The government argues that through the reforms to the NHS, its principles will remain intact. Suggestions that increased commercial involvement may lead to hidden charges and disguised co-funding arrangements have been denied. But is this assurance a little shallow and too late ...
The Surgery Line telephone system, allegedly used by up to 20% of doctor's surgeries in England, is claimed to be "The revolutionary co-funded enhanced telephony service, designed specifically for GP surgeries".
Daisy Group, led by Chief Executive Matthew Riley, featured as a business guru on "The Apprentice", bought the company behind the product last year and now presents it under its own name as Daisy Surgery Line.
Daisy may be one of many commercial providers of services used for the NHS, who would argue that patients should pay through co-funding arrangements. The BMA, representing those who will lead Clinical Commissioning Groups, supports this argument.
I believe that this issue has to be nailed now, before we are talking about paying thousands of pounds for "NHS" treatment, rather than a few pounds to book an appointment with a NHS GP.
I have sought to engage with Mr Riley, in the hope of persuading him that co-funding is not currently acceptable for access to NHS services. I have tried to explain that the benefits of Enhanced Telephony can only be used by NHS providers via a 03 number, so that callers do not incur a premium charge.
Things may change in future for the NHS, but the principles of universal equal access and "free at the point of need" remain in the NHS Constitution at present. Proponents of the co-funding of telephone access to NHS services have argued their point strongly in responses to recent public consultations, but their view has been rejected.
Despite the ban on use of numbers that cost more, Daisy Group continues to maintain that use of 084 telephone numbers to co-fund the Surgery Line system at the expense of callers is acceptable in the NHS. It appears to defend this by leaning on the fact that some BT callers incur penalty charges for calling geographic numbers outside the terms of their Call Plan, which are greater than the premium charged for calling 084 numbers.
This increasingly rare and wholly anomalous situation cannot be exploited to provide a justification for "co-funding", when NHS providers have to consider all whom they serve.
|•||Daisy Group seems to ignore the fact that those subscribed to the most used BT tariff (Unlimited Anytime), and its social tariff (BT Basic), pay nothing to call geographic rate numbers (including 03), whereas they pay a call setup fee plus 4p or 5p per minute to call the numbers used for Surgery Line.|
|•||Daisy Group seems to regard as irrelevant the fact that all mobile and public payphone callers pay more, often amounting to many pounds more for a call, despite a ministerial statement regarding the relevant terms of the NHS GP contract - "It is absolutely clear that there is no distinction between landlines, mobiles or payphones".|
The public debate
Statements of fact from Daisy Group, The BMA, Ofcom and many others are covered in this blogging - Daisy Surgery Line and "Enhanced Telephony".
Daisy Group has declared itself ready to participate in factual public debate on these issues. I am delighted to engage. In particular, I would be delighted to read that Daisy Group and the BMA no longer hold the positions referred to above, despite them being fairly derived from existing published material.