside Out.
:00:00. > :00:00.We've got a special programme tonight -
:00:00. > :00:00.a check up on the health of our health service...
:00:07. > :00:09.And I'm here in Cannock Chase - a place with a little known
:00:10. > :00:16.But first, our cameras catch patients illegally
:00:17. > :00:32.Mike, do you want to, why are you, why are you doing that, Mike?
:00:33. > :00:35.Is rationing of services becoming a reality as hospitals struggle
:00:36. > :00:44.Some people will get health care for free and others won't.
:00:45. > :00:47.And we look back on 70 years of the NHS and the nurses who faced
:00:48. > :00:57.He went, "You are black, I don't want a black nurse touching me."
:00:58. > :00:59.I'm Ayo Akinwolere with more surprising stories from right
:01:00. > :01:17.Our hospitals are facing one of their busiest winters.
:01:18. > :01:21.And with wards full to the brim, money ever tighter and budgets under
:01:22. > :01:23.enormous strain, the last thing the NHS needs is to be
:01:24. > :01:27.But that's effectively what's been happening -
:01:28. > :01:33.patients have been SELLING drugs prescribed by their doctors.
:01:34. > :01:38.Jonathan Gibson has been investigating.
:01:39. > :01:44.Pressure on the NHS is increasing. GPs are at breaking point.
:01:45. > :01:55.And funding the health service doesn't come cheap.
:01:56. > :01:58.Take prescriptions - in 2015 they cost the NHS in England
:01:59. > :02:08.And many of those are repeat prescriptions for patients
:02:09. > :02:09.with long-term conditions like Ram Raman from Walsall.
:02:10. > :02:12.I've just called you in for your medicines review.
:02:13. > :02:15.Just looking at a couple of items you've had on your repeat list.
:02:16. > :02:19.I don't use them, you can take them off.
:02:20. > :02:22.By stopping prescriptions that are no longer needed responsible
:02:23. > :02:27.patients like Ram are saving the NHS in Walsall money.
:02:28. > :02:31.Actually you have saved the NHS around ?100 over the year.
:02:32. > :02:37.The NHS is under great pressure but if you don't
:02:38. > :02:40.need an item it really is your ownership to protect the NHS
:02:41. > :02:43.and to ensure that actually if I don't need it,
:02:44. > :02:49.But a system which relies on honesty is also open to abuse and that's
:02:50. > :02:54.what I'm worried is happening in other parts of the Midlands.
:02:55. > :02:57.We're all familiar with auction websites like ebay -
:02:58. > :03:00.it seems you can virtually buy and sell anything these days and I'm
:03:01. > :03:06.worried that's exactly what some people are doing.
:03:07. > :03:14.Oh, venlafaxine is a prescription only drug for treating depression.
:03:15. > :03:18.Well, this guy who's selling venlafaxine says
:03:19. > :03:23.She doesn't need it so they've decided to sell it on.
:03:24. > :03:28.Are people allowed to do that? Absolutely not.
:03:29. > :03:33.But it's not just drugs to treat depression or your teeth.
:03:34. > :03:35.I've just spotted another called caverject.
:03:36. > :03:40.It's a drug for treating erectile dysfunction.
:03:41. > :03:44.Oh, yeah. It's definitely prescription only.
:03:45. > :03:52.So why has this guy got eight for sale on ebay? Really?
:03:53. > :03:57.I've ordered a couple through the post to find out
:03:58. > :04:00.as well as some other prescription only medicines being
:04:01. > :04:04.It comes in the form of this injection kit so you need
:04:05. > :04:11.I asked him for proof that these products were genuine and he's
:04:12. > :04:18.It looks like his doctor is prescribing these to him
:04:19. > :04:23.on the NHS and he's just selling them on.
:04:24. > :04:30.The guy selling his NHS prescriptions to treat impotence
:04:31. > :04:33.lives in Nottinghamshire and its Friday so I've come up
:04:34. > :04:34.with the perfect reason for calling around.
:04:35. > :04:39.And it's worked, so, secret camera running,
:04:40. > :04:52.I'm hardly through the door and he's straight down to business.
:04:53. > :05:00.That won't be a problem - he's got 24 in stock.
:05:01. > :05:08.the prescriptions so you can sell them on?
:05:09. > :05:18.Yeah, I take it you don't pay for your prescriptions then?
:05:19. > :05:23.So the NHS looks after him and he looks after himself.
:05:24. > :05:24.So have you got many regular customers?
:05:25. > :05:26.Yeah, well three or four, haven't we?
:05:27. > :05:33.Guess it's a bit of an extra income isn't it?
:05:34. > :05:37.I get four a month because they don't allow
:05:38. > :05:39.you to have any more than four a month.
:05:40. > :05:42.That's 48 boxes a year costing the NHS about ?500.
:05:43. > :05:52.Here we go, four packets each containing an injection,
:05:53. > :06:03.He gets the money and you and I pick up the bill!
:06:04. > :06:05.But ?500 is small change compared to the cost
:06:06. > :06:09.of another NHS prescription I'm being offered for sale.
:06:10. > :06:13.I'm on my way to meet a man whose prescription drug costs the NHS
:06:14. > :06:17.It's a cold Thursday night and he's asked to meet me
:06:18. > :06:25.in a service station car park on the M6 near Coventry.
:06:26. > :06:45.He's here all right but he's on the other side of the motorway.
:06:46. > :06:47.My cameraman's watching my back as I head across
:06:48. > :07:00.Shall we have a quick chat in the car?
:07:01. > :07:03.I thought he'd go straight for the cash but he's
:07:04. > :07:08.Who's going to be using this and is he aware or is she aware
:07:09. > :07:11.of how this medicine works and what it actually does?
:07:12. > :07:22.But it doesn't take him long to get down to business.
:07:23. > :07:28.is used to treat arthritis and can only be prescribed by
:07:29. > :07:34.He gets prescribed a box every four weeks.
:07:35. > :07:37.I'm accumulating a box every three months.
:07:38. > :07:40.Being honest with you, I've only put it up on ebay because the person
:07:41. > :07:42.that was normally collecting from London, three,
:07:43. > :07:50.He's also breaking ebay's rules by listing it.
:07:51. > :07:53.I was thinking if someone's going to get me done for this cos
:07:54. > :07:56.I shouldn't really post an ad like this
:07:57. > :08:05.And if I want more,that's no problem.
:08:06. > :08:07.After all, the NHS gives him almost ?10,000 worth
:08:08. > :08:14.OK, well, target number two, drug number two and -
:08:15. > :08:28.Really shocking?really, really, shocking.
:08:29. > :08:30.Community pharmacist Jyoti says what they're doing
:08:31. > :08:33.These are prescription only medicines that have been
:08:34. > :08:35.prescribed for an individual for their individual condition.
:08:36. > :08:40.But then to sell them on for a financial gain
:08:41. > :08:45.for themselves is defrauding the NHS its defrauding everybody
:08:46. > :08:53.and it's actually an illegal thing to do.
:08:54. > :08:57.It could also lead to a prison sentence.
:08:58. > :09:00.These are just a few of the prescriptions
:09:01. > :09:05.Everything from prescription toothpaste to anti-depressants
:09:06. > :09:07.and those high-end expensive injectable drugs prescribed in good
:09:08. > :09:14.faith by the NHS to patients who are illegally selling them on.
:09:15. > :09:16.Patients like the man selling his NHS impotence injections.
:09:17. > :09:20.Instead I got an email from his wife.
:09:21. > :09:23.Yes, she said, we know what we are doing is wrong but we're
:09:24. > :09:27.not making a lot of money out of it - barely enough, she says,
:09:28. > :09:36.Do you ever get the feeling someone's missing the point?
:09:37. > :09:43.I've told him I want to buy more of his drugs but this time I'm not
:09:44. > :09:48.Mike, I'm not really called Steve, I'm a reporter for the BBC and I'm
:09:49. > :09:51.trying to find out why you're selling NHS prescriptions
:09:52. > :09:58.Mike, do you want to, why are you, why are you doing that, Mike?
:09:59. > :10:10.But moments later, he gives me a call.
:10:11. > :10:19.I just want to apologise because I know what I've done was wrong.
:10:20. > :10:21.So you won't be selling NHS prescriptions anymore?
:10:22. > :10:33.Well, you heard what he said, whether or not that's
:10:34. > :10:37.true, I don't know - there's no way of telling.
:10:38. > :10:40.We may have closed the door on one fraudster's activities but it's
:10:41. > :10:42.clear he's not the only patient willing to sell his
:10:43. > :10:53.Ebay told us its sellers must comply with the law and its'
:10:54. > :10:55.sellers are prohibited from listing prescription drugs.
:10:56. > :10:58.It says it works with the medicines and health care products regulatory
:10:59. > :11:00.agency to remove any such items from sale as soon as
:11:01. > :11:11.But first we're looking at pressure to ration some treatments
:11:12. > :11:13.and asking: Is the NHS still a National Service?
:11:14. > :11:16.Does where you live now matter more than ever when it comes
:11:17. > :11:20.Chris Jackson has been trying to find out.
:11:21. > :11:26.The NHS is facing the most significant financial challenge in
:11:27. > :11:33.its history. There are fears the service we have grown up with his
:11:34. > :11:39.National Service. Absolutely, there National Service. Absolutely, there
:11:40. > :11:49.is a post code lottery. Yellow at its criminal, absolutely criminal.
:11:50. > :11:53.This is going to get worse. Is the NHS in danger of ceasing to be a
:11:54. > :11:56.National Service, where everyone is entitled to the same care? It is
:11:57. > :12:02.treating all patients but is it becoming a post code lottery Web
:12:03. > :12:13.access can depend on where you live. We're going to put that to the test.
:12:14. > :12:19.On a bad day, it ruins your life. Muscle pain because my bones are
:12:20. > :12:24.screaming at me at times. Ben Franklin has hepatitis C, a virus
:12:25. > :12:32.which can cause liver damage. I'm about to lose my job. I could
:12:33. > :12:38.possibly lose the flat. There are new drugs which could potentially
:12:39. > :12:41.cure then's hepatitis but they are expensive and rationed. Then has
:12:42. > :12:45.been denied them. All I got was been denied them. All I got was
:12:46. > :12:47.white, basically because my liver wasn't bad enough. And that made me
:12:48. > :12:52.want to go out and just get want to go out and just get
:12:53. > :12:55.absolutely wasted and ruin my lover, just so they would treat me. I
:12:56. > :13:02.wouldn't do that but I wouldn't be surprised if anyone else wouldn't.
:13:03. > :13:07.is claimed that there are no clues is claimed that there are no clues
:13:08. > :13:13.in parts of the North and long waits in places like London. Two people
:13:14. > :13:16.with exactly the same stage of liver damage could present in different
:13:17. > :13:20.parts of the country and in one they can walk in and get hepatitis C
:13:21. > :13:25.and in another part of the country, and in another part of the country,
:13:26. > :13:29.they may go there and be told, I'm sorry, you're going to have to wait.
:13:30. > :13:34.This is inherently unfair. NHS England told us it was regularly
:13:35. > :13:37.reallocating unused hepatitis C treatment to places with waiting
:13:38. > :13:47.lists. The number of patients treated with increased by 25% next
:13:48. > :13:56.year. It is the fact it is down to money that upsets me the most. Just
:13:57. > :14:02.money. So, Ben is taking the risk of treating himself with cheaper copies
:14:03. > :14:14.of the drugs. How much did you spend on the box? ?1300. I am tired of
:14:15. > :14:17.being tired, basically. Ben is hoping the generic drugs will cure
:14:18. > :14:22.him within a matter of weeks and he is not alone. The hepatitis C trust
:14:23. > :14:31.estimates around 1000 people in Britain may have bought the drugs
:14:32. > :14:35.abroad. If you go outside, there are halos around the light, light and
:14:36. > :14:41.shadows, it is often hard to see things, they are distorted. Gloria
:14:42. > :14:50.MacShane has cataracts in both eyes. I cannot take stayers because any
:14:51. > :14:52.kind of confidence... Cataracts are supposed to be treated within 4.5
:14:53. > :14:55.months of referral. Gloria, who months of referral. Gloria, who
:14:56. > :14:59.lives in the north-east, says she has been waiting seven. It is too
:15:00. > :15:07.long because there is a potential accidents. There is such a change in
:15:08. > :15:11.a person's moved. If Gloria had lived in Luton, await greater have
:15:12. > :15:17.lottery? Absolutely, there is a post lottery? Absolutely, there is a post
:15:18. > :15:25.code lottery. It is not about clinical need, it is about some
:15:26. > :15:33.places in England having pressures and de-prioritising cataracts
:15:34. > :15:40.surgery. That does not field too National to me. It makes me angry
:15:41. > :15:44.because it is almost like survival of the fittest. Clinical
:15:45. > :15:48.Commissioning Groups or CCGs control health budgets. It is claimed
:15:49. > :15:49.Hadley treatments like cataract Hadley treatments like cataract
:15:50. > :15:58.surgery by slimming down referrals. Others require patients to lose
:15:59. > :16:01.weight before getting operations like hip replacements. Is bringing
:16:02. > :16:05.an operation in these circumstances can save money in the short term.
:16:06. > :16:09.Whilst these CCGs say it can be clinically justified, the Royal
:16:10. > :16:13.College of Surgeons says it cannot. There is very good evidence that
:16:14. > :16:18.people are now not getting elective operations which they desperately
:16:19. > :16:23.sometimes require, simply because of financial restriction. It is up to
:16:24. > :16:29.the clinicians to decide who should have what treatments and therefore a
:16:30. > :16:35.bureaucratic system which produces a blanket ban, we think, is morally
:16:36. > :16:37.wrong. It is faintly systems system is forgetting appointments with
:16:38. > :16:44.specialists are another form of rationing. Why are they treating
:16:45. > :16:48.their patients with certain content? Last month, MPs complained about a
:16:49. > :16:52.private company they paid ?10 for every GP referral they stopped. This
:16:53. > :16:57.is rationing by the back door and has the potential to compromise
:16:58. > :17:01.patient safety. The same private company overseas referrals in North
:17:02. > :17:07.Tyneside. We have spoken to doctors who say the system is putting
:17:08. > :17:12.patients at risk. The GPs who heard speaking out how to does that cancer
:17:13. > :17:16.diagnoses are being held up. I can't get a patient referred to a
:17:17. > :17:20.dermatologist, the referral management service said it was a
:17:21. > :17:26.skin lesion and rejected. That was a disaster. It was a nasty, invasive
:17:27. > :17:30.cancer. The system is dangerous. They are putting up barriers. They
:17:31. > :17:36.are using delaying tactics. It is getting between the Doctor and the
:17:37. > :17:39.specialist. In a statement, North Tyneside CCGs said there was no
:17:40. > :17:44.evidence the system caused additional risk or delay. Cancer
:17:45. > :17:49.referrals to not go directly through the system and go directly to
:17:50. > :17:52.hospital. The number of vessels not backed to GPs in England had risen
:17:53. > :17:56.30% in the last two years. You can 30% in the last two years. You can
:17:57. > :18:02.see the details of our research online. Regional differences.
:18:03. > :18:08.Circling-mac always been part of the NHS, as has shortages, but today the
:18:09. > :18:12.is under unprecedented pressure. If is under unprecedented pressure. If
:18:13. > :18:16.it does not get more funding, waiting times will increase the
:18:17. > :18:20.quality of patient care will suffer. We will see different decision taken
:18:21. > :18:26.in different parts of the country and different services being
:18:27. > :18:31.available. Is the NHS still a National Service? One of our most
:18:32. > :18:36.prominent medics is clear. No, it is not a National Service. It is a
:18:37. > :18:40.local health service. It leads to inequality in health care, that the
:18:41. > :18:43.problem. Some people will get health care for free and others won't. In a
:18:44. > :18:54.statement, the Department of Health told us...
:18:55. > :19:00.Standards of care are improving. We asked the Health Secretary and NHS
:19:01. > :19:06.England for an interview. Both declined. People actually paying for
:19:07. > :19:13.NHS services, clinical commissioners, did agree to speak.
:19:14. > :19:16.It is a National Service, with local based on need. Demographically,
:19:17. > :19:20.populations vary significantly from town to removal from county to
:19:21. > :19:24.county, it's really important that we commission and respond to the
:19:25. > :19:28.needs of that population from a local basis. It is about making sure
:19:29. > :19:32.the path is correct. We don't want to squander any money. We have
:19:33. > :19:35.limited resources so it is really important we spend most effectively
:19:36. > :19:41.and get the best value for our population. Those forced to take
:19:42. > :19:53.their own action, rationing appears all too real.
:19:54. > :19:57.All of these films are available on iPlayer.
:19:58. > :19:59.Keep up to date on Twitter - @bbciowm.
:20:00. > :20:01.And it's ayo@bbc.co.uk if you'd like to get in touch,
:20:02. > :20:09.Now, the NHS has been with us for 70 years.
:20:10. > :20:12.It was the brainchild of Nye Bevan, seen here with Jennie Lee
:20:13. > :20:30.She went on to become a much-loved MP for Cannock.
:20:31. > :20:32.And here is the very desk Nye Bevan worked at.
:20:33. > :20:36.In fact, you could say THIS is actually where the NHS was born.
:20:37. > :20:39.Trish Adudu's looks now at the part it plays in all our lives.
:20:40. > :20:41.The National Health Service has been around for nearly seven decades.
:20:42. > :20:44.It's seen us through fourteen Prime Ministers.
:20:45. > :20:52.And most recently, one monumental vote.
:20:53. > :20:56.The British people are spoken, the answer is, we are out.
:20:57. > :20:58.When it comes to the nation's politics and finances,
:20:59. > :21:01.the power of those three little letters has been unrivalled.
:21:02. > :21:06.But despite all the political analysis, the constant
:21:07. > :21:08.scrutiny and daily debate, it seems there's a massive gap
:21:09. > :21:13.There's very little done now about what the NHS
:21:14. > :21:15.means to us culturally, the most meaningful
:21:16. > :21:20.experiences in our lives, they happen in the NHS.
:21:21. > :21:24.We're born in the NHS, we have serious, life-threatening
:21:25. > :21:27.illnesses in the NHS, the NHS takes care of us day-to-day
:21:28. > :21:38.And that's what Professor Bivins and her team of historians want to mend.
:21:39. > :21:40.They've started a massive research project, incredibly,
:21:41. > :21:43.the first of its kind, to find out what impact the NHS has
:21:44. > :21:58.When you talk about culture and the NHS, what do you mean?
:21:59. > :22:03.The NHS has a culture of its own practices had an impact on broader
:22:04. > :22:08.culture. You might think of the Carry On films, they do not mention
:22:09. > :22:13.the NHS but they are all done with that public- private split in mind.
:22:14. > :22:14.In other words, the culture of having an NHS has gone into the
:22:15. > :22:16.wider culture. There's a post office museum,
:22:17. > :22:18.there are several museums for the railways but there's no NHS
:22:19. > :22:21.museum, so one of the things we're trying to do is to curate at least
:22:22. > :22:25.a virtual museum of the NHS. Its sounds obvious when Roberta
:22:26. > :22:27.explains it but when you think of the NHS, culture is hardly
:22:28. > :22:30.the first thing that comes to mind. But we are very proud of it,
:22:31. > :22:33.director Danny Boyle paid homage to the NHS in the opening ceremony
:22:34. > :22:52.of the London Olympics as a shining It is central to people's lathes, in
:22:53. > :22:57.terms of health care. On a national basis, it is something that connects
:22:58. > :23:04.Britain. It is such a massive employer and what is a huge part of
:23:05. > :23:06.people's lives. It is now the fifth largest in the world.
:23:07. > :23:09.Hearing people's first-hand experiences of the NHS is vital
:23:10. > :23:12.to Jack and Roberta's research into its cultural history.
:23:13. > :23:18.And that history touches not just this country but much of the world.
:23:19. > :23:20.I'm about to meet a nurse, originally from Jamaica,
:23:21. > :23:29.who made it her personal mission to work for the NHS.
:23:30. > :23:33.I heard Celia is a bit of a special lady who has had an amazing
:23:34. > :23:49.Hello, Celia! Tell us about the reception he got when you arrived
:23:50. > :23:55.here? I remember a gentleman in mental health, because that was my
:23:56. > :23:57.first training. When I introduced myself, he went, they are black, I
:23:58. > :24:02.don't want a black person touching don't want a black person touching
:24:03. > :24:05.me. I looked at my hands and said, who knows? When I am finished with
:24:06. > :24:12.you, you might also have some blackness on you. After I said it, I
:24:13. > :24:17.thought wow, that's the wrong thing to have said. But I did it. And then
:24:18. > :24:22.understand me? And he said, I do but understand me? And he said, I do but
:24:23. > :24:27.I don't want you to care for me. I said, that's fine. The ward sister
:24:28. > :24:32.came down and I remember her saying, they only have black nurses here, so
:24:33. > :24:39.you will even let them care for you or you won't get well. And he said,
:24:40. > :24:47.all right, I will have her. Has the NHS helped overcome those racial
:24:48. > :24:53.prejudices? It didn't do it. Now, the NHS is into equality and
:24:54. > :24:57.diversity and challenges out there. But you will find that earlier, many
:24:58. > :24:58.of us took steps to make sure we started that challenge.
:24:59. > :25:02.So, for Celia and many others like her, working for the NHS wasn't
:25:03. > :25:05.just a job caring for the sick but a platform to bridge social gaps
:25:06. > :25:14.Sickness is common to all nations but fortunately, so the nursing
:25:15. > :25:15.instinct. In the 60s, the NHS
:25:16. > :25:19.was on a recruitment drive mostly Trips to hospitals, dentists and GPs
:25:20. > :25:24.often brought white people's first experiences with black
:25:25. > :25:28.and Asian people. And from initial division
:25:29. > :25:45.came the first signs In the 1970s, when the National
:25:46. > :25:51.Front is growing and you have this sort of vividly expressed street
:25:52. > :26:00.racism, you have other incidents in NHS hospitals, there is an incident
:26:01. > :26:04.in Middlesex where the Ministry of health was trying to deport foreign
:26:05. > :26:06.nurses and the entire hospital staff occupied the administration block,
:26:07. > :26:08.arranging a sit in. With the racial and social landscape
:26:09. > :26:10.changing, Birmingham in particular was fast becoming
:26:11. > :26:22.an ethnically diverse hub. In many ways, burning is more
:26:23. > :26:26.representative of what it was like across the UK. Birmingham is one of
:26:27. > :26:30.the first cities to have a liaison officer from the migrant community
:26:31. > :26:36.to help bring new migrants to Birmingham. It is part of the NHS
:26:37. > :26:37.story. My next stop is Malcolm Tomlinson,
:26:38. > :26:40.a man with four decades of experience working for the NHS
:26:41. > :26:43.in Birmingham with the West And he still loves it,
:26:44. > :26:51.as I'm about to find out. I was expecting him to ask me
:26:52. > :27:16.to meet him at home with a cuppa Today, you have come to look at the
:27:17. > :27:20.Ambulance Service society's base. We are all ex-ambulance staff and we
:27:21. > :27:24.restore and maintain these vehicles as a hobby.
:27:25. > :27:27.With more than 30 ambulances on site, could this form the core
:27:28. > :27:36.The shame is that no one can see them locked away in garages. We
:27:37. > :27:41.been trying for a number of years to been trying for a number of years to
:27:42. > :27:50.get funding, to open a proper heritage centre. The only are
:27:51. > :27:55.treated like a load of old men from last of the summer Wine and people
:27:56. > :28:00.don't want to know. Would you like to see a museum in the West
:28:01. > :28:02.Midlands? I certainly won't. Can I have a go with the ambulance? If you
:28:03. > :28:09.can move it, you can have a go. After a quick lesson in one
:28:10. > :28:12.of the ambulances Malcolm And if you'd like to get
:28:13. > :28:21.involved with the history project we mentioned,
:28:22. > :28:23.just go to peopleshistorynhs.org. I'll be back next week,
:28:24. > :28:33.maybe from somewhere close to you. Next week - legendary radio
:28:34. > :28:40.broadcaster Ed Doolan opens up about his battles with dementia
:28:41. > :28:42.and his determination to stay That's here on Inside Out
:28:43. > :29:08.next Monday evening. Hello, I'm Louisa Preston
:29:09. > :29:11.with your 90 second update. 30 British tourists shot
:29:12. > :29:13.dead in Tunisia in 2015. Today, an inquest was told
:29:14. > :29:16.that security forces Donald Trump provokes
:29:17. > :29:21.a mixed reaction. Downing Street welcomes the promise
:29:22. > :29:24.of a "quick and fair" trade deal. But foreign ministers
:29:25. > :29:27.are concerned by his comments