simond001 wrote on Aug 30^th, 2007 at 8:08am:


I think we are in danger of getting carried away with the argument about funding and the cost of new telephone systems.   Firstly, the doctors are funding their existing systems already.   We should only be talking about the marginal additional cost of a new system.   That additional cost is of course a fully allowable business expense so the doctor can claim that money back out of his tax payments.   

We are not talking about massive expenditure here.   A quick search on Google will show that a new private switchboard to handle up to, say, 100 extensions can be purchased for well under £1000.    Of course there are set-up costs and maybe new handsets and some customisation/parameterisation of the software and making recorded messages etc.    This is not an excessive cost to the doctor; they've all done it before with older equipment which was vastly more expensive.   Like everything electronic these systems now cost a fraction of the price 10 years ago.   

So I say, no need for any additional cost to the NHS, the doctors can easily afford to fund their own systems out of their current budgets.

NGMsGhost wrote on Aug 30^th, 2007 at 3:05pm:


Except that the doctor is paying nix.   The patients are paying through their call costs and NEG are probably raking in £50,000 upwards year on year for the life of the system.    Talk about a bad deal for the patients!!

simond001 wrote on Aug 30^th, 2007 at 12:23pm:

I hope you recognise that the points you make stand as strong justifications for two hated concepts. I am not suggesting that you would seek to advance or defend them, but I ask you to consider carefully.

When increasing "headline" rates of taxation is unpopular and increasing public expenditure is popular, the obvious solution is to raise money by "stealth taxes". You seem to suggest that we would be best not to bring this issue to public attention, as service cuts will be an inevitable consequence of exposing what may be seen as the necessity of GPs funding their operations by collecting money from patients without them being aware of it.

You also seem to suggest that patients should be ready to knowingly pay to maintain the level of service provided by their GP so that NHS services are not "free at the point of use". My first posting to this thread dealt with this point at some length. If the realities of the market, to which you refer, are given too much rein within the NHS then its cherished funding principle is lost altogether.

Please feel no personal animosity from myself, I address only possible implications of the points you make.


It may be that the DoH has mistakenly directed PCTs to allow practices to fund NHS services delivered by receptionists or nurses out of money collected from patients. This is in breach of the GP contract, and so those positions would be put at risk if the terms of the contract were now belatedly enforced.

It may be difficult to determine where the responsibility for any such unhappy situation would lie. It would be very tempting to bring in another party who was responsible for proposing the breach of the contract, knowingly exploiting this error by the DoH, and deriving commercial benefit from the breach. If such cases exist, then it may be difficult for the four parties to work out how the matter could best be resolved, as blame is likely to be flung around between them.

Now that such cases will come into the open, I believe that the government should not redefine the principles of the NHS so that the present situation may continue - a proper solution must be found for each individual case. I cannot say what that would be in each case and would not wish to propose a single universal answer, but solutions must be found.

Others may believe that the government should simply let things remain as they are by redefining the principles of the NHS to confirm a position which some believe to exist already and may support. For myself, I do not believe that the NHS should deliver "value for money" to its individual "consumers", nor that we should each have a free "choice" about how much of our gross income we spend on healthcare.

If this were so, then every NHS practice could have whatever telephone system and however many nurses and receptionists its patients were prepared to pay for. Some would find that perfectly acceptable. Those of us who do not must recognise that these matters are far from simple.

David

And again:

http://www.yorkshireeveningpost.co.uk/dewsbury-news/Premium-wait.3164532.jp

Perhaps others will join me in pointing out to those involved that it makes no difference how wonderful the "patient experience" may be. NHS GPs cannot fund their services by charging patients through taking a revenue share no matter how "low" the "cost" of the "call".

David

P.S. Different listing in this version -
http://www.yorkshireeveningpost.co.uk/news/Premium-wait.3163915.jp

"Hello. Thank you for calling. All of our receptionists are just on their tea break, but please hold while we generate more revenue from your call..."

Some comments have appeared on the Enfield Independent website : ----

Posted by: NHS Patient, London on 11:38pm Wed 5 Sep 07
Unfortunately these improvements cannot go ahead for NHS patients. The terms of the contract which the Primary Care Trust is required to have in place must prevent practices from receiving remuneration from NHS patients. Part of the extra cost of calling these "revenue sharing" numbers is paid to the practice. NHS services may not be funded by payments from patients. Patients are waiting for the government to confirm that the principle of the NHS being "free at the point of use" will be re-instated, by explicitly banning use of 0844 numbers by GPs. Alternatively this principle will be abandoned and Enfield patients will be free to pay for whatever other improvements they wish NHS providers to make to their services.
Unfortunately these improvements cannot go ahead for NHS patients.
The terms of the contract which the Primary Care Trust is required to have in place must prevent practices from receiving remuneration from NHS patients.
Part of the extra cost of calling these "revenue sharing" numbers is paid to the practice.
NHS services may not be funded by payments from patients.
Patients are waiting for the government to confirm that the principle of the NHS being "free at the point of use" will be re-instated, by explicitly banning use of 0844 numbers by GPs. Alternatively this principle will be abandoned and Enfield patients will be free to pay for whatever other improvements they wish NHS providers to make to their services.

Posted by: George, London on 10:24am today
This is an appalling and incompetent piece of journalism. To mindlessly accept and print such corporate propaganda without any investigation of the facts or background is a disgrace to the journalistic profession. Why don't you go back and talk to a good number of patients at the Enfield surgery and obtain some real opinions and reactions. Ask them if they are happy to pay up to 40p per minute to call their doctor on a mobile or a call box. Are they happy to subsidise their doctors phone system. Report that 27 MPs have put down a motion in Parliament condemning doctors for using 0844 a premium rate number. Try and report the truth and facts for a change.

Posted by: George on 10:29am today
Any patient of this Enfield surgery, or indeed any person who would object to their surgery going to 0844 can vote against on the Prime Ministers website -- Stop doctors using 0844 numbers --- http://petitions.pm. gov.uk/NGN-use-by-GP s/ -- Go there and VOTE NOW!!!

[quote author=idb link=1160182005/315#326 date=1189076864]Would this be our very own Derrick by any chance I wonder.

Careful Derrick as NEG now have your address.

I trust you will be keeping your mobile phone and a baseball bat by your bedside in case of a raid by Alistair Campbell and his fellow NEG thought police in the middle of the night.

If we hear you have suddenly disappeared we will make sure to tip off the Police as to who they should have at the top of their list of prime suspects.

derrick wrote on Sep 6^th, 2007 at 5:11pm:

Great work - well done.

The lies are more than countered by the true facts of the story as reported. Set against the expectations one may reasonably have for someone who is not a PR professional getting something into the media, this is a terrific achievement.

If you are happy to become a local hero, you will deserve it.

David