Following the Kirkup Inquiry into events at Morecambe Bay Maternity Unit where mothers and babies died unnecessarily; James Titcombe and other members of MBIA called for the resignation of the Ombudsman, Dame Julie Mellor.    morecambebayinquiry   James writes on his blog;

“We must also mention that of all the organisations involved in the events at Morecambe Bay, the Health Service Ombudsman have been by far the most incompetent. The Kirkup report refrains from strong direct criticism of the Health Ombudsman, but a careful review of the report by anyone knowing the full history of their involvement reveals some damning truths. Time and time again we feel that the Ombudsman’ Office has shown the wrong culture and has acted in an indefensible way.”

“Today our families wish to lead the call for Dame Julie Mellor to resign so that new leadership can start to change this culture and recover the shattered creditably of this organisation. The many patients who have been forced to experience this tier of the NHS complaints system deserve nothing less.”

Carl Hendrickson
Liza Brady
Simon Davey 
James Titcombe

Before the ink was dry, more damning revelations were put in the public domain by Shaun Lintern from HSJ.   Which can be read in full here:  phsos-capability-questioned-after-morecambe-bay-report

A particularly telling quote from Bernard Jenkin, Chair of PASC stated that:

“There is absolutely no dispute that there is a lack of capacity for immediate, objective, independent and confidential investigative capacity into clinical incidents. The capacity simply does not exist and there is confusion about who is responsible for what.”

“The PHSO was never set up with clinical incident investigations in mind. It is not a system we are going to recommend that patient safety relies on.”

James continues with;

“If it wasn’t for the Kirkup inquiry the decision of the Ombudsman would have been the final word. It would have vindicated the individuals involved and their behaviour as well as reinforce the poor culture.  That is the opposite of what the PHSO is supposed to do and increases the chance the same thing will happen again. It is dangerous and only a few weeks ago the Ombudsman said in a statement that they stood by the quality of their investigations.  The actions of the PHSO are disgraceful. They have revised their statement only after Bill Kirkup intervened. I think Dame Julie should consider her position.”

So is Dame Julie Mellor a fit and proper person to lead PHSO through its modernisation programme?  

Let us look at the evidence. 

A member of the establishment with an entry in Debretts Julie Mellor was awarded a DBE in 2006 and took office as the Ombudsman in January 2012 following a partnership at Price Waterhouse Coopers (2005 – 2011)  wikipedia

“Julie has a reputation for strong leadership, including turning around failing public bodies and supporting staff teams to deliver more effectively and efficiently.”  (From CV to PASC)  publications.parliament 

She was to be a ‘new broom’ brought in to replace Ann Abraham whose tenure had been tainted by events at Mid Staffs  Julie Bailey comments on PHSO and suggestions of collusion with CQC over baby deaths at Morecambe Bay.

So what has Dame Julie achieved in the last three years? 

Starting with ‘listening to customers’ it is not clear what progress was made between January 2012 and April 2013, presumably discussion took place concerning the newstrategic-plan  which was announced in November 2012.  The central thrust of this plan was to provide ‘more impact for more people’ and it was decided that PHSO would investigate up to 10x more cases; a plan launched on 1st April 2013.    more-investigations-for-more-people

By the end of 2013 with news that PHSO were investigating  4 x more cases Dame Julie released this update;

“As well as carrying out more investigations, another of our aims is to make sure that we have a strong voice in the debate about the reform of the complaints system across the public sector. “  end-of-year-message-from-the-ombudsman

Shame that this ‘strong voice’ was not in evidence during a recent Radio 4 interview on 7.2.15  Following the disclosure from PHSO that 40% of NHS investigations were inadequate, Dame Julie was asked by James Naughtie what should be done about poor NHS complaint handling and she replied,

“Ultimately up to the health sector to explore and understand why these investigations are not happening and work together to make sure they can get more consistent investigations in the future.”   

phsothefacts- evidence to PASC 

By February 2014 it was announced that the Ombudsman was now handling  8 x more complaints than the previous year and in May 2014, as we entered a new financial year, there was a promise to virtually double the previous number of complaints investigated which stood at 2,199 for 2013 – 14.

“Our ambition is to investigate around 4,000 cases a year by the end of 2014-15.” 

This was an ambitious target indeed given that the numbers of front-line staff had actually decreased from 131 to 122.  investigative_staff_levels

Latest figures show that Dame Julie is on track to meet her target with  3,085 investigations completed in January 2015.  januarys-performance-statistics  However this push to carry out more investigations has come at a heavy price.  There appears to be a major rift between management and front line staff which was clearly highlighted in the 2013 staff survey  where confidence in senior managers fell from 60% to 19%.

Although required to adopt new ways of working and a significant increase in workload, front line staff were not allocated any specific funds for training as part of the strategic plan.  money_spent_on_training  Instead under the stewardship of Dame Julie £120,000 was spent on board development and leadership coaching for three senior members of staff.  This contract was awarded to Rosemary Jackson Consulting, a previous colleague of Dame Julie and led to a rap over the knuckles from the NAO. health-ombudsman-was-investigated-over-contract-failings

There continue to be questions raised about how contracts are awarded and finances monitored at PHSO, as revealed in these FOI requests.  whatdotheyknow.com/request/silver_bear_ltd  and whatdotheyknow.com/request/phso_individual_directorate

Dame Julie Mellor also set up a new ‘Unitary Board’ on arrival at PHSO.

“The Ombudsman has chosen to appoint executives and non-executives to a unitary, decision-making Board to provide robust governance and assure Parliament of the effectiveness and efficiency of the organisation.  The core purposes of the PHSO Board are to lead, provide stewardship, and to preserve and build our reputation.”  the-board

The board consists of 8 members, four senior staff and four non-executives and is chaired by Dame Julie herself.  board-members  She has ultimate control over the board which scrutinises the work of PHSO.

“The Ombudsman is accountable to Parliament through the Public Administration Select Committee.  To reflect her statutory accountability the Ombudsman has the right to disagree with the Board’s decisions but will do so as a last resort and put her reasons in writing to the Board.”

This whole set up smacks of cronyism and effectively puts Dame Julie in charge of holding herself to account.

When Steve Jobs was asked to go back into Apple to save the company from bankruptcy, one of his first moves was to request that everyone on the board resigned.  He bluntly stated that he could either turn the company around or ‘wet nurse’ the board but didn’t have time to do both.

We need a ‘Steve Jobs’ as our new Ombudsman and if this public body is ever going to radically reform its service delivery then the entire board and most of the senior management, (who let’s face it have stood by mute) must resign along with Dame Julie.

The scrutiny board should be capable of scrutiny and should consist of front line staff, representatives from the union, advocacy group representatives and interested lay people in a 50 – 50 split with senior staff.

It could be argued that Dame Julie has hit her target,

but  has she missed the point?