On 29th April two members of the PHSO Pressure Group met up with Rosie Cooper MP at Westminster to discuss the dire state of the present Parliamentary and Health Service Ombudsman. We informed her that the continued failure of PHSO to deal with complaints fairly to provide justice and remedy was causing widespread suffering as people struggled to find closure. When you have lost a loved one unnecessarily or suffered personal injustice you do all you can to prevent that happening to others in the future. The Ombudsman, who should protect the public from the abuse of power and ‘put things right’ deliberately defends public bodies and NHS trusts by denying and manipulating the evidence to find no case to answer. It is time for this to stop.
Below is our follow up letter to Rosie Cooper MP explaining why there needs to be legislative reform of the Parliamentary Ombudsman and a complete overhaul of the current system. We are also calling to be represented at the Cabinet Office inquiry into complaint handling and public Ombudsmen services. Any inquiry into complaint handling should start and end with the complainant.
Dear Rosie Cooper MP,
Thank you for meeting with members of the PHSO Pressure Group recently to discuss the appalling state of the present Parliamentary and Health Service Ombudsman. This body is not fit for purpose and has been corrupted from its original intention, which was to protect the citizen from the abuse of power. Perversely, the Ombudsman serves to protect the public bodies from genuine complaints, resulting in a failure to address key issues and improve service delivery. This was brought to public attention at the Mid Staffordshire Hospital inquiry, where none of the complaints were investigated by the Ombudsman during the period under review, including that presented by Julie Bailey.
The dire state of the Ombudsman service was recognised in 2011 by the Health Select Committee when they called a complete overhaul of PHSO. http://www.parliament.uk/business/committees/committees-a-z/commons-select/health-committee/news/11-06-28-clreoprt-substantive-/ Chair Stephen Dorrell stated that, “The legal and operational framework of the Health Service Ombudsman should be widened so that she can independently review any complaint which is referred to her following rejection by a service provider. The Ombudsman’s current terms of reference prevent her from launching a formal investigation unless she is satisfied in advance that there will be a ‘worthwhile outcome’. We have concluded that this requirement represents a significant obstacle to the successful operation of the complaints system. Patients should be able to seek an independent review of the findings of internal reviews by care providers; the terms of reference under which the Ombudsman works prevent her from properly fulfilling this role. This needs to be changed.”
We are a group of individuals who have all suffered injustice at the hands of the Ombudsman. By coming together and sharing our experiences we can prove that PHSO deliberately deny or manipulate the evidence to avoid carrying out a full investigation. Even those members of the group who have had investigations are not satisfied with the service. The Ombudsman strategically focuses on minor issues and allows major breaches to go unattended, they are inaccurate in their reports altering the facts of the matter and any sanctions or action plans are minimal with little account of the suffering caused. These action plans are then left unmonitored by PHSO as this is not within their remit and for all we know may never be implemented by the public body concerned. The whole process is corrupt and allows public bodies to treat complainants with impunity knowing there is little chance of sanction by the Ombudsman. There is no public confidence in the present Ombudsman service and we are calling for the complete overhaul recommended by never delivered in 2011.
The present Ombudsman Dame Julie Mellor is publically encouraging more people to make complaints as part of an initiative to raise the profile of PHSO, but this action is viewed by members of the Pressure Group as a slap in the face and gross hypocrisy when PHSO consistently fail to investigate the vast majority of complaints which are already presented to them.
‘Older people should be encouraged to complain and should be taken seriously when they do. But my fear is that too many older people are suffering in silence.’
We may be ‘seeing the tip of the iceberg’, she said… (Dame Julie Mellor, Mail Online 6.4.14)
Dame Julie Mellor’s statement in the same article that, “Complaints are a gift to the NHS because that is how improvements are achieved”” is particularly galling as many offer similar ‘gifts’ to the Ombudsman only to have them returned unopened. She certainly does not practice what she preaches and the data will confirm that.
In 2012-13 (latest available figures) PHSO received 4,889 complaints which needed to be reviewed. For 3,914 (80%) no action was taken due to Ombudsman discretion. Only 384 received a full investigation (7.9%) and 230 were upheld (4.7%). For the vast majority making a complaint made no difference.
The Pressure Group are aware that from 2013 a new initiative, ‘More impact for more people’ has been implemented which is designed to provide more investigations and improve feedback to organisations. We do not have confidence that this programme will deliver robust, impartial investigations and believe that it is simply a rebranding exercise where previous ‘assessments’ are relabelled ‘investigations’ in order to meet targets. The reason for our concern is that following a FOI request PHSO revealed that only 30% of their staff currently carry out investigations whereas 54% are in management roles and the average time for completion of an investigation has fallen from 162 days to 39 days this year. PHSO are attempting to do more for less and we cannot see how they can complete quality investigations of complex issues without a proper commitment to staffing and time allocation. Only 42% of these new investigations are being upheld compared to 85% previously. This would suggest that the extremely high threshold of evidence against the public body has simply been shifted to the investigation stage from the assessment stage. This will not satisfy the complainant or put things right.
Continued denial of justice and remedy can lead to severe and on-going emotional trauma. Without justice there can be no closure and many people who have already suffered a painful bereavement, continue to struggle with additional psychology damage due to the failure of PHSO to acknowledge and properly investigate their concerns. The complaint methodology used by PHSO means that complaints as made are never actually addressed. To add insult to injury many Pressure Group members have experienced imperious, arrogant, patronising and dismissive attitudes from caseworkers. There is a high price to pay for society and for the NHS as people become ill due to the stress of a long and fruitless fight for justice.
The Ombudsman does not represent good value for money. At £34m per annum each investigation (2012-13) costs just short of £87,000. The Ombudsman is unaccountable to members of the public. It is impossible to win at judicial review due to the total discretion enjoyed by the Ombudsman, so it is inaccurate to say that the Ombudsman is accountable under the law. The Public Administration Select Committee (PASC) have no real powers to sanction the Ombudsman or hold her to account and they cannot intervene in individual cases.
PASC themselves accept that the Ombudsman service is ‘outdated’ in their recent report ‘Time for a Peoples’ Ombudsman’ and calls for a strengthening of accountability for PHSO by appointing a Minister for Complaints. Bernard Jenkin MP, Chair of PASC stated that,
“We have to make these changes. PHSO is part of our service to our constituents, and its way behind the times. Our voters have a right to complain about public services when mistakes, misunderstandings and maladministration occur. We so often see that people complain not for their own benefit, but to ensure lessons are learned and the same mistakes are not inflicted on others. As we recently reported, the disaster at the Mid-Staffs hospital is a tragic example of what happens when the complaints system does not work.”
The report calls for changes in legislation to be decided by the Cabinet Office following their review of complaint handling and the role of the public sector Ombudsmen.
Guy Horsington, Private Secretary to Oliver Letwin stated in an email to phsothefacts that,
“As you are aware at the end of last year the Minster gave a commitment to explore further some of the issues that the Public Administration Select Committee (PASC) had raised by undertaking two further pieces of work:
- to investigate how public services can make best use of complaints, and ensure complaints are welcomed as a valuable source of information about where improvements are required; and
- to take a wider look at the role and powers of the public sector Ombudsmen.
Both pieces of work are being taken forward by teams based in the Cabinet Office, working with Departments and key stakeholders.”
The decisions made during the Cabinet Office Inquiry will be crucial to developing an effective Ombudsman service which works for the people to protect them from the abuse of power. Complainants are ‘key stakeholders’ in this process and should be represented at the discussions. Complainants have used the system from top to bottom and hold the ‘gold dust’ knowledge apparently valued by those in authority. We are the end users and as tax payers we pick up the bill. The PHSO Pressure Group are therefore requesting a seminar with members of the Cabinet Office and other key stakeholders so that we can contribute to the final decision.
This should be in keeping with Oliver Letwin’s own views as he stated to PASC that,
‘Valuing complaints and supporting people who feel the need to complain should be at the heart of the values which drive public services. The importance of leadership cannot be overstated. Complaints must be valued from the very top of an organisation and seen as something to be welcomed.” (PASC Report – More Complaints Please!)
So far, we have not felt ‘welcomed’ by Mr. Letwin or the Cabinet Office, but hopefully there will be a realisation that we have a great deal to offer each other. The PHSO Pressure Group has first hand knowledge of the problems encountered by complainants and suggestions for ways forward. I have enclosed a copy of our summary report which gives some information in this regard. A full and detailed report will be sent via email.
Our hard work and experience could save a great deal of time for the Cabinet Office committee. Improving services for complainants must start and end with the complainants themselves.
We hope that you and other MPs will see the value of our contribution as experienced and committed members of the public looking to improve complaint handling for those who follow in our footsteps.
PHSO Pressure Group