On 8th February 2024, Ombudsman, Rob Behrens and Patient Safety Commissioner, Henrietta Hughes, wrote a joint letter to government which can be seen in full below. Both have regulatory roles to play in improving patient safety and both are struggling to gain headway with the recalcitrant NHS. Supposedly independent of government, this correspondence shows they are in fact totally dependent on government, due to their limited powers.
Regulation of public services resembles a Punch and Judy show. Characters, such as the Ombudsman pretend to beat upon the heads of the public sector workers when they step out of line, or in Ombudsman speak, are guilty of maladministration. But the real movers and shakers are beyond his reach so he must call upon the government to clobber the NHS managers in the hope they will bear down on the front-line staff until everyone follows the Ombudsman’s standards. The only character without a stick is the patient, who is regularly dropped on the head, thrown out of the window or put through the sausage mincer. Oooops.
Just like Punch and Judy, public sector regulation is a show for public consumption, using a well-worn script that hasn’t changed and isn’t likely to. The correspondence below explains why.
Key points:
- The letter starts with an acceptance that government is aware of the problems. If they are aware, why no action?
- It goes on the demonstrate the way that patients are ignored or dismissed when they raise complaints closing down potential feedback.
- PHSO has indeed heavily invested in producing new standards to improve complaint handling, yet it seems those at the top, the ones who could actually make a difference, have yet to embrace them. So what was the value of this endeavour?
- The suggestion that the patient’s voice should be heard at director level can be nothing more than virtue signaling as Behrens knows only too well that those in power don’t want to be bothered by pesky truthtellers, himself included. If any patients do get wheeled into board rooms they will have been carefully vetted first.
- Finally, the reason for the countless oversight bodies is that every time a scandal breaks a new body is created to show that action has been taken. Each new body is given very limited powers and if any of them actually start making waves at higher levels they are immediately neutered as in the case of HSIBB.
And so the show goes on, with new characters emerging on the crowded stage to pretend to beat up on each other and protect the long-suffering patient. The one player who never suffers a public beating, yet deserves it the most, is the one with its hand firmly up the jacksie of all the other characters making sure they stick to the script.
That’s the way to do it!
phsothetruestory 
Here’s the latest way to do it:
‘Help improve our service: join us at our Dilemma Café’
https://www.ombudsman.org.uk/news-and-blog/events/help-improve-our-service-join-us-our-dilemma-cafe
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‘This diagram shows how the PSC represents the voices of patients to policy makers, regulators and providers of medicines and medical devices, which includes…
PHSO, which investigates complaints not solved in the NHS
…
The PSC has the power to make them respond.’
https://www.gov.uk/government/publications/medicines-and-medical-devices-bill-overarching-documents/medicines-and-medical-devices-bill-patient-safety-commissioner
Can’t think why anyone would object to the PSC having teeth!
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If the PSC has teeth why isn’t she using them? The mesh scandal continues with many patients suffering from harm. Writing a report about it isn’t enough.
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The Patient Safety Commissioner was born of the Cumberlege Report into the ‘mesh scandal’ which has scarred the lives of so many women. In the report the Patient Safety Commissioner would have power to hold bodies to account but somewhere along the line that part got lost.
So what will a Patient Safety Commissioner mean?
“The plan is to have an individual with “real standing” outside and independent of the system, accountable to the parliamentary Health and Social Care Select Committee.
The Commissioner would be expected to take up and investigate patient complaints where appropriate, and hold organisations to account – the review had stated that the failure of health authorities to respond to concerns was a recurrent theme.”
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The opening four words of this joint letter states ‘In our regulatory roles’. A cursory examination of the PHSO website states: “We are neither a regulator nor consumer champion”. Readers will find this on the website by scrolling down to PHSO/About us/Who we are/Our role.
It would appear the Health Safety Commissioner is now another person who doesn’t understand the role of the Ombudsman.
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We need the next government (likely Labour) to prioritise reforming the landscape and giving whatever organisation it chooses to regulate/oversee the failings in our NHS the powers to enforce change rather than “recommend”. Too easy for the NHS otherwise
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There is a reason the ombudsman doesn’t have powers of compliance and doesn’t even request them.
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Does it not request them when it asks for ombudsman reform? (Genuine question – I’m not across the detail)
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No the Ombudsman has never asked for powers of compliance only own initiative powers to investigate without a complaint.
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From the tone of the letter it seems that the Commissioners are unaware that they are the puppets and not the puppet masters. Perhaps the status of the position is all they crave and appearances are everything. Even the opening sentence of the letter is misleading. Do these Commissioners really have regulatory roles when they don’t have the power to regulate anything? The Ombudsman is a complaint handler and the Patient Safety Commissioner is a report writer. In reality she isn’t even a Patient Safety Commissioner as her remit is limited to drugs and medical devices. Writing reports about drugs and medical devices which everyone ignores.
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That about sums it up Nicholas. They both write reports everyone ignores.
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When you know the whole thing is a show, there is no going back, and other things, you once believed in. are soon revealed to be just as corrupt, and that is the hardest thing to accept, especially as the ‘rest’ hits you like an avalanche.
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Forwarded to Tugendhat (who has aspirations of becoming MP don’t they all)) who is affectionately is called ‘Tag along Tom’. Our MP.
Who as ever will do nothing. When are we going to get a real leader not a I’ll get as much as I can for myself while I can person? Unfortunately most suffer from Little man Syndrome.
Any one who wants the greased piglet back as MP has really lost the plot. Read his R.I.P – ‘Failure of State’ a C19 Fascio – that’s just one of the Major Disasters of our time who was MP at the time – Doso.
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On 16th April 2018 Mr Behrens announced his new strategy 2018-21:-
Delivering an Exemplary Ombudsman Service.
He encouraged us to read and disseminate the strategy. He looked forward to working with complainants, organisations and staff to, ‘achieve our vision’.
He communicated he had developed, ‘the new strategy with valuable input which include the, organisations we investigate and work with. ‘
Let us look at his Objective 3:-
‘To work in partnership to improve public services, especially frontline complaint handling’ He wrote, ‘We are confident that through continuous learning and improvement ….we are well placed to achieve the objectives we have set out.’
Was the view myopic .as it appears the vision has not been achieved?
Was the confidence for achieving objectives misplaced?
Can we be forgiven for wondering if those glossy Strategies are perhaps just word salads? Before consigning them to the bin, perhaps they serve as a challenge to those who enjoy anagrams. I’ll kick off with the word, ‘Exemplary’, .. let’s see…..ah yes, how about ‘lame’.?
MW
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Spot on. No doubt the new ombudsman will make similar promises and ask for time to achieve them only to be thwarted by the system once again.
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My experience pretty much illustrates all the key points:
1. NHS leadership did not listen to me and were not accountable. Instead, my feedback was dismissed and I was attacked and smeared for speaking out.
2. As soon as I raised a complaint, I became a problem, no longer a patient. What followed was a disturbing sequence of lies, abuse of power and official obfuscation as the individuals at DHCFT were prepared to go to any lengths to cover up to protect their own personal reputations and interests.
3. In my case, the Ombudsman was going to uphold my complaint based upon independent expert clinical opinion, but then colluded with the NHS to destroy the original report, under go a u turn and not uphold it at all
4. Far from giving my voice a platform , the NHS did everything possible to silence me: they wanted me in prison or in my grave
5. My story illustrates how ineffective the plethora of regulators, commissioners and other professional bodies are in fulfilling their duty as a protective layer of accountability and in maintaining patient safety, they all close ranks and cover for one another:
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