NGMsGhost wrote on Sep 19^th, 2009 at 5:04am:

I address these points in reverse order, to return to topic in conclusion.

The (optional) bundling of Caller Display goes back to “BT Privacy at Home”. This was a fairly elaborate scheme with the objective of getting BT customers registered with the Telephone Preference Service, so that competitors would not be able to pinch them through telemarketing. Others had previously been using that technique of customer retention (often without the customer’s permission) and BT wanted to offer a carrot to ensure that its customers would sign up in droves. It was highly successful to that end.

I do not go along with the suggestion that others cannot compete with bundled provision of “Caller Display” on a line. Similar additional services such as 1471 and 1571, at the basic level, are already generally bundled by all. I cannot see why there must be a different approach to bundling between these three. Basic 1471 and 1571 could easily be unbundled. I suspect that if Caller Display facilities, or even the wonderful “True Call”, become more commonly built into telephone receivers then the line facility will become commonly bundled (as it is on mobile networks where handsets have this feature).

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I understand the political concept of free markets serving the needs of service users to mean that prices for a particular service are levelled down to within a very narrow band. (In theory they all become the same, because the provider charging more for the same service gets no business.) This is not achieved when perhaps minor or totally insignificant differences in what is offered from competing providers are associated with a wholly disproportionate difference in price.

Assessment of the operation of a market must consider what “choice” consumers actually need and the extent to which they are realistically able to exercise it. New Labour is not alone in simply pointing to (and promoting) the existence of “choice” and “competition”, as if this must mean that the needs of service users are being served. In many cases, it simply means that failure can be attributed to a particular consumer or provider, which is highly convenient for those who accept responsibility for the overall provision of the service.

The theory of markets is compelling; it is now deeply rooted in much of our politics, and accepted as if part of some universal truth. One may expect the Prime Minister to refer to this when he responds to this petition. Last Monday’s announcement implied that the effect of a ban on premium rate call charges would be achieved through a “marketplace”. (It certainly will not be achieved by the suggested terms of a revision to the GMS contract, unless any sanction for the use of 084 numbers is expressly absent.) With a newly announced extended “choice” of GP to add into a market-driven approach, can we expect patients and telephone service providers to be blamed for any failure of the “ban”?

Just over 3 weeks to go until the deadline. Please sign the petition to the Prime Minister if you haven't already done so:

http://petitions.number10.gov.uk/Healthtelephone/

Keith wrote on Nov 6^th, 2009 at 2:44pm:

This suggestion is perhaps supported by the fact that the directions to NHS bodies referred to in the announcement have not yet been issued. Neither have the formal discussions on the revisions to the GP contract begun.

Nothing would happen with the GPs when the terms suggested in the announcement are applied to the contract anyway. This is because there is an assumption that all 084 numbers are OK because all of the telephone companies are about to change all of their tariffs so that nobody has to pay more than the cost of a geographic call to call them. This is not "woolly" - it is complete nonsense.

The Department of Health even hints that Ofcom regulations, which only apply to calls to 0845 numbers by BT customers not subscribed to any of its packages, cover all calls to 084 numbers from any provider on any tariff. Others attempt to press this false understanding.

The delay in taking the promised action could however provide an opportunity for the error to be corrected before it is actually put into effect. I must urge other members to join me in trying to get this point recognised in any way that would bear on what the Department of Health is doing.

My latest media release covers these points, and also the topic of this thread. Please let nobody get confused about the extent of my influence on this matter. The more who are making these points through whatever channels are open to them, the more chance we have of these points being understood and recognised.

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The issue of how PCT's behave raises the familiar point about their role and accountability. They are obliged to consider guidance, and to comply with directions, from the Department of Health and once the Health Act 2009 is implemented they will be required to "have regard to" the NHS Constitution. They are however accountable to nobody in particular.

It is however fair to point out that the general terms of their contracts with GPs are defined for them by statute. Whilst they have some freedom about the way in which they interpret the terms, one would expect them to try and offer a consistent view, following guidance from the Department of Health.  There is however very strong public opposition to PCT's making their own decisions on any issue that applies to others in the same way, as is this is precisely what is known as "the postcode lottery".

I have sent this message to Number 10 today.    51,380 people deserve a prompt answer.


Dear Prime Minister,

When are you going to provide a Response to the Petition submitted by Guy Mayhew calling for you to “prevent local health centres and hospitals from using 08 numbers such as 0844, 0845 or 0870”?

Yet more media coverage (perhaps related) - see this item.

An interesting development of the DH position is reported in a formal statement read out in the piece. Nothing too dramatic, but a more coherent basis from which to pursue the issue. I quote the statement and attempt to progress it here.

A Government Response to the Petition has been posted on the PM's website here :---

http://www.number10.gov.uk/Page15215

It states :---

Responsibility for provision of local health services now rests with local NHS organisations as they have the specific knowledge and expertise that makes them best placed to plan, develop and improve services according to the needs of the local population. The provision of telephone services for patients and the public is therefore a matter for the local NHS.

However, the message from the Department of Health has made it very clear to NHS organisations that patients should not be expected to pay more than the equivalent of a local call to contact their GPs.

NHS organisations have a duty to ensure that they provide the best possible service to their local populations. We expect Primary Care Trusts and GPs to ensure locally that telephone systems do not place a financial burden on patients.

My mistake, this was the response to the previous Petition.   My apologies for causing confusion.   It will be interesting to compare this previous response to the next one when it does eventually appear!

Barbara

I have sent you a PM