16/01/2017 Inside Out West


16/01/2017

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Denied, how were you live can seriously affect your health. The

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

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absolutely criminal. Sorry. In a special programme, we are asking, is

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the NHS really a National Health Service? If I lived in a different

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part of the country I would be entitled to some kind of funding and

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I would not have to sell my house. And surviving blue Monday. How

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having a laugh could save your life. I'm loving it already, I'm loving

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it! Welcome to the new series of Inside Out West.

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We have all seen the headlines, not enough money, too many patients, the

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NHS is under pressure like never before so is rationing health care

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the answer? Chris Jackson has been investigating. The NHS is facing the

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most significant financial challenge in its history.

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There are fears the service we have grown up with is

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Absolutely there is a postcode lottery.

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

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When everyone is entitled to the same care?

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It's treating more patients but is it becoming a postcode

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lottery, where access can depend on where you live?

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It feels like my bones are actually screaming at me at times.

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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've been off sick and could possibly lose the flat over my head.

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There are new drugs that could potentially cure Ben's hepatitis.

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All I got was "Wait", basically, because my liver wasn't bad enough.

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That made me want to go out and just get absolutely wasted

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and ruin my liver just so they would treat me.

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But I wouldn't be surprised if somebody else would.

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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

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of the North and long waits in places like London.

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Two people with exactly the same state of liver damage could present

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themselves in different parts of the country and in one they'll be

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able to walk in and get hepatitis C treatment immediately and get cured.

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In another part of the country they may go there and be told,

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"Sorry, you're going to have to wait."

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NHS England told us it was regularly reallocating unused

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hepatitis C treatment 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's down to money, that upsets me the most.

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So Ben is taking the risk of treating himself with cheaper

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The fact that I've had to pay for my treatment, it's criminal,

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I'm just tired of being tired, basically.

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

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The Hepatitis C Trust estimates around 1000 people in Britain may

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If you go outside there are halos around light.

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It's often hard to see things. They are distorted.

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Gloria MacShane has cataracts in both eyes.

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Go up or down stairs with any kind of confidence.

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Cataracts are supposed to be treated within 4 1/2 months of referral.

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

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Because there's such potential for accidents and there is such

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If Gloria had lived in Luton, her weight could have been

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Absolutely, there is a postcode lottery.

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having poor systems, budget pressures and

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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's almost

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Clinical Commissioning Groups, or CCGs, control health budgets.

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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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Whilst the CCGs say it can be clinically justified

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the Royal College of Surgeons says it can't.

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There is very good evidence people are now not getting

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elective operations, which they desperately

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sometimes require, simply because of financial restrictions.

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It is up to the clinicians to decide who should have what treatments.

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Therefore a bureaucratic system producing a blanket ban

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It is also claimed new systems for vetting appointments

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with 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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and has the potential to compromise safety.

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The same private company oversees referrals in North Tyneside.

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We spoken to doctors who say the system is

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

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I tried to get a patient referred to a dermatologist.

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The referral Management service said it was

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a skin lesion and rejected it. That was a disaster.

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It was a nasty, invasive skin cancer.

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They are putting up barriers, using delaying tactics.

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It is getting between the doctor and the specialist.

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In a statement North Tyneside CCG said there was no evidence

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the system caused additional risk or delay.

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Cancer referrals do not go through the system

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The number of referrals knocked back the GPs in England has risen

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You can see the details of our research online.

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Shortage and regional difference have always been part of the NHS.

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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

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and the quality of patient care is going to suffer.

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We will see different decisions taken in different parts

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of the country and different services being

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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 it leads to inequality in health care,

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Some people will get health care for free and others will not.

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In a statement, of the Department of Health told us that far

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from rationing more people than ever are getting prompt treatment

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3,261 cancer patients are being seen every day and that

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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.

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It is a national service with local variation based

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Demographically populations vary significantly from town to rural,

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It is very important we commission and respond to the needs of that

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It is about making sure the 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 important we spend

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most effectively and get the best value for our population.

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For those forced to take their own action,

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One NHS treatment seriously under the cosh is IVF, and it could get

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worse here in the West. Doctor Dawn half has been to meet one couple was

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remodelled having a family is hanging in the balance -- Doctor

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Dawn Parker. It can be the happiest time of your life but not for

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everyone. I was lucky enough to have my children without difficulty but

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for those who do not conceive so easily, support for the NHS is

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disappearing fast. In some parts of the country, there is no funded IVF

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treatment offered at all. Is the west of England in danger of

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becoming the next IVF blackspot? I've come to Somerset to meet one

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couple trying for their first baby. Jade and her husband, Nathan, have

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been together four years and got married a year ago. When did you

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decide you wanted to start a family? When we first got together there was

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always an understanding that it would have to be soon because I am

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35, and after a year we started trying. And yes, nothing. You have

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been trying for three years now. Four years. And at what point did

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you start thinking it wasn't working? About 18 months ago,

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really. And I guess people around you were getting pregnant and that

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cannot have been easy. Yes, my friends started families in between

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the times that we have tried to start a family. Jade and Nathan went

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to their local NHS for fertility treatment. You have invested a lot

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of time and emotion into this now. Where are you at the moment? At the

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moment we have just started IVF treatment. I have just been on the

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tablets. I am just finished with those tablets. And this is funded by

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the NHS? It is. What will happen if this does not work? We're hoping

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that we have another go, because we have been accepted for two cycles of

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IVF. So we're hoping that we will get another go, after this, but I

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understand that the CCG have changed this, so I don't really know. So

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there is some doubt as to whether they can provide that. Yes. How does

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that feel? Heart-wrenching. Jade's concern comes from the fact that her

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local NHS Clinical Commissioning Group cut funding to ?3500 per

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patient, enough for just one IVF cycle, completely at odds with the

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recommendations. These are the NHS guidelines. They state that every

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woman between 23-39 should be offered three cycles of IVF, not

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one, not two, but three. To understand why that's so important,

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you need to go back to 1978 and the birth of the first test-tube baby,

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Louise Brown, two Bristolian parents. At that time doctors

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estimated one and a million chance of success. Since then the procedure

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has been refined but stayed largely the same. Eggs from the woman are

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fertilised with sperm, one fertilised egg is put back in the

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uterus and the rest are frozen and used if the first doesn't work. All

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of this is known as one cycle of IVF. Today, as many as 40% of IVF

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cycles result in the birth of a child. But there is a best case

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scenario, and for many couples, the success rates are much, much lower.

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For them, more than one cycle is essential but, even though the NHS

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recommends three cycles, in most of the West of England you now only get

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one. Treatments vary, with Wiltshire the most generous. In

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Gloucestershire you can get up to three cycles but only Cliveden does

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the full recommended package. That is about to change, though. Swinton

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will be reducing IVF revision from three fresh cycles to one fresh

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cycle plus two frozen embryo transfers. This has been a difficult

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decision but it puts us into line with our local partners including

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Wiltshire and helps us to stay within our spending budget. If the

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NHS is not paying for IVF treatment, who does? This is Paula, with her

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eight-month daughter Anna, a sister Julie, was five. Paula was advised

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by her gynaecologist that she might not conceive without extra help but

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when she made inquiries about IVF she discovered she did not meet the

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criteria, because her husband had children from a previous

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relationship. I was absolutely devastated. I could not understand

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why I could be turned down when somebody with no children, like me

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but with a partner who had no children, code, and it also depends

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where you are in the country. In some parts of the country even

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though people have partners with children they are still being funded

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for IVF and fertility treatment whereas in Somerset, their criteria

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is different to elsewhere in the UK. It is really difficult to deal with.

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So we sold the house, we were lucky, it soared straightaway, and we moved

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to a nearby town to fund the IVF treatment. That was in August and we

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started fertility treatment the following January, 2007. How much

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did you end up spending on the treatment? In total, ?33,000 over

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nine years. What to think of the current system 's it's completely

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unfair. I would like to see, across England, there is just guidance on a

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set amount for each person, so not the postcode lottery, but just two

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or three rounds giving out to everybody. I know that if I lived in

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a different part of the country I would have more rounds funded for me

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and it wouldn't have mattered if my husband had children from a previous

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marriage but I would have been entitled the funding and I would not

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have had to sell my house. Back with Jade. She's on her way to Bristol,

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one hour from home, for what could be her only funded cycle of IVF. It

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is really exciting, obviously, having waited so long, but also,

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apprehensive. We hope that we're going to get our other go.

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What Jade really wants to know is why the rules have changed. I have

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come to Yeovil to talk to the people responsible for funding treatment.

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The provision has been reduced from The provision has been reduced from

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three cycles down to one. Can you tell me how that happened? We

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started the process of reviewing what we would commission in Somerset

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and actually, the budget for the provision stayed the same so we took

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the important step of reducing the number of years woman had to wait

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from three years down to two. And we would get more live births for the

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same amount of money than unfortunately funding two cycles

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compared to one. There is always a limited pool of money and you have

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to do describe, we have to decide which services we want to continue

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to commission. We have more of an elderly population with more health

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needs, and they all, along with increased costs. -- they all come

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along. There you have it, the NHS has a limited pot of money, and

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someone has to decide how best it is spent. What would you do?

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We're here to tell your story. If you've had an experience of hospital

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treatment that you want us to look into, it is easy to get in touch,

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either on Facebook or Twitter. If you have not heard, today is blue

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Monday, officially the most depressing day of the year. Someone

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who really needs cheering up is Mark Millar, from DIY SOS, so we sent him

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to try an unusual way of tackling stress. I know what it looks like. I

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am in a room with a bunch of strangers doing an impersonation of

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an orangutan cat a rave. What on earth am I doing here? If someone's

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planning comes in for the next job, we can get moving on that, but we

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haven't got any more time and we don't have any more money. This is

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me at the day job, trying to get impossibly big projects finished on

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time. We have to have that surface on their on budget. A lot of money,

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thousands of pounds. You drop the meat fridge, and put a few passed

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in. It does not come without cost. That is a no. I am incredibly

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stressed much of the time and sometimes I feel like it is getting

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on top of me. But I'm also a person who likes to have a laugh. And that

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brings me to the challenge I have been set. I have agreed to be a

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guinea pig for Inside Out to see if laughter will do anything for my

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stress levels. I'm going to take part in a session of laughter Yoga.

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Something I've never tried before, and I know very little about. Before

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I go any further, I want to get proper medical opinion on my stress.

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I'm not sleeping very well. I'm getting a lot of panic attacks. My

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chest is a bit tight. I cannot relax. I feel dreadful in the

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mornings. You're not sleeping well and you are feeling a bit, roughly

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how long is that been a problem? It has been going on for about 18

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months. One common consequence of stress is high blood pressure.

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Doctor Anderson is keen to measure mine. I know that you will say that

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it is two numbers. Yes. What should mine be before you look at it?

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Ideally it should be something like 140/80. Would you like to see what

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it is? That is a bit higher than it should be. That is not going to help

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with the stress. As it is a bit high, we'll give it five minutes and

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it again and see if it does come down under. Sometimes it comes down

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if you have a bit of a rest. My BP is all the place. Laughter is good

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for everybody. I cannot imagine it would do any harm. We can do more

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detailed checks into your weight and your cholesterol, so that we can be

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sure that you are, that they are all as good as they should be. And look

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how happy you are. I am. I'm not sure that Doctor Anderson is

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convinced that my stress will be fixed by laughter, alone. So I am

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off to meet an academic who has studied laughter it self. He starts

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by plainly some of his favourite laughs. This is a man laughing. And

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this is... The next example really is a human woman laughing. She would

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not be making these sounds. HIGH PITCHED CACKLING. So, you can

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get to quite an extreme place with laughter. It is something that

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changes the physiology of your body, and it does so in a way that relaxes

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you, so when you have been laughing, you get an immediate reduction in

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adrenaline and adrenaline is your fight or flight hormone, so the

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stress levels come down when you have been laughing, and you also get

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a reduction in cortisol, which is the hormone that makes you feel

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really stress. You also get endorphins. So laughter is something

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that in the medium to short-term is something that makes you feel

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better. I have been invited to take part in a session of laughter Yoga.

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Can someone standing room and tell me how to laugh, and raise my

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endorphins? Will that help? It seems too. Certainly, the endorphin

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changes with laughter happen, it doesn't matter how you get the

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laughter. Even if it starts being laughter. Even if it starts

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unnatural and fate, that can lead to unnatural and fate, that can lead to

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real laughter, because laughter is highly contagious and you can laugh,

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just because you're laughing, and the more you laugh, the more you

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will continue laughing, so that seems weird at the start but that is

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crucial to laughter Yoga. I tell you what, that was great. All I want is

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a life full of laughter, now. Right, it's time for my laughter Yoga

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session. I have no idea what to expect. All I know is, when and

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where. This is being hosted by Joe, who describes himself as a laughter

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facilitator. First he puts everyone into a relaxed frame of mind and we

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are encouraged to move around. This is nothing to do with jokes being

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funny, it is about the act of laughing itself. It is the laughter

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that does it. It doesn't take long for me to lose it. I am loving it

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already, I am loving it! What are we laughing at? Absolutely nothing. We

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are just laughing. And sooner or later, it turns into the real thing.

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I am not laughing so much my face is starting to hurt! -- I am now

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laughing so much. GALES OF LAUGHTER. It is infectious,

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it is really silly. Before long you're all just cackling and crying.

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Is just great. And you can work your eye muscles with this, as well. I

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used to take light relief Nursery, seriously, I'd worry about what

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people thought, I'd have trouble expressing myself and now I am able

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to let go and find the fun in life, you see the beauty in life, as well.

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I was a laughter is the opposite distress. It is stress buster. Some

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table like a dance or write or play table like a dance or write or play

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an instrument or sing to get rid of stress, I think the most immediate

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way to do it is to laugh. That was amazing. I didn't know what to

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expect, I didn't know what was going to happen to me. I was shocked at

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how brilliant it was. Once I let myself go it was really good fun. It

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filled me up. I felt all of these different muscles in my head, neck

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and chest and stomach, I feel lovely. I feel quite soporific, you

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know? It is really, really nice. That night, I got a perfect night's

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sleep and the next morning my BP was much lower. Laughter Yoga might not

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be the only way to combat stress, but it certainly made me feel a lot

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happier. Seriously, though, what did happier. Seriously, though, what did

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you all think? Don't worry, they are not ignoring me, they are on our

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Facebook page. You should check out our social media. The details are on

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your screen. That is it for this week. Thank you for watching.

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Goodbye. Next week, we investigate abuse claims at a youth football

:28:44.:28:50.

Academy. He groomed me to make me feel that this was normal, he would

:28:51.:28:56.

ask questions about how much I loved and trusted him and how dedicated I

:28:57.:28:58.

was 30, a Hello, I'm Louisa Preston

:28:59.:29:07.

with your 90 second update. 30 British tourists shot

:29:08.:29:09.

dead in Tunisia in 2015. Today, an inquest was told

:29:10.:29:11.

that security forces Donald Trump provokes

:29:12.:29:15.

a mixed reaction. Downing Street welcomes the promise

:29:16.:29:19.

of a "quick and fair" trade deal. But foreign ministers

:29:20.:29:22.

are concerned by his comments

:29:23.:29:25.

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