NEG appear to have misunderstood what the Government is really saying.    The day after NEG published this piece the Minister for Health Mike O'Brien said in Parliament :---

".... 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 .......  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."

NEG should notice that he said ".... we want them to be out now, ...."

idb wrote on Jan 16^th, 2010 at 9:22pm:

The latter point is acknowledged in the NEG statement!

The BMA is promoting the widely-believed myth that calls to 084 numbers "should" be charged at "the local rate". Based on this, NEG confirms that the numbers it uses are subject to this requirement.

This is a distortion of the conditions that historically (in the case of 0845) and currently (in the case of 0844) are imposed on BT. It also, as acknowledged by NEG, ignores call charges from mobiles.

When these existed as distinct items, "local rate" applied to calls to 0845 numbers and "national rate" to 0870. This was demanded of BT and generally followed by its competitors at the time. Many people genuinely do not recognise that things have changed - not least the use of the mobile as the only phone, rather than as an additional "luxury".

The conditions that still apply to calls to 0844 numbers from BT enable the called party to select the rate to be charged (up to 5p per minute). NEG select the highest of these (call type "g6") to maximise the revenue share. It may of interest to note that latest recruit to Surgery Line demonstrates a change to use of call type g11 for which the rate from BT is set at 4p per minute - this could be significant if the decision to switch to g11 was perhaps taken before the rate for weekday daytime non-inclusive geographic calls from BT went from 4.5 to 5.25 pence per minute on 1 October 2009.

The NEG assurance relates to the fact that the rate selected for Surgery Line is less than the weekday daytime rate for geographic calls from BT for those outside the terms of an inclusive package. Those who are prepared to accept the "other rates may differ" nonsense as sufficient must recognise that this approach dismisses those with BT packages in effect, all Virgin Media customers and all users of Mobiles and Public Payphones as being unworthy of consideration.

What is most dangerous, and is being fed by the BMA and NEG, is the assumption that these callers are being ripped off by their telephone service provider. The fact that some of the premiums appear excessive and disproportionate may support this argument. We must however continue to point out that insofar as this is true, it is totally separate issue. It is fundamentally fair and reasonable for the cost of the revenue share to be recovered from callers, given that it exists. Some of us may wish for revenue sharing to be prohibited or for the cost to be met out of other charges (e.g. packages fees, as with BT and 0845). Until that day arrives however, and there must be doubts that it ever will, we should keep those arguments out of this debate, if we would be content for use of 084 numbers to be banned in the NHS before more radical changes are made.

My personal view is that regulations to limit the level of revenue sharing mark-ups should be introduced, if only because the existence of such regulations would make them more transparent. I see this and other changes as being likely to emerge, eventually, from the work that Ofcom will be doing this year. We are however so close to victory on the NHS issue, with the fundamental point being acknowledged and issued in Directions, that we must press on to secure this relatively modest objective, rather than waiting perhaps at least another 5 years before we may achieve more.

This is all a game of bluff.

idb wrote on Jan 17^th, 2010 at 12:50am:

The BMA guidance simply refers to what has been said by NEG:
Quote:

It is well known that the lead negotiator for the BMA GPC is a client of NEG and a defender of the principle that it is acceptable for patients to pay for "improved" access to NHS services. This view was expressed in this radio interview, although it was not repeated after it had been challenged.

Clearly the BMA GPC and NEG are working together to protect what is seen to be a common interest. (This raises the question of what the majority of BMA members in NHS General Practice would think about a small proportion of their number having their costs subsidised by payments from patients.)


idb wrote on Jan 17^th, 2010 at 12:50am:

Yes it can. NEG does not charge any patient more than the cost of geographic call to ring Surgery Line numbers.

NEG is not a registered provider of telephone service, it is an agent of Talk Talk as it provides equipment and services to Surgeries. I can guarantee that I do not charge anyone more than 1p per minute to call anywhere in the world, but then I too am not a provider of telephone service. Talk Talk, like all other providers (barring some exceptional situations with BT), charges its residential customers more than the cost of a call to a geographic number to call Surgery Line numbers. Talk Talk could not give such a guarantee, whereas NEG can.

The government is itself bluffing in that it has not publicly called the bluff of the BMA / NEG. I suspect that both parties have walked away from the negotiations on the revised GMS contract believing that they have achieved what they want. I am not prepared to wait until the revised contract comes into force in April to have this tested, possibly even in the courts.

[This may not, strictly speaking, be a NEG propaganda issue]

http://www.londonderrysentinel.co.uk/news/Local-number-for-GP-out.6103581.jp

<<
Local number for GP out of hours

Published Date: 25 February 2010

SICK people seeking a doctor outside normal office hours in Londonderry now ring a local telephone number following changes introduced by the service deliverer.
Western Urgent Care is responsible for the provision of the GP Out of Hours Service in Londonderry, Tyrone and Fermanagh and handles roughly 100,000 calls per year from its base on the Northland Road.

Up until last week people who needed to contact a doctor outside normal office hours, at weekends or on bank holidays rang a generic 0870 telephone number. But that all changed last Monday when a local 02871 number was introduced.

The change followed the implementation of new rules by the communications watchdog Ofcom last August governing 0870 telephone numbers and aimed at giving consumers a much clearer idea of how much it costs to call these numbers.

Ofcom noted that 0870 numbers were previously used by many businesses and organisations to provide a wide range of information and advice including many customer service lines.

But consumers were often charged more for calling these numbers than they would if they called a "geographic rate."

General Manager of Western Urgent Care Mr Eugene Dunne said the switch to a local telephone number was a simple matter of economics and reducing costs.

"Basically it was down to the cost," said Mr Dunne. "With the 0870 numbers Western Urgent Care was being billed for the entire cost of the call.

"With the local number patients will be charged no more than if they were contacting their doctor as normal," he said.

The Western Urgent Care service has been in operation since 2005 and handles approximately 100,000 telephone calls annually.

Its existing telephone number changed from 08706062288 to 02871865195 on Monday, February 15.

Users are reminded that if they ring the old telephone number they will get a voice message telling them the new number to ring.
>>

SilentCallsVictim wrote on May 19^th, 2010 at 7:38pm:
One always has to keep in mind the open, honest and thoroughly decent manner in which this upstanding company operates.

http://www.negtec.co.uk/openbook.htm

<<
Much of the confusion in today's telephony markets is due to the deliberate efforts of companies to obscure their revenue streams. Bills are hard (if not impossible) to understand as a direct result of too much or too little information. We operate a different system. If you want we will tell you exactly how your costs will be generated and how we make our money, and we'll do it in English!!! We are not ashamed of making money or how we do it, so we won't act as if we are. We're a salespersons worst nightmare! Our job is to negotiate on your behalf, if your looking at changing your telecoms supplier can you afford not to have us on your side? (sic)
>>

Of course, that 4.2p figure is the pre-VAT cost - which begs the question of how many patients can avoid paying VAT?

Attempting to shift the 'blame' onto the telephone provider is a bit rich too - but what can we expect in a culture awash with spin?

Dave wrote on Sep 7^th, 2010 at 1:55pm:

I have asked the Department of Health for a copy of this research; it demands close examination.

Others may wish to do the same, perhaps through formal FOI requests.

---

Quote:

The BT Network Call performance report is available to individual BT customers. The absence of a plural in the reference to this item suggests that the key source element in this research could well have been a single GP practice. The practice in question may have been "typical" in some respects, however it will be interesting to see the evidence used to support the claim that the 93% call failure figure is typical.

(A "typical" NHS Patient may have a BT landline with the Unlimited Weekends Call Plan. Another "typical" NHS Patient may have BT Unlimited Anytime, cable TV, a contract mobile, a PAYG mobile, or no home telephone. Characteristics of typical cases may be useful as illustrations, but they cannot simply be used directly as the basis of a projection to a wider population, unless that characteristic can itself be established as being "typical". This cannot be done simply by association.)

It will also be interesting to see which statistical theory is used to provide the "safety" found to support the overall projection, in particular the apparent assumption that 0% of surgeries with geographic numbers have a queuing facility.

(I comment here for the benefit of forum members who may be looking to challenge NEG, but I do not think it worth the trouble of engaging with incomplete nonsense in full public debate.)

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For the sake of pursuing the key issue, I am prepared to accept NEG's claim that Surgery Line is exceptional in that it requires the unlimited queuing facility available on the network through use of a non-geographic number, with the consequent additional cost. This could of course be provided through use of a 03 number, which NHS GPs in England who are tied into contracts for Surgery Line are required to adopt before 1 April 2011. Their contract for telephone service from Talk Talk permits a change from a 0844 to the equivalent 0344 number at any time. It is unfortunate for NEG that they have to incur the expense of a non-geographic number, as many would argue that for a typical GP surgery this is going much further than is necessary to provide a perfectly good service to patients.

As we have seen with NHS Direct, it is over-costly solutions that are threatened by the need to make the NHS more cost-efficient in these straitened times. Improper use of revenue sharing numbers can indicate that an over-costly solution has been used, so because the cost of the solution cannot be justified to the user, external funding has to be engaged - this is available from the caller's telephone company by using a revenue sharing number. If that company is not BT, then the cost will certainly be passed on as a premium charge to the caller. The "over-costly" point is not true in every case where a revenue sharing number is used, however it is probably true for Surgery Line which takes the improper funding even further to provide many other unnecessary "goodies".

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If NEG is pressing the Department of Health to ensure that every GP provides an adequate and cost-effective telephone system then it has my full support. I doubt however that many will find the full cost of Surgery Line to meet these requirements - it does very much rely on what NEG calls its "revolutionary co-funding" arrangement.

If NEG is trying once again to persuade the Department of Health that its ignorant and false assertion about the cost of telephone calls to 0844 numbers is true, then I can only agree with its assertion that "facts" are what must be considered.

It is a fact that callers on BT Call Plans, all other landline tariffs, mobile contracts, mobile PAYG tariffs and from public payphones pay more to call NEG 0844 numbers than an equivalent call to a geographic number.
The fact that NEG is apparently unaware of this may be true, but it is irrelevant.
It is also a fact that the BMA GPC believes that NEG's incompetent assurances about call costs are significant, but this too is irrelevant.

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[Conclusions follow ...]