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Mr. Simon Hughes (Southwark, North and Bermondsey): I rushed in as soon as my hon. Friend started speaking, so I am grateful to him for giving way. Does he accept that the experience in the health service is that it is often far better if people can complain immediately to someone very close by who can deal with their anger, frustration or dissatisfaction? If they have to leave the complaint until later and go through some bureaucratic procedure, it is often too late.
If every bit of the health service had a structure within which people received information saying, "Unhappy? Talk to person X. Ring this number now", so that they could talk there and then to someone who was not directly managing their mother, sister or child in the bed--
Mr. Deputy Speaker (Mr. Michael J. Martin):
Order. The hon. Gentleman should not be making a speech. I call Mr. Oaten.
Mr. Oaten:
My hon. Friend is absolutely accurate. The first principle must be ensuring that mistakes do not happen in the first place. The second principle must be providing a local system for complaints. The third or fourth tier should be the ombudsman.
There is a good illustration of why complaints procedures will become critical. The ombudsman's report refers to litigation in the NHS. There is certainly a fear that we are turning into an American-style culture and that in future instead of going to the ombudsman, people will go to their lawyer as the first port of call. There is concern that litigation is getting out of control. I hear that the Government are looking into the question of litigation. I welcome that, but the estimates of £235 million seem set to grow in the future. I wonder whether the Minister will expand on or write to me later about how hospitals are managing that process.
I understand that hospitals make contributions to funds managed by the NHS for internal insurance against complaints and litigation. Are those funds adequate? How much does the NHS have to set aside for litigation? Is there a role for the private sector to step in and provide cheaper insurance?
I want to conclude by saying a little about the Parliamentary Commissioner for Administration--another complicated title. It essentially means the ombudsman who does the stuff that the health ombudsman does not do. Concerns are expressed in the report about the length of time that it takes to deal with complaints. Some of the reports say that the average time taken to deal with cases last year was 91 weeks. That is clearly unacceptable. It is good that the time is down from 100 weeks the year before, but clearly a lot more work needs to be done. The delay is of particular concern when we realise that sometimes the complaints are about the length of time that it took another organisation to help someone. It almost seems as though the ombudsman is rubbing salt into the wound by delaying that process. It greatly undermines the confidence of individuals if the people to whom they complain perform in the same poor way in relation to the problem. I am concerned that that should be looked into and that improvements should be sought.
I want to pick up on the point made by the Chairman of the Select Committee, the hon. Member for Cannock Chase, concerning those organisations that have not been brought within the remit of the ombudsman. One that especially stands out is the Student Loan Company. I have received complaints about that company and, although a vast amount of its work might not fall within the remit of the ombudsman, some administration elements would benefit from having recourse to the ombudsman.
Mr. Desmond Browne (Kilmarnock and Loudoun):
I too welcome the opportunity to hold the debate this evening. It is a pleasure to follow the hon. Member for Winchester (Mr. Oaten), my colleague on the Select Committee. Having heard what he did in a previous life, and the communication difficulties that he doubtless faced at that time, it is no wonder that, in a relatively short time, he is able to put to the House a quite fluent and coherent argument. I share the hon. Gentleman's desire for a greater awareness of the ombudsman's jurisdiction and of the role of Members of Parliament therein; I shall deal with that in more detail in a few moments.
Despite my membership of the legal profession--a qualification that I share with at least one other member of the Select Committee--I share the desire of the hon. Member for Winchester for clarity, and his concern about the growth in medical negligence litigation and the drain that that causes both on financial and on other resources of the national health service. I have some first-hand knowledge of that matter. I also share the craving for the demystification of jargon of which he spoke.
It is also a privilege to serve under the chairmanship of my hon. Friend the Member for Cannock Chase (Dr. Wright) and to follow him in the debate. I have beena member of the Select Committee on Public Administration for only a few months. In common with the hon. Member for Winchester, my membership postdates the reports that we are debating--indeed, it postdates the chairmanship of my hon. Friend the Member for Cannock Chase. However, in that short time, I have come to realise why my hon. Friend has such a reputation in these matters. I shall say no more--[Interruption.] Shall we just call it an enviable reputation? I am in danger of talking myself into having to buy his book. Thanks to his chairmanship, to the prodigious output and the obvious skill and learning of our Clerk, and to the help of my Committee colleagues, I have learned much during the short time that I have been a member of the Select Committee. However, I take personal responsibility for the words that I shall utter tonight--they are all mine.
In 1966, Richard Crossman said that the Parliamentary Commissioner for Administration was established to provide the Back-Bench Member of Parliament with
However, despite the undoubted success of the scheme in providing a weapon of parliamentary control over the administration of government--in the words of my hon. Friend the Member for Cannock Chase, "a highly effective instrument"--it does that only for a complainant who is able to seek the assistance of the ombudsman through a Member of Parliament.
Last year--30 years after that
Were the bald referral statistics the whole story, they would provide evidence equally for arguments that the ombudsman system was being appropriately used and for arguments that the system was being underused. However, Members of Parliament are clearly not referring to the ombudsman's office only such cases as they have reason to believe fall within his jurisdiction and they are unable to resolve themselves--the dual role that it was intended that Members of Parliament should play as gatekeepers to the system.
The ombudsman himself has advised Members that, in doubtful cases, they should not try to fathom the complexities of his jurisdiction, but should simply refer the cases to him. Hon. Members appear to have taken him at his word: as the ombudsman's reports down to the most recent one confirm, about 70 per cent. of cases referred to him have a subject of complaint that is not within his jurisdiction.
I would argue that, although the parliamentary ombudsman system has been an undoubted success and has provided a Rolls-Royce service in those 30 per cent. of cases that are either fully investigated or resolved informally, it has not been a success in respect of that countless unknown number of complainants who are potential clients of the service but who, for one reason or another, never get their cases to the ombudsman. We ought to address that problem, which has arisen as a consequence of several coincidental factors. I propose to draw the House's attention to some of those factors and to suggest some solutions.
The first element in my argument is that the House of Commons has paid insufficient regard to the work of the ombudsman in the past, so we should not be surprised by the lack of awareness among the general public and newly elected Members of Parliament. It is widely recognised that, among other functions, debates in the Chamber serve to enhance parliamentary awareness of issues. It is now almost five years since the last debate on the work of the ombudsman, and I share other hon. Members' dismay at that delay.
In opening the last debate on the Parliamentary Commissioner for Administration, Mr. James Pawsey, then Chairman of the Select Committee, said:
I recognise that, to an increasing extent, much of the valuable work carried out by and in the House of Commons is done outside the Chamber. However, given the nature of the service provided by the parliamentary ombudsman to Members of Parliament, one would have thought that a rare debate on the report of the Select Committee on the ombudsman's reports to the House would have attracted an audience and participation significantly wider than the members of the Select Committee itself.
I do not want to be misunderstood or misinterpreted--I am not arguing for the cancellation of debates if they do not attract the attention of many hon. Members besides the members of a specific Committee, supported by afew others with special interests or Front-Bench responsibilities. Debates such as today's--sparsely attended or not--at least have the intrinsic merit that they attract to the Dispatch Box a Minister who is briefed on the issues of the day.
When the Select Committee structure was established in 1979, the new Government at least appeared determined to give Parliament the teeth to monitor the work of Government Departments. The Procedure Committee that initiated the changes argued that a new balance had to be struck with the central aim of allowing the whole House to exercise effective control and stewardship over Ministers and the expanding bureaucracy of the modern state.
In introducing the proposals, the then Leader of the House referred to revolutionary changes that marked a crucial day in the life of the House of Commons. He said:
Indeed, when the Parliamentary Commissioner for Administration and the Health Service Ombudsman were appointed in 1967 and 1974 respectively, it is undoubtedly true that the Committee gave the ombudsmen backbone. The danger then was that the first Parliamentary Commissioner for Administration, as a former civil servant, might bow to pressure from former departmental colleagues and, to coin a phrase, "stay native". The Committee encouraged him to think more confrontationally and, at least in important cases, to conduct individual investigations.
I argue that there was then creative tension between the ombudsman and the Committee. However, now that the system is fairly well established, the Committee has a close relationship with the ombudsman. It is a settled relationship that no longer appears to generate much creative tension, apart from the Committee's interest in the throughput time of investigations. The Committee appears to walk in stride with the commissioner, which has some benefits. However, when the relationship between the Committee and the ombudsman was at its most creative, the Committee was snapping at his heels.
The argument that the ombudsman and the Select Committee are a powerful combination for securing remedial action is a separate issue. Undoubtedly, nothing concentrates the mind of a reluctant Department better than the threat of a grilling before the Select Committee. There is no doubt that recalcitrant Departments threatened with this big step find it easier to come up with rather than refuse a remedy. However, that productive dynamic would not be undermined in any way if the Committee presented a more challenging and questioning face to the parliamentary ombudsman. I would argue that the Committee no longer does that, apart from on one or two minor issues.
I turn to the question of the Member of Parliament filter, and in this part of my contribution I hope to address the points made earlier by way of intervention by the hon. Member for South Staffordshire (Sir P. Cormack)--I am sure that, if I fail now, he will give me an opportunity to do so later.
I believe that a central reason for the underuse of the Parliamentary Commissioner can be found in the Member of Parliament filter. By putting in place the hurdle of the Member of Parliament filter in 1966, the House accepted three arguments. First, there was the practical reason that, without it, the parliamentary ombudsman would be inundated with complaints. The filter would keep such complaints at bay and within manageable limits. Those who now argue for the retention of the filter often say that the number of complaints to the ombudsman has reduced because of the increased number of alternative complaints procedures provided within Departments or organisations.
If that argument is true, the siphoning off of complaints to intradepartmental complaints procedures would help to stem the expected flood were the filter to be removed. As a member of the legal profession, I was never impressed by the floodgates argument when it was put to me from the Bench in connection with any decision.
Those of us who believe that the existence of the filter and the requirement for the intervention of a Member of Parliament--not the filtering provided by the Member, but simply the requirement for the intervention--have a stifling effect on potential claims, must accept that their removal would have serious resource implications.
However, we accept the commitment of additional resources to the identification of maladministration and the resolution of complaints as an appropriate expenditure which will lead to cost savings in the long run.
The filter may control the quantity of complaints received, but it does nothing to ensure equality of justice for all complainants, and generates a fundamental flaw increasingly out of kilter with modern thinking about access to justice for all. It is also out of kilter with the Government's ambitions for public services as set out in chapter 3 of the White Paper, "Modernising government". Paragraph 6 of that chapter says that the Government want public services that, among other things,
In 1997, communications from Members of Parliament to Ministers were estimated to amount to 200,000--the equivalent of about 300 per year per Member. If we compare that with the 1960s, when research shows that Members of Parliament were generating only about 20,000 letters a year, we get a flavour of how little threat an unfiltered ombudsman system would be to Members of Parliament in their exercise of that role.
In 1999, it is not the fear of a constitutional rivalthat threatens Members' parliamentary lives, but the increasing demands made of them to help their constituents. The number of people seeking the help of their Members of Parliament has increased dramatically. In the mid-1960s, the total mailbag for Parliament consisted of 10,000 letters a week. By 1997, that figure had increased to 70,000 letters, 40,000 of which were incoming mail. What does the arithmetic show? Do Members of Parliament answer 10,000 letters a week? That would be slightly disturbing--[Interruption.] No, they do not all come to me. There can hardly be a Member of Parliament who would not welcome some relief from that increasing burden.
Next, the House accepted what was described as the ground of the high constitutional principle--that the ombudsman should be an additional weapon in a Member of Parliament's armoury rather than a freestanding institution undermining Ministers' and Departments' accountability to Parliament. It is a good job that the frequency of, and the participation in, debates about the ombudsman's work are not the only measure of how highly Members have regarded that "high constitutional principle" since 1967.
How could an ombudsman who has no power to institute his own departmental audit, and whose annual reports merit pathetically few column inches in our national newspapers and almost no electronic media coverage, present any alternative to the constitutional position adopted by the House as a safeguard of ministerial responsibility?
"an extremely sharp and piercing instrument of investigation."
Unfortunately, the parliamentary ombudsman scheme got off to an inauspicious start and attracted much criticism for its timidity. Over the subsequent 30 years, its reputation has been enhanced, to the point where it occupies
"a part of the fabric of the UK's unwritten constitution."
The quotation is taken from the first report of the Select Committee in 1990.
"sharp and piercing instrument of investigation"
was created--20 per cent. of Members of Parliament found no use for it. The 550 Members who did refer cases referred, on average, only three cases each. Consequently, from a high watermark of 1,933 cases in 1996, the number of new referrals to the ombudsman has steadily decreased to an annual total of about 1,650.
"I welcome this debate; the first since 1991. Clearly that is far too long an interval and the House should be given greater opportunity to consider the work of the Parliamentary and National Health Service Commissioners."--[Official Report, 15 December 1994; Vol. 251, c. 1125.]
When responding to that debate, the then Parliamentary Secretary, Office of Public Service and Science could give neither Mr. Pawsey nor other hon. Members who had
raised the same point any assurance that there would be any more regular debates on the issue. However, I am sure that, were the former Minister still a Member of Parliament, he would be asking himself these questions: why is it now almost five years since the last debate on the work of the ombudsman, and how seriously does the House of Commons take that work, given that such irregular debates take place?
"we are embarking upon a series of changes that could constitute the most important parliamentary reforms of the century."--[Official Report, 25 June 1979; Vol. 969, c. 35.]
That historic perspective on the establishment of Select Committees was not shared by everyone--certainly not by all Members of the House. At the time of the debate on the substantive motion setting up the Committees, the then Member of Parliament, Willie Hamilton, contended that the whole process was
"the status quo in a different wrapping."
He continued:
"The Government are making these proposals precisely because they know they are cosmetic and will not change anything much."--[Official Report, 25 June 1979; Vol. 969, c. 98-99.]
Viewed from today's perspective, it would appear that the arguments for a new system advanced by the Procedure Committee then could be asserted with equal strength today. The Committee's report said:
"surveillance of the Executive will not be substantially improved unless other reforms take place, such as . . . among other things . . . more access to the Floor of the House of Commons."
There can be no criticism to the effect that the Select Committee on Public Administration or its predecessor, the Select Committee on the Parliamentary Commissioner for Administration, have failed to devote sufficient time to considering the work of, and reports from, the ombudsman: on the contrary.
"make it easy to complain and get a result when things go wrong."
Secondly, the House accepted the argument that a filter would make the establishment of the ombudsman's office more acceptable to Members of Parliament who might otherwise have seen it as a rival to their grievance- handling activities. In 1999, do we really believe that a system that absorbs about 1,500 complaints a year, and rejects 70 per cent. of them, is a rival to Members of Parliament in their "ombudsman" and advocacy roles?
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