Examination of Witnesses (Questions 20-37)
ANN ABRAHAM
18 JANUARY 2007
Q20 Kelvin Hopkins: On our visit
to the job centre in Clapham the other day one thing that came
across very strongly was a very great sense of pride in being
civil servants, of a strong commitment to the people they were
trying to help. This public service ethos was still very strong
with these people, but they were now in a world where they have
to get through perhaps 40 clients a day. It is now measured performance
in terms of numbers of people through the door. They are not supposed
to engage quite so much. Everything is on computer so they just
took the details, pressed the computer keys and an answer came
out. It was becoming less personal and staff were becoming very
frustrated and felt very unhappy about the fact they were being
shifted from this public service world to a performance measuring
world governed by IT, where all the knowledge was on the IT and
not in their own minds. Do you not think that something is being
lost in general and that the best way to deal with the public
and the complaints would be to rebuild that sense of very strong
personal commitment, of public service, of pride in working for
a public authority responsible to the people they are serving?
Ann Abraham: I am all for pride
and also for passion. Gus O'Donnell has four "Ps": Pride,
Passion, Professionalism and Pace. Pride in public service comes
through in the Charter Mark Review and the importance of retaining
that recognition is absolutely key. You do not have to have "public"
in there to have pride in service. I have been to that job centre
as well. It is obviously the one that you get taken to. I have
also been to some others in my time, as I am sure you all have.
Q21 Chairman: The point Kelvin was
making was what they were saying was, because we pressed them
on this, there has been a process of de-skilling. At one time
they would have been expected to know the whole field, intensive
training, going away for periods of retraining and so on. The
job had been de-skilled so they did identifiable segments of the
work, pressing buttons on a computer. If that is what has happened,
is it not likely, therefore, that complaints will rise and be
upheld more because people are less on top of the job in the round
than they once were?
Ann Abraham: The simple answer
is yes. Certainly complaints to me will be more likely to be upheld
because one of the principles of good administration is the whole
customer experience and looking at things in a joined-up way.
Yes is the simple answer to your question. It flies absolutely
in the face of everything David Varney is saying about the whole
customer experience and that lovely phrase he has about public
service islands. He describes that in terms of different departments.
I have described DWP as having a series of agencies that do not
necessarily join up. What you are saying is within the agency
there are bits of the job that do not join up. We have some challenges
on our hands.
Q22 Chairman: Although you are resisting
Kelvin's first point surely he is onto something. If the argument
is that the eye has gone off one ball, which was the whole consumer
service area including complaints and redress that we once had,
where has the eye gone? The eye has gone to all this choice, contestability,
performance, information and so on, if you do not like services
go somewhere else. Against all that complaints is boring, old
fashioned, is it not? It is out of tune with the times. You can
see why this might have happened.
Ann Abraham: I can see why it
might have happened but actually I come back to where I came in.
I think it is very interesting reading the Charter Mark Review
report and reading David Varney's report almost immediately afterwards
because you can contrast them, in one sense. The Charter Mark
talks about all the things you have described and the huge value
in complaints, feedback, learning and customer experience, and
actually the Service Transformation report seems to come from
another place. Actually if you reflect on it I do not think they
are that different. There is a logical progression that can be
made as long as the connection is made. The Service Transformation
report is efficiency driven. It is a Treasury document, it was
commissioned by the Chancellor, but there is still lots in there
about improving services for the citizen while benefiting tax
payers. I do not have any problem with that being both a citizen
and a tax payer, like most of us are. Those are the things that
drive my office as well. What I am saying is I see the charter
work as the foundation. I see service transformation as being
an updating but not a negation of anything that has gone before.
The really important thing to do here is to bring in all of the
benefits, all of the concepts and all of the value that came with
the work on Citizen's Charter and what followed it, including
the work this Committee did which actually drove a lot of that
forward. Let us take up this document, which is only being maintained
for archive historical purposes, and get out the real wisdom from
this, add to it the updating which says we do need to break down
this public service island tendency that we have gone into, particularly
if it has gone into compartmentalised production line stuff, and
bring in a recognition of what customers expect in the 21st Century
in terms of the response times and technology and opening hours
and all the rest of it. Let us add that on to the foundations
rather than take those foundations away and build something different.
We will not succeed if we only take David Varney's report and
do not take what came before it.
Q23 Mr Prentice: Very briefly, are
people less willing now to put up with poor and indifferent service?
Ms Abraham: Some people are.
Q24 Mr Prentice: What has brought
about this change rather than just resignation on behalf of people
to become active complainers?
Ms Abraham: I suppose, if you
ask Ben Page these questions, and he does a very fast and furious
presentation on this, he will do the whole: how customer and consumer
and citizen expectations have changed over recent times. A lot
of it is driven by the private sector and what the private sector
offers, and there are expectations that come from that in terms
of when you can get somebody on the end of a phone and how long
you might expect to wait for a response to your email, and so
on. I think there is some of that. I come back, though, to some
of the questions about the people. They may not be resigned but
actually they are not the white male, middle-class, articulate
people with the stamina, the persistence, to find their way through
the systems of complaint and redress, and they are the ones that
worry me, because quite often they are not getting the service
they are entitled to, the benefits they are entitled to, the redress
they are entitled to.
Q25 Mr Prentice: You mentioned MORI.
Ever since 1997 and the Citizen's Charter in 1994, and before
then, we have all been banging on about minimum standards, and
in the material that MORI unearth people have a very clear preference
for uniform standards across the country. Is not one of the reasons
that people are more likely to complain because they are just
more clued up about their rights?
Ms Abraham: Some people are.
Q26 Mr Prentice: On the private sector,
is there anything that we can learn from Richard Branson that
we are not already doing?
Ms Abraham: I am sure there are
things to be learned from the private sector.
Q27 Mr Prentice: Because they can
screw things up pretty badly, can they not?
Ms Abraham: Absolutely. I am not
in the "private sector good" "public sector bad"
or vice versa camp at all, and I have said that, I think, many
times in front of this Committee. I have had, as I suspect many
others have had, personal experience of the NHS at its best and
at its worst and the NHS contracting services out to the private
sector and, therefore, experience of the private sector in health
doing a very fine job thank you very much. Therefore, I am sure
there are lessons to be learned from the private sector around
those private sector organisations that understand the value of
feedback and complaints, and they are the ones, I think, that
are worth either getting to sit here, or to give evidence, or
to go and see, and, yes, I think that would be a good idea.
Q28 Mr Prentice: Are complainants
getting together as complainant groups using websites and the
internet, and so on, to put pressure on organisations? Are there
any examples of that happening? I am thinking about the Health
Service, people getting together complaining that they are not
getting the drugs that they need, or whatever?
Ms Abraham: It is not something
that is particularly—
Q29 Mr Prentice: Does it surprise
you that that is not happening?
Ms Abraham: I am just trying to
think. I am not saying that we have not seen any of this, but
I would not say it was a huge feature. We have had a number of
examples, I suppose. NHS reconfiguration, I think, is an interesting
one, but usually there is an MP in there somewhere. It is about
looking for solutions to concerns that people have. Probably that
is not one for me anyway. Yes, we see some of it, but we do not
see a huge amount of it. The vast majority of people who come
to us come as individuals.
Q30 Mr Prentice: Picking up what
Jenny said earlier about the easier you make it for people to
complain the more people might complain, are there examples of
websites (and we know the Government is closing down 550 of them)
that make it easy for people to complain and show them the pathway
through? Are there some examples you can give us there? If not
it does not matter.
Ms Abraham: I do not think I can,
honestly. I hope ours does, but I would not want to single out
any particular department. My concerns will always be much more
what are the barriers that stop people getting through, but, no,
I probably do not want to single anybody out.
Q31 Mr Prentice: You mentioned the
Healthcare Commission. Is there an overlap then? It is confusing
to me what the Health Service Ombudsman (you) does and what the
Healthcare Commission does. You mentioned Foundation Trusts and
you said, because I jotted it down, "They have supported
in the past a certain standard of performance"—I thought
that was a good one—but they have got their own complaints
handling. For people out there it must be mystifying who to complain
to the Health Service.
Ms Abraham: Yes, I agree. You
will be aware of my report on Making Things Better in terms
of the NHS complaints procedure, and I have been very disappointed
that, despite an initial very positive response to the recommendations
from the Department of Health, the Healthcare Commission and a
whole range of others, it has really been very, very tough to
make progress in this area and I know it is very, very difficult
for people who want to make a complaint about healthcare to understand
and navigate their way through the system. I am sure there is
much more that can be done to make it simpler, quicker, clearer,
and I am happy to talk about that at great length, which I am
sure we have not got this morning.
Q32 Chairman: Thank you very much.
Just as we wrap up and developing Gordon's point, do you think
this comes a bit out of the NAO Report, the suggestion that there
might be some value in having a common access point to complain
to the whole complaint network? It is not only confusing for the
Health Service, it is confusing everywhere. People do not know
who provides what service and they do not know, therefore, how
the complaints procedures work. Would it be a good idea to simply
have a place where someone could go who would be simply instructed.
If they want to complain about a public service, this is how they
might do it—something like NHS Direct—Complaint Direct.
Ms Abraham: I suppose the slightly
flippant answer to that is I thought that was my job. That specific
recommendation in the NAO report really did concern me, in the
sense that I think the last thing we need is to set up another
huge organisation to deal with complaints. It is the same in the
health context, where for a while now (and we are now very pleased
to see that Sir Liam Donaldson had knocked the idea fairly firmly
on the head in his latest report) there would be a single complaints
portal. It is easy to say. It is a bit like coming back to these
compartmentalised bits of jobs. Who is going to answer those phones?
Who is going to answer those emails? How are they going to know
all this? How is it going to be kept up-to-date? How are departments
in the NHS going to be required to ensure that that single source
has got up-to-date information? I am much more interested in some
fundamental principles, and I offer the principles of good administration,
which have got a lot in them about putting things right, and continuous
improvement as a framework of principles here. My office, with
its major overhaul of the front end, is at least an organisation
that has an overview of central government and the NHS. Clearly
we do not cover the wider public service and local government,
but we have pretty good connections to ombudsmen that cover all
of public service, I have always thought, when trying to solve
problems, that the starting point ought to be to build on what
is there rather than to create new organisations.
Q33 Chairman: I am surprised you
are so negative about this, because I thought you welcomed it.
You are not saying that anybody in the country who wants to know
how to complain about something should come to you, are you? That
would be absurd. There is not such a place. As Gordon says, even
if it was just a website, somewhere that you could tap into that
would just navigate you round the complaints system: you type
in the kind of complaint you have got and it tries to help you
to find the place to go to.
Ms Abraham: Who would do that?
Which government department would own that? The Cabinet Office
is not a service delivery department. Where is the expertise coming
from? What I am saying is I think that a lot of time, money and
energy could be wasted in trying to set something up like that.
I think that there is a huge amount that could be done better
in existing systems. I think that if Government is thinking, in
response to Sir David Varney's report about compressing the number
of websites and rationalisation, that there is a complaints angle
to that, there are all kinds of links to be made and I think my
office has got a role to play. I suppose what I think about that
is that it is easy to say, like so many of these things, and very,
very difficult to deliver to the sort of quality that it would
have to if it was going to make a difference. So, no, I am not
a fan.
Chairman: I can see that.
Ms Abraham: But I think I have
got a contribution to make here.
Q34 Chairman: You certainly have.
I think that is us done, unless you have got anything you particularly
need to add. This is just an initial canter through some of these
issues which we shall probably come back to again as we explore
them, but from our point of view it has been a very, very useful
preliminary session. Have we failed to ask you something that
is the most important thing, in which case you should say so?
Ms Abraham: I have scattered my
responses with ideas of people whom you might see.
Chairman: Indeed you have; we have got
a long list.
Ms Abraham: I have not, in the
course of that, suggested the Cabinet Secretary, and I will do
it now, because I think it is important that there is breadth
and depth in this inquiry (and I am sure there will be knowing
the Committee), but I think that that overview from the Cabinet
Secretary and the Capability Review issue is important. I think
if you want real depth about learning the hard way from complaints,
you might like to ask the Permanent Secretary of the MoD to come
and talk about Debt of Honour—I think their internal inquiry
is coming to its later stages and that seems to me to be real
depth—and then, I think, the breadth and depth ones are
the ones I have talked about: DWP, Revenue, Health on continuing
care, the ones that are in the memorandum.
Q35 Chairman: This is all very helpful.
The Cabinet Secretary is coming to see us in three weeks time.
What shall we ask him then?
Ms Abraham: I have got a list
of questions for you.
Q36 Chairman: Excellent. You do not
have to go through the whole list?
Ms Abraham: One of them is about
accountability, I think, for complaint handling performance.
Q37 Chairman: All this shows how
dependent we are going to be on you in this inquiry as we proceed,
and we see you as our great reservoir of knowledge and source
of advice, so thank you very much for being so willing to help
us.
Ms Abraham: Thank you for the
opportunity; I have enjoyed it.
|
