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Wednesday, 6 April 2011

GP telephone system provider NEG joins the debate on NHS reforms - to question "free at the point of need"

In its response to the Ofcom consultation on Simplifying Non-Geographic Numbers, leading Primary Care Telephone System Provider, NEG, argues that the principle of "free at the point of need" does not work for “enhanced” GP telephone systems. Its Surgery Line system is too expensive to be funded properly by GPs themselves.

"Since 2008 we have offered our customers the choice of using a 03 number. None to date has chosen to do so." ....
"Our years of experience of delivering enhanced telephony solutions in NHS Primary Care organisations leads us to conclude that
the reason is the crucial contribution made to their infrastructure and technology costs by revenue sharing, which is permitted on 084 numbers, but not on 03 numbers.

It is of course the revenue sharing element of 084 numbers which makes them more expensive to call than geographic numbers. Calls to 03 numbers must be charged at no more than the rate of a call to a geographic number and included in packages on the same basis.

As the government pauses in its considerations of the NHS reforms, it is surely vital that this argument in favour of using money from patients to provide “investment” in “enhanced” telephone systems be considered - openly and honestly, with the facts on the table. I have always been ready to participate in any such discussion.

My latest published contribution to this debate includes examples of call costs and links to published telephone tariffs. The NEG document, and its supplement, is heavy on quotations and opinion, but light on relevant facts.

I will leave it to readers to draw their own conclusions about why (on page 65/75) NEG pleads with Ofcom to qualify its efforts to introduce greater price transparency, because this would threaten its business (and the NHS!), whilst NEG seeks to suggest that it has nothing to hide.

(The mythical ‘084 number that is not more expensive than a geographic number to call’ has still not been sighted by myself or Ofcom! Whilst it is spoken of by NEG, the BMA and the Department of Health, and even claimed to exist in vast numbers; until an example has been seen one must doubt its existence in truth!)

There is some urgency as, since 1 April, NHS GPs using 084 telephone numbers stand in breach of their NHS contract!

The government will need to move swiftly to amend the NHS Constitution if it wishes to make this, and perhaps other provider-set NHS charges, legal. There is no such provision currently in the Health and Social Care Bill. The only NHS charges currently permitted are those explicitly set by parliament.

We must be clear on whether the reformed and liberated NHS is to be “free at the point of need” or not. I have my view, which is different to that of NEG, but it is most important that we understand what is the true position for “our NHS” in England as we move forward.

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