Health and Community Care Committee, 08 Mar 2000

Meeting date: Wednesday, March 8, 2000

Official Report 254KB pdf

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Petition

The next agenda item is the Executive's response to the petition that we passed to it in December from Mr Ooms about the NHS complaints procedures. Mr Ooms wanted to bring a particular set of circumstances to Parliament's attention, but his petition opened up a debate on some of the wider issues. That is the way in which we deal with petitions—we try to consider the wider issues.

It is clear from the Executive's response that the NHS complaints procedure is undergoing a UK-wide evaluation, and that a Scottish group is taking part in that evaluation. The minister expects to receive an interim report in March this year and a final report in January next year. The evaluation is being led by the Department of Health in England; it is being assisted by a Scottish advisory group of complaints personnel and patients' representatives, which was set up to oversee the Scottish evaluation. That is the current situation. Are there any comments?

Health is a fully devolved matter, so would not it be entirely competent for the Executive to make its own statement? The Executive's response says that there is Scottish representation on the on-going project, but I am not entirely clear on why we have to wait for the results of a United Kingdom initiative. I am not being stupidly nationalistic about this.

I confess that I am not aware of the background to this, but Margaret Jamieson is.

The main reason for the evaluation being UK-wide is that people can obtain health care south of the border. On occasion, individuals are transferred from a Scottish hospital to one in London because they require specialist services. The aim is to create a seamless system, so that if someone who has moved around the country has a complaint, the process will be the same, although different individuals will deal with it. That is for the convenience of patients and also assists those against whom a complaint is made.

We may be able to put a different slant on things, but the procedure will remain basically the same. The only difficulty that I have with that is that I am unaware whether it extends to co-operatives of general practitioners providing out-of-hours services, who seem to think that the NHS complaints procedure does not apply to them. Richard Simpson may be able to assist us on that.

There is a primary care NHS procedure. The problem is that such co-operatives are not part of the primary care trusts, the acute trusts or the individual primary care units—the partnerships. They are a new entity, which was created after the current complaints procedure was introduced. Most of them have a complaints procedure, but nothing is defined for them.

We can respond to the Executive with that point.

In its letter, the Executive says

"When letters are received in this department from patients or their representatives who have grievances in relation to the NHS complaints procedure their names (with their permission) are passed to the evaluators, who may contact them in the course of their research."

We can seek clarification on whether Mr Ooms's case has been passed to the evaluators. We will also bring to the attention of the evaluators the situation regarding co-ops and their English equivalent, whose name I cannot remember. I try to forget the name of the English equivalent, so that I do not get too confused.

We are talking not about the local health care co-operatives, but about GP out-of-hours co-operatives.

We will bring that to the Executive's attention.

I do not know the status of the interim report, but can we ask to see it? I imagine that that will be possible and that we will be able to comment on it. Our work load is becoming rather unmanageable, but we should be able to submit our comments on the evaluation. I accept what Margaret Jamieson said, but the Scotland Act 1998 gives us the option of having our own system if we find what is proposed unacceptable.

That is absolutely right, and I support that fully. Would it be worth finding out what the Executive's approach is to that process, and what representation it is making in the UK process? I would like to know its current attitude, and the representations that are being made on our behalf. Can we write to the minister?

We can ask for further information on the Executive's input so far.

On the second page of her letter, the minister says that this

"is not intended to be an academic project, but a practical and realistic analysis based as far as possible on . . . actual experiences".

I have received various complaints from people, some of them going back a few years. Should I say to them that they can submit their complaints as part of this process? Is this an continuing process to which we can refer people who have been through the complaints procedure?

Yes. We could ask for some guidance for elected representatives on whether, when we pass things on, this is what will happen to them. What is the time frame for this? When did these letters start being passed on? If you passed something on to the Executive six months ago about a constituent, has that gone in, or is this something that has just happened in the past month, the past six weeks or whatever? We need some guidance, for us and for our colleagues, on what may be happening to letters that we pass on to the Executive about complaints against the NHS.

If we have received letters that we feel epitomise the problems that underlie the complaints procedures within the NHS—problems similar to those that have been experienced by Mr Ooms—is it in order for us to pass them on as part of this process? I have three such letters on my desk.

We can get some guidance on that matter. If the NHS has been dealing with such complaints regularly only for the past two months as part of this evaluation process, it might be that if you had anything prior to that date which you considered to be a classic example of where the complaints procedure is falling apart, then you could proactively pass that on. I think that guidance would be useful not only to members of this committee, but to all our colleagues who are having to deal with this as well.

Can I just finish—

Mary needs to understand that there are local complaints procedures as well as the Scottish complaints procedures.

These are people who have been through all that.

On occasion, individuals continue to complain because they do not receive the answer that they are looking for.

I appreciate that.

I am well aware that, in my local area, the acute trust is evaluating its complaints procedure. That evaluation is being conducted by the local health council, and the trust has put me forward as somebody who should be interviewed by the health council because of the system that we operate.

At the same time, if someone has a specific experience, for example, if they have lost a child, and if they feel that we can learn from that experience, we should not exclude them.

My desk is a bit of a mess with all the complaints just now. I do not mean to muddy the waters, but there seems to be a problem with the grievance and disciplinary procedure for NHS staff. They are disciplined and off work sometimes for three, four or five years. We are talking about the patients complaints procedure. Could we not consider the staffing procedure as well? A lot of them are nurses or doctors. There is a crying need for this to be carried out fairly and efficiently within the NHS, which does not seem to be happening just now.

That is a specific contract of employment issue. I do not think that we have the right, under any devolved settlement, to interfere with individuals' employment.

It costs the NHS hundreds of thousands of pounds and—

Right.

It is totally separate from the complaints procedure.

Well, I think we should—

Dorothy-Grace is next.

There has been a fair amount of work done on workplace bullying, of which there is a great deal in the NHS, as there is in any large organisation.

We are straying from the agenda.

Staff are our best possible sources of—

I am sorry, Dorothy. We should move on from this subject.

I shall bring that item to a conclusion. As members know, it is my style to allow people to have their say as far as possible, but I agree with Richard Simpson that we have strayed from the agenda. I suggest that we send the minutes and the Official Report of this discussion to the Executive, along with our response, so that ministers can see what we have touched on. Complaints by patients will always have implications for the staff who are complained about. Thank you for your contributions to that subject.