Message to MPs brought into the fight to eliminate NHS telephone Service Charges

This posting simply contains the draft and circulation of a circular letter to MPs. Supportive comment is posted here.

Draft of email message sent to MP's

This message is offered as a briefing, and suggests action that you may wish to take on behalf of your constituents.

According to my records, obtained from the NHS Choices database some time ago, there are 5 or more NHS GP surgeries located in your constituency using expensive "Business Rate" 0844 telephone numbers - they are listed below.

Patients who call them pay a Service Charge of 5p per minute in addition to the Access Charge applicable according to their chosen telephone tariff. Ofcom is currently consulting on proposals to require users of such numbers to openly declare this Service Charge, from which they and their telephone service provider benefit. Ofcom also proposes separate declaration of the Access Charge - currently ranging from a call setup fee of 11.5p to a surcharge of 35p per minute.

Clearly any such Service Charge is forbidden by the terms of the NHS Constitution. When the Ofcom proposals are implemented, the unacceptability of this use of 084 telephone numbers (along with many other examples) will become transparent.

The GP contract with the NHS was amended last year to give GPs until 31 March 2011 to cease use of telephone numbers that are more expensive to call than an equivalent call to a geographic number. Calls to these 0844 numbers are invariably more expensive, the only exception being some cases where a caller would face an excessive penalty charge for making a call to a geographic number outside the terms of their selected Call Plan, which could be greater than the cost of calling a Business Rate number. I cannot believe that there is any surgery where all of its patients find themselves in this unusual position, so as to provide a perverse justification for the application of a Service Charge.

Many surgeries claim that they need to retain a non-geographic telephone number to support their telephone system, for which they have committed to a long term contract. There is no need for them to cancel any such contract. All network telephone services providers permit migration from a 0844 number to the equivalent (Geographic Rate) 0344 number, even within the term of a contract for network telephone service. The only cost incurred in such a change would be due to the loss of revenue from patients - revenue which is being obtained improperly and must now be foregone.

Very few GPs have taken the action necessary and changed their telephone numbers during the months that have passed since the contract revisions were introduced and notified to them. The BMA GPC has advised them to retain their 0844 numbers, as it holds the view that NHS patients should meet the costs of improved NHS services, according to the quality of service provided. To evade the intended purpose of the contract changes, which it negotiated, the BMA GPC advises members to rely on false assurances from system providers regarding the cost of calling.

The Department of Health has indicated that it is not offering any support to PCTs, nor does it intend to take any action of its own, so as to ensure that use of these expensive telephone numbers is ceased.

You may therefore wish to make representations to your PCT, on behalf of your constituents or join me in seeking to draw national attention to this issue.

Now that Ofcom has revealed the true situation with these numbers, the Department of Health should no longer be hiding behind misleading and false information that it has obtained from some unreliable source - you may also wish to call Ministers to account for the lack of clear guidance on this matter. It is quite absurd for every practice and PCT to have to go through exactly the same process of looking up nationally published tables of telephone charges, when the conclusion should be the same in every case - all 084 numbers are more expensive to call than Geographic Rate numbers, apart from a few specific anomalous and perverse cases.

Regardless of how parliament may decide that the NHS is to be managed most effectively, I would see it as vital that its fundamental principles, e.g. the delivery of NHS services without providers levying charges on patients, are maintained. The way in which this particular issue of principle is resolved can be used in consideration of the provisions of the coming Health Bill and will help our understanding of how (what may continue to be known as) the NHS will develop in future.

Further details and references for published items relating to this message are given in my blog posting - MPs brought into the fight to eliminate NHS telephone Service Charges. There is also a link to the draft of this circular message with a full circulation list.

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The surgeries referred to above are as follows:

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Circulation

MP	Constituency	GPs
David Anderson	Blaydon	5
Hilary Benn	Leeds Central	5
Nicholas Boles	Grantham and Stamford	5
David Burrowes	Enfield, Southgate	5
Yvette Cooper	Normanton, Pontefract and Castleford	8
Nicholas Dakin	Scunthorpe	7
Justine Greening	Putney	7
William Hague	Richmond (Yorks)	5
Margaret Hodge	Barking	6
Martin Horwood	Cheltenham	9
Jessica Lee	Erewash	5
Phillip Lee	Bracknell	5
Edward Leigh	Gainsborough	5
Brandon Lewis	Great Yarmouth	5
Andrew Love	Edmonton	5
Karen Lumley	Redditch	6
Jason McCartney	Colne Valley	5
Karl McCartney	Lincoln	5
Anne Milton	Guildford	6
Greg Mulholland	Leeds North West	6
Andrew Murrison	South West Wiltshire	6
Andrew Percy	Brigg and Goole	8
John Redwood	Wokingham	5
Linda Riordan	Halifax	7
Barry Sheerman	Huddersfield	5
Alec Shelbrooke	Elmet and Rothwell	7
Marsha Singh	Bradford West	6
Dennis Skinner	Bolsover	5
Henry Smith	Crawley	8
Peter Soulsby	Leicester South	8
Andrew Turner	Isle of Wight	6
David Ward	Bradford East	6
John Whittingdale	Maldon	6