The latest from the PHSO is designed to shed some light on the types of complaints the office is now investigating. I was particularly interested to see how much and how quickly the number of cases has grown from 384 in 2011/12 to 2199 in 13/14. Also how money is now frequently part of the settlement and how this is linked to the conclusions the Ombudsman has reached on clinical matters.
I doubt the increase in numbers is linked to compensation payments. True, £130,000 was paid out by the Home Office whose failings had meant a family endured what the Ombudsman called ‘a living nightmare’‘, but sums are generally much lower than this. For instance, a widow was paid only £2000 in recognition of the multiple missed opportunities that a Midlands Foundation Trust hospital had to save her husband’s life – this award obviously involved close consideration of clinical decisions and actions.
Big Money Little Money
I am on the whole in favour of settlements that include money as a form of redress or recognition of loss be it private or public sector. But what is that £2000 about in respect of an avoidable death? Surely it should either be much more or else nothing. What I would be confused about as a complainant is how to chose my best route in NHS-related complaints. Why go to the Ombudsman when the NHS Litigation Authority, now closing about 14,000 cases a year, is making provision of no less than £9.6 billion for present and future claims against it. Why not go to where the big bucks are? Fear of losing? Fear of lawyers?
Advice on the route to choose
Choosing the right route to pursue your action is a current issue in the discussion about whether to have a single portal for all public service complaints. This, it is argued, will simplify life for complainants who may well be bewildered by the variety of different schemes offered by different bits of the public service.
But in offering such directional advice – if the approach is adopted – will the front line doing the triage and routing of the public’s problems be able to discuss difficult questions of compensation – ie using the lawyers whose names pop up when you google “NHS litigation”? Should I go for the big money and don’t worry if it takes over a year and remember you could lose – or go for the free service and get very little? Does it work the other way around – lawyers advising people to go to the Ombudsman? Is there a rough rule of thumb that you go for the litigation route if you need very large sums for say lifetime care for a casualty of the system, but for the Ombudsman if the admissions process was faulty or staff attitudes were poor?
The Need for Quality – follow the French?
We are now seeing a lot of change and choice in the administration of justice, the routes to redress and the role of money in settling complaints. As we look to reform these channels of justice for the citizen, I worry less about process than I do about the people. My major concern is the quality of the people working in these organisations. You come across all manner of folk inside them – solicitors, policemen, ex-bank staff etc. What they have in common is that their first choice was some occupation other than complaint handling.
Do we need the French juge d’instruction system and have colleges like the ENM offering courses in becoming a judge in France – do we need something link that for complaint managers giving them the right qualifications with opportunities for specialisation in matters clinical, tax affairs, planning law? Simplifying the way in for complainants is one thing – but is it not more important to have some measure of the quality and experience of those working inside the system? The invitation to view the types of complaint is admirable – next let us know more about the people who settle them. Sea green incorruptibles, I’m sure, but will their qualifications stand up to scrutiny?