Published in Tribune 16 February 2007
The NHS was founded on the principle that healthcare should be free at the point of use and based on need, not ability to pay. Nye Bevan’s original vision only lasted 4 years before being steadily eroded by a stream of healthcare costs with charging for prescriptions, dental services and spectacles beginning in 1952.
Further costs, including transport and parking, are not prohibitive for the occasional short hospital stay. However, they are particularly burdensome for the elderly and those with chronic conditions who often find themselves catapulted further into poverty by the misfortune of falling ill. In 2000 the Government made a commitment in the NHS Plan to provide a personal bedside television, radio and telephone to all patients funded by the private sector and paid for by users as part of the Patient Power programme. One of the principle grievances my patients have about their stay in hospital is the high cost of using these amenities.
Ofcom investigated Patientline and rival Premier Managed Payphones after relatives of sick patients complained about the rip-off rates people are being charged with costs of £3.50 per day to watch television and incoming call costs of up to 49p per minute – double the cost of a call to Australia. A recorded message, which cannot be skipped, makes incoming calls even more expensive.
The Health Select Committee investigated healthcare charges and concluded that the cause of these very high charges is the Government’s decision to install bedside units which can also be used by health professionals to access electronic patient records and allow electronic prescribing. However, most hospitals have not taken up these services and do not intend to do so. The Government was unwise to insist on such an ostentatious and unnecessary adjunct to the already extravagant National Programme for IT. To insist the cost was picked up by companies is tantamount to passing the costs on to patients.
A simple way to avoid excessive telephone costs is to use the mobile phones which most people now have. However, there has been a blanket ban in most hospitals due to an erroneous fear of ‘interference’ with medical equipment. The Medicines and Healthcare products Regulatory Agency (MHRA), the agency responsible for medical safety, has found that there are no technical reasons why mobile phones should be banned outright from hospitals, only in critical care areas. The vast majority of ward beds do not fall into this category.
However, concession agreements entered into by the companies with NHS Trusts included that mobile phones would continue to be prohibited within hospitals. The Ofcom investigation noted that in some cases there was evidence that the provider had applied pressure to maintain a total ban on the use of mobile phones in hospitals. The only reason to maintain a blanket ban on wards is to protect the monopoly for Patientline and similar companies.
NHS Trusts cannot be expected to share the extra costs of phone calls as their current priorities are to balance budgets in an extremely difficult financial environment. The Department of Health should either provide funds to decrease the cost of phone calls in hospitals or lift the blanket ban on mobile phone use in hospitals. The sick and poor, while confined to hospital, need not suffer the additional misfortune of social isolation.
Suresh Pushpananthan is a specialist registrar neurosurgeon, lecturer in neurosurgery and a member of the Central Council of the Socialist Health Association