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Denied, how were you live can seriously affect your health. The
fact that I have to pay for my treatment, it is criminal, it is
absolutely criminal. Sorry. In a special programme, we are asking, is
the NHS really a National Health Service? If I lived in a different
part of the country I would be entitled to some kind of funding and
I would not have to sell my house. And surviving blue Monday. How
having a laugh could save your life. I'm loving it already, I'm loving
it! Welcome to the new series of Inside Out West.
We have all seen the headlines, not enough money, too many patients, the
NHS is under pressure like never before so is rationing health care
the answer? Chris Jackson has been investigating. The NHS is facing the
most significant financial challenge in its history.
There are fears the service we have grown up with is
Absolutely there is a postcode lottery.
So is the NHS in danger of ceasing to be a national service?
When everyone is entitled to the same care?
It's treating more patients but is it becoming a postcode
lottery, where access can depend on where you live?
It feels like my bones are actually screaming at me at times.
33-year-old Ben Franklin has hepatitis C.
The virus can cause life-threatening liver damage.
I've been off sick and could possibly lose the flat over my head.
There are new drugs that could potentially cure Ben's hepatitis.
All I got was "Wait", basically, because my liver wasn't bad enough.
That made me want to go out and just get absolutely wasted
and ruin my liver just so they would treat me.
But I wouldn't be surprised if somebody else would.
The money is there for just over 10,000 treatments.
It is claimed that means there are no queues in parts
of the North and long waits in places like London.
Two people with exactly the same state of liver damage could present
themselves in different parts of the country and in one they'll be
able to walk in and get hepatitis C treatment immediately and get cured.
In another part of the country they may go there and be told,
"Sorry, you're going to have to wait."
NHS England told us it was regularly reallocating unused
hepatitis C treatment to places with waiting lists.
The number of patients treated will increase by 25% next year.
The fact that it's down to money, that upsets me the most.
So Ben is taking the risk of treating himself with cheaper
The fact that I've had to pay for my treatment, it's criminal,
I'm just tired of being tired, basically.
Ben is hoping the generic drugs will cure him within a matter of weeks.
The Hepatitis C Trust estimates around 1000 people in Britain may
If you go outside there are halos around light.
It's often hard to see things. They are distorted.
Gloria MacShane has cataracts in both eyes.
Go up or down stairs with any kind of confidence.
Cataracts are supposed to be treated within 4 1/2 months of referral.
Gloria lives in the North East and says she has been waiting seven.
Because there's such potential for accidents and there is such
If Gloria had lived in Luton, her weight could have been
Absolutely, there is a postcode lottery.
having poor systems, budget pressures and
That does not feel too national to me.
Gloria expects to get her operation later this month.
It really makes me angry because I think that it's almost
Clinical Commissioning Groups, or CCGs, control health budgets.
It is claimed some are delaying treatments like cataract surgery
Others are requiring patients to lose weight
before getting operations like hip replacements.
Postponing an operation in these circumstances
Whilst the CCGs say it can be clinically justified
the Royal College of Surgeons says it can't.
There is very good evidence people are now not getting
elective operations, which they desperately
sometimes require, simply because of financial restrictions.
It is up to the clinicians to decide who should have what treatments.
Therefore a bureaucratic system producing a blanket ban
It is also claimed new systems for vetting appointments
with specialists are another form of rationing.
Why are they treating their patients with such contempt?
Last month MPs complained about a private company
being paid ?10 for every GP referral they stopped.
and has the potential to compromise safety.
The same private company oversees referrals in North Tyneside.
We spoken to doctors who say the system is
The GPs, who fear speaking out, have told us that cancer
I tried to get a patient referred to a dermatologist.
The referral Management service said it was
a skin lesion and rejected it. That was a disaster.
It was a nasty, invasive skin cancer.
They are putting up barriers, using delaying tactics.
It is getting between the doctor and the specialist.
In a statement North Tyneside CCG said there was no evidence
the system caused additional risk or delay.
Cancer referrals do not go through the system
The number of referrals knocked back the GPs in England has risen
You can see the details of our research online.
Shortage and regional difference have always been part of the NHS.
Today the differences could get much worse.
The NHS is under an unprecedented level of pressure at the moment.
If it does not get more funding, waiting times
and the quality of patient care is going to suffer.
We will see different decisions taken in different parts
of the country and different services being
One of our most prominent medics is clear.
No, it is not a national service. It is now a local health service.
I think it matters because it leads to inequality in health care,
Some people will get health care for free and others will not.
In a statement, of the Department of Health told us that far
from rationing more people than ever are getting prompt treatment
3,261 cancer patients are being seen every day and that
We asked the health secretary and NHS England for an interview.
The people actually paying for NHS services,
the clinical commissioners, did agree to speak.
It is a national service with local variation based
Demographically populations vary significantly from town to rural,
It is very important we commission and respond to the needs of that
It is about making sure the pathway is correct.
We do not want to squander any money.
We have limited resources so it is really important we spend
most effectively and get the best value for our population.
For those forced to take their own action,
One NHS treatment seriously under the cosh is IVF, and it could get
worse here in the West. Doctor Dawn half has been to meet one couple was
remodelled having a family is hanging in the balance -- Doctor
Dawn Parker. It can be the happiest time of your life but not for
everyone. I was lucky enough to have my children without difficulty but
for those who do not conceive so easily, support for the NHS is
disappearing fast. In some parts of the country, there is no funded IVF
treatment offered at all. Is the west of England in danger of
becoming the next IVF blackspot? I've come to Somerset to meet one
couple trying for their first baby. Jade and her husband, Nathan, have
been together four years and got married a year ago. When did you
decide you wanted to start a family? When we first got together there was
always an understanding that it would have to be soon because I am
35, and after a year we started trying. And yes, nothing. You have
been trying for three years now. Four years. And at what point did
you start thinking it wasn't working? About 18 months ago,
really. And I guess people around you were getting pregnant and that
cannot have been easy. Yes, my friends started families in between
the times that we have tried to start a family. Jade and Nathan went
to their local NHS for fertility treatment. You have invested a lot
of time and emotion into this now. Where are you at the moment? At the
moment we have just started IVF treatment. I have just been on the
tablets. I am just finished with those tablets. And this is funded by
the NHS? It is. What will happen if this does not work? We're hoping
that we have another go, because we have been accepted for two cycles of
IVF. So we're hoping that we will get another go, after this, but I
understand that the CCG have changed this, so I don't really know. So
there is some doubt as to whether they can provide that. Yes. How does
that feel? Heart-wrenching. Jade's concern comes from the fact that her
local NHS Clinical Commissioning Group cut funding to ?3500 per
patient, enough for just one IVF cycle, completely at odds with the
recommendations. These are the NHS guidelines. They state that every
woman between 23-39 should be offered three cycles of IVF, not
one, not two, but three. To understand why that's so important,
you need to go back to 1978 and the birth of the first test-tube baby,
Louise Brown, two Bristolian parents. At that time doctors
estimated one and a million chance of success. Since then the procedure
has been refined but stayed largely the same. Eggs from the woman are
fertilised with sperm, one fertilised egg is put back in the
uterus and the rest are frozen and used if the first doesn't work. All
of this is known as one cycle of IVF. Today, as many as 40% of IVF
cycles result in the birth of a child. But there is a best case
scenario, and for many couples, the success rates are much, much lower.
For them, more than one cycle is essential but, even though the NHS
recommends three cycles, in most of the West of England you now only get
one. Treatments vary, with Wiltshire the most generous. In
Gloucestershire you can get up to three cycles but only Cliveden does
the full recommended package. That is about to change, though. Swinton
will be reducing IVF revision from three fresh cycles to one fresh
cycle plus two frozen embryo transfers. This has been a difficult
decision but it puts us into line with our local partners including
Wiltshire and helps us to stay within our spending budget. If the
NHS is not paying for IVF treatment, who does? This is Paula, with her
eight-month daughter Anna, a sister Julie, was five. Paula was advised
by her gynaecologist that she might not conceive without extra help but
when she made inquiries about IVF she discovered she did not meet the
criteria, because her husband had children from a previous
relationship. I was absolutely devastated. I could not understand
why I could be turned down when somebody with no children, like me
but with a partner who had no children, code, and it also depends
where you are in the country. In some parts of the country even
though people have partners with children they are still being funded
for IVF and fertility treatment whereas in Somerset, their criteria
is different to elsewhere in the UK. It is really difficult to deal with.
So we sold the house, we were lucky, it soared straightaway, and we moved
to a nearby town to fund the IVF treatment. That was in August and we
started fertility treatment the following January, 2007. How much
did you end up spending on the treatment? In total, ?33,000 over
nine years. What to think of the current system 's it's completely
unfair. I would like to see, across England, there is just guidance on a
set amount for each person, so not the postcode lottery, but just two
or three rounds giving out to everybody. I know that if I lived in
a different part of the country I would have more rounds funded for me
and it wouldn't have mattered if my husband had children from a previous
marriage but I would have been entitled the funding and I would not
have had to sell my house. Back with Jade. She's on her way to Bristol,
one hour from home, for what could be her only funded cycle of IVF. It
is really exciting, obviously, having waited so long, but also,
apprehensive. We hope that we're going to get our other go.
What Jade really wants to know is why the rules have changed. I have
come to Yeovil to talk to the people responsible for funding treatment.
The provision has been reduced from The provision has been reduced from
three cycles down to one. Can you tell me how that happened? We
started the process of reviewing what we would commission in Somerset
and actually, the budget for the provision stayed the same so we took
the important step of reducing the number of years woman had to wait
from three years down to two. And we would get more live births for the
same amount of money than unfortunately funding two cycles
compared to one. There is always a limited pool of money and you have
to do describe, we have to decide which services we want to continue
to commission. We have more of an elderly population with more health
needs, and they all, along with increased costs. -- they all come
along. There you have it, the NHS has a limited pot of money, and
someone has to decide how best it is spent. What would you do?
We're here to tell your story. If you've had an experience of hospital
treatment that you want us to look into, it is easy to get in touch,
either on Facebook or Twitter. If you have not heard, today is blue
Monday, officially the most depressing day of the year. Someone
who really needs cheering up is Mark Millar, from DIY SOS, so we sent him
to try an unusual way of tackling stress. I know what it looks like. I
am in a room with a bunch of strangers doing an impersonation of
an orangutan cat a rave. What on earth am I doing here? If someone's
planning comes in for the next job, we can get moving on that, but we
haven't got any more time and we don't have any more money. This is
me at the day job, trying to get impossibly big projects finished on
time. We have to have that surface on their on budget. A lot of money,
thousands of pounds. You drop the meat fridge, and put a few passed
in. It does not come without cost. That is a no. I am incredibly
stressed much of the time and sometimes I feel like it is getting
on top of me. But I'm also a person who likes to have a laugh. And that
brings me to the challenge I have been set. I have agreed to be a
guinea pig for Inside Out to see if laughter will do anything for my
stress levels. I'm going to take part in a session of laughter Yoga.
Something I've never tried before, and I know very little about. Before
I go any further, I want to get proper medical opinion on my stress.
I'm not sleeping very well. I'm getting a lot of panic attacks. My
chest is a bit tight. I cannot relax. I feel dreadful in the
mornings. You're not sleeping well and you are feeling a bit, roughly
how long is that been a problem? It has been going on for about 18
months. One common consequence of stress is high blood pressure.
Doctor Anderson is keen to measure mine. I know that you will say that
it is two numbers. Yes. What should mine be before you look at it?
Ideally it should be something like 140/80. Would you like to see what
it is? That is a bit higher than it should be. That is not going to help
with the stress. As it is a bit high, we'll give it five minutes and
it again and see if it does come down under. Sometimes it comes down
if you have a bit of a rest. My BP is all the place. Laughter is good
for everybody. I cannot imagine it would do any harm. We can do more
detailed checks into your weight and your cholesterol, so that we can be
sure that you are, that they are all as good as they should be. And look
how happy you are. I am. I'm not sure that Doctor Anderson is
convinced that my stress will be fixed by laughter, alone. So I am
off to meet an academic who has studied laughter it self. He starts
by plainly some of his favourite laughs. This is a man laughing. And
this is... The next example really is a human woman laughing. She would
not be making these sounds. HIGH PITCHED CACKLING. So, you can
get to quite an extreme place with laughter. It is something that
changes the physiology of your body, and it does so in a way that relaxes
you, so when you have been laughing, you get an immediate reduction in
adrenaline and adrenaline is your fight or flight hormone, so the
stress levels come down when you have been laughing, and you also get
a reduction in cortisol, which is the hormone that makes you feel
really stress. You also get endorphins. So laughter is something
that in the medium to short-term is something that makes you feel
better. I have been invited to take part in a session of laughter Yoga.
Can someone standing room and tell me how to laugh, and raise my
endorphins? Will that help? It seems too. Certainly, the endorphin
changes with laughter happen, it doesn't matter how you get the
laughter. Even if it starts being laughter. Even if it starts
unnatural and fate, that can lead to unnatural and fate, that can lead to
real laughter, because laughter is highly contagious and you can laugh,
just because you're laughing, and the more you laugh, the more you
will continue laughing, so that seems weird at the start but that is
crucial to laughter Yoga. I tell you what, that was great. All I want is
a life full of laughter, now. Right, it's time for my laughter Yoga
session. I have no idea what to expect. All I know is, when and
where. This is being hosted by Joe, who describes himself as a laughter
facilitator. First he puts everyone into a relaxed frame of mind and we
are encouraged to move around. This is nothing to do with jokes being
funny, it is about the act of laughing itself. It is the laughter
that does it. It doesn't take long for me to lose it. I am loving it
already, I am loving it! What are we laughing at? Absolutely nothing. We
are just laughing. And sooner or later, it turns into the real thing.
I am not laughing so much my face is starting to hurt! -- I am now
laughing so much. GALES OF LAUGHTER. It is infectious,
it is really silly. Before long you're all just cackling and crying.
Is just great. And you can work your eye muscles with this, as well. I
used to take light relief Nursery, seriously, I'd worry about what
people thought, I'd have trouble expressing myself and now I am able
to let go and find the fun in life, you see the beauty in life, as well.
I was a laughter is the opposite distress. It is stress buster. Some
table like a dance or write or play table like a dance or write or play
an instrument or sing to get rid of stress, I think the most immediate
way to do it is to laugh. That was amazing. I didn't know what to
expect, I didn't know what was going to happen to me. I was shocked at
how brilliant it was. Once I let myself go it was really good fun. It
filled me up. I felt all of these different muscles in my head, neck
and chest and stomach, I feel lovely. I feel quite soporific, you
know? It is really, really nice. That night, I got a perfect night's
sleep and the next morning my BP was much lower. Laughter Yoga might not
be the only way to combat stress, but it certainly made me feel a lot
happier. Seriously, though, what did happier. Seriously, though, what did
you all think? Don't worry, they are not ignoring me, they are on our
Facebook page. You should check out our social media. The details are on
your screen. That is it for this week. Thank you for watching.
Goodbye. Next week, we investigate abuse claims at a youth football
Academy. He groomed me to make me feel that this was normal, he would
ask questions about how much I loved and trusted him and how dedicated I
was 30, a Hello, I'm Louisa Preston
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