You have to worry when the Ombudsman asks the citizens to explain the ‘point of complaining’ but let me set that in context. PHSO have actually asked film students to put together a 45-second film on the title ‘What’s the point of complaining’ and enter a competition to win a cash prize of £400. If anyone could educate the Ombudsman on this subject with a single 45-second film then it would be worth a lot more than £400.  film-competition-whats-point-complaining Let’s see what the Parliamentary and Health Service Ombudsman (PHSO) have to say about their complaint handling service.

We were set up by Parliament to provide an independent complaint handling service for complaints that have not been resolved by the NHS in England and UK government departments.

We share findings from our casework to help Parliament scrutinise public service providers. We also share our findings more widely to help drive improvements in public services and complaint handling.  about-us/who-we-are

So according to PHSO they provide an ‘independent’ complaint handling service for citizens with complaints about government bodies and the NHS. In fact, they are the only body who handle individual complaints apart from the occasional investigation by NHS England and the even more occasional public inquiry.  They give resolution to citizens caught in a dispute with public bodies and they also ‘drive improvements’ by sharing the findings of their investigation reports and so preventing further harm. So far so good.

On Monday 26th March 2018 Southern Health Foundation Trust pleaded guilty to criminal charges of negligence and harm caused by a failure of its health and safety management systems.  The trust accepted;

“It is a matter of significant regret that between April 2011 and spring 2016 the Trust did not adequately address the quality and safety, governance and assurance challenges it faced in a timely and robust way.” (28)

The court judgement concluded;

From the perspective of the Court, it is not merely a matter of regret but of very grave
concern that the endemic failures disclosed by the investigations following the
avoidable deaths of TJ and Connor were allowed to arise at all and to persist for so
long. That concern is heightened by the failure to have learned any lessons or to have
addressed the systemic failures adequately or at all between April 2012 and July 2013,
for which there appears to be no excuse at all. (29)

Southern Health Foundation Trust suffered from ‘endemic failures’ which caused actual bodily harm to patients in their care, for at least five years, for which no lessons were learned. So how come the Ombudsman (PHSO) didn’t detect and share these endemic failures with parliament to drive reform given the length of time it continued and the large number of people affected. (722 unexpected deaths over 4 years with only 272 properly investigated)

During the time of endemic failures at Southern Health (2011 – 2015) the Ombudsman received 164 complaints from members of the public. These complaints should have raised concerns but PHSO investigated only 16 of these cases, (9.7% of the total submitted) and upheld to some degree just 5 (3.0%)  This low uphold rate goes some way to explaining why issues at the Trust persisted for so long, causing avoidable death and suffering to many and why ‘no lessons were learned’.

In February 2018 another scandal broke this time concerning Liverpool Community Health NHS Trust (LCH)  An investigation by NHS Improvement found that between 2010 and 2014;

Patients suffered “significant harm” because of multiple serious failings by a “dysfunctional” NHS trust…  Liverpool Community Health NHS trust (LCH) provided poor, unsafe and ineffective care to patients, including inmates at HMP Liverpool, the scathing report concluded.

“Patients put their faith in the NHS, and they should be able to trust that dangerous and dysfunctional services will be dealt with immediately. Sadly that has not been the case here and it took the help of a local MP to sound the alarm, and many years for the full facts to emerge,” said Jeremy Taylor, chief executive of National Voices, a coalition of more than 150 health and social care charities.

Dangerous and dysfunctional services delivered by LCH without redress for at least a four year period. Surely some of the people who suffered would have made a complaint to PHSO. The table below shows that from 2010 – 2014/15 the public made 43 complaints to the Ombudsman. These figures demonstrate a steep rise from 2012 onwards yet the Ombudsman investigated just 5 cases (11.6%) and upheld none (0%) in this time period giving LCH an unblemished record. Since 2010 the Ombudsman has partially upheld only 1 complaint against LCH giving a green light for dysfunctional services. 

In these two instances, the Ombudsman (PHSO) failed to provide redress for the vast majority of those who made a complaint.   (97%+ with no uphold)  But more alarmingly it failed to spot and rectify serious, dysfunctional bodies who were able to deliver harmful services to the public for prolonged periods without redress. In short, the Ombudsman failed in both the specific aims of its given remit.  Which begs the question,

‘What is the point of complaining?’

and at a cost of £37m per annum,

what is the point of PHSO?

complainant trapped in a glass dome while regulators walk round the outside using up time to prevent legal action.