Parliamentary Committee urges HMRC to stop using "premium charge" 0845 telephone numbers

In its report on "The Administration and effectiveness of HM Revenue and Customs", the Treasury Select Committee calls on HMRC to "investigate alternatives to 0845 numbers, including 0345".

This falls short of my demand that HMRC immediately make available the 0345 equivalent for every one of its 0845 numbers.

This pragmatic and easily adopted solution could enable callers to save up to 41p per minute in premium charges. By simply allowing the second digit of any published HMRC number to be swapped from a "8" to a "3", the cost and confusion of lots of individual number changes could be avoided. Furthermore, such a measure could be adopted immediately, without waiting for a new telephone service contract.

The loss of the modest subsidy which HMRC derives from its use of 0845 numbers would be more than offset by the saving to callers. In most cases calls to 03 numbers are included in call packages, whereas 0845 numbers are subject to a premium charge. The one exception to this rule is BT, which originates around 25% of non-business calls. BT includes both 0845 and 03 numbers in its call packages and is prevented by regulation from adding its own charge to the money it has to pay to HMRC on 0845 calls.

I have demanded that the same approach of providing 0345 equivalent numbers be adopted by DWP agencies, NHS Direct, NHS 24 and all other public bodies (including BBC local radio stations) currently using 0845 numbers. When circumstances permit, or number rationalisation is being undertaken, then proper changes to 03 numbers can occur.

If Ofcom goes ahead with its proposals for revised regulation of non-geographic numbers, HMRC (and others) will shortly be required to always advise the "Service Charge" of around 2p per minute which is imposed on callers to 0845 numbers, to its benefit. Telephone companies will also be required to publish their associated "Access Charge". When this long overdue transparency is applied to this murky area, HMRC will not be able to hide from the need to justify its Service Charge, which is presently hidden within "bundled" telephone call charges.

All 03 numbers are classified as “Geographic Rate” as calls must be charged at no greater rate than that for a geographic number. Service Charges and Access Charges do not apply to calls to geographic or 03 numbers.

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Notes

1.	The Report is summarised here - note the first listed Recommendation.
2.	The Conclusions and recommendations are listed here - see item 27.
3.	The relevant item in the report is found here - see sections 112 / 113.
4.	My evidence to the committee is published here.
5.	Details of the effect of Ofcom's proposals and further comments are found here.

The BMA advises its members to continue the 084 telephone number scam

In its July 2011 newsletter the BMA General Practitioners Committee disputes the accuracy of a statement made to parliament, and advises members using 084 numbers that they are not bound by the terms of their NHS contracts.

See "Guidance for practices using 084 numbers" in BMA GPC Newsletter July 2011 (p7).

See "GPs (Premium Rate Telephone Numbers)" in Hansard 12 July 2011 Cols 149/150.

The essential argument from the BMA GPC is that if members have been misled by their own telephone system provider, they can continue to breach the terms of their NHS contract, obtaining subsidy at the expense of patients, for the 5 year duration of their arrangement with that provider.

A number of NHS GPs have entered into such arrangements in the last few weeks (contact me for details).

The BMA claims that the Minister misled parliament when stating: "Since April this year, GPs have not been allowed to use a number that charges patients more than the cost of an equivalent geographical call."

To make its point, the BMA relies on the fact that one provider of surgery telephone systems has decided that the only "patients" covered by this statement are those who happen to be subject to a particular tariff of charges from a particular telephone company.

Furthermore, the BMA also denies the fact that all network telephone service companies allow customers to migrate from 084 to 03 numbers at any point during the term of a contract, without penalty.

IT IS A DISGRACE FOR AN ORGANISATION WHICH IS NOW COMMITTED TO CAMPAIGN AGAINST THE DANGERS POSED BY GOVERNMENT NHS REFORMS TO ITSELF BE ACTIVELY ENGAGED IN SUPPORTING THIS MEANS OF UNDERMINING THE PRINCIPLES OF THE NHS.

I am at a loss to understand how the BMA can support and promote the notion that only some patients are entitled to access NHS services "free at the point of need".

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BMA Guidance to Members

The BMA made its policy position very clear in the original guidance to members it published in January 2010 -
GPC GUIDANCE: USE OF 084 NUMBERS IN THE NHS, January 2010)

"... calls to NHS services should incur as low a charge as possible, but that this must be balanced by the quality of communications service that the patients are accessing."

The government had rejected this argument, refusing to alter the NHS Constitution to cause NHS patients to pay according to the "quality of service" received. Through this guidance, the BMA therefore sought to undermine the objectives of the regulations intended to outlaw use of subsidy from patients.

Following the recent statement in parliament, the BMA has now revised its guidance -
GPC GUIDANCE: USE OF 084 NUMBERS BY GP PRACTICES, July 2011.

It no longer states its policy position, but continues to oppose attempts to eliminate the illegal practice of NHS providers subsidising their costs at the expense of patients.

There are three points in the guidance which highlight this approach.

1 - Cost of calling from Mobile Phones

The answers to questions in parliament included the comment: "It is absolutely clear that there is no distinction between landlines, mobiles or payphones. The directions are very clear that patients should not expect to be charged any more."

The BMA disagrees that this is a fair interpretation of the following statement from the contracts: "persons will not pay more to make relevant calls to the practice than they would to make equivalent calls to a geographical number".

The BMA argues that because there is no specific reference to mobile phones, GPs may ignore the fact that many patients will use a mobile phone to call the practice -

"The regulations do not include any specific requirement for practices to consider the cost of calls from mobile phones. In terms of call tariffs, the call rates which patients are charged depend on their mobile phone service provider. It is a matter for individual members of the public to ensure that they are happy with the terms and conditions of the mobile phone arrangements that they enter into with their mobile phone provider."

It is most odd to suggest that in 2009, when the regulations were drafted, "calls to the practice" would not be reasonably understood to include calls from mobile phones and that "persons" who are unable to obtain a landline are not covered by the rights under the NHS Constitution. That is however the BMA position.

2 - Providers of telephone systems to GPs

The BMA suggests that providers of GP telephone systems are competent to advise on whether the number used by the GP is compliant with the terms of their NHS Contract. THIS IS DEMONSTRABLY UNTRUE.

"It is the practice’s responsibility to satisfy itself that the requirements of the regulations are met. One way for a practice to do this is to contact the company providing telephone services for the practice, and ask them to confirm that the practice’s contract is compliant with the current GMS and PMS regulations. As noted above, the main telephone service providers are aware of the new regulations, and should be able to provide this statement on request."

The major provider of surgery telephone systems - Network Europe Group, now owned by Daisy Group (led by "The Apprentice" star Matthew Riley) - advises that all 084 telephone numbers are compliant with the relevant regulations.

In doing so, it disregards the possibility of calls being made:

•    ... from Mobile Phones

•    ... from Public Payphones

•    ... from Landline Call Providers other than BT

•    ... within the terms of a BT Call Plan

Whilst there will be some who remain after all of these possibilities are excluded, the NHS is a universal service. There is nothing in the drafting of the contracts under which GPs provide NHS services to suggest that this type of extensive qualification should be applied to a determination of whether or not use of a particular number is prohibited.

3 - The need to incur penalties on varying a contract

The BMA suggests that GPs in long term contracts for telephone service could not vary the terms of this arrangement so to become compliant with the terms of their NHS contract without penalty.

"...many GP practices have signed multi-year contracts with telephone services providers which cannot be varied, renegotiated or terminated without substantial financial penalty"

In respect of the point at issue - the type of non-geographic number being used - THIS IS SIMPLY FALSE.

GPs are commonly using the revenue share earned from 084 numbers (at the expense of patients) to fund lease payments and pay service charges on surgery telephone systems. Early termination of the leasing arrangement would undoubtedly cause a penalty to be incurred, similarly the terms of the commitment to the system may also be rigid. The requirements do not however address these matters, only the improper manner in which they are being funded.

All network telephone service providers (notably Talk Talk - the provider of network telephone service to most of the NHS GPs using 084 numbers) allow customers to migrate from 084 to 03 numbers at any point during their contract for telephone service WITHOUT PENALTY. Calls to 03 numbers are (by regulation and in practice) charged at no greater cost than that of an equivalent call to a geographic number.

There may be other options open, but there is no question that this variation could be accomplished, without penalty, in every case.

All GPs are expected to meet the costs of running their NHS surgery from payments received from the NHS - not from patients as they access NHS services. All NHS GPs should be paying for their telephone system in the same way. The loss of the revenue share benefit derived from the 084 number on migration to 03 returns those GPs currently in breach of their contracts to the same position as other BMA GP members.

I find it extraordinary that the BMA GPC is actively supporting the idea of competition between members on the basis of the cost of calling them!

Some of my other recent comments on this issue

•    Apprentice star Matthew Riley asked to stop undermining the NHS

•    Ban on use of 084 telephone numbers in the NHS confirmed in parliament

•    PCTs failing to understand DH Guidance

•    NHS GPs using expensive telephone numbers - new database

**** asked to stop undermining the NHS

On 17 July I published a news release in which I referred to Daisy Group Plc.

I now understand that this may contain material which is misleading and inaccurate.

I must ask that anyone who has read this item contact Daisy Group Plc before using any of this material to ensure that only accurate information about this company is published.

Please accept my apologies if you have been misled in any way.

Ban on use of 084 telephone numbers in the NHS confirmed in parliament

Many GPs and NHS bodies are failing to comply with the ban on the use of 084 numbers for patients to contact the NHS. They have been pretending that the ban does not apply to patients calling from mobile phones or public payphones.

Calls to ALL 084 numbers from mobile phones and public payphones are invariably more expensive than equivalent calls to geographic rate (01/02/03) numbers. See published provider tariffs and summary, showing that the same is true for many landline callers also. This fact is rarely denied, some pretend that it is not relevant!

This pretence was most "clearly" dismissed in parliament yesterday by Health Minister Anne Milton. In answers to questions, she said -

"Since April this year, GPs have not been allowed to use a number that charges patients more than the cost of an equivalent geographical call."

"It is absolutely clear that there is no distinction between landlines, mobiles or payphones. The directions are very clear that patients should not expect to be charged any more."

"The Department is very clear, and the general medical services contract makes it very clear, that GPs are not allowed to do this."

NHS Campaigner David Hickson comments:

"This unambiguous clarification of some very simple words should cause those who have been seeking for PCTs to misunderstand their duties to change their approach.

"I call on the BMA GPC and Network Europe Group to admit defeat in their attempts to get the principle of co-payment introduced to the NHS. They should aim to assist GPs in working to provide the best possible service to patients UNDER THE TERMS OF THE NHS. Their argument, that patients should pay for an improved NHS service as they use it, was rejected in September 2009.

"PCTs have the clarity that they have been waiting for. They can now easily dismiss attempts to fudge the terms of the requirements. If GPs are under contract for a system which requires a non-geographic number, they can switch to the equivalent 034 number at any time.

"There is no reason why the NHS could not be free of the need to call 084 numbers within a few months. All NHS Bodies are subject to the same Directions as GPs. Even NHS Direct, exempted from the ban, can adopt 0345 4647 as a clearly, but gently, advised alternative to 0845 4647 for the remainder of the life of the service."

Further points

The Department of Health only covers the NHS in England. The Welsh and Scottish Governments should note and copy this action.

It is now time for the Cabinet Office to direct all public bodies to follow the same approach. The only exceptions may be cases where it is valid to impose what Ofcom calls a "Service Charge" on those who access public services by telephone. The charge should be declared, explained and justified in all cases where 084 or Premium Rate telephone numbers are used.

Bodies such as HMRC and the DWP agencies can avoid the initial cost and confusion of a complete number change by adopting the 034 equivalents as alternatives to all of their many published 084 numbers. The present imposition of a “Service Charge” for telephone enquiries from Tax Credit and benefit claimants, jobseekers and pensioners surely cannot be justified!

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Please refer to my briefing PCTs failing to understand DH Guidance, for detail, references and links. I cannot say what part this publication played in informing the exchanges in parliament.

News Alert - "premium rate telephone numbers" - announcement expected

Health Questions, Tuesday 12 July 2:30 pm
"(8) ... the use by GP surgeries of premium rate telephone numbers"

It is hoped that in answer to this, the 8^th question on the Order Paper, the Health Minister will confirm that many PCTs are misinterpreting the terms of GP contracts by continuing to permit use of 084 telephone numbers, on quite spurious grounds.

This briefing shows that the terms of the regulations are perfectly clear and cannot be interpreted other than as a ban on use of 084 telephone numbers by GPs. The briefing also indicates how PCTs have been misled so as to arrive at a misunderstanding.

My database and maps, covering all of the PCTs and Health Boards in England, Wales and Scotland, show a total of 1,372 GP surgeries where the principles of the NHS are shown to be breached. Clear and specific regulations introduced in December 2009 and April 2010 have simply not been enforced.

We wait to hear what action the government will take in defence of the principle that all of us are entitled to access NHS services without being subject to a charge to the benefit of the NHS provider. (A premium on the telephone bill is no different in effect to a till at the surgery reception desk.)

Ofcom misuses its persistent misuse powers against Silent Callers, again

Ofcom has today announced a further misuse of the powers it holds to take action against all those found to be causing unnecessary inconvenience annoyance or anxiety by misuse of the telephone network. (See update notes (i) and (ii) - 7 July 2011 on this "Competition Bulletin".)

Sadly, Ofcom only uses these powers against those who breach a formal tolerance limit, based not on the amount of nuisance caused, but as a proportion of other activity by the same company on the same day.

The action by Ofcom against nPower and Homeserve is to be welcomed, if only because it draws attention to the nuisance which they will be permitting to continue causing. This only amounts to the issuing of Notifications and the consequent public shaming at this stage. Looking at previous cases, precedent and proportionality make it unlikely that the previous limit of £50,000 for a fine will be exceeded.

The limited detail of these cases which has been revealed so far demonstrates how Ofcom is tolerating the practice of hanging up in Silence when a call is answered - only intervening when an offender tells Ofcom that it has breached the rules. Furthermore, the Silent Calls made by nPower are not covered by the action and only some of those made by HomeServe are deemed to be in breach of the Ofcom tolerance "rules".

Silent Calls are totally unnecessary

If no agent is free to handle an answered call a very simple message, simply naming the caller and apologising, could be played. Ofcom suggests a far more elaborate version of this, but does not demand its use, so long as the 3% allowance of abandoned calls is not exceeded.

Many companies, including BT and British Gas publicly declare that they make Silent Calls up to this limit. They will not however say how many calls and how much nuisance they are knowingly causing to their customers and others.

The only acceptable limit for SILENT calls is 0%. Those who are prepared to say who they are when they abandon calls can take the consequences!!

Answering Machine Detection

Ofcom has muddied the waters with new rules covering the use of this obsolete equipment, designed to detect the clicks and whirrs of a mechanical answering machine.

Ofcom now declares that when this notoriously inaccurate equipment detects an answering service it is acceptable to hang up in Silence, but callers must wait until the next day before repeating the call - probably with the same effect if the detection was erroneous.

Many in the Call Centre industry would wish for providers of network answering services to provide a clear signal of some sort whenever the answering service is engaged. This would enable 100% accurate detection of use of such services, rather than the present unacceptable method of listening to the tone of voice and mode of speech from the answer.

Ofcom has explicitly rejected this option, known as Answering Service Detection, firmly supporting the use of a technology that became obsolete when mechanical tape recorders ceased to be the primary way of applying an answering service.

The present method of AMD is obsolete and wholly unacceptable, as it is perhaps the primary cause of Silent Calls. Requiring a Silent Call to be repeated on the next day, rather than the same day is no answer.