Further statement by the Health Minister

Seven days ago I presented 5 questions to Mike O'Brien, Minister of State (Health Services) regarding the announcement "NHS TO BAN PREMIUM RATE CHARGES".

I stated that in the absence of the necessary clarification and explanation, I would draw the conclusions stated below. I am still awaiting a reply and record these conclusions for now. I will adjust or withdraw them as necessary when a reply is received.

1. The announcement is rendered meaningless by the indication that use of revenue sharing 084 telephone numbers by local GPs and Hospitals will not be banned. Many of those who call them incur a charge greater than that of calling a normal landline number. Changes to the GMS contract and directions to NHS PCTs and Trusts cannot affect these premium charges. Use of 084 numbers would have to be banned in effect, regardless of the intention, for the announcement to have any meaning. The BMA's welcome of the announcement as indicating "Changes to charges for 084 numbers" has not been challenged or disputed, despite the fact that there is no basis for such an assumption in the DH statement.

2. The announcement that "The use of phone numbers that charge the public or patients a premium rate to contact the NHS are to be banned in England" is untrue. The ban will only cover local GPs and Hospitals. It will not cover providers of NHS dentistry, NHS pharmacy, nationally provided and contracted NHS services, nor the many other locally provided and contracted NHS services that cannot be described as being GPs or Hospitals.

3. There are good reasons for NHS Direct not undertaking the trouble and expense of a complete change of its 0845 4647 number, as the number is likely to be phased out shortly. I have long been suggesting that the alternative 0345 4647, which is set up ready and waiting, should be brought into use in parallel so that many callers could at least have the possibility of avoiding a premium charge, even though some would inevitably suffer it. This is not to be announced. This means that either NHS Direct itself, or BT Global Services, as claimed by NHS Direct, will continue to benefit from the full £1 million a year of subsidy provided at cost to callers because this alternative, although in use and working, is not connected.

4. The Department of Health implicitly suggests that all telephone subscribers should fund the revenue share provided to users of 084 numbers, by there being no difference in call charges between these and ordinary landlines. Any NHS provider that did not avail itself of the benefit of this extra funding would therefore be wasting money. As it is extremely unlikely that telephone companies could offer special rates for calling NHS providers, this would have to apply to all users of 084 numbers. In time, everyone who did not wish to incur extra cost by having an unsubsidised geographic number would choose 084. This bizarre suggestion has not been properly explained and remains on record to be seen as the nonsense that it must be.

5. The Minister is invited to respond to my suggestion that we have seen an appalling, but typical, example of populist politics being applied by aggregating a variety of misled and misleading subjective opinions presented in a consultation to come up with an unworkable solution. A consultation is not some exercise in democracy, although it may potentially be used to confirm the existence of strong opinions. Its primary purpose is to obtain such useful advice and information as may be available from those with an interest, so as to inform a careful determination of the policy to be pursued.

This matter must be addressed properly. I look forward to receiving confirmation that it will be.