The end of NHS Direct - misuse of expensive 0845 telephone numbers will continue for some time

From: David Hickson – campaigner for the NHS

There is no great news story in the "revelation" that the NHS Direct Health Advice and Information service is to be withdrawn. It has long been recognised as being a very expensive way of delivering non-emergency primary health care.

The new 111 service was always intended to replace it, acting simply as a signpost for callers, rather than as a means of delivering care. (Andy Burnham seems to have changed his tune from when he was Health Secretary.) That is why 111 will be cheaper - the only assessment necessary is of the type of care that is required.

111 will however take some time to get up and running. If, as originally conceived, it will incorporate access to social care services then local bodies will need to engage in significant re-organisation and incur expense to adopt it. The 101 concept showed that local bodies are reluctant to invest in amalgamated services, even when offered additional government funding. This was withdrawn from 101 and will not be offered with 111. Many see the risk of 111 withering as a potentially good idea that never worked, like 101.

0845 4647 - an expensive number for most callers, delivering £1 Million pounds per annum in subsidy due to the revenue that it generates - will continue for some years yet. Likewise, access to many Out of Hours GP services and the Choose and Book helpline, which are also operated by the NHS Direct NHS Trust using expensive 0845 telephone numbers. If, as is claimed by the NHS Direct NHS Trust, it allows BT Wholesale to keep this money, then the whole organisation needs to be reviewed.

Those who do not benefit from the regulated low rates offered by BT, incur premium rates to call 0845 numbers – up to 40p per minute. This includes the 26% of socio-economic group DE households who rely entirely on mobiles.

Last December all NHS bodies were directed to cease using expensive telephone numbers (obviously including those beginning 0845) within one year, but the NHS Direct NHS Trust was exempted from these provisions.

I have long proposed that alternative 03 numbers (including 0345 4647, which is already configured and ready for use) must be introduced to work alongside the existing numbers during this lengthy period of transition, given that a full number change would incur inappropriate expense.

The government may be short of money - but so are citizens - it is not acceptable to continue using revenue sharing 0845 telephone numbers to subsidise the cost of providing public services at the expense of NHS patients as they access healthcare, Tax Credit claimants as they make enquiries of HMRC and Jobseekers as they contact JobCentres.

Please contact me for further comment and information. (I can supply references to support the preceding comments.)

32% of consumers receive Silent Calls - Ofcom takes no action

A recent Which? survey has found 32% of consumers receiving at least one Silent Call in a two week period.

Whilst householders can prevent marketing calls from compliant companies by registering with the Telephone Preference Service,
only Ofcom has powers to take action against callers who hang up in silence.

Ofcom holds the power to issue a “Notification of Misuse”, to use to stop Silent Calls, but has not used it since October 2008.

Ofcom itself reports that it received evidence of 100,000 Silent Calls from identified callers in 2009.

Ofcom can follow such a Notification with an enforceable demand to cease the practice, which can lead to a penalty of up to £50,000 whenever it is breached.

Ofcom has never used this power. Ofcom has instead sought for the maximum penalty to be increased to £2 Million, so that it may never be used.

Ofcom has a policy of tolerating Silent Calls, based on the total number of calls made each day, so no consumer complaint could ever lead to action.

Ofcom has recently consulted on a further weakening of its policy, to explicitly allow one Silent Call to be made by any single caller to any single recipient each day, regardless of the total number made.

This is a grave misuse of Ofcom's powers and a direct refusal to follow the directions of parliament, which stated in 2006,
"We expect you to use your powers to eradicate the nuisance of Silent Calls".

UCAS Premium Rate Telephone number - an alternative is available

Many are advertising the premium rate telephone number used by UCAS – 0871 468 0 468 – without the proper additional price information that should be provided when promoting this chargeable premium rate service. Phonepay Plus, which regulates these services on behalf of Ofcom, demands that “Pricing information is one of the fundamental pieces of information that premium rate promotional material must display”.

Please note that BT offers reduced regulated rates for calls to this number and is therefore not a typical example to use as an illustration of the cost.

There is an alternative number available – 01242 545701 – which provides limited access to exactly the same service. This is NOT a premium rate number. It provides a much cheaper way of accessing the service, especially for the majority (75%) who call from mobiles and non-BT landlines, as well as those who benefit from call inclusive packages from BT and others. It must be noted that the capacity of this alternative number is limited and so callers may receive the engaged tone.

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I am happy to engage in debate on whether UCAS should be funded by students who use the service.

I would also be keen to express my views on whether it is fair that those who can afford to hang on whilst paying a premium rate should get a better service than those who are only able to afford the alternative, with the risk of getting engaged tone.

I see this as part of the wider issue; which includes NHS providers, HMRC and DWP agencies obtaining funding from service users by use of expensive telephone numbers.

Attempt to reduce the cost of calling 0845 numbers thwarted by Ofcom

Ofcom has today announced that efforts by BT to force other telephone companies to lower their charges for calling 0845 numbers have been blocked.

This is the simple summary of a complex final dispute determination by Ofcom published here - Determination to resolve a dispute between BT and each of Vodafone, T-Mobile, H3G, O2, Orange and Everything Everywhere about BT‘s termination charges for 0845 and 0870 calls.

Many public service bodies, notably HMRC and the DWP, use 0845 numbers which are expensive to call from most telephone services. Users of 0845 numbers gain a subsidy from the caller’s telephone company, the cost of which is generally passed on in higher charges. BT alone is prevented from charging higher rates to its calling customers by legacy regulation.

BT had attempted to get in on the act by itself taking a bigger slice of the “revenue share” when its customers are being called. It had attempted to impose charges on call originators according to what they charged their customers. BT claimed that this would have the effect of reducing their charges, rather than boosting its profits. Ofcom accepts that the effect would have been to reduce charges, but has blocked the move for other reasons.

Callers from non-BT lines will therefore continue to pay high rates to make enquiries about Child Support, Pensions, Tax Credits and other benefits and when contacting JobCentres. The same applies to calls to NHS Direct and many other NHS services. These are just some examples of where revenue sharing 0845 numbers are being misused.

It is fundamentally improper for the cost of providing many public services to be subsidised by payments from those who use them. If these 0845 telephone numbers are to be retained then this would appear to be an example of where the cost of addressing the deficit is falling on the narrower shoulders of needy parents, pensioners, low earners, the unemployed and the sick. The cost of providing whatever public services survive the cuts must be shared fairly amongst us all, through taxation, not through charges on those who need to use the services.

The government must react to the news that the cost of calling 0845 numbers will not be falling, by announcing that their use will be ceased forthwith.

Ofcom and industry approve of Silent Calls - I propose to sack Ofcom

Consultation and responses

Responses to the recently concluded Ofcom consultation on changes to its policy on Silent Calls have been published.

Ofcom proposes to formally permit Silent Calls, so long as only one such call is made per caller per day to any one person.

THIS IS UNACCEPTABLE NONSENSE.

Published responses from industry players including BT, Cable & Wireless, the CBI, The Direct Marketing Association, The Market Research Society and even Ofcom's own watchdog on consumer issues, The Communications Consumer Panel, all support Ofcom's approach to authorising the making of Silent Calls.

My response laments the fact that after having implicitly authorised the making of Silent Calls for many years, Ofcom has now for the first time made this clear and formal.

Ofcom is thereby in breach of the clearly expressed will of parliament, regarding how it should properly use the powers that it holds to address this type of nuisance -

"We expect you to use your powers to eradicate the nuisance of Silent Calls" [Hansard, Sound clips].

Sacking Ofcom for failing to do its duty

Ofcom is clearly too close with industry when using powers that have nothing to do with general regulation of any particular group.

Unlike Ofcom’s powers as a regulator, the persistent misuse powers are simply in force to protect citizens from anyone who misuses the telephone network. Habitually hanging up in Silence on an answered call is unnecessary and unquestionably persistent misuse of the telephone network, regardless of who does it and why.

For this reason, my consultation response includes an outline proposal for these powers to be removed from Ofcom, to be exercised by a "citizens agency" . In the spirit of the "Big Society", I have offered to commit my own efforts to this project. (see Notes below.)

Silent Calls continue to be a major problem, and recognition that Ofcom does nothing effective inevitably causes the number of complaints it receives to fall - that is Ofcom's declared objective.

In the consultation document, Ofcom reports receiving evidence of around 100,000 attributable Silent Calls in 2009 - it did not use its powers once to deal with any of these cases.

Ofcom appears to be admitting defeat; I will continue to argue that the powers do enable effective action to be taken, and I am now prepared to prove it.

I have presented my proposal to Dr Vincent Cable, Secretary of State for Business, Innovation and Skills and await his response. No fundamental change to the law is necessary.

Further discussion

Please contact me for further information and comment. I would be delighted to dispute any justification offered by the organisations listed above.

(In the Autumn, a House of Commons committee will be debating the proposal for the maximum penalty available to Ofcom in connection with these powers to be increased by a factor of 40. I believe that it is vital for public opinion on the issue of how Ofcom is using its powers to have been clearly expressed well before that time. My proposal is serious, but most of all I want to stimulate public debate on the question of whether Silent Calls should be allowed or prohibited. The number and the frequency should only affect the level of any penalty.)

Notes

My proposal is briefly outlined in this media release and covered more fully in the final section of my consultation response (pages 13-15, or use bookmarks in the document)