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 processor
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
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 broadcastsasuming that you consider this
to be a useful exercise.
Actually, the BBC received my book a little
before Christmas last when they also interviewed mefor
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
procedureand how it functions in practicecame 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