16/01/2017 Inside Out West Midlands

Welcome to a new series of Inside Out.

We've got a special programme tonight -

a check up on the health of our health service...

And I'm here in Cannock Chase - a place with a little known

But first, our cameras catch patients illegally

Mike, do you want to, why are you, why are you doing that, Mike?

Is rationing of services becoming a reality as hospitals struggle

Some people will get health care for free and others won't.

And we look back on 70 years of the NHS and the nurses who faced

He went, "You are black, I don't want a black nurse touching me."

I'm Ayo Akinwolere with more surprising stories from right

Our hospitals are facing one of their busiest winters.

And with wards full to the brim, money ever tighter and budgets under

enormous strain, the last thing the NHS needs is to be

But that's effectively what's been happening -

patients have been SELLING drugs prescribed by their doctors.

Jonathan Gibson has been investigating.

Pressure on the NHS is increasing. GPs are at breaking point.

And funding the health service doesn't come cheap.

Take prescriptions - in 2015 they cost the NHS in England

And many of those are repeat prescriptions for patients

with long-term conditions like Ram Raman from Walsall.

I've just called you in for your medicines review.

Just looking at a couple of items you've had on your repeat list.

I don't use them, you can take them off.

By stopping prescriptions that are no longer needed responsible

patients like Ram are saving the NHS in Walsall money.

Actually you have saved the NHS around ?100 over the year.

The NHS is under great pressure but if you don't

need an item it really is your ownership to protect the NHS

and to ensure that actually if I don't need it,

But a system which relies on honesty is also open to abuse and that's

what I'm worried is happening in other parts of the Midlands.

We're all familiar with auction websites like ebay -

it seems you can virtually buy and sell anything these days and I'm

worried that's exactly what some people are doing.

Oh, venlafaxine is a prescription only drug for treating depression.

Well, this guy who's selling venlafaxine says

She doesn't need it so they've decided to sell it on.

Are people allowed to do that? Absolutely not.

But it's not just drugs to treat depression or your teeth.

I've just spotted another called caverject.

It's a drug for treating erectile dysfunction.

Oh, yeah. It's definitely prescription only.

So why has this guy got eight for sale on ebay? Really?

I've ordered a couple through the post to find out

as well as some other prescription only medicines being

It comes in the form of this injection kit so you need

I asked him for proof that these products were genuine and he's

It looks like his doctor is prescribing these to him

on the NHS and he's just selling them on.

The guy selling his NHS prescriptions to treat impotence

lives in Nottinghamshire and its Friday so I've come up

with the perfect reason for calling around.

And it's worked, so, secret camera running,

I'm hardly through the door and he's straight down to business.

That won't be a problem - he's got 24 in stock.

the prescriptions so you can sell them on?

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

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

So have you got many regular customers?

Yeah, well three or four, haven't we?

Guess it's a bit of an extra income isn't it?

I get four a month because they don't allow

you to have any more than four a month.

That's 48 boxes a year costing the NHS about ?500.

Here we go, four packets each containing an injection,

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'm being offered for sale.

I'm on my way to meet a man whose prescription drug costs the NHS

It's a cold Thursday night and he's asked to meet me

in a service station car park on the M6 near Coventry.

He's here all right but he's on the other side of the motorway.

My cameraman's watching my back as I head across

Shall we have a quick chat in the car?

I thought he'd go straight for the cash but he's

Who's going to be using this and is he aware or is she aware

of how this medicine works and what it actually does?

But it doesn't take him long to get down to business.

is used to treat arthritis and can only be prescribed by

He gets prescribed a box every four weeks.

I'm accumulating a box every three months.

Being honest with you, I've only put it up on ebay because the person

that was normally collecting from London, three,

He's also breaking ebay's rules by listing it.

I was thinking if someone's going to get me done for this cos

I shouldn't really post an ad like this

And if I want more,that's no problem.

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

OK, well, target number two, drug number two and -

Really shocking?really, really, shocking.

Community pharmacist Jyoti says what they're doing

These are prescription only medicines that have been

prescribed for an individual for their individual condition.

But then to sell them on for a financial gain

for themselves is defrauding the NHS its defrauding everybody

and it's actually an illegal thing to do.

It could also lead to a prison sentence.

These are just a few of the prescriptions

Everything from prescription toothpaste to anti-depressants

and those high-end expensive injectable drugs prescribed in good

faith by the NHS to patients who are illegally selling them on.

Patients like the man selling his NHS impotence injections.

Instead I got an email from his wife.

Yes, she said, we know what we are doing is wrong but we're

not making a lot of money out of it - barely enough, she says,

Do you ever get the feeling someone's missing the point?

I've told him I want to buy more of his drugs but this time I'm not

Mike, I'm not really called Steve, I'm a reporter for the BBC and I'm

trying to find out why you're selling NHS prescriptions

Mike, do you want to, why are you, why are you doing that, Mike?

But moments later, he gives me a call.

I just want to apologise because I know what I've done was wrong.

So you won't be selling NHS prescriptions anymore?

Well, you heard what he said, whether or not that's

true, I don't know - there's no way of telling.

We may have closed the door on one fraudster's activities but it's

clear he's not the only patient willing to sell his

Ebay told us its sellers must comply with the law and its'

sellers are prohibited from listing prescription drugs.

It says it works with the medicines and health care products regulatory

agency to remove any such items from sale as soon as

But first we're looking at pressure to ration some treatments

and asking: Is the NHS still a National Service?

Does where you live now matter more than ever when it comes

Chris Jackson has been trying to find out.

The NHS is facing the most significant financial challenge in

its history. There are fears the service we have grown up with his

National Service. Absolutely, there National Service. Absolutely, there

is a post code lottery. Yellow at its criminal, absolutely criminal.

This is going to get worse. Is the NHS in danger of ceasing to be a

National Service, where everyone is entitled to the same care? It is

treating all patients but is it becoming a post code lottery Web

access can depend on where you live. We're going to put that to the test.

On a bad day, it ruins your life. Muscle pain because my bones are

screaming at me at times. Ben Franklin has hepatitis C, a virus

which can cause liver damage. I'm about to lose my job. I could

possibly lose the flat. There are new drugs which could potentially

cure then's hepatitis but they are expensive and rationed. Then has

been denied them. All I got was been denied them. All I got was

white, basically because my liver wasn't bad enough. And that made me

want to go out and just get want to go out and just get

absolutely wasted and ruin my lover, just so they would treat me. I

wouldn't do that but I wouldn't be surprised if anyone else wouldn't.

is claimed that there are no clues is claimed that there are no clues

in parts of the North and long waits in places like London. Two people

with exactly the same stage of liver damage could present in different

parts of the country and in one they can walk in and get hepatitis C

and in another part of the country, and in another part of the country,

they may go there and be told, I'm sorry, you're going to have to wait.

This is inherently unfair. NHS England told us it was regularly

reallocating unused hepatitis C treatment to places with waiting

lists. The number of patients treated with increased by 25% next

year. It is the fact it is down to money that upsets me the most. Just

money. So, Ben is taking the risk of treating himself with cheaper copies

of the drugs. How much did you spend on the box? ?1300. I am tired of

being tired, basically. Ben is hoping the generic drugs will cure

him within a matter of weeks and he is not alone. The hepatitis C trust

estimates around 1000 people in Britain may have bought the drugs

abroad. If you go outside, there are halos around the light, light and

shadows, it is often hard to see things, they are distorted. Gloria

MacShane has cataracts in both eyes. I cannot take stayers because any

kind of confidence... Cataracts are supposed to be treated within 4.5

months of referral. Gloria, who months of referral. Gloria, who

lives in the north-east, says she has been waiting seven. It is too

long because there is a potential accidents. There is such a change in

a person's moved. If Gloria had lived in Luton, await greater have

lottery? Absolutely, there is a post lottery? Absolutely, there is a post

code lottery. It is not about clinical need, it is about some

places in England having pressures and de-prioritising cataracts

surgery. That does not field too National to me. It makes me angry

because it is almost like survival of the fittest. Clinical

Commissioning Groups or CCGs control health budgets. It is claimed

Hadley treatments like cataract Hadley treatments like cataract

surgery by slimming down referrals. Others require patients to lose

weight before getting operations like hip replacements. Is bringing

an operation in these circumstances can save money in the short term.

Whilst these CCGs say it can be clinically justified, the Royal

College of Surgeons says it cannot. There is very good evidence that

people are now not getting elective operations which they desperately

sometimes require, simply because of financial restriction. It is up to

the clinicians to decide who should have what treatments and therefore a

bureaucratic system which produces a blanket ban, we think, is morally

wrong. It is faintly systems system is forgetting appointments with

specialists are another form of rationing. Why are they treating

their patients with certain content? Last month, MPs complained about a

private company they 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 at risk. The GPs who heard speaking out how to does that cancer

diagnoses are being held up. I can't get a patient referred to a

dermatologist, the referral management service said it was a

skin lesion and rejected. That was a disaster. It was a nasty, invasive

cancer. The system is dangerous. They are putting up barriers. They

are using delaying tactics. It is getting between the Doctor and the

specialist. In a statement, North Tyneside CCGs said there was no

evidence the system caused additional risk or delay. Cancer

referrals to not go directly through the system and go directly to

hospital. The number of vessels not backed to GPs in England had risen

30% in the last two years. You can 30% in the last two years. You can

see the details of our research online. Regional differences.

Circling-mac always been part of the NHS, as has shortages, but today the

is under unprecedented pressure. If is under unprecedented pressure. If

it does not get more funding, waiting times will increase the

quality of patient care will suffer. We will see different decision taken

in different parts of the country and different services being

available. Is the NHS still a National Service? One of our most

prominent medics is clear. No, it is not a National Service. It is a

local health service. It leads to inequality in health care, that the

problem. Some people will get health care for free and others won't. In a

statement, the Department of Health told us...

Standards of care are improving. We asked the Health Secretary and NHS

England for an interview. Both declined. People actually paying for

NHS services, clinical commissioners, did agree to speak.

It is a National Service, with local based on need. Demographically,

populations vary significantly from town to removal from county to

county, it's really important that we commission and respond to the

needs of that population from a local basis. It is about making sure

the path is correct. We don't want to squander any money. We have

limited resources so it is really important we spend most effectively

and get the best value for our population. Those forced to take

their own action, rationing appears all too real.

All of these films are available on iPlayer.

Keep up to date on Twitter - @bbciowm.

And it's [email protected] if you'd like to get in touch,

Now, the NHS has been with us for 70 years.

It was the brainchild of Nye Bevan, seen here with Jennie Lee

She went on to become a much-loved MP for Cannock.

And here is the very desk Nye Bevan worked at.

In fact, you could say THIS is actually where the NHS was born.

Trish Adudu's looks now at the part it plays in all our lives.

The National Health Service has been around for nearly seven decades.

It's seen us through fourteen Prime Ministers.

And most recently, one monumental vote.

The British people are spoken, the answer is, we are out.

When it comes to the nation's politics and finances,

the power of those three little letters has been unrivalled.

But despite all the political analysis, the constant

scrutiny and daily debate, it seems there's a massive gap

There's very little done now about what the NHS

means to us culturally, the most meaningful

experiences in our lives, they happen in the NHS.

We're born in the NHS, we have serious, life-threatening

illnesses in the NHS, the NHS takes care of us day-to-day

And that's what Professor Bivins and her team of historians want to mend.

They've started a massive research project, incredibly,

the first of its kind, to find out what impact the NHS has

When you talk about culture and the NHS, what do you mean?

The NHS has a culture of its own practices had an impact on broader

culture. You might think of the Carry On films, they do not mention

the NHS but they are all done with that public- private split in mind.

In other words, the culture of having an NHS has gone into the

wider culture. There's a post office museum,

there are several museums for the railways but there's no NHS

museum, so one of the things we're trying to do is to curate at least

a virtual museum of the NHS. Its sounds obvious when Roberta

explains it but when you think of the NHS, culture is hardly

the first thing that comes to mind. But we are very proud of it,

director Danny Boyle paid homage to the NHS in the opening ceremony

of the London Olympics as a shining It is central to people's lathes, in

terms of health care. On a national basis, it is something that connects

Britain. It is such a massive employer and what is a huge part of

people's lives. It is now the fifth largest in the world.

Hearing people's first-hand experiences of the NHS is vital

to Jack and Roberta's research into its cultural history.

And that history touches not just this country but much of the world.

I'm about to meet a nurse, originally from Jamaica,

who made it her personal mission to work for the NHS.

I heard Celia is a bit of a special lady who has had an amazing

Hello, Celia! Tell us about the reception he got when you arrived

here? I remember a gentleman in mental health, because that was my

first training. When I introduced myself, he went, they are black, I

don't want a black person touching don't want a black person touching

me. I looked at my hands and said, who knows? When I am finished with

you, you might also have some blackness on you. After I said it, I

thought wow, that's the wrong thing to have said. But I did it. And then

understand me? And he said, I do but understand me? And he said, I do but

I don't want you to care for me. I said, that's fine. The ward sister

came down and I remember her saying, they only have black nurses here, so

you will even let them care for you or you won't get well. And he said,

all right, I will have her. Has the NHS helped overcome those racial

prejudices? It didn't do it. Now, the NHS is into equality and

diversity and challenges out there. But you will find that earlier, many

of us took steps to make sure we started that challenge.

So, for Celia and many others like her, working for the NHS wasn't

just a job caring for the sick but a platform to bridge social gaps

Sickness is common to all nations but fortunately, so the nursing

instinct. In the 60s, the NHS

was on a recruitment drive mostly Trips to hospitals, dentists and GPs

often brought white people's first experiences with black

and Asian people. And from initial division

came the first signs In the 1970s, when the National

Front is growing and you have this sort of vividly expressed street

racism, you have other incidents in NHS hospitals, there is an incident

in Middlesex where the Ministry of health was trying to deport foreign

nurses and the entire hospital staff occupied the administration block,

arranging a sit in. With the racial and social landscape

changing, Birmingham in particular was fast becoming

an ethnically diverse hub. In many ways, burning is more

representative of what it was like across the UK. Birmingham is one of

the first cities to have a liaison officer from the migrant community

to help bring new migrants to Birmingham. It is part of the NHS

story. My next stop is Malcolm Tomlinson,

a man with four decades of experience working for the NHS

in Birmingham with the West And he still loves it,

as I'm about to find out. I was expecting him to ask me

to meet him at home with a cuppa Today, you have come to look at the

Ambulance Service society's base. We are all ex-ambulance staff and we

restore and maintain these vehicles as a hobby.

With more than 30 ambulances on site, could this form the core

The shame is that no one can see them locked away in garages. We

been trying for a number of years to been trying for a number of years to

get funding, to open a proper heritage centre. The only are

treated like a load of old men from last of the summer Wine and people

don't want to know. Would you like to see a museum in the West

Midlands? I certainly won't. Can I have a go with the ambulance? If you

can move it, you can have a go. After a quick lesson in one

of the ambulances Malcolm And if you'd like to get

involved with the history project we mentioned,

just go to peopleshistorynhs.org. I'll be back next week,

maybe from somewhere close to you. Next week - legendary radio

broadcaster Ed Doolan opens up about his battles with dementia

and his determination to stay That's here on Inside Out

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