The 0845 number debacle.

One of the great successes of Za Nu Labour’s running of the National Health Service was its use of a system of government that used to be common in Eastern Europe. It was called communism whereby everything was dictated from the central offices of the all wise Party under the guidance of the supreme leaders the Laurel and Hardy of modern healthcare Mr Blair and Mr Brown all for the benefit of the people.

The former ex great leader was famously handbagged by a patient who asked him about his health reforms and to explain why she could not get an appointment under all of his improved access targets. Under Comrade Blair’s preferred model such dissent would have resulted in a quick trip up to a gulag for a period of re-education but under what remains of democracy and public scrutiny in this country his lack of knowledge of matters healthcare was on view for and enjoyed by all.

Following along from his enlightened leadership one of the reforms that the new General Medical Services (nGMS) contract ushered in was the need for a single phone call to enable instant access to your GP or more importantly the out of hours service.

Now in theory this would seem at first to be a good idea. You dial one number and can access your, or a, GP 24 hours a day. True market reform for the good comrade patients’ benefit no evil private sector backhanders here. The non paying customer, we call them patients, gets instant self centred medical gratification a bit like certain politicians and their DVDs but then these cost the taxpayer via the MPs expenses.

Prior to this at ND Central we had a single telephone number which when the working day used to finish at 18.00hrs would switch on to an answer machine which gave the contact details for the out of hours or deputizing service that we as GPs paid for to cover our patients after hours to allow us some sleep.

Now the blessed Tony, a true socialist conservative Anglican Catholic, who believed in comprehensive education for all, bar his own children, in the NHS for all, except when he was ill, and who can now do no wrong, he only has to confess not to be responsible, thought let us supply the out of hours care using the private sector for private medicine good, socialised medicine bad and costs rose astronomically for a worse service.

Back to the phone call side of things this two phone call issue was clearly a huge problem to the likes of Tony and Gordon for they were all wise and so the nGMS contract gave prizes for a single call. Being true socialists and wishing to share this great idea of a single call for all ills an 0845 HEALTH (we purposely omit the W at the start of ealth) was suggested and PCTs, government sponsored enforcers “encouraged” GPs to sign up for deals with 0845 numbers. If you don’t you won’t get paid for you will fail to provide a Sovietly acceptable one phone call to tick the “quality” box.

Remember dear readers that PCTs are staffed by those who at best were in your remedial class in any Northernshire comprehensive school a few of whom could read and count. So GPs were “encouraged” using the “free” market model so loved by Tony and Gordon to sign up to Party deals for GPs were given the same true NHS Choice offered to patients via the market which is none.

Move forward and although the Party dictated and approved idea is good a few people noticed that some pigs are more equal than others (Hewitt - excuse us we just sneezed) when it comes to profiting from telecommunications and a few dissenters in need of political re-education noticed that if they ring on a mobile, which after all is only the preserve of the politician and drug dealers, not a pensioner on a limited income, they were disadvantaged. For the 0845 number is not a local charge number it has many different costs depending where you ring from to access it.

So the Party does a massive U-turn on its equitable access policy and tells GPs you can’t have a 0845 number. You can look here for who hasn’t by PCT and compare them with the sink estate PCTs, sorry comrades, spearhead PCTs and see which PCTs have the best in remedial NHS management. This does seem to be a recurring association dear reader that we have noticed by chance during our researches over the past few years.

Now this is the history what are the practicalities to current GPs given that the true socialists Brown and Blair have peed over the NHS and retired to pastures newer, richer and more idle lifestyles that befit all true socialist Party members?

Well the first is that local Soviets are asking us (= demanding) that we GPs get them out of the brown stuff they insisting on putting us in. We now have to change our numbers or else.

This is excellent for the remedials who agreed the contracts but could not read all those big words in them for all they saw were the flashy teeth of the nice salesperson who flattered them and told them what a good deal this until they signed. When the X was one the bottom of the contract in the managers' best crayon the salesperson said "Thank you for signing and so long sucker” and disappeared in a puff of fairy dust never to be seen again.

And those signing such “deals” are the “world-class” commissioners of old trumpeted as such by the Laurel and Hardy of UK plc healthcare now joined by their new bum chums the Charlie Chaplain of healthcare (Lansley) with the help of hop(e)along Clegg.

So the get out clauses for GPs for contracts enforced on us are now as follows:

1) you can revert to your original single line with an answer machine and lose money for not providing a single point of access. Not a problem to us comrade GP we merely follow orders.

2) you can keep your current 0845 number and we will shaft you for doing so. Not a problem to us comrade GP we merely follow orders.

3) you can ask your current 0845 provider to change to another number that will be dialled when the patient dials 0845. Your current 0845 number then provides a call switching “service” which would involve no cost to the PCT morons who thought of this but scratch deeper and you find that once the call is switched from the 0845 number to your out of hours provider you the GP then pays for the patients call. So a patient's call to a surgery costs the patient but the patient's diverted call to out of hours costs the GP. Another great buy one pay for two value for NHS money idea like PFI. Not a problem to us comrade GP we merely follow orders.

4) you could consider doing the same using another provider and get stung in the same way. Not a problem to us comrade GP we merely follow orders.

5) you can pay a fortune for reprogramming your current phone system to divert calls which once again you have to pay dearly. Not a problem to us comrade GP we merely follow orders.

Best still we hear that some local Soviets are insisting that practices write to all their patients to tell them of the Practice new number change policy which would mean a net loss to correct "their" folly.

It is said that in any society there are rights and responsibilities. Increasingly in the NHS the rights of the politicians are that they have no responsibility and the same is so in NHS management. Until these groups acquire some responsibilities GPs and all involved in healthcare will continue to spend time not treating patients but mopping up political and management collateral damage inflicted on them via continuous "reform" and incompetence.

In the same way that these “world-class” commissioning managers have screwed up the Darzhole centres they have also screwed up the 0845 numbers and once again someone other than them will be paying for it.

Now if you were a betting man who would you back to win in Mr Lansley’s, new NHS market? The NHS’s commissioning managers, the patient or the private sector? Go on have a flutter it has to be a dead cert . . .

Praise be to the Party for allowing the least able in our society to bugger up the NHS time and time again. Bloody comedians only they ain’t that funny when you're the ones sorting out their fine messes once again.