Whilst efforts to enforce the ban on use of expensive telephone numbers by NHS GPs in England continue, they are undermined by NHS bodies doing the same.
NHS bodies in breach
The most notable examples however are the NHS Direct Health Advice and Information service for England (0845 4647) - shortly to be withdrawn, NHS Direct Wales (0845 4647) and NHS 24 for Scotland (08454 24 24 24).
By their "approved" use of revenue sharing telephone numbers it may be seen that the principle of "co-payment" - i.e. subsidy from patients through payments made as they access NHS services - is sanctioned by the respective governments, although not by the respective parliaments.
GPs in breach
Not only are cases like this seen to breach the very principles of the NHS, they also make it more difficult for independent contracted providers of NHS services to be brought in line with those principles.
My database of officially listed cases of use of expensive telephone numbers by NHS GPs, currently shows the following total numbers of cases:
Failure by Governments
Following a public consultation, the then Minister of State (Health Services) said on 14 September 2009:
"We want to reassure the public that when they contact their local GP or hospital, the cost of their call will be no more expensive than if they had dialled a normal landline number."
As we approach the second anniversary of that statement, it can be seen that both the previous and the current UK government have failed to deliver that reassurance. The governments holding devolved authority are in no different position, indeed that have not even declared the intention.
By proposing reform that does not address the problem of the projected massively increased costs of publicly provided health services, indeed by loosening the mechanisms that may hold back their scope to within the bounds of public affordability, the UK government clearly intends that payment for access will become necessary in England.
With England having thereby opted-out from the NHS, can we be sure that it will continue in the remainder of the UK?