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Wednesday, 26 August 2009

NHS phone calls – GP premium rates to end, but when? - the BMA says "later", or "never" - TALK TALK holds the key

From: David Hickson – campaigner for the NHS In January 2008, Health Secretary Alan Johnson announced “I’ll end GP call charges” 1. It now falls to Andy (“#welovetheNHS” 2) Burnham and Mike (“free more often than not” 3) O`Brien to fulfil this promise. “In September”, one of these gentlemen will be announcing a ban, as the positive (?) outcome of a consultation that ended last March. Will this be next week, at conference 4, or ... ? The (“Look after our NHS” 5) BMA opposes a ban, suggesting that commercial markets should be allowed to operate in the NHS. It believes that NHS patients should be charged according to the quality of service that they receive. Most of its members reject this nonsense, however it is said to be part of the BMA creed 5. The major obstacle to a prompt and comprehensive ban is probably the “Bright Ideas” TALK TALK group. The vast majority of NHS GPs using 0844 numbers (771 in my sample of 811 6) have these from the TALK TALK business to business division, formerly known as Opal Telecom. These contracts all have many years to run and it has been suggested that the cost of breaking them would be too great. The BMA demands that they be allowed to run their course on 084 numbers. TALK TALK has failed to tell us that these contracts do not need to be broken – a bright idea indeed! It is normal practice in the telecoms business for customers to change from one type of number to another during the term of a contract, with an appropriate adjustment to the terms. NHS GPs could therefore easily swap from 0844 xxxxxxx to 0344 xxxxxxx, changing only the 2nd digit of their number. This assumes that they were content to keep their service with TALK TALK and wished to retain the systems that are linked to it. Calls to 03xx numbers are charged as for ordinary 01/02 numbers with revenue sharing prohibited. This may sound petty and technical, but it is the key to solving this problem. Whilst retaining all the benefits of their existing telephone systems, GPs would of course lose the benefit of the revenue share subsidy that has been coming from patients. As TALK TALK is such a bright company (along with the other members of the Carphone Warehouse Group), it may wish to offer GPs better than normal terms under the new arrangement. This would recognise the profit that it has been making (improperly), and would continue to make (properly), out of NHS patients and be a helpful gesture to aid retention of both its good name and its customers. The BMA suggestion that TALK TALK should continue paying over the revenue share even though it is receiving nothing extra from callers 7 is perhaps taking things too far. I fear that when the Minister makes his announcement, he will suggest that the TALK TALK contracts have to be served out unchanged. This would leave some NHS GPs charging their NHS patients for up to 7 more years, whilst others are prohibited from doing so. If nothing is done to clarify the situation in the meantime – TALK TALK will have to take the blame. Notes and links TALK TALK and its agents have failed to make any comment about this issue. They have declined opportunities to perhaps confirm that the number change option could not apply (to shut me up) and failed to grasp the opportunity to take credit for having presented it. One must therefore assume that nothing has been done. The comments made in discussion with me on TV by a representative of the main agent involved (Network Europe Group) are typical.

  1. Hull Daily Mail March 7 2008
  2. DowningStreet tweet
  3. Libertarian interpretation of the principles of the NHS presented to parliament by the Minister of State (Health Services) - in total contradiction of the NHS constitution, which permits only charges that are specifically sanctioned by parliament – Hansard 16 June 2009
  4. Ministerial Speeches to Labour Party Conference (0870 043 5533) on Monday 28 / Wednesday 30 September 2009?
  5. See the website, my comment, the source of the quotation used.
  6. See my list of 0844 using GPs
  7. The slightly confused reference to “local rate” in this statement can only be taken to mean that suppliers of services on 0844 numbers should retain the financial arrangements currently in place, whilst allowing callers to incur no premium charge. That can only be achieved by moving away from revenue sharing numbers.

I cover this issue at greater length in my blog posting - Looking forward to the end of use of 084 numbers in the NHS

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