HOLDING THE ANGELS ACCOUNTABLE

7th November 2022

If you happen to be one of the ever growing number of people who gets no treatment or sub-standard treatment from the NHS, and you dare to make a complaint, the chances are you will be wasting your time. After the tick-box internal complaints procedure, in which the management plays on its staff default status of ‘heavenly angel’, you are likely to be catapulted towards the ‘independent’ Parliamentary and Health Service Ombudsman (PHSO). This quango is supposed to provide alternative dispute resolution. The role is in theory meant to protect democracy by allowing people to have their grievances heard.

The word ‘ombudsman’ comes from the old Norse umbodhsmadr, which means some kind of public officer or commissioner and the idea of this system to settle disputes began in eighteenth century Scandinavia. But the concept is not totally new, since in ancient Rome there existed a ‘Tribune of the People’ which had a similar role. 

It is important to note that the ombudsman really means a body overseeing justice for that vague notion of the general public.  So it is not really going to be concerned with justice for the individual.  This is why mere mortals rarely see good outcomes when it comes to dealing with the all-powerful state.  There is a similar concept of public trumps individual in the legal system. Before an alleged crime is considered by the courts it must pass the ‘public interest test’. This test is, predictably, steeped in mystery, but roughly translates to the private interests of the elites. The pretence that some government appointed body can decide what matters to you and me, and that somehow equals justice, is laughable. Especially when remembering Orwell’s wise words all men are equal but some are more equal than others.

I decided to take a look at the performance of the PHSO in regard to its resolution of complaints made by individuals about NHS services over the last few years. It is easy to spot which party invariably turns out to be the ‘more equal’ one. The table below shows statistically how many of complaints received are either partly or fully upheld.  It makes for dismal reading.

               

Year                 Total Complaints       Accepted for Detailed       Fully Upheld         Partly Upheld                                             Received                  Investigation   

2019/20                25220             956  (3.8%)                            112  (0.44%)             528  (2%)

2020/21               19475               471  (2.4%)                           79  (0.4%)          236  (1.2%)

2021/22              27885                  512  (1.8%)                        63  (0.23%)              307   (1.1%)                                   

There is a pattern emerging in the above.  The amount of complaints taken on for detailed investigation appear to be falling and the amount of those fully upheld is also falling. The percentage of total complaints received that are either fully or partly upheld is falling too.   The grand total of complaints received between the years 2019 through to 2022 is 72580.  Only 254 in total were fully upheld (0.35%).

The words extreme bias come to mind. It seems unlikely that the vast majority of people who take the time to refer their case to the ombudsman have no basis for their complaint. Nor that heavenly angels are soaring around all the NHS trusts overseen by Boards of sublime deities. The more likely explanation is that the PHSO is about as independent as a breastfeeding baby.   Failing to uphold complaints merely allows for public bodies to be careless, knowing that their mistakes or negligence will not be discovered or investigated. As it is there is very little personal accountability within the NHS which leaves patients increasingly at risk of abuse.  The NHS has long boasted about its ‘zero tolerance’ approach to members of the public who use its services. So it’s about time the public had zero tolerance for the failings of public sector bodies like the NHS, its staff and their PHSO mates.  For example a disclaimer could be put on complaints correspondence something along the lines of:

(your name) is operating a zero tolerance  policy.  Patients must be able to use the health service without fear of abuse, and feel comfortable to use its complaints procedures without fear of abuse of process. Please treat this person with respect

Should a grievance be serious enough that a patient or their family needs to take it to court, the judge will expect the ombudsman to have been approached first.  This is clearly just a delaying tactic since for most people approaching the ombudsman will be a complete waste of time. There is also between a nine months to a year wait just for the PHSO to decide whether they are going to investigate an issue at all.  At the present time the PHSO is only taking on what it considers to be the most serious cases, which means even less people will be getting any kind of fair resolution.

A quick look at Trustpilot online shows 97 percent of reviews have given the PHSO only one star. There is no option for people to give zero stars but there has been a demand from the people who use Trustpilot for there to be a zero star option.

It is very obvious that the PHSO is not fit for purpose. It’s arbitration a mere coat of whitewash. Far from allowing redress for grievances, it merely adds to those grievances.  Perhaps it is time we washed our hands of the PHSO. One alternative could be to have local patient bodies acting as a type of jury to hear complaints. No system will ever be completely fair, but that would perhaps be an improvement.