An allegory for our times: 

Some parents, lets us call them Mr and Mrs Smith, take their parental responsibility very seriously and decide to hire a professional Nanny to ensure that their children obey the rules and go to bed on time.  They pay top money to ensure they get a Nanny who can deliver.  When the Nanny arrives at the house the parents go through the rules, telling the Nanny what the children can and can’t do.  The Nanny is delighted that these boundaries have been so well considered and documented and looks forward to a trouble free stay with the family.  Then the parents tell the Nanny that although the children are required to follow all the rules and go to bed on time the Nanny can not instruct them to do so; she can only advise. The Nanny has no power to enforce any of the rules and cannot go into the children’s rooms to check that they have followed any of her suggestions.  However, the parents make it clear that they expect the Nanny to deliver good compliance to the rules and the Nanny will have to submit a report detailing how many suggestions she has given, how long it took the children to respond and how many were followed through.

Then with a smile, they call the children in.  They introduce the new Nanny and tell the children that she will ensure that the rules are followed at all times.  Bending down to make sure the children have full understanding, they tell them that they are only required to ‘have regard’ to what the Nanny says.  They are not, at any time, under any obligation to carry out the Nanny’s requests.  Then the parents sweep out for the evening safe in the knowledge that all will be well.

Having no power to give direct instruction or enforce good behaviour,  yet under an obligation to fulfil her contract, the Nanny is forced to negotiate with the children a bed time which is acceptable to them so that she can report back to the parents that they went to bed on time.  Equally, all the stated rules provided by the parents become negotiable with the Nanny turning a blind eye as often as possible so as not to report back breaches in behaviour.  Where there is an obvious flouting of the rules the Nanny records this as a ‘shortcoming’  and not a deliberate breach giving the children the benefit of the doubt due to their age or disposition.

In effect, the children know they are not being monitored at all.  They act however they like telling the Nanny a tall story if they get caught out.  The Nanny willingly accepts their version of events in order to keep her record clean.  The parents can report to all their friends that their children are supervised by a top Nanny under strict guidelines.  Mr and Mrs Smith congratulate themselves on a job well done and use their weekly scrutiny of the Nanny’s report as evidence that there is robust accountability of their children’s actions and therefore nothing to worry about.

This sounds like a crazy model to apply if you want X to monitor the behaviour of Y with any measure of authority or control.  Yet this is the model to be applied to the new Public Service Ombudsman.  

14 (8) designated authority must have regard to any recommendations contained in a statement under subsection (1)(c) in respect of the authority (but is not required by virtue of anything in this Act to give effect to any such recommendations). (p16)  draft_public_service_ombudsman_bill_2016

Without the authority to ensure any recommendations are followed, the Ombudsman must negotiate an acceptable agreement with the public body in order to report back to parliament that they have high compliance ratings.  Then the government can state with confidence that the public are well protected by an effective independent and impartial Ombudsman so everyone can sleep well in their beds.

What could possibly go wrong?

Well, new ‘Nanny’ Rob Behrens due to take over from Dame Julie Mellor on April 1st has spotted a potential weakness in the plan and made his views on compliance clear in his pre-appointment interview with PACAC.

“…if you are going to make a recommendation in a report you have to make sure that is addressed and if it’s not addressed you want to know why and you want to give the oxygen of publicity to the fact that it hasn’t been

PACAC pre-appointment meeting (10.28)

The oxygen of publicity was probably more effective when rating University compliance in his role in the Office of Indepent Adjudicator (OIA) for higher education.  Students can choose which University to apply to, but on the whole users of the NHS and other public services have no choice but to use the services provided.  In further talk of ‘leading from the front’ he gives clear indication that naming and shaming would be the order of the day for any authority with the temerity to ignore the Ombudsman.  He obviously hasn’t read the small print. Despite threatening to name and shame government ministers who ultimately control the delivery of their departments, he still got the job.  I’m sure they will soon put him straight on who is really in control.

Meanwhile, Keith Conradi, the new Chief Investigator at the Healthcare Safety Investigation Branch (HSIB) has also realised that the odds are stacked against him.  Reported in the Health Service Journal on 5th January 2017, Mr Conradi makes a plea for further powers regarding compliance.

  • Health Service Journal 5th January 2017 
  • HSIB chief investigator says organisation needs statutory independence and powers
  • Keith Conradi reveals plan for intelligence unit to highlight issues for investigation
  • Healthcare Safety Investigation Branch could consider multiple incidents in several locations for one investigation
  • Emphasised “safe space” protection was not immunity for serious wrongdoing

The head of the NHS’s new patient safety watchdog has said it needs statutory independence and extra powers to demand that NHS organisations respond to its warnings.

Keith Conradi, chief investigator at the Healthcare Safety Investigation Branch, told HSJ he was lobbying the health secretary for additional powers, including evidence gathering and requiring trusts, regulators and the Department of Health to respond to its safety recommendations.

Mr Conradi, who was head of the Air Accident Investigations Branch for 14 years, said: “I am lobbying for legislation that does require a response [to safety recommendations]. This is what happens in aviation – there is a requirement to respond. That doesn’t say you have to comply but if you decide not to you have to give a reason. If you are intending to accept the recommendation you have to say how you intend to work your way through it.

“I believe that without having those powers in the background, people will take these [recommendations] away and no difference will be made.”

Without those powers  – no difference will be made.

So why is it that Mr and Mrs Smith can’t see that a Nanny with no powers of coercion will fail to control unruly children?  Everyone else can see it, including the children.  Why hire the best Nanny in the field, pay them a six figure salary from public funds then deny them the powers to be effective.  What could possibly be the point of that?