Examination of Witnesses (Questions 120
- 123)
WEDNESDAY 28 MARCH 2001
DR DAVID
CARSON, MR
ANDREW PALETHORPE
MR R THOMPSON
AND MS
C HEANEY
120. It is with Ministers but there is no connection
between what a Bill might say and the results of a study. The
results of a study sit by themselves.
(Mr Thompson) Indeed, and we think it is very important
that we try to connect whatever comes out of the evaluation of
the complaints procedure with the new structures that will emerge
within the NHS. We feel we have a responsibility to try and make
those connections as integrated and as sensible as possible because
this will be quite a significant change to the way in which the
NHS, I believe, connects with patients who wish to make complaints
and the public at large.
Chairman: I understand and agree with all that.
Mr Trend
121. You mentioned earlier the advocacy arrangements
that have been made in the Bill, which were very controversial
in both Houses of Parliament. A cynic might say that Ministers
were holding back the review in order to present both a problem
and a solution. If Parliament cannot analyse the problem before
it looks at the proposals for the solution, I think that is a
bad deal.
(Mr Thompson) Certainly Ministers are very keen to
make sure that sensible proposals emerge from the evaluation.
It is important that you try to integrate the two particular processes
together. We have heard several examples from the Ombudsman's
office of how difficult it often is for patients to enter into
the complaints process. I personally believe that the intention
around a lot of the proposals within the Health and Social Care
Bill is to provide that support and advocacy for patients in the
future. In that sense I personally believe that the two processes
do need to be closer together. There will be a consultation process,
as I say, once the Bill is completed. No doubt the public at large
and others will make their representations at that time.
Mr Turner
122. As far as I have understood them, the proposals
you have put forward seem to me to be quite good and on the right
lines to ensure that we get a better NHS than we have had in the
past. The difficulties we had with the earlier session were on
enforcement. How can we be assured that the kinds of things that
you want to do are going to be enforced? How can we be convinced
that what you want to achieve will actually be achieved?
(Mr Thompson) Certainly I think parts of the review
of the complaints procedure show a sense that patients do not
always feel empowered within the processes that we have at the
moment. The setting up of the patients and advocacy liaison service
within trusts (which will include primary care trusts for example)
and the independent advocacy service, which will be available
to all patients, are two very concrete ways in which patients
in the future should be able to be supported through the complaints
procedure. We are keen that that consultation takes place. No
doubt primary care and the way in which out-of-hours services
work may well come up as an issue within that consultation period.
123. Are you absolutely happy that, at the end
of the day, if the organisation—the patients and advocacy
liaison service—comes up with a decision, that that decision
will be able to be enforced? The Chairman was referring to the
problem of a patient being struck off a GP's list. You accepted
that that was not natural justice. Are you happy that natural
justice will apply?
(Mr Thompson) I think there is a much greater chance
of that now. In addition to the patients and advocacy liaison
service, each trust, for example, will have a patients' forum
and a panel service will elect a non-executive director to sit
as a member of that particular trust board. I cannot comment on
the individuals in these particular cases with Healthcall. For
example, in those trusts in the future one of the non-executive
directors will emerge from the Patients Forum. I think there is
a much greater chance within the current and future structures
of the NHS for patients to have a say and be directly involved
in the decision-making processes in each primary care trust. Yes,
I do believe there is a much greater chance.
Chairman: We will provisionally end there. We
would like to have you back when we see the review and what the
shape of the new complaints system is going to be. The Committee
is extremely interested in this matter. It notes that the only
bit of the complaints system that applies is that the NHS should
be covered by traditional competencies, and that is the Ombudsman,
because of its conspicuous independence. We shall be looking carefully
at what is proposed to make sure that it passes tests of that
kind. We are grateful for this first conversation and we look
forward to our next one. Thank you very much indeed.
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