Government efforts to prevent NHS GPs ripping off patients have failed - this must now change!

Government efforts to prevent NHS GPs ripping off patients through use of revenue sharing telephone numbers have failed
- this must now change!

From: David Hickson - campaigner for the NHS

This story in the Daily Mail - Millions of patients pay 40p a minute to phone their GP - reports a claim by Network Europe Group that

“Up to 200 doctors' practices have switched to the controversial 0844 numbers in the past six months”.

These switches all followed the conclusion of a public consultation in March 2009. This confirmed that there is no significant support for the idea of patients paying a premium rate to subsidise the cost of surgery telephone systems.

Every surgery that has switched since January 2008 has disregarded comments made in parliament by the then Health Minister, Ivan Lewis, warning GPs of the consequences of failing to note that the government was considering its position on the issue - see Hansard 21 Jan 2008 : Col 1334.

This raises the question of what the Primary Care Trusts have been doing to protect the interests of the NHS patients they serve in each locality. With many NHS bodies themselves using 084 numbers, one must wonder how seriously they will take the Directions recently issued to them. All are however now under a legal duty to have regard to the terms of the NHS Constitution – see ... ILLEGAL.

The current Health Minister Mike O’Brien is quoted as saying “Where there is evidence that callers are being charged more than the equivalent of a local rate call, then we expect GPs to take steps to stop it”.

I offer Mr O’Brien the evidence of the telephone tariffs that charge more for patients to call 0844 numbers, as used by NEG clients, than local or other geographic numbers - Telephone tariffs used by NHS Patients. As these tariffs cover all of the UK, this should be sufficient for him to issue guidance that 0844 numbers may not be used.

It is simply a matter of determining that some patients will be using tariffs on Lists 1 and 2 in that document, and that not all are using tariffs on List 3. It can be seen that the former tariffs include those from Talk Talk, the actual provider of the telephone service used by NEG and its customers.

In a recent publication, Talk Talk confirms that NHS GPs using 0844 numbers can change to 0344.

It refers to existing customers being able to “Move to another number range”, noting that “Ofcom has reserved 034x numbers for customers with matching 084x numbers”.

The “steps to stop it” for NHS GPs are therefore very clear, given that they are tied into long term contracts for the supply of telephone service from Talk Talk - they must switch to 03 numbers, which are guaranteed by regulation to cost no more to call than local or other geographic numbers.

This facility is provided by Talk Talk, which claims to offer “flexibility and understanding”. Those who have signed up since January 2008 were warned of the possibility of having to make some such change.

It is not good enough for the government to simply “expect” this breach of the principles of the NHS to stop.
It must ensure that it happens

The guidance from the GPC of the BMA suggesting that practices should obtain undertakings from their telephone service provider regarding the cost of calling their number is essentially unsound.

In this case however, Talk Talk would be able to confirm that calls to its 0844 numbers are charged at more than the “local rate” to its residential customers.

The fact that its agent, NEG, is not a registered provider of telephone service, and therefore charges nobody for making telephone calls, makes its assurances about its call charges look somewhat hollow (if not deliberately intended to deceive).

Notes

1. The Talk Talk Group trades as “Opal Telecom” when providing services to businesses.
   
   
2. All users of 084 numbers benefit from a “revenue share” paid by the call originating telephone company to their telephone company. This additional cost is naturally generally passed on to callers in premium charges.
   
   
3. Call charges for callers are not set by users of numbers, their system providers or their telephone service provider.
   
   
4. BT is alone in being regulated in the rate per minute it must charge for calls to the various sub-ranges of 0844 numbers. It cannot therefore include them in packages.
   It’s call set-up fees are not regulated, nor are its charges for calls to geographic numbers when outside the terms of a package.
   BT charges are based on selection of the appropriate call plan for the times when calls are made. Penalty charges apply when calls are made outside these times.
   As these penalty charges are unregulated, the penalty on a call to a (non-revenue sharing) geographic number may exceed the revenue sharing “premium” applied to a call to a 0844 number.
   Pending possible action by Ofcom in the near future, this is one of a number of perverse effects currently seen with charges for 084x numbers.