This posting is for a general briefing, however it contains the essence of a message distributed to the Chief Executives of ALL PCTs and SHAs in England.
These comments are prepared in the light of recent comments published by
- the BMA
- and NEG Ltd
- and answers to questions in parliament given by the Minister of State (Health Services).
There could be a cloud of confusion that needs to be dispelled. I offer my assistance and urge verification of my comments.
The Directions to NHS bodies concerning the cost of telephone calls issued on 21 December 2009
must be considered, in effect, to represent
a ban on the use of 084 telephone numbers in the provision of NHS services.
As there is no general regulation of the cost of calling particular telephone number ranges, the Department of Health requires that attention be given to the actual costs incurred by patients. It has however (so far) failed to understand the effect that revenue sharing, which applies to all 084 numbers, has on unregulated charges in the market.
Regardless of undertakings by GP system providers and the perverse effects seen in some telephone tariffs (under some circumstances as a result of legacy regulations that apply only to BT), the cost of paying the revenue share that provides financial benefits to all users of 084 numbers is generally passed on to callers.
The Minister and the Department of Health are quite correct to declare that in a NHS "free at the point of need" NO PATIENT should be required to pay for access to NHS services, even if the money is collected, and the financial benefit is received, indirectly.
System providers to GPs and others can issue any personal undertaking they wish about the cost of calling, it has no meaning. The cost of a telephone call is set by whoever provides telephone service to the patient. Some may have been totally misled on this point, or led to accept a false belief that charges to callers are set by agreement with the called party.
This briefing document shows that those who pay more to call any 084 number than the equivalent cost of a call to a normal ("geographic") number include all users of:
Public Payphones, all Virgin Media landlines, all Contract and PAYG Mobiles.
If any NHS provider could be sure that no patient would call using these (or some other) services, then it could continue using a 084 number. Unlike 084x, 03xx numbers are subject to general regulation; this requires that the cost of calling may be no more than that of calling a geographic number.
I have invited recipients of my message to verify my comments with those having the relevant authority and let me know if they are challenged. I have also asked to be advised if there is any known situation where there are no patients who would call under the terms of the types of tariff listed above.
I must urge anyone reading this briefing who can identify any factual errors here, or in the any of the supportive material, to please submit a comment or contact me.