As a member of Which?, the consumer association, I remember being surprised to read that they found in April 2011 that 8% of doctors’ surgeries were still using revenue-sharing 0844 phone numbers after they were banned. Nearly two years later, I’m less surprised that Lightwater Surgery are still using theirs, however. I’ve had many dealings with this practice, and in particular with one of the four partners, Dr Adrian Davis.
Retreat from Windlesham
Lightwater Surgery used to have a branch in Windlesham. They closed it down after a sham consultation process, which I will blog about in full at a later date. I saw then one instance of Davis putting his own interests before his patients’. Like many people in Windlesham, I have re-registered with another practice. I didn’t do this because I thought Davis was a bad doctor (I never consulted him), I don’t feel qualified to judge this. I changed practice for the same reasons that I now drink Costa coffee instead of Starbucks.
In December last year I stood as the Labour candidate in the Lightwater West by-election. Although I didn’t win this time, we spoke to hundreds of people on the doorstep and I feel I now have a mandate to campaign on the issues they raised. One of these issues was the additional cost of phoning the surgery for an appointment over and above the cost of a normal local call.
The crux of the issue is clause 29B of the General Medical Services contract, which is a contract between the practice and the local Primary Care Trust (ours is NHS Surrey).
29B.1. Where the Contractor is party to an existing contract or other arrangement for telephone services under which persons making relevant calls to the practice call a number which is not a geographical number, the Contractor must comply with sub-clause 29B.2.
29B.2. The Contractor shall—
29B.2.1. before 1st April 2011, review the arrangement and consider whether, having regard to the arrangement as a whole, persons pay more to make relevant calls than they would to make equivalent calls to a geographical number, and
29B.2.2. if the Contractor so considers, take all reasonable steps, including in particular considering the matters specified in sub-clause 29B.3, to ensure that, having regard to the arrangement as a whole, persons will not pay more to make relevant calls than they would to make equivalent calls to a geographical number.
29B.3. The matters referred to in clause 29B.2.2. are—
29B.3.1. varying the terms of the contract or arrangement,
29B.3.2. renegotiating the contract or arrangement, and
29B.3.3. terminating the contract or arrangement.
The next question is: do calls to 0844 numbers cost more to call than a local number having regard to the arrangement as a whole? Well clearly they do. Two thirds of BT customers have inclusive call packages so it costs them more to call one of the 8% of surgeries with 0844 numbers. There are set-up charges for phoning 0844 numbers that don’t apply to geographical numbers. Also, half of all phone calls in the UK are made using mobiles and these often cost much more to phone 0844 numbers.
So, it is clear that having regard to the arrangement as a whole these numbers cost more so GP practices shouldn’t be using them. All we need now is for the contract to be enforced.
Who Can Enforce the Contract on Our Behalf?
PCTs like NHS Surrey are branches of the Department of Health and exist to ensure that the public is properly served by GP surgeries which are independent businesses run to make a profit for their owners usually. NHS Surrey didn’t seem to know about clause 29B until I informed them and they are trying to ignore its significance now. PCTs will be abolished in a few months so it would be embarrassing and a lot of effort for them to enforce the contract now.
I addressed Windlesham Parish Council to ask them to contact NHS Surrey and request that the contract be enforced. Here is how it was minuted:
A further question had been raised by a Windlesham resident about the 0844 telephone number being provided by the Lightwater doctor’s surgery for incoming calls and requested that the Parish Council write to NHS Surrey to ask them to change this to a local number.
Members had said that they would investigate this matter and take any necessary action. At the full Council meeting, the Clerk had read out a letter from the Lightwater Surgery in which it had stated that the Practice complies with the NHS regulations in respect of using an 0844 number but it is likely that the Surgery will move to a local 01276 number next year. The Clerk had been asked by Members to get official confirmation from NHS Surrey and report back at a future meeting.
The letter referred to is here: Davis letter to WPC. I obtained this using a Freedom of Information request.
It seems Davis is unaware of clause 29B too. His letter is misleading to the Council, presumably unintentionally. There has never been any technological barrier to having multiple phone lines on an 01276 number. His contract requires him to cancel the phone package with the provider, by April 2011.
Follow the Money
As I told the Council, Davis and the PCT seem to want to run down the clock until the PCT is abolished and hope they can leave the 0844 number in place. Surgeries gain financially by having an 0844 number because their overall phone package is cheaper, including line rental and outgoing calls. Patients lose out because their phone calls cost more. The net result is money going from the patients to the doctors. That is why it’s banned.
I wrote an article about this for a local magazine which was shown to Davis for comment before publication. He threatened to sue the magazine and call in the Press Complaints Commission. Understandably it got spiked. This is how Davis works. I am lucky enough to be able to withstand his threats so I published the article here. This is what he didn’t want you to read.
There is another surgery in Surrey Heath which still uses a 0844 number, Park Road Surgery, Camberley. One of the partners there is Dr Andy Brooks, the Chief Officer of the Surrey Heath Clinical Commissioning Group. I tried to ask him about this at a meeting for the CCG but he refused to answer because he was there in his capacity as Chief Officer not practice partner. I left a note requesting a statement from him about it. Answer came there none.
Join the Campaign
If you would like to help force Lightwater Surgery, or Park Road Surgery, to obey their legal contracts, please write to Michael Gove MP with copies of your phone bills showing calls to the surgery and other, geographical, calls to compare the costs. Please do this soon to stop this unjustifiable rip-off of NHS patients.
If reading this makes you feel like changing doctors, just pop into another doctors’ practice and ask to re-register. I did this at Bagshot and filled in a form there and then without remembering to bring my NHS number card or anything else. If you have to drive to Lightwater Surgery, you might as well drive to Bagshot where the parking is better too.
Doctors’ practices get money for each person on their register. You are the customer. The customer is always right.
I should point out that many others have been involved in this campaign and I’ll be very happy to name and credit them here if they contact me with their permission to do so.
Post Post Script
Davis’s letter above admits that they will have to change their number, belatedly, this year. However, I hear it could be very soon indeed. Well done to everyone involved. Victory in sight!