A liberated NHS - Free to levy charges on patients? - Advance briefing on Andrew Lansley's announcement 12 July 2010

From: David Hickson - campaigner for the NHS and other public services

My engagement in the campaign to stop use of revenue sharing telephone numbers in the delivery of NHS services is part of a wider objective –

TO MAINTAIN THE PRINICPLE OF "FREE AT THE POINT OF NEED" DESPITE AN INCREASINGLY CONSUMERIST APPROACH TO THE NHS.

An increasing emphasis on local decision making, whilst proper in many respects, can serve to undermine this general principle, which applies to us all, throughout the UK.

The present government is left to implement regulations on telephone numbers used for the NHS in England, introduced by its predecessor. NHS bodies and contractors have to each try to work out for themselves whether the subsidy which they obtain from use of revenue sharing telephone numbers is passed on in charges to patients who call them.

In fact, telephone tariffs are all set nationally (for the UK), and the charge applicable to calling a particular type of number cannot be varied by local agreement. All 084 numbers are more expensive to call for users of Virgin Media landlines, Public payphones and Mobiles. In many cases they are also more expensive for customers of BT (which originates 25% of telephone calls) although there are a few exceptions, due to legacy regulations on BT, which are currently under review by Ofcom.

These exceptions are mistakenly assumed by some to be the norm.

I have now come across another example of a Hospital NHS Foundation Trust which has been told by its telephone services company that published tariffs from other telephone companies do not apply to its expensive 0844 number. It has therefore decided to retain it. I have of course been able to prove that this is nonsense, but local decision makers only need to satisfy themselves that it is OK for them to continue to receive subsidy from NHS patients as they access services.

The BMA continues to endorse totally false assurances given to its members to a similar effect.

The Department of Health does not know how best to deliver healthcare locally, however it could find out about the cost of different types of telephone calls (once only) and pass this information on. My offers of help and outline briefings have been disregarded.

We wait to hear if Andrew Lansley's announcements today, about liberation for local NHS providers, will offer further opportunities to reduce the demand on the empty public purse by raising money from "consumers" as they access the NHS.

If the financial situation is so grave that we must now abandon the sixty-year-old principles of the NHS, then let us at least do so with our eyes open.

I am available for comment on any specific points that may emerge from today's announcements and will be issuing further briefings on relevant matters.