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Sunday 30 August 2009

NHS GPs using 0844 numbers can change to 0344

Talk Talk confirms that NHS GPs using 0844 numbers can change to 0344 to comply with the forthcoming ban

We are promised a ministerial announcement on the outcome of a consultation about a proposed ban on use of revenue sharing 084 telephone numbers in the NHS within the next month.

Opal Telecom, the business services part of the Talk Talk Group, is the provider of the vast majority of the expensive revenue sharing 0844 telephone numbers improperly used by many NHS GPs.

Some have mischievously suggested that these GPs with 0844 numbers must be excluded from the forthcoming ban, BUT ... This is founded on the false understanding that their long term contracts with Talk Talk deny them the opportunity to simply move to a different type of telephone number in order to comply.

THIS IS NOW SEEN TO BE UNTRUE.

Opal Telecom (Talk Talk) has recently published a booklet advising customers about how they can change their telephone number, referenced from this page.

Revenue sharing on 0870 numbers was banned for everyone by Ofcom with effect from 1 August 2009; that is what prompted this publication. As some Talk Talk customers on 084 numbers face a similar ban in the near future, this same information is directly relevant to their situation.

  • Move to another number range” is advised as the way forward for those who do not wish to face the consequences of new regulations. The document lays out the options.
  • There is extensive reference to the 03 range, including confirmation that “Ofcom has reserved 034x numbers for customers with matching 084x numbers”. Changing only the second digit of the telephone number (0844 xxxxxxx to 0344 xxxxxxx) would ease many of the difficulties inevitably associated with a number change. Other ways of avoiding revenue sharing are also advised.
  • Talk Talk Group corporate values are said to include “Flexibility and understanding” and being “here for the long term”.
This shows that GPs will be able to readily comply with a ban, without being required to abandon existing systems or suffer contract cancellation penalties.

The Talk Talk Group states that it is ready to offer the necessary flexibility. Its understanding of the fact that the loss of revenue share income may create financial difficulties for its customers, and its desire to continue to serve the NHS for the long term, will doubtless ensure that it makes the most generous possible new arrangements for current and future NHS users of its services.

This may be further encouraged by a desire to avoid any embarrassment at having been part of what many see as a scam on the NHS. The false suggestion that its 0844 numbers guarantee callers a low rate, when that is clearly untrue for its own residential customers not to mention those with mobiles, will be remembered by the Department of Health officials who repeated it in a statement in 2005.


I am very concerned that as there has been no public discussion of this obvious solution for NHS GPs, it may not have been recognised. Major contributors to the Department of Health consultation, notably NEG Ltd – the provider of the “Surgery Line” system that is funded out of the revenue share on these numbers – and also the BMA, have made no reference to this option in their public statements.

My attempts to obtain reassurance that the Department of Health is properly aware of this option have received no response. I do not wish to pre-empt the forthcoming announcement, however I do not wish to hear it made without one of the primary elements having been dealt with. As stated above, Ministers have apparently been misled on vital issues relating to this matter previously.

Further to my previous briefings, this newly published document states that the number change option is indeed available. This information needs to be reported and circulated now to correct earlier misleading reports of GPs being tied in to contracts that prohibit a change of number. I have good reason to believe that some GPs have not been made aware that this option is available to them. It would be foolish to have to bring this matter up on the back of an announcement which falsely assumed that some GPs had to be granted immunity from a ban.

Wednesday 26 August 2009

NHS phone calls – GP premium rates to end, but when? - the BMA says "later", or "never" - TALK TALK holds the key

From: David Hickson – campaigner for the NHS In January 2008, Health Secretary Alan Johnson announced “I’ll end GP call charges” 1. It now falls to Andy (“#welovetheNHS” 2) Burnham and Mike (“free more often than not” 3) O`Brien to fulfil this promise. “In September”, one of these gentlemen will be announcing a ban, as the positive (?) outcome of a consultation that ended last March. Will this be next week, at conference 4, or ... ? The (“Look after our NHS” 5) BMA opposes a ban, suggesting that commercial markets should be allowed to operate in the NHS. It believes that NHS patients should be charged according to the quality of service that they receive. Most of its members reject this nonsense, however it is said to be part of the BMA creed 5. The major obstacle to a prompt and comprehensive ban is probably the “Bright Ideas” TALK TALK group. The vast majority of NHS GPs using 0844 numbers (771 in my sample of 811 6) have these from the TALK TALK business to business division, formerly known as Opal Telecom. These contracts all have many years to run and it has been suggested that the cost of breaking them would be too great. The BMA demands that they be allowed to run their course on 084 numbers. TALK TALK has failed to tell us that these contracts do not need to be broken – a bright idea indeed! It is normal practice in the telecoms business for customers to change from one type of number to another during the term of a contract, with an appropriate adjustment to the terms. NHS GPs could therefore easily swap from 0844 xxxxxxx to 0344 xxxxxxx, changing only the 2nd digit of their number. This assumes that they were content to keep their service with TALK TALK and wished to retain the systems that are linked to it. Calls to 03xx numbers are charged as for ordinary 01/02 numbers with revenue sharing prohibited. This may sound petty and technical, but it is the key to solving this problem. Whilst retaining all the benefits of their existing telephone systems, GPs would of course lose the benefit of the revenue share subsidy that has been coming from patients. As TALK TALK is such a bright company (along with the other members of the Carphone Warehouse Group), it may wish to offer GPs better than normal terms under the new arrangement. This would recognise the profit that it has been making (improperly), and would continue to make (properly), out of NHS patients and be a helpful gesture to aid retention of both its good name and its customers. The BMA suggestion that TALK TALK should continue paying over the revenue share even though it is receiving nothing extra from callers 7 is perhaps taking things too far. I fear that when the Minister makes his announcement, he will suggest that the TALK TALK contracts have to be served out unchanged. This would leave some NHS GPs charging their NHS patients for up to 7 more years, whilst others are prohibited from doing so. If nothing is done to clarify the situation in the meantime – TALK TALK will have to take the blame. Notes and links TALK TALK and its agents have failed to make any comment about this issue. They have declined opportunities to perhaps confirm that the number change option could not apply (to shut me up) and failed to grasp the opportunity to take credit for having presented it. One must therefore assume that nothing has been done. The comments made in discussion with me on TV by a representative of the main agent involved (Network Europe Group) are typical.

  1. Hull Daily Mail March 7 2008
  2. DowningStreet tweet
  3. Libertarian interpretation of the principles of the NHS presented to parliament by the Minister of State (Health Services) - in total contradiction of the NHS constitution, which permits only charges that are specifically sanctioned by parliament – Hansard 16 June 2009
  4. Ministerial Speeches to Labour Party Conference (0870 043 5533) on Monday 28 / Wednesday 30 September 2009?
  5. See the website, my comment, the source of the quotation used.
  6. See my list of 0844 using GPs
  7. The slightly confused reference to “local rate” in this statement can only be taken to mean that suppliers of services on 0844 numbers should retain the financial arrangements currently in place, whilst allowing callers to incur no premium charge. That can only be achieved by moving away from revenue sharing numbers.

I cover this issue at greater length in my blog posting - Looking forward to the end of use of 084 numbers in the NHS

Thursday 20 August 2009

Ofcom creates more confusion about the cost of making telephone calls

From: David Hickson – campaigner against misuse of telephone numbers Ofcom has today published Number Crunching. This guide is said to look at “some of the common numbers in use today, what they are used for and how much it costs to call them from a BT landline”. The guidance given adds to some of the confusion that exists around telephone number ranges in areas of current contention and concern. In attempting to achieve the worthy objective of presenting a complex situation simply, it fails to provide essential and necessary information in a number of ways.

** Because some of BT’s charges are regulated, they are NOT TYPICAL of the general pattern. The repeated suggestion that “other providers’ prices may vary” makes the guide useless to the majority of callers. It could be said to be false and misleading, in that it is BT’s pricing structures that vary from the normal pattern. 0845 and 0870 provide the clearest example.

** There is no clear explanation of “revenue sharing”. Calls to 0845 and 0844 numbers are generally far more expensive than others because money is invariably passed to the receiving end. The fact that some recipients can deny receiving a share as income is irrelevant, as the benefit is obtained in some other way. To descibe the receipt of benefit as only “generally” occurring provides a clear opportunity for consumers to be misled by those who claim to be exceptions to this principle. (There are no exceptions, other than those who gift money to their telephone service provider.)

BT’s margin on calls to revenue sharing numbers is regulated by Ofcom and is much less than that which it takes on other chargeable calls. When the 1 October BT price increases render this document out of date they will leave BT’s charges for calls to ALL revenue sharing numbers as LESS THAN it’s standard call charge. This is because BT is inflating the unregulated cost of standard calls to persuade customers to subscribe to inclusive packages, from which calls to the expensive revenue sharing numbers are excluded.

By using BT as an example, it is suggested that calls to revenue sharing numbers are cheaper than calls to ordinary numbers. This grossly distorts the actual general reality.

** There is no clear description of the various package structures used by mobile (and landline) companies. Some packages are “limited” whereas others are not, some types of call are typically included whereas others are not. The loose and selective specific detailed references to the latter element are not strictly accurate.

** In referring to 0800, “Childline” is the only named example. This is the most atypical example that there could be. Numbers used by “Helplines” under the Telephone Helplines Association scheme are in the 0808 80 range and provided free by most mobile operators. Childline is one of very few organisations for which a separate arrangement has been negotiated for mobile operators to provide free calls on 0800 numbers.

There are many other points that could be made – in time, I may prepare and release my own alternative version of a simlar document.

The idea is excellent, some of the information is useful, but overall the execution is very poor.

In aiming to produce a simple guide, one must not attempt to give all of the detail, or enter into areas that require confusing qualifications. Examples selected must however be truly illustrative and not misleading, rather than just convenient. I fear that convenience has overridden these other vital points. To suggest that accuracy is achieved by qualifications and references to other material is to deny that a simple accurate guide has been produced.

I regret that I can foresee this authoritative document being used to justify various rip-offs, and the improper use of revenue sharing numbers by public service providers (notably in the NHS), against which I am campaigning. I can provide many examples from the past where information very similar to that published here has been improperly quoted for the purpose of creating confusion and to deliberately mislead consumers.

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

Monday 17 August 2009

Misuse of revenue sharing telephone numbers by the government

From: DAVID HICKSON – campaigner against misuse of revenue sharing telephone numbers in the public sector.

A quick campaign status update covering three areas of concern.

Please contact me for further details and comment on any of the following, and other related issues: DEPARTMENT of HEALTH (NHS) “September” has been promised as the “date” for an announcement covering the outcome of the consultation on a proposed ban on use of 084 numbers in the NHS (which concluded in March). We will then be able to test the professed “love for the NHS” when we see what efforts are made to re-instate its most fundamental and beloved principle of being “free at the point of need”. I will be available to provide briefing and comment when the announcement is made. In the meantime there are issues that are likely not to have been resolved, as well as the major issue itself, which may warrant coverage whilst the “I love the NHS” story is running. (I offer myself as the twibbon-wearing “NHSPatient” user of Twitter.) DEPARTMENT for WORK and PENSIONS (various agencies) The new minister, Jim Knight, has been briefed on the ongoing failure of officials to deal with this matter. A new article in the primary organ of pressure for the government - 40p a minute to ring Job Seekers Direct – (which does not address the fact that benefit claimants also pay the same rates when calling DWP agencies) may help to press my former campaigning colleague into action. DEPARTMENT for TRANSPORT (DVLA) Two weeks after it ceased receiving any subsidy from calls to its 0870 number, the DVLA continues to subject many callers to premium charges. Whilst BT has now dropped all its rates for calling 0870 numbers, as revenue sharing no longer takes place, Virgin Media and the Mobile Operators continue to levy premium charges. This wholly unjustified surcharging by these telephone companies is an absolute disgrace. It was wrong for the DVLA to benefit from stealth charges; it is perhaps even worse that it continues to use 0870 numbers when only the profiteering telephone companies benefit.

Saturday 15 August 2009

OUR BELOVED NHS

From: David Hickson – Campaigner for the NHS When choosing the Twitter user-name “NHSPatient” I did not realise how important this might become.
We love the NHS because of the unique principles that distinguish it from any other healthcare system. The key principle is “free at the point of need”, being funded (almost exclusively) through progressive taxation.
We can argue over whether treatment and care meets or exceeds necessary and desirable standards, but that is a characteristic of how it is managed from time to time, not of the nature of the service.
The present government has long delayed its response to an unnecessary consultation on a necessary ban on use of revenue sharing telephone numbers. Even now, there are severe concerns that the ban may not be complete.
Whilst representatives of a potential future government have sought to present themselves as ready to fund it, one must question whether the possibility of allowing funding to be obtained from patients by stealth will be too attractive to resist. That is what the present government has done and it is only coming around to (perhaps) correcting its mistake over four years later.
Those who argue that one should have the freedom to use one’s financial resources to secure better service within the NHS, and that this is a valid way of funding improved services, are arguing against its very principles.

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