Having re-railed my gravy, I will have a go at some simpler points.

Until such time as he says otherwise, Andy Burnham inherits the unfulfilled undertakings given by Alan Johnson. When speaking generally as a member of the government, any minister speaks for the government, not themself as an individual. This is especially true for members of the Cabinet. Use of the singular ("I"), rather than the more common plural ("we") adds weight to an undertaking, but cannot change its nature.

The "111" proposal is far too big to simply be a device for delaying addressing the revenue sharing issue (which is relatively small).

If getting into the general politics underlying use of revenue sharing numbers for public services, we must remember that (all things being equal) we are asking for the burden of cost to be shifted from the service user onto the tax-payer. What price any proposal that adds to public expenditure, especially in the current climate?

If, as is common, we try to dodge the point by listing places where the missing money could be found, we must explain why we were not calling for that to be done anyway, as a separate issue.

For those unable to follow the references to the well-repeated remarks from the longstanding-, but shortly to be former-, Shadow Secretary of State for Health, I regret that I cannot offer a simplified version.

http://news.bbc.co.uk/2/hi/health/8420327.stm

Non-emergency 111 health number to be piloted

<<
Trials of a new three-digit telephone number for patients seeking non-emergency medical care in England will be launched in 2010.

The North East, East of England and East Midlands will pilot the free 111 number which will act as an alternative to 999 when people do not need A&E.

The service will not initially replace NHS Direct but could do so in the longer term if it proves successful.

Ministers said it would help route patients to the right service.

The move follows a consultation by Ofcom earlier this year.

People calling 111 will be able to get health advice but also information about out-of-hours GP services and walk-in centres.

It is hoped it will take the pressure off 999 calls.

Estimates suggest up to half of 999 calls do not need an emergency response.

Anyone calling the number with an emergency will be directed to 999 for an ambulance to be dispatched, the Department of Health said.

Health Minister Mike O'Brien said: "Patients have told us that they need clear, easy advice on how to find healthcare quickly when its less urgent than 999 and I am delighted that Ofcom has allocated 111 for these purposes.

"This will be particularly useful outside of GP surgery hours and for people who are away from home."

Nick Chapman, chief executive of NHS Direct said: "We believe that it will increase the access that patients have to the information and advice they need to help themselves and make best use of the NHS."

Peter Weissberg, medical director for the British Heart Foundation, said people with symptoms of a heart attack must still call for the emergency services without hesitation.

"Calling 999 as soon as you think you may be having a heart attack gives you the best possible chance of survival.

"Every year approximately 86,000 people die from heart attacks, a third of whom die before reaching hospital, often because the patient delays calling for help."
>>

Have a read here

http://www.ofcom.org.uk/consult/condocs/three_number_non_emergency/statement/

Paragraphs 1.6 & 1.7

Also...

Ofcom also confirmed that the Department of Health intends that calls to the number will be free.

Ofcom's press rbelease is here:
http://www.ofcom.org.uk/media/news/2009/12/nr_20091218

Also confirms it will be "free".  I note that they don't use the term "free to caller" that they use when they mean it really is free, from mobiles too.


(Edit:  SCV posted after I started mine.)

The situation with 111 has developed.

It is announced that the service will be "introduced", not piloted, starting in the summer and it will be free to call.

I quote from the DH media release of 18 June - https://nds.coi.gov.uk/Content/detail.aspx?NewsAreaId=2&ReleaseID=413941

Quote:

It is important to note that ALL NHS Direct services were exempted from the recently issued Directions prohibiting use of "expensive" numbers, because they were to be replaced by 111. The new service is not just for "urgent" situations, as opposed to whatever other categories of need there are short of "emergency".


In this media release I express concern about whether the government has considered the operational and cost implications of making this number free to call. (They will have been in negotiation with all providers, including mobiles, so there is no danger that they have been forgotten.) I raise other issues there, and also in commenting on coverage of the story in "Smart Healthcare".


I am sure that keen saynoto0870-ers will be quick to discover how far this free service for contacting any part of the NHS can be used nationally whilst it is being rolled out in particular areas. It may be that the cheapest way to contact NHS Direct or Choose and Book will be to use your mobile to be connected via Darlington. Detection of the area from which the call is originated will be essential for the full operation of the service; we wait to see how effectively this will be deployed for calls from mobiles and how it is operated during the roll out.


I have to admit to being wrong to think that the new government would abandon, or defer, this idea because of the sizable costs that will be involved. These will be seen not just in running the service, but in the considerable efforts of reconfiguration and co-ordination that will be necessary to make implementation successful. There is as yet no indication of whether a key feature of the proposal by the previous government - integration with access to social care services, so as to begin the process of integrating the NHS with a "National Care Service" - will remain a feature. This is what the early adopters listed were keenly planning for; will they get the funding they were expecting? will other areas be compelled to follow a similar model, probably at greater cost? which are the other areas of the NHS that will have to suffer deeper cuts in order to pay for this?

Please understand that I am not opposed to free telephone calls. We all know that everything has to be paid for somehow and the government does not see itself as having lots of spare cash at present. Eliminating additional charges on patients should be a greater priority than subsidising the cost of their calls.

sherbert wrote on Jun 21^st, 2010 at 8:44am:
The DH will have had to make the necessary arrangements with all telephone companies before being able to announce that the implementation is going ahead - this is not like someone announcing a 0800 number. Had there been different charging arrangements for different types of caller, this could have been covered in some way, but the announcement is totally clear on this point.

The announcement is brief and the DH has not offered any further information about the scope of the service, or clarification on any points. One is left having to refer to statements from a previous government. N.B. The previous DH announcement, referred to above in reply #20, is now archived at - http://collections.europarchive.org/tna/20100330144652/http://www.dh.gov.uk/en/M....

SilentCallsVictim wrote on Aug 17^th, 2010 at 5:27pm:

Confirmed.

Dave wrote on Aug 26^th, 2010 at 12:54pm:

We trust that this rule will apply to all providers. I can confirm this in practice for BT, Virgin Media and Orange.