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Friday, 27 May 2011

NHS Direct has caught up with mobile apps - but not mobile voice calls!

NHS Direct has announced the launch of a useful app for smart mobiles - "NHS Direct mobile app - for trusted health advice straight to your pocket",
but it continues to withhold the 0345 4647 alternative "Geographic Rate" telephone number, which would save mobile callers from incurring unnecessary premium charges.

0345 4647 has been set up for use as an alternative to 0845 4647, but NHS Direct refuses to make it available for use.
Only around 25% of non-business voice telephone calls are now made using BT, where the effect of perverse legacy regulation enables callers to 0845 numbers to avoid the premium charges which are normally associated with calls to 084 ("revenue sharing") numbers.

The cost subsidy of around 2p per minute from which NHS Direct benefits through use of a 0845 number is generally translated into a premium charge to callers. Tariff arrangements however mean that these calls are excluded from packages which include unlimited calls to Geographic Rate numbers. The effect is seen with landlines but most markedly with all mobiles. Of the common providers, T-Mobile shows this most clearly.

A T-mobile contract holder would be able to call 0345 4647 for free, but pays 41p per minute to call 0845 4647, only 2p of which is a charge for accessing a NHS service.

No need for the expense and confusion of a complete number change - NHS Direct must make the 0345 4647 alternative available immediately.
This applies to the proposed non-NHS English Health Service, as well as NHS Wales.

NHS Scotland must do the same with NHS 24, by adopting 0345 4 24 24 24 alongside 0845 4 242424.

Tuesday, 10 May 2011

The NHS "Free at the point of use" - in future ? - now?

NHS GPs are continuing to adopt expensive telephone numbers - the latest goes live tomorrow!

When there are more than 1000 to choose from, it seems unfair to highlight a single case, but it serves as a good example.

On Wednesday 11 May, the West Pottergate Health Centre in Norwich will adopt its new 0844 telephone number.

This will enable a new telephone system to be largely paid for by patients, through the "revenue share" that applies to these numbers, causing callers to pay more than for an ordinary call.

This is NOT the "NHS free at the point of use" to which Minister of State, Simon Burns MP, claimed to be committed in parliament yesterday [see end of para].

In its published information about the change, the practice encourages patients to " use a landline", acknowledging that calls from mobiles cost more than the cost of an equivalent call to a geographic number (this is not conditional, it is true in every case).

Patients are not however advised to avoid inclusive packages, landline providers other than BT or public payphones, although the same is true for these. It is only those who would incur a penalty charge, for making a daytime geographic call outside the terms of their Call Plan, who would not pay more to call this number.

The NHS is a universal service and GPs are required to have regard to " the arrangement as a whole" when considering the cost of calling them, relative to that of an equivalent call to a geographic number. This practice will therefore (admittedly) be joining the many others who are in clear breach of the terms of their NHS contract.

Hoping that patients will change their type of telephone, provider and type of Call Plan so as to keep the practice inside the terms of its contract, does not reflect the purpose for which patients expect to receive advice from their GP.

Responsibility for enforcing the terms of the contract rests with Primary Care Trusts, described by Mr Burns as one of the "layers of unnecessary management" that he is removing [see start of para], through the upcoming reforms.

I comment,

"We may think it right that patients in England should pay to receive improved health services - if we do, then we must say so, and stop confusing ourselves and each other with meaningless slogans.

"If England wants to opt out of the NHS because it cannot afford the overheads, wants patients to be given true "choice" and aims to produce better outcome statistics than can be obtained from a taxation-funded system that treats everybody - then let us be honest about it.

"I am a joint-owner of 'our NHS' and I will continue to fight to keep England within it."

Sunday, 1 May 2011

Rip-off GP telephone number provider openly seeks to undermine the NHS

In a most extraordinary development, Network Europe Group (the provider of the "Surgery Line" GP telephone system part-funded by patients, who pay premium rates to call 0844 numbers) has publically declared its opposition to the principle that NHS services are funded by taxation, rather than by patients as they access services.

Quoted in this article - Company defends charges for calling GP practices, in the Leamington Spa Courier,
NEG opposes the action that its GP customers need to take to comply with their NHS contracts, by saying ...

“the cost would be borne by the practice and ultimately the taxpayer”

The reason given is the very reason why practices MUST make the necessary change - switching to a 03 number so as to provide the technical benefits required by Surgery Line, but at no greater cost than that of a geographic call for the caller. It is quite odd to see the basis of funding for NHS services being given as a reason why NHS GPs should not adhere to this principle.

The cost of providing NHS services is properly carried by the practice, ultimately funded by the taxpayer, not the patient as they access the service. This has been the whole basis of my involvement in this issue - I am delighted to see "the other side" now being open about its position of opposition to the principles of the NHS. (NEG continues to misrepresent the position of the Department of Health and misinterpret the requirements actually imposed on GPs. By declaring its clear intention to work against the fundamental principles of the NHS, we can see all of its other statements in a clear context.)

The Surgery Line telephone system is admittedly too expensive for GPs to pay for in the normal way. The number used is however nothing to do with NEG, it is a matter of the arrangement between the practice and the network telephone service provider - normally TALK TALK in the case of Surgery Line users.

Talk Talk allows migration from 084 to 03 numbers at any point during the term of a contract. This is exactly what all of the 1000 or more GPs who are currently in breach of their contract (see below), but want, or are committed, to use non-geographic numbers must do immediately. Other NHS GPs pay for their telephone systems, and other surgery expenses, out of the money given to them from our taxes. That is how the NHS works!

As we are now “pausing and reflecting” on the NHS reforms, perhaps we need to get our thinking clear on the meaning of "free at the point of need". A commercial company, like NEG, finds it difficult to understand and easy to oppose. It can even use an undisguised attack on the fundamental principles of the NHS as a “defence”. As we look for more commercial involvement in the NHS - do we understand this principle and do we want to keep it?


References to other material

I cover the detail of the requirements under the GPs contract with the NHS in this blog entry.
My league table of the areas of England with GPs in breach, and lists of those surgeries.
The equivalent list for Wales, where the situation is identical.
The list covering NHS Coventry and NHS Warwickshire - "the Arden Cluster" (as referred to in the Courier article).
I have previously commented on the views of NEG, although not expressed with the clarity seen in the quote covered by this item.

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