By Alex Stevenson
There are fears GPs could face a funding shortfall after the government's decision to abandon premium rate phone numbers for NHS organisations.
Ministers are committing to ensuring patients do not have to pay more than the cost of a local call - amid fears it will not be able to live up to the pledge.
Health minister Mike O'Brien announced the move after nearly 3,000 members of the public made their feelings known in a consultation earlier this year.
084 numbers were originally introduced to stop patients being worried by hearing an engaged tone when they tried to get through to GP practices or other NHS numbers.
While they were instead put through to a queuing system the numbers cost more than local rates, causing the hostile response.
"It is clear from the feedback we have received that patients support the banning of any number or tariff which is more expensive to call," Mr O'Brien said.
"For people on low incomes, and for those who need to contact their local doctor or hospital regularly, these costs can soon build up. We want to reassure the public that when they contact their local GP or hospital, the cost of their call will be no more expensive than if they had dialled a normal landline number."
This commitment, campaigner David Hickson claimed to politics.co.uk, is simply unrealistic.
"That's what they think they can say - they will shortly find out that is wrong. Or alternatively the minister will have to go back on his assurance," he said.
084 premium rate numbers charge a transmission fee significantly higher than normal calls, payable by the caller's telephone company to the telephone company managing the organisation with the 084 number.
Mr Hickson has conducted detailed research to show the extent of GPs within the NHS which rely on 084 numbers - an average of around ten per cent, although five have over 20 per cent.
After offsetting any charges, revenues from the premium rate numbers are shared between the company and the number-holder. GPs typically use the cash to finance the services they offer.
"If you are going to disallow a situation whereby patients and others pay more than the cost of a local call, you're dreaming if you think revenue-sharing can carry on," Mr Hickson explained.
"In many cases these are on quite long contracts. The GPs have signed up to these confident the money will continue to flow in from the rev-sharing numbers. If they find that in order to comply they're going to have to give up their revenue-sharing numbers. they're going to be in trouble.
"They're not expecting that. They've not budgeted for that. They've no idea in many cases how expensive it's going to be."
The government insists it will be able to implement the change. It has made clear it does not intend to ban NHS organisations from using 084 numbers, but only ensure patients do not pay more than their local rate.
In a statement the Department of Health said: "The ban on the use of numbers charging patients a premium rate to call NHS services will allow a marketplace to evolve where 084 numbers compete alongside 01, 02 and 03 numbers, but where patients will pay no more than the cost of a local call.
"The ban means that GPs and other NHS organisations remain free to use 084 numbers, providing patients are not charged more than a local rate number."
Wolverhampton South West MP Rob Marris welcomed the change, which he has been campaigning for for around three years. It follows the banning of premium rates for 0870, 0871 and 09 numbers in April 2005.
"The government has been using tens of thousands of these numbers. I regard that as completely unacceptable for public services," he told politics.co.uk.
Mr Marris hopes a straightforward switch from 084 numbers to reserved 034 numbers can take place, as happened with the transition from 0870 numbers.
"My understanding is that for the vast majority of the NHS, including GPs, the switch to non-revenue-sharing numbers can be effected very quickly without significant cost," he added.
"Therefore I do not want to see months of further delay in making a change which should have been made years ago."
Today is significant, Mr Hickson said, because "this is the first time anyone has said in historical terms no one should have to pay premium rates for public services for telephones".
Even if many of the feared difficulties do not arise, however, ending the usage of premium rate numbers for the NHS will only be the first step towards ridding the public sector of them. Mr Hickson pointed out many other government departments rely on them, opening up new battlegrounds on which to campaign.