bazzerfewi wrote on Dec 8
th, 2011 at 7:53am:
... is it a criminal offence or a civil offence or may be none of the above.
Many may be interested to read the following outline of the situation as I understand it.
The general terms under which GPs provide NHS services are found in the terms of a civil contract between them and the PCT. These terms are set by parliament and were varied in 2010.
Since April 2010, a contractor has not been permitted to arrange to use a telephone number "unless it is satisfied that, having regard to the arrangement as a whole, persons will not pay more to make relevant calls to the practice than they would to make equivalent calls to a geographical number".
Where an arrangement that fails this test was already in place, contractors are required to "take all reasonable steps" including consideration of "varying the terms of the contract or arrangement", so as "to ensure that, having regard to the arrangement as a whole, persons will not pay any more to make relevant calls to the practice than they would to make equivalent calls to a geographical number".
This variation is a simple prohibition of use of expensive numbers, except where a telephone service provider would not allow variation of the terms of their contract on reasonable terms. Stipulations about the facilities for contact with a practice that must be offered are doubtless contained elsewhere in the terms of the NHS GP contracts - I have not looked, as I cannot imagine any GP not offering telephone contact.
There is no requirement to provide alternative numbers, because there is no number that can be used which requires an alternative. Provision of an alternative number that offered the same access as that currently available on a 084 number would be considered to be a suitable variation to the terms of the contract or arrangement. If this were done then there is no reason why the expensive number should continue to be used! (This can become something of a circular argument, as it comes down to asking why one needs an expensive alternative to a geographic number.)
There is no reason why a practice could not consider offering alternative geographic rate numbers, that offered alternative access to the practice, in the event that they were unable to vary their arrangements on reasonable terms. I have however not yet seen any evidence of a case where the obvious variation (migration to 03) is not available on reasonable terms. It is standard industry practice to offer such migration at any time and without penalty.
If, or when, I see evidence of any deviation from this standard, I will be able to draw attention to this meddling in the terms of the NHS by a commercial organisation. Such political interference is not illegal, but neither would it be illegal to draw attention to it, given that the evidence was sound and properly obtained.
I believe that any PCT which has accepted a claim that a practice has considered varying its arrangements, but found that this cannot be done on reasonable terms, should be holding this evidence. It needs to do so to protect its own position.
The relevant legal remedies that I am aware of are as follows:
- A PCT may take action against a contracted GP for a breach of the terms of their contract. There is a procedure to be followed, but the case could eventually end up in a civil court.
- There are doubtless many ways in which the duties of a PCT are defined in statute. Most recently, there has been added an obligation to have regard to the NHS Constitution. Any failure by a public body to perform its functions properly is open to "Judicial Review". If a large number of lawyers were prepared to offer their services to the cause on a pro bono basis, then this could be worth considering.
Preparation of the NHS Constitution was seen by some as the perfect opportunity to lay out the rights of patients in a form that could be directly enforceable in law by a patient against the provider of a NHS service. Both government and opposition at the time recognised that it was lawyers who were at the head of the group arguing for such action, and were concerned about the legal costs that could be faced by both NHS bodies and independent providers in defending themselves against actions being brought by claims companies.
For myself, I regret the fact that we do not have a "Constitution", in the sense in which the term is generally understood, however I see that this is tied in with a wider issue concerning legal processes that needs to be resolved. The rights are declared in the NHS Constitution, however we are reliant on them being treated with a sufficient degree of importance by officers of the NHS, as there is no simple legal mechanism by which they may be enforced.
I am sure that other legal avenues will be considered. I have only addressed those which I see as being currently relevant. I would be delighted to learn of other legal processes that could be usefully engaged, in addition to the procedural and PR avenues that are already being followed.
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GPs all over England (not just in South Yorkshire) (Read 945,790 times)
