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Thursday, 1 March 2012

"Evidence" relevant to NHS GPs in breach of their contracts by using 084 telephone numbers

These comments are to explain the evidence from telephone bills submitted and published at this link - Evidence of NHS GPs in breach of their contract - and to outline the context in which it is provided.

This is a summary of an email message circulated to: Simon Burns MP, Minister of State (Health Services), the MPs serving the constituencies in which the listed practices continuing to use these numbers operate their surgeries, the "complaints" departments of the relevant PCTs and their Chief Executives.

The Context

The message quoted from the comments made by Mr Burns in reply to the parliamentary debate on 24 January, on the issue of NHS GPs in breach of their contracts by using 084 telephone numbers, as listed in this blogging. It concluded with the comment highlighted in this item - "PLEASE SEND US THE EVIDENCE".

I continued, commenting as follows.

I regret the fact that Mr Burns is apparently not seeking the precise, concrete evidence of compliance (i.e. of GP practices and PCTs having looked at published evidence of call costs) that he says is needed. Most claims of compliance are based precisely on carefully selected anecdotal examples of perverse effects and the subjective opinions of highly interested "friendly" parties.

Many have concluded that Mr Burns wishes to see copies of telephone bills indicating that telephone providers do indeed charge in accordance with their published tariffs, causing callers to actually pay more than the cost of an equivalent call to a geographic number to contact a NHS GP. I think it odd to assume that Mr Burns is challenging the integrity of the telephone companies and demanding precise evidence that they charge properly, whereas he is happy to accept that the most unusual circumstances apply to so many GPs (i.e. that a very particular group of tariffs apply to all of their callers) without requiring any evidence.

I have approached my own MP, a member of the government, who advises me that evidence from telephone bills is required by both Mr Burns and PCTs.

The Evidence

In the course of my campaigning efforts I have frequently spoken with practice managers to gain an understanding of how they see the situation and to verify points of detail about their position in relation to their NHS patients. This has involved me making calls to their expensive numbers, which are shown on my telephone bill.

It is important to understand that, although I am not a registered patient of these practices, these are nonetheless "relevant calls", as defined in the regulations, because I was discussing their provision of NHS services.

I have therefore been able to prepare the evidence which is published here.

I trust that each of those to whom this evidence has been presented will recognise their duties and responsibilities, not to me, but to the citizens whom they respectively serve.

Further points

I understand that many would wish to see information related to the surgeries from where the practices provide their services, rather than the identity of the practice. Unfortunately Mr Burns dismissed the evidence which I had presented of nearly 1,300 surgeries, stating "what they do not say is which practices they are". I had sourced my information from NHS Choices, which does not clearly identify the practice.

I have addressed this point by publishing a cross-reference covering all of the relevant cases at http://tiny.cc/GP084Practices.

I cannot provide any evidence of " overcharging". Quite the reverse, my evidence shows charges precisely in accordance with published tariffs, as it is intended to do.

A precise approach to this matter cannot entertain the foolish assumption that GPs, or their telephone system providers, directly determine any of the charges set by those who provide telephone service to their callers. GPs do need to understand that when their own telephone service provider benefits from a "revenue share" (as currently occurs with all 084 numbers), it is most likely that this additional cost to the call originator will be passed on to callers.

GPs do not however have any control over whether or not this happens, whether or not an additional premium is added, nor indeed any control whatsoever over the cost of an equivalent call to a geographic number. It is the possibility of the latter being less which is all that they have to address.

If anybody has any evidence of a NHS GP levying any charge whatsoever for access to NHS services, then this would indicate a most serious breach of the principles of the NHS.

If a "patient-focussed" health service is ever introduced to replace the "National" health service in England, it would be quite natural and proper for providers to charge for their services. We await proposals for how those charges may be regulated and perhaps subsidised from taxation, but that is for another time, as I see no such proposals in the current Health Bill.


The circulation of the message was as follows:

Simon Burns MP - Minister of State (Health Services);

Jon Ashworth MP; Jake Berry MP; Crispin Blunt MP; Angie Bray MP; Lyn Brown MP; Edward Davey MP; Mark Francois MP; Kelvin Hopkins MP;
Helen Jones MP; Eleanor Laing MP; Karen Lumley MP; Mary MacLeod MP; Greg Mulholland MP; Toby Perkins MP; Gavin Shuker MP; Rosie Winterton MP;

'Leigh Broggi, Customer Care Officer - NHS Kingston'; 'PALS - NHS Ealing'; 'Making Experiences Count Team - NHS West Essex';
'Complaints Team - NHS Leeds'; 'Customer Services - NHS Leicester City'; 'PALS - NHS Doncaster';
'Sonia Spurr, Patient Relations & Involvement Manager - NHS Worcestershire'; 'PALS - NHS Luton'; 'Customer Services - NHS South Essex';
'PALS - NHS Warrington'; 'PALS - NHS Hounslow'; 'PALS - NHS Surrey'; 'Monica Zenonos, PALS Manager - NHS Newham';
'Ms Linda Manson, Complaints Manager - NHS Derbyshire County'; 'Complaints Office - NHS Bolton';

Kathy Doran - Chief Executive - Cheshire PCT Cluster; Mike Burrows - Chief Executive - Greater Manchester PCT Cluster;
John Lawlor - Chief Executive - Airedale, Bradford and Leeds PCT Cluster; Andy Buck - Chief Executive - South Yorkshire and Bassetlaw PCT Cluster;
David Sharp - Chief Executive - Derbyshire PCT Cluster; Catherine Griffiths - Chief Executive - Leicestershire PCT Cluster;
Eamonn Kelly - Chief Executive - The West Mercia PCT Cluster; Angela McNab - Chief Executive - Bedfordshire and Luton PCT Cluster;
Sheila Bremner - Chief Executive - North Essex PCT Cluster; Andrew Pike - Chief Executive - South Essex PCT Cluster;
Anne Rainsberry - Chief Executive - NHS North West London; Alwen Williams - Chief Executive - NHS East London and the City;
Ann Radmore - Chief Executive - NHS South West London; Anne Walker - Chief Executive - Surrey PCT Cluster

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