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Friday, 13 November 2009

The Department of Health confirms that NHS "access charges" are permissible

From: David Hickson – campaigner for the NHS

Quoted below is a most helpful reply I have received from the Department of Health. The relevant section is highlighted. I quote it here:

The restriction on charging applies only to the provision of services
and does not extend to ways in which services are accessed,
including for example charges relating to telephone calls to access services.

This confirms that NHS providers are free to levy “access charges” in connection with NHS services, although not for the services themselves.

As “access” is what happens “at the point of need”, then the statement “free at the point of need” has no meaning.

This finally confirms why the Department decided not to ban use of 084 telephone numbers in the NHS, although seeking to pretend that it had.

All calls to 084 numbers earn money for the person called, through their telephone service provider. This cost is normally passed on in a premium charge to the caller.

The Health Act 2009 has now been granted Royal Assent. The status of the NHS Constitution and this interpretation of the first of the rights that it declares will have to be tested in court.

This statement declares the following. All NHS services accessed by telephone, e.g. the NHS Direct advice and information service, the Choose and Book appointments line and any other service with an appointment making service operated by telephone may be subject to a charge at the discretion of, and to the financial benefit of, the provider. We are not talking about the charge imposed by a telephone company for a normal telephone call, but the surcharge applied to fund a share to the recipient.

It implies that other “access charges” are acceptable also. This could include an appointment booking fee applied to all patients and charges for the services of hospital porters and ambulance drivers who only provide access to services. There could also be a vehicle access charge for those who use ambulances or taxis or get lifts to hospitals in order to avoid car park charges (which are themselves fully cleared by this statement).

“Our beloved NHS” has been stolen by the government currently in power – see Theft of the NHS. We will have to go to court to see if parliament has truly sanctioned this in legislation.

Dear Mr Hickson,
Thank you for your further emails to the Department of Health about 084 numbers used by the NHS.  I have been asked to reply.
I note that the only new question you have posed in your latest emails asks about how 084 numbers are compatible with the NHS Constitution, and so I will reply solely on this point.
Part 1 of the NHS Act 2006 sets out the primary duty on the Secretary of State to promote a comprehensive health service and to provide or secure the provision of services for that purpose.  The section goes on to state that those services must be provided free of charge (unless charges are expressly provided for).  The NHS Constitution reflects the existing legal position by setting out the right to receive NHS services free of charge, apart from certain limited exceptions sanctioned by Parliament.  Charges related to telephone calls are not currently exempted and the NHS Constitution does not alter this.  The restriction on charging applies only to the provision of services and does not extend to ways in which services are accessed, including for example charges relating to telephone calls to access services.
I hope this reply is helpful.
Yours sincerely,
Customer Service Centre
Department of Health

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