The consultation document can be downloaded from Department of Health here:

http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_091879

The deadline for responses is 31 March 2009.

---

Source: BBC News

http://news.bbc.co.uk/1/hi/health/7783963.stm

Doctors' phone line use reviewed
By Jane Dreaper
BBC News health correspondent

<<
A ban on the use, by GP surgeries and other parts of the NHS, of phone numbers which begin with 084 is being considered say ministers.

They have launched an England-wide consultation to ask with people whether they want to keep the numbers.

Doctors say the new systems enable them to offer patients a better service.

But campaigners argue using the more expensive numbers is against the founding principles of the NHS, which should be "free at the point of need."

Increasing numbers of GP surgeries, hospitals and primary care trusts now have 084 numbers for patients use, such as when booking appointments.

Callers to the numbers are put in a queue, rather than encountering a constantly engaged tone.

Any revenue that is raised has to go towards the cost of the phone systems.

However complaints over the use of the numbers - which are usually more expensive than local calls - have lead to a government rethink.

Over the next three months people in England will be able to give their views on whether the practice should be allowed to continue.

…
>>

This report has been posted on the BBC News website:

http://news.bbc.co.uk/1/hi/health/7783963.stm

Doctors' phone line use reviewed  
By Jane Dreaper
BBC News health correspondent  


 
A ban on the use, by GP surgeries and other parts of the NHS, of phone numbers which begin with 084 is being considered say ministers.

They have launched an England-wide consultation to ask with people whether they want to keep the numbers.

Doctors say the new systems enable them to offer patients a better service.

But campaigners argue using the more expensive numbers is against the founding principles of the NHS, which should be "free at the point of need."

Increasing numbers of GP surgeries, hospitals and primary care trusts now have 084 numbers for patients use, such as when booking appointments.



Dr Richard Vautrey says his patients get a better service

Callers to the numbers are put in a queue, rather than encountering a constantly engaged tone.

Any revenue that is raised has to go towards the cost of the phone systems.

However complaints over the use of the numbers - which are usually more expensive than local calls - have lead to a government rethink.

The additional expense depends on the phone company, and what their call plan is, but if the caller is using a mobile it can reach 40p per minute.

Over the next three months people in England will be able to give their views on whether the practice should be allowed to continue.

'Dramatic improvement'

The NEG (Network Group Europe) company, which supplies 084 numbers to the NHS, says 10 million patients across the UK are registered with a doctor's practice that uses the system.

One such surgery is the Meanwood Practice in Leeds, where Dr Richard Vautrey is based.

Dr Vautry, deputy chair of the British Medical Association's GP Committee, said: "Before we put in the system, patients were concerned about the difficulty they had in getting through on the phone.

"Surveys showed it was an area of weakness for us.

"It's never going to be perfect - but the 084 number has given us a dramatic improvement and certainly made a big difference.

"Any idea that GPs make money from these numbers is a myth.

"The cost to our practice has in fact increased since we put in the new system.

"Before it was £7,000 a year and now it's £10,000."

Opposition

But phone campaigner David Hickson said the use of the numbers was "completely unacceptable."

He said: "The NHS is supposed to be free at the point of need.

"The difference in each call may be only a few pence for some people, but the costs can really mount up for others - especially for people who are using mobiles because they don't have a landline.

"I find it bizarre that the government is doing a consultation on this now.

"It's more than three years since the Department of Health banned GPs from using 0870 and other higher cost numbers. 084 numbers should have been stopped then."

One solution could be to use 03 numbers across the NHS. These offer the extra functions of automated 084 systems, but without patients having to pay extra.

However some GP surgeries are locked into phone contracts lasting as long as seven years.

Government view

Health Minister Ben Bradshaw said: "A few years ago we banned the previous systems that were proving expensive.

"But people got round it by using 084 numbers. We now need to find a sustainable solution.

"We'd have to look carefully at whether existing contracts could be interrupted."

Mr Bradshaw confirmed that the consultation would also seek the public's view about the phone line service NHS Direct using an 0845 number.

Dean Raiment, the managing director of NEG, said: "We also share the government's determination that patients all over the country should receive the best possible service.

"We look forward very much to continuing to work with the Department of Health as part of the consultation process, to determine the most appropriate solution."

A classic example of delay, procrastination and inaction by this "do nothing" Government!

There is already masses of evidence that patients do not like these rip-off numbers and MPs regard them as a rip-off and, contrary to the fundamental principle of the NHS that it should be "free at the point of need".

28500 people signed a petition against these numbers last year and over 100 MPs have signed Early Day Motions condemning them.  

What we want is action NOW!!!   Stop timewasting!!

Does anyone know how we contribute to the review?

There was a piece on BBC Radio 4's Today programme this morning:

http://news.bbc.co.uk/today/hi/today/newsid_7785000/7785011.stm

Here is the consultation
http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_091879

Such a shame that the consultation uses the terms "local rate" and the incorrect area code "0207"....

It also seems to link the availability of extra services to the type of number one calls. which is of course incorrect.  Extra features can be installed on any telephone number.   Page 7 of the consultation "“Local Rate numbers” Is the quality of Service Better? NO”.   ::)

On my own domestic landline I could install extra features  too if I so wished.  Divert on busy, holding calls, Call queuing, “Press 1 for Me, Press 2 for the Wife, Press 3 to leave a message etc.”  Of course, I haven’t enabled such extra features, because tI find them ANNOYING.

If a phone line is busy, or none is available to take your call, I prefer an engaged tone.   With an engaged tone you know instantly that the phone line is busy, and you do not get charged AT ALL for the call.  With a menu system you are paying to hear usually a long-winded message that no one is available to take your call. I know which I prefer!

I note we can reply by email. Do we know if we have to scan the forms and attach our replies or can we simply send a text email.

I've sent a reply in plain text, with Q1, Q2 and Q3 as appropriate, and the first bit of each heading for the relevant other sections requiring a response.

I suggest that patients contact local newspapers, TV and radio news. Even if your GP uses a normal geographical (01/02) number, the media might be interested if other surgeries in their area use revenue sharing 084 numbers because it provides a story that not all GPs need to use these numbers and crucially not all take funding from patients on a 'pay as you use' basis.

repton3 wrote on Dec 16^th, 2008 at 9:47am:

Here is the consultation http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_091879

Replies are invited by email as well as post. Here's a copy of the questions to be answered plus a bit of explanation from the background section.

You can respond by emailing your responses to the questions to:
084consultation@dh.gsi.gov.uk

Questions for callers to the NHS
Q1
Do you agree with the principle that people should not be charged more than the cost of a local rate call to access NHS services by telephone?

Q2
As a patient or carer calling the NHS, would you prefer to call a telephone number that has extra functions? (See page 5)

(Page 5 of the consultation document includes the following explanation:
What are the extra functions provided by 084 numbers?
084 numbers provide several extra functions, including allowing a caller to:

• be held in a queue, so ending the problem of getting an engaged tone;
  
• access a push-button choice of options that can be used to route calls, for example to appointments, repeat prescriptions or a practice nurse;
  
• be redirected to other locations or other services such as out-of-hours services; or
  
• access automated booking and appointment systems.
  

Is there another way to provide the extra functions?
Yes, 03 numbers were introduced by Ofcom in 2007 as an alternative to non-geographical numbers such as 084 numbers. 03 numbers offer the same extra functions as 084 numbers but are charged at the same rate as a call to a local number. However, a charge is levied on the person or organisation receiving the call. )

If your answer to Q2 is Yes:
• Which functions do you value most when calling a telephone number such as 084, which has enhanced functions?
• Why do you value these functions?
• Who do you think should pay the additional cost of providing this type of telephone system in the NHS?

If your answer to Q2 is No:
• What are your main reasons for not liking these functions?

Q3
The Government is considering banning the use of 084 numbers in the NHS where the cost to the patient is greater than calling a local geographical number. Do you think they should be banned?
Please give your reasons.

Any other comments?
Please use the space below for any additional comments that you would like to include.

There are now 162 published comments on this in response to the story on the BBC News website with 111 or so awaiting moderation (including mine).  The comments basically all oppose misuse of 0844 numbers by doctors and its clear there is much a larger band of people vigorously opposed to 0844 use than just the small number of activists who regularly post on this website.

See http://newsforums.bbc.co.uk/nol/thread.jspa?sortBy=1&forumID=5814&start=0&tstart=0&edition=1&ttl=20081216141153#paginator

I am sure the government plan to rig the consultation or just simply ignore the consultation responses as Ofcom and Phonepayplus (nee ICSTIS) have consistently done on this matter. :o >:( [smiley=thumbdown.gif] [smiley=thumbdown.gif] [smiley=thumbdown.gif]

I wonder if there is anyone as brave as the chairman of that UK Statistics body in the medical profession who is prepared to break ranks over this.

It was also discussed on the Jeremy Vine show on BBC Radio 2 today, in the first half hour.  They had a doctor on Sarah Jarvis who pops up on TV and radio often,  her surgery had a 0844 number but changed back to a local number after complaints from patients about cost.  The Doctors asked if it was possible to have all the fixtures of the 0844 scheme on a geographical number and it was  :o

Reflecting on a long day, I feel that the campaign has moved forward.

There does seem to be a general acceptance that the defence of 084 numbers as uniquely offering better features has been largely dismissed. It all comes down to funding. I cannot see how a government suggestion that NHS patients should perhaps pay to subsidise provision of NHS services as they use them could possibly prevail.

I cannot see any justification for a three month delay, however that is now what we must accept, no matter how much we may hate it (unless we see a serious prospect of the government changing its mind and abandoning what it has just announced). There may be valid reasons that are not apparent, e.g. the government may fear an unproductive battle with the BMA and wants strong public support on its side. The timing could be to tie in with the NHS constitution legislation that may be used as the basis for enforcing a ban. (This is only speculation - I remain opposed to the need for a consultation on the basis of what I know at present.) Whilst the language used suggests otherwise and could cause great embarrassment if it were true, the possibility that the delay is an indication of there being no intention to do anything cannot be wholly dismissed.


I intend to reflect further on how this time with the issue out in the public domain can perhaps be used as an opportunity to achieve more. With public attention on the declared unacceptability of 084 numbers for the NHS, there should be a great opportunity to make progress with other government departments and public sector bodies. It could also help with any pressure being exerted on the private sector as well.


There remains the question about whether use of 03 numbers is necessary, which is starting to become a topic of contention in this forum.

I am prepared to accept that some solutions are designed to work on geographic numbers, whereas others are suited to non-geographic. So long as the NGN being considered begins with 03, I am content for this to be a matter for individual choice between alternative offerings; it is not an issue that I would wish to take a stand on.

If it is cheaper for those who are tied into a long term contract for a NGN to switch from 0844 to 0344 and retain a system that is found acceptable to patients (other than the present cost of calling), then I would not oppose such a decision. If a practice decides that a new 03xx based solution is better than any alternative improved system on a geo number that is offered, then again I would not oppose. It is for those who offer geo number based solutions to get out there and start marketing them. With the chance to exploit the subsidy obtained through revenue sharing removed, they have a more level battleground on which to compete.

I want to encourage all forum members to exploit all opportunities available to them to get media coverage for the issues that we share. Furthermore, I do not believe that this is "our" campaign, it belongs to all NHS patients and all those who have to call revenue sharing numbers. Whilst we may be able to help people to understand the issues, it is the campaigning efforts of those who cannot afford to call their doctor because they do not have sufficient credit on their mobile which must seen as the most eloquent contributions to media coverage.

It is interesting to note that one party has immediately stepped forward to add comment on the government consultation:

http://www.ofcom.org.uk/media/features/03nhs

I am sure that there is much to criticise about this intervention to the debate, however it seems to be on the "right" side.

See today's Daily Telegraph....Here....

http://www.telegraph.co.uk/health/healthnews/3792815/GPs-surgeries-could-be-banned-from-using-expensive-084-numbers.html

My own thoughts after a brief look are, what hope do we have to convert big business from using "local rate" and "national rate" if Ofcom can't stop using it?! Isn't it Ofcom after all that said you shouldn't use those terms...?

Surely the attention of ministers and DH senior management and MPs needs to be directly drawn by SCV (he has the contact lists) to the fact that there were 490 comments on the story on the BBC news website and that 95% of them were overwhelmingly hostile to the continued use of 0844 numbers.  This is despite the best efforts of employees of doctors surgeries using 0844 numbers or NEG salesmen to make one or two posts in support of the continued use of 0844 phone numbers.

When everybody else including the COI, Sir David Varney and Ofcom have already accepted that the use of these hidden revenue share numbers is wrong when the cost of calling may be a barrier to access to the service by the general public then why does there need to be any further consulation.  Why can't the DH simply set a date by which these doctors surgeries must move to an 03 number or 01/02 number and also push through any necessary emergency legislation to prevent NEG and other suppliers being allowed to charge contractual penalties for making this change which exceed the real value of the free phone equipment and installation labour that they have provided.  Specifically they should not be able to charge for the loss of their many years of planned extortion of doctors patients that far exceed the cost of the installed equipment.  NEG always knew they were playing with dynamite here so too bad if it goes off in their greedy and mean spirited corporate face.

I am not in the habit of publishing campaign tactics, however the following may give some impression of my current thoughts and activities. I hope readers will appreciate why I do not offer precise detail.

It is also not my habit to tell people what to do, so please take any comments here as suggestions.

I see the DH consultation as being the wrong way to deal with the situation, but that is what we have.


I believe that it will be necessary to ensure that a very large show of public support for the proposed implementation of a ban on use of 084 numbers is implemented swiftly at the conclusion of the consultation. I hope that members will use whatever resources they have in support of this.

The BBC and other media are actually surprisingly open to suggestions of stories, although one should only generally expect a percentage success rate in single figures. Most TV producers are driven by levels of listener and viewer reaction, so any suggestion of a new angle on what has already be done, noting the reaction to the BBC story, is likely to be well received. What has already been done will not simply be repeated.

Given that there will be three months in the new year before anything will finally be achieved, there is no great rush. Copies of the consultation document will be distributed to every GP surgery and made available for all other NHS organisations to distribute. The Department of Health has no plans to arrange public discussions or events, however it is likely that many such events will occur, both for the public in particular localities and for particular interest groups. Members may wish to consider how such events may be promoted and to get generally involved in recruiting support for a strong response. Those in a position to arrange such events should be targeted.

Conveniently. a new e-petition to the Prime Minister has recently appeared with a closing date early in April - http://petitions.number10.gov.uk/Healthtelephone/. Efforts to ensure that there is an extensive show of support for the simple point of the consultation, through this petition, are already underway. Other members may wish to do what they can to this end.

The NHS.Patient website is in the course of being expanded to provide information specifically relevant to this consultation. Any other efforts in this line, such as a specific properly designed campaign website, would be a great help as a rallying point.


What is also important is for the plans for how the ban will be put into effect to be drawn up. This means that the obstacles presently in place, which led to the consultation rather than an immediate ban, must be removed. I do not see the balance of public opinion as being one of those obstacles, given that there is not a straight choice between not paying more and having a better service. Those who are able to do so, and believe that it is possible, should work on changing the thinking and positions of those who may make a difference.

When considering weight of numbers as a factor in changing public policy, we must remember that over 28.000 people signed the e-petition to the PM and it was thought necessary to hold a public consultation. The number of comments on the BBC website is significant and can be used to advantage in certain ways.

Please understand my reluctance to offer too much detail of strategy and tactics to public view and discussion. The BMA, the DH, Opal Telecom, NEG, BT, NHS Direct and all the other players in this process do not hold their strategy meetings in public, openly assigning tasks to specific individuals so that all can see the strengths and weaknesses of their position and personnel. I do not see any good reason why we should expose ourselves in this way.

This forum should also not be so arrogant as to see itself as the undisputed core of the concern on this issue. I am sure that there are many individuals and groups outside this forum with no less potential for effecting change on this particular issue (i.e. 084 numbers in the NHS).

Some links to material of all sorts covering the consultation are now available here. This includes some broadcast material, newspaper and on-line news, news releases from DH, Ofcom and the BMA, the new (and old) e-petition(s) to the PM and links to many discussion forums (including this) where the issue is being covered.

If anyone has any suggestions of other items to be added, or wishes to do this job more effectively, please let me know by PM or email (nhs.patient@ntlworld.com).

(There was, I believe, quite a bit of broadcast material of which I do not have recordings.)

I have sent this letter to the Consultations Co-ordinator and to Ofcom today by email.



To: The Consultations Coordinator Department of Health, 3E48 Quarry House, Leeds LS2 7UE

This is a criticism and complaint about mistakes and errors within your Consultation Document.   I am very surprised at the number and extent of factual errors within your consultation document and I would appreciate your immediate response on the following points.  

I believe this to be important and urgent as this document is promoting an incorrect understanding to the public.   It also indicates that you do not understand some fundamental aspects of these telephone systems and the use of 084 numbers.

1  On page 4 you state ---
" ...the Government recognises that the extra functions offered by an 084 number can improve access to services for patients."  
These functions are not provided by "the 084 number", they are provided by a "number translation service".   These functions can be equally provided to any number including 01, 02 and 03 numbers.

2 On page 4 you state ---
"A local call rate is the amount you pay to make a telephone call within a local geographical area. Each geographical area has a specific area code, for example 0207 for central London. Calls to local numbers from landlines are usually charged at the local rate."  
The practical distinction between local and national call rates was abandoned in 2004.   Since that year all calls to geographic numbers have been at a single rate for all but a tiny minority.    Calls from "for example 0207 for Central London" cost the same whether you are calling within the local area or anywhere else throughout the country including Scotland, Wales and Northern Ireland.   Calls to anywhere in the country from any originating area are at the same cost.   This applies to calls from landlines and mobiles.

3 On page 4 you state ---
"It is common in the NHS to have additional functions attached to 084 numbers. These functions are not generally available with local rate numbers, although it is possible to buy equipment to run alongside a local rate number that enables extra functions to be provided."
This is incorrect where it states  "These functions are not generally available with local rate numbers".   Additional functions can be provided for geographic numbers just as easily as for 084 numbers using a number translation service or locally installed equipment.

4 On page 5 you state: ---
"GP practices and other NHS organisations using 084 numbers do not make a profit from 084 numbers. The money generated by 084 numbers goes towards the cost of providing that number and the functions."
This is being economical with the truth.   It is advertised by the main supplier of these systems, NEG, that doctors do not have to pay anything for their new phone systems and that 1 or 2p per minute of every incoming call is provided by revenue share to pay for the system.   This allows the doctor to obtain the system without any expenditure at all instead of providing funding in the normal way as a capital expenditure.   This means that doctors are effectively allowing this capital to go to their bottom line as profit.   The capital expenditure would of course be treated as an allowable expense by the Revenue.    The point is, you are misleading the public by making this statement.

5 On page 7 you start a table which compares Local Rate, 084 and 03 numbers.    Your comments about the "quality of service" for local rate numbers is inaccurate as all these aspects can be provided or avoided depending on how the system is set up.

I can provide information and evidence to substantiate the statements I have made.   If you wish to see it please let me know.     This may not be an exhaustive list of factual criticisms so there may be some additional points to be made by myself or others.

I feel that these points should receive your urgent attention as it is supremely important that a Government document is seen to be strictly accurate with the facts it is stating and that it does not mislead the public in any way.

I look forward to your early reply,

Yours sincerely,

It's interesting that NEG claim 10 million patients are registered with GPs using 084 numbers. Whenever I'm searching for alternate numbers, I always get the impression that very few surgeries actually use 084 numbers. Most seem to retain local numbers. I presume that's because it's the big practices that use these systems. Single-doctor practices are more likely to use standard numbers, but account for a smaller proportion of patients.

As an aside, in another thread I mentioned a practice I used to be registered with (and my parents still are). It's a fairly large one, so I wondered if they'd also moved to 084. In fact, I'm quite impressed, as not only do they still use geographical numbers for most things, including making appointments, but the one NGN then have, for out-of-hours, it an 03 number! The only 084 number on their site is for NHS Direct...
http://www.churchstreetsurgery.co.uk/

While I realise some people with health problems may not want to change doctor, I'm sure the majority of people registered with a doctor never or rarely go to see them. Yet I believe GPs receive funding according to how many patients they have registered with them. Surely people should abandon surgeries that use rip-off numbers? Once they start losing patients, they'll soon change their mind on these numbers.

jrawle wrote on Dec 19^th, 2008 at 10:56am:

I always get the impression that very few surgeries actually use 084 numbers.

Members may like to refer to the information that was collected over a period around a year ago and is published here. As it is all from proper published sources, it suffers from any incompleteness or inaccuracies found there. It has not been updated to reflect the current position, or that at any single point in time. It does however go a very long way towards showing the extent of the problem.

Quote:
It's interesting that NEG claim 10 million patients are registered with GPs using 084 numbers. Whenever I'm searching for alternate numbers, I always get the impression that very few surgeries actually use 084 numbers. Most seem to retain local numbers. I presume that's because it's the big practices that use these systems. Single-doctor practices are more likely to use standard numbers, but account for a smaller proportion of patients.







Well, every surgery in Horsham, West Sussex, has gone over to 084 numbers and I don't suppose we are the only town to have a '100% coverage' of 084 numbers.

The tables found here can be copied and pasted into a spreadsheet or database (when viewed using IE). They have postcode as a separate column and so are designed to permit geographic analysis, in addition to the PCT breakdown that is provided.

If someone has the necessary postcode data, the time and the skills, I would be delighted to incorporate further summarisation into the published information. If someone could persuade NHS Choices to release the full database of GPs that underlies its website, then the whole job could be done more professionally. This data, along with available (but not for free) postcode tables would allow preparation of up-to-date lists of percentages by town / district and electoral ward / parliamentary constituency. I considered doing this when preparing the information, but my limitations, including an absolute ban on direct expenditure, caused me to stop short.

Inspired by loddon, I also have complained to the consultations coordinator, as follows:
The consultation document is fundamentally misleading, and I believe should be withdrawn and revised.
From residential lines, except for the small minority of people on BT's light user tariff (which is being phased out), there is no such thing as a local call. Almost all residential users in, say, Penzance, pay the same price to call Penzance or Aberdeen. Moreover, many users are on tariffs which charge a flat monthly fee for all calls to 01 02 and 03 numbers, either for stated periods (eg weekends) or 24/7. For these users, the marginal cost of a call to 01 02 and 03 is zero. Calls to 084 numbers are always excluded from these deals.
Incidentally, 0207 is not a code for inner London, and never has been. 020 is the code for the whole of London. This error is not important in itself, but it illustrates the technical incompetence of whoever prepared and signed off the consutation document.
The document obliquely admits, correctly, that the services that are provided on 084 can be provided on 01 and 02 numbers (by buying a suitable small PBX). It then makes completely misleading comparisons between calls to what it is miscalling 'local' numbers, and calls to 084.
For example, the answers to "why are GPs using 084?" evade the issue. The correct answer is that some GPs have fallen for the 084 sellers' spiel, which (if you decode it) is that they can, by signing up for an 084 number, avoid the (relatively modest) capital cost of small PBX, and get similar call-queuing etc services at their patients' expense.
The document prejudges another issue, by claiming that calls via 084 get a 'better service'. That is a matter of opinion. For example, many people might prefer to get a (free) engaged tone, and try later to talk to a human, rather than paying 5 pence a minute (or far more from a mobile) to be held in a queue by a machine.

Source: Daily Mail

http://www.dailymail.co.uk/news/article-1095602/Doctors-banned-charging-patients-ring-surgeries-0845-numbers-scrapped.html

Doctors banned from charging patients to ring surgeries as 0845 numbers are scrapped

By Daniel Martin
Last updated at 7:46 PM on 16th December 2008

Doctors could be banned from charging patients 40p a minute to ring their surgeries, ministers said yesterday.

Around a fifth of the 8,000 practices in England - with ten million patients on their books - flout Government guidance by using 0844 and 0845 numbers.

GPs keep part of the charge patients pay when they call to fix an appointment, obtain test results or get repeat prescriptions.

An official review has been launched into whether surgeries and Health Service organisations should be made to use local-rate numbers, such as those starting 03.

Health minister Ben Bradshaw said: 'We are concerned that some people are paying above the odds to contact the NHS.

'For people on low incomes who need to contact their local doctor or hospital regularly, those costs can soon mount up.

'We know that some people value the extra service that 084 numbers can offer but others object to being charged more than the cost of a local call to access NHS services.

'We receive regular complaints from members of the public and parliamentarians about this.'

Calls to 084 numbers cost 5p a minute from a landline - more than the cost of a local call - and 40p from a mobile.

The Department of Health has tried repeatedly to stop GPs using high-cost numbers.

In 2005, it issued guidance over complaints that GPs were using 0870 numbers which are even more expensive.

But doctors moved on to 084 numbers - either 0844 or 0845 - which, although not technically premium rate, are still much dearer than a local call.

Two years ago, ministers issued further guidance, saying GPs could charge no more than the local call rate of 3.25p a minute.

But because family doctors are private operators, ministers have until now been reluctant to force them to change.

Phone campaigner David Hickson told the BBC's Today programme that use of costly numbers was completely unacceptable. He said: 'The NHS is supposed to be free at the point of need.

'The difference in each call may only be a few pence for some people, but the costs can really mount up for others - especially for people who are using mobiles because they don't have a landline.'

Network Europe Group, a telecoms company, says it has installed 0844 numbers in 1,200 surgeries and believes rivals have signed up 300 more for 084 services.

The company claims that patients gain because instead of hearing an engaged tone their call goes into a queue.

Laurence Buckman, chairman of the British Medical Association's GP committee, said: 'Telephone systems should make accessing a GP easier and also be cost effective for patients.

'We therefore welcome this consultation on how to improve the current system.

'The best way forward is for the Government to work with the telephone industry to make sure the companies that supply these systems move to local rate call arrangements with NHS organisations.'

Dr Buckman added that many surgeries were tied into long-term contracts, some of which can last seven years.

The telephone advice service NHS Direct also uses the higher-rate 0845 number and Mr Bradshaw said this policy would be reviewed. Some hospitals and primary care trusts also use the numbers.

GPs earn an average of £118,000 a year - up more than 50 per cent in four years.

They are also taking a higher proportion of the money they receive from the Government rather than investing in staff and services.

Source: e-Health Insider

http://www.e-health-insider.com/news/4413/official_consultation_on_084_numbers

Official consultation on 084 numbers
16 Dec 2008

<<
The Department of Health has launched a three month consultation on whether it should ban the use of 084 numbers in the NHS in England.

The 14 week consultation is the latest development in a long-running debate on use of revenue-sharing numbers by the health service.

So far, the DH has seemed reluctant to ban the numbers, despite calls to do so by campaigners. The government has said it will publish a response to the consultation by the end of April 2009.

As many as 1,500 GP practices in the UK are believed to use 084 numbers, which are also used by some hospitals and the helpline NHS Direct.

Health minister Ben Bradshaw said: "We know that some people value the additional service that 084 numbers can offer, but others object to being charged more than the cost of a local call to access NHS services. We receive regular complaints from members of the public and parliamentarians about this.”

The consultation document says: “We wish to find out how valuable people think the enhanced functions provided by 084 numbers are, and how they might otherwise be provided without patients having to pay more than a local call rate for them.”

It also says: “It is not an option to leave things as they are.” Possible outcomes include making the use of 03 numbers universal across the NHS. 03 numbers offer the same services as 084 numbers and are charged at a local rate - but an additional charge is levied against the person or organisation receiving the call.

A ban on the use of 0870 and 0871 numbers by GP practices, NHS dentists and NHS opticians was introduced in April 2005 when the government declared that the use of premium rates by the NHS was “an unfair additional cost” for many patients.

In January this year, the DH announced that it was to run a data collection exercise on the use of 084 numbers in the NHS and health minister Ivan Lewis gave a “cast iron guarantee” that NHS Direct would not be allowed to use an 0845 number when its contract comes to an end.

The data collection exercise was expected to be finished by the end of March. Since then the government has not taken any action, although in a letter to an MP in September, Bradshaw indicated that guidance would be issued to primary care trusts on ensuring that patients can access their GP or other NHS organisations without incurring additional costs.

Dr Richard Vautrey, deputy chair of the British Medical Association’s GP Committee, whose own practice uses an 084 number, said he welcomed the consultation and that he hoped the government would find a way to reduce the cost to patients while maintaining the telephone systems funded by 084 numbers.

He said GP practices did not make a profit from these but were instead investing more money to provide a better telephone system for patients.

David Hickson, a campaigner against use of 084 numbers, said: “It would be a disgrace” if the only action the government took was to conduct the public consultation on the issue.

“It is intolerable that three months is being wasted getting the obvious answer to this silly question about one tiny aspect of the NHS,” he said.

Hickson added: “For the NHS to be "free at the point of need" GPs, hospitals, other NHS bodies and NHS Direct must be required to cease using numbers beginning 0844 or 0845, because part of the payment made by patients when calling these numbers is provided as income or subsidy to the service provider.”
>>

At the end of this report, there is a link to an interesting Personal View of Derek Hodgson, head of telecommunications for the Imperial College Healthcare NHS Trust:

http://www.e-health-insider.com/comment_and_analysis/357/personal_view:_derek_hodgson

Source: Pulse

http://www.pulsetoday.co.uk/story.asp?sectioncode=23&storycode=4121502&c=2

GP surgeries could be forced to ditch 084 numbers

16 Dec 08

By Steve Nowottny

GP surgeries could be banned from using more expensive 0844 and 0845 telephone numbers, it was announced today.

Ministers have launched an England-wide public consultation on the use of the numbers, which can cost patients up to 20p a minute to call from mobile phones – and warned ‘it is not an option to leave things as they are.’

At least 800 practices in England are thought to use the numbers – with as many as one in three surgeries doing so in some parts of the country. Numbers beginning with 084 are also used by some hospitals and primary care trusts.

GPs using the numbers argue that it enables them to provide patients with a better service, and cuts down the time taken to contact surgeries by routing calls more effectively. But ministers fear patients are being unfairly over-charged.

Health minister Ben Bradshaw said: ‘We are concerned that some people are paying above the odds to contact the NHS. For people on low incomes who need to contact their local doctor or hospital regularly, these costs can soon mount up.’

‘We know that some people value the additional service that 084 numbers can offer, but others object to being charged more than the cost of a local call to access NHS services. We receive regular complaints from members of the public and parliamentarians about this.’

The Department of Health had originally been due to rule on the issue in March, but delayed the publication of its report pending ‘information gathering’.

The BMA welcomed the consultation - but defended the use of 084 numbers.

Dr Laurence Buckman, GPC chair, said: 'Where 084 numbers are used by the NHS there is good evidence that patient satisfaction has improved, with better and quicker access to services because of the additional functions within the telephone system.'

'We believe the best way forward is for the government to work with the telephone industry to make sure the companies that supply these systems move to local-rate call arrangements with NHS organisations. After all it was the government that encouraged many GPs to move to 084 numbers in the first place to help meet their access targets, and many surgeries will now be tied into long-term contracts.'

But consumer lobbyists expressed impatience at the further delay.

Campaigner David Hickson said: ‘It is intolerable that three months is being wasted getting the obvious answer to this silly question about one tiny aspect of the NHS.’

‘For the NHS to be ‘free at the point of need’ all of these bodies must be required to cease using numbers beginning 0844 or 0845, because part of the payment made by patients when calling these numbers is provided as income or subsidy to the service provider.’

The public consultation seeks views from patients, GPs, NHS bodies, the telecommunications industry and other interested parties, and closes on 31 March 2009.

Remember, in Norfolk the councils and the police charge citizens to call them via premium 084x numbers.

Source: Norwich Evening News

http://www.eveningnews24.co.uk/content/news/story.aspx?brand=ENOnline&category=News&tBrand=ENOnline&tCategory=news&itemid=NOED17%20Dec%202008%2014%3A02%3A21%3A933

Costly calls to doctors could be banned

SARAH HALL
17 December 2008 15:00

Health bosses in Norfolk have welcomed a consultation which could ban the use of expensive phone numbers patients use to call surgeries.

The government has launched a national inquiry into the use of 084 numbers in doctor's surgeries which can cost up to 45 pence a minute.

In Norfolk there are three surgeries which use this number and up until now it has been up to the individual practice whether they keep this prefix.

But NHS Norfolk said it would not encourage the use of the numbers. Dr John Battersby, director of public health for NHS Norfolk, said: “NHS Norfolk is aware that some of practices use the 084 number and the total number which currently do this in Norfolk is three.

“GP practices are independent contractors and although this is a decision which practices may take, NHS Norfolk would encourage GPs to consult with their patient representative groups before considering installing such a phone system.

“We welcome the consultation launched into the review of the use of 084 numbers across the NHS and should we receive clear guidance following this, we will of course work with the practices who currently use this number in moving to an alternative system.

“NHS Norfolk will be responding in full to the national consultation by the closing date.”

In the past doctors have argued that the 084 systems enable them to offer a better service but health campaigners argue that using the more expensive numbers is against the founding principles of the NHS, which should be “free at the point of need”.

North Norfolk MP Norman Lamb said: “The Department of Health made it clear three years ago that it is wrong for doctors to use premium rate phone numbers. The fact that this is still a problem is unacceptable.

“Calls to these numbers can cost mobile phone users 35p per minute. This is deeply unfair to patients. These charges should be scrapped, not reviewed.”

Last July some surgeries in the county were criticised for switching to the 084 dialling codes Costessey Medical Practice and Acle Medical Centre but surgeries claimed they did not charge any more than a local call which is about 5p a minute.

Earlier this year Norfolk Police were also under fire for changing to the 0845 phone number with concerns raised that people would be put off reporting crimes because of the expensive call rate.

Source: Healthcare Republic

http://www.healthcarerepublic.com/news/PHARMACIST/869701/Government-may-ban-practices-using-084-numbers/

Government may ban practices from using 084 numbers
17-Dec-08

GP practices could be banned from using 084 telephone numbers, the government has said.

The 084 code provides a number of functions not available with standard phone calls, such as a queuing system which allows callers to connect to busy lines rather than re-dialling.

But calls to the number are also more expensive than local calls. The extra income is shared with the organisation taking the call.

The government is now holding a 14-week consultation on whether to ban NHS organisations from using 084 numbers.

‘We know that some people value the additional services that 084 numbers can offer,’ said health minister Ben Bradshaw.

‘But others object to being charged more than the cost of a local call to access NHS services.

'For people on low incomes who need to contact their local doctor regularly, those costs can soon mount up.'

GPC chair Dr Laurence Buckman said that he welcomed the consultation. But he pointed to evidence that 084 numbers have improved patient satisfaction, and noted that the government had encouraged NHS organisations to move to the new system in order to meet access targets.

‘We believe the best way forward is for the government to work with the telephone industry to make sure the companies that supply these systems move to local-rate call arrangements with NHS organisations,’ he added.

Source: Kentish Gazette

http://www.kentishgazette.co.uk/paper/default.asp?article_id=38395

Teenager's bid to block 08 numbers

Kentish Gazette Thursday 18 December 2008

by Adam Williams

A TEENAGER has launched a petition to ban health centres from using 08 phone numbers.

Guy Mayhew, 16, of Plough Lane, Swalecliffe, decided to take action after his mother Sue was charged 8.51 on her phone bill, after being placed on hold for 85 minutes by Whitstable Health Centre's switchboard.

Mrs Mayhew, 46, was given an apology and a refund by the centre when she presented them with a copy of her phone bill.

Guy, an ICT student at Canterbury College and former Chaucer Technology School pupil, launched his petition on the Number 10 website earlier this month.

"An 08 number usually has a 10p connection fee, even if you don't get through and if you call the centre's 01 number, they redirect back to the 08 number," said Guy, who also runs community website www.swalecliffe.com

He added: "If I was to call an 01 number, it would cost less than 1p a minute with no connection fee.

"It's not really fair on older patients in this current economic climate, because they rely on their local NHS service.

"It's wrong to charge them this higher rate when they're struggling to pay utility bills."

Eastern and Coastal Kent PCT spokesperson Nick Evans explained the change to the higher charge numbers helps surgeries screen their incoming calls with greater ease.

"The general policy is that if a health centre is owned and run by the PCT, it should not be using higher-than-standard-rate phone numbers," he said.

"Independently-run GP surgeries, however, do have the right to use 08 phone lines and while the PCT does not endorse their use, we cannot ask GPs to remove them."

The health centre says the 0844 number was introduced at the Whitstable and Chestfield surgeries in direct response to a patient survey.

"We had received complaints from patients that they were not able to get through on the telephone at the extremely busy times," said practice manager Lesley King.

"Requests for a queuing system were made, so patients would know where they were and decide to either wait or call back later. We believe whichever phone system we use, we will still continue to get complaints due to the sheer volume of calls.

"This does seem to be a nationwide problem."

Guy Mayhew's petition is open until April 4, 2009, and can be accessed at petitions.number10.gov.uk/healthtelephone

Source: Whitstable Times

http://www.thisiskent.co.uk/whitstable/Doctors-cut-cost-phone-calls/article-555354-detail/article.html

Doctors to cut cost of phone calls

Wednesday, December 17, 2008, 14:26

WHITSTABLE Medical Practice is looking to change its telephone system after Government calls to ban expensive 084 numbers.

Surgeries in Harbour Street, Whitstable, and Reeves Way, Chestfield, are tied into a seven-year contract after adopting the system - which allows its 32,000 patients to join a queue rather than hear an engaged tone - in 2006.

Calls to book appointments at either surgery can cost up to 40p per minute from mobile phones.

But practice manager Lesley King says they are looking for a way out.

"We are tied into a long contract but are trying to find a way out of it," she said.

"The telephone system was put in as a response to patient surveys and complaints about not being able to get through on the telephone at extremely busy times.

"Patients requested we had a system with queuing so they knew where they were in the queue and therefore whether to wait or ring off and call back later."

Lesley says the practice was assured calls would be charged at 4.2p per minute - equal to the standard BT rate

"You can imagine that with approximately 21,000 and 11,000 patients the surgery telephone lines will always be busy," she said.

"Mobile telephone calls do cost quite a bit more than land line telephones but we believe everyone who has a mobile telephone accepts this is the case.

"We still get people who firmly believe because it is the NHS that everything, including the call from their homes to the surgery, should be free.

"Since installing this system things have changed quite considerably with telephone providers offering free local calls and the ever-increasing patient demand.

"We believe, regardless of whatever telephone system we have in the surgery, we will still continue to get complaints because it is down to the sheer volume of calls.

"We have changed our working practices to ease this as much as possible and are at a loss as to what more we can do."

Source: BMA

http://web2.bma.org.uk/pressrel.nsf/wlu/SGOY-7MDFCD?OpenDocument&vw=wfmms

BMA welcomes consultation on the use of 084 numbers in the NHS
(issued Tuesday 16 Dec 2008)

Commenting on the Department of Health consultation on the use of 084 numbers in the NHS announced today (Tuesday 16 December 2008), Dr Laurence Buckman, Chairman of the BMA’s GP Committee, said:

“Telephone systems should make accessing a GP easier and also be cost-effective for patients; we therefore welcome this consultation on how to improve the current system.

“Where 084 numbers are used by the NHS there is good evidence that patient satisfaction has improved, with better and quicker access to services because of the additional functions within the telephone system.

“We believe the best way forward is for the government to work with the telephone industry to make sure the companies that supply these systems move to local-rate call arrangements with NHS organisations. After all it was the government that encouraged many GPs to move to 084 numbers in the first place to help meet their access targets, and many surgeries will now be tied into long-term contracts.”

Source: Hull Daily Mail

http://www.thisishullandeastriding.co.uk/news/Consultation-use-084-numbers-GP-surgeries/article-551584-detail/article.html

Ban on 084 numbers at GP surgeries?

Tuesday, December 16, 2008, 15:15

MINISTERS are considering a ban on the use of controversial 084 numbers at GP surgeries.

Earlier this year, the Mail reported on how the system, which charges patients up to 5p a minute from land lines and 40p a minute from mobile phones, was being used by 11 surgeries in East Yorkshire.

The system, operated by Surgery Line, has been branded unfair by patients and health watchdogs

Now the Government has launched an England-wide consultation to ask people whether they want to keep the numbers.

The Patient's Association is on a list of prospective co-campaigners to become engaged in public discourse and promoting media coverage throughout the consultation process.

It was therefore of great interest to see one of its vice-presidents using his ready access to the media to promote an issue of concern to patients - http://www.guardian.co.uk/society/2008/dec/23/hospital-superbugs-branson-mrsa.

The coverage however reports a suggestion that the NHS should emulate the airline industry. When one notes the following - http://www.virgin-atlantic.com/en/gb/customerrelations/contact_us/phone.jsp - this is seen not to be such a positive suggestion.

On the other hand, if the Patient's Association were to support the proposal for a ban on use of revenue sharing numbers in the NHS, perhaps its vice-presidents might wish to join a bandwagon in support. An announcement that a major airline had abandoned revenue sharing numbers to help encourage the NHS to do the same would not only be great publicity for the airline, it would also aid the campaign in respect of the NHS and beyond.

A point worth returning to once we have, I hope, all had a Merry Christmas.

... But on Boxing Day morning we arise to find the following statement picked up by Google-

http://www.devonshirelodge.co.uk/telephone_system.htm.

Although fairly recent, and updated on 21 December 2008, to include a link to the NEG Statement, there is no clear evidence of its age. The timing of the number change will come to light in due course.

The statements about call costs (retained after an update on 21 December 2008, following the announcement of the DH consultation) provide strong evidence of how NEG Surgery Line is being promoted based on misleading material. I refer to the fact that VAT and the 7p call setup fee each applies to both calls to 0844 and other numbers on BT's most widely used residential tariffs (in common parlance, this is what would be understood by the word "standard"). The cost of calling from landlines, payphones and mobiles does vary considerably, for example many BT customers pay nothing to call a normal landlline number at various times. In all cases the new number is more expensive to call than the old.

I have never received any explanation of how calls can be answered more quickly other than by a change to the number of receptionists manning the phones, or to their procedures. To imply that patients can save money as a result of calls being connected (hence triggering charging) before they are answered, must appear absurd. Furthermore, when the cost per minute of a call is invariably increased, it will be interesting to learn of how the claim that any (let alone many) patient(s) pay less can be sustained.

The discussions that will inform public opinion during the course of the consultation will be interesting.

Source: Southport Visitor

http://www.southportvisiter.co.uk/southport-news/southport-southport-news/2008/12/24/two-southport-surgeries-in-row-over-costly-phone-numbers-101022-22537228/

Two Southport surgeries in row over costly phone numbers
Dec 24 2008 by John Siddle, Southport Visiter

TWO Southport surgeries which charge patients up to 40p a minute to ring doctors could be forced to use cheaper local-rate numbers.

St Mark’s Medical Centre, Derby Road and Ainsdale Medical Centre may be banned from using potentially costly 0844 and 0845 numbers, which patients have to ring to book an appointment, obtain test results or repeat prescriptions.

MPs have launched a review to decide whether practices should be allowed to use a system which sees callers charged 4.2p per minute from a BT landline but 40p from a mobile.

Southport politician John Pugh said: “High cost phone numbers are creeping like a disease throughout the NHS and other public services.

“It is effectively a form of profiteering and it is highly inappropriate in the NHS, where people have no choice but to phone.”

Around 1,500 of England’s 8,000 practices are understood to use 084 numbers, which are not premium-rate but still costlier than a local call - 3.25p a minute.

Conservative councillor Brenda Porter urged both surgeries to revert to familiar 01704 numbers, which patients could remember easily.

The prospective Tory MP said: “If you’re sick, then making an appointment should be as easy as possible and cheap as possible. “

St Mark’s Medical Centre practice manager Paul Cheston defended the system, which puts callers in queues to prevent engaged tones and records all calls.

He laid the blame at mobile phone operators for the high cost of calling.

He said: “We do not charge patients 40p a minute to ring our surgery, particular phone companies do.

“If they use BT, it costs 4.2p a minute.”

But local healthcare campaign group CARES also demanded the town’s two practices revert to cheaper-rate numbers.

Spokeswoman Cath Regan said: “The NHS is meant to be free at the point of need so it is quite outrageous that they are making money out of sick people like this.”

---

Mr Cheston evidently believes that those telephoning from BT landlines will be VAT registered. Should expenses which are exclusive of VAT not be spent as part of operating a business?

How does the provision of contacting an NHS GP surgery figure in the running of a business? Is the NHS diversifying into making businesses better as well as individuals? Perhaps Woolworths should have been a registered patient at St Mark’s Medical Centre.

Source: Harlow Herald

http://www.harlowherald.co.uk/content/hlwherald/news/story.aspx?brand=HLHOnline&category=NewsHarlow&tBrand=HertsCambsOnline&tCategory=newslatestHLH&itemid=WEED23%20Dec%202008%2017%3A14%3A12%3A300

MP warns surgeries over phone lines
09:11 - 27 December 2008

DOCTOR'S surgeries in Harlow are being urged to scrap phone numbers which charge patients more than a local call.

The Herald revealed back in May that some surgeries in the town had changed their contact numbers from a 01279 phone number to a 0844 number which meant residents who do not normally pay for local calls are being charged.

Harlow MP Bill Rammell has now written to all surgeries in Harlow which use the 0844 prefixed phone numbers, and the government, urging them to scrap the system.

The Department of Health is currently consulting on whether to scrap the use of 0844 numbers in the NHS.

Mr Rammell said: "I feel this system of making money from patients who simply want to phone up to make a doctors appointment is grossly unfair, and I am pleased that the Government are looking at options to change the rules. "The NHS in general and GPs have seen a huge increase in funding under this government. These phone number rip-offs are unjustified.

"I have responded to the government's consultation, urging them to stop this unfair practice and I have also written to those surgeries in Harlow who advertise revenue-earning phone numbers.

"GPs undertake vital and valuable work in our community, but I am urging them to reconsider their position on this issue.

Interestingly, St Mark's Medical Centre in Southport is trialing a new phone system called Patient Partner:


Quote:

St Mark's introduces a new telephone appointment system - test St Mark's is currently trialling a new telephone appointment booking system called Patient Partner. The system allows patients to book appointments on a 24 hour-a-day basis via an automated telephone service, freeing up administrative time. The system is very flexible and the patient can call to make, re-arrange or cancel appointments at any time of the day. The patient can also be text with a timely reminder so they don’t forget their appointment.

St Mark's phone number is a 0844 477 Opal Telecom one, which seems to be used by those on NEG's Surgery Line.

Patient Partner is a service provided by Voice Connect. It mentions case study surgeries on its website, and they use different types of phone numbers:

• Dapdune House Surgery, Guildford 0844 477
  
• Pemberton Primary Care Resource Centre, Wigan 0844 477
  
• The Village Surgery, Poole geographical
  
• Gosport Medical Centre geographical

A PDF brochure is available from Ocean Telecom here.

The interview on BBC Breakfast on the morning of 16 December with an NEG representative and a campaigner is online here.

Source: Cornwall Conservatives

http://www.cornwallconservatives.com/index.php?sectionid=3&pagenumber=460

Campaigner welcomes consultation over use of 0844 telephone numbers for doctors’ surgeries

A CAMPAIGNER has welcomed the recent announcement that a consultation into the use of the controversial ‘Surgery Line” telephone system is to be held.

Sheryll Murray has spoken of her support for the public consultation over the use of expensive 0844 telephone numbers by GPs and healthcare providers.

Sheryll said she hoped the consultation exercise would highlight the alarming issues many patients had faced after surgeries refused to provide them with cheaper, local telephone numbers.

Earlier this year, Sheryll issued calls for doctor’s surgeries across South East Cornwall to make public their local direct dial telephone numbers for patients’ use, rather then rely on using the costly 0844 telephone numbers.

As part of those calls, she put forward proposals that the Cornwall and the Isles of Scilly Primary Care Trust (PCT) should make is compulsory for all GPs to publish the local telephone number - in addition to the 0844 number – in a report submitted to its select committee.

In May, the PCT informed Cornwall County Council’s Health Scrutiny Committee that it had formulated a three-point action plan over the issue – which included requesting GP surgeries to offer a choice of either using the 0844 or local telephone numbers to patients.

However, since then Sheryll has received a number of complaints from patients that some surgeries in South East Cornwall have refused to provide them with the cheaper, local numbers.

Now, she is urging anyone who has faced such difficulties to take part in a public consultation exercise over the issue, which runs until March 31st 2009.

Sheryll, the Conservative Prospective MP for South East Cornwall, said: “I would urge all patients who are unhappy with the use of these numbers by their surgery or other healthcare provider to respond to the consultation.

“I will be sending a full report on my work over the past year to the Dept of Health.

“Many GP surgeries entered in to contracts with telephone service providers in good faith and if the Minister concludes that the use of these numbers must be stopped, he must ensure that any financial compensation for breaking contracts with telephone service providers is not at the expense of patient care or the GP practices.”

Source: BMA Cymru Wales Blog

http://bmacymruwales.blogspot.com/2008/12/bma-welcomes-consultation-on-use-of-084.html

BMA welcomes consultation on the use of 084 numbers in the NHS
Tuesday, 16 December 2008

The announcement by the Department of Health that it's to launch a consultation on the use of 084 numbers by GP surgeries should be broadly welcomed.

The whole point of using phones to contact a GP, is to make it easier for people to get in touch with surgeries. But it should also be a cost-effective system for patients.

There is strong evidence that patient satisfaction has improved where the 084 numbers are used, with better and quicker access to services, because these telephone systems have added functions. GPs do not in any way want to profit from patients. But perhaps the public may think the added convenience these numbers provide, make the (usually small) additional cost worth it.

Let's not forget as well, that GPs were encouraged to switch their numbers in the first place to ensure better access for patients. And it’s not just GP surgeries which use these numbers, NHS Trusts do as well.

As the DoH has decided this issue now needs addressing, maybe it's time the Welsh Assembly Government did the same, so the Welsh public aren't paying more than those across the border, to get a GP appointment.

Posted by Richard Lewis at 15:32

[Richard Lewis is the Welsh Secretary of the BMA]

---

You may remember that the Welsh Assembly Government is reviewing the use of these numbers:

http://www.walesonline.co.uk/news/health-news/2008/07/13/patients-being-ripped-off-by-gp-phone-charges-91466-21331577/

I have heard today that there will shortly be another hero to add to the 0300 list.

NHS Blood and Transplant, which comprises what was the National Blood Service and UK Transplant, will shortly be announcing that the following two numbers will be replaced by 0300 123 xxxx.

Organ Donor Line - 0845 6060 400
Blood Donor Line - 0845 7 711 711

A final decision on whether to adopt a single number for the combined body (the preferred option), or to retain two separate numbers, is awaited. Once this has been made the change will be announced with due publicly.

When this can be announced it will add weight to the consultation process. In the meantime there is no need to apply pressure to this body, nor can it be used as an example of those who will be retaining 0845 numbers.

(This change has actually been in the pipeline for a very long time. Public bodies do move very slowly; sometimes so slowly that it is difficult to believe that they are moving at all.)

It certainly looks like the NHS is moving (albeit slowly) from 0845 numbers towards 0300 123 numbers - Change4Life being probably the first example of an NHS related body using an 0300 number.

Dave wrote on Dec 29^th, 2008 at 3:48pm:

“If they use BT, it costs 4.2p a minute.”... Mr Cheston evidently believes that those telephoning from BT landlines will be VAT registered. Should expenses which are exclusive of VAT not be spent as part of operating a business?

I think it's more of the likes that NEG may be telling surgeries it costs 4.2p and forgetting to mention that doesnt include VAT.

My main concerns, which I will put in my consultation response, are:-  

*NHS is meant to be free at point of use

* Patients who may not have a landline, or be financially better off (who is these days?) are penalised by ringing a 084x rather than a geographical or 03x which, if applicable, is included in any inclusive minutes.

* Surgeries generally believe this to be a local or lo-call rate and it's NEG themselves that maintain this deception

* It may not be diallable from some operators outside the UK

* It really hard to say that calls are answered sooner because if a surgery only has one person able to answer a call at any one-given time then you may not actually get through any quicker compared to a surgery that operates a geographical and not a 084x number.  Yes, it would save redialling but on the flip side you could be held in a queue for several minutes (maybe even 10mins or more) at a cost of 5p/min (from a BT landline but obviously considerably more from a mobile) whereas ringing a surgery with a geographical number it could be included in any inclusive minutes and it doesnt cost anything to receive an engaged tone.

The last point, I belive, is one that some people may forget.  It's a matter of choice. I personally dont want to wait a long time in a queue at upto 40p/min when I could ring a surgery on their geographical number and get and engaged tone and just keep ringing back when convenient until its not engaged.  However some people may not care about waiting ages in queue and paying upto 40p/min.

If a surgery operated both a 0844 number and their underlying geographical number and callers were aware of advantages/disadvantages of each number then that would prove that the surgery (and ultimately NEG) are doing it to "benefit" patients rather than just to make money.  As far as i'm aware surgeries arent aware of any underlying geographical number as NEG keep this to themselves for obvious reasons

bbb_uk wrote on Jan 5^th, 2009 at 9:43pm:

The last point, I belive, is one that some people may forget.  It's a matter of choice. I personally dont want to wait a long time in a queue at upto 40p/min when I could ring a surgery on their geographical number and get and engaged tone and just keep ringing back when convenient until its not engaged.  However some people may not care about waiting ages in queue and paying upto 40p/min. If a surgery operated both a 0844 number and their underlying geographical number and callers were aware of advantages/disadvantages of each number then that would prove that the surgery (and ultimately NEG) are doing it to "benefit" patients rather than just to make money.  As far as i'm aware surgeries arent aware of any underlying geographical number as NEG keep this to themselves for obvious reasons

This is an interesting point. I am not sure if this is seen as only applying in the event of use of revenue sharing numbers not being banned.

Let us say for example that a NHS practice decided to continue using Surgery Line, but on a 0344 (or even a geographic) number, funded other than by patients. How far would the principle of choice demand that patients were offered alternative ways of making contact by telephone?

Furthermore, does the principle of choice work the other way around; should all surgeries be required to provide patients with the option of waiting in a queue (at no cost if they have an inclusive package) if that is what they would prefer?

My own view is that it is for each practice to decide how best to serve the needs and wants of its patients, however the use of revenue sharing telephone numbers should not be an option available to it. I do not believe that there should be a two-tier service; with one option available at a fee and another, which some would see as inferior, available without a charge being made by the practice.

It appears that an otherwise moderately-behaved campaigner has been caught "fuming", or should that be "smoking", over the revelation that NHS Direct is operating a total of 69 revenue sharing 0845 numbers (if one adds 46 47).

It is perhaps odd that this highly tabloid piece did not make something of the potential soixante-neuf allusion that was offered, perhaps with a picture.

It is perhaps more odd that the fuming campaigner apparently did not make any reference to the on-going consultation, but then you can never trust what you read in the papers.

Ahem!

"They should be concentrating on running telephone services for patients that cost no more than a local call."

A far less tabloid piece here.

No reference to "local calls" or the agitated state of mind of a campaigner, and properly placing the particular issue in the broader context.

Publication of the Mirror piece has however excited interest from other organs of the media, of which more may be seen in due course.

SilentCallsVictim wrote on Jan 6^th, 2009 at 8:04am:

this highly tabloid piece

I now understand why this story was put together for publication hurriedly, late in the day, after a change of mind on the part of the editor, who had initially decided not to run it.

It was needed as the basis for editorial comment.

To have "The Voice of the Mirror" so clearly on our side perhaps shows that this issue transcends Party politics.

The EHealth Insider report cannot even get the NHS Direct number correct ...

" ... In addition to its main 0845 4567 helpline number ..."


I despair at these incompetents  >:(

Those who have been able to review the DH consultation document on use of 084 numbers may have picked up that it seems to be written to get a particular response.  Essentially, respondants are misled into believing that some of the 'useful features' are only available with 084 and not 01, 02 or 03.

I've asked the DH consultations co-ordinator to respond to the following:




I have a copy of the consultation document and will provide comments in the normal way.

However, there are serious and substantial errors in the consultation document.  These include:

p4 'These functions are not generally available with local rate numbers'.  As there is no such thing, on the UK telecoms network, as a 'local rate number', it is assumed the reference is to a geographic number.  All the call managment features available with 084 numbers are available with 01, 02 and 03 numbers.  The choice to provide such features is made by the provider; it is not determined by the number used to access the service.

p4 'Why are these extra functions needed?'.  The inference is that the fuctionality is connected to 084.  This is not the case.

p5 'What are the extra functions provided by 084 numbers?'.  The statement that these functions are provided by 084 is untrue, in the sense that each of them is perfectly possible with any other category of number.

p5 'Is there another way to provide the extra functions?'.  Whilst the suggestion of 03 numbers is helpful, 01 and 02 numbers should not be excluded.  Again, the same point applies.

p5 'Why are GP practices increasingly using 084 numbers?'.  Again, the listing suggests that these features are only available via 084 numbers.  Untrue.

p7 'GP practices and other NHS organisations using 084 numbers do not make a profit.'  To describe this statement as being economical with the truth would be to be very polite.  The deal with telecoms systems providers means that the extra call revenue is diverted into providing systems in which GPs would otherwise have to make a capital investment.  This is no different than suggesting that making patients buy their own wound dressings would not lead to GPs making a profit - it would reduce their essential overhead costs which has the same effect as increasing profit.

p7 'How to local rate, 084 and 03 numbers compare?.  The features attributed to 'local rate' (sic) numbers are, as outlined above, incorrect.


As you will gather I am very clear that the presentation of information as 'facts', when they are not, seriously undermines this consultation.  This is so serious that any results will be rendered meaningless.

I would be grateful if, by return, you will let me know what action you intend to take.

Thank you.

questedh wrote on Jan 7^th, 2009 at 11:12pm:

respondants are misled into believing that some of the 'useful features' are only available with 084 and not 01, 02 or 03.

There is no question that the document does not properly distinguish between non-geographic (084 / 03) and geographic (01 / 02) numbers. The truth about 03 is in there, but it struggles to emerge.

In a spirit of genuine open enquiry, I seek enlightenment on the main point of contention in the posted comments.

I understand that many features exploited by telephone systems on non-geographic numbers use facilities hosted at the network telephone exchange. Use of these features comes at a cost which is met by a part of the revenue share income when available, or by additional charges to the user when not.

I also understand that similar or identical features can be provided by facilities on equipment at the (surgery) premises on the end of any number. Again these would come at a (possibly lesser) cost. There may however be differences in the nature of the feature, e.g. a local line fault may leave the whole service out of order and the size of the queue of waiting callers is constrained by the capacity of the incoming lines, which would otherwise only need to accomodate actual conversations in progress.

I had understood that it is possible for some of the facilities available with non-geographic numbers to be hosted on some geographic exchanges. Again this would be at a cost charged to the user, although I am not sure if this would be different to that applied when on a non-geographic number. I also understand that there can be clever tricks achieved by re-routing calls to geographic numbers through other exchanges to take advantage of facilities not otherwise available and then back again. This facility would also incur a cost.

The posted comments seem to suggest that the exchange hosted facilities available on non-geographic numbers are equally available on geographic numbers in all cases and in all respects. This would mean that the only valid reason for incurring the expense of a 03 number would be a desire to avoid the service being associated with any geographic locality.

I would be most grateful if my understanding could be enhanced.


The weak references to 03 (and possibly further misleading information) leave the consultation dangerously close to presenting the option of a better service only being available at a higher cost to patients. I cannot disagree with the suggestion that the consultation is thereby flawed, however those behind the consultation do know very well that this is a false choice, and what is more they know that we know that they know this.

I am confident that the results of simple responses to the consultation will indicate both that patients want better telephone services and that they do not wish to pay for NHS services as they access them. If the latter point were to come out in the other direction, Darzi would have to start his work all over again as he reported overwhelming support for the principle of "free at the point of need" in the NHS. This principle currently occupies a leading place in the draft NHS Constitution.

Patient satisfaction surveys have repeatedly shown that improved telephone systems lead to a significant increase in satisafaction ratings, so it is unlikely that respondents would reject the idea of improved systems.

The true purpose of the Consultation is to provide a period of public discussion and debate, with the engagement of key players, to determine how a ban on use of 084 numbers could be put into effect without compromising the quality of telephone systems. As all features have to be paid for in some way, the difficult question is, who (if not the patient) should pay?

This question is particularly difficult in the case of GP systems that are subject to long term contracts and are currently funding through revenue sharing. It has been suggested that these systems could be migrated to 03 numbers with revised funing arrangements. If, as is suggested, they could equally well be migrated back to the local numbers that were used previously, then this would represent a significant breakthrough. I urgently need confirmation on this point.

As those who can offer feature-rich telephone systems on geographic numbers must be regarded as key players in the Consultation, I look for them to come forward to show their hand and make their case in the public debate.

SilentCallsVictim wrote on Jan 8^th, 2009 at 1:27am:

I would be most grateful if my understanding could be enhanced.

I'm amazed that after all this time involved with the campaign and having even met the esteemed Tanllan in person that you still seem to struggle to comprehend even these most basic features of the UK telephony systems and its revenue sharing aspects.

Still I expect this persistent Janet and John style approach makes you far more interesting for coverage by say The Daily Mirror.

Most of what you say agrees with my understanding, in so much as I am only a member of the public with a specific interest in this technology, and not a participant in the actual industry.

Simply put, when you dial a phone number, the first few digits will identify the operator of the number and therefore the exchange that will handle the call.  For BT's 01 & 02 numbers, this will usually be the local telephone exchange.  For other operators, it need not be anywhere near the subscriber.  It's then up to the exchange what features it will offer the end user.   Numbers can be ported between operators, so it's possible for example for calls to a number originally allocated to BT to be passed over to any other operator, subject to the relevant porting agreements being arranged.

How a given operator gets the calls to the subscriber is up to them - BT mostly run a physical cable (copper or fibre optic) from the local exchange to the subscribers premesis.  Other operators may offer the calls via an internet connection (VoIP), radio waves (e.g. direct to a mobile phone, as per Orange geo numbers) handle it directly (in the case of recorded information services) or simply feed it back into the system by calling another number (how most NTS systems work, forwarding to a landline with its own number).

[it's quote possible for a call to traverse several networks.. e.g. I used to run an 0870 that was forwarded to a BT line. This had divert on busy to a Tesco geographic 0161 number, which was actually provided by VoIP via an internet connection to my local PBX, which if there were nobody in, could in turn forward it to my mobile (via a VoIP service provider..)]

The actual network faciltiies available to the subscriber, queuing, routing depending on time of day or origin, etc., are partly dependant on the operators equipment that the call arrives in on, but more importantly, on the marketing policies of the operator concerned.  e.g. most BT local exchanges can handle call queuing and conditional forwarding, but you'll only get offered them as part of a featurenet package.. (Or in a much watered down form as Call Waiting and Call Diversion)..

So, by porting your number to a more accomodating operator, you can do anything you like with any number.

irrelevant wrote on Jan 8^th, 2009 at 9:23pm:

I am only a member of the public with a specific interest in this technology, and not a participant in the actual industry.

Are you sure as your last post seems to display the same level of detailed technical awareness of how the whole damn setup works as Tanllan.

Still journalists seem to prefer talking to SCV because of his dogged persistence in pushing forward his KISS arguments that eschew becoming bogged down by the boring technical complexities of what actually is and is not physically achievable on the network.

NGMsGhost wrote on Jan 8^th, 2009 at 10:35pm:

Are you sure as your last post seems to display the same level of detailed technical awareness of how the whole damn setup works as Tanllan.

You can learn a lot by reading uk.telecom ...
I did work for a company that was part-owned by BT once, but that was 20 years ago...    No, I've just had a technical interest in phone systems ever since I built my own modem and re-wired the house for plug-in phones about 25 years ago; several years before the current BT sockets became available.  Most of my hobby and professional life has been influenced by modem and on-line comms ever since, although only from a consumer point of view. Doesn't stop me reading up on how things work though.

Source: OnMedica

http://www.onmedica.com/NewsArticle.aspx?id=bffec7e7-3e4d-416d-a9b0-cfb605742428

BT drops practices 0845 phone number charges

OnMedica staff
Monday, 12 January 2009

BT has dropped its charges for 0845 and 0870 phone numbers for its customers if they have a call package, it has been announced.

The decision could ease pressure on the estimated 1,000 GP practices in England alone that use an 084 number – a decision which has prompted much criticism from patients whose call packages do not cover such numbers, forcing them to pay more to call their doctor.

More than 1,000 practices use 0845 numbers, which provide extra functions such as queuing for unanswered calls.

From Friday (Jan 16), patients will be able to phone around 300 practices that use 0845 numbers for free.

The change, however, does not include numbers beginning with 0844, which is the more commonly used prefix for GP practices, but it is hoped that this will, in time, also become included in BT’s call packages and those of other phone service providers.

---

What planet are these people living on? The call rate for any 0844 number block is chosen by its respective operator. As GPs are customers of these providers, it is ultimately of their own making.

Do they really believe BT, Virgin Media and other originating telephone call retailers are charities? It will cost them about 4 pence per call minute more than had it been an 01, 02 or 03 number and all for their benefit!

It does not help build a good perception of doctors.

Dave wrote on Jan 15^th, 2009 at 5:39pm:

Source: OnMedica http://www.onmedica.com/NewsArticle.aspx?id=bffec7e7-3e4d-416d-a9b0-cfb605742428 BT drops practices 0845 phone number charges

Registered users of this site, "the leading online medical publication for doctors and UK healthcare", will be able to read the following comments on this article.


Quote:

BT has not dropped any charges, it has added two types of call which may be called without further charge to packages that apply at certain times for those who pay to subscribe. Only 1.4 million BT customers will be able to call the 272 GP surgeries with 0845 numbers in South Yorkshire and the West Midlands, plus a few others, during normal surgery hours. The NHS serves many others. There is no way that calls to these, or over 1000 GPs using 0844 numbers, could ever become free for all BT customers at all times. The facts of revenue sharing mean that we will never see all companies offering all 084 calls at normal rates. GPs and other NHS providers who continue to benefit from the subsidy obtained by use of 084 revenue sharing numbers must now change to 03 numbers, if they need the extra network functions. 03 numbers must be included in packages or charged at no more standard landlines (01 / 02 numbers). Revenue sharing is prohibited, so services have to be funded properly, not out of fees paid by patients, whether in call charges or package subscriptions.

I understand that a small number of printed copies of the consultation document have been despatched to every GP surgery in England to be made available to patients and staff who may wish to respond.

Requests for further copies, and reports of none being received are being handled by the consultation team at 084consultation@dh.gsi.gov.uk.

Members may wish to approach their local practices to ensure that the consultation process is progressing properly. Support is just as likely to be found at practices where staff and patients wish to retain the principles of the NHS, as at those where they are being breached.

Many practices recently encouraged patients to sign petitions in favour of supporting the NHS through the "Save our Surgeries" campaign. They may also be keen to promote the petition to preserve the principles of the NHS - http://petitions.number10.gov.uk/Healthtelephone/ - as promoted on this site.

I would urge members to make the point that the consultation is not about returning to ineffective telephone systems as the only alternative to patients paying for them. Each surgery must have the best telephone system that it can, but it must be funded properly.

Some good news - Pharmacists back ban on practices' 084 numbers

(The press release is found here)

Most local pharmacies use local numbers, however there are some which use 084 and even 087 numbers. Those which are registered providers of NHS services will be covered by the ban.

Some good news (for those who enjoy a fight).

The GPC of the BMA has declared the BMA position on the consultation - see page 6 of this document

Apart from some waffle about contracts, which can be addressed, and BT, which is irrelevant, the main point is standing in opposition to the principle of the NHS being "free at the point of need".


Quote:

we believe that people should be charged as low a cost as possible to call NHS services but that this has to be balanced by the quality of service the patients are accessing

This simply begs the question of how much a patient should be charged for a high quality operation on the NHS, or high quality nursing care. "As low a cost as possible" perhaps, but the NHS constitution declares that there can be no cost imposed on a NHS patient.

Let us hope that the majority of BMA members, who hold to the principles of the NHS, will let their voices be heard.

This is the bit that is complete and utter nonsense!


Quote:

We also welcome BT’s decision to allow 0845 numbers to be free within their call packages. This suggests that the Government could encourage all telephone companies to review their call charges to NHS services, and include 084 numbers in comprehensive call packages so that patients do not incur additional costs.

They expect telephone call retailers to stand to far far higher charges (14 times) and include them at zero fee!!!

Do GPs live in the real world????  ::) ::) ::) :'( :'( :'(

This evidence leads me to believe that some do not.

The E-Health Insider website is now carrying the story on the BMA's disgraceful consultation response:-

See www.ehiprimarycare.com/news/4599/bma_says_084_must_run_its_course

As far as I can see this BMA response is absolutely typical of the patronising non customer focused attitude still displayed by so many GPs (and that my mother has bad personal experience of in the last two years) that has always put me off both them in particular and the medical profession in general.

Namely that doctor always thinks he knows what is best for you and that you must jolly well do as you are told by doctor without question, even if it is complete bunkum, as it is here.

The BMA have proved here that they are nothing more than a trade association who only care about the financial welfare of doctors who have stupidly signed up to these ripoff deals losing money if they are forced to terminate the contracts early by the NHS.

The BMA clearly couldn't give a stuff about the financial consequences of GP accessibility for patients, especially if they need to call their GP on a Payphone or a mobile phone where 0844 is subject to racketeering levels of call pricing. :o >:( [smiley=thumbdown.gif]

Some more links on this:

http://community.healthcarerepublic.com/blogs/editors_blog/archive/2009/01/28/don-t-let-doh-off-hook-on-084-ban-in-rush-to-go-green.aspx
http://www.pulsetoday.co.uk/story.asp?sectioncode=23&storycode=4121981&c=1


Has BMA published its response publicly or has it just been given to industry journals?

Dave wrote on Feb 26^th, 2009 at 1:26pm:

Has BMA published its response publicly or has it just been given to industry journals?

It has published an outline of what it will be submitting, in the monthly GPC newsletter distributed to local medical committees around the country.


SilentCallsVictim wrote on Feb 24^th, 2009 at 6:17pm:

The GPC of the BMA has declared the BMA position on the consultation - see page 6 of this document

(my original posting contains a typo - "GMC" should read "GPC" - I appear to have lost the ability to modify my postings)

More nonsensical suggestions from doctors:

http://www.healthcarerepublic.com/news/PHARMACIST/883518/GPC-says-practices-exempt-084-ban/


Quote:

The GPC welcomes BT’s decision to allow 0845 numbers to be free within their call packages. It says this suggests that the government could encourage all telephone companies to review their call charges to NHS services and include 084 numbers in comprehensive call packages so that patients do not incur additional costs.

Why should telephone providers with which calls are made (retailers as it were) provide subsidy to GPs when it's not in their interest to do so? Do GPs not realise that a supermarket that sells a product as a loss do so for their own benefit because it will bring customers into the store?

Why would a retailer have a loss leader solely for the benefit of the manufacturer of the product?  ::)

It is crucial that it is understood that the cost of calling all 0844 numbers from BT lines is set by the telephone providers who operate the ranges. GPs are these providers' customers, so are thereby responsible for the higher inter-operator 'wholesale' charges which provide subsidy for their telephone system.


The article goes on to say:

Quote:

A GPC concern is that when the new telephone systems were put in with the 084 numbers, many surgeries had to sign up to a long contract and, even if they want to change, they cannot at the moment.

More nonsense! Are GPs not old enough to understand the implications of opting into a long term contract?

Stewart Jackson MP also supports the review:

http://www.stewartjackson.org.uk/news.html?bM=1&bD=9&bY=2009&bT=244

http://www.gazette-news.co.uk/news/4112509.Campaign_to_say____no_to_084___/

Campaign to say ‘no to 084’

3:00pm Tuesday 10th February 2009

<<
A PARISH council is urging patients to have their say on the use of 084 numbers at doctors’ surgeries.

Kelvedon Parish Council raised concerns last year when the new numbers were introduced at Kelvedon Surgery, in High Street, in place of the cheaper local code 01376.

Barbara Lord, practice manager, said the number improved service at no extra cost.

The Department of Health has now launched a public consultation on the issue.

Graham Dossett, who campaigned for the parish council on the issue, said: “The council would encourage people to take a few minutes to look at the stuff the Department of Health has published and take less than a minute to tick the boxes and have their say.”

The consultation information is available via the DoH website.

The department document states: “We wish to find out how valuable people think the enhanced functions provided by 084 numbers are, and how they might otherwise be provided without patients having to pay more than a local call rate for them.”

The consultation closes on March 31.
>>

No extra cost to the surgery that is.  ::)

Further to the main consultation process the Department of Health has now announced that there will be two public "events" on 19 March 2009 in London. One for the telecomms industry, the other for "others",

These events, which are announced here, are intended to help inform the consultation process.

Given that the intention is for these events to be relatively small, I fear that the open nature of the invitation will either cause many to be disappointed, or for many further events to have to be arranged.

I see that the second paragraph giving the reason for the consultation mentions only the benefit enhanced functions  utilising 084 numbers-it does not state that they can equally be accessed through 03 range.

Why is the Department of Health holding a public consultation on the use of 084 numbers in the NHS?

The Government is considering banning the use of 084 numbers in the NHS. This is because patients who use 084 numbers are paying more than the equivalent cost of calling a geographical number (i.e. a number beginning 01 or 02) to access services provided by the NHS. The Department of Health has issued guidance on several occasions which has made its position clear on this, and does not expect this situation to continue.
However, the Government recognises that the extra functions offered by numbers such as those from the 084 range can improve access to services for patients. We wish to find out how valuable people think the enhanced functions provided by 084 numbers are, and how they might otherwise be provided without patients having to pay more than the cost of dialling a normal geographical number.

Sorry, I appear to have misread the final sentance of the reason for the public consultation. Please ignore my previous post. :-[

redant wrote on Mar 6^th, 2009 at 6:27pm:

I see that the second paragraph giving the reason for the consultation mentions only the benefit enhanced functions  utilising 084 numbers-it does not state that they can equally be accessed through 03 range.

The references to use of 03 numbers, as the obvious means of offering the same functions as those provided by "numbers SUCH AS those from the 084 range", are not as strong as they might be, although they are there. If they were clearer it would be difficult to show why there was any need for a consultation!

The fact is that those keen to retain the benefits of revenue sharing have raised vague and spurious objections to use of 03, which the Department of Health needs help to dismiss. One hopes that those attending the industry event will be able to provide the necessary assistance, as well as demonstrating that the same or equivalent functions can be provided on geographic numbers.

Those attending the "other" event should be able to deal with the disgraceful BMA proposal that the principle of "free at the point of need" be abandoned in favour of NHS patients paying for access to NHS services according to the quality of service provided.

Another MP is backing the ban:

http://www.adriansanders.org/adriansandersmp/2009/02/bay-mp-calls-fo.html

Adrian Sanders: Bay MP calls for ban on 084 numbers in the NHS

Following the Department of Health’s recent announcement that it is to review how people contact NHS services, Torbay MP has called for the use of expensive 084 numbers to be stopped.

084 numbers cost the caller more than the standard local rate but do provide extra functions such as allowing effective management of a large volume of calls. However, there are fears that the numbers are being used as a money making exercise by the NHS, taking money from vulnerable patients.

Ofcom even introduced 03 numbers in 2007 to provide the same functions as 084 numbers but at the same rate as local calls.

Adrian has praised local services in Torbay, which have steered clear of charging patients, but NHS Direct, the national helpline, uses an 084 number.

The Government is seeking the views of staff and patients on this issue and Adrian is encouraging everyone with an interest to respond to the consultation at: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_091923

Adrian commented: “The principle of the NHS is a free service at the point of use. 084 numbers are more likely to impact on vulnerable groups such as the elderly and disabled and they should not have to pay more than the local rate to contact vital health services.”

And another one:

http://www.labouronline.org/wibs/164727/7f87882e-7f05-b434-a568-db1e1c6e7b57

MP urges Government and Harlow GPs to scrap 084 Phone Numbers - 15 January 2009

Bill Rammell MP today wrote to all Harlow GP surgeries advertising 084 phone numbers and to the Government urging them to scrap a system which charges patients more than an equivalent cost of a local call to make a doctors appointment, and generates income through revenue-sharing schemes.

In a consultation running until March 09, the Department of Health are currently considering banning the use of 084 numbers in the NHS.

Mr Rammell said: “I feel this system of making money from patients who simply want to phone up to make a doctors appointment is grossly unfair, and I am pleased that the Government are looking at options to change the rules. The NHS in general and GPs have seen a huge increase in funding under this Government. These phone number rip-offs are unjustified.

I have responded to the Government’s consultation, urging them to stop this unfair practice and I have also written to those surgeries in Harlow who advertise revenue-earning phone numbers.

GPs undertake vital and valuable work in our community but I am urging them to reconsider their position on this issue. “

Four surgeries in Harlow advertise 084 numbers – Lister Medical Centre, Barbara Castle Medical Centre, Broadley Health Centre and The Hamilton Practice at Keats House.

A petition on the Prime Minister’s Number 10 website objecting to this practice has attracted over 28,500 signatures.

http://www.andyreedmp.org.uk/30564.html?itemid=104636&listingid=32293&feedid=33208

Welcome for GP 084 number consultation.

Andy Reed today welcomed news that the Department for Health would consult on the use of 084 numbers in GP surgeries and the NHS in England.

"I have received a number of complaints about the use of premium rate numbers by GPs. I have asked the PCT to investigate in th past and raised this with Ministers. There are a few surgeries locally which use these numbers which cost more than a local call especially when called from a mobile. It seems as thought the government want to end GPs using these and I welcome that. Already people are chatting about this on my face book site. It seems GP access is still an issue!"

http://bexleylibdems.org.uk/news/000130/lib_dem_calls_for_end_of_084_telephone_numbers_by_doctors_surgeries.html

Lib Dem calls for end of 084 telephone numbers by doctors surgeries

1.34.07am GMT Sat 20th Dec 2008

Old Bexley & Sidcup Liberal Democrat candidate is calling for an end to the use of 084 numbers by NHS services, including GPs surgeries.

Duncan Borrowman says: "0844 and 0845 numbers can cost mobile phone users 35p a minute. Many 0845 lines now hold you in a queuing system, which can cost you extortionate rates while you are on hold to make an appointment.

"The Department of Health has launched a 3-month consultation on the abolition of the use of these lines in the NHS, and I urge local residents to respond to the consultation calling for a ban on their use."

It may be going too far to suggest that the ban has support from within a PCT, however the following item has just popped up in Google from the West Hertfordshire PCT website -

Official consultation on 084 numbers

The copy includes many quotations, but is original in its arrangement and comment. I may be biased, but I would suggest that whilst there is a proper degree of objectivity, the tone and structure of the piece leaves the reader in little doubt about the sympathies of the author.

I emailed the consultation team re the meeting due to take place in London and asked the following questions 1) why were the industry and public being kept apart. 2) Why were their not regional meetings. 3) No mention in the invitation of 03 alternative.

I apend their reply which may be of interest:


Quote:

Dear Sir, Firstly thank you for your email and your interest in the consultation. The reason that we decided to hold one event for the public and one for industry was to try and focus the conversation on each party’s respective points of view.  The thinking behind this was not about keeping the two parties apart, but allowing their views and ideas to be captured as effectively as possible. London was simply chosen as the location because of its transportation links – the venue itself it located near major train and underground stations allowing good access.  Unfortunately we are unable to hold the events in multiple locations and apologise for any inconvenience that this has caused. The consultation itself is focused at looking into the problem of using 084 numbers in the NHS and exploring all of the potential alternatives.  One of those alternatives is the use of 03 numbers.  Within the full consultation document this is discussed and it covers the functionality that the 03 numbers can provide.  The invitation letter was meant to give a very quick overview of the events and the consultation.  The full explanation of the subject and the consultation itself is provided online which was highlighted in the letter.  The full consultation booklets will also be available to all attendees at the events. Kind regards The 084 Numbers Consultation Team, Department of Health

If anyone would like to go along to the consultation event on Thursday, then please drop them an email. Details here.

The event is at Bonhill House, 1-3 Bonhill Street, London, EC2A 4BX from 1.30pm to 4.30pm.

Quote:

However, the Government recognises that the extra functions offered by numbers such as those from the 084 range can improve access to services for patients. We wish to find out how valuable people think the enhanced functions provided by 084 numbers are, and how they might otherwise be provided without patients having to pay more than the cost of dialling a normal geographical number.

What a load of clap-trap. All of these 'extra functions' can be provided on virtually any telephone number, be it 01, 02, 03, 07, 08 or 09. My primary care physician operates a telephone system with all the features one would expect, on a standard area code. Many health care providers here will also provide a toll-free number for those patients calling from outside the local calling area, where the call may otherwise be considered as regional or long distance.

About the only reason for 08/09 numbering, in terms of 'enhanced fuctions' is when it is likely that thousands of simultaneous calls take place to a given number - telephone voting and the like.

A surgery does not need an 08 number as it can provide exactly the same facility on a geographic number. Unfortunately, Ofcom has drilled into people the belief that for any 'enhanced service', a NGN is required. This is simply not the case, however NEG exploits this false belief.

idb wrote on Mar 13^th, 2009 at 9:42pm:

What a load of clap-trap.

Fear not. There will be many at the consultation event for the industry next Thursday morning ready to talk about how they provide systems such as this, without the need for non-geographic numbers.

Whilst those who could use geographic numbers choose 03 (e.g. the Met Police, which could have chosen any 020 number) I am not prepared to totally dismiss the possibility of some benefit being available from non-geographic numbers, other than geographic anonymity.

NEG claims that the features of Surgery Line work equally well on 03 numbers, which is good enough for me. If some want to take the argument one step further, then fair enough. I do not want to get involved in trying to take the issue too far, at the risk of losing the battle for the sake of some extra ground that is not strictly necessary.

SilentCallsVictim wrote on Mar 6^th, 2009 at 3:12pm:

Further to the main consultation process the Department of Health has now announced that there will be two public "events" on 19 March 2009 in London. One for the telecomms industry, the other for "others", These events, which are announced here, are intended to help inform the consultation process. Given that the intention is for these events to be relatively small, I fear that the open nature of the invitation will either cause many to be disappointed, or for many further events to have to be arranged.

With the public "events" close, it may be worth reminding ourselves of the capabilities of NEG:

http://www.assemblywales.org/standards-report-e.pdf

Originally posted in the 2006 thread:

http://www.saynoto0870.com/cgi-bin/forum/YaBB.cgi?num=1146620207

Paragraph 6 is somewhat amusing:

<<
All the GPs at the Practice are self-employed and contracted to work in the
NHS in Wales. The cost of maintaining the NEG system (nearly £600 per month)
is met wholly from the Practice funds although the Practice does receive back
nearly £300 a month from NEG. The net cost to the Practice is therefore over
£300 per month which means that over a seven –year period each of the
Partners in the Practice will pay out of their own finances around £5,000 to
help fund the new telecommunications service.
>>

idb wrote on Mar 14^th, 2009 at 3:07am:

With the public "events" close, it may be worth reminding ourselves of the capabilities of NEG:

NEG have constructed a clever little scheme, which is not so easy to attack fairly as some may believe.

It is however wholly unacceptable in the context of a NHS "free at the point of need". The Department of Health recognised this in the context of 0870 numbers, however they seemed to wholly miss the fact that the revenue share on 0844 numbers was not a free gift from the telephone companies. Thanks to the efforts of very many campaigners, the DH now understands what is going on.

The only arguments against a ban on use of 084 numbers that can be put forward require the principle of "free at the point of need" to be seriously compromised. These are charges imposed by individual NHS providers for access to NHS services and as such are wholly unacceptable.

Whatever we may feel about prescription charges, these are universal (in each territory) and imposed by the relevant legislative body, with exemptions based loosely on need and ability to pay.

Car parking charges are wholly unacceptable for those who need to park a car to access NHS services. In other cases they may simply be a charge for the service of car parking at the normal rate for the area. There are cases where the rate of charge is a rip-off, but that type of over-charging applies to the provision of car parking facilities in many places, it is not a charge for NHS services.

These other issues represent worthy points for discussion in their own right, but they do not provide any relevant precedent for providers, especially indendent contractors, charging for access to NHS services.

I understand that representatives of NEG will be attending the Thursday morning event.

Dave wrote on Mar 13^th, 2009 at 9:08pm:

If anyone would like to go along to the consultation event on Thursday, then please drop them an email. Details here. The event is at Bonhill House, 1-3 Bonhill Street, London, EC2A 4BX from 1.30pm to 4.30pm.

I should emphasise that the afternoon event is for the public. There is also an event on the same day in the morning for the industry. I think it is particularly important for providers of these telephone systems to attend to help the DH to understand what is possible, because, as we know there are a lot of myths and nonsense about.

Whether or not these services can be provided on geographical numbers is not such an important question. If the only non-geographical numbers give the providers of the GP's telephone numbers generate the same level of payment, then that will create a level playing field. At the moment, it is skewed towards the 0844/5 non-geographicals because of the revenue benefits.

I am quite sure that any telephone system provider that can offer their solution using a geographical number will do so because this is a good selling point. I am sure that surgeries don't want to change their local number which patients know. The non-geographical numbers are also longer making them harder to remember.

Dave wrote on Mar 13^th, 2009 at 9:08pm:

If anyone would like to go along to the consultation event on Thursday, then please drop them an email. Details here..

I am planning to attend this meeting in London and I know that our esteemed Forum member SCV is also attending.    Are any other members of this Forum planning to attend?

It could be useful for us to get together prior to the meeting for a laugh and perhaps a discussion on what needs to be said and our approach, and maybe retire to a suitable location afterwards to ruminate, mull over, celebrate or complain about the meeting and how it was conducted.

You are welcome to let us know by posting on this thread or by sending a private message if you prefer.   We would be delighted to meet up with other Forum members.   This is a rare opportunity and it is important to have a bit of fun from time to time.

The database lists quite a few alternatives for surgeries. It is interesting to note that the menus for many of these are actually on the 01/02 numbers rather than the 0844s.

So the 0844 number queues a call until a line becomes free at the surgery at which point the caller is presented with the menu. If they wish to speak to the nurse, for example, they must wait in the queue behind everyone else who may be calling the receptionist to book an appointment.

Quite an inefficient system, there to keep patients in a queue generating revenue me thinks.

If these 0844 numbers are really there for network queuing, then the menu should be network based as well. Selecting individual menu options should put the call through to different geographical (direct dialling in) numbers at the surgery.

Members of this Forum may be interested in the response to the Consultation published by a certain Mr hickson here : ---

http://homepage.ntlworld.com/davidhickson/NHS.Patient/DH%20consultation%20response.pdf

I heartily recommend it for a cracking good read, the many points it makes, the comments on the Consultation Document itself and the depth of analysis presented.   I hold marginally different views on some aspects but am substantially in agreement with his response.

In my view the NHS would be making a grave error of judgement if they were not to impose a ban on all 08 numbers throughout the NHS itself and any agencies or Charities which receive part of their funding from the NHS.     If they were to decide not to implement a total ban and very quickly then they would deserve to have the wrath of the Gods and the good members of this Forum  descend upon them.    The resultant anger and protest would be catastrophic for the NHS.   However, I am sure they will see the correct way forward as this time there are NO excuses.

It will be interesting to see to what extent the report promised by the end of this month reflects and incorporates the content of this response.

loddon wrote on Apr 3^rd, 2009 at 12:11pm:

Members of this Forum may be interested in the response to the Consultation

The web site in question is ready and able to host other responses that may be thought worthy of attention.

Please send them, with some indication of consent to publication, to the email address given below. Material relating to the consultation is indexed at http://homepage.ntlworld.com/davidhickson/NHS.Patient/Consultation%20Links.htm.

N.B. It is not the policy of the Department of Health (or indeed other government departments) to publish individual consultation respsonses.

The consultation and the proposed ban covers NHS bpdies as well as contractors such as GPs.


Dave wrote on Apr 5^th, 2009 at 4:41pm:

Source: Mid Yorkshire Hospitals NHS Trust http://www.midyorks.nhs.uk/NR/rdonlyres/FDA3BBB5-CBD8-4D8A-8F14-010F37D10B1E/69799/Microsoft_Word__FOI_response_08_177.pdf Freedom of information Act request Income generated from use of 0844 telephone numbers The 0844 number covers all of our hospitals and enables us to better manage the large volume of calls we receive from patients and visitors in a quicker and more efficient way. Our four hospitals serve a population of more than half a million people and the benefit of having our current system means that we not only have the capacity to take a large number of calls at any one time, but callers only have one number to remember when contacting any of our hospitals. Because we know that some telephone providers now have lower standard rates and cheaper packages, we have publicised the direct telephone numbers for our wards and departments for anyone who has these inclusive packages. These have been made available to our local GPs and to our patients when they attend their appointment. We have also advertised in the Yellow Pages and we are looking at advertising in other directories. We have also posted a contact form on our website for patients so that they can change or amend an appointment, or make a general enquiry, without picking up the phone. Since the introduction of the 0844 number in summer 2006, the Trust has received income in the region of £82k. This money has been reinvested into services at the Trust to ensure that we deliver high quality care to our patients. Response issued by Assistant director of corporate affairs 5 February 2009

One must assume that the Trust will have no problem making up for the loss of this wholly improper source of income, and perhaps meeting further costs that have been funded in the same improper manner, when it changes over to a 03 number in the very near future.

Source: Fenland Citizen

http://www.fenlandcitizen.co.uk/news/5-phone-bill-to-make.5189012.jp

£5 phone bill to make doctor's appointment

Published Date: 22 April 2009
By sarah cliss

A WOMAN has blasted a local doctor's surgery after racking up nearly £5 in phone charges trying to make an appointment.

The woman, who is in her fifties and from Emneth but doesn't want to be named, is furious that calling the North Brink Surgery in Wisbech cost her just under £5 when she tried to make an appointment.

She said: "I started trying to get an appointment by ringing the surgery from about 8.30am.

"But all I could get through to was an answering service, which told me all the operators were busy and to call back later.

"I know that if you don't get through first thing in the morning all the appointments are gone. So I just kept calling, and calling until I eventually got through.

"I didn't realise just how much it was costing me. I got the appointment I needed, but I was horrified when my phone bill came and I noticed that every time I had rung the surgery it had cost me 11p plus VAT.

"I totted up the cost of all the calls and it was nearly £5 – I couldn't believe it, I was just incensed."

Now the woman is warning other people to be on their guard against racking up a huge phone bill simply by calling for a doctor's appointment.

"I wouldn't mind if I had been calling a chat line or something, you exptect that to be expensive – but I don't expect to have to pay out nearly £5 to get through to my doctor's surgery.

"I don't have to see the doctor very often but some people aren't so lucky and I just wonder how many realise exactly what it is costing to make an appointment.

"I have been told the practice gets some of the money from the calls, but I don't think it is right that people who are ill are being take advantage of in this way," she added.

Phillip Wearing, North Brink's practice manager, defended the use of the 084-prefixed phone-line.

He said it had been introduced to improve the service offered to patients.

He said the old system had left patients frustrated because they would get the engaged tone if they rang at busy times.

The new system allows up to 10 people to be held in a queue for an appointment at anyone time, which he said was less frustrating.

He said the practice was investigating what happened on the day the woman called to make her appointment and said the system allowed all calls to be tracked.

Mr Wearing also said the practice was awaiting the outcome of a consultation on the use of 084 numbers by the NHS.

He pointed out patients had the option of making an appointment on-line and added that phone call charges varied according to the tariff imposed by the phone operator.

He admitted other patients had raised concerns about the use of a 'premium rate' phone line by the surgery in feedback forms returned to the practice.

He said the practice received a small rebate on calls to the surgery, but this was simply to cover the cost of the system.

The Consultation on use of 084 telephone numbers in the NHS finished on the 31st March and a Government Response was promised by today, 30th April  2009.

Today the Dept of Health announced that the Response will be delayed here :--- http://www.dh.gov.uk/en/Consultations/Closedconsultations/DH_091879

"Ben Bradshaw MP, Minister of State for Health Services, said:

"The consultation period on the use of 084 numbers in the NHS ended on 31st March 2009.  We have been very pleased with the level of public response to this consultation, having received a much higher volume of responses than expected.  Whilst this is, of course, very positive news in itself in terms of demonstrating the strength of public feeling around this issue, it is important to ensure that in reaching an outcome, we fully take into account the breadth of responses received.  We are currently analysing those responses as quickly as possible in order to identify the most appropriate course of action, and the outcome of this will be communicated as early as possible."


The only reason for any delay that is offered is that the analysis of responses will take longer than expected.   That might not be entirely unreasonable (although the DH have had four and a half months already to look at the responses as they appeared and to have modified their plans in order to minimise any delay) in view of the higher volume of responses.   In my opinion what is unacceptable is the utter inadequacy of this announcement.

• • There is no indication of how many reponses have been received compared with the number expected.
    
  
  
  • There is no indication of how much longer the analysis will take.  As all responses were received by the end of March and many must have been received during the previous three and a half months, there has been plenty of time to assess the amount of work and time that will be needed.
    
    
  • No new publication date is offered
    
  .
  

This is an entirely unnecessary and unsubstantiated delay which is made much worse by leaving it open ended.    

This amounts to gross incompetence by the Department.    Having initially stated a date for publication it is mandatory by all reasonable professional standards to revise the plan and announce a new completion date.      It is malpractice to leave out altogether any end date .    This must be the logical deduction because otherwise the Department knows full well what is required but it is employing crass and manipulative delaying tactics.

This is not an area of pioneering research or difficult technical, medical or ethical issues.    This a consultation on implementing a ban on certain telephone numbers.   This is about action which is already being considered and on which the public are demanding a decision.

There is no justification for not being honest and open with a keenly interested public.    This is the very opposite of open and consultative government.   Instead of keeping the public informed the public are being kept in the dark.

Having just started to watch the BBC daily soap Doctors, it occured to me that this series would be the ideal place for this issue of 0844 versus normal telephone numbers to be discussed in a dramatic sense. The BBC could show all the behind the scenes bribery made by telephone companies, the effects of having to pay for these calls by people on low incomes, etc, etc.

It would get the true facts out to millions of people who have probably never even given these numbers any thought.

Any opinions?

poppasmurf wrote on May 4^th, 2009 at 9:40am:

It would get the true facts out to millions of people who have probably never even given these numbers any thought. Any opinions?

Millions? Are you telling us that millions watch a day time soap when at it's best an evening soap will only attract a few million? ;D

Is this the BBC who for years asked the pulic to dial 0870 numbers to contact them?  They probably would still use them but for people from this forum lobbying against it, so I think the suggestion has probably not got legs! (and the BBC still use 0871 numbers for various contacts such as Saturday Kitchen-may be the wrong program title)

sherbert wrote on May 4^th, 2009 at 10:52am:

poppasmurf wrote on May 4th, 2009 at 9:40am: It would get the true facts out to millions of people who have probably never even given these numbers any thought. Any opinions? Millions? Are you telling us that millions watch a day time soap when at it's best an evening soap will only attract a few million? ;D

Yes, especially now since it's repeated on BBC HD at 6pm.  And, I think, the BBC has started to learn from it's mistakes. It is after all the largest organisation to start using 03 numbers on virtually all its contact numbers - or is that a fallacy?

poppasmurf wrote on May 4^th, 2009 at 11:14am:

sherbert wrote on May 4th, 2009 at 10:52am: poppasmurf wrote on May 4th, 2009 at 9:40am: It would get the true facts out to millions of people who have probably never even given these numbers any thought. Any opinions? Millions? Are you telling us that millions watch a day time soap when at it's best an evening soap will only attract a few million? ;D Yes, especially now since it's repeated on BBC HD at 6pm.  And, I think, the BBC has started to learn from it's mistakes. It is after all the largest organisation to start using 03 numbers on virtually all its contact numbers - or is that a fallacy?

Well, Doctors does not appear in the top 30 in the viewing figures, and at number 29 and 30 are programmmes called 'Flog It' and 'Department Store' and they are viewed by 1.28 million people. So not quite sure where them 'millions' of viewers from 'Doctors' comes from. Probably more like hundreds! ;D

sherbert wrote on May 4^th, 2009 at 12:40pm:

Well, Doctors does not appear in the top 30 in the viewing figures, and at number 29 and 30 are programmmes called 'Flog It' and 'Department Store' and they are viewed by 1.28 million people. So not quite sure where them 'millions' of viewers from 'Doctors' comes from. Probably more like hundreds! ;D

Alright, so it's only 765,482 viewers. So what!  It was only an idea for goodness sake. If it's a daft idea, then so be it.  Surely, any publicity against 08 numbers should be welcome, but if you don't agree then go and find another way of reaching 765,482 people. Good luck, and maybe I'll rubbish your idea!

PS. According to Wikipedia, Doctors gets an audience of between 1.25 and 1.5 million viewers every day. In addition, it is also shown on the satellite channel Watch, which will add many more viewers to the total.

Poppasmurf, I was only winding you up. Of course I take your point :)

Another story from E-Health Insider yesterday: DH delays 084 number decision

Pulse Today continues to monitor and report on the Consultation :----


http://www.pulsetoday.co.uk/story.asp?sectioncode=23&storycode=4122956&c=2

DH delays 084 decision after 'huge response'
10 Jun 09

By Steve Nowottny

The Department of Health has been forced to delay a decision on whether to ban GP surgeries using 084 numbers after receiving an ‘exceptionally high’ number of responses to its consultation, Pulse has learned.

The department had been due to publish its decision, which could affect telephone numbers at around 1,500 GP practices across the UK, by the end of April.


But the department’s 084 consultation team revealed in an email: ‘We have received approximately 3,000 responses to the overall consultation which is many more than we had anticipated getting, and which we understand from the central consultation team is an exceptionally high response rate to a departmental consultation.’

A Department of Health spokesperson confirmed a ‘huge response’ had prompted the delay, but was unable to say when the outcome of the consultation would be published.

--------------------------------------------------------------------------------

An interesting exchange in the Commons Committee on the Health Bill, which places a duty on NHS organisations and their contractors (e.g. GPs) to "have regard to" the NHS Constitution.

The Constitution includes "You have the right to receive NHS services free of charge, apart from certain limited exceptions sanctioned by parliament".

Mike O'Brien, the Minister of State, was asked by one of his own backbenchers about the absence of a sanction for use of revenue sharing telephone numbers. The question of when a response to the consultation would be provided was also raised (although this had nothing to do with the debate in progress), which enabled O'Brien to duck the main question.

In relation to the consultation response the following was said:

Quote:

We will shortly announce the outcome, but I do not have the date for that announcement. I hope to look at the issue in some detail in the near future, and I hope that we will then be able to announce how we intend to pursue it.

The Hansard text of the exchanges is published here.

If anyone knows the identity of the mystery campaigner who engaged with the Minister on this topic during the lunchtime adjournment to the proceedings, it would be of great interest to hear what was said. It was not the person named.

Copy of letter sent to members of the press.

The DoH Consultation on banning 084 Numbers within the NHS

The Consultation originally promised that the results of the Consultation would be published by the end of April.   That date has been missed by a mile and there is absolutely no indication from the DoH when these results will be published.   I have asked them repeatedly for a new publication date and they have obstinately refused to give any date while pathetically saying that they will publish soon.    This is totally unacceptable, in my view.   It insults the public by not providing a revised date, by witholding the actual responses to the public consultation and is totally contrary to the promises of more open and transparent government by the current Prime Minister.

The DoH continues to hide behind the excuse that the response to this Consultation was so large they were overwhelmed and are still analysing the results.   This is patently untrue.   They have admitted privately that the analysis was completed well before the end of April and a report was placed before the Minister at that time.   What is happening now looks like political prevarication and obfuscation with the intention of keeeping the public in the dark.   Suspicions are being aroused that there is deliberate delay and scheming to mislead the public.

This matter is crying out for thorough investigation and for the DoH to be called upon to open up on what was supposed to be a public consultation.   The public needs to know what was said in response to the consultation as well as the responses from the medical and DoH people and the Telecomms industry, taking account of commercial confidentiality of course.    

It may be that the DoH is still working on how to actually implement a ban on 084 numbers within the NHS but this is not an acceptable excuse for witholding the results of what was said to the consultation given that the results were promised by April.   There is no reason why they should not publish the responses and analysis of the consultation now!    If necessary an accompanying statement could say what they need to say about action or decisions that are ongoing work.

The Government has been forced recently to be more open with trivial matters such as MPs expenses but is that lesson being learned in regard to straightforward matters of public consultation???   This unexpained and unjustified delay together with an absence of honest open communication is now looking very bad for the Government.   The attitude shown by the DoH makes a mockery of the whole idea and purpose of Public Consultation.    We need and demand a statement NOW.

The Department of Health has taken sooooooooooo long to get on with its consultation on banning 084 numbers that a Midlands PCT has decided to go ahead and take action to get rid of 084 numbers now.     This item in the  Birmingham Mail today reports    Health trust helps patients save money with campaign on 084 telephone numbers


"With the assistance of the PCT, 22 of its GPs have abandoned revenue sharing 0845 numbers in favour of 0345 numbers ......"  

and

“This sets a fine example to other PCTs and demonstrates that the problems in addressing this issue can be overcome.”

The whole story is at ;---

http://www.birminghammail.net/news/birmingham-news/2009/07/04/health-trust-helps-patients-save-money-with-campaign-on-084-telephone-numbers-97319-24069848/

The full text of the report is as follows :---

Health trust helps patients save money with campaign on 084 telephone numbers

A BIRMINGHAM health trust is helping save patients cash by leading the way on eliminating expensive 084 phone numbers to GP surgeries.

Campaigners have been fighting against the revenue-sharing numbers, which the Department of Health has also condemned as they cost a higher fee of 5p a minute.

Birmingham-born campaigner David Hickson, who previously led a rally call to stop companies making “silent” telemarketing calls, praised Heart of Birmingham Primary Care Trust (PCT) for taking action to change the pricey system.

“Whilst the Health Minister contemplates a delayed response to the recent consultation on a proposed ban on use of revenue sharing 084 numbers in the NHS, Heart of Birmingham PCT has been getting on with the job,” Mr Hickson said.

“With the assistance of the PCT, 22 of its GPs have abandoned revenue sharing 0845 numbers in favour of 0345 numbers, which must be charged in the same way as calls to local numbers and may not be subject to revenue sharing.

“This sets a fine example to other PCTs and demonstrates that the problems in addressing this issue can be overcome.”

There is strong public opinion on the expensive call system and an internet petition to Prime Minister Gordon Brown to ban the use of revenue sharing numbers attracted more than 26,000 signatures.

Mr Hickson is heading a campaign as he claims the 084 numbers “exploit” patients.

The 0844 and 0845 non-geographical numbers were introduced to help surgeries deal with more calls on more modern telecom systems, but there was an extra cost to patients when calling doctors for an appointment on these numbers as they paid more than a local rate call to offset the cost of equipment used.

These numbers allow patients to wait in a call queue rather than having to repeatedly hang up and redial, choose from a menu of options and be automatically directed to the most appropriate place without having to dial another number and also book appointments or order repeat prescriptions via an automated system.



(It should be noted that references to a certain Mr Hickson being the leader of any campaign are entirely assumptions made by the newspaper).

Bartley Green Medical Practice has now changed its number from 0845 601 6584 to 0121 214 8612. The 0845 number has a recording on redirecting to the new number. The website and NHS website still give the 0845 number.

Dave wrote on Jul 5^th, 2009 at 11:56am:

Bartley Green Medical Practice has now changed its number from 0845 601 6584 to 0121 214 8612. The 0845 number has a recording on redirecting to the new number. The website and NHS website still give the 0845 number.

This practice is under South Birmingham PCT so perhaps the move away from 084 numbers by GPs is spreading from the Heart of Birmingham to adjacent areas.

Would this practice and the others mentioned be candidates for our Hall of Fame?

loddon wrote on Jul 5^th, 2009 at 9:34pm:

Would this practice and the others mentioned be candidates for our Hall of Fame?

I've added this one.  ;)

Is there a list of the GPs who come under the Heart of Birmingham PCT who have changed or who will be abandoning their revenue sharing numbers?

Dave wrote on Jul 5^th, 2009 at 10:45pm:

Is there a list of the GPs who come under the Heart of Birmingham PCT who have changed or who will be abandoning their revenue sharing numbers?

The list of 0845-using GPs on the NHS.Patient website shows 33 for Heart of Birmingham PCT. This was obtained from NHS Choices some time ago.

A review of the current NHS Choices list does not identify any that have changed, however a new health centre (run by Care UK) has opened in Greet with a 0345 number.

There are no 0345 numbers shown in the latest guide published by the PCT.

If anyone is very interested in this sort of detailed information, which is not to be found in the public domain, they could consider making a Freedom of Information request! One might have imagined that this could have been of interest to a local journalist. Local people who have seen the news story may want to follow this up with the PCT.

In the last few days, the following item has appeared on the internet:

084 numbers in Primary Care

This is the NEG response to the Department of Health consultation.

I start a discussion on it in this thread.

NEG, in their submission, have not considered the possibility of GPs offering geographic numbers alongside their 084 numbers as Northumberland have done:---    

"Council RESOLVED that:

(b)      Both the 0845 and 01670 numbers be included on the Council’s website and on any future literature with immediate effect together with a link to an explanation of the charging policy. "

This is what the Dept of Health could do as a result of its recent Consultation on the banning of 084 numbers in the NHS as an interim step.

All GPs currently using 084 numbers should be required to reveal their 01/02 numbers with immediate effect and publish them alongside their 084 numbers until their current supplier contracts expire.    This would give the choice to all their patients who could choose which number they would prefer to use.

This is a principle which the present Government has introduced into the NHS and a principle that it is enthusiastically promoting.    What an ideal solution!    Totally on message with the Governments ideas and patient choice being exercised within the NHS.    This was proposed during the Consultation so we expect that it has been given serious consideration in the options placed before the Minister.   Northumberland Council have demonstrated that issuing geographic numbers alongside 084 numbers is a feasible practical and realistic option.

loddon wrote on Jul 8^th, 2009 at 9:07pm:

NEG, in their submission, have not considered the possibility of GPs offering geographic numbers alongside their 084 numbers as Northumberland have done:--- ...

(see this response to a similar posting)

... Of course not. NEG argue for the right of GPs to fund investment in their surgeries using money from revenue sharing telephone numbers (i.e. from patients). That investment would be reduced if not all telephone calls were through the revenue sharing number. How would a receptionist be expected to answer a question about which of the two numbers someone should call - "Don't call the 0844 it's always more expensive" ? !!

Presented with a requirement to offer a geographic alternative, GPs would certainly be reluctant to incur the cost of redirecting calls made on the geographic number to the same network-based waiting facility so that all calls were queued to be answered in strict sequence. Unless such a requirement were stipulated, so that all calls received exactly the same service, the door would be open for terminating the geographic number on a single handset in the corner of the reception area. This handset would be labeled "pauper's line" and would be answered whenever convenient, or perhaps simply left off the hook. (This would enable the receptionist to avoid the follow-up question "So why do you have two numbers, then?".)

I believe that this proposal is well-intentioned but ill-considered. This is not (for me) simply about giving some people the chance to save a bit of money. It is about the principles of the NHS. These demand that all investment in NHS services is funded by taxation, not by patients as they use NHS services. The idea of a two-tier service within the NHS, with better options for those who pay and an adequate service for those who do not, is precisely what those who truly believe in the principles of the NHS continue to fight against. That is why we are deeply concerned about the concept of "choice" and all other aspects of consumerism, for fear of where they will inevitably lead. The Surgery Line scam (regardless of the way it is misrepresented) is a clear example of this. I would oppose it if it were presented totally honestly.

Anyone got any update on what is happening and when we are likely to get a response from the DoH?

It is pretty mind blowing that there can be such a delay.

What happens when they have to consider something mildly difficult?

Keith,

The timing of your question could not have been better!    I have been continuously pestering the DH for a statement of when they intend to respond to the Consultation  since the end of April, which was when they had originally said a response would be published.    I have received a statement today from the Dept of Health which says :----

"Officials have now met with the new Minister to agree the recommendations from the consultation, and the Minister plans to make an announcement on the outcome of the consultation in September, alongside the publication of the Department’s response to the consultation."

loddon wrote on Aug 7^th, 2009 at 9:03pm:

" ... the Minister plans to make an announcement on the outcome of the consultation in September, alongside the publication of the Department’s response to the consultation."

A decision to do nothing could easily be covered in a response to the consultation. An announcement, "We are going to do nothing" or "We will look at this again in a year's time" does not seem that likely. That is not to say that we will achieve all that we have sought, the exclusion of NHS Direct has already been announced.

In guessing on the likely date for an announcement of a popular move, one may be drawn to the Labour Party Conference which starts on Monday 27 September. The actual date of Andy Burnham's speech is not yet published. If Mike O'Brien is to have the honour of making the announcement, then it would be earlier.

Cheers guys - feedback much appreciated.

I did some chasing sometime ago, but got fed up with the bland template responses.

Back in March, there was a Government consultation paper and, from the tone of it, it made it sound like the use of 0844 (etc) numbers - at least in the public sector, such as Health - was going to be banned.

The consultation ended in March and feedback was promised "within a month".

I have heard nothing since and was wondering if anyone had learned what the result was.

We have taken legal advice and we are basically stuck with the contracts that some of our GP practices have signed. However, if we knew that the Govt had banned the numbers, it would give us a stronger negotiating position with the provider.

Many thanks.

Andrew_Weight wrote on Aug 27^th, 2009 at 3:38pm:

We have taken legal advice and we are basically stuck with the contracts that some of our GP practices have signed. However, if we knew that the Govt had banned the numbers, it would give us a stronger negotiating position with the provider.

Andrew, could you tell us a little about yourself and why you have asked this question?    You mention being "stuck with contracts ... that GPs have signed".   Are you with a PCT or with a phone system supplier or what?   It would be interesting and helpful to us.

By the way, you imply that you have certain expectations about the outcome from the Consultation; could you tell us what it is that you expect?

Andrew_Weight wrote on Aug 27^th, 2009 at 3:38pm:

The consultation ended in March and feedback was promised "within a month". I have heard nothing since and was wondering if anyone had learned what the result was.  Many thanks.

The answer to this was given in post #114 above, in a situation report.    We await the announcement and publication of the government response some time in September.

GPs using Talk Talk (Opal Telecom) 0844 numbers can change to 0344.

A guide to changing numbers is published.

Briefing issued.

loddon wrote on Aug 7^th, 2009 at 9:03pm:

"Officials have now met with the new Minister to agree the recommendations from the consultation, and the Minister plans to make an announcement on the outcome of the consultation in September, alongside the publication of the Department’s response to the consultation."

A liitle more news!!   I have been pressing the Dept of Health for the date in September.    They haven't revealed that yet but I have been told today that a posting on the website is "imminent".     So I can only suggest that, if you are interested, you keep looking here :---

http://www.dh.gov.uk/en/Consultations/Closedconsultations/DH_091879  

Personal comments on an imminent annnouncement - blogged here.

Press release from DH on consultation response is here:

http://nds.coi.gov.uk/clientmicrosite/Content/Detail.aspx?ClientId=46&NewsAreaId=2&ReleaseID=406581&SubjectId=36


The page for this consultation, which contains links to the consultation itself and the response is here.

SilentCallsVictim wrote on Sep 11^th, 2009 at 8:43am:

Personal comments on an imminent annnouncement - blogged here.

More blogging now possible - see links below.

So we've been waiting six months for a response which covers less than 10 pages.  ::)

There will not be a ban on 084 numbers, but a ban on premium rate charges. The DH believes that there may come a day when revenue sharing numbers cost the same as local calls.

The ban is to be enforced through changes to the GMS Contract. It will be up to GPs to ensure that all their patients do not pay more than a local call. I am not sure how the DH is envisages that GPs can control this.

If it were to be written into a GP's contract that patients pay no more than a geographic call, and one or more of his or her patients end up paying more, can the GP be legally held to account?

Source: BBC News

http://news.bbc.co.uk/1/hi/health/8251290.stm

<<

Ban for NHS premium rate numbers

The use of premium phone rates by GP surgeries and hospitals is to be banned in England, the government says.

It comes after 3,000 people responded to a public consultation about the use of 084 numbers in the NHS, and 90% said calls should be charged at local rates.

The 084 numbers will not be banned but must cost no more than a standard call.

[…]

The British Medical Association said the proposals to limit the cost of 084 numbers to that of local calls was the fairest way forward for patients and practices.

Dr Richard Vautrey, deputy chairman of the BMA's GPs committee, said: "Patients who call their surgery because they're ill shouldn't be penalised because they have to call an 084 number, so we're pleased that the phone companies who supply these lines to practices have agreed to ensure that their tariffs are in line with local charges.

[…]

>>

The news release from the BMA is here:

http://web2.bma.org.uk/pressrel.nsf/wlu/STRE-7VSHKC?OpenDocument&vw=wfmms

Dr Vautrey says:

“We’d also like to see more phone companies include 084 numbers in the comprehensive call packages they offer customers to increase the benefit for patients. Calling these numbers should be treated no differently from calling other geographic numbers.”

---

In response to the quote: I bet you would. You expect other telephone companies to cover the cost of the higher charge to your telephone company for your telephone system. Obviously, ultimately these costs get passed back to callers in general in increased package fees.

Dave wrote on Sep 14^th, 2009 at 12:44am:

So we've been waiting six months for a response which covers less than 10 pages.  ::) There will not be a ban on 084 numbers, but a ban on premium rate charges. The DH believes that there may come a day when revenue sharing numbers cost the same as local calls.

It is interesting to see the specific text in the Dept of Health website:


Quote:

It is not our intention to prohibit ‘revenue sharing’ as part of our proposals – the important thing is to ensure that patients are not being made to pay more than the equivalent cost of calling an 01 or 02 number. ‘Revenue-sharing’ arrangements allow for a proportion of the money paid to the supplier to go towards the ongoing cost of running an 084 number, which includes the cost of renting the equipment from the supplier.

This would appear to suggest that NO provider - mobile or landline - will be able to charge more than they would normally charge for an equivalent 01 or 02 call at that specific time of the day for a call to a doctor's surgery. If that is indeed the case, where will the 'revenue share' that is specifically NOT being prohibited come from?

All sounds like double-speak to me!  >:(

......... another New Liebour smoke and mirrors announcement!

You can see it now.  One minute after midnight on September 30th, at the very instant that BT's call rate increases from 4.5p to 5.25p per minute, NEG's publicity machine whirs into action:

"Get a SurgeryLine system,  calls are cheaper than local rate"


Quote:

http://web2.bma.org.uk/pressrel.nsf/wlu/STRE-7VSHKC?OpenDocument&vw=wfmms Dr Vautrey says: “We’d also like to see more phone companies include 084 numbers in the comprehensive call packages they offer customers to increase the benefit for patients.”

The first to do so would certainly have a heaven-sent publicity platform!

But, even if that happens, what about the cost of calling from a phone box or from a PAYG mobile?

Keep up the pressure folks.

This mess will get unravelled - if we can catch it while it is hot news it will be easier.

From today's Daily Telegraph..

http://www.telegraph.co.uk/health/healthnews/6173779/NHS-must-not-charge-more-than-local-rate-for-phone-calls-ministers.html

Others here on this site far cleverer than me will be able to interperate what it will mean

Health Minister Mike O’Brien said:

“We have been concerned that some people are paying more than the cost of a local call rate to contact the NHS.  It is clear from the feedback we have received that patients support the banning of any number or tariff which is more expensive to call.

“For people on low incomes, and for those who need to contact their local doctor or hospital regularly, these costs can soon build up. We want to reassure the public that when they contact their local GP or hospital, the cost of their call will be no more expensive than if they had dialled a normal landline number.”

The Department of Health will work with the British Medical Association’s GP Committee over the coming months to integrate the legislative changes into the GP contracts

and

The ban on the use of numbers charging patients a premium rate to call NHS services will allow a marketplace to evolve where 084 numbers compete alongside 01, 02 and 03 numbers, but where patients will pay no more than the cost of a local call. The ban means that GPs and other NHS organisations remain free to use 084 numbers, providing patients are not charged more than a local rate number.


Minister O’Brien says “It is clear from the feedback we have received that patients support the banning of any number or tariff which is more expensive to call.”     The consultation paper was not about tariffs it was about 084 numbers.    It said that the DoH was considering banning 084 numbers, it asked for views about 084 numbers, it never mentioned tariffs.  It is clear that the vast majority wants 084 numbers to be banned.   So why not ban those numbers?

It is ridiculous for him to say that he is only banning certain tariffs while allowing use of 084 numbers to continue.    Is he going to ban 084 tariffs when calls are made to NHS services, but presumably not in all other cases.    How is that going to be done?   It is unrealistic and will not be possible.   Bear in mind that most calls these days are made within a call package, whether callers are using a landline or a mobile phone; this means that most normal geographic calls are made at zero marginal cost because they are pre-paid within the package.    The tariff for any 084 number will only match that price if it is included within the package.   I do not believe that only 084 calls to the NHS can specifically be included in packages.    This is the reason that the announcement by O’Brien is a failure and a complete disaster.     0844 numbers are entirely excluded from all packages at all times.   0845 are excluded from most packages at most times, especially day times.   This means that almost all calls to GPs 0844 and 0845 numbers will cost more than the cost of a geographic call.

This is the reason that this statement is a failure.   A complete disaster.  A sham.  A  shameful attempt at deception of the public.    The Minister is basing his whole case on the comparative cost of 084 calls with geographic number calls in the small minority of cases.   His only intention is to allow the rip-offs to continue, to allow NEG, the monstrous lying cheating disreputable gang that they are, to continue ripping off NHS patients.   The Minister has no backbone, no honesty, no principles.   He is a disaster.  He has lied when saying that he wants “to reassure the public that when they contact their local GP or hospital, the cost of their call will be no more expensive than if they had dialled a normal landline number.”   This statement is no reassurance, it  will only destroy any trust or confidence that the public might have in him and the useless ineffective government to which he belongs.   It is a damning indictment of the Department of Health which has wasted vast amounts of taxpayers money in carrying out this false non-consultation.

It is obvious that all the honest contributions to the consultation by members of the public, many contributors to this website and most of the NHS respondents have been ignored.   This is an insult to all these people as well as an insult to the public at large.    This announcement is a disgraceful attempt at a confidence trick and should be rejected by all.

Our protests must continue.   The campaign must carry on with renewed vigour and determination.   We will not accept this announcement as an answer to the requirement that all phone calls to all NHS services are charged at a fair rate which allows patients to call at normal geographic rates, which includes unrestricted use of calls to NHS and GPs within phone packages.  

I would urge everyone to write in protest at this announcement to the Minister, to their MP, to the press.

From the BBC web site....(my highlights)


Ban for NHS premium rate numbers
NHS hospital staff
084 numbers are increasingly being used within the NHS

The use of premium phone rates for people contacting the NHS in England is to be banned, the government has said.

It comes after 3,000 people responded to a public consultation about the use of 084 numbers in the NHS, and 90% said calls should be charged at local rates.

The 084 numbers will not be banned but calls to hospitals or GP surgeries must cost no more than a standard call.

Doctors' leaders welcomed the change, saying patients should not be penalised because they are ill.

However, the ban would not apply to the cost of making phone calls from hospital beds, an NHS spokesperson said.

Campaigners against higher tariff 084 numbers, increasingly used within the NHS, say they go against the founding principles of the NHS which is that it is "free at the point of need".

Call costs can vary but some 084 numbers can cost as much as 40p per minute, while some others are set at the same rate as a standard call.

But an additional problem for patients is that many phone companies do not include 084 numbers as part of their inclusive packages. In particular, mobile phone users often have to pay extra to call the numbers.
     
We have been concerned that some people are paying more than the cost of a local call rate to contact the NHS
Mike O'Brien, Health Minister

Doctors had argued the use of 084 numbers enable them to offer patients a better service, such as a queuing system rather than an engaged tone.

It had been proposed that the numbers should be banned completely but the Department of Health said that would simply lead to the use of other higher tariff numbers

Instead they are taking moves to ensure that numbers used in the NHS do not cost the patient more than the cost of calling a geographical number.

Ofcom has previously said it would like public sector organisations to switch from 0845 numbers to a special suite of 03 numbers, which would be charged at the same rate as calling a normal landline number.

The Department of Health said there were plans for NHS Direct to move to one of the 03 numbers but its 0845 number would continue for now.

Concern

Health minister Mike O'Brien said: "We have been concerned that some people are paying more than the cost of a local call rate to contact the NHS.

"For people on low incomes, and for those who need to contact their local doctor or hospital regularly, these costs can soon build up.

"We want to reassure the public that when they contact their local GP or hospital, the cost of their call will be no more expensive than if they had dialled a normal landline number."

In Scotland, fewer than 4% of practices use premium rate numbers but the government is planning to issue advice on pushing down costs for those that do.

The British Medical Association said the proposals for England to limit the cost of 084 numbers to that of local calls was the fairest way forward for patients and practices.

Dr Richard Vautrey, deputy chairman of the BMA's GPs committee, said: "Patients who call their surgery because they're ill shouldn't be penalised because they have to call an 084 number, so we're pleased that the phone companies who supply these lines to practices have agreed to ensure that their tariffs are in line with local charges.

"There are many added benefits that telephone systems using these numbers have and which patients find helpful, for example better and quicker access, so it's good to see that the government has recognised this and has not gone for a complete ban on the use of these numbers."

Katherine Murphy, director of the Patients' Association, said: "It's great that the Department of Health has listened to patients. Asking them to pay extra costs for phone calls was unreasonable.

"Patients have had to wait long enough for the ruling. Let's hope the change happens as quickly as possible."

But David Hickson, a phone charges campaigner, said he believed the government would have trouble implementing the proposals.

"The government has failed to realise that the only way to ensure people only pay a normal charge is by prohibiting numbers that might charge more," he said.

"The only way to do it is to prohibit 084 numbers."

Isn't it quite remarkable that neither the Telegraph article nor the BBC article have reader comments turned on? It is quite clear that the media has been requested by O'Brien not to allow public comment on this absolutely scandalous pack of lies. Without banning 084 numbers for ALL medical practices - doctors; hospitals and associated government departments - nothing will change. O'Brien and his cheating, lying colleagues know this - but don't want to be exposed for the charlatans they really are. What absolute hypocrisy!  >:(

(But I've just realised that the Daily Mail does have reader comments enabled. Maybe it is time for all regular posters to this forum to tell it like it is; comment on the Mail site and let the public see just what a sham this announcement is. Shame they got the headline wrong, though. 0845? I thought it was 0844.....)

http://www.dailymail.co.uk/news/article-1213223/Whitehall-pulls-plug-GPs-costly-0845-phone-lines.html

It's all hand-waving and no action!

The published results of the consultation exercise clearly states "A total of 87% of all public respondents agreed that 084 number should be banned."  So where's the ban?

Para 3 of the DoH response is the key:

"The ban on the use of numbers charging patients a premium rate to call NHS services will allow a marketplace to evolve where 084 numbers compete alongside 01, 02 and 03 numbers, but where patients will pay no more than the cost of a local call. The ban means that GPs and other NHS organisations remain free to use 084 numbers, providing patients are not charged more than a local rate number. "

What do they mean by a "marketplace"?  Are we going to have a choice of using an 084, 01, 02 or 03 number when we call our GP or health centre?

Unless of course this is a sneaky way to prevent the use of revenue-sharing numbers without having to go up against the entrenched forces of the GPs by an outright ban, simply by allowing the public a right to veto the introduction or retention of an 084 number by saying "I can't ring your 084 number at a local-rate charge from my mobile-phone or VoIP phone service".  Does that sound likely?

It's just been one BBC News that the 0844 numbers will remain the same but the cost will be reduced to the local rate.


A quote from Dr Vautrey from the Yorkshire Evening Post:

http://www.yorkshireeveningpost.co.uk/news/Leeds-GP-welcomes-move-to.5643534.jp

Dr Vautrey said his surgery used an 0844 number but the company supplying it had assured the Government it cost no more than a local call.

Dave wrote on Sep 14^th, 2009 at 1:16pm:

Dr Vautrey said his surgery used an 0844 number but the company supplying it had assured the Government it cost no more than a local call.

I very much suspect that they are basing this on the announcement by BT that their charge for calling 01,02,03 numbers outside a package will go up to 5.25p per minute from 1st October.    This will mean that calls to geo numbers will then cost more than the 5.0p per minute(inc 17.5% Vat) for calling their 0844 number.

This is the facile attempt at deception and sleight of hand being played by O'Brien and his Department.   It won't wash as the public will not accept this get out.    O'Brien has stated that "The ban means that GPs and other NHS organisations remain free to use 084 numbers, providing patients are not charged more than local rate numbers ."   As said previously, most calls to geo numbers are now made by people with a package, using both landlines and mobiles, and the marginal cost, because they are pre-paid, is zero pence.    Under O'Brien's proposed scheme that price must be matched otherwise the Minister will be seen to have lied and this whole business has been about the minister wearing no clothes much like certain self deluded kings!! ;D

Have just come home after being out all day & with no access to radio/TV/internet.  The BBC radio news this morning led me to believe it was a done deal & 0844s would be banned.   This "result" is appallingly disappointing and an absolute nonsense  as others here have said - how on earth can a GP, even if willing, control the costs charged by a teleco to each of his patients?   It is a stupid announcement made by those who choose not to understand the situation.  I suspect that what they mean is that as long as the notional cost per minute is no higher than a "local" (ie non-existent) call, that is OK no matter how many people pay more because of packages etc.  It is enough to make one cry!

Another worry is that I have just had a letter from this O'Brien man sent to me by my MP which is supposed to be reassuring over the genetic prscribing issue, I was going to forward it to Epilepsy Action but now wonder whether it is worth it as O'Brien is just someone who plays with words to bury his true meaning and obviously cannot be trusted.

Our GPs do not use 0844, thank goodness, but I would much rather redial than be held in a queue anyway, at least I can leave it a few minutes & call again, if you are in a queue you feel compelled to keep one's place or it could be even longer.   Last Friday, we needed to speak to a GP as a member of the family who was ill was getting worse rather than better, we were promised a call back, it did not materialise until about seven phone calls (& six hours!) later.   How much would that have cost us if our GPs did have an 0844 what with the endless menus etc?!

This situation is now even more of a disgrace than it was and shows this govt just thinks everyone else is really really stupid.

There has been some interesting media coverage of the announcement.

This is probably the best piece.

A report from Which?:

Which? scores a win on cost of calling your GP

http://www.which.co.uk/news/2009/09/which-scores-a-win-on-cost-of-calling-your-gp-184477.jsp

---

Source: Politics.co.uk

http://www.politics.co.uk/news/health/doubts-remain-as-nhs-premium-rates-numbers-scrapped-$1326518.htm

<<
Doubts remain as NHS premium rates numbers scrapped
Monday, 14, Sep 2009 10:33
By Alex Stevenson

There are fears GPs could face a funding shortfall after the government's decision to abandon premium rate phone numbers for NHS organisations.

Ministers are committing to ensuring patients do not have to pay more than the cost of a local call - amid fears it will not be able to live up to the pledge.

[…]

"It is clear from the feedback we have received that patients support the banning of any number or tariff which is more expensive to call," Mr O'Brien said.

"For people on low incomes, and for those who need to contact their local doctor or hospital regularly, these costs can soon build up. We want to reassure the public that when they contact their local GP or hospital, the cost of their call will be no more expensive than if they had dialled a normal landline number."

This commitment, campaigner David Hickson claimed to politics.co.uk, is simply unrealistic.

"That's what they think they can say - they will shortly find out that is wrong. Or alternatively the minister will have to go back on his assurance," he said.

084 premium rate numbers charge a transmission fee significantly higher than normal calls, payable by the caller's telephone company to the telephone company managing the organisation with the 084 number.

Mr Hickson has conducted detailed research to show the extent of GPs within the NHS which rely on 084 numbers - an average of around ten per cent, although five have over 20 per cent.

After offsetting any charges, revenues from the premium rate numbers are shared between the company and the number-holder. GPs typically use the cash to finance the services they offer.

"If you are going to disallow a situation whereby patients and others pay more than the cost of a local call, you're dreaming if you think revenue-sharing can carry on," Mr Hickson explained.

[…]

>>

---

The DH's statement says:

3. The ban on the use of numbers charging patients a premium rate to call NHS services will allow a marketplace to evolve where 084 numbers compete alongside 01, 02 and 03 numbers, but where patients will pay no more than the cost of a local call. The ban means that GPs and other NHS organisations remain free to use 084 numbers, providing patients are not charged more than a local rate number.

6. The ban will be enforced through proposed changes to the GP contract (in consultation with the British Medical Association’s GP Committee), and the issuing of Directions to NHS PCTs and Trusts. These changes will be put in place as soon as practicable.

This suggests that GPs will be responsible for controlling the charges to their telephone numbers.


However, the BMA's statement says:

Changes to 084 number tariffs, which will ensure that patients who call them do not pay more than the equivalent cost of a local number, are the fairest way forward for patients and practices, the BMA said today (Monday 14 September 2009).

It doesn't look like GPs will be doing anything with the BMA passing the buck. Maybe the DH, Ofcom, the telephone companies or the tooth fairy will change the tariffs. ::)

So does this mean that there is a stalemate with no way of implementing the Minister's pledge?  :-?


The Minister said that there is strong feeling among patients for a ban and that changes will be made to ensure that they will be charged at no higher rate than a call to a normal landline number:

“We have been concerned that some people are paying more than the cost of a local call rate to contact the NHS.  It is clear from the feedback we have received that patients support the banning of any number or tariff which is more expensive to call.

“For people on low incomes, and for those who need to contact their local doctor or hospital regularly, these costs can soon build up. We want to reassure the public that when they contact their local GP or hospital, the cost of their call will be no more expensive than if they had dialled a normal landline number.”

So how will Mr O'Brien's pledge be delivered?

Dave wrote on Sep 15^th, 2009 at 12:45am:

So how will Mr O'Brien's pledge be delivered?

By the issuing of a 'clarification' statement in a few weeks.

It will say, "What the minister meant was the cost would not be allowed to exceed the cost of a call to a normal 01 or 02 number from a residential BT landline for someone who does not have an all inclusive calls plan."

All of a sudden, those who have to use a callbox or mobile are forgotten.

Heinz wrote on Sep 15^th, 2009 at 9:21am:

All of a sudden, those who have to use a callbox or mobile are forgotten.

... also forgotten are those who subscibe to Virgin Media, or a call plan from any of the "BT clones" such as Talk Talk.

If this were to happen, the BT publicity - "sign up to a call plan, but that will mean you have to pay extra to call your GP", will be interesting.

I do not believe that it will happen as suggested as any discussion of points of detail will cause this situation, as it stands, to fall apart.


Unless there is something very clever that we do not know about yet, the DH and the BMA are still at loggerheads over this. They have each declared their negotiating positions.

The DH says - we don't care what number you use so long as it does not cost the caller more than the cost of an ordinary call. If you can find a number that meets that requirement, then you are free to use it and to keep your revenue share.

The BMA says - it's your job to protect our revenue share income and make the necessary arrangements with the telephone companies to ensure that the numbers we use are "local rate" like we were told, and as you confirmed in 2005.

The fault is in presenting these negotiating positions as if this were a solution, and in not having moved forward in 18 months.

N.B. In referring to the BMA, I do not mean those working in the 90% of surgeries who do not use revenue sharing numbers, nor the few hundred who apparently responded to the consultation suggesting that their own use of 084 numbers be banned (there is no specific figure, but if you do the maths it has to be around 300). I am referring to the chief negotiator from the General Practioner's Committee, who seems to be adopting a position that may not be shared by his members in general.

An interesting piece in the Cambridge News, although sadly it maintains the rubbish that tariffs will be adjusted:

http://www.cambridge-news.co.uk/cn_news_home/DisplayArticle.asp?ID=448902


The reason the DH gave for not simply banning 084 numbers is because it believes that another premium number range may come into existance in the future and it may get used. Not if members of SAYNOTO0870.COM can help it!

What the DH should do is say to GPs, you can only use 01, 02 or 03 numbers. Should any new types of number come along in the future that are no more than a landline call for all, then they too could be added to the list.

hello

this is my first post as I am enraged by this.

after trwaling through the BT website, it looks like it will be more expensive to call a normal number from a BT phone during the day (when the doctors are open) than ringing an 0844.

Please correct my maths if I am wrong.

call to uk landline post 1st October 5.25ppm, cost to 0844 5ppm,
call set up for uk landline 9p per call, call set up to 0844 2.97p per call

So instead of the costs reducing by this none ban, the cost (although not directly attached although I do have a conspiracy theory) is going up.

The 0844 at least paid towards the surgery whilst the cost of the call to the 01 number is going straight to BT

http://www.productsandservices.bt.com/consumerProducts/displayCategory.do?categoryId=CON-HOME-PHN-R1 is the BT pricing


am I right?

Remember that a lot of people have inclusive packages with BT land lines so depending which option they are on, the 01, 02, 03, 0870 & 0845 numbers, will be counted as inclusive calls

geesus1 wrote on Sep 15^th, 2009 at 12:49pm:

after trwaling through the BT website, it looks like it will be more expensive to call a normal number from a BT phone during the day (when the doctors are open) than ringing an 0844. Please correct my maths if I am wrong. call to uk landline post 1st October 5.25ppm, cost to 0844 5ppm, call set up for uk landline 9p per call, call set up to 0844 2.97p per call So instead of the costs reducing by this none ban, the cost (although not directly attached although I do have a conspiracy theory) is going up. The 0844 at least paid towards the surgery whilst the cost of the call to the 01 number is going straight to BT

This is BT's position for its most basic tariff. The "all inclusive" one still charges 0844 numbers at the 5ppm, but geographical calls at 0ppm.

The nature of the market for geographical calls is that there are varying tariffs. In general, from landlines there are the two extremes: all inclusive and chargeable.

In contrast, 0844 calls drive a coach and horses through this process and remain the same irrespective of tariff.

The new marketing lie, or less than half truth - and expect to start hearing it a lot more often fairly soon - will be that 0844 numbers are cheaper to call than ordinary landlines.

I heard this when calling a call centre number for Parcel Force the other day. The 0191 listed on here is no longer valid, so they tell you to call 0844....... and that it's no more expensive ...... but they can't be arsed to tell you what the actual call rate is

This will probably happen all over the place, ignoring the fact that plenty of people have inclusive calls for ordinary landlines but never these.

I called Ofcom to complain about this announcement being misleading and factually inaccurate for more hours a week than it is true, and in any case totally untrue until BT tariffs increase.

I rather suspect the person I spoke to may have once worked at Vodafone customer services, judging by the scathing insolence he used, which is certainly a new experience when talking to Ofcom [well, for me at least]

Anyway: there is no requirement to give tariff announcements on 0844 numbers, I was told. Ok fine, I replied, but if a company voluntarily does so, it should not be inaccurate to the point of being misleading or evasive.  

You've made some other complaints here before haven't you sir? You should be aware then that Ofcom does not intervene in disputes; perhaps you should take out a private small claims case against Parcel Force for damages.

Let's just say I gave him some suggestions about how Ofcom might do its job, including that they'd spent at least 4 years fannying about with the dilemma of 0870 numbers, then by design allowed phone companies to introduce adjacent numbers that were bound to cause confusion and an expanding continuation of the whole shambles. And that 0844 were actually much more expensive off-peak than 0870 ever was.

It's outside our control, he said. Ofcom allocates the numbers, so I'll thank you not to lie to me, I replied


Maybe I'm wrong, but I thought the announcement was that doctors will be banned from using premium rate numbers

Ofcom will tell you that 0844 numbers are not premium rate.

So my interpretation would be that 0844 will very likely continue to be used, and the minister's choice of words implies he's unaware of enough detail of what he's talking about.

andy9 wrote on Sep 15^th, 2009 at 6:24pm:

Maybe I'm wrong, but I thought the announcement was that doctors will be banned from using premium rate numbers Ofcom will tell you that 0844 numbers are not premium rate. So my interpretation would be that 0844 will very likely continue to be used, and the minister's choice of words implies he's unaware of enough detail of what he's talking about.

The DH news release states that "phone numbers that charge the public or patients a premium rate to contact the NHS are to be banned". It goes on to say "The ban means that GPs and other NHS organisations remain free to use 084 numbers, providing patients are not charged more than a local rate number."

So GPs can use 084 and.or revenue sharing numbers where they cost no more than a call to a normal landline number.

Of course, we know that this isn't possible, so in effect it means a ban on 084 numbers. However, the BMA thinks that changes in tariffs will be made so that GPs can continue using their 084 numbers.

Source: Lincolnshire Echo

http://www.thisislincolnshire.co.uk/news/Calling-GP-cost/article-1337078-detail/article.html

<<

Calling your GP may not cost as much
Tuesday, September 15, 2009, 06:30

Patients at 16 Lincolnshire GP surgeries will only need to pay the rate of a local call when dialling their doctor.

The surgeries use an 084 number that can cost the caller as much as 40p a minute.

This has sparked outrage from patients who say they should not be financially penalised for ringing an NHS service.

But the Government ruled yesterday that excess charges incurred by a caller needing to ring a 084 number to contact their surgery will be scrapped.

Patients will still dial 084 numbers to get through to their surgery, but will soon only pay for the cost of a local call.

The Department of Health says the changes will be put into GP contracts over the coming months.

Sarah Howells, spokesman for NHS Lincolnshire said: "There are currently sixteen GP surgeries in Lincolnshire using 084 numbers.

"NHS Lincolnshire is working closely with these practices to integrate the national changes into GP contracts."

[…]

>>


It's one thing putting clauses into contracts, but how are GPs going to comply with them? How can they influence the charges that every last telephone provider charges? Ofcom could not enforce regulation on providers to charge 0870 numbers at no more than a normal landline, so what makes the DH think that GPs will be able to do it?

From NEG:

http://www.networkeuropegroup.com/neg-084.html

NHS free to choose 084 numbers for local patients

On 14th September 2009, Health Minister Mike O'Brien MP announced that new legislation will be introduced to ensure that local patients do not pay more than the cost of a local call to contact the NHS. This means that GPs and other NHS professionals and organisations will in future remain free to use 084 number based solutions for local services, providing patients do not pay any more than a local call.


The announcement means:

•The use of 084 numbers in the NHS will continue with the support of the Department of Health, so long as patients do not pay more than the cost of a local call;
•Decisions on whether to adopt an 084 number will continue to be freely taken by an individual GP surgery, dental practice or other NHS organisation;
•Revenue sharing is to be allowed to continue;
•The proposed action will allow a marketplace to evolve in which 084 numbers compete alongside 01, 02 and 03 numbers;
•NHS Direct will retain its current 084 number until the Government and OfCom are clear about any future role and function they may have in implementing a national 3-digit number for urgent care.

Commenting on the Government's announcement, NEG Managing Director and chief patient-exploiter, Dean Rayment said

"We applaud the Government's decision to allow patients, GPs and other NHS professionals to continue to benefit from the increased services, convenience and choice that are provided by the use of 084 numbers. We were always confident that, once the full facts about NHS telephony services were considered objectively by the Department of Health, the retention of the option to choose 084 numbers would be seen to be the best solution for patients, GPs and the NHS."


Background to the Government's Announcement

The Department of Health announced a consultation exercise on "The use of 084 numbers in the NHS" on 16th December 2008. The consultation closed on 31st March 2009.

In its official response to the DH consultation exercise, NEG demonstrated:

•For virtually all patients' calls, the local GPs’ 084 number is not more expensive to call than using an ordinary number;
•More than 4.5 million patients use an 084 number to contact their GP surgery every month;
•When allowed to be given the choice, GPs choose 084 numbers because it allows them to improve access and invest in quality services for patients;
•GPs do not make a single penny of individual profit from 084 numbers.

Here are the smiling faces:

http://www.networkeuropegroup.com/about-us-management-team.html

I repeat what Dr Richard Vautrey said:

Dr Vautrey said his surgery used an 0844 number but the company supplying it had assured the Government it cost no more than a local call.

Well Dr Vautrey is wrong

I phoned the BMA, and said I thought the press release was inaccurate in detail and risked misleading people, and expanded on some of my reasons

I've been invited to submit my concerns in an email

idb wrote on Sep 15^th, 2009 at 11:31pm:

"In its official response to the DH consultation exercise, NEG demonstrated: •For virtually all patients' calls, the local GPs’ 084 number is not more expensive to call than using an ordinary number; "

That is a stunning statement.

NEG's 5p a minute is not less than BT's 4.5p a minute peak rate to ordinary landlines, and penty of people can make calls cheaper than using BT

So if they have convinced anyone that 5p is not more expensive than 4.5p, they have a remarkable ability to mislead people

But surely, from the other posts in this thread, it seems that once the inceased BT prices take effect, the cost to call an 0844 from a landline without any inclusive call package etc WILL be less than a call to a landline, taking account of ppm, set up charge etc?   Please don't anyone think I am in any way saying 0844s are OK, that couldn't be further from the truth, I think they should be banned full stop for everyone everywhere, I am just anticipating the cynical distortion of facts on which the govt, NEG, BMA & some GPs etc will rely to justify their profit or inaction.  If I have misunderstood please someone put me right.   It seems that right through the whole campaign against ngns/premium rates, used by whoever, there has been a deliberate policy by those who use them to ignore completely the issue of call packages because the "basic" call to landline tariff distorts the facts.   In despair, I ask how do we get these people to understand, particularly as they don't want to??

A brief comment on the issue of the BT tariff changes affecting the relative position of 0844.

It is highly likely that this will be used in an attempt to disguise the truth, however I do not believe that it could be sustained for long. It does not require the greatest degree of understanding to point out the flaw in the argument. Most people recognise that not everybody uses landline service from BT without using a package. The argument will undoubtedly be made and used to cause further confusion, I do not however see it as the crucial point that will inevitably cause the issue to be decided.

For many years the cost of calling 0845 numbers on BT has been LESS than that of a normal number and they are now included in packages. This has not prevented 0845 from being considered as being part of the problem. The fact that NHS Direct will be exempted from the "ban" has been mentioned explicitly, as if this were an issue. If the cost of chargeable calls from BT had been accepted as the key factor, then 0845 would never have been included in the scope of the matter at all.

If we are talking about lies and deception, NEG claims that the BT price changes in April created the situation where "For virtually all patients' calls, the local GPs’ 084 number is not more expensive to call than using an ordinary number". The further change could remove the word "vitually" from this false claim, but we are already deeply into the territory that will be even more accessible from October.

Once again we have an escalation of government pick pocketing.

I need to call my physiotherapist to arrange an appointment on yet another thieving 0844 number. The physiotherapist visits a local doctors surgery once a week to use their premises.

The BT argument is completely irrelevant to many people (eg students, house sharers, hostel dwellers) since a lot of people these days do not waste money on BT when they already have inclusive calls on their mobiles.

I was wondering if somebody could give me the same and address of the NEG CEO so I can lie in wait and steal his/her wallet/purse, and see how they like being robbed!

Barbara wrote on Sep 16^th, 2009 at 11:59am:

But surely, from the other posts in this thread, it seems that once the inceased BT prices take effect, the cost to call an 0844 from a landline without any inclusive call package etc WILL be less than a call to a landline, taking account of ppm, set up charge etc?

Yes, but NEG are quoting themselves as having said is, not will be

The deadline for submissions in this process was a few months ago, and at the time they made the statement it was demonstrably untrue.

And even now, or in a couple of weeks time, their sweeping generalisation of For virtually all patients' calls ought to be viewed as at best incomplete or at worst intentionally misleading, as it applies to neither inclusive landline bundles nor mobile minutes

andy9 wrote on Sep 16^th, 2009 at 3:17pm:

... viewed as at best incomplete or at worst intentionally misleading

As the submission was based on incorrect figures, this view is unnecessarily generous. When using the correct figures for the highly selective example chosen, not even that shows 0844 calls to be cheaper in any circumstances. (From 1 October this will change to make 0844 calls invariably cheaper, but for only one of the examples quoted.)

Members may wish to refer to a commentary on the NEG submission.

I fully endorse the general point made by Andy in this posting. As I said previously, we are already deep in the territory that will become more accessible on 1 October.

---

P.S. Members may wish to report a "broken link" on the NEG website. (The item is labelled "NEG government consultation 084 click here")

The published response to the DH consultation, which was available some hours ago, has apparently been removed. This would seem odd, considering the pride in this work that is reflected in the recent comments on the government reaction to it.

SilentCallsVictim wrote on Sep 16^th, 2009 at 3:36pm:

P.S. Members may wish to report a "broken link" on the NEG website. (The item is labelled "NEG government consultation 084 click here") The published response to the DH consultation, which was available some hours ago, has apparently been removed. This would seem odd, considering the pride in this work that is reflected in the recent comments on the government reaction to it.

That's interesting

Source: Fenland Citizen

http://www.fenlandcitizen.co.uk/news/Wisbech-surgery-to-review-call.5651595.jp

<<

Wisbech surgery to review call service following ban

Published Date: 16 September 2009

A WISBECH doctor's surgery has promised to look into its patients' call service following a government announcement banning the use of premium rate numbers by NHS organisations.

Philip Wearing, practice manager at the North Brink Surgery, said it was too soon to say what action they would be taking following Monday's announcement which outlaws the use of 084 numbers from April.

The surgery hit the Citizen front page earlier this year when a patient claimed to have spent around £5 trying to get through to the practice to make an appointment.

At the time Mr Wearing defended North Brink's use of an 084 number, saying it provided a better service for patients as it allowed their calls to be held in a queuing system rather than getting an engaged tone.

[…]

Mr Wearing said techinically the surgery was not an NHS organisation as it was a private business contracted through the Primary Care Trust.

However, he said they would be seeking advice from the PCT and would take appropriate action on that advice.

>>


The Fenland Citizen article from April in which one of North Brink's patients was reported to have run up a £5 bill ringing it is here:

http://www.fenlandcitizen.co.uk/news/5-phone-bill-to-make.5189012.jp


Coming back to the report above, published today, the author has used the DH's news release from the ban of 0870 numbers in 2005 as it reports that only 290 surgeries are using these numbers and that the Minister who made the announcement was John Hutton. I gather this is also where the reference to "lo-call" rate has come from.

One solution, at least in the mean time, would be that the surgery should promote its geographical number, 01945 468900.

Let us be clear that using the 01945 number does not mean that there is no queuing. Patients will get the engaged tone when the maximum number of simultaneous calls that the number can accept has been reached.

So using a 0844 number because callers will never hear the engaged tone simply means that there can be, practically speaking, an infinite number of calls waiting.

The reason for making this point is make readers aware that no 0844 number does not mean no queuing.

The question GPs should ask is how many calls should be queued? Should there be a limit (at which point all other callers get the engaged tone) or not? Which is best is not something I'm interested in getting into.

Thoughts collected and blogged

SilentCallsVictim wrote on Sep 17^th, 2009 at 6:18am:

Thoughts collected and blogged

So all in all, all parties are just stalling for time and they aren't any nearer to having a workable solution than they were when the consultation commenced nine months ago. The media has reported the nonsense that "tariffs will be adjusted". GPs will resume signing up to new contracts for telephone systems that use 084 numbers.

When the Parliamentary recess ends on Monday 12 October, hopefully MPs will question how the Health Minister will deliver his promise to "reassure the public that when they contact their local GP or hospital, the cost of their call will be no more expensive than if they had dialled a normal landline number."

David, I'm struggling to get into your blog. It just freezes every time I try. It might be me (I am using a pretty old version of IE [6]), but I'm not having a problem with any others and I'm in and out of web sites all day.

Dave, I agree with you 100%. This is such a pigs ear of a solution that I think NEG and GPs will carry on with their fingers crossed until and if someone does anything about it. That could be years of more complaints. I suspect a lot will depend upon what the PCTs do. If they insist that the call costs do not exceed the cost of a geographic call from a mobile, inclusive package or phone box then the GPs will have no option but to move from 0844 numbers because the 0844 (as we all know) can not be reduced to that price (often a marginal cost over the package cost of nil) for every single telephone supplier and still involve revenue sharing. However if they make the requirements very woolly eg only comparing to BT landline non inclusive packages then we have a real mess.

The latter can not be justified because of the issue of pay phones, inclusive packages and mobile phones. I think mobile phones will be the crunch issue as so many people use them and the premium can be so large eg 40p compared to 'zero' per minute for some.

Dave wrote on Sep 17^th, 2009 at 12:39pm:

... question how the Health Minister will deliver his promise to "reassure the public that when they contact their local GP or hospital, the cost of their call will be no more expensive than if they had dialled a normal landline number."

It was not a "promise" but expression of a hope to be able to deliver a "reassurance"

After the speech by his boss today, it is very easy to see how that reassurance will be delivered, perhaps in a few years time, by a different minister.

"If your local GP or hospital does not have a number that is "local" enough for your personal needs, then you can choose another. We actually find that GPs with 084 numbers are able to deliver a better telephone service and therefore attract more and better-off patients also creating a better atmosphere in their 'Costa patient's lounge'.
"Busy people for whom time is money find the priority booking system (sponsored by Accurist) a great advantage in those surgeries where it is offered. Calling their special £1 per call lines gives you first access to same day appointments and your choice of doctor. Several surgeries that refused to offer this service had to close, as they fell into defecit due to lack of demand. That is unfortunate, but the NHS has to deliver what people want. GP's can't buck the market.
"Many surgeries now offer a direct telephone consultation with a GP, for only £1 per minute (£2 after 6.30 p.m.). This is an indication of how technology is improving the service that is delivered to NHS customers in Digital Britain.
"For those whose needs are best met by cheaper services there is the Dr Ronald freephone service where appointments for children can be booked by calling a freephone number that also gives free advice about healthy eating. When they visit the McSurgery they will receive a "I'm feeling poorly hat" and discount vouchers for a meal at their local McDonald's restaurant.
"Customers are getting what they want."

If public spending is to be constrained but "investment" in the NHS to be maintained, then this is what we can look forward to.

SilentCallsVictim wrote on Sep 17^th, 2009 at 2:08pm:

It was not a "promise" but expression of a hope to be able to deliver a "reassurance"

To me "reassurance" means a lot more than "hope".       It means to restore confidence.       It means we can all have "confidence" in the Minister, and thereby in our Government that they will not let us down.        I mean, a Minister assured us in 2005 that we will not have to pay more than the price of a "normal landline number", we were assured again in 2006 and 2007 and now we have at last been "reassured".

We can relax, sure and confident that our Minister has already made sure that we will not pay any more than if we had "dialled a normal landline number".       This is a lot more than mere hope.         The Minister has had his team studying the issue for more than 18 months and having consulted with the medical professionals, with the telecoms industry and even with some experts the problem has been cracked ----- we can be "reassured".

Do you think we need the Minister to confirm his reassurance?

Oh, SCV, that is very witty but so terrifyingly probable, as is all the best satire!   I have no faith whatsoever in the goverment and really no more in GPs to act in the true interests of patients (not customers, customers are usually in a willing association, I generally don't want to be ill!)

(PS I noticed, just before I posted this, that I had been logged out of the site but I hadn't done anything to cause that & the computer had been switched on all the time - does anyone know how this could have happened?)

Barbara wrote on Sep 17^th, 2009 at 3:06pm:

(PS I noticed, just before I posted this, that I had been logged out of the site but I hadn't done anything to cause that & the computer had been switched on all the time - does anyone know how this could have happened?)

This will happen if you have cleared your cookies and or history. I clear both from time to time and then have to log back in, not only to this site but others I have registered with as well....hope this helps.

Thanks Sherbert but I hadn't, not even sure I know how to (sounds pathetic).  I think it is this computer again, have had it since January & it has spent more time being repaired than with me, only got it back yesterday after it had apparently had a virus removed & I was still signed in then and this morning, the only time I have ever had to sign in again since registering was when using a new or different computer!

Barbara,

I have sent you a PM

:)

Barbara, It has happened to me a couple of times for no apparent reason - the last time a few weeks ago. I hadn't cleared down cookies or history. I have no idea why.

SilentCallsVictim wrote on Sep 16^th, 2009 at 3:36pm:

P.S. Members may wish to report a "broken link" on the NEG website. (The item is labelled "NEG government consultation 084 click here") The published response to the DH consultation, which was available some hours ago, has apparently been removed. This would seem odd, considering the pride in this work that is reflected in the recent comments on the government reaction to it.

All is well,
any technical problems have been overcome; the link from the main NEG website works again. The index page is here.

Mr Rayment can once again take pride in everyone being able to see how NEG demonstrated to the Department of Health that


Quote:

For virtually all patients' calls, the local GPs’ 084 number is not more expensive to call than using an ordinary number

This was achieved using the figures given on this page. The message is delivered by the graphics found on the pages linked from there.

One may see that the phrase "virtually all" only excludes those who make calls lasting longer than 12 minutes. Everybody calls 0844 numbers using the "BT Standard" tariff, even those who suffer the higher setup fee for non-inclusive 01/02/03 calls because they are on a BT call plan (although oddly this group are exempted from the 1 April rate increase to 4.5p!). Even more oddly, those who call 01/02/03 numbers on the “BT Standard” tariff incur the setup fee that applies to call plans.

This is a "fact" (according to the definition of that word employed by NEG). The figure given for 0844 calls is not incorrect. It is just irrelevant and set against figures that are incorrect, leaving the result even more meaningless than it would have been if the correct figures had been used for this highly selective atypical example. This simply makes no useful contribution to the debate, even the corrected figures for these examples do not prove anything of great significance either way.

We can all review these figures and reflect on Mr Rayment's further  quoted comment from Monday.  


Quote:

We were always confident that, once the full facts about NHS telephony services were considered objectively by the Department of Health, the retention of the option to choose 084 numbers would be seen to be the best solution for patients, GPs and the NHS. We congratulate Ministers on their willingness to listen and respond fairly and responsibly to the facts.

To be fair to Mr O'Brien, he may not have been swayed by these "facts". He has not bought them hook, line and sinker. The proposed solution to the problem is stated as being conditional on them being true (which is why it is a waste of time).

Mr O'Brien has however almost echoed NEG's words as it proposes its recommended solution in the Executive Summary of the response.


Quote:

Promote choice for primary care providers and competition between 03 and 084 solutions

This is remarkably similar to the third point in the DH announcement:


Quote:

The ban on the use of numbers charging patients a premium rate to call NHS services will allow a marketplace to evolve where 084 numbers compete alongside 01, 02 and 03 numbers

To my mind the threats contained in the following statement, also from the Executive Summary of NEG's response, explains why we do not yet have a solution to the problem. Unlike some of the nonsense, these comments are serious and require serious attention. I fear that officials have not yet succeeded in dealing with this. They have announced an "outcome" from the consultation, and suggested that an unworkable solution will be implemented, when these serious matters have yet to be resolved.


Quote:

The forced migration of 084 to 03 numbers would remove competition for quality at a local level - forcibly remove existing valued providers from the marketplace - and, in our view, could require a massive and open-ended commitment to taxpayer subsidy which we consider to be unnecessary and unworkable in the medium to long term.

Dave wrote on Sep 16^th, 2009 at 7:55pm:

Source: Fenland Citizen http://www.fenlandcitizen.co.uk/news/Wisbech-surgery-to-review-call.5651595.jp << Wisbech surgery to review call service following ban Published Date: 16 September 2009 A WISBECH doctor's surgery has promised to look into its patients' call service following a government announcement banning the use of premium rate numbers by NHS organisations. …

A letter has been published by Fenland Citizen on the topic of North Brink Practice's premium number:

http://www.fenlandcitizen.co.uk/letters/Dismayed-by-phone-line-comments.5671773.jp


Also, other media coverage yet to be reported on this thread:

Source: Worcester News

Counties’ 084 numbers have been changed
7:10pm Monday 21st September 2009

http://www.worcesternews.co.uk/news/4641040.We_have_led_the_way_over_calls_to_NHS/


Source: eGov Monitor
Herefordshire Ahead of National Ban On Premium Rate Numbers for Healthcare
Published Monday, 21 September, 2009 - 09:54
http://www.egovmonitor.com/node/28473

Is anyone aware of anything that is happening re the 0844 numbers. Seems everyone is carrying on in their own sweet way with the poor and disadvantaged still being stung when they call their GPs on their mobiles or from payphones.

Hopeless!

Whilst progress with GPs must await the discussions on the changes to the GMS contract, work on implementing the ban should now be well underway by NHS bodies.

One hopes that proud locally accountable NHS bodies will be sufficiently aware of their duties and obligations not to have to wait until enforcement action is taken against them by government departments, as threatened in the announcement last week.

For those who understand something of NHS politics, it will be interesting to see what happens with Foundation Trusts and private hospitals providing NHS services. This issue was one of those not addressed by the announcement.

Members may be interested to read a message circulated to the media addressed to the leading examples listed on the NHS.Patient web site.

David,

Thanks for the reply. Also just to let you know I can get into your blog now without any problem and an excellent article it was, as was your letter to the media.

I called my PCT today to ask what was happening. They said they had to get back to me and to their credit they did promptly. However the response is "They are awaiting offical guidelines and timescales".

I am cynical that this will all be ignored generally until enough of a stink is kicked up yet again.

Keith wrote on Sep 25^th, 2009 at 5:37pm:

... I am cynical that this will all be ignored generally until enough of a stink is kicked up yet again.

Thanks to Keith for the comment and commendation.

I am told that the DH is "working on" the Direction to be issued to PCTs and Trusts, although there is no answer to the question of how on earth an announcement could have been made before this work had been completed. In my published message I have adopted the position that Enforcement Directions should only be necessary in the case of a failure to exercise what is clearly now understood to be a duty to patients by the local independent arms of the NHS.

In truth, nobody likes being told what to do, but equally nobody likes to take responsibility for themselves when someone else could be blamed. This truth is universal, but is seen particularly in the public sector where some balanced sense of where the "public interest" lies has to inform every decision. Devolution to bodies without clear accountability makes decision taking genuinely very difficult. That is why PCTs and other trusts are (wrongly in my opinion) waiting for explicit directions. They will get no directions in respect of GPs until the revised GMS contract has been agreed.

The issue will not be ignored. The stink will come, as soon as there is enough material for it to hit the noses of those who can do what is necessary. A useful piece of excrement came into my hands late this afternoon. If suitably blended and presented it may do the trick. "Watch this space".

Some interesting excerpts of a consultation response from one provider which tears into the consultation document for its factual inaccuracies:

http://www.03-number.co.uk/084_government_consultation.htm

Dave wrote on Sep 29^th, 2009 at 9:05pm:

Some interesting excerpts of a consultation response from one provider which tears into the consultation document for its factual inaccuracies: http://www.03-number.co.uk/084_government_consultation.htm

It wasn't the only response to tear in to the consultation though.  Mine did so pretty extensively but as far as I can tell the complacent civil servants at DH never even read most of it.

Why do you think they repeatedly claimed it would be so horribly expensive or difficult to publish all the responses that they received. :) ::)

Dave wrote on Sep 29^th, 2009 at 9:05pm:

Some interesting excerpts of a consultation response from one provider which tears into the consultation document for its factual inaccuracies: http://www.03-number.co.uk/084_government_consultation.htm

One of the quotes from this response states:

Quote:

Consultation Document Page 7: "GP Practices and other NHS organizations using 084 numbers do not make a profit from 084 numbers. The money generated by 084 numbers goes towards the cost of providing that number and the functions." There is no stipulation in the provision of revenue-sharing on 084 numbers that the revenue must be assigned to any cost of providing functionality. It should also be stated that the cost of the number and functions has been artificially inflated in the perception of the purchasers to bring it in line with the considerable revenue share that is available from 084 (particularly 0844) numbers. The market cost of such functionality can only be judged if it is isolated from the revenue-sharing arrangements.

This is of course what the whole revenue-sharing number racket is about. Providers' true costs are masked because of the regulation on BT to keep down the amount it retains for originating such calls.

Dave wrote on Sep 29^th, 2009 at 9:48pm:

This is of course what the whole revenue-sharing number racket is about. Providers' true costs are masked because of the regulation on BT to keep down the amount it retains for originating such calls.

Do we know any more about this particular telecoms company and why it is they are so willing to attack other traditional covert revenue share NTS numbers in favour of lower profit 03 numbers?

Dave wrote on Sep 29^th, 2009 at 9:05pm:

Some interesting excerpts of a consultation response from one provider which tears into the consultation document for its factual inaccuracies: http://www.03-number.co.uk/084_government_consultation.htm

The point that is missed is that use of 084 numbers DOES provide the additional functionality. The revenue share money earned from callers is used to pay for it, wherever it is technically deployed.

The issue is about money, not technology.


NGMsGhost wrote on Sep 29^th, 2009 at 9:20pm:

It wasn't the only response to tear in to the consultation though.  Mine did so pretty extensively but as far as I can tell the complacent civil servants at DH never even read most of it. Why do you think they repeatedly claimed it would be so horribly expensive or difficult to publish all the responses that they received.

It is for the DH to consult when and how it chooses and to handle the responses in whatever way it wishes.

It is for respondents who wish their responses to be seen in the public domain to publish them. There are links to two from the NHS.Patient website. If many more were published, I would happily arrange a proper catalogue.

The situation has however now moved on with the consultation having concluded and largely produced the effect that we wished for. The right words have been spoken by the Minister in response.

They have however been combined with some very silly words and largely ineffective action is being taken. There may be some merit in drawing from the unhappy past, however we must be focused on moving forward to a happier future.

(P.S. I note that other postings have been made since those I am responding to. I have nothing to add.)

SilentCallsVictim wrote on Oct 4^th, 2009 at 5:06pm:

I hope that others will join me in lobbying MPs and Ministers to ensure that we have a proper resolution.

Part of the action that I have taken is in a circulated briefing.

Please feel free to copy any of the points made in your own lobbying.

Source: Southport Visiter

http://www.southportvisiter.co.uk/southport-news/southport-southport-news/2009/10/07/nhs-will-end-premium-rate-call-charges-to-southport-surgeries-101022-24863360/

<<

NHS will end premium-rate call charges to Southport surgeries

Oct 7 2009  by John Siddle, Midweek Visiter

PATIENTS, who were charged up to 40p a minute to ring Southport surgeries, are quids in after the NHS decided to scrap premium rate telephone calls.

St Marks Medical Centre, Derby Road and Ainsdale Medical Centre are among those currently using controversial 084 and 085 prefixes, which sees callers charged 4.2p per minute from a BT landline and up to 40p from a mobile.

Now, after a consultation with MPs, changes in tariffs mean patients will still dial 084 numbers but will only pay for the cost of a local call.

The changes, which will be introduced over the coming months, have been welcomed by Southport MP, John Pugh.

He said: “High cost phone numbers have been creeping like a disease throughout the NHS and other public services.

“People have no choice but to phone and we should not be profiting from the sick.”

[…]

>>


This twaddle about tariffs being changed continues. St Marks Medical Centre should do the right thing and publish its geographical number, 01704 511799.

Dave wrote on Oct 8^th, 2009 at 4:10pm:

Source: Southport Visiter http://www.southportvisiter.co.uk/southport-news/southport-southport-news/2009/10/07/nhs-will-end-premium-rate-call-charges-to-southport-surgeries-101022-24863360/ St Marks Medical Centre, Derby Road and Ainsdale Medical Centre are among those currently using controversial 084 and 085 prefixes, which sees callers charged 4.2p per minute from a BT landline and up to 40p from a mobile.

There's that cost quoted excluding VAT gain.

It's 5p per minute unless you have a way of avoiding paying VAT!

BTW, the standard of journalism can be judged by the reference to non-existent "085 prefixes"

Heinz wrote on Oct 8^th, 2009 at 7:22pm:

There's that cost quoted excluding VAT gain. It's 5p per minute unless you have a way of avoiding paying VAT! BTW, the standard of journalism can be judged by the reference to non-existent "085 prefixes"

As I am sure you know even you are not correct  ;) from 1st October the cost for a daytime chargeable 01/02/03 call from BT is 5.25ppm with a 9.05p set up fee, source,BT Tarrif Guide

We all have a way of avoiding paying VAT at 17.5%. We stay out of our time machines.

The correct rate for the call to the surgery in question from BT is 4.894 pence per minute (including VAT at 15%).

The 9.05p setup fee applies to most residential customers.

derrick wrote on Oct 9^th, 2009 at 12:44pm:

Heinz wrote on Oct 8th, 2009 at 7:22pm: There's that cost quoted excluding VAT gain. It's 5p per minute unless you have a way of avoiding paying VAT! BTW, the standard of journalism can be judged by the reference to non-existent "085 prefixes" As I am sure you know even you are not correct  ;) from 1st October the cost for a daytime chargeable 01/02/03 call from BT is 5.25ppm with a 9.05p set up fee, source,BT Tarrif Guide

Sorry Heinz, I,(still), keep mixing up/forgetting the 0844 & 01/02/03 numbering set up :-[
maybe they are getting to me ;D

My, unusually Political, blog on the effects of the concluding stages of the Health Bill deliberations in parliament is found at:
http://nhspatient.blogspot.com/2009/10/theft-of-nhs.html.

It is highly relevant to this topic.

Article on page 12 of todays' Sunday Post

Ban on costly calls to surgeries

http://www.dcthomson.co.uk/mags/post/postindex.htm

DOCTORS’ surgeries and hospitals are to be banned from imposing premium-rate phone numbers on patients.

Some have been charging up to 40p a minute more than standard costs for calls to make appointments.

Health secretary Nicola Sturgeon is to put pressure on NHS boards and GP practices to replace the numbers with cheaper alternatives.

The move will bring Scotland into line with England, where a ban was announced last month following a public outcry.

Premium rate

Dozens of medical practices use premium rate 084 numbers that enable them to collect a portion of the charge paid by callers.

Under the new rules the 084 prefix may still be used but the tariff must be adjusted to ensure patients only pay the equivalent of a local call.

This is already the case with calls to NHS 24.

Last night Margaret Watt, of the Scotland Patients’ Association, called for any profits already generated from the numbers to be repaid.

She said, “These numbers are a tax on the sick. We welcome the ban but NHS boards and GP practices should be forced to reinvest any profits made from them back into front-line health services.”

Doctors and dentists were prohibited from using national rate 0870 numbers more than four years ago.

But it emerged during an Ofcom consultation earlier this year that many had switched to high-tariff 084 lines instead. While not as expensive as 0870 numbers, these are still much dearer than a local call.

Not penalised

Dr Dean Marshall, chairman of the BMA’s Scottish GP Committee, agrees that patients who call their surgery because they’re ill should not be penalised.

He said, “These numbers are not widely used by GP practices.

“However, we hope phone companies who supply these lines to practices in Scotland will agree to ensure that their tariffs are in line with local charges. This principle should apply to all public services.”

Meanwhile, the Scottish Government is investigating the feasibility of switching NHS 24 from its current 0845 number to a special three-digit non-emergency code.

Previous plans to make all landline calls to NHS 24 free were ditched because of the £300,000-a-year estimated cost.

A Scottish Government spokeswoman said, “We strongly believe patients should be charged as little as possible when they contact health services.

“GP practices should be encouraged to ensure new contracts ensure patients are charged the lowest rate possible and in the case of existing contracts, that GPs enter into talks with their provider to achieve revised agreements that would see patients pay the lowest rate practicable.”

More muddled journalism and meaningless political rhetoric.

I predict it will result in no action and NHS use of 5p/minute 0844 numbers will be allowed to continue now that BT, still the largest calls provider (and, despite so-called competition, the one the others follow), has raised its standard weekday daytime rate for 01, 02 and 03 calls (for those not on their Unlimited Anytime Plan) to 5.25p/minute.

Heinz wrote on Oct 18^th, 2009 at 8:20pm:

I predict it will result in no action and NHS use of 5p/minute 0844 numbers will be allowed to continue now that BT, still the largest calls provider (and, despite so-called competition, the one the others follow), has raised its standard weekday daytime rate for 01, 02 and 03 calls (for those not on their Unlimited Anytime Plan) to 5.25p/minute.

Even though 0844 numbers are almost never included in mobile phone bundled minutes or landline call packages and BT Payphones division still charges 1800% more per minute to call an 0844 number than a number starting 01/02/03. :o

I presume New Labour reckons they will have been booted out of office by the time the chickens home to roost and that the incoming Conservative government will then be forced to pick up the pieces. >:(

NGMsGhost wrote on Oct 18^th, 2009 at 9:41pm:

I presume New Labour reckons they will have been booted out of office by the time the chickens home to roost and that the incoming Conservative government will then be forced to pick up the pieces. >:(

We may have to wait a very long time to see an incoming Conservative government in Scotand.

The government may be different, from time to time and place to place, but the civil service remains the same.

It will be interesting to see where the governments would find the extra money to replace that currently being paid by NHS patients.They are already looking to not only reduce the current account defecit but also pay off the National Debt.

SilentCallsVictim wrote on Oct 18^th, 2009 at 10:01pm:

It will be interesting to see where the governments would find the extra money to replace that currently being paid by NHS patients.They are already looking to not only reduce the current account defecit but also pay off the National Debt.

Once again SCV you return to that self defeating argument in an open public forum where our opponents will be reading what we post.  I am surprised that one normally so conscious as you of the dangers of entering in to arguments that undermine what the campaign is trying to achieve now does so in this open public forum.  Oh but hang on aren't you now a one man NHS phone calls campaigner who does your own thing so as not to have the logical inconsistencies in your own campaigning positions exposed.  If so then what are you doing posting here?

The money can always be found to do things when there is the political will.  Just look at Iraq or Afghanistan and the cost of making these change to phone numbers used for call centres is utterly piffling amounts that is of no consequence at all in the overall context of the budgets of the organisations we are talking about.  The amounts of money involved are only significant to the parasites who vend these numbers to the public sector.

I remain at a loss to understand why as a supposed suporter of this campaign you suddenly start advancing arguments that I would expect to hear only from Network Europe Group or from some slimey chief executive of a local authority paid over £200,000 per annum and with a Marie Antoinette like attitude towards the cost of phone calls by their local residents.

I have strongly supported the general position taken by O'Brien (S), Penning and Lansley over the matter of the NHS Constitution in the Health Bill and I look forward to their statements when the truth about the so-called "ban" emerges, as I hope it will in the next few days.

As is rightly said, the money that is necessary will be found. We are however where we are because nobody has succeeded in finding a clever way of dealing with the problem of the GPs under contract to NEG with the blessing of the Department of Health and its Scottish equivalent. None of us would agree with a pay-off, but no alternative has come forward. The Political problem is with making any public statement that involves additional public expenditure (or loss of income) at present. Great Political capital can be earned from comments about catering in the Palace of Westminster, whereas we do not hear costed pledges of even the most modest additional spending (unless one believes that it is OK for non-domiciles to evade their tax liability whilst the present inheritance tax regime is in place).

The point about revealing campaigning tactics to enemies is fairly made. We are now however at the stage where this matter has to be opened up to proper public debate. It risks being pushed under the carpet due to inevitable confusion about BT tariffs. There is nothing to be gained by hiding the truth by pretending that we are not calling for additional public expenditure on some scale, as we are also calling for businesses to cover their costs through their properly declared prices, rather than hidden extras. I hope that this is not part of a hidden agenda or an embarrassing secret for the campaign.

I hope that the campaign does not subscribe to the school of thought which suggests that the problems of the financial services sector can be addressed by re-couping the money from senior staff remuneration. Please do not tell me that the money lost by abandoning revenue sharing can all come out of the salaries of doctors, senior civil servants and private sector executives, or that it will be distributed around out of the money saved by telephone companies in not having to pay for Ofcom, when it is abolished by a new government.

SilentCallsVictim wrote on Oct 18^th, 2009 at 11:54pm:

Please do not tell me that the money lost by abandoning revenue sharing can all come out of the salaries of doctors, senior civil servants and private sector executives, or that it will be distributed around out of the money saved by telephone companies in not having to pay for Ofcom, when it is abolished by a new government.

What an excellent idea SCV.

I think you may just have hit on the solution to the whole problem although for the sake of simplicity I would have no problem whatsoever with requiring just the GPs themselves to pick up the cost of cancelling their contracts with NEG out of their own personal salaries rather than using the budgets of the GP practices that they work for.

After all it seems to be only natural justice that they should suffer the financial consequences of their own original poor judgement in signing these deals largely for their own financial benefit and against the financial interests of their patients.

SilentCallsVictim wrote on Oct 18^th, 2009 at 11:54pm:

… It risks being pushed under the carpet due to inevitable confusion about BT tariffs. …

Should we be calling for an end or change to the "NTS Condition" regulation on BT that causes the premiums associated with "revenue sharing" numbers to be hidden? With all the nonsense that is going on; those benefitting claiming ignorance, it would seem like a good idea. That said, call prices will probably rise.  :-/  :-/

Dave wrote on Oct 19^th, 2009 at 12:20am:

SilentCallsVictim wrote on Oct 18th, 2009 at 11:54pm: … It risks being pushed under the carpet due to inevitable confusion about BT tariffs. … Should we be calling for an end or change to the "NTS Condition" regulation on BT that causes the premiums associated with "revenue sharing" numbers to be hidden? With all the nonsense that is going on; those benefitting claiming ignorance, it would seem like a good idea. That said, call prices will probably rise.  :-/  :-/

Or at least the prices of non bundled calls will rise or if not the price of the call bundles will rise instead.

A case of heads they win and tails they win I fear........................

NGMsGhost wrote on Oct 19^th, 2009 at 12:40am:

Dave wrote on Oct 19th, 2009 at 12:20am: SilentCallsVictim wrote on Oct 18th, 2009 at 11:54pm: … It risks being pushed under the carpet due to inevitable confusion about BT tariffs. … Should we be calling for an end or change to the "NTS Condition" regulation on BT that causes the premiums associated with "revenue sharing" numbers to be hidden? With all the nonsense that is going on; those benefitting claiming ignorance, it would seem like a good idea. That said, call prices will probably rise.  :-/  :-/ Or at least the prices of non bundled calls will rise or if not the price of the call bundles will rise instead. A case of heads they win and tails they win I fear........................

Perhaps any changes should be introduced in phases.

Dave wrote on Oct 19^th, 2009 at 12:20am:

Should we be calling for an end or change to the "NTS Condition" regulation on BT that causes the premiums associated with "revenue sharing" numbers to be hidden?

A simple answer to that question would depend on the effect that it would be known to have, i.e. how BT would propose to use the freedom that would result.

If the simple rules of economics applied, then BT would aim to take a similar margin on these calls to that which it does on others, however it would be constrained by the market. In theory, the cost of 084 calls would rise and that of others (which presently must cross-subsidise by providing BT with coverage of its general overheads and profit) would fall. I would at least need to be reassured of the latter before putting my weight behind such a campaign.

One could argue that because BT already treats 0845 numbers in the same way as geo numbers in respect of inclusive calls, then it could readily do the same when non-inclusive. That does not however help a great deal because this would still represent a distortion, as the greater cost is hidden. When a whole variety of cases are bundled together in a package there is inevitably a high degree of cross funding, e.g. light users pay for the calls of heavier users. In the same way those who have no calls to 0845 numbers in their inclusive calls pay for those who do. If we are seeking visibility of the premium then non-inclusive 0845 calls would have to be more expensive. BT would find that very hard to sell, given the fuss it made about them last January.

Current users acquired 0844 and 0845 numbers on the basis of an assurance about the cost of calls from BT. They and their callers would undoubtedly feel aggrieved if prices rose, especially in the case of 0844 where they selected a particular price level (if only from BT).

The common view seems to be that the revenue share on 0845 will end at some point in the not too distant future, i.e. within the next five years. This will be somewhat similar to what happened with its original partner, 0870.

This would leave the mess of 0844/3 as a mess. Without the price fixing, 0844 would make no sense at all. Without BT as the dominant market player, price fixing for a single provider makes no sense at all. As the market moves towards use of mobiles, which do not respect the full complexity of the 0844 call types, then the whole thing becomes meaningless. This is why Ofcom does not want to touch it.

My own view, which is based on only a limited understanding of the possible valid uses of the lower grade 0844 ranges, is that it should be scrapped as soon as possible. 0871/2/3 already includes a 6p per minute option for the 5p per minute crew, which should meet their needs. 0874 could be reserved for migration. If I knew more about the uses of the .5p/1p/2p per minute and the fixed rate per call ranges (if anyone uses them when they cost up to 40p per minute from a mobile) then I would say more.

As things stand, it is my considered view that we will have to work as hard as we can to explain the fact that BT is the anomaly, the one whose charges vary from the norm, rather than the opposite.

Campaigning for tax increases is one thing, campaigning for telephone call costs to be raised is another.

NGMsGhost wrote on Oct 19^th, 2009 at 12:40am:

A case of heads they win and tails they win I fear........................

Of course "they" win! Which businesses do you want to fail.

SilentCallsVictim wrote on Oct 19^th, 2009 at 1:21am:

Of course "they" win! Which businesses do you want to fail.

Businesses that are based on lieing to and cheating the customer and which do not deliver any actually useful services deserve to fail.

Why are you one of those people who believes that businesses can do anything in the name of profit, even if it means breaking the law or murdering people?

NGMsGhost wrote on Oct 19^th, 2009 at 1:39am:

SilentCallsVictim wrote on Oct 19th, 2009 at 1:21am: Of course "they" win! Which businesses do you want to fail. Businesses that are based on lieing to and cheating the customer and which do not deliver any actually useful services deserve to fail.

The first part sounds like all businesses, and the second like none.


Quote:

Why are you one of those people who believes that businesses can do anything in the name of profit, even if it means breaking the law or murdering people?

I used to be, before I stopped beating my wife.

Most businesses justify their existence on the basis of helping the economy, providing employment and providing goods and services that some people are prepared to pay for. Businesses that cannot make a profit adequate to serve their investors do fail, whether they deserve to or not.

I certainly believe that every business is capable of breaking the law, although I cannot recall ever advocating or justifying such conduct. I cannot think of a situation where murdering people is not breaking the law, so I cannot comment on those who would take this course of action as an alternative to law breaking.

---

NGMsGhost wrote on Oct 19^th, 2009 at 12:02am:

I would have no problem whatsoever with requiring just the GPs themselves to pick up the cost of cancelling their contracts with NEG out of their own personal salaries rather than using the budgets of the GP practices that they work for.

I wonder if retrospective "anti-incorporation" legislation will be a feature of any of the party manifestos at the forthcoming general election.

Allowing people to hide behind the terms of an incorporated partnership, or employment in a corporate body of any form, is a severe obstacle to natural justice.

SilentCallsVictim wrote on Oct 19^th, 2009 at 2:54am:

Allowing people to hide behind the terms of an incorporated partnership, or employment in a corporate body of any form, is a severe obstacle to natural justice.

Arter the recent banking crisis I came to the conclusion that incorporation and completely unlimited liability in general was a severe obstacle to the delivery of natural justice.

Most directors of culpable banks (not least Sir Fred Goodwin) have largely evaded natural justice due to the existence of this unrestricted limited liability.

Your contention that all businesses must apparently operate on an ethical and commercial model similar to that utilised by NEG I find to be both untrue and unpalatable.  I see plenty of businesses that make a profit but still deliver high quality services that are run in the best interests of their clients.

NGMsGhost wrote on Oct 19^th, 2009 at 9:31am:

Your contention that all businesses must apparently operate on an ethical and commercial model similar to that utilised by NEG I find to be both untrue and unpalatable.

It is regrettable that businesses practice deceit whilst appearing to be ethical. Life would be much easier if all crooks wore an eye mask and carried a bag labelled "swag" at all times. It is a sad fact of life that we have to swallow the unpalatable fact that this is not the case.

I am surprised at the contention that many businesses do not even appear to be ethical. The robust defence of its position mounted by NEG certainly does not indicate a readiness to appear to be unethical, quite the reverse. Every representative of NEG that I have encountered has totally failed to convince me of their honesty and integrity, in some cases they have not even bothered to try, deliberately withdrawing from public engagement with me. They have however clearly succeeded in appearing to be honest and ethical in the eyes of some.

I do not believe that NEG would bother to go to such lengths to set out its claims in public if all of its current and potential customers were similarly unethical and willing knowing participants in a deception of others.

 
 I have to attend the Portishead Medical Centre, and note the number is 0844 477 3286.  The information they give regarding the use of 0844 numbers is that the 0844 number costs less than a BT local call (no mention of calls from mobiles) and would ask the question can this be true? Can anybody please advise me as I want to take this up with them.  A copy of the details from their news report is attached below:
   
 
     Consultation on 084 telephone numbers 15/9/2009  
   

Following the recent public consultation on the use of 084 telephone numbers in the NHS, the Department of Health have now issued their conclusions.

They recommend that 0844 numbers can continue to be used as long as a premium rate is not charged. 'Premium rate’ means a call that costs more than a local call.

Calls to our telephone number (0844 477 3283) actually cost very slightly less than a BT local call. As a result of this ruling we are hopeful that telephone service providers will now be forced to include 084 telephone numbers alongside 01.. and 02.. numbers in their call packages.

We will pass on further information as soon as it becomes available.









 

   
Portishead Medical Group website
Portishead Health Centre, Victoria Square, Portishead BS20 6AQ
Tel 0844 477 3283 Fax 0844 477 3286



--------------------------------------------------------------------------------
© 2004 Designed by Dr Luke Koupparis
{NHS Zero Tolerance website} {Practice policy on violence} {Removal policy}
   

redant wrote on Oct 22^nd, 2009 at 6:31pm:

I have to attend the Portishead Medical Centre, and note the number is 0844 477 3286.  The information they give regarding the use of 0844 numbers is that the 0844 number costs less than a BT local call (no mention of calls from mobiles) and would ask the question can this be true? …

It is now true because the cost of a 0844 call is 4.89 pence per minute inclusive of VAT, but the cost of a "local" call on a non-inclusive package is 5.25 pence per minute.

Think of it like this. If I were to tell you that you can buy a lottery ticket for the price of a can of Coke, would you believe me? Of course you can! In airports and other such locations vending machines charge £1 or more for a can of Coke.


What provider are you with and which tariff?

Portishead Medical Centre should take a leaf out of nearby Harbourside Family Practice, based in the Marina Health Centre which opened earlier this year as its number is not a local 01275 number but a 0300 one.

Hi Dave
I am sad to admit to "talktalk" inclusive package i.e all calls at any time (except non-geo of course) and broadband.  Transferred from onetel to the 18 month contract.  The 0844 is cheaper if compared to BT "local" rate, but does not, of course, take into account mobile phones.  If I have to call it will be on my mobile and this is what angers me.  The government seem to have really lost the plot on this issue-but did not really expect anything else?

Dave wrote on Oct 22^nd, 2009 at 6:54pm:

It is now true because the cost of a 0844 call is 4.89 pence per minute inclusive of VAT, but the cost of a "local" call on a non-inclusive package is 5.25 pence per minute.

http://www.saynoto0870.com/cgi-bin/forum/YaBB.cgi?num=1229408403/190#190

Quote:

I predict it will result in no action and NHS use of 5p/minute 0844 numbers will be allowed to continue now that BT, still the largest calls provider (and, despite so-called competition, the one the others follow), has raised its standard weekday daytime rate for 01, 02 and 03 calls (for those not on their Unlimited Anytime Plan) to 5.25p/minute.

redant wrote on Oct 22^nd, 2009 at 8:10pm:

Hi Dave I am sad to admit to "talktalk" inclusive package i.e all calls at any time (except non-geo of course) and broadband.  Transferred from onetel to the 18 month contract.  The 0844 is cheaper if compared to BT "local" rate, but does not, of course, take into account mobile phones.  If I have to call it will be on my mobile and this is what angers me.  The government seem to have really lost the plot on this issue-but did not really expect anything else?

In this case you have the surgery wrong in 3/3 cases.

Their statement does not apply to your mobile, your Talk Talk package, nor the equivalent BT package, where the rate for local calls is zero.

If their rate is slightly less than the BT equivalent local rate, then they should be paying you a small amount of money for each call you make to the surgery.


You could also point out another highly relevant comment from the announcements of 14 September.

Dr Richard Vautrey of the BMA said “we’re pleased that the phone companies who supply these lines to practices have agreed to ensure that their tariffs are in line with local charges"

Talk Talk supplies 0844 477 3286 (through NEG). I can promise you that Talk Talk has no plans whatsoever to include 0844 numbers in its packages, likewise BT. Even though they both endure tiny margins on these calls, the adjustment to the package fee that would be necedssary has been described to me as representing "financial suicide". Customers would not bear it - they would demand the return of the cheaper package option, without 0844 included. At the same time everyone would get a 0844 number for themselves - why not benefit from 2p per minute revenue share as well as free line rental if it costs your friends no more to call you!

The cost of the revenue share has to be carried by those who call the numbers, not every customer. It is totally wrong that every BT and Talk Talk customer has to pay for the revenue share on 0845 calls, however some believe that this will shortly be ending.


(P.S. We refer to "local rate" remembering that for BT and most other telcos this is the same as "national rate".)

Members may be interested to note that the Directions to NHS bodies referred to in the September 14 Statement were issued on Monday afternoon.

The formal directions accompanied a "Dear colleague" letter.

I comment and raise issues in a media release.

My latter point is significant. I see it as vital to get those who can speak with formal authority to point out the nonsense implied by these directions.

"The arrangement as a whole" is only relevant according to the choices of telephone tariff made by patients, it has nothing to do with any action by a NHS provider. If a revenue sharing number is selected, it may be fairly assumed that telephone service providers will pass on the extra cost incurred (in providing the revenue share) to callers. This is what one must reasonably expect, unless one perhaps believes that nobody has paid for the presents that will be found under the tree on Friday morning.

To assume that every caller to a 0844 number has subscribed to a BT call plan other than "Anytime" is quite absurd. It is almost equally absurd to assume that patients calling 0845 numbers are only subscribed to BT or to a few selected mobile tariffs that charge the same high rates for both 0845 and geographic calls. (With BT one must include those who I describe as its "clones" - those who parrot the structure of its tariffs.)

Providing NHS services is not the same as running a grocer's shop, where one could perhaps offset discounts from which some customers benefit (paid for by suppliers) against additional costs incurred by other customers (in aiding one's bottom line) when assessing the impact of one's pricing policy on consumers in general. This type of consumerist nonsense has no relevance to the NHS. NHS services are provided to individual patients in need, not to a group of consumers whose interests may be considered collectively, as a group. I will not get involved in playing the consumerist game, even if it may be seen to suggest that use of 084 numbers must be stopped in the NHS.


On a more positive note, for those who are very patient, we see the date of 21 December 2010 as that by which all existing numbers must have been reviewed.

The future for discounted rates for calls to revenue sharing 084 numbers may look a little bleak by then as Ofcom is likely to have made some progress in its review of the "NTS condition" on BT, which is what lies behind them. The perversity of the present situation is well recognised by all parties and so it is possible that specific proposals for radical change will be on the table within the next 12 months. Where revenue sharing is to remain, I think it likely that the present cap on BT's charges will be removed, although the opportunity for profiteering may be restricted by a cap on the premiums that may be applied by all providers (for each and every group of NTS numbers). It may seem odd to celebrate the possibility of some charges being increased (although others will be lowered), however this would help to clarify the situation by showing up revenue sharing for what it is. Once recognised, it is clearly unsuitable for use in the NHS - and other public services.

I look forward to working with members and others to take these matters forward in what could be an interesting New Year.

One, slightly confused, item of media coverage found: DoH bans practices using premium-rate numbers.

The directions issued on Tuesday afternoon only cover NHS bodies themselves, not contractors such as GPs. It is however very likely that the forthcoming contract changes will reflect a similar approach, so the points probably stand.

SilentCallsVictim wrote on Dec 24^th, 2009 at 2:21am:

Members may be interested to note that the Directions to NHS bodies referred to in the September 14 Statement were issued on Monday afternoon. The formal directions accompanied a "Dear colleague" letter.

This "Dear Colleague" letter is written by someone called Nick Hall, Deputy Director.    It is the most ridiculous, stupid, nonsensical letter issued by any government Department for a long time.    It is utterly self contradictory because it says that the Department is "prohibiting the use of telephone numbers which charge the patient more than the equivalent cost of calling a geographic number to contact the NHS", and then says "These Directions do not prohibit ..... non geographic number ranges such as 084 ...".     Only someone practiced in the art of doublethink and in deceiving and lying to the public could write such nonsense.    It is deplorable that such a person as Hall should expect to be paid a salary by the public and then to show such contempt for patients and public.

Mr hall reveals himself as an incompetent idiot who has presided over a mamoth waste of taxpayers money to conduct a completely pointless and worthless "Consultation" on the banning of 084 numbers to which 3000 people responded and in which the overwhelming majority said they wanted a ban.    In addition an even larger consultation was taking place simultaneously in the form of a Petition on the PM's website to which 51,000 people affirmed their desire for 084/7 numbers to be banned or prevented.    

It is difficult to avoid the conclusion that this whole consultation and the Parliamentary "fact-finding" exercise which commenced in February 2008 were always intended to be a procedure to find some artful way of avoiding imposing a ban.   Well the plan has failed because we are not taken in at all, and can plainly see what has been going on.    Indeed some of us could see what this was all about from the very beginning.  

This issue of the use of 084/7 numbers within the NHS needs to be looked at again, only this time it needs to be done properly and efficiently.   It should take all of 5 minutes to announce a ban --- simple.

I am planning to publish - and provide to all relevant  NHS persoinnel - as complete as possible a list of those telephone tariffs on which callers pay more to call 0845 and 0844 numbers. In addition there will be lists of those where the cost is the same or less.

I propose to use the tariffs in force from 1 January, as all will be adjusted from this date to accomodate the change in VAT. For simplicity, I only wish to address weekday daytime rates. Whilst rates at other times will be relevant in some cases, I believe that the point will be made adequately without risking undermining it by including information that will be irrelevant to many.

At this stage I do not wish to give the detailed rates, but will provide links to the published information.

The first list will enable all those proposing to use 084 numbers to know whether or not they can do so in compliance with the DH directive. It appears that each will need to verify that none of the patients they serve would be likley to ever subscribe to these tariffs. The subsequent lists are essential so that any information obtained to the contrary can be seen in context in a balanced presentation.

If anyone would like to help by providing lists of tariffs from their own research (with each option identified separately, accompanied by hyperlinks and page / item references) I would be very grateful. It could be useful for a new thread in this forum to be used to collect this information, so that we can avoid duplicating work.

SilentCallsVictim wrote on Dec 28^th, 2009 at 1:33am:

[...]If anyone would like to help by providing lists of tariffs from their own research (with each option identified separately, accompanied by hyperlinks and page / item references) I would be very grateful. It could be useful for a new thread in this forum to be used to collect this information, so that we can avoid duplicating work.

You may find the information provided by Magenta Systems helpful:

http://www.magsys.co.uk/
http://www.telecom-tariffs.co.uk/
http://www.telecom-tariffs.co.uk/residx.htm

idb wrote on Dec 28^th, 2009 at 4:04am:

You may find the information provided by Magenta Systems helpful

It is helpful, thank you. Getting a comprehensive list of providers, so that the information provided may be complete is very important.

If anyone comes across some useful information about which of the less well known providers has a significant number of subscribers, so as to make them worthy of inclusion, that would be very helpful.

N.B. I want to be sure that price lists effective as at 1/1/10 are being used and that links/references to these are provided.

For those of us of a more gadget-loving nature, one of the more prolific VoIP providers, betamax, generally offers free*, untimed, anytime, calls to UK landlines for a period (usually 90 days) after you add credit to your account.  0845 calls are of course always charged.  The particular brand I use has prices here however an independently compiled full list is here.  

The other big VoIP player is Skype, which is of course now owned by eBay, and their rates are here.


(* I'm assuming I can use the word "free" here, rather than "inclusive", as there is no recurrent charge, and the credit you add to get them is wholly usable for chargeable calls, and carries over for as long as you want it to!)


HTH.

I came across this independent analysis today and thought Forum readers may be interested in this view of the background to our campaign against GPs use of 084/7 numbers :---

"NHS Spending Black Hole

This out of control public sector spending is no better illustrated than the more than tripling of the NHS budget from £37 billion to more than £120 billion, which ignited a Gordon Gecko style greed is good ethos, that gripped the NHS and wider public sector that sought to not only match the private sector in terms of pay but beat [it] when pension entitlements are taken into account.

GP Pay illustrates the greed factor more than anything else that contributed towards the 2009 MP Expenses Scandal. When New Labour came to power in 1997 average MP pay was £43,722 against average NHS GP pay of £44,000, so both were inline with one another at that time. However, in 2003 something started to go seriously wrong with GP Pay which took off into the stratosphere as GP's decided to award themselves pay hikes of more than 30% per annum at tax payers expense that has lifted average GP pay to over £126,000 per annum against £64,000 for MP's.

This was as a consequence of the now infamous GP contracts where basically devious greedy GP's hoodwinked a gullible incompetent Labour government health ministers into signing up to contracts which were meant to deliver greater value for money for the tax payer but were instead designed to do the opposite and resulted in GP's pay doubling whilst at the same time cutting back on hours worked. This was not only a total fiasco for the nations health and finances but also ignited jealousy amongst MP's that directly led to the adoption of the policy of claiming expenses to the maximum so as to fill the ever widening gap between MP's and NHS GP's, as MP's could NOT get away with awarding themselves pay hikes of 30% per annum without losing their seats at the next general election in response to voter outcry, therefore across the board systematic abuse of expenses started to take place which basically means real average MP pay is currently approx £98,000 per annum.

This example illustrates why the Labour party appears destined to leave office with the economy left in the worst state since any time since the Second World War. No British Government since WW2 has run an annual budget deficit of 15% of GDP and it is this deficit as a consequence of the public sector spending black hole that the next Government will have to come to grips with which implies deep spending cuts of as much as 10% or £60 billion. "

loddon wrote on Jan 1^st, 2010 at 8:37am:

I came across this independent analysis today and thought Forum readers may be interested in this view of the background to our campaign against GPs use of 084/7 numbers

When publishing a lengthy piece it is common courtesy, if not a legal requirement, to identify the source.

The claimed increase in the personal remuneration drawn by partners in General Practices is disputed, indeed I find it hard to credit.

The terms of the revised GP contract are acknowledged to have been a terrible mistake and efforts have been made, with some success, to claw some of this back.

The relevance to our campaign is interesting. I believe that the power held by the BMA GPC, as shown by the quoted achievements in negotiation, has been demonstrated again in the outcome from the consultation. The simple way for a profligate government to have achieved its declared objective of no patient paying a premium rate to contact the NHS would have been for GPs using 0844 number to have been paid off from public funds. This is what happened in 2004, but it has not been repeated.

---

On the Politics addressed by the posting.

New Labour recognised that to be elected it had to adopt the "greed is good" principle that was seen to have been accepted by the electorate, so as to keep Old Labour out of power. Trying to mix the "Labour" tendency for greater spending on public services that benefited all with the "New" tolerance for lower taxation inevitably led to deficits and increasing government debt. The much criticised "stealth taxes" and increase in NI contributions were insufficient to balance the books. It is arguable as to whether this situation contributed to the "credit crunch" or whether a global financial situation led to the recognition of a situation that was probably bound to be exposed in time anyway. (I personally believe that "the environment" is one of a number of factors that will cause us to have to look more critically at economic growth, which would, and still could, provide the answer to the problem of government debt.)

Whilst a general election has not yet been called and manifestos have not yet been published, I have yet to hear any clear indication from those with any prospect of forming the next government that "greed is good" is to be abolished or that economic growth will not provide a significant part of the solution to the debt problem. The Conservatives have opposed the government's efforts to support growth (or at least limit the impact of recession) through maintained public spending, however they have committed to maintaining spending on the NHS rather than acknowledging that there is a Black Hole that offers potential for saving. It would also appear likely that some GPs have moved into the group that will benefit from the proposed relaxation of inheritance tax (wherever they were educated). In the absence of any clear new vision one must look back to historic principles of the party to see see what direction it may take. After what will be 13 years in power, New Labour lacks the energy to find any new direction and so offers more of the same. The prospect of others having a part in forming a government raises many interesting possibilities, however our voting system and political culture conspire against a truer Politics that enables us to vote with the expectation or hope of our MP playing some part in influencing government, whichever party they may represent. We seem to prefer to have a government representing a minority of voters with a variety of opposition groups that collectively represent an overall majority of voters.



The issue of our campaign with reference to public services is about equity ("social justice", if you will). We argue that the cost of providing access to public services should not be passed to those who use them, it should be covered out of public funds, raised primarily from taxation (now, or if initially by debt then later). I cannot see how any other Political issue is relevant. A Government is responsible for setting principles and political direction, competence in applying principles and achieving desired outcomes is a matter for individual ministers and the civil servant who support them.

SilentCallsVictim wrote on Jan 1^st, 2010 at 11:14am:

When publishing a lengthy piece it is common courtesy, if not a legal requirement, to identify the source.

I apologise for forgetting to to identify the source, which is, of course, the Market Oracle :---

http://www.walayatstreet.com/    It is the article dated 31 Dec 2009.   The extract begins 6 or 7 paragraphs from the beginning of the article.

I made no comment myself, expecting Forum readers to draw their own understanding and conclusions from the section presented.

Directions to NHS bodies concerning the cost of telephone calls 2009 which came into force on 21st December 2009.

Directions to NHS bodies regarding cost of telephone calls

SilentCallsVictim wrote on Dec 28^th, 2009 at 1:33am:

I am planning to publish - and provide to all relevant  NHS persoinnel - as complete as possible a list of those telephone tariffs on which callers pay more to call 0845 and 0844 numbers. In addition there will be lists of those where the cost is the same or less. ... If anyone would like to help by providing lists of tariffs from their own research (with each option identified separately, accompanied by hyperlinks and page / item references) I would be very grateful. It could be useful for a new thread in this forum to be used to collect this information, so that we can avoid duplicating work.

I now have ready a draft of the information that I intend to publish later today. If anyone would like to assist in checking and perhaps correcting it, I would be delighted to send them a copy. If so, please contact me by PM or email.

I will post links to the published version in due course.

No NHS TRUST, Strategic Health Authority, Special Health Authority or Primary Care Trust (all NHS Bodies) may use any 084 number!!!!!

On 21st December 2009 the Department of Health issued its "Directions" which came into force on the same date stating that all NHS Bodies must stop using 084 numbers if any "person" might be charged more than for a normal geographic call.  

The "Directions" did not explicitly ban the use of 084 numbers.   Instead they required each NHS Body to examine tariffs and call charges and decide for themselves whether "persons" (they mean patients and all callers) will not pay more than the equivalent cost of a geographic number.

This means that hundreds of "Bodies" all over the country must carry out the same amount of work in complete duplication and is a massive waste of time, work and money --- all at a time when public expenditure is under immense pressure and costs and expenses should be reduced NOT increased.

David Hickson the campaigner has offered to save all these "Bodies" much of this unnecessary duplication of work and cost by providing a comprehensive analysis of the tariffs and cost considerations involved.    He has sent them directly to all the Bodies and also published them here :---

http://davidhicksonmedia.blogspot.com/2010/01/use-of-revenue-sharing-084x-telephone.html

Put simply, the analysis shows that NO NHS Body can use any 084 number!!

Further to my previous posting I must observe that this whole exercise by the Department of Health, which has followed the "fact-finding" exercise announced in Parliament in January 2008 and the "Consultation" which commenced in December 2008, has been a massive unnecessary delay and waste of time and public money.    It could all have been done so much more quickly and easily years ago and saved millions of patients the cost and aggravation of having to call these rip-off numbers which should never have been used in the first place.

Unfortunately, this issuance of "Directions" does not deal with the problem properly and it can clearly be seen what  incompetent idiots the Secretary of State, Andy Burnham and his predecessor, Alan Johnson, are and how they have failed to look after the interests and health of the public.    They have failed in their duty.    These "Directions", signed by NIck Hall, obviously a useless jobsworth senior civil servant in the DoH, give these NHS Bodies until December 2010 to carry out this task of looking at call costs and tariffs and deciding what they are going to do about them.    A task which David Hickson has already carried out for them within 2 weeks of the "Directions" being issued.    The "Directions" also give the NHS Bodies the get-out of offering to call people back if requested which just goes to show what a lot of shysters, con men and scam artists all the current Ministers and their civil servants in the DoH are!!.

What is needed is a proper ban on use of all 084/7 numbers within the NHS and throughout government departments and agencies and ALL Public Bodies immediately.

Here, here, loddon!!   Your final paragraph should become our slogan as it encapsulates very neatly our purpose regarding ALL the public sector.

loddon wrote on Jan 5^th, 2010 at 12:04pm:

Unfortunately, this issuance of "Directions" does not deal with the problem properly ...

Yes, we can get carried away with the politics, the mud slinging and the campaign slogans. It may be very comforting to know that we have been right all along and the attacks may be perfectly justified. The purpose of campaigning is however to achieve specific objectives, whatever our, perhaps differing, underlying aims may be.

Although the Directions issued are nonsense when taken as a whole, I believe that they do provide sufficient authority for a ban to be introduced in effect, even though it is stated that this is not the intention. Let us press on for victory, rather than writing off what has been achieved so far and launching a new campaign.

See www.virginmedia.com/callcosts

Virgin Media now charges 9.19 pence per minute plus 10 pence call setup for calls to GP surgeries on 0844 477 and other similar prefixes.

Oral questions in Parliament tomorrow at just after 14:30 are to the Secretary of State for Health.

http://www.publications.parliament.uk/pa/cm200910/cmordbk2/100112o01.htm


Quote:

9      Mr Laurence Robertson (Tewkesbury): What recent guidance his Department has issued to GP practices on their use of 0844 telephone number systems; and if he will make a statement. (310024)

Dave wrote on Jan 11^th, 2010 at 5:15pm:

Oral questions in Parliament tomorrow at just after 14:30 are to the Secretary of State for Health. http://www.publications.parliament.uk/pa/cm200910/cmordbk2/100112o01.htm Quote: 9      Mr Laurence Robertson (Tewkesbury): What recent guidance his Department has issued to GP practices on their use of 0844 telephone number systems; and if he will make a statement. (310024)

Let us hope for some interesting debate.

MPs and media have now been briefed on a further development, the BMA's publication of secrets about how the GP contract is being revised and how the scam will be able to continue. My briefing is published here

The GPC guidance may warrant separate attention here, however let us see if a spark catches light in parliament or in the media.

The BMA's General Practitioners' Committee (GPC) has just published Guidance: Use of 084 Number in the NHS. Quotes below are from that document with my comments below each quote box.


Quote:

GP practices (and all others bodies within the NHS using 084 numbers) should obtain written confirmation from their phone service supplier that the charge for a call to their number is no more expensive than making an equivalent local call. The DH has been assured by the main phone service supplier, NEG (Network Europe Group, a national provider of telephony services such as Surgery Line), that this is the case.

What total and utter nonsense! The supplier of a receiving telephone service is not in a position to give any guarantees about call costs because callers are billed by their own individual providers. Therefore any "confirmation" is entirely worthless!

NEG, naturally, is at the front of the queue to give "assurances". What about the other providers of these systems? Will they follow suit or will their customers (surgeries) switch to 01/02/03 numbers?



Quote:

This does not mean that the use of 084 numbers in itself has been banned. As long as the tariff is equivalent to local rates, and the practice obtains a written guarantee from their phone supplier (usually NEG) that they are charging rates in line with local geographic calls, then they will be deemed to have fulfilled their medical services contract. If any legal action should be taken to challenge this, it would be against the Primary Care Trust (PCT) and not the practice.

So there we have it; according to this guidance, a written guarantee from a practice's phone supplier (as it points out, usually NEG ::)), omits it from being legally liable if this guarantee is challenged. The PCT, that is the taxpayer (my bolding!) picks up the tab, as a result of the practice's non-compliance with the "ban".



Quote:

Practices entering in to new telecommunications contracts would normally be expected to have a clause inserted to allow them to cancel the contract if the company is not using an appropriate call tariff. However, the DH has been unable to persuade NEG to insert such a penalty-free get-out clause into existing contracts.

No surprises there then.  ::)



Quote:

If a practice is tied into a contract which does not comply with the new regulations, it must remain with its telecommunications supplier until the contract terminates. Thereafter, it will be obliged either to ask for a revised contract from the same supplier, which complies with the new regulations, or to find another supplier.

But what happens should someone challenge it in court that patients at the practice are paying more than a local call? Is the PCT (tax  payer) still liable?

What about where a "guarantee" has been given to the practice and its PCT has been taken to court and the court has decided that the practice is not complying with the new regulations? Is the practice still permitted to continue until the end of the contract? Does the PCT still carry the legal responsibility can?



Quote:

From 21 December 2009, when the legislative changes were made, PCTs and practices have been expected to review the contractual arrangements with their telephone provider annually. This should take the form of obtaining a written guarantee from the telecommunications supplier about call charges.

So guarantees must be obtained annually to abstain the practices of any legal blame should they be challenged.



Quote:

Should GPs terminate their contracts with existing providers? Existing contracts do not need to be terminated, but where there is evidence that callers are being charged more than the geographical call rate, then GPs are expected to take all reasonable steps to prevent this from happening. Whilst terminating their telephony contract is an option open to GPs, practices can also consider varying or renegotiating the terms of their contract or providing a call-back facility for patients who don’t want to pay a premium rate.

The "reasonable step" that a GP should to alleviate the problem it to switch numbers to either a local geographical one beginning 01 or 02 or a non-geographical one beginning 03.



Quote:

What does this mean for GPs tied into long-term contracts? Unfortunately the Government was unable to persuade NEG to add a clause into existing contracts to allow NHS organisations an early release without penalty, but practices should ensure that any new contracts they enter into do include such a clause. However, if a patient wishes to make a complaint about the cost of calling the practice, they should make the complaint against the PCT, not the practice. Should legal costs be incurred, the PCT would be liable.

Pass the buck to the taxpayer.  :'(


continued in next posting…

…continued from previous posting



Quote:

Do practices have to provide information about their telephone system and rates under the Freedom of Information Act (FoIA)? Yes, practices are obliged to reply to such a FoIA request. It is likely that other practices would receive similar requests, so the Local Medical Committee should co-ordinate replies so that all practices provide a consistent message. In the FoIA reply, it should be highlighted that when all costs are taken into account, the practice does not gain financially from ‘revenue sharing’, and that provision of an 084 telephone line service may even cost the practice more that that of a standard phone system. Practices can also ask their supplier to provide the information necessary to demonstrate that their call charges are in line with geographic call charges, as required by the new legislation.

Should a response to a request under the terms of the Freedom of Information Act not relate to information held by the body in question at that the time of the request? So how does that mean that a practice may obtain that information to demonstrate that call charges are compliant with the regulations, specifically to fulfil a FOI request?

Dave wrote on Jan 12^th, 2010 at 1:28pm:

Quote: This does not mean that the use of 084 numbers in itself has been banned. As long as the tariff is equivalent to local rates, and the practice obtains a written guarantee from their phone supplier (usually NEG) that they are charging rates in line with local geographic calls, then they will be deemed to have fulfilled their medical services contract. If any legal action should be taken to challenge this, it would be against the Primary Care Trust (PCT) and not the practice. So there we have it; according to this guidance, a written guarantee from a practice's phone supplier (as it points out, usually NEG ::)), omits it from being legally liable if this guarantee is challenged. The PCT, that is the taxpayer (my bolding!) picks up the tab, as a result of the practice's non-compliance with the "ban".

The publication of this guidance is, I feel, useful for this campaign. There is incontrovertible evidence, easily obtained as shown by one forum contributor, that charging rates for 0844 are higher than those for geographic calls on many tariffs. Any guarantee from NEG would be worthless. NEG will not be able to give any assurance whatsoever that a call from a cellular tariff to its 0844 ranges will be charged at a lower rate than a call to an 01 or 02 number. This should, of course, be the end of the matter.

FOI requests could be very interesting:

Practices can also ask their supplier to provide the information necessary to demonstrate that their call charges are in line with geographic call charges, as required by the new legislation.

Clearly, it is simply impossible, even with NEG-Dean-speak, to demonstrate the above.

It would be a convenient moment to remind ourselves of NEG's "guarantees""

A random "Case Study", in this case, Manor Drive, Worcester
http://www.networkeuropegroup.com/pdf/gps/Manor-Drive-Worcester.pdf

How your patients benefit

Patients benefit by having their calls
answered more quickly. The engaged
tone becomes rare – even at peak times -
because you are able to handle incoming
calls more efficiently, whilst patient calls
are spread out during the day. Calls to
084 or ‘lo-call’ numbers cost patients 4p
per minute, the same as the first minute
of BT’s standard call rate between 6am
and 6pm. This means that many
patients will actually pay less in total
because their call is answered and
processed more quickly. Significantly, the
cost of calls from mobiles remains
unchanged - these account for around
30% of all calls to surgeries.

Dave wrote on Jan 11^th, 2010 at 5:15pm:

Oral questions in Parliament tomorrow at just after 14:30 are to the Secretary of State for Health. http://www.publications.parliament.uk/pa/cm200910/cmordbk2/100112o01.htm Quote: 9      Mr Laurence Robertson (Tewkesbury): What recent guidance his Department has issued to GP practices on their use of 0844 telephone number systems; and if he will make a statement. (310024)

In advance of posting a link to the formal Hansard record that will be published tomorrow morning, I will quote the draft of the relevant exchanges. I highlight the points that we must focus on as they provide valuable references from which to press for achievement of our objectives. I will leave it to others to point out the errors and misunderstandings.


Quote:

9. Mr. Laurence Robertson (Tewkesbury) (Con) : What recent guidance his Department has issued to GP practices on their use of 0844 telephone number systems; and if he will make a statement.    [310024] The Minister of State, Department of Health (Mr. Mike O'Brien) : The Department issued guidance and directions to the NHS in England on 21 December, just before Christmas, that patients should not be expected to pay more than the cost of a local call to contact the NHS, including doctors’ surgeries. GPs will have this year to end the practice completely and get out of any contracts that cause that to happen. Mr. Robertson: I thank the Minister for that response, but he will be aware that the practice is continuing. He says that it must end this year, but there is an awful lot of this year left, so when does he expect the practice to end? Not only does it make it expensive for people to call their local general practitioner, but older people in particular often prefer a human being to answer the phone, rather than be responded to by a machine. Mr. O’Brien: I agree that we need to ensure that this practice of some GPs charging more than a local rate for contact ends as quickly as possible. We have made it absolutely clear to GPs that they must get out of these contracts—a number of practices have signed up to and are legally bound by them—and they have the year to do so. We have engaged with some of the companies involved and, to be fair to them, they have said they are prepared to negotiate equitable arrangements with the GPs to see whether we can get them all out of this as soon as possible. They have all got to be out by 21 December, but we want them to be out now, or as soon as they possibly can be.

I hope that by reference to the "contract" O'Brien was referring solely to the contract for use of a 0844 number. Where a practice and its patients are happy with the general features of Surgery Line, I see no reason why the legal and / or other costs of getting out of the contract for the system should be incurred. I dearly hope that the "equitable arrangements ... to get them out of this" involve transferring the service to the equivalent 0344 or some other number. So far as the issue of concern to us here goes (and it is the same for the Department of Health), that would be a complete solution.

The quality and desirability of the Surgery Line system is a separate issue, as is the quite proper desire to see NEG suffer in some way for all of its past wrongs. I urge fellow members not to think that I would have any qualms about the latter objective being persued, it is just that I would not expect anyone engaged in delivering service for the NHS to see this as being a worthy use of their time. On the first point, unlike Mr Robertson and others, I deliberately retain my position of total neutrality.

As I have said before, the wind is now with us, although there is a lot of work to be done to get the ship safely in to harbour. The captain seems to have set the right course, although he has shown anything but a steady hand on the tiller, and has engaged a pilot that is determined to direct him back out to sea, as happened previously. Senior members of the ship’s company have no desire to reach land as they are enjoying the voyage, however many passengers are feeling distinctly sea-sick and cannot wait.

As for us, we may be seen as pirates trying to take over the ship, however I see us more as coastguards urging the captain to dismiss the improper pilot and take proper advice.

I was disappointed with Mike Penning's response. He said that it is the patients' providers that is also ripping them off.

When he started to speak I was expecting him to explain that the issue of call charges is beyond the control of the GPs, but instead sought to blame the originating telcos and even attacked the cost of 0300 numbers!

Dave wrote on Jan 12^th, 2010 at 9:56pm:

I was disappointed with Mike Penning's response. He said that it is the patients' providers that is also ripping them off. When he started to speak I was expecting him to explain that the issue of call charges is beyond the control of the GPs, but instead sought to blame the originating telcos and even attacked the cost of 0300 numbers!

Disappointing is definitely the word.

My best explanation is that he has bought into the idea promoted by many that 0845/0844 should be charged at local rate. He must have some conception of what is "proper" to be able to refer to the cost from public payphones as being "over the top".

One fears that, as with many of the incoherent exchanges over questions, the front benches are now fully drawn up on battle lines for the coming election. Mr Penning's comments were simply taking an opposite stance to that taken by the government - defending users of 084 numbers by suggesting that it is not their fault that some patients pay more (we may hear this nonsensical argument again) and opposing use of 0300 numbers.

Not wishing to rush the year on, by the 21 December the current Government may not be in power, so it could be another's problem to deal with if the nonsensical mess isn't rectified soon.

SilentCallsVictim wrote on Jan 12^th, 2010 at 9:12pm:

patients should not be expected to pay more than the cost of a local call to contact the NHS, including doctors’ surgeries. GPs will have this year to end the practice completely and get out of any contracts that cause that to happen. Mr. O’Brien: I agree that we need to ensure that this practice of some GPs charging more than a local rate for contact ends as quickly as possible. We have made it absolutely clear to GPs that they must get out of these contracts ....... with the GPs to see whether we can get them all out of this[/highlight] as soon as possible. They have all got to be out by 21 December, but we want them to be out now, or as soon as they possibly can be.

These statements are remarkable because they contrast so startlingly with the prevarication, equivocation and contradiction of the Minister's "Statement" issued 14th September 2009 and the "Directions" issued by the Department of Health on 21st December 2010.    

The words used by Minister O'Brien completely contradict the "Guidance" issued by the GPs Committee of the BMA just four days ago.     Who are we to believe?    Suddenly a Minister appears to be using clear unequivocal language!     If the Minister is correct, (and his words were not off-the-cuff -- they must have been carefully prepared in order to answer the question submitted by MP Robertson well in advance) then the BMA must withdraw or rewrite their "Guidance" to make it clear to GPs that they cannot continue to use 0844 numbers and they must take proper action this year.

I am beginning to think that I may have to change my opinion of Minister O'Brien who has unexpectedly sounded clear and decisive on this matter, and I will be delighted to do so.   Let us hope that this course of action will continue to a satisfactory conclusion.

Dave wrote on Jan 12^th, 2010 at 10:52pm:

Not wishing to rush the year on, by the 21 December the current Government may not be in power, so it could be another's problem to deal with if the nonsensical mess isn't rectified soon.

Strictly speaking, we must have a new government before December, because we must have a new parliament, from which a government is formed.

A cynic may say that Mike O'Brien can be as tough as he wishes about what will happen by December because he will not be in the job to clear up the mess. I do not however believe that the apparent change in tone is explained that simply.

Member Loddon correctly points out the differences that exist between the BMA and the government. Negotiation on the revisions to the GPs' contract are still underway and it is not uncommon for two opposed parties to emerge from negotiations each claiming victory.

What we must look for is guidance about how the carefully drawn contractual terms are to be interpreted in practice. This applies firstly to what people will do when regarding them and perhaps secondly to how any legal challenge would be resolved. O'Brien may think that the 0844 numbers have to be given up, the BMA may think otherwise. Only when these two positions are set directly against one another will we see which will triumph.

I am working furiously to get this resolved at the earliest possible stage.

http://www.ehiprimarycare.com/news/5538/gpc_enters_the_fray_on_084_numbers

GPC enters the fray on 084 numbers

13 Jan 2010

<<
GP practices can continue to use 084 numbers if they obtain confirmation from their supplier that they are no more expensive than making a local call - and the main provider of such services to GPs will guarantee this, according to the BMA’s GP committee.

Latest guidance from the General Practitioner Committee states that the Department of Health has been assured by the main phone service supplier Network Europe Group, which supplies 084 telephony services such as Surgery Line, that call charges are no more expensive than making a local phone call.

The guidance has infuriated a campaigner against use of 084 numbers in the NHS, who claims it is impossible for any company to guarantee the rates for 084 numbers that can be charged by more than 200 different companies.

The GPC says that as long as the tariff is equivalent to local rates and the practice obtains a written guarantee from their supplier that they are charging rates in line with local geographic calls “they will be deemed to have fulfilled their medical services contract.”

The guidance, which applies in England only, goes on to state that any legal action to challenge this, for instance by a patient, would be against the primary care trust and not the GP practice.

David Hickson, a campaigner against use of 084 numbers in the NHS, claims no company could guarantee calls were the equivalent of a local call because patients used so many different telephone providers to contact their surgery.

He said his own research showed that those calling a Surgery Line 0844 number during the weekday daytime will pay more than the cost of an equivalent geographic call if using BT public payphones, any landline package from Virgin Media, any pay as you go or contract mobile phone from Vodafone, O2, Orange, T-Mobile, 3 and Virgin Mobile, BT Unlimited Anytime plan, and current landline tariffs offered by First, Phone Co-op, Pipex, Saga, Sky Talk and Tesco Home Phone.

He told EHI Primary Care: “Health Minister Mike O’Brien gave a promise in parliament yesterday (January 12) that by December 2010 no patient would be paying more than the cost of a local call to contact the NHS.

"If this is to happen then all Surgery Line users will need to change from 0844 to the equivalent 0344 number. This will enable them to retain their contracts with NEG and Talk Talk, whilst also respecting the DH requirements and the principles of the NHS."

The guidance from the GPC advises practices entering a new telecommunication contract to have a clause inserted allowing them to cancel the contract if the company is not using an appropriate call tariff.

However, it says the DH has been unable to persuade NEG to insert such a penalty-free get out clause into existing contracts.

The guidance adds: “If a practice is tied into a contract which does not comply with the new regulations it must remain with its telecommunications supplier until the contract terminates. Thereafter, it will be obliged either to ask for a revised contract from the same supplier which complies with the new regulations or to find another supplier.”

Practices will be expected to review the arrangements with their telephony provider annually, following the directions issued by the DH last month, which the GPC says should take the form of obtaining a written guarantee about call charges.

The GPC says practices should note that revenue sharing has not been banned by the government and that there are no intentions to draft regulations in Scotland, Wales or Northern Ireland.

Fiona Barr
>>

http://www.healthcarerepublic.com/news/977055/GPC-guidance-084-numbers-worthless-says-NHS-campaigner/

GPC guidance on 084 numbers 'worthless', says NHS campaigner

Susie Sell, healthcarerepublic.com,
13 January 2010, 00:05am

<<
Guidance issued by the GPC that suggests practices can continue to use 084 numbers despite a recent government ruling has been called 'worthless' by a NHS campaigner.

Legislation introduced last month asserted that calls to practices, hospitals and PCTs in England must cost less than premium rates.

However, GPC guidance suggests this ruling ‘does not mean that the use of 084 numbers in itself has been banned'.  

The guidance said: 'As long as the tariff is equivalent to local rates, and the practice obtains a written guarantee from their phone supplier that they are charging rates in line with local geographic calls, then they will be deemed to have fulfilled their medical services contract.'

It added: 'The DoH  has been assured by the main phone service supplier, Network Europe Group (NEG) that this is the case.'

The guidance also outlined that if any legal action should be taken to challenge this then it would be against the PCT, and not the practice.

However, NHS campaigner David Hickson said what callers pay is not determined by NEG, but by their own telephone service provider, and as such ‘any guarantee from NEG is totally worthless'.
>>

The full text of yesterday's oral question and answer in Parliament has now been published:

http://www.publications.parliament.uk/pa/cm200910/cmhansrd/cm100112/debtext/100112-0002.htm#10011255000022


Quote:

GP Telephone Numbers 9. Mr. Laurence Robertson (Tewkesbury) (Con): What recent guidance his Department has issued to GP practices on their use of 0844 telephone number systems; and if he will make a statement. [310024] The Minister of State, Department of Health (Mr. Mike O'Brien): The Department issued guidance and directions to the NHS in England on 21 December, just before Christmas, that patients should not be expected to pay more than the cost of a local call to contact the NHS, including doctors' surgeries. GPs will have this year to end the practice completely and get out of any contracts that cause that to happen. Mr. Robertson: I thank the Minister for that response, but he will be aware that the practice is continuing. He says that it must end this year, but there is an awful lot of this year left, so when does he expect the practice to end? Not only does it make it expensive for people to call their local general practitioner, but older people in particular often prefer a human being to answer the phone, rather than be responded to by a machine. Mr. O'Brien: I agree that we need to ensure that this practice of some GPs charging more than a local rate for contact ends as quickly as possible. We have made it absolutely clear to GPs that they must get out of these contracts-a number of practices have signed up to and are legally bound by them-and they have the year to do so. We have engaged with some of the companies involved and, to be fair to them, they have said they are prepared to negotiate equitable arrangements with the GPs to see whether we can get them all out of this as soon as possible. They have all got to be out by 21 December, but we want them to be out now, or as soon as they possibly can be. Mike Penning (Hemel Hempstead) (Con): This situation is not just in the hands of GPs; the provider that the patient is using is also ripping them off. For instance, when someone phones a GP's surgery on an 0845 number from a call box, the charges will be over the top, and people will still be charged even on the new 0300 numbers. Will the Minister examine why these patients are still being ripped off by their providers, as well as by GPs? Mr. O'Brien: Our objective is to ensure that anyone trying to contact the NHS locally pays a local rate, and we need to ensure that such practice is adopted. If the hon. Gentleman has evidence to suggest that particular issues are arising, I would be happy to discuss them with him.

Source: Pulse

http://www.pulsetoday.co.uk/story.asp?sectioncode=23&storycode=4124726&c=2


Quote:

Don't hang up on 084 numbers yet urges GPC 12 Jan 10 By Ian Quinn The GPC has issued new advice to GPs telling them that they can carry on using controversial 084 numbers, despite a recent ruling by the Government . A ban came into force last month on the use of phone numbers that charge the public or patients a premium rate to contact the NHS. However, GP leaders have stressed that the change in the law means 084 numbers can still be used if call charges are no more expensive that those of the equivalent local calls. The GPC said many practices valued 084 numbers because they improved patient access by providing extra functionality. The advice reads: ‘The legislation does not mean that the use of 084 numbers in itself has been banned. As long as the tariff is equivalent to local rates, and the practice obtains a written guarantee from their phone supplier (usually NEG) that they are charging rates in line with local geographic calls, then they will be deemed to have fulfilled their medical services contract. 'If any legal action should be taken to challenge this, it would be against the Primary Care Trust (PCT) and not the practice.’ GP practices, it added, should obtain written confirmation from their phone service supplier that the charge for a call to their number is no more expensive than making an equivalent local call. The DH had been assured by the main phone service supplier, NEG (Network Europe Group, a national provider of telephony services such as Surgery Line), that this is the case, it said.

So, that gives greedy doctors freedom to rip off NHS patients who are also BT customers with their 5p/minute 0844  numbers (because BT's local rate for those without an inclusive calls plan is 5¼p/minute weekdays).

However, what happens to NHS patients who are also Virgin Media customers now that Virgin Media has in creased its charges to an incredible 9p/minute (in fact, I think it's more than that) for calling 5p/minute (BT rates) numbers?

Source: Fenland Citizen

http://www.fenlandcitizen.co.uk/letters/Patients-should-not-face-high.5943617.jp


Quote:

Patients should not face high call costs Published Date: 30 December 2009 By Unknown AS any Wisbech North Brink patient will be aware the cost of calling the surgery is very costly. I have recently received an email from the Prime Minister's office regarding GP surgeries using 0844 numbers. The email is in response to an online petition which lobbied the Government to ban the use of such numbers. The email states "The Department of Health's ongoing position on this issue has been that patients should not be expected to pay more than the equivalent cost of calling a geographical number and, in the meantime, Ministers expect NHS organisations to continue to take this into account". Why is it then that North Brink Surgery patients are still being charged extortionate rates to contact the surgery? The email further states that: "The ban will be enforced as soon as the necessary legislative changes can be made. This will be early next year for GP practices". So, it appears that North Brink are sadly going to keep on charging higher call rates right up until they are banned from doing so. Is not time to get back to some good old fashioned doctoring rather than creating a business empire that is based on charging patients for a service that should be free at the point of entry? Perhaps, there is a need for key members of the North Brink team to remind themselves what the NHS is all about. "The system was born out of a long-held ideal that good healthcare should be available to all, regardless of wealth - and that principle remains at its core. With the exception of charges for some prescriptions and optical and dental services, the NHS remains free at the point of use for anyone who is resident in the UK". (NHS Website) I rest my case. A SMITH Wisbech via email

North Brink Practice has been mentioned elsewhere in this forum. The alternative number that it probably wishes to keep secret is 01945 468900.

Fear not - victory is in sight. The most powerful political force in the land (apart from the Daily Mail) is on the case:

http://www.mumsnet.com/Talk/_chat/896545-why-do-gp-39-s-practice-have-08444-No

---

Latest circulated briefing published.

---

And now a further interesting development:

Use of revenue sharing (084) telephone numbers in the NHS is now ILLEGAL

Millions of patients pay 40p a minute to phone their GP - By Sophie Borland and Daniel Martin, Daily Mail.

The cartoon helps draw attention to the issue, but the article includes some very serious allegations (or claims) depending on one's point of view.

My response to the news is published here

http://i.dailymail.co.uk/i/pix/2010/01/25/article-1246064-08042341000005DC-351_233x353.jpg

I looked on the NEG website this morning and was disturbed to see the following:

"Government and BMA give Green Light to 0844 numbers".

I accept that this is a blantant untruth but they keep pushing it, and many people will believe it.

PS. Is NEG anything to do with Talk Talk, as I yesterday agreed to sign up with them. If they are connected, I will cancel the order.

poppasmurf wrote on Jan 26^th, 2010 at 11:26am:

PS. Is NEG anything to do with Talk Talk, as I yesterday agreed to sign up with them. If they are connected, I will cancel the order.

Yes and No. NEG is an agent of Talk Talk.

The 0844 numbers used by Surgery Line clients are provided by Opal Telecom (the member of the Talk Talk group providing services to businesses).

Talk Talk/Opal is the registered provider of the telephone service used by these GPs. (NEG is not a registered provider of telephone services.)

This organogram of the Carphone Warehouse Group shows the structure. It is perfectly correct to use the more familiar brand name of the parent company.

My belief is that Talk Talk should be encouraged to continue to be a responsible and trusted provider - and therefore assist these GPs in getting off 0844 numbers, probably onto 0344.

I would use your relationship with them to help press them to behave in this way.

We recently celebrated a decision by Talk Talk to include 0300 numbers in its definition of "local calls", which are offered free (inclusive) at all times, so that local public services would not be excluded. If lots of GPs end up on 0344, then this will have to be extended.

SilentCallsVictim wrote on Jan 26^th, 2010 at 1:10pm:

We recently celebrated a decision by Talk Talk to include 0300 numbers in its definition of "local calls", which are offered free (inclusive) at all times, so that local public services would not be excluded. If lots of GPs end up on 0344, then this will have to be extended.

In actual fact, TalkTalk has made all 03xx calls "local" for the purposes of its billing:
http://broadband.talktalk.co.uk/pricechange

TalkTalk has two packages; Talk UK Evening & Weekend and Talk UK Anytime. Both include calls to all 01/02/03/0845/0870 numbers during evening and weekend periods. During the daytime on weekdays (when most people will call their GP), local geographic calls are included on both packages and likewise all 03 numbers can be called for no extra cost. The difference is essentially that on the E&W one, national geographic and 0845/0870 calls are chargeable whereas they are not for Anytime subscribers.

An interesting development in the Daily Mail story

At 12:56 today (26/1/10) NEG posted a comment - please do not report this as abuse - it must remain on the record.

This demonstrates two interesting points of view about the situation:


Quote:

With NEG Surgery line the cost of calls from a landline to an NHS body is no higher than equivalent geographic number. This is recognised both by the government and the BMA, who do not object to GP's using NEG Surgery Line.

Quote:

The government guidelines do not include the cost of calling from a mobile phone because these tariffs are set by the mobile carriers themselves and neither the government nor industry supplies like ourselves have any control over them.

It will be interesting to see if the Department of Health shares these views.

There is no way of creating a permanent link to this particular comment, so I have created a jpg image to show it in context. Friends are free to use this.

SilentCallsVictim wrote on Jan 26^th, 2010 at 3:47pm:

An interesting development in the Daily Mail story At 12:56 today (26/1/10) NEG posted a comment - please do not report this as abuse - it must remain on the record. This demonstrates two interesting points of view about the situation: Quote: With NEG Surgery line the cost of calls from a landline to an NHS body is no higher than equivalent geographic number. This is recognised both by the government and the BMA, who do not object to GP's using NEG Surgery Line. [quote]The government guidelines do not include the cost of calling from a mobile phone because these tariffs are set by the mobile carriers themselves and neither the government nor industry supplies like ourselves have any control over them.

It will be interesting to see if the Department of Health shares these views.

There is no way of creating a permanent link to this particular comment, so I have created a jpg image to show it in context. Friends are free to use this.
[/quote]

So are NEG saying that the Government/Industry DO set local BT/Virgin/Sky/etc telephone rates? What they are saying above infers that they do.

poppasmurf wrote on Jan 26^th, 2010 at 3:54pm:

So are NEG saying that the Government/Industry DO set local BT/Virgin/Sky/etc telephone rates? What they are saying above infers that they do.

BT, and BT alone, is subject to regulation of its pence per minute rates for calling the various sub-ranges of 0844 numbers. Its call setup fee, its rates for geographic numbers and the way it assembes packges are NOT regulated.

The assumption that NEG is trying to foster is that competition forces all other providers to mirror BT precisely. This is untrue.

There is also the implied assumption that BT should include 0844 calls in packages, which it does not.

As users of 0844 numbers benefit from revenue sharing, that money has to come from somewhere.

Quote:

Up to 200 doctors' practices have switched to the controversial 0844 numbers in the past six months, flouting Government guidelines that no one should pay more than the cost of a local call to ring their surgery.

Which surgeries are these then?  :-?

In comment on the article about GPs' phone numbers in todays Daily Mail :---
http://www.dailymail.co.uk/news/article-1246064/Millions-patients-pay-40p-minute-phone-GP.html

someone calling himself Joe from Derbyshire says :---


"I hate to tell you, but in actual fact you are wrong and NEG are correct. The Department of Health guidelines do not apply in any way, shape or form to mobile phone charges, which has been confirmed in meetings between the lead policy officials in the Department with the industry."

So the DoH has said to the "industry" that the guidelines do not apply in any way, shape or form to mobile phone charges!!!!  :o :o :o >:(

If this is true we must wonder what sort of incompetent, moronic, uncaring buffoons are managing all this? :(    Are they really as useless and hopeless as we fear? :( :(

What about the Minister's statement in Parliament on 12th January  when he said "patients should not be expected to pay more than the cost of a local call to contact the NHS, including doctors’ surgeries. GPs will have this year to end the practice completely and get out of any contracts that cause that to happen.
Mr. O’Brien: I agree that we need to ensure that this practice of some GPs charging more than a local rate for contact ends as quickly as possible. We have made it absolutely clear to GPs that they must get out of these contracts ....... with the GPs to see whether we can get them all out of this[/highlight] as soon as possible. They have all got to be out by 21 December, but we want them to be out now, or as soon as they possibly can be. "

Anyway, it doesn't really matter if they choose to ignore mobile phone charges -- does it? -- because 0844 cost more than geographic numbers on all tariffs with all phone companies don't they?? ;) :) :) ;D ;D

Alls well that ends well!!


Read more: http://www.dailymail.co.uk/news/article-1246064/Millions-patients-pay-40p-minute-phone-GP.html#ixzz0dkeDJbJ7