The move from NHS Direct to 111 – the immediate and long-term costs

Written by John Dale on .


Your article on the demise of NHS Direct and the new 111 service is very well informed.  In fact the NHS logo you have on the article was also well devised as it clearly shows the fragmentation of the NHS that is now occurring, not by this government alone but over the past successive governments starting with Maggie Thatcher’s drive to bring into healthcare the buying in and the contracting out of services. It is all about the privatisation of the NHS.

As NHS Direct moves over to 111, Harmoni will probably take the majority of centres for the new service, now that the other main private players have decided not to bid.

This whole process will cost hundreds of millions of pounds.  But following a Freedom of Information request, the Department of Health admitted they did not know the costs involved (suggesting that I need to contact NHS Direct for their costs and all the other organisations for their costs).

The base costs will be created by Harmoni, the ambulance services involved and any other successful bidders having to establish call centres (not a cheap business if you want true resilience) and of course the decommissioning of NHS Direct centres and making staff redundant.  Your assertion by the government that NHS Direct staff will just move across is just not true as one service in North East has refused to take the NHS Direct nurses.

Add to this the costs you alluded to in your article of three times the number of ambulance deployments in the pilots, as well as the incorrect referrals to A&E and we will have to foot a bill for hundreds of millions of pounds.
All so unnecessary when all that was required was for the NHS Direct service to morph into a new service similar to 111 but with decreasing nurses over a period of time to a level where GP Out of Hours Services, A&E and Ambulance Services could see the benefits and not suffer these huge increases in the wrong use of their resources.

This is a criminal disaster. The government, who blatantly said they wanted to close NHS Direct within weeks of taking office, are now doing this by stealth and they are overseeing the biggest privatisation of the NHS that has ever occurred.

I should tell you why I am interested in these changes: I was the General Manager of the NHS Direct site that covered Avon, Gloucestershire and Wiltshire and prior to that I was project leader for the first NHS Direct pilot in Milton Keynes.  I retired from NHS Direct last year.


John Dale
Milton Keynes