The Department of Health has now made it absolutely clear from the floor of the House of Commons that the ban applies to all numbers that cost more than the cost of an equivalent call to a geographic number, whether called from a landline, mobile or payphone.
This may represent news to some PCTs, who will have received assurances from their practices such as that widely circulated,
a copy of which is published here -
Quote:...
some telecoms providers (e.g. NEG) “have chosen to charge no more for an 084 call than a call to a geographic number when dialing from a fixed line”
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Having held many meetings with the Department of Health over the past year, we understand that the Department of Health would be happy for an NHS body such as yours to get this reassurance in the form of this letter from NEG to you confirming that the cost of calls via the Surgery Line solution is no higher.
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The Department accepted our evidence, which led to them confirming in their response that: “Some providers have chosen to charge no more for a 084 call than a call to a geographic number when dialing from a fixed line.”
You can be confident, therefore, that your decision to continue to deliver excellent services for your patients using NEG Surgery Line has the full support of the Department of Health and the British Medical Association.
Up until now the Department of Health has never taken the trouble to point out that any reference to the cost of calling "from a fixed line" was not as significant as suggested by the preceding quotation. (This comment was with reference to some telephone call service providers, not system providers such as NEG, anyway). It has never confirmed its support for any particular system, nor indeed of any system being funded by use of a revenue sharing number. It has always stuck to the terms of the regulations as drafted, making it plain that it is these terms which PCTs are expected to enforce on GPs.
It is widely acknowledged that the cost of calling 084 numbers from a mobile is greater than that of calling geographic numbers. A variety of reasons have been advanced to suggest that this fact does not make use of 084 numbers fall outside the terms of the regulations. This argument is now firmly quashed by referring to the answer given on Tuesday.
In respect of payphones, there can be no dispute whatsoever.
There is some doubt about whether Andrew Love received the assurance sought by asking -
Quote: Can the Minister assure us that the clear advice she is giving here today will be distributed around the health service, so that we can put an end to this?
The
recording of the exchanges shows that the Minister began her response with the single word sentence "Yes." This (and the phrase which followed) is commonly used in parliament to acknowledge a well made point before responding to it, and was therefore excluded from the Official Record (Hansard). In response to a direct closed question however it may fairly be taken as an affirmative reply.
Efforts to ensure that the Department writes to all PCT Chief Executives, regardless of whether or not such an assurance was given, are underway. Members may wish to press their own MP to join in these efforts.
PCTs have a degree of autonomy and the Department has long been reluctant to "micro-manage" their activities. They do however all lean very heavily on what they understand to be the position of the DH, especially if this helps them avoid having to take difficult action. A clear statement, in the form of a letter, simply repeating what was said in the house, would make it far more difficult for them to avoid taking action against GPs in breach.
The relationship between the Department of Health and NHS bodies is complex and undergoing change. Suffice to say that one may be happily surprised by the strength and clarity of the comments made on Tuesday! There are other ways of ensuring that PCTs comply with their duties, rather than seeking for the DH to intervene.
Whether or not the DH writes to PCTs, they can also be pressured by patients, MPs and local media - all of whom now have a clear reference in Hansard to indicate that they may be contradicting the explicit directions of the Government, as confirmed to the Parliament to which it is accountable. There are further formal options.