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Doctors' phone line use reviewed - DH consultation (Read 225,180 times)
Barbara
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Re: Doctors' phone line use reviewed - DH consulta
Reply #225 - Jan 5th, 2010 at 2:13pm
 
Here, here, loddon!!   Your final paragraph should become our slogan as it encapsulates very neatly our purpose regarding ALL the public sector.
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SilentCallsVictim
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Re: Doctors' phone line use reviewed - DH consulta
Reply #226 - Jan 5th, 2010 at 2:45pm
 
loddon wrote on Jan 5th, 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.
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Dave
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Re: Doctors' phone line use reviewed - DH consulta
Reply #227 - Jan 9th, 2010 at 9:34pm
 
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.
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Dave
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Re: Doctors' phone line use reviewed - DH consulta
Reply #228 - Jan 11th, 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)
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« Last Edit: Jan 11th, 2010 at 5:16pm by Dave »  
 
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SilentCallsVictim
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Re: Doctors' phone line use reviewed - DH consulta
Reply #229 - Jan 12th, 2010 at 1:17pm
 
Dave wrote on Jan 11th, 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.
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« Last Edit: Jan 12th, 2010 at 1:19pm by SilentCallsVictim »  
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Re: Doctors' phone line use reviewed - DH consulta
Reply #230 - Jan 12th, 2010 at 1:28pm
 
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 Roll Eyes), 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.  Roll Eyes


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.  Cry


continued in next posting
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« Last Edit: Jan 12th, 2010 at 1:30pm by Dave »  
 
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Dave
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Re: Doctors' phone line use reviewed - DH consulta
Reply #231 - Jan 12th, 2010 at 1:29pm
 
…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?
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Re: Doctors' phone line use reviewed - DH consulta
Reply #232 - Jan 12th, 2010 at 1:46pm
 
Dave wrote on Jan 12th, 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 Roll Eyes), 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.
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Re: Doctors' phone line use reviewed - DH consulta
Reply #233 - Jan 12th, 2010 at 2:27pm
 
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
.
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SilentCallsVictim
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Re: Doctors' phone line use reviewed - DH consulta
Reply #234 - Jan 12th, 2010 at 9:12pm
 
Dave wrote on Jan 11th, 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.
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Re: Doctors' phone line use reviewed - DH consulta
Reply #235 - Jan 12th, 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!
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Re: Doctors' phone line use reviewed - DH consulta
Reply #236 - Jan 12th, 2010 at 10:41pm
 
Dave wrote on Jan 12th, 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.

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Re: Doctors' phone line use reviewed - DH consulta
Reply #237 - Jan 12th, 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.
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Re: Doctors' phone line use reviewed - DH consulta
Reply #238 - Jan 12th, 2010 at 11:13pm
 
SilentCallsVictim wrote on Jan 12th, 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.
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« Last Edit: Jan 12th, 2010 at 11:17pm by loddon »  
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SilentCallsVictim
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Re: Doctors' phone line use reviewed - DH consulta
Reply #239 - Jan 12th, 2010 at 11:39pm
 
Dave wrote on Jan 12th, 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.
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