NHS GPs are still adopting 084 telephone numbers, 2 years after this was prohibited

From: David Hickson of the Fair Telecoms Campaign - campaigner for the NHS

New regulations were added to the NHS GP contracts in April 2010, prohibiting use of telephone numbers which cost more than an equivalent call to a geographic number.

Except in a few cases, where callers incur sizeable "out of plan" penalty charges for daytime calls to geographic numbers, the 0844 numbers listed below are more expensive. This applies to callers from landlines, mobiles and payphones.

The higher cost is simply explained by the fact that all 084 numbers attract a "revenue share" (paid by the call originating telephone company to the benefit of the user of the number). The amount varies, but in the case of the numbers listed below, it is equivalent to a 4p per minute subsidy being paid by the caller to the person called.

On 27 March 2012, Secretary of State for Health Andrew Lansley confirmed in parliament:

"We have made it very clear that GPs should not be using 0844 numbers".

There are 1,247 surgeries still using these numbers in England and Wales note. They have failed to comply with their contracts, which demand, in effect, that they vary the terms of their arrangements by migrating to the equivalent 034 number. If they wish, they could cancel their existing arrangements altogether, but this is not demanded.

Of perhaps greater concern is the fact that the following NHS GP practices have newly adopted these expensive numbers in the last couple of months:

◊	Handsworth Medical Practice - Handsworth Avenue, Highams Park, London, E4 9PD - 0844 387 8525
◊	Chadwell Heath Health Centre - Ashton Gardens, Chadwell Heath, Romford, Essex RM6 6RT - 0844 387 8044
◊	Knowle House Surgery - 4 Meavy Way, Plymouth, Devon, PL5 3JB - 0844 387 8895
◊	Abbey Dale Medical Centre - 50 Common Edge Road, Blackpool, Lancashire, FY4 5AU - 0844 387 8685

Positions taken on this issue

(see Possible sources for further comment below)

•	Enforcement of the terms of the GP contracts is currently the responsibility of the (shortly to be abolished) Primary Care Trusts.
	Mr Lansley may care to explain how he believes that the ban may be enforced, and why enforcement is not being carried out.
•	The British Medical Association appears to support this form of co-payment - patients subsidising GPs' telephone systems.
	It claims that practices would not be able to afford the cost of their chosen telephone system without this additional financial support from patients.
•	The four numbers listed above in red are assigned to Talk Talk Business. It appears that they have been allocated to a reseller - NEG Ltd (part of the Daisy Group).
	NEG stoutly defends use of these revenue sharing numbers, especially for the provision of "socially important services".

As well as the practices themselves, it would be interesting to know which of the above believe that access to NHS services should continue to be "free at the point of need". It is fair for us to pay our telephone services providers for calls, but incurring a premium to subsidise the costs of the NHS provider is unacceptable and prohibited.

Some may suggest that in the new "patient-centred" English Health Service, patients should pay to subsidise the costs of a GP's telephone system. I campaign for the retention of the NHS in England.

I comment -

Mr Lansley's ongoing reforms are intended to remove central control from the NHS.

If he cannot ensure that its basic principles, which he affirms, are enforced, then we no longer have a NATIONAL Health Service worthy of the name.

See my proposed remedy below.

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Note: The contractual conditions referred to by Mr Lansley apply only to the NHS in England. Identical conditions apply in Wales, where they are enforced by the Local Health Boards.

Possible sources for further comment:

♦	The Department of Health. The Department will be able to clarify the terms of the relevant contractual requirements. Andrew Lansley's office will be able to confirm what he meant by "… should not be using …".
♦	The British Medical Association. Comment may be provided by Dr. Richard Vautrey - Deputy Chairman of the BMA General Practitioners Committee and partner in Meanwood Group Practice, Leeds (0844 477 1799). Each area is served by a Local Medical Committee, representing the interest of local GPs.
♦	Talk Talk. The numbers provided by NEG are on services provided by Talk Talk Business. Talk Talk will be happy to confirm that all of its direct clients are able to migrate from 084 to 034 numbers at any point during the term of their contract, without penalty. If this same facility is not withheld by NEG, then its NHS GP clients are able to utilise it so as to comply with their NHS contractual requirements at a cost which is not unreasonable.
	Talk Talk will also be able to confirm that its residential customers who use their landline for weekday daytime calls are advised to subscribe to its Talk UK Anytime tariff. This charges 13.1p + 6p per minute for calls to the (type "g11") 0844 numbers listed above, as against "zero" for a call of up to one hour to a geographic or 03 number. (Those who subscribe to its Talk UK Evenings and Weekends tariff are penalised for "out of plan" Weekday Daytime calls to geographic numbers at the rate of 13.1p + 7.95p per minute.)
♦	Daisy Group Plc - owners of NEG. Daisy Chief Executive, and "Apprentice" judge, Matt Riley, is ready to defend his company's role in pressing these numbers on GPs and to contradict the view of the Secretary of State. (See this BBC North West Tonight item from 2 August 2011.)
	Mr Riley seems not to understand how the industry works. His broadcast statement could be taken to suggest that Talk Talk, along with all other landline call providers, charge for 0844 calls at "local rates". Nobody has ever done this. Daisy itself charges 6.5p per minute for "type g11" 0844 calls, as against 2p per minute for "local, regional and national" calls (see Daisy Fixed Line Tariffs).
	When he says " we'd only charge a local rate call", Mr Riley fails to suggest under what circumstances Daisy would alter its present charging policy; he is certainly not referring to the situation as it exists.
	The BBC was wrong to suggest that Daisy is in any way a party to the contracts between its GP clients and the NHS. If GPs use information provided by Daisy, it is they who are fully responsible for the accuracy of that information.
♦	Primary Care Trusts. These are now managed on a "Clustered" basis by 50 bodies covering areas of England. Each of the Clusters appears to have adopted a slightly different policy regarding enforcement. In almost all cases this amounts to tolerance of this breach of the principles of the NHS.

My proposed remedy

Where the technical benefits available with "non-geographic" numbers are thought to be cost-effective, these can be provided using 03 numbers - for which calls are charged at the same rate (if any) as calls to geographic numbers in all cases.

03 numbers are not subject to revenue sharing, so GPs choosing to deploy the benefits obtained must meet the full cost of their telephone systems without the benefit of subsidy at the expense of their patients. GPs are funded, from our taxation, to provide NHS services. If they believe this funding to be inadequate, they can argue their case. Whilst the principles of the NHS remain in effect, they cannot be permitted to take money from patients.

For those currently using systems which rely on the features of non-geographic numbers, they must immediately migrate from 084 to the equivalent 034 number. A plan for this can be agreed by the parties. This could include a gesture on the part of Talk Talk Business to relieve some of the costs of using non-geographic numbers.