If you have been paying attention over the last few years you will realise that ‘accountability’ is nothing more than a soundbite used to maintain the illusion that we live in a democracy. Was anyone actually held to account for the PPE scandal, or Partygate? And what of Dido Harding and the missing £37 billion? You may argue that some people resign and others are sacked but most simply lie low for a while before popping up again to secure another cushty position. But you can’t have democracy without notion of accountability and so the farce continues.
The Parliamentary and Health Service Ombudsman is part of the UK accountability structure with the authority to investigate government departments and the NHS and hold them to account. In turn the Ombudsman is accountable to Parliament via the Public Administration and Constitutional Affairs Committee (PACAC). This neat arrangement allows the Cabinet Office to disregard any prying questions from concerned MPs with the oft-repeated brush off listed below.
The Ombudsman does indeed set his own standards and marks his own homework without undue interference from the members of PACAC. But once a year the public are invited to submit evidence to the committee in preparation for the annual scrutiny session. This year, the meeting will be held on 29th November at 9.30 am, somewhere in the bowels of parliament. For the first time in two years the public will be able to attend in person. No doubt the PHSO staff will once again take up the front row seats so that the camera does not inadvertently catch sight of a member of the public shaking their head in disbelief at the rhetoric spewing from the dynamic duo of Rob Behrens CBE and Amanda Amroliwada CBE. Given that the members of the committee are handed a question to ask in a short pre-meeting, it is easy for the PHSO management team to wriggle free from any difficulties with phrases such as ‘we count in complex ways’.
In an effort to assist the beleaguered committee members, PHSOtheFACTS have submitted key data in the form of written evidence since 2013. This year is no exception and PHSOthetruestory are happy to publish some of this written evidence for perusal and public consideration ahead of the great event.
We can see from the evidence submitted by Nicholas Wheatley, the (modern) Ombudsman has once more been busy declining investigations. It will be interesting to see if any of the committee members ask the Ombudsman what he has been doing instead of investigations to resolve public complaints.
Written evidence from Nicholas Wheatley (PHS41)
Public Administration and Constitutional Affairs Committee Parliamentary and Health Service Ombudsman Scrutiny 2021-22
a) 90% reduction in the number of Parliamentary investigations carried out by the PHSO
The graphs below show that there has been a 90% reduction in the total number of Parliamentary investigations carried out by the PHSO since 2014-15.
In 2014-15 about 64% of Parliamentary complaints were investigated, while in 2021- 22 only about 5% were investigated.
Committee members will be well aware that the complaints they submit to the PHSO on behalf of their constituents are rarely investigated these days.
The data for the graphs comes from PHSO documents found in the corporate publications section of the PHSO website.
85% reduction in all investigations carried out by the PHSO
When the report on the Parliamentary and Health Service Ombudsman Scrutiny 2020-21 was read out in the Committee Meeting of 17th May 2022, it incorrectly stated in paragraph 9 that the number of investigations was on a downward trend from 2,348 in 2017-18 to 1,494 in 2019-20, which would represent a decrease of 36% in 2 years.
The report was later corrected to show that there were in fact just 1,122 investigations in 2019-20, which represents a decrease of 52% over 2 years.
As can be seen from the graphs below the number of investigations has actually decreased from 3,715 in 2016-17 to 612 in 2021-22. A decrease of 85%.
In 2016-17 about 46% of all complaints made to the PHSO were investigated. In 2021-22 only about 8% of all complaints were investigated.
The data for the graphs comes from the PHSO Annual Accounts found in the corporate publications section of the PHSO website.
The decrease in the percentage of complaints investigated in 2021-22 despite the small increase in the number of complaints investigated is as a result of the 24% increase in complaints coming to the PHSO in that year.
Because there is a lag between a complaint being accepted and a decision being made the figure for the percentage of complaints investigated is an approximation.
Editors note: The first principle seems to be don’t open a can of worms if you can kick the can into touch. However, even the glib Rob Behrens, has to investigate some complaints and in the interests of appearing impartial must uphold a small percentage of them. Herein lies the effectiveness of the Ombudsman service in improving public services and providing remedy for maltreated citizens. Unfortunately, the evidence supplied by Nicholas Wheatley would suggest that even in those rare upheld cases there is little remedy or improvement to be found.
Impact on other Organisations
The PHSO has produced a number of reports over the years but they seem to have had remarkably little impact on the organisations reported on. There is also very little feedback or follow up on the reports and when there is it is usually not very positive.
In the foreword to the annual report the Ombudsman mentions a report produced by the PHSO in January 2022 relating to compensation payments to people who had been underpaid in regards to their ESA benefits. It should be made clear that it was the DWP who identified the error and refunded the lost money. The PHSO complaint related to compensation payments.
However, according to an article by the journalist David Hencke, the DWP has ignored the recommendations for compensation made by the PHSO. He states:
“The decision also shows up the weakness of complaining about maladministration to the Parliamentary Ombudsman, Robert Behrens, in cases involving the ministry as it ignores his rulings.”
There have been multiple failures of maternity care identified by independent reports, most recently the report into the failures at East Kent.
Yet despite hundreds of cases of failure now being identified, the PHSO has been remarkable by its absence. It might be thought that a complaints organisation should have picked up the problems with maternity care. Yet it seems that no-one complained to the PHSO.
The PHSO did produce a report in 2013 into failures of maternity care at Furness General Hospital but it seems to have had little effect on the standards of care across the NHS.
Mental Health Services
In 2019 the Ombudsman produced a report into failings in the care and treatment of two young men with mental health problems at North Essex Partnership University NHS Foundation Trust.
In October 2022 Channel 4 Dispatches showed a documentary about the same North Essex Partnership University NHS Foundation Trust which in their words stated that “…an NHS Trust responsible for serious failures resulting in multiple deaths still isn’t keeping patients safe”
In 2015 the PHSO produced a report into a complaint against HS2 and it was followed up with a report by PACAC.
However, 6 years later the very same complainant had to raise another complaint on a similar matter and another report was produced by the Ombudsman. It seems that HS2 had learnt nothing from the first report.
The Ombudsman published a report into eating disorders after failures of care led to death of a young patient named Averil Hart.
On 14 May 2019, 18 months after the Ombudsman published his report, PACAC held a follow up inquiry at which Dr. Dasha Nicholls, Chair of the Faculty of Eating Disorders at the Royal College of Psychiatrists, and Andrew Radford, Chief Executive of BEAT Eating Disorders, gave evidence.
When asked what impact the report had made, Dr Nicholls replied “As yet I would say relatively little”.
Dr Radford claimed that the situation was “as bad now, if not worse than it was in 2012 when Averil died”.
In the Ombudsman’s Casework Report of 2019, a case concerning the DWP and the new state pension can be found on pages 14 and 15.
The DWP did not however properly implement the changes recommended in the report.
According to the journalist David Hencke:
“So what happened? Sweet nothing. The DWP ignored the deadline and then produced a factsheet which I know from correspondence the Ombudsman clearly felt did not fit the bill. But after one attempt to get this changed the Ombudsman dumped the issue and wimped out of getting the ministry to implement their recommendations.”https://davidhencke.com/2021/09/12/whitehalls-rip-off-ministry-the-dwp-dodges- paying-compensation-to-millions-of-pensioners-and-the-parliamentary-ombudsman- lets-it-off/
Editors note: With so few investigations and such little impact from those which are fully investigated, perhaps the committee will recommend that our new Chancellor, Jeremy Hunt, considers the abolishment of the Parliamentary and Health Service Ombudsman and put the considerable savings into the poor fund.
After all the game is well and truly up and this accountability exercise is fooling no-one as articulated by this recent user of the service on the Trustpilot site.
It is obvious to anyone who scratches the surface of this organisation that it is unfit for purpose, but no doubt the members of the committee will be able to put any such thoughts out of mind as they go through the motions of holding the Ombudsman to account one more time …..
I note that, so far, 5 of the 22 submissions published by PACAC have been made by ‘officialdom’ (6 if you include the one by PHSO itself). They are worth reading in full but here are some extracts:
NHS Resolution (PHSO017)
“Our experience of working with the PHSO has been positive, meeting regularly to discuss our shared objectives and how we can work collaboratively to achieve our shared objectives”
Local Gov’t and Social Care Ombudsman (PHSO032)
“The Local Gov’t and Social Care Ombudsman and PHSO take the opportunity to learn from each other through their membership on each others’ Boards and through regular operational discussions between managers from both organisations”
Health Safety Investigation Board (PHSO037)
“At the policy level, the PHSO have demonstrated they value HSIB as an important partner organisation. We have regular conversations at senior policy level”
“HMRC have an excellent working relationship with PHSO and their caseworkers/investigators are professional, knowledgeable and easy to engage with”
In addition, the GMC commenting their evidence:
“PHSO and GMC continue to be trusted sector partners including as part of our membership of the wider Health and Social Care Regulators Forum”.
So what does this tell us?
1. Cosy relationships exist between PHSO and various bodies they are supposed to investigate. Public bodies should not view PHSO Investigators as ‘easy to engage with’. It should be quite the opposite.
2. What the LG & SC Ombudsman and PHSO learn from each other is borne out by the appalling Trust Pilot reviews of both organisations (181 reviews for LG &SC – classified as bad).
3. PHSO, as an arms length body, has a statutory duty to investigate NHS and Government departments and should not be treating them as working partners or, as NHS Resolution state, be collaborators.
4. For collaboration read collusion.
It is no wonder that officialdom is content but so many members of the public who engage with PHSO in good faith are not. The public evidence is in stark contrast.
Will other submissions be published? The reference numbers tell us only about half have been so far.
I am reminded of the nursery ditty we use to sing to our children about the wheels of the bus going round and round all day long. It’s about time PACAC recognised the wheels have come off at PHSO!
LikeLiked by 1 person
Thank you Della for again bringing to public attention the issue of accountability of the Ombudsman. Through such clear blogs we all have opportunity to understand something more of the system . The data-combing and excellent analysis of Nicholas Wheatley serves to underpin. It is miserable that year in, year out, there seems to be ‘remarkably little impact’ on the organisations reported on.
I note that ‘Subeditors’ (see responses) talks about the, ‘theatre of accountability’. Debi Evans, a presenter on UK Column, is becoming curious about the priorities of another body -the MHRA. Many of those reporting to the MHRA appear to be detailing life changing harms yet the MHRA seems slow to respond in terms of pattern spotting, analysis etc. Oddly this doesn’t dent MHRA self congratulation.
Debi Evans comments on the recently held MHRA board meeting (online). Anyone who has attended a PACAC (PHSO) meeting in the past may observe parallels. Her comments are here, with snippets from the meeting :-
It the link (above) fails to work, if interested, you could search UK Column News 16th Nov start at 51mins 50s
‘Customer satisfaction with the overall service is likely a lot lower than portrayed in the statistics quoted by Ms Amroliwala. A complainant feedback survey was produced by the PHSO in 2015-16 with detailed statistics.
It lists the following statistics for complaints that were not upheld:
“15% satisfied that the decision was fair and unbiased
14% satisfied that the outcome followed a thorough assessment
14% satisfied that evidence was produced to support the decision.”
It is likely that if the 2021-22 Service Charter results were differentiated by decision then similar results to those shown above would be obtained.’
I can’t think why they stopped recording this information!
PHSO in practice:
Compensation recommended in 35 cases in 2021/22 (parliamentary complaints):
I forgot to contextualize the 35 cases in which compensation was recommended.
According to the PHSO:
‘Of the complaints we investigate each year, we uphold, in full or in part, around 50%.’
Click to access PHSO_Overview_Leaflet_2021.pdf
‘Complaints about UK Government Departments and other Public Organisations 2021-22’
(otherwise known as the table of zeros!)
TOTAL COMPLAINTS RECEIVED – 7,145
Annex B – Referrals by MPs to PHSO, 2020-21
‘In total 2,653 complaints were referred to PHSO by MPs during 2020-21.
Just under three quarters of MPs (73%/473) referred five or fewer complaints to PHSO during 2020-21 (including MPs who did not refer any complaints to PHSO). Just under a quarter of MPs (22%/144) referred between 6 and 10 complaints.
71 MPs did not refer a single complaint.’
To see Annex B (including graph) download:
The direct access version of ‘3 February 2022, PHSO response to MoJ Victims’ Bill consultation’ does not have a page 9 containing the graph:
Click to access PHSO_response_to_MoJ_Victims%27_Bill_consultation.pdf
The table of zeroes indeed. The Ombudsman has been driving towards net zero long before it became fashionable.
Check to see if you live in one of 71 parliamentary constituencies where administrative bodies seemingly sort out any problem people have:
‘MP referrals for the year 2021/22’
(the average electorate in an English constituency is about 73,000)
PHSO TOTAL COMPLAINTS RECEIVED – 7,145
Compensation recommended in 35 cases
By removing the MP filter, is Rob Behrens expecting that another 1,000 complaints will result in five more recommendations of compensation?
Excellent article showing the PHSO in its true light. Perhaps mainstream media will take off the blinkers one day.
This annual get-together is where we hear a lot about the Venice Principles, how good things would be if only the Ombudsman had greater powers, how the PHSO fares much better compared to other ombudsmen, international ombudsmen, hand-picked performance indicators, and something about a recommendation to pay someone loads of money (but we are not told that it’s 1% compensation and 99% money owing for some obvious balls-up). We are also told complainants are happier and that the PHSO has improved, but not told about Trustpilot:
The MP filter is likely to get an airing since it’s likely for the chop. The argument is that it is a barrier to justice. I’m not persuaded. We’ll no longer see that MPs each pass on average about 4 complaints to the Ombudsman annually – a perfect opportunity to make the PHSO look busier. What was Bruce Forsyth’s catchphrase – ‘What do complaints make? More funding!
LikeLiked by 1 person
Spot on Jeff. The ombudsman is only ever interested in increasing his power and status but doesn’t use the power he already has to do any good in this world.
A great eidence based article on the deep flaws and failings of the PHSO. The PHSO acts as little more than part of the theatre of accountability in this country. In 2014, the Patients Association carried out an independent investigation into the PHSO and found it to be incompetent and not fit for purpose.. and nothing has changed nearly 10 years. The PHSO serves as nothing more than one more layer of institutional cover up and fails exceptionally well in its duty to protect patients and the public from life changing harm . See this personal account of the lengths the NHS will go to to cover up and the failings of PHSO: