Select Committee on Health Minutes of Evidence

Letter from Mr John Elder to the Clerk of the Committee (ACI 81)

  As per our recent telephone conversations, I have enclosed a report, based both on information gathered for my recent book and through some personal experience, which it is hoped be of use in the forthcoming Health Committee enquiry.

  However, in the process, I seem to have overlooked a couple of valid aspects of certain parts of my report. These are itemised as follows:

  1.  An "independent review" panel has no executive authority over any action by a trust or health authoriy or family health services practitioner, and is not permitted to suggest in its report that any person should be subject to disciplinary action, or referred to any of the professional regulatory bodies. Effectively, therefore, this component of the NHS complaints procedure has no real teeth when a complaint is found to be justified.

  2.  My impression of the attitudes of the medical practitioners concerned in the two complaints lodged by me is not good. There were refusals to provide information; a lack of response to correspondence; evasiveness; defensive postures; and even attempts to convince me that my fears were unfounded. By contrast, the co-operation of complaints handlers was generally acceptable, although response to correspondence invariably was belated and sticking to promised timescales was similarly a problem. I felt that delaying tactics were part of the process—or so it seemed.

  There is no specific coverage of patients' rights in my report, since the subject is too wide-ranging in scope. albeit, reference to the index in my book and the erratum and addendum sticker at the end of this section will provide the necessary comparative information which, incidentally, is quite extensively portrayed and may be useful for the purposes of the Enquiry.

  During the research for Who cares about the health victim? I received a fairly substantial volume of case history material relating to patients'/relatives' experiences. Unfortunately, largely due to the risk of breaching confidentiality and, to a much lesser extent, restrictions on page space only a small percentage of this information actually appeared in the book.

  It is quite possible that these case histories can be presented verbally to the Committee in abbreviated and more anonymous form. I would be prepared, also, to give evidence of my personal experience of two complete journeys through the NHS complaints procedure which hae been only very briefly touched upon in the appended report. Both of these cases are currently being considered by the Health Service Commissioner, so that an element of discretion would need to be exercised in this respect. There are other points about the NHS, some significantly on the positive side, which given the opportunity I would like to mention to the Committee.

  You are, of course, aware of BBC Radio 4's series of five consecutive broadcasts between 29 March and 1 April of this year looking at the NHS complaints procedure and associated issues. If you have not already done so, perhaps you can ask them for a tape of the broadcasts—asuming that you consider this to be a useful exercise.

  Actually, the BBC received my book a little before Christmas last when they also interviewed me—for what it was worth. Albeit, it was gratifying to hear that all of the book's special focus on the detail of the NHS complaints procedure—and how it functions in practice—came through in the programme. At the time, this information was not really in the public domain. Nor was there any existing published source providing details of what was on offer in other advanced societies in this and associated areas concerning health care.

  What also seemed surprising, prior to circulation of the book, I did not come across a single health correspondent (or equivalent) in the press or broadcasting who was familiar with the specifics of the NHS complaints mechanism. And they certainly had no idea of what was going on in foreign parts. Frankly, I still find the whole thing hard to believe. But I digress.

2 June 1999

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