Will Talk Talk be fined for Silent Calls - and what about undermining the NHS?

An article by a Mail on Sunday reporter - TalkTalk facing new Ofcom fine over silent calls – suggests that I may have been wrong to make the assumption headlined in a previous release.

It is claimed that sources now suggest that Ofcom will not follow the same approach with Talk Talk as it recently did with Homeserve and nPower.

Although Ofcom issued Notifications of Misuse to both companies, neither was subject to a penalty nor an enforceable obligation to cease the practice.

Ofcom treats many millions of Silent Calls as not being misuse at all; it applies a percentage tolerance and recently introduced a “one a day is OK” rule.

We know that Ofcom “has issues” with Talk Talk, having previously taken action against it on another matter.

I too “have issues” - it is expensive Talk Talk telephone numbers that are being used by many NHS GPs to subsidise the cost of their telephone systems at the expense of patients and in breach of their NHS contracts. I have published a list of 1,115 NHS surgeries using expensive Talk Talk numbers (80% of the total of such cases).

If Talk Talk were, exceptionally, to be subjected to a financial penalty for persistent misuse, this could appear to be spite by Ofcom, as many other Silent Callers do not even have their known Silent Calling brought to public attention. Furthermore, as Ofcom is in the habit of not publishing details of the scale of the misuse, we will have no idea about whether or not the penalty is proportionate.

Neither Talk Talk, nor its agent, can be fined for undermining the NHS. It is the GPs who may follow their guidance who are actually breaching their NHS contracts by using expensive telephone numbers. Talk Talk is however a major part of the problem – it could become a major part of the solution.

Daisy Group endorses "co-funding" for access to NHS services

The government argues that through the reforms to the NHS, its principles will remain intact. Suggestions that increased commercial involvement may lead to hidden charges and disguised co-funding arrangements have been denied. But is this assurance a little shallow and too late ...

The Surgery Line telephone system, allegedly used by up to 20% of doctor's surgeries in England, is claimed to be "The revolutionary co-funded enhanced telephony service, designed specifically for GP surgeries".

Daisy Group, led by Chief Executive Matthew Riley, featured as a business guru on "The Apprentice", bought the company behind the product last year and now presents it under its own name as Daisy Surgery Line.

Daisy may be one of many commercial providers of services used for the NHS, who would argue that patients should pay through co-funding arrangements. The BMA, representing those who will lead Clinical Commissioning Groups, supports this argument.

I believe that this issue has to be nailed now, before we are talking about paying thousands of pounds for "NHS" treatment, rather than a few pounds to book an appointment with a NHS GP.

The arguments

I have sought to engage with Mr Riley, in the hope of persuading him that co-funding is not currently acceptable for access to NHS services. I have tried to explain that the benefits of Enhanced Telephony can only be used by NHS providers via a 03 number, so that callers do not incur a premium charge.

Things may change in future for the NHS, but the principles of universal equal access and "free at the point of need" remain in the NHS Constitution at present. Proponents of the co-funding of telephone access to NHS services have argued their point strongly in responses to recent public consultations, but their view has been rejected.

Despite the ban on use of numbers that cost more, Daisy Group continues to maintain that use of 084 telephone numbers to co-fund the Surgery Line system at the expense of callers is acceptable in the NHS. It appears to defend this by leaning on the fact that some BT callers incur penalty charges for calling geographic numbers outside the terms of their Call Plan, which are greater than the premium charged for calling 084 numbers.

This increasingly rare and wholly anomalous situation cannot be exploited to provide a justification for "co-funding", when NHS providers have to consider all whom they serve.

•	Daisy Group seems to ignore the fact that those subscribed to the most used BT tariff (Unlimited Anytime), and its social tariff (BT Basic), pay nothing to call geographic rate numbers (including 03), whereas they pay a call setup fee plus 4p or 5p per minute to call the numbers used for Surgery Line.
•	Daisy Group seems to regard as irrelevant the fact that all mobile and public payphone callers pay more, often amounting to many pounds more for a call, despite a ministerial statement regarding the relevant terms of the NHS GP contract - "It is absolutely clear that there is no distinction between landlines, mobiles or payphones".

The public debate

Statements of fact from Daisy Group, The BMA, Ofcom and many others are covered in this blogging - Daisy Surgery Line and "Enhanced Telephony".

Daisy Group has declared itself ready to participate in factual public debate on these issues. I am delighted to engage. In particular, I would be delighted to read that Daisy Group and the BMA no longer hold the positions referred to above, despite them being fairly derived from existing published material.