Examination of Witnesses (Questions 540
- 558)
THURSDAY 16 FEBRUARY 2006
MR SEAN
WILLIAMS AND
MR DAVID
STEWART
Q540 Mr Amess: I just wondered. Holland
is a tiny little country and we are tiny with a huge population.
America has a state system. I am trying to think how you would
apply those two examples.
Mr Williams: I think it is just
a matter of Government policy. You can take a view that the cost
of these services, which are to provide facilities for patients,
should be recovered through a commercial payment by patients or
not. To be honest, it is not a matter for Ofcom to take a judgment
on that.
Mr Stewart: To answer the question
behind your question: I am not sure what the situation is in Australia.
Q541 Dr Taylor: I would like to go
on a little bit longer because I too was intrigued by the complex
web. I think really we are discovering that the Government ordered
a Rolls Royce with absolutely every extra, when there was no way
all those extras could be used. If you are having the electronic
patient record available, when it is not available (because the
NHS computer system is so far behind schedule), they have made
Trusts buy a system that cannot possibly be used. Is that not
right? As we put it to Patientline last week, their message at
the beginning of the phone call should have said, "Thank
you very much for using this service. It is going to cost you
49p but you are helping the NHS towards its aim of having readily
available electronic patient records at the bedside" and
Patientline agreed. Are we not within our right to condemn the
Department of Health for ordering something as complex as we have
which could not be used?
Mr Williams: I think it is not
for Ofcom to make a judgment about the state of the system. We
could say that it is clear to us that it is a highly specified
system and that it is costly to install and that the consequence
of the costs and the fact that all those costs have to be recovered
through charges is that consumers will pay higher prices.
Q542 Dr Taylor: Right. I would like
just to get a bit of detail. We believe that Chelsea and Westminster
are using some of the capability. Can you give us detail? Are
they using all the capability?
Mr Stewart: We are aware of a
few cases where there are services being used by hospitals rather
than end-users. We did not look in huge detail at this question,
but our understanding is that that relates to issues like gathering
orders for patients' food and other distribution of information
of that kind. I am happy to come back to the Committee with details,
but the other point to make, I guess, is that that is a question
you might put to them.
Q543 Dr Taylor: You would not know
about any other hospitals that are using the service a bit more
fully.
Mr Stewart: It is certainly not
widespread. There are a number of instances where it is going
on, but it is certainly a handful of hospitals.
Mr Williams: Again, I think it
is really for the providers and the Department to answer that.
Q544 Dr Taylor: Would you know if
the capability would be there to order pathological investigations,
x-rays on the system?
Mr Williams: I think you would
need to ask the other providers in the Department.
Q545 Dr Taylor: Right. Could you
see the telecom system in hospitals developing further? In what
way would you think it is possible for it to go further—or
is this, for the moment, the ultimate if it were fully used?
Mr Williams: I think it is something
that the Patient Power Review Group will have to work through
because there is now a considerable investment in bedside communications.
They therefore have an established position and it will be for
the providers and the Department to work out how they can best
be used and what further functionality and developments there
could be.
Q546 Dr Taylor: This review group
has been constituted already, has it?
Mr Williams: That is my understanding.
Mr Stewart: That is right.
Q547 Dr Taylor: By the Department
of Health.
Mr Stewart: That is right, and
I believe it is due to report in June this year.
Dr Taylor: Thank you.
Q548 Chairman: Mr Williams, you said
it is really not for you to comment, and I accept that to some
extent. Your report was quite hard-hitting. I am looking at the
letter you sent to the Secretary of State, in which you said,
"Currently there is no skip facility enabling repeat callers
having to hear the same message each time they call. This further
raises the cost of each call." That is pretty tough stuff.
People reading that will think only one thing: that they are getting
ripped off. In the message that Richard just read out, they do
not have to listen to that or pay to listen to it for more than
one occasion. Would you not say that is right?
Mr Williams: We have remitted
to the Department to consider whether or not a skip facility should
be instituted in order to skip that message.
Q549 Chairman: Technically there
is no problem with that.
Mr Stewart: That is right and
we welcome the commitment on all sides to discuss that issue.
We have pushed in our discussions with them that it be on the
agenda, so we are very pleased that it is.
Chairman: Okay.
Q550 Charlotte Atkins: You have not
really found any wrongdoing, as such. How worthwhile was your
investigation?
Mr Williams: We have our own statutory
duties to look after the interests of citizens and consumers in
the communications markets. It was clearly a matter of public
concern that these call prices should be so high. It was clearly,
therefore, appropriate for us to look into the matter and I think
it was an investigation that was definitely worthwhile. We invested
a certain amount of resource, not untypical of such investigations.
In this particular instance we found that it was not a matter
of the application for competition law but a matter of Government
policy. It might have turned out otherwise. It is often the case
that we open investigations into matters of concern and at the
outset we do not know what the outcome is going to be.
Q551 Charlotte Atkins: Any investigation
that you do will obviously preclude you doing other investigations
if you have limited resources. We have heard from the NHS Confederation
that these units are very popular with patients.
Mr Williams: Yes, indeed. I think
we would endorse the view that they provide valued services to
patients. All I would say is that I do not think we have not done
something else in our investigations programme because we have
done this. Within the discretion we have over what things we should
investigate and should not, I think we are of the view that we
have investigated all those things that we should have done and
this was one of them.
Mr Stewart: You are right, of
course, to observe that we do have limited resources, but, as
Sean said, you do not know when you begin an investigation quite
where that might lead. You do know that there is an issue of consumer
concern and that you have a responsibility to choose from amongst
the issues of consumer concern that you see which issues you need
to explore further. Having crossed that first hurdle—in
other words, having realised that there was a reason to suspect
an issue of competition law in this case—we then investigated
that, but we did so in a way which I think reflects the fact that,
as soon as we were able to reach a conclusion that this was not
one to take further forward, the right thing for us to do was
to package up those findings and hand those issues back to the
Department and back to the providers to see if they could come
up with some data solutions. So we have not carried forward the
investigation past the point when it was apparent that that was
the best way forward, and I think we are satisfied that that means
that the investment of resources has been that which is necessary
effectively to discharge our duties and hopefully make some contribution
to a way forward but not an over-investment. I think the most
telling outcome really is that, as a consequence of our investigation,
there is now a Patient Power Review Group that will be looking
at these issues.
Q552 Charlotte Atkins: The main issue
that comes out of your investigation is the huge cost of incoming
calls to patients. Would you see that as one of the areas which
the NHS should be looking at most acutely?
Mr Stewart: Yes.
Q553 Charlotte Atkins: This tax on
friends and relatives having to pay for this extraordinarily expensive
system.
Mr Williams: It is certainly the
case that the issue about the balance of charges between the different
users is something that the review group should look at.
Q554 Charlotte Atkins: Especially,
presumably, as when people are calling in they do not get the
shock of the overall cost until they get their telephone bill.
Mr Stewart:
Q555 Charlotte Atkins: Whereas the
patient presumably pays upfront for the use of those calls.
Mr Stewart: That is certainly
a common theme running through the complaints that have been made
to Ofcom.
Q556 Charlotte Atkins: And you have
made recommendations to the NHS that something should be done
about the fact that, very often, despite the message—which
presumably people do not listen to very carefully—they are
not aware they are going to be charged so hugely for a call to
a friend or relative in hospital.
Mr Williams: In a sense, our letter
to the Secretary of State is our suggestion that they should look
at exactly those kinds of issues.
Charlotte Atkins: Thank you.
Q557 Chairman: Could I thank you
both very much indeed for coming along and helping us with our
inquiry. I have no doubt that we will be reporting on this in
due course—hopefully it will not too long anyway.
Mr Williams: Thank you very much,
Chairman, for the invitation to come along and help you. We are
very happy to help.
Q558 Chairman: Hopefully your investigation
is going to be helpful in the next few months.
Mr Williams: We hope so too.
| 
