Joanna has a liver condition called Haemochromatosis. She had a liver transplant when she was nineteen days old and she's been on the transplant waiting on the list for a second transplant for several years.

She takes a range of medications each day to stay alive.

As a child her prescriptions were free but, since turning 19, she’s had to pay, and she just can’t afford them. Now 22 and a student, her loan and part-time job barely cover the food and rent. The one-off annual pre-payment certificate of £104, to cover her prescriptions, is out of the question.

Over the past couple of years, she's managed to pay for her prescriptions by buying a 3-monthly pre-payment certificate. She then tries to space out the collection of her prescriptions to fit as many medications into that 3-month time frame as possible.

While this works with her other medications, her anti-rejection pills don't quite stretch as there aren't quite the right number in each box. So for a few days, Joanna halves her dose to make it last until she collects her next prescription. She knows this is a risky decision, particularly given her transplanted liver is failing. But taking a few less pills for a few days feels like the right thing to do so that she can afford to eat and live.

She’s baffled that she and thousands of others like her - with long-term conditions like chronic asthma, Parkinson’s and Crohn’s Disease - have to pay for their prescriptions, while those with conditions like Type-1 diabetes don’t pay a penny. If she lived in Scotland, Wales or Northern Ireland she and everyone else would get their prescriptions for free.

So why is the system so unfair in England? Wouldn’t free prescriptions for all - so people don’t ration their life-saving medications - protect people's health and save the NHS money in the long-run?

Or is there a method in what looks, to her, like madness?

Producer: Beth Eastwood Show less