Health and Community Care Committee, 07 Dec 1999

Meeting date: Tuesday, December 7, 1999

Official Report 155KB pdf

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Petition

Item 2 is a petition from Mr Ooms on the national health service complaints procedure. Are there any comments?

This petition raises important issues, although it is not exhaustive. I hesitate to suggest another study, but at some point we will have to examine the complaints procedure. In the past few days, the Health Committee at Westminster has produced an excellent report on procedures related to adverse clinical incidents and outcomes in medical care—there is a UK health complaints procedure at the moment, but it need not be a UK procedure in future. I recommend that report to everybody, as it raises a lot of general concerns, and goes wider than the petition.

We should recognise that the petition raises important issues, but that we will want to consider the matter more comprehensively at some future date. It would not be wise to pick out individual problems in the procedures, as it could be argued that there are more general concerns that have not been raised by this petition. We cannot immediately hold a study into this, so there is probably not a lot we can do at the moment.

Is there any other action that we can take? Should we forward this petition to the minister so that she can decide whether there are issues for her to address?

Another option—I hesitate to mention it, as we already have three reporters—is for one of us to examine this issue. However, we are heavily loaded with issues. It is an important issue, which will have to be addressed in the fairly near future. Apart from appointing a reporter, this committee cannot do very much on it at the moment.

In the past few weeks, members have asked whether health boards provide the best structure. As we go through our business, we will highlight other issues that we should take time to address.

If we are suggesting that we pass this matter on to the health minister, we should understand that there are 27 NHS trusts with 27 sets of procedures, and there are health boards. We might tell the minister that we are failing because there are so many different procedures—some are very good, others are not—and that the complaints procedure needs to be re-evaluated, as I think it will be. Clinical governance will certainly have an impact.

We could suggest that the Scottish Executive consider implementing a consistent complaints procedure so that there is some assurance that there is consistent treatment across the country.

Margaret Jamieson's point is well made; clinical governance will make it even more important to have a consistent procedure.

My fundamental concern—it has been reflected in other criticisms—is how independent of the trust the complaints procedure is. The main thrust of the Westminster Health Committee's recommendations is that the procedure should be made more independent.

I hesitate to mention what is happening at Westminster, but you all know my views so I can probably get away with it. The Department of Health is conducting an investigation into the complaints procedure. We need to look at it in Scotland. Perhaps we can ask the Executive to look at it, but it would be difficult for the committee to do that at the moment.

I support that. We should ask the Executive to look at it. We should not duplicate the work that is being done at Westminster. A number of issues are raised by the petition, one of which is that there are separate complaints procedures for primary care teams and for trusts and, as the case in question demonstrates, serious complaints usually relate to both. We should ask the Executive to look at the Westminster report, at how the complaints procedure is working in Scotland and particularly at how the system is working in relation to the new structures that came in on 1 April 1999.

We could also ask the Executive to comment on what it sees as the issues raised by the petition and to report back to us.

This is an individual complaint. As a non-clinician, it seems to me that although some of it is valuable to us, aspects of it are beyond what the committee should be looking at.

We must not get involved in the detail of complaints. That is very important. The petition is backed by the evidence on the individual case, but we cannot get involved in any individual case or the committee will spend all its time on such issues.

We must make that point strongly. Each petition that is passed to us will be dealt with on its own merits, but as a general rule it is not our job to become involved with individual cases.

I agree, but this complaint is not isolated. I have two similar cases on my desk, which I am not certain how to progress. One has been through a fatal accident inquiry. We should thank the people who submitted this petition because the headings on their paper summarise most of the main problems inherent in the current procedures. It should not be set aside. People must feel happy about an open, honest, accessible and truthful health service. The Executive should investigate it thoroughly and consider the issue of consistency.

As Margaret said, we must aim for consistency. We should remember that the point at which people make a complaint against the health service is usually one of great stress for them—they are likely to be lay people up against clinical issues on which they may have had very little information.

That is usually where the complaint starts.

We will ask the Executive to consider it, in terms of the points raised about the complaints system, bearing in mind that with the advent of clinical governance it will be a very important issue. We should send a copy of the Official Report of this discussion to the Executive so that it can see what our thinking on the matter is. We should suggest that it pay attention to the Westminster inquiry and present a complaints system that serves patients as well as the health service.