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Q461 Mr Amess: This may be a bit difficult for you to answer, but how much money do you think would have to be generated from the National Health Service to reduce the charges to a reasonable level?
Mr Lewis: It is extremely difficult to answer that question because it depends entirely on the mix of services provided and what some of the additional costs are of providing those services. We do not see a single solution to this, but we do see, if you like, there being a menu of actions which, brought together, should enable incoming call charges to be reduced to a level that callers would consider to be acceptable and would remove a number of other irritations, one of which is the need at present for the warning at the beginning of all incoming calls about the cost of those calls.
Q462 Mr Amess: Finally, and you have sort of already answered this, Ofcom and the criticisms - what is it your intention to do about these criticisms?
Mr Lewis: Well, I am not usually someone who would make complimentary remarks about a regulator, but they did actually, I think, do a quite thorough job to a reasonably tight timetable. Their conclusions were that the level of incoming call charges, which was the specific bit they were investigating, were a cause for concern, they were a source of complaints and they looked out of line with other telecoms charges. However, they did conclude, first of all, that the level of those charges was heavily influenced by the specifications that had been set by the NHS for these systems back in 2000: the highly sophisticated technology; the requirement to put one of these units at every bed even though it is uneconomic; and the requirement to provide a range of free services for the NHS, such as free radio, free information services and so on. They concluded, as a consequence of that and combined with the cap that has been established on charges to patients, that the providers had very little choice other than to effectively charge these higher prices to incoming callers, and they described the charges as being the result of a "complex web of government policy and agreements". In addition to the published report ----
Q463 Mr Amess: What does that mean, do you think?
Mr Lewis: I think you would probably have to ask Ofcom, but I think it relates back to the policy when the programme was set up and the way it was funded. They have published a report and they have also written to the Secretary of State with a series of recommendations, we understand, although we have not seen that letter as yet, but hope to do so as part of the work of the review party.
Q464 Dr Taylor: Is it fair to say, Mr Lewis, because you have said that your system will have a computer by the bedside which would show an electronic patient record, that the relatives who are paying 49p a minute for their incoming calls are in some way subsidising the national programme for IT?
Mr Lewis: Not at present because at present the usage of the system----
Q465 Dr Taylor: But it is there.
Mr Lewis: Well, indeed. The usage of the system for that purpose is at present very limited. There is just one hospital, Chelsea & Westminster, which is using our system to access an electronic clinical record at the bedside, and very successfully so, so effectively -----
Q466 Dr Taylor: Does your warning message say, "Thank you very much for using this service. It is going to cost you 49p, but you are helping the NHS towards its aim of having readily available electronic patient records at the bedside"?
Mr Lewis: In principle, that is a correct conclusion. We do not include that in the message for fear of lengthening it further.
Q467 Jim Dowd: Because that would cost them a further 49p! We are actually talking about the kind of charges for incoming calls that people were desperate to pay ten or 15 years ago in the early days of mobile technology, but I will put that to one side. I am sure it is difficult to estimate, but what proportion of inpatients take advantage of your services?
Mr Lewis: A very high proportion do. Approximately 70% of the terminals we have at the bedside at any one time have a patient registered to them and about half of those on any one day will be paying for a service or people will be paying to call them. The other half will be making use of the free services, radio, television, if they are children or have special needs, or may not be using the service on that particular day, so it does have a very high level of usage.
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