CC: Department of Health enquiries
From: David Hickson - campaigner for the NHS
Yesterday (9 December 2009) BBC South East broadcast a new statement from the Department of Health on the issue of use of revenue sharing 084 telephone numbers by NHS service providers. I quote,
“The government’s position is very clear. Where there is evidence that patients are being charged more than the equivalent of a geographic call, then GPs and all NHS bodies should take all reasonable steps to rectify this. Whilst terminating their contract is an option open to them, the practice could consider altering or re-negotiating the terms of their contract, providing a call back facility for patients, or other options.
Every one of these numbers costs some patients more
The majority (in numeric terms) of telephone tariffs charge more for a call to any 084 number than to a geographic number. There are several exceptions to this rule in respect of 0845 numbers, as used by services such as NHS Direct, and just one in respect of 0844 numbers, as used by over 1000 GPs. Put simply, every patient using a mobile phone to contact the NHS on a 084 number is being charged more, as is every user of a VirginMedia landline.
BT is subject to special and unique regulation of its charges for calling 084 numbers, which therefore vary from the normal pattern.
Does the Department of Health require specific evidence of every individual case before it will take appropriately firm action to apply the principles of the NHS? NHS services must not be funded by payments made by patients as they access those services. I would be happy to become engaged in collecting the necessary evidence, if my general assertion is disputed.
The first thing that must be done is to prohibit any further 084 numbers being adopted by NHS providers. Waiting for the evidence in new individual cases and then considering alteration to a newly signed long term telephone supply contracts is not a satisfactory way to proceed.
For those already contracted for the provision of non-geographic numbers, there is a simple solution. Telephone service providers allow migration from any 084x number to the equivalent 034x number within the term of a contract. (Calls to all 03xx numbers must, by regulation, be charged at no higher rate than calls to geographic numbers, in all circumstances including through packages and for mobiles and payphones as well as landlines.)
Whilst a possible major change in the near future causes NHS Direct to retain some of its existing 0845 numbers, it would require no effort whatsoever to arrange for the equivalent 0345 numbers to operate in parallel with suitable, but modest, publicity.
The suggested “call back” option is of very limited use and is potentially unnecessarily expensive for all. It is not necessary for NHS providers to relieve callers of the normal cost of a telephone call, they must simply not use revenue sharing numbers that may cause a premium charge to be incurred. On a simple call to arrange a GP appointment, the time taken to arrange a call back is likely to be almost as great as that to complete the transaction; furthermore this would be of little help if the caller has been paying at a premium rate for a lengthy period whilst waiting to get through. The DWP has recently introduced this approach for lengthy calls that are answered swiftly, however this is only an interim step towards a proper and more cost effective resolution.
Action not being taken
We are still waiting to see the Directions to NHS bodies and proposed revisions to the GMS contract announced on 14 September. It is quite extraordinary that in all the time that this issue has been under consideration the Department of Health has failed to recognise that calls to 084 numbers do cost (at least some) patients more than a geographic call. Despite ill-considered suggestions that this will change, there is only one telephone company that has increased the cost of geographic calls to overtake that for calls to revenue sharing numbers.
As the government strives for fairness and equity in difficult times it is a disgrace that those less well off, relying on PAYG mobiles, not only incur the highest call charges, but also incur the highest additional premiums when calling NHS services using 084 numbers.