You can forget all that ‘listening and learning’ stuff when it comes to the NHS. History shows that successive governments have deliberately diminished the voice of the patient when dealing with complaints about healthcare.
Let’s start with this reference to the ‘complaint monitoring panels’ (1999) who, according to this extract from the Mid Staffs review, would have been more able to prevent the national scandal from harming so many before the ‘Cure the NHS’ campaign brought it to light. Unfortunately, these panels were abolished in 2004 so unable to detect the horror of neglect which featured in the report from 2005 to 2009. Mid-Staffordshire-Trust-inquiry-how-the-care-scandal-unfolded.html
Here are the key points:
The system worked extremely well.
The panels reviewed every complaint
They reviewed action points from previous meetings to ensure change had taken place
When the Healthcare Commission took over in 2004 they were ‘overwhelmed by complaints and there was no follow up. This body was in turn abolished in 2009 with the bulk of the monitoring role going to CQC who have no powers to investigate individual complaints.
Community Health Councils acted as effective, local complaint monitoring panels from 1974 to 2003. They were abolished by Tony Blair who declared ‘war’ on complainants who were bringing the NHS into disrepute.
Blair used the ‘full weight of the Government’s publicity machine’ to help hospitals rebut complaints whilst at the same time abolishing those bodies which effectively spoke out on the patient’s behalf. Rhion Jones gives a warning as the Welsh government consider abolishing their Community Health Councils. He accurately records the shambles which followed, leaving patients in England with no effective means of representation.
Insofar as the replacement body will cover both the NHS and social care, the change is very welcome, but if the ‘abolition of CHCs’ sounds familiar, it is because fifteen years ago, the English tried the same trick. Managers were fed up with those they saw as local interfering busybodies inspecting NHS facilities (unannounced – what affrontery!) and generally being unco-operative when it came to service changes, that the then Labour Government was persuaded to wind them up. What followed was a case study in how not to manage change. First they invented Public & Patient Forums, which were not Forums but Committees, only for them to be castrated in infancy and replaced by something called Local Involvement Networks – called LiNKS – which were Forums – but actually couldn’t be called that!
LiNKS was hobbled from the outset. Ministers decided not to specify how these new creations would work. Each one therefore spent about eighteen months trying to work it out, and some never managed it. In no time, they were gone – to be replaced by Healthwatch, which seven years later, are still just about finding their feet. For about five years, the NHS was not subject to effective public/patient (as opposed to Council) scrutiny. It is this mistake that the Welsh Government risk repeating. wales-to-abolish-community-health-councils-can-it-avoid-the-mistakes-made-in-england
Essentially, more democratic bodies with actual powers to deliver improvements are replaced by government quangos who have only ‘advisory’ powers. Then they wonder why nothing ever improves in the NHS and hold a series of Health Safety conferences to get to the bottom of it. Kelvin Hopkins MP and member of PACAC knows exactly why the staff at PHSO are having difficulty improving first-tier complaint handling and took the time to inform Rob Behrens and Amanda Campbell at the last scrutiny meeting. He believes that ‘private providers’ are behind the move, making it more difficult for anyone to hold them to account. Just as well he is standing down as an MP; dropping truth bombs like that can cause repercussions.
So there we have it. A simple formula. Take away all the bodies who have teeth and represent the people. Replace them with quangos who are starved of resources and powers. Then any harm caused by cuts to the NHS, inadequate staffing levels or lack of suitable drugs or resources can all be swept under the carpet. Rob Behrens, Ombudsman accepts that he has the role of ‘igniting’ the momentum across the NHS to improve complaint handling. His apparent lack of enthusiasm for the task is no doubt due to his awareness that as he works to ignite, the government work to extinguish and so the wheels turn.
I have actually been threatened with having my life saving treatment stopped for speaking up about patient safety as a patient.
Rob Behrens couldn’t ignite a BBQ!
LikeLiked by 1 person
Well put EJ. Indeed Blair and his side kicks were the worst evil inflicted on this country. They spun everything.
I honestly don’t know what their motivations were. But PR seems to have been an end in itself.
Britain as a whole is appalling for management. The military approach has extended to civilian areas including NHS. Hierarchical, bullying, ineffective and generally toxic. Because there is no profit motive the wastage is staggering. Cover ups are endemic and keep the house of cards standing.
As a patient you expect simply to be treated for your condition. What you get is anything but. Why would that be? The level of fraud in the NHS is up, down, sideways, inside and out, legal and not. And fraud is what it is. A doctor treating you messes you about or is negligent. That’s fraud. They are paid to do a job, they aren’t doing. However, further up the chain. Every quango is in on it. Who buys medicines, from American companies, and why? The contracts awarded. There are so many legal cases of different types of fraud, which can only represent a fraction of what goes on.
So against this background, your care is the last thing on their mind.
Then there is the learned helpless mantra, across the public sector, moaning about not having enough money. Manners doesn’t cost money, yet they don’t have any. The public sector doesn’t need more money. It needs less.
A country that was built on exploitation never needed good management. Until a viable source of new exploitation emerges. We are proverbially screwed.
It all just for show, and we pay for this dis-service with our taxes.
The potted history on this blog underlines the continuing and worsening situation. Partly I feel as the error makers are supported with their cover-up/deceit. The whistle-blowers/those who care to avoid potential injury are not supported, worse still they are bullied beyond belief. Add cutbacks and crafty moves on privatization = complainants are indeed ghosted and therefore no voice. Yet.
Well, we all know that these organisations are set up as a front, more PR, pretending to the populace that there is remedy, there is justice, there is oversight. When really there is none. As always it takes brave members of the public to bring scandals into the open. Complainants are treated so poorly, instead of seen as a free resource in improving things. But they don’t want to improve things do they. It’s all about keeping a lid on it, discrediting complainants and whistleblowers and defending the reputation of these shoddy public bodies no matter what. They have no morals or scruples, they don’t care who they hurt. The lives of the public mean nothing to these evildoers.
Thanks for this interesting history.
If the culture promoted by gov. was one of learning from complaints then surely more would be investigated at Ombudsman tier? Else the opportunity to determine any commonality amongst complaints brought is lost.
The predetermination that the majority of cases are thought not to warrant any investigation at Ombudsman level is disturbing.
LikeLiked by 2 people
This sums up my experience. No accountability in the NHS, Trust CEOs being paid obscene salaried with no accountability, senior Managers who aren’t held accountable and can move around with immunity despite FPPR. The CQC in particular have legal obligations and statutory powers but won’t sue them. Can’t have patients telling the truth can they or a flag ship Trust being warned/prosecuted. After mid Staffs the mantra was never again but it has happened so many times since and will continue to do because systems that can harm or even kill patients aren’t changing. This is wholly down to the ineffectiveness of organisations like the CQC, PHSO, NHS Trusts themselves, along with nursing and Doctor registration bodies who appear to ignore what is obvious to others.
I believe that the shortage of nurses and Doctors has contributed to the approach taken by the GMC and NMC in all but the most serious of cases. No-one was ever prosecuted or struck off over mid Staffs and if they were it would be those at the bottom of the chain. All of this contributes to patients being given the run around trying to get answers, the truth and the hollow apology which is meaningless and overused by the NHS. But the avoidable harm isn’t happening to those who could effect change and ostrich syndrome is the norm along with new trend of ghosting complainants. For some being ghosted at the start means they don’t even get past go and it takes resilience to keep at people ad organisations to get anywhere.
LikeLiked by 2 people
Until patients families independent advocates and campaigners , that is experts by experience of harm ( unfunded by drug companies NHS bodies etc eg cqc patients association ) are embedded and empowered in all oversight and scrutiny and safety and complaint review committees ..until this happens ..we can have no faith robust action will be taken to fully address avoidable harm.
LikeLiked by 1 person
Absolutely right Richard. So obvious they won’t do it.
LikeLiked by 1 person