SilentCallsVictim
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From watching this debate, I see two separate issues being discussed.
The first is the question of whether NHS GPs should use "state of the art technology" to provide the best service to patients, at a price which those responsible for managing NHS budgets find reasonable. I cannot see the problem, nor understand what legitimate interest NEG could have beyond this point.
The second is the contentious political issue of NHS funding - is this about the quality of service that NHS GPs provide to their paying customers?
As citizens we may all express personal views on this subject. I cannot see why a company, or someone speaking as its representative rather than as a citizen, would wish to get drawn into a political debate. Perhaps the NEG representative could explain this to me, either directly or through the forum.
I offer thoughts on the second issue, as a citizen.
We have become trained to see ourselves as consumers of services provided to the public. We behave accordingly, demanding "value for money" and "choice". It is therefore natural that many reject the principle of funding NHS services through taxation.
It is absurd to offer "value for money" by providing the most health care to those who pay the most tax, as they may not want it. "Value for money" is only delivered if those who use NHS services the most are those who pay the most.
Unless some options are inferior, there is no meaningful "choice". "Value for money" demands that we pay less for an inferior service (e.g. a doctor using an inadequate telephone system for booking appointments).
Charging fees for booking appointments can help meet the objective of ensuring that people only see their doctor when they really need to. For a serious "choice" to be made when considering booking an appointment, some alternative potential expenditure must have to be sacrificed.
This does not work when the level of the fee is insignificant. The NEG survey referred to in this thread shows that only 18% are sufficiently poor or miserly to be put off from using their doctor with the fees for calling 0844 numbers at their present level.
The NEG representative admits that the fee is too low to affect their own behaviour. The 18% reduction in those competing for the doctor's time actually helps to make it even easier for them to get through to book an unnecessary appointment.
The market is not working properly, as a considerable amount of resource may be being wasted.
To be properly effective, the appointment booking fee would need to be set at a level where all but the very rich (immune to any effect on behaviour by financial imposition) were discouraged from wasting money on unnecessary appointments.
This would also provide an additional benefit by placing doctors under pressure to deliver "value for money" to their customers. If the customer only pays the doctor a few pence for the appointment, demanding "value for money" does not compel the highest standards of care.
If a practice set its charges at an appropriate level it would probably get rid of some patients altogether, which would naturally improve the quality of its services still further. The principle of "choice" would not be lost for the poor and miserly as the demand in the market would doubtless be met by the charitable sector, or private social entrepreneurs, staring up alternative "free to use" services outside the administrative constraints of the NHS.
As NEG appears to wish to claim credit for having helped bring financial pressure to bear on as many as 18% of potential time-wasters, then it is perhaps to be congratulated on this modest achievement.
NEG is a business that is responding to the consumer society. It operates in a free market providing services that its customers choose to buy.
One must assume that NEG is sufficiently open and honest about the prices of its services to its customers to remain within the law. These customers fail to declare the prices they charge to those who become their own customers, or even fail to disclose the fact that they are making any charge. That is however not NEG's responsibility, unless it wishes to admit complicity in this fraud.
Picking a fight over unexceptional levels of hyperbole and misrepresentation in marketing, when NEG has what is seen as convincing consumer research to show the effectiveness of its solution, seems to be a rather fruitless exercise in a consumer society.
If PCTs and other NHS commissioning bodies allow GPs to raise revenue by charging fees, then it is for them to defend this decision against any challenge, through their own channels of accountability. NEG is only accountable through the market, to its potential future customers.
Let the government and the NHS organisation openly declare adoption of consumerism in the NHS. Let them confirm and salute the consumerist definition of "democracy" which proudly allows the preferences of the majority to override the interests of a minority as significant as 18%.
Let us decide whether we wish to be regarded as citizens or consumers in our relationship with the NHS and other public bodies. As with Ofcom's statutory principal duties (repeatedly referred to in this thread), these are distinct roles that may conflict.
(As I am formally retired from campaigning efforts, I cannot conduct extended discussion of these points in this public thread. I can be contacted by email.)
David
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