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Wednesday, 19 August 2009

Don't just “love the NHS", look after it - An open message to Dr Hamish Meldrum, Chairman of the BMA

Dr Meldrum As a campaigner against all use of revenue sharing telephone numbers by NHS providers, I am delighted to read your press release “Don't just “love the NHS", look after it, BMA tells politicians”. You state a belief that the core NHS values, such as “free at the point of need”, are being undermined by the demands of competition and exploitation by profiteering private companies. I totally agree, and find it disappointing that the BMA does not reflect the views of most of its members in General Practice. They, it would appear, stand firmly against being drawn into schemes that provide profit to private companies at the direct expense of patients, in order to improve their “competitive position” in satisfaction survey tables. The BMA however continues to support the use of revenue sharing telephone numbers, to obtain funding for services from patients, by a minority of its GP members. A strong and eloquent (although ill-founded and thereby fatally flawed) defence of this practice is found in the comments of Network Europe Group, an agent for the Talk Talk Group 0844 telephone numbers used by many NHS GPs, from which both companies profit at the expense of patients. In its response to the recent Department of Health consultation on the subject, NEG suggests that choice is more important than cost for NHS patients. It offers this as a justification for patients being charged so as to enable GPs to acquire improved telephone systems. (It must be understood that most of the functional benefits referred to are not in any way related to the technical features available with non-geographic telephone numbers, but are suggested as being available only due to the funding derived from the revenue share.) The market for provision of NHS primary care services is indeed based on quality rather than cost to the patient. That is why the core NHS values have to be lovingly and carefully protected, rather than negligently assumed to be soundly in place or dismissed as irrelevant in a “consumer” society. The position of the BMA on this specific matter is found in the views expressed by Dr Richard Vautrey, representing the BMA as a contented customer of NEG, when recently in debate with me on the Radio 4 Today programme. Furthermore, I am able to quote and comment on the BMA response to the consultation which is said to propose that the cost incurred by patients in accessing NHS services should be related to the quality of service provided. If any member of the BMA is so deluded and confused by the market culture as to believe that expressing such a view represents looking after the core values of the NHS, then the hackneyed biblical entreaty “Physician, heal thyself” is too apposite to resist. (We have had enough of moats in Politics recently, so I avoid any reference to “motes”.) We await the forthcoming announcement of what the politicians currently in government, the temporary custodians of our beloved NHS, are going to do about use of revenue sharing telephone numbers. To show love for the NHS and care for its core values, this would have to be a complete and immediate ban, contrary to the expressed wishes of the BMA. That announcement and the reactions to it may provide a useful indication of who is prepared to act out of love for the core values of our NHS. Can you tell me that the BMA has now changed its view and is ready to join me in showing love for the NHS by demanding that all use of revenue sharing telephone numbers must be ceased, so as to protect its core values? I hope that you will be able to reply, and look forward to hearing from you. regards David

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