General Practitioners: Telephone Services

Health written question – answered on 11th February 2011.

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Photo of David Morris David Morris Conservative, Morecambe and Lunesdale

To ask the Secretary of State for Health when he expects non-geographic telephone numbers for GP surgeries to be phased out; and if he will make a statement.

Photo of Simon Burns Simon Burns The Minister of State, Department of Health

Following a public consultation on the future use of 084 numbers in the national health service, Directions to strategic health authorities and primary care trusts, and to special health authorities and NHS trusts in England (with the exception of NHS Direct NHS Trust) were issued in December 2009. The Directions instruct those organisations not to use contact telephone numbers which have the effect of the patient paying a premium above the cost of a call to a geographical number. Corresponding regulations were issued as an amendment to the General Medical Services Regulations in spring 2010.

The regulations do not prohibit an organisation from using specific number ranges for the purpose of contacting NHS services, Organisations remain free to use non-geographical number ranges such as 084, providing that patients are not charged more than the equivalent cost of calling a geographical number to do so.

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David Hickson
Posted on 14 Feb 2011 2:20 pm (Report this annotation)

THE REGULATIONS, WHICH MR BURNS INHERITED, BUT HAS REFUSED TO REVIEW, ARE BASED ON A FALSE PREMISE, WHICH HE REPEATS IN THE ANSWER.

ALL 084 NUMBERS CAUSE PATIENTS TO BE CHARGED MORE THAN THE EQUIVALENT COST OF CALLING A GEOGRAPHIC NUMBER.

The call charge paid is set by the telephone company which the patient uses to call the NHS service provider. When this is a 084 number, an additional fee is paid on to the telephone company which supplies the NHS provider. This "Service Charge" (as it is now called by Ofcom) is generally used to subsidise the cost of their telephone service.

Telephone companies pass on the cost to callers and the benefit to the NHS provider that is called. As there is no "Service Charge" with "Geographic Rate" (01/02/03) numbers, the cost of calling a 084 number is naturally greater. This effect is exaggerated by the fact that these calls are excluded from the inclusive packages which are generally used to make "normal" calls at no marginal cost.

The only odd case is with BT landlines, which account for around 25% of non-business telephone calls. For calls to 084 (and other expensive) numbers, BT is prohibited from itself making any money on the call, so the only charge is the amount passed on to the other end (plus a modest allowance for BT costs). For calls to geographic numbers, BT is free to charge whatever it wishes. The BT penalty charge for making calls to geographic numbers outside the terms of a Call Plan is greater than the value of the maximum Service Charge on 084 numbers!


The issue is further confused by the fact that, due to not being able to make any money on them, BT is able to offer 0845 calls as inclusive in packages. The much higher "Service Charge" with 0844 numbers (around 5p per minute rather than 2p per minute), prevents BT from included these in its packages. A few other landline call providers copy BT, however all calls to all 084 numbers from Virgin Media, Talk Talk, all contract and PAYG mobiles and from public payphones are more expensive than equivalent calls to Geographic Rate numbers.

NHS patients are not required to take telephone landline telephone service from BT. Neither are they prohibited from subscribing to an inclusive package from BT, as those who do will pay more to call a 0844 number, as generally used by GPs.


It is fine to say that "patients may not be charged more than the equivalent cost of calling a geographic number". It is not the NHS provider that actually levies the charge for calling them, so the statement could be said to be meaningless. The simple fact is that by choosing a telephone number that has a Service Charge associated with it, NHS providers will ensure that patients do pay more, even though the Service Charge is collected by the patient's telephone company and passed to them through theirs.

The level of the penalty charge imposed by BT on those who make geographic calls outside the terms of their Call Plan should not be considered as a significant factor. The NHS is a universal service, serving minorities such as those who do not have a sufficiently good credit rating to rent a landline, as well as whatever proportion of the population choose to pay penalty charges when calling through BT.

ALL 084 NUMBERS INCLUDE A SERVICE CHARGE - THERE ARE NO 084 NUMBERS THAT ARE NOT MORE EXPENSIVE TO CALL THAN A GEOGRAPHIC RATE NUMBER


The answer to Mr Morris is that only 03 numbers are charged at no greater rate than that for calling geographic numbers. If PCTs are to impose the terms of the contract revisions properly, then all NHS GPs will have ceased using 084 numbers by 31 March 2011. (They could readily do so by migrating to the equivalent 034 number at any point within the term of their contract for telephone service, thereby retaining any technical benefits derived from use of non-geographic numbers.)

NHS bodies were required to do so by 21 December 2010, but that Department of Health Direction has not been enforced.

It appears that "the NHS is being liberated" from the requirement to adhere to the principle of "free at the point of need". I cannot say whether this is deliberate, or simply due to a failure to understand the issues on the part of Mr Burns and his officials.

At this time of change and uncertainty it is vital that we be reassured that the fundamental principles of the NHS will not get lost in the course of re-organising its management structure.

(More on this on my NHSPatient blog).

David Whitaker
Posted on 15 Feb 2011 9:59 pm (Report this annotation)

It is essential that Doctors get tighter regulation in regard to performance. We need to see every patient receiving a customer satisfaction questionnaire to enable
them to give constructive feedback. It is high time Doctors were made accountable to their patients as oppose to them having the upper hand to rush through appointments and indeed pass the book.