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Surgeries charge more for calling (Read 184,674 times)
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Re: Surgeries charge more for calling
Reply #90 - Nov 21st, 2007 at 10:37am
 
Thank you for attaching the sheet from Surgeryline, I am however concerned that the business case and impact has not been properly assessed by park surgery, particuarly as a busy practice manager.

There are funamental flaws in the document you have sent me, I have bullet pointed some issues below which I would be greatful if you could answer.

- I have spoken personally to a number of people that call the surgery reguarly who have not reported any engaged tone problems, my understanding is that the surgery system is fairly new and already has a queue and options system. Could you please explain what research leads to the opening statement in the document.

- Your definition of controlled premium rate services in the 09 range is correct, (10p - £1.50 per min), however premium in more common usage would refer to something that is more expensive than the current service.

- Standard BT rate was what I was told today by your reception staff, however there is no mention of standard for what. 0844 is 5ppm at all times, standard BT rate is at least 25% cheaper than this for the existing number, and the majority of callers don't pay BT Standard rates anyway.

- Calls from a landlines and mobiles with inclusive minuites to 217100 would have been free for many people as part of the line rental, calls to non geographic numbers such as 0844 are charged at between 15ppm and 40ppm (approx) depending on the operator from a mobile. Mobile phones are commonly used by young people and those on low incomes, as well as working people because of convinience and the expense of installing a landline. By your own definition calls from a mobile are now at a premium rate, whereas before they would have been inclusive.

- 0844 is inaccessible from abroad, this means that any foreign doctors or patients needing to liase with their UK surgery from abroad will no longer be able to call the surgery, i'm sure you will agree this could potentially put patients at risk.

- 0844 is more difficult to remember, and the cost of calling it is not certain - this may put vunerable people off calling the number at all, as well as meaning that patients with poor eyesight, dyslexia etc may transpose the number. If nothing else 217100 is a very memorable number so why change it.

- The document states that the use of 0844 is NOT to subsidise telephone equipment, if this is the case why the use of 0844. I have an 01403 number provided free of charge from a SIP voip provider which has voicemail and if I wanted it could also provide virtual PBX soloutions. It seems that the surgery already have a good system, why do you feel that it needs to be changed - surely employing more staff or installing more phone lines is a better option than answering calls quicker so they are charged for and playing patients music.

My suggestion would be that should the surgery wish to continue to serve the community and demonstrate that it is not the victim of clever sales tactics which generate money for surgeryline and park surgery, that it either retain it's 217100 or offer alternative DDI 01403 numbers for each of the menu options to truely give customers.

I look forward to your response, and would be happy to make an appointment to discuss this with you futher amicably.

Yours faithfully,

Response

Park Surgery is a business partnership of general practitioners.  As a business we have to maintain an efficient service for our patients.

When we moved to these premises we installed a new telephone system that included auto attendant and dispensed with our switchboard.  This was in response to patient surveys where we were criticised for the difficulty of getting through to the surgery at peak times.

In the recent 3 patient surveys we have again been criticised for busy phones first thing in the morning.  We have been looking for a possible solution and therefore decided to improve the techincal ability of our system with Surgery Line.  This will give patients an immediate acknowledgement of their call, tell them where they are in any queue and give them options so that they can get to the correct department quickly.

Patients make calls to the surgery to make appointments -  even calling every week this cost would be minimal.  They might also call to speak to their doctor and might have a 5-10 minute conversation.  Again even once a week this call would be around 50p. The practice spends a lot of time returning patient calls to mobile phones which has increased our expenditure over the years.

Patients needing to call from abroard will have a separate telephone number to ring.  There is no risk to patients - we are not an emergency service and patients can also contact us by e-mail.

It is pointless to install more telephone lines if the staff are not avialable to answer them - we already have 9 staff dedicated to answer the phones on a daily basis and a limited staff budget.

We are improving the technical management of our telephone system.

I have removed names.
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loddon
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Re: Surgeries charge more for calling
Reply #91 - Dec 16th, 2007 at 12:07pm
 
The Motley Fool have produced an article comparing costs of phone calls called "Expensive Phone Numbers"[size=14][/size] : ---

There are some comments about doctors using and abusing 0844 numbers following the article : ---

http://www.fool.co.uk/news/money-saving-tips/household-bills/2007/12/14/were-tal...

"At 09:32 on December 16 2007, RocketSteve said:

My local Doctors' decided to change to an 0844 number and proudly advetise that this is 'cheaper' for their clients to call. I had a meeting with them to discuss that their statement was untrue, but they were so fixed on the costs to them (poor £100k plus salaried Doctors) that they would not let the geographical number out. Their statement is clealy not true as patients are 99.9% local and from my mobile it's free to call 01/02 numbers during my initial minutes.
Should I speak to Trading
"

"At 10:30 on December 16 2007, kiwigirlscot said:

Hi RocketSteve,

If you know how to pick a good argument with someone research and make yourself knowledgeable about the Ottawa charter and also knock on effects of having a limited income. I don't know how far this may get you but it does oblige medical professionals to many standards including affordability and accessability of services.
By introducing numbers that cost money they are actually reducing the accessability for people that are struggling to make ends meet already.
Also, remember that it's the very people that can't afford to make these calls that are the ones that usually most require medical attention and are most likely to slip through the care system cracks.
Flow on effects of being financially challenged include the fact that these people can't afford the best food choices which increase the risk of health problems, also they are less likely to be able to heat their homes adequately in the cooler months which can also cause health issues, are more likely to suffer from at least some form of depression etc. I could go on!
Also, they may not have a connected phone which could mean the need to use a phone box to make an appointment of which I am guessing probably costs even more than using a landline for the same call.
Therefore, your doctors is actually disempowering the very people they should be protecting!"

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Re: Surgeries charge more for calling
Reply #92 - Dec 16th, 2007 at 12:14pm
 
loddon wrote on Dec 16th, 2007 at 12:07pm:
"At 10:30 on December 16 2007, kiwigirlscot said:

Hi RocketSteve,

If you know how to pick a good argument with someone research and make yourself knowledgeable about the Ottawa charter and also knock on effects of having a limited income. I don't know how far this may get you but it does oblige medical professionals to many standards including affordability and accessability of services.
By introducing numbers that cost money they are actually reducing the accessability for people that are struggling to make ends meet already.
Also, remember that it's the very people that can't afford to make these calls that are the ones that usually most require medical attention and are most likely to slip through the care system cracks.
Flow on effects of being financially challenged include the fact that these people can't afford the best food choices which increase the risk of health problems, also they are less likely to be able to heat their homes adequately in the cooler months which can also cause health issues, are more likely to suffer from at least some form of depression etc. I could go on!
Also, they may not have a connected phone which could mean the need to use a phone box to make an appointment of which I am guessing probably costs even more than using a landline for the same call.
Therefore, your doctors is actually disempowering the very people they should be protecting!"


In view of the thoroughness of knowledge and soundness of views displayed by this lady I am surprised we have not seen her posting regularly in the www.saynoto0870.com discussion forum.
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Re: Surgeries charge more for calling
Reply #93 - Jan 4th, 2008 at 5:12pm
 
More local media coverage

Local interest and research led to the following in the Nottingham Evening News on 22 December:

SURGERIES IN NOTTS USING HIGHER COST PHONE LINES
LOCAL DOCTORS USING THE 0844 NUMBERS

With a little help, the story was picked up and taken forward by its sister paper, the Derby Evening Telegraph on 3 January, accompanied by a editorial comment piece:

DOCTORS RAPPED ON CALL CHARGES
ALL THE SURGERIES USING 084 NUMBERS
CALL CHARGES ADD INSULT TO INJURY

This was then followed by a correction, advising that some practices had now gone back to geographic numbers:

GPS START TO CURE CALLS COMPLAINTS

Further investigation has revealed that the situation at Long Eaton Health Centre is rather complex, so we wait to learn how the change back was apparently so simple. The service there is not SurgeryLine and the Health Centre is run by the PCT.

I understand that there will be a further item in the Derby paper next week.

(P.S. I have just heard that Long Eaton is covered by both papers, so there could be some interesting competition)


Local interest in Staffordshire was found here by Google:

http://www.kidsgrove.info/main/index.php?name=PNphpBB2&file=viewtopic&t=3429

This has been followed up and should lead to some media coverage.
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Re: Surgeries charge more for calling
Reply #94 - Jan 4th, 2008 at 6:23pm
 
SilentCallsVictim wrote on Jan 4th, 2008 at 5:12pm:
Local interest in Staffordshire was found here by Google:

http://www.kidsgrove.info/main/index.php?name=PNphpBB2&file=viewtopic&t=3429

But the North Staffordshire Combined Healthcare NHS Trust lists it with a geographical number which rings unanswered at the moment:

http://www.nsch-tr.wmids.nhs.uk/site/location.php3?locn_id=28

Have they changed back to geographical?  Undecided
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SilentCallsVictim
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Re: Surgeries charge more for calling
Reply #95 - Jan 4th, 2008 at 8:41pm
 
Dave wrote on Jan 4th, 2008 at 6:23pm:
But the North Staffordshire Combined Healthcare NHS Trust lists it with a geographical number which rings unanswered at the moment:

Have they changed back to geographical?

I think not.

I understand that the number only changed to 0844 recently. There are a number of websites which still show the old number, including http://www.kidsgrove.info/contacts.htm! I suspect that these are simply out of date.

To add to the potential for confusion, NHS organisations have confusing names. The Combined Services Healthcare Trust does not deliver or contract GP services, that is done by the Primary Care Trust. The CSH trust obviously has a unit at the Health Centre which could be using the old number, although I would be very surprised. There is no indication of a change back.

The number at Kidsgrove is in the same group as those associated with Surgery Line. The Long Eaton case is very different for a number of reasons, so let us not get too excited

David
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Re: Surgeries charge more for calling
Reply #96 - Jan 21st, 2008 at 12:33pm
 
HOUSE OF COMMONS ADJOURNMENT DEBATE
0844 REVENUE SHARING TELEPHONE NUMBERS
MONDAY 21 JANUARY 2008


Graham Stuart MP will introduce a debate on this topic at the end of today’s sitting in the Commons chamber.

This will commence after any 10:00 pm divisions at the conclusion of the debate on Europe.

The debate will last for 30 minutes. Mr Stuart may take interventions from other members. A minister will reply on behalf of the government.

This is simply a discussion; the only vote will be “that this house do now adjourn”.


The debate will be broadcast by BBC Parliament and by Parliament Live

A record will be found in Hansard from 8:00 am on Tuesday morning

Members may wish join efforts to encourage participation by MPs and coverage by the media.

Links to the published proceedings will be published in the Parliamentary update thread.
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Re: Surgeries charge more for calling
Reply #97 - Jan 24th, 2008 at 5:17pm
 
This is as off-topic as one could get, but it is relevant - a news story about 126 Surgeries that DO NOT charge more for calling.

The familiar serarch of the 126 surgeries serviing Cumbria Teaching PCT on NHS Choices shows not one 0844, or 0845, telephone number. The article quoted below from the North West Evening Mail, published 24/1/08, is therefore seen to be true - although the debate actually happened on Monday.

Patient calls not a rip-off

Quote:
CUMBRIA’S GP surgeries are not using rip-off premium rate telephone numbers, unlike in other areas of the country.

A parliamentary debate is to be held into the fact that more than 1,500 GP practices in England have switched to using the expensive 0844 numbers. They are called revenue sharing numbers, because GPs can keep part of the charge patients pay when they try to call their local surgery.

Practices can earn up to 2p per minute from each call to the 0844 numbers, which cost patients 5p per minute and up to 40p per minute from a mobile.

But Cumbria Primary Care Trust this week confirmed that the GP surgeries do not use the premium rate numbers.



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Re: Surgeries charge more for calling
Reply #98 - Jan 24th, 2008 at 9:18pm
 
Source: Pulse

http://www.pulsetoday.co.uk/story.asp?sectioncode=23&storycode=4116896&c=2

Government warns GPs over 084 phone charges

23 Jan 08

By Gareth Iacobucci

The Government is to clamp down on GP practices using controversial 0844 telephone numbers in surgeries.

Speaking in a House of Commons debate, Ivan Lewis, parliamentary under secretary at the Department of Health, said it was not ‘consistent with best professional practice’ to charge patients above the local rate.

The debate follows recent moves by PCTs to force GPs to ditch 0844 phone numbers, after consumer lobbyists accused practices of profiting from patients calls.
Click here to find out more!

He said: ‘I urge them (GPs) to reflect on the fact that many of their patients will be on low incomes and particularly vulnerable. In those circumstances, they should consider whether it is consistent with best professional practice to go down the road of charging patients above the local rate.’

Mr Lewis warned GPs that the Government will shortly begin ‘a serious evidence-gathering process’, that might lead to ‘even stronger guidance on what will be expected of GPs.’

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Re: Surgeries charge more for calling
Reply #99 - Jan 24th, 2008 at 10:33pm
 
Source: Graham Stuart MP's website

http://www.grahamstuart.com/index.php?sectionid=3&pagenumber=103

<<

Graham Stuart MP welcomes Government u-turn on issue of 0844 telephone numbers in GP surgeries

23rd January, 2008

Local MP and Health campaigner, Graham Stuart, has welcomed a Government u-turn on the issue of 0844 telephone numbers in GP surgeries.

Graham introduced a debate in the House of Commons on Monday night on the use of 0844 telephone numbers in GP surgeries. These are more expensive than a standard local call, and can cost patients 5p per minute from a landline and up to 40p per minute from a mobile.

More than 1,500 GP surgeries in England have switched to using the expensive 0844 and 0845 numbers and it is believed that the new system is being installed in up to 40 surgeries every month. Government services such as the Department for Work and Pensions and the Tax Credit Office also use 0845 numbers, as does NHS Direct.

The Government Minister present, Ivan Lewis, recognised that key public sector services should not be using high-cost telephone numbers which overcharge members of the public. He gave a cast-iron guarantee that when the contract next comes up for the phone system for NHS Direct, it will not be renewed at an 0845/46/47 or similar high rate telephone charge.

He also requested that MPs submit to the Department any evidence they may have about the impact of high call charges in GP surgeries on the elderly, the disabled, the poor and the sick. Graham has now submitted a small report, which will include letters he has received from more than 20 constituents who have expressed their concern about the phone charges.

He said, “I’m happy that the Department has accepted that these overpriced phone charges are unacceptable and that GP surgeries should be reverting to the cheaper options available. I’m also reassured that the Minister will be reviewing the evidence submitted to him which explains in detail the suffering these call charges have inflicted on people, especially the elderly and those on low incomes. I’ll be keeping an eye on the situation to ensure that the Minister’s actions match his words and that the promise on the NHS Direct phone charge is met, but for now I’m happy that the issue is being taken seriously by Government

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Re: Surgeries charge more for calling
Reply #100 - Jan 25th, 2008 at 9:44am
 
I know I am an old cynic, but me thinks this could be a bit of a cop out. How long is ths contracts for? My surgery started their's last October, so is it for one year, five or what? Same as the NHS direct. I guess they are long contracts and will be very difficult to get out of. I hope you guys will tell me that I am wrong.
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Re: Surgeries charge more for calling
Reply #101 - Jan 25th, 2008 at 10:53am
 
sherbert wrote on Jan 25th, 2008 at 9:44am:
me thinks this could be a bit of a cop out.
Yes it could.

This is all a bit tricky; please bear with me.

To stop further practices going over to revenue sharing numbers, the DH has to clearly state that receipt of money from revenue sharing is a breach of the GP's contract with the NHS. Soft advice and warnings are insufficient.

The problem it is seeking to address, by its soft approach, is that which would arise if patients were able to register valid complaints about the fact their surgery, with time to run on its revenue sharing arrangement, is known to be breaching its NHS contract. The government is therefore reluctant to impose a strict prohibition, with exemptions for those with existing revenue sharing arrangements.

Whilst recognising the problem, one cannot accept the soft solution currently in place. Any practice that fails to follow the suggestion not to change over or renew would effectively delay the prohibition for however long its arrangement is set to last. In principle, this could go on for ever.

I believe that there are better ways of addressing the situation and have highlighted these in my evidence presented to the minister. Sadly, these cannot be fully discussed in a public forum.

The key point is that the important contract here is that between the GP and "our" NHS. That is being breached. Whilst the DH and some PCTs may have been complicit in these breaches, that is no reason why the terms of the contract may not now be strictly enforced. If public servants have failed in their duty to citizens, that may be a separate matter worthy of attention.

David

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Re: Surgeries charge more for calling
Reply #102 - Jan 28th, 2008 at 5:59pm
 
It seems that most surgeries are piling into this jolly nice little money making scheme (0844 numbers). I dont use my surgery much but neither did I realise the large and totally unjust charge when calling these numbers. I have BT Option 1 and over-ride that  for the most part by using 18185 but as 0844 are not allowed through this scheme and as there doesnt seem to be any way to find a geo or other and cheaper alternative to these nasty numbers one must either visit the surgery in person or 'pay up and look big'. I agree with someone else in this thread who stated that this actually contravenes the whole ethos of the NHS, that treatment (and presumably getting an appointment) should be free at point of need ! (Or at least should only cost the charge to one party, the phone company)
Someone else also stated that it had been put inplace because patients had complained they couldnt get through and this would help that problem. Duh, dont think so.....I had to make dozens of attempts at different times before I actually got through to a receptionist, so that explanation just doesnt wash. This seems to be yet another way to rip off us nice accepting Brits, and frankly I for one have had enough.
Maybe we should all get together and pursue the PCT's via our courts to get this removed Nationally, using the aforementioned contravention ?
I'd like to out my surgery here  and now.
it is The Hathaways Surgery at Chippenham in Wiltshire.  SHAME ON THEM  
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Re: Surgeries charge more for calling
Reply #103 - Jan 29th, 2008 at 3:31pm
 
Source: E-Health Insider Primary Care

http://www.ehiprimarycare.com/news/3421/practices_use_of_0844_numbers_to_be_inve...

<<

Practices use of 0844 numbers to be investigated
29 Jan 2008

The government is to gather evidence about the use of 0844 telephone numbers by GP practices and its impact on patients, ahead of a possible clampdown on their use.

Health minister Ivan Lewis told a House of Commons debate that GPs making use of 0844 numbers should consider whether it is “best professional practice” to charge patients above the local rate.

He also gave a “cast iron guarantee” that the government will not allow NHS Direct to use an 0845 number when the NHS Direct contract comes to an end.

Lewis said: “It is entirely unacceptable for any professional working under the banner of the national health service to rip patients off by charging them more than the standard local call rate for contacting their surgeries. That is the Government's position.”

He told MPs that there were difficulties since GPs were self-employed, and also because some individuals had already signed up to contracts with telephone companies, but said he was happy to send a “strong signal” to practices considering signing up for 0844 numbers.

The health minister was taking part in an adjournment debate secured by Graham Stuart MP for Beverley and Holderness who claimed he had been contacted by patients after almost a dozen GP surgeries in east Yorkshire switched to 0844 numbers.

He told the House of Commons that service provider Network Europe Group have more than 1,200 GP surgeries using 0844 numbers and claimed that more than 300 other practices have had 0844 or 0845 numbers installed by other companies.

Lewis said a motion tabled in the House of Commons in November calling for an end to the use of 0844 numbers had been signed by almost 60 MPs and that the Department of Health had received more than 100 letters of complaint on the issue since January 2007.

He added: “This issue has united politicians, residents and patients groups alike - people who can spot an unfair practice when they see one, and who do not like it when the chronically ill, the old, the disabled and those on low incomes are taken advantage of. That is what I believe is currently happening, under the present system, under the present Government.”

The BMA’s General Practitioner Committee has defended the use of 0844 numbers. Last September it hit back at press criticism of use of 0844 numbers by GP practices which is claimed was “particularly galling” when many other public services including NHS Direct and many hospitals also use similar numbers.

It added: “Whilst we fully support the view that practices should not seek to make significant financial gains from their telephone systems, there is no evidence to suggest that using an 084 number allows practices to do this. In fact, many practices using 084 numbers are often able to deal with their calls more efficiently and quickly, therefore costing patients less overall.”

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Re: Surgeries charge more for calling
Reply #104 - Jan 29th, 2008 at 3:34pm
 
Source: Rob Marris MP's website

http://www.robmarris.org.uk/index.php/?p=613

<<

0845 Victory! – Good News for Consumers.

24 January 2008

Rob has claimed a victory for consumers this week when he secured a ‘cast iron guarantee’ from the Parliamentary Under Secretary of State for Health, Mr Ivan Lewis, that when the contract for NHS Direct comes up for renewal it will not be renewed with an 0845 number.

Rob said: “This is perhaps a mere drop in the ocean in the debate around the use of 0845 and other similar numbers but nevertheless it is a welcome victory and shows that the Government is prepared to listen on an issue over which they have direct control.

“I was delighted with the Minister’s answer to my question that a contract on which so many people depended would not be renewed with a number that had a higher rated telephone charge.

“The problem doesn’t end there of course. For many people contact with their GP can often be through the use of 0845 or 0844 and other similar high rated telephone numbers. This can place an additional burden on those who can least afford it, the poor, older people and those with disabilities.

“Further, if people lose their jobs, they might be faced with an 0845 number when claiming jobseeker’s allowance through the Department for Work and Pensions. If they get tax credits, they might have to call an 0845 number. Even worse, if they are fed up with all that and complain to the parliamentary ombudsman, they still have to call an 0845 number.

“Characteristic of all of these higher rated telephone numbers is the pattern of them not being a part of the normal telephone package available to consumers. I am pleased that the Government is listening to the many concerns being raised around the widespread use of these numbers and look forward to future measures being considered that ensure that the most vulnerable in our society are not penalised through excessive charging when trying to access essential services.”

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