Ask the average man on the street about the NHS complaint system and they will have something to say, albeit derogatory. Ask them about the Health Service Ombudsman and most will say, ‘Who?’ The Parliamentary and Health Service Ombudsman, (PHSO) to give them their full title, is the Cinderella of the regulatory system. They sit at the apex of the complaint process and are the final arbitrators, although keen to inform you that they are not ‘regulators’.
Since the demise of the Healthcare Commission in 2009 the Parliamentary and Health Service Ombudsman has provided the second and final tier in the NHS complaint process. If the NHS trust has given you the run-around, denied evidence and manipulated the facts, then once you finish with their complaint process you can go to the Ombudsman free of charge. On their website you will see that:
“Our role is to investigate complaints that individuals have been treated unfairly or have received poor service from government departments and other public organisations and the NHS in England.”
They work to “put things right”
Given that the Ombudsman is both ‘independent’ and ‘impartial’ it may be with a sigh of relief that you collect together once again all your evidence and submit a logical and eloquent account of your complaint. Finally, someone will take action and ‘put things right’. But when the Ombudsman arrives on her white charger, who’s side will she be on?
The present Ombudsman is Dame Julie Mellor who was appointed in 2012 as the new face of the Parliamentary and Health Service Ombudsman. Their own research confirms that 64% of the public believe that making a complaint will make no difference. Why the lack of confidence in a free, impartial and independent complaint body? Partly this is due to their low public profile. 52% of people questioned for a Which? survey released in March this year, did not even know that the Parliamentary and Health Service Ombudsman existed. Of those who did complain half (49%) felt their complaint was ignored. 49% is a surprisingly low figure, as they actually ignore a lot more cases than that every year. Let’s look at the figures.
In 2012 -13 of the 4,889 complaints submitted to the Ombudsman 3,914 (80%) were dismissed with no action taken. Only 384 (7.9%) were given the formal investigation headlined on the Ombudsman’s website. For 80% making a complaint had made no difference, as their complaint was ‘resolved’ without any direct action and no investigation.
For 80% of complainants, nothing was ‘put right’.
The Health Service Ombudsman did not uncover the scandal at Mid Staffs, turning away Julie Bailey’s complaint without an investigation. Neither did it work quickly to investigate the poor practice at Morecambe Bay maternity unit where James Titcombe’s baby son died unnecessarily. They turned his complaint down as well.
You can of course ask for a review if you are not satisfied with the handling of your complaint. Reviews are carried out internally by the ‘review team’ who rarely find fault with the original assessment process. When you are allowed to mark your own homework like this it is possible for the Parliamentary and Health Service Ombudsman to state that they only have to correct their decisions 0.4% of the time. (Annual Resource Account) This gives them an amazing 99.6% accuracy rate.
What of the lucky few who had investigations and 85% were at least partially upheld. Were they satisfied that complaining had ‘made a difference’. Sadly no. A common complaint is that the Parliamentary and Health Service Ombudsman ignored major issues and focused instead on minor breaches, gave excuses for faults in service delivery and found all kinds of poor practice ‘reasonable’. When they did agree that maladministration occurred they offered derisory compensation or low level recommendations for improvements, which were not followed up to ensure implementation. As an example a young man incapacitated by an NHS mistake; now paralysed and needing round the clock care was offered £3,500 by the Parliamentary and Health Service Ombudsman on upholding his case. Another man in his mid-thirties suffered a nervous breakdown following maladministration by Ofqual which prevented him taking up employment with a large company. PHSO upheld his case and suggested a payment of £750 although he is still out of work. Big deal.
PHSO regularly let NHS trusts and public bodies off the hook with no sanctions whatsoever. You may be surprised to learn that when the Ombudsman lifts her mighty sword to smite the enemy, it is the complainant who gets clobbered.
Presently the Parliamentary and Health Service Ombudsman is totally unaccountable. Technically they are accountable by judicial review for their decisions but in the entire history of the Ombudsman only one case has ever been found against them and most are dismissed before they even come to court. They are accountable to the Parliamentary Administration Select Committee chaired by Bernard Jenkin for their service delivery, but the committee has no powers to review individual cases or give binding recommendations.
The Health Service Ombudsman, supposedly designed to protect the citizens from the abuse of power is the worst offender of abuse. Arrogant and indifferent they treat complainants with impunity knowing they are safe behind the law.
A group of individual complainants have joined together to create the PHSO Pressure Group. We believe that all complainants should have an impartial investigation, as promised on the Ombudsman website. We are looking at making changes in legislation so that the public can hold the Ombudsman to account for poor service delivery. You can visit our website here: phsothefacts and find out more by reading this excellent account from Scriptonite.
The Health Service Ombudsman is unfortunately not our knight in shining armour. In fact the Ombudsman is no more than a dustbin for persistent complaints. Don’t waste a stamp – complaining to this body really does
‘make no difference’.