Public Administration Select Committee - Minutes of EvidenceHC 757

Oral Evidence

Taken before the Public Administration Committee

on Tuesday 18 December 2012

Members present:

Mr Bernard Jenkin (Chair)

Charlie Elphicke

Paul Flynn

Robert Halfon

Kelvin Hopkins

Priti Patel

Steve Reed

________________

Examination of Witnesses

Witnesses: Dame Julie Mellor, Parliamentary and Health Service Ombudsman, and Ms Helen Hughes, Chief Operating Officer, the Office of Parliamentary and Health Service Ombudsman, gave evidence.

Q1 Chair: Dame Julie, welcome to your first session in front of this Committee as Parliamentary and Health Service Ombudsman. I welcome Helen Hughes, also.

You are statutorily forbidden from discussing individual cases and I thought it would be helpful if we reminded ourselves of that. It is also the policy of this Committee not to prosecute or investigate individual cases, but we are anxious to learn about what you have learnt from your first few months in office. You have been in office for nearly a year now-almost exactly a year. What do you think you have achieved? What has surprised you most?

Dame Julie Mellor: Perhaps I could give a few minutes of context before I answer your question.

Q2 Chair: Sorry. You did remind me a minute ago you wanted to say a few opening words. Please go ahead.

Dame Julie Mellor: I am really pleased to be here to talk about our work because, as the Parliamentary and Health Service Ombudsman, our relationship with Parliament-and with PASC through to Parliament-is at the heart of our independence and authority. It is what gives us the authority to make judgments in cases across Central Government and the Health Service on your behalf.

In preparation for today, you have our annual report, covering 20112012, and you also have a short memorandum talking about performance, strategy and organisation. I expect to deal with most of the questions. I will be covering performance and how our experience of doing casework has been a major driver of the strategy that we have been developing. You kindly welcomed Helen, as well, who joined us in September; she was not here during the year being covered today, but she is here in case there are questions on the finance and people aspects of our organisation.

I wanted to highlight something we have done differently this year in the information we have provided, to try to make it easier for you to assess our performance. What we have done is try to provide comparable data, so you have two to three years’ data rather than just the one year’s data; you can therefore look at trends up and down. Where possible we have provided comparisons with other ombudsman services. In terms of our performance, I think there is a picture painted by our performance and our experience of the casework about the complaints system in the public sector that has been one of the drivers of our strategy. As you have said on other occasions, Chair, there is a chronic and urgent problem with the complaints system in the public sector. We have areas to improve; that is reflected in some of the written evidence submissions you have received. We have also taken account of feedback from the Health Select Committee, from yourselves and individual MPs, and from the public and our staff.

My focus in my first months has been twofold: one is continuing to deliver the service, and the other is looking at what we need to do in the future to have more impact on more people. We will do more investigations; we will do investigations that are shorter where they can be, and give the resources to those more serious and complex cases where they should have it. We also need to prevent people coming to us. To do that we want a much more active relationship with Parliament so we can be relentless with Parliament in highlighting service failures and establishing expectations of service providers. We also need to be relentless in shining a light where complaints are not sorted properly by services. To do all that will take investment and require savings to be made. It will take time: to manage expectations, I do want to be very clear that changes will be achieved over the next three years, not tomorrow. However, we would be happy to share more detail of our strategic plans, which we are in the process of developing-including an outline timetable in the spring.

The last thing I wanted to say at the end of my first year is thank you for appointing me last year. I think my ambition has grown as a result of our engagement with people. We have had an incredibly positive response from the hundreds of people to engage with us on establishing what our shared vision is for the complaints system. This is a shared vision where complaints make a difference and help improve public services for everyone. I very much look forward to working with this Committee to see how together we can take a lead in transforming the complaints system and realising that vision.

Q3 Chair: Thank you. As you know, we are interested in the whole complaints system. What has most surprised you in your first year? What do you think is your single most important achievement?

Dame Julie Mellor: To be honest, I do not know whether anything has surprised me because I spent so long researching the role before I applied for it. My predecessor very kindly spent the whole of December with me before I joined, so I had a pretty good feel for the role when I joined. The thing I am most proud of from our first months in office is our engagement with people, so that there is now a shared vision for the complaints system. We are clear that we will be doing more investigations for more people in the future.

Robert Halfon: Could I ask a general question?

Chair: Certainly, as you must leave, unfortunately.

Q4 Robert Halfon: Yes, I am sorry. I have college journalism students visiting, so I have to leave early. Can I just ask what you are doing to look at privacy of data and how, if people make complaints, even anonymous complaints, agencies of the State use that data? For example, somebody might report that something is going on in a care home and that agency might identify the person who reported that to the care home. How would you react to that? Is that something you would deal with-the protection of people’s private data?

Dame Julie Mellor: If someone was making a complaint about the release of their data, to be honest I am not sure. I would probably need to rely on colleagues. I think, however, that it would normally be dealt with the Information Commissioner, not by us.

Q5 Robert Halfon: If somebody reported individuals who were claiming benefits when perhaps they should not have been, and social services identified those individuals, it could potentially cause great distress to the individuals concerned if it were found out who reported them. What would be your response to that?

Dame Julie Mellor: That kind of case we have dealt with. In fact, there was a case in one of our previous reports where someone became the victim of harassment as a result of revealing information about a claim.

Q6 Robert Halfon: I sent your predecessor something that happened in my own area, where pensioners were treated to two years of violence and harassment because they had reported someone who should not have been claiming.

Dame Julie Mellor: In past cases, we have been able to get the kind of redress that individuals have wanted: for example, getting agencies to work together, because one of the problems is that the individual might give the information to Jobcentre Plus, but actually the people who have reported it need to move and it is the local authority that needs to deal with the move. I know in the past we have managed to get the agencies together and get a remedy that the individuals were happy with in terms of moving them so that they felt protected.

Q7 Robert Halfon: Do you have any role in terms of ensuring that agencies properly protect people’s identities? I know there are Freedom of Information issues. In my own case there was an agency of the State involved. I had recently sent something to the Care Quality Commission and they then identified my name to the organisation. I had received an anonymous note, which I felt it was my duty to send to the Care Quality Commission, but they then released my name to the organisation, causing me huge difficulties. That is not only about Freedom of Information; it is about the workings of the organisation. What is your view on that?

Dame Julie Mellor: As I said, I think we might well have a remit in some of those cases, but our unique role is to respond when an individual comes to us with something they think has gone wrong and expresses the injustice they have experienced. That is when we can look at that, make a decision on whether the evidence supports what they are saying and whether there was an injustice, and find a remedy. It relies, however, on an individual complaining.

Q8 Chair: What we are finding in Whitehall Departments is that they are very generally concerned with how they do things and the process by which they do things. The outcomes are very often less important than the process-indeed, your predecessor raised this as an issue: Departments are not outcomefocused. How do you address that in your own work? How do you measure the effectiveness of your outcomes rather than processes? Of course, you are a very processorientated organisation.

Dame Julie Mellor: You are asking the kind of question we have been asking ourselves over the last few months as we develop our strategy going forward. The way we have measured things, in terms of the information you have in front of you, is that we do look at process in terms of numbers of cases going through. We also look at customer satisfaction, although I have to say I think our approach to customer satisfaction will have to be reviewed as part of our new strategy, because I am not convinced the data is meaningful a lot of the time.

Q9 Priti Patel: Dame Julie, you have touched upon the whole notion of a shared vision across organisations and across the partners that your organisation works with. In your written evidence, you highlight a degree of growing resistance by some organisations to follow or take on board recommendations from your organisation at draft report stage. Where do you think this is going in terms of the relationship with the Ombudsman as such, in terms of engagement so that that shared vision can be expanded upon with those organisations, so that they can see the value of the recommendations that you are making?

Dame Julie Mellor: That speaks to one of the four things that we want to do more of. If we are going to be able to cope with a higher volume of complaints, we need to be looking at how the system as a whole operates. Therefore, one of the things we want to do is use more of the evidence from our cases to go back to the bodies in our jurisdiction and be a leader on how they need to improve their complaint processes. For example, in my predecessor’s first annual report on complaint handling in Central Government, its agencies and other public bodies, she called the complaints system across Central Government, "inconsistent, haphazard and unaccountable."

I met with Permanent Secretaries as a group this year and they have agreed to respond to that criticism and establish some common standards across Central Government and agencies for handling complaints based on our principles of good administration, good complaint handling and good remedy. They have revitalised a group called the CrossGovernment Complaint Handling Forum. The Permanent Secretary to the Department for Work and Pensions is taking a lead in tasking that group to develop those standards and look at how they are met across Government.

I was pleased that Sir Bob Kerslake has asked us to provide information on an annual basis on the performance of individual Departments, to take into account in the appraisals of Permanent Secretaries. I made it very clear to that group of Permanent Secretaries that I expected their Boards to be looking at complaint handling performance regularly, looking at a mixture of things: the number of complaints they receive; the issues in those complaints and what action they have taken to improve the services as a result of that learning and what more they might need to address; and, thirdly, what the experience of their customers is of complaining to them. I did that because research over a number of years has shown that while some parts of the public sector had been taking recommendations on the substantive issues and how they could learn to improve services from complaints, I believe that no organisation in the past had been able to say they had asked their customers about their experience of complaining.

We are beginning to see a package of things. Indeed, in our report from this financial year on complaint handling across Central Government, we have been able to report improvements-particularly in the Department of Work and Pensions and Defra. Defra have been quite open in saying that was as a result of my organisation and its investigation into the Rural Payments Agency, and how they realised they did not have the information at Board level to know what was going on and what complaints were coming in. They now do.

Q10 Priti Patel: Where do you see this, though, in terms of the strategic imperative that you have for your organisation? Is this one of the top three priorities that you will be focusing on? What is your own actual expectation? You have highlighted-quite well, actually-the potential new ways of working through the Civil Service and across Permanent Secretaries to achieve good performance management, which is a good thing. In terms of the actual improvements and how they will be measured across the Civil Service, and specifically in relation to taking forward your recommendations around certain organisations, how will you judge that?

Dame Julie Mellor: At a very high level, that is about whether the more detailed articulation of that vision, which we can measure from the public, has come to pass. For example, in our strategy document, which we published a few weeks ago, our research had shown that people did not know where to go to complain or how to do it. They felt it would be complex and bureaucratic, and 40% of those who had a complaint did not make the complaint. One thing is that we would measure it by whether the public are confident that complaining about public services is straightforward and fair. Do the public, when they complain about public service, feel that they have been listened to, treated fairly and had mistakes put right? We then need to look at what measures we can have that public services are learning from complaints and using that learning to improve the services they provide for everyone. At the very high level, those would be the kinds of things we look at.

Q11 Priti Patel: In, let us say, the window of the next five years, what is the expectation from your side? You started off by saying you have become even more ambitious for the organisation. Do you see a percentage shift in terms of difference and a positive way forward? How do you think you will be able to assess this going forward?

Dame Julie Mellor: Assess our strategy as a whole?

Q12 Priti Patel: No, I mean the difference in terms of ways of working with organisations. What would success be for you? How would you judge that success?

Dame Julie Mellor: Do you mean specifically on improving their complaint handling?

Priti Patel: Yes.

Dame Julie Mellor: The simple answer is that this is exactly the work we are doing at the moment. For each of our four aims, one of which is leading the way to improve the complaints system, we will need to specify the metrics that we need. We will need to baseline and then we will need to set targets for that.

However, I think it comes back to the public confidence in making complaints, i.e. the impact of actions we have taken to help services improve. How many Boards will we be able to report on next year as regularly looking at their customers’ experience of complaining? We will need to look at the uptake of recommendations we make and whether we have delivered what we said in terms of the way we work with organisations to help them improve their complaint handling across the board. There will be a mix of outputs from us, the outcome of that and the longterm impact on the public feeling.

Chair: Before we move on, we seem to be on the question of complaint handling. I will ask Steve Reed to follow up in a moment, but first Mr Hopkins will ask about complaints in the health service.

Q13 Kelvin Hopkins: I have long been concerned about the system of complaints within the Health Service. There was a very strong feeling that when the Community Health Councils were abolished and replaced by other reformed systems, it was an attempt to weaken patient power, if you like. It was even suggested that, with the entry of private companies into health provision, these private companies did not want strong, effective, independent patient representative bodies making life uncomfortable for them. This was debated some time ago, since when there have been some reforms of patient representation and patient complaint systems. I just wondered whether you felt that the complaints systems in the Health Service were inadequate. If they were adequate and were stronger, fewer complaints would be passed on to your office and things could be dealt with more effectively at an earlier stage.

Dame Julie Mellor: Today that question in a sense is hypothetical, in that there has been such a huge change in the health landscape with the reforms last year and the Health and Social Care Act. One of the things that we highlighted in the report that we published a couple of months ago on complaint handling in the NHS was the need for goodquality complaint handling to be embedded in those organisations with new leaders and new responsibilities. That will be a real challenge, of which the NHS Commissioning Board is very aware, and the kind of worries that we have from our experience of the current system-before the new landscape comes into effect next April-is that one of the groups within the NHS that are perhaps most resistant to recognising our role and powers is GPs.

This year we have seen repeated inappropriate removal of patients from GP lists. Of course, some of those GPs will be leaders of the new Clinical Commissioning Groups and will have very significant responsibilities to make sure that the complaints system works properly-that the providers that they commission have decent complaint handling, that they are ready to take complaints about their own commissioning decisions, and that they use complaints data to inform those commissioning decisions. There must be a mindshift for some GPs if they are going to be leading clinical commissioning groups and embedding goodquality complaint handling

Q14 Kelvin Hopkins: It is interesting that you raise the question of GPs, because GPs are not direct employees of the Health Service; they have always been independent contractors with the Health Service. However, if things go as the Government wants them to, more components of the Health Service will become independent, contracting organisations-some will be private companies, indeed. That situation will become worse.

At the moment, when things go wrong at my local hospital and patients come to see me, I write to the Chief Executive of the Hospital Trust and I can get some kind of action or some kind of response. If, however, there is a myriad of independent contracting organisations, that will be more difficult. It would be more difficult for you as well, I would have thought.

Dame Julie Mellor: Yes. I will add something to your previous question and then come on to the question of independent providers. Perhaps what I did not acknowledge are the kinds of problems that we do still see, which I do not expect to go away in the new landscape. We reported this year that we are still seeing poor communications with patients and families and inadequate explanations through the complaints process. Those are still problems that we are seeing.

You also mentioned Community Health Councils. One of the things we try to do with our contact centre is to ensure that, where people are pursuing a health complaint, we let them know about local advocacy services to support them in making that complaint and to give them that clout at a local level. In order to deal with the embedding of decent complaint handling that is now required in the new health landscape, we want to play a part in that.

You are quite right: we are beginning to see more complaints coming through about independent providers, because there are more of them. Their response is variable. Some of them have actually clocked that they may be a supermarket providing optician services, but a hamper will not do in terms of a remedy if someone's sight has not been diagnosed or treated properly. Some of them are responding very well and want to understand our principles of good complaint handling. I imagine there will be others that are less so; that is an area where we hope to bring together, in the future, those independent providers, to make sure they are clear on what we expect of them.

Q15 Kelvin Hopkins: My own view is that direct employment of all people in the Health Service is the way it should be, because they would be properly accountable to the Health Service and ultimately to the Department of Health and Parliament; but it seems now that successive Governments believe that the market should decide these things. If, however, things go wrong in a particular hospital, we cannot, after we have died or had a terrible operation, say, "Well, we will choose to go to another hospital. We have had a terrible problem at a particular hospital and we might have actually died." At the Mid Staffordshire hospital an appalling number of patients died because a financially driven trust was more concerned about how they were performing financially than about caring for patients. One is concerned about that. Is it going to make your life more difficult as this process proceeds and we become more marketised and more fragmented with more contracting?

Dame Julie Mellor: The good news is that our remit follows the public pound; independent providers are within our remit. Individuals have the right to come to us.

Q16 Robert Halfon: Do you think that the Ombudsman should be the last resort of complaint or more like the first resort? Following on from my colleague’s question, rather than people having to go through the hospital procedures, which take weeks or many months, could they just write to the Ombudsman straightaway and the Ombudsman then contacts the hospital?

Dame Julie Mellor: We were set up to be a final, independent appeal of decisions by service providers. In the main that is how we operate. We do have the discretion to take on cases before a complainant has had a final response from the service provider, but in the vast majority of cases it is much better if things are resolved locally-partly because the learning by that organisation will be more direct. It is much more likely to happen more quickly. I think the model is right.

Q17 Robert Halfon: Do you think the Ombudsman should be able to issue enforceable guidelines to agencies of the State, in terms of how quickly they respond and how they deal with complaints, so they would have to provide a proper standard of dealing with these things? Too often when people write in, they either do not get a reply or they get a reply many months down the line and so on and so forth. If there were strict guidelines you could then follow up to ensure these guidelines were being followed.

Dame Julie Mellor: One of the things our organisation has done is publish principles of good complaint handling and good remedy, which are, in a sense, those guidelines of good practice. We will be relentless in shining the light on where those guidelines are not being met; that is where we need Parliament to work with us. We can support Parliament in scrutinising service providers and how they handle complaints.

Q18 Robert Halfon: Should we remove the MP filter?

Dame Julie Mellor: The short answer is, I think, yes. We are the only Parliamentary Ombudsman service in the world with no direct access for members of the public to our service. We are providing a service on behalf of Parliament. I have sat in our contact centre with our staff, listening to calls coming in. When you have to say to someone who has had a final reply from the service provider, "Before we can look at it, you must take a piece of paper that we will send you to your MP to get it signed and send it back," the phone goes down. They have been persistent to even find us. We know that onethird of the forms we send out do not get returned. We think there is unmet demand from people who just give up; we do not even get as far as sending them the form. We know that 85% of the public are in favour of direct access.

I think a decent solution is to have a twin track, so that those who want to go to their MP can, and those who want direct access can go that way. However, I do not detect a particularly strong appetite in this Parliament, from Parliament itself, to change this. I am a pragmatic person and I want to look at what we can do to make this easier for MPs and complainants in the meantime. One of the things we are looking at as part of the planning we are doing is whether we can make this happen electronically so it is more immediate and someone does not have to go and find their MP and get them to sign it. We are looking at those kinds of solutions at the moment.

Q19 Mr Reed: Given the way we are talking about complaints, it sounds as if that is a process that floats across the surface of a service that is underperforming. What powers do you have? What additional powers may you need to start to influence the organisational culture of organisations whose service provision is operating below par, so that they properly integrate the complaints process into their service improvement and design?

Chair: I should add that Mr Reed is the one member of the Committee you will not have met, because he is brand new.

Mr Reed: Hello.

Dame Julie Mellor: Hello, and congratulations on your election.

Mr Reed: Thank you.

Dame Julie Mellor: You are picking up on something-and you probably had not been elected when we published our strategy, so I will make sure you have a copy of it. One of the things we want to do more of is use the learning from the cases to be relentless in highlighting service failure and getting Parliament’s help with that, or us helping Parliament. We should be able to provide more evidence and insight from our casework to support the Select Committee.

For example, in the New Year we will be publishing something on sepsis, because we have seen too many complaints on that particular issue about basic guidelines not being followed and therefore the service not being adequate. Of course, in the case of sepsis it is critical because if you do not treat people with overwhelming infection very quickly, they are much more likely to die. We will be collaborating with Bruce Keogh, his medical team and the Royal College of Physicians on recommendations from that set of investigations we have completed and we can also make that evidence available to the Health Select Committee, to help it in its scrutiny role, because that is fundamentally what we are about: supporting you in your role of scrutinising the executive.

Q20 Mr Reed: I understand that over the previous year, 20112012, you had a 7% fall in the number of complaints within your parliamentary jurisdiction. Why do you think that was?

Dame Julie Mellor: We do not know. However, what we do know is that awareness of us is low. Research with the public has shown that 45% of those we researched in a quantitative survey were never told of the existence of the Ombudsman, as they should be when they are going through the complaints process in the body and jurisdiction. For those Central Government complaints we need more MP referrals. We want to look at what we can do to support MPs and their caseworkers in doing their jobs, so that they know when and how to refer to us. We have a dedicated helpline for MPs and their caseworkers so that we can see more referrals coming in. One of my primary aims is to make sure it is easier for more people to find and use our service.

Q21 Mr Reed: From that, should we infer that you believe it is down to the availability of your services, not people being less aware than in the previous year?

Dame Julie Mellor: No, I am saying that we do not know about the 7%. What I am saying overall is that there is huge unmet need regarding failures in public services and Central Government, where people who have an experience that they would like to complain about are not complaining. Our research showed that 18% of people had had something happen in the last year that they would like to complaint about, and 40% of those did not do so because they felt it was too complicated in terms of going to the service provider-but they are also not being told about us and therefore not coming through us.

Q22 Mr Reed: I see that you also welcome the new CrossGovernment Complaints Handling Forum. What impact do you think that will have on the quality of complaint handling across Government?

Dame Julie Mellor: It is too early to tell. I welcome the commitment to establishing consistent standards across Government. As I said in answer to Priti Patel’s question, the way in which we will measure how that is working is by actually finding out whether the public are more confident to complain, they feel they have been listened to and that things have been put right.

Q23 Mr Reed: Are there particular areas you think it should focus on initially?

Dame Julie Mellor: There are a number of parts of Central Government that we have concerns about-let me see if I can find my list. Let us take three areas: the UKBA for delays, Her Majesty’s Courts Service, and the Child Support Agency. In fact, at a seminar we held to share the research with this Committee before you joined it, we also looked at what is in MPs’ constituency case bags and looked at the overlap between the areas we are concerned about and areas you are concerned about. I think those would match MPs’ concerns.

The other big area for MPs was ATOS and the assessment of capacity to work. Unfortunately, in terms of our dealings with that, it is slightly more complicated in that the decision that is made through the ATOS service is appealed to a tribunal. It is if there had been a service failure that it would come to us, so for the poor complainant that is quite confusing.

Q24 Mr Reed: Looking back at the work that has been going on to get the forum going, I presume you are getting adequate and full support from very senior people in the Civil Service, such as the Head of the Civil Service or the Cabinet Secretary?

Dame Julie Mellor: Yes. I think I mentioned a number of those things to Priti Patel in terms of the discussions I have had. The proof of the pudding will be in the eating, but the discussions I have had in response to the report we published in the year that is being looked at now, 20112012, which showed this haphazard, inconsistent and unaccountable complaints process, I think there have been a very positive response and renewed commitment. We will have to see what the results are.

Q25 Mr Reed: Do you see any resistance from any parts of Government to the forum and its proposed work or, indeed, your work?

Dame Julie Mellor: Of course, in dealing with individual complaints we face resistance. In fact, there is some anecdotal evidence of increased resistance that I want us to keep our eye on-in the Health Service in particular. One of the frustrating things about the anecdotal evidence is we will finish our investigation; we then send out the draft report to the service provider and a bit later to the complainant. If there is resistance, this is the point at which they are either not accepting our findings or resisting the specific recommendations. In the anecdotal evidence we have, after several months of going round and round on this, they then accept everything, so it was a wasted effort on their part, a waste of our time and public money and it would have been much better if they had accepted things straightaway.

Q26 Chair: I am sure you receive plenty of support from individuals when you go and see them about complaints handling. In general, however, the system does not understand complaints handling yet, does it? Far too many complaints have to be made; there is a resistance about complaints that you do not see in the private sector, is there not? I used to work for a major motor company, a manufacturer. We have all made complaints to people like John Lewis Partnership or Marks & Spencer and they have incorporated complaints into their business model. We are a long way from that in Whitehall, are we not?

Dame Julie Mellor: Yes, is the short answer. The slightly longer answer is this: again, positive signs are the open public services agenda, where it is very clear that the intention is to use public service users’ experience to inform improvements and a political recognition that complaints are part of that intelligence.

Q27 Chair: They are a good thing. They show customers care about the service they are receiving.

Dame Julie Mellor: Yes, absolutely.

Q28 Chair: They are too often seen as an indication of failure, which people do not want to hear about.

Dame Julie Mellor: Yes.

Q29 Chair: What do we need to do to change this culture?

Dame Julie Mellor: You are quite right. To add some evidence to it, in the research we did, 64% of those who did complain about something felt it would not make any difference to what happened in the future for other service users. The disillusionment out there about complaining is rife. One of the things we have a responsibility to do in the way that we communicate about it is not to just say, "Those service providers are bad and wrong," but to show the difference that complaining can make, the huge difference it can make to people’s lives. There is a part that we can play to shift that culture in the way that we talk about the remedies that are achieved, because what most people want is to understand what happened. If something went wrong they want an apology. If it can be put right they want it put right and they want to make sure it does not happen to anyone else.

To give you an example of a remedy that was achieved without a formal investigation, our contact centre answered the phone to a family member of someone who had not had benefit for several years. It transpired that they had had to appeal, it had gone to a tribunal, the tribunal had found in their favour and they were entitled to benefit. They were owed £50,000. Actually, just as a result of the phone call to us, they received the £50,000 with interest. That is the impact it can have on people’s lives.

We need to do that. It is part of what I expect the Boards particularly to do. I do think, fundamentally, this comes down to leadership. The Boards of public organisations need to be looking at that information regularly so they know their customers’ experiences of complaining, what the issues are and what action is being taken.

Q30 Chair: As you know, it is an ambition of this Committee to do an inquiry into complaints handling to follow up on the work that you have been doing, because every Member of Parliament handles a huge number of complaints about public services. We want to see how we can integrate our case work with your organisation more effectively so that you help us handle complaints better and we get better outcomes and we change the culture of Whitehall. That is a big manifesto, but I hope we are going to tackle it.

Dame Julie Mellor: That is great.

Q31 Mr Reed: Could I briefly come in on that point? Do you think a more effective complaints process can sufficiently change the way that public services work, or do we need to look at the relative balance of power between the provider and the user of services? What I am thinking is that in the private sector, the customer ultimately has the power to walk away and go elsewhere, which, in the public sector, they tend not to have. Do we need to look at the whole way public services are run, or can we do this through a complaints process?

Dame Julie Mellor: I do not think I have an answer to that one, honestly. There is a huge amount that we can achieve. One of the things that is unique about ombudsmen is, when you are dealing with a complaint in your casebook for your constituency, your caseworker has to try and persuade people to do things differently. In a sense we do rebalance that power, because in law our findings are final-unless the service provider wants to take us to judicial review, which is very, very, very rare.

Our findings are final; with Parliament’s support, 100% of our recommendations are implemented. We are a mechanism for rebalancing that power. We need to use that power slightly differently in future to make sure that we are contributing to the culture, not just rebalancing it for individuals.

Q32 Kelvin Hopkins: In a sense, this comes back to my original point following Mr Reed’s point. Direct employment, transparency and accountability to elected representatives-through Parliament or local authorities, but particularly through Parliament-has to be a major factor in making sure that services are provided correctly and that care is right and so on. That is one point. Also, financial pressures and the Government’s emphasis-I think it is mistaken-on the importance of financial performance in such things as health has had a damaging effect.

Q33 Paul Flynn: One third of the complaints disappear, presumably because of the MP filter, at that stage. After you have carefully examined them, in 78% of the complaints you receive you decide there is no case to be made against a public body. Only 1.7% of the complaints to the Health Service actually go to a full investigation. Are these plausible figures? The cases that get through to a full investigation seem to be a very small percentage.

Dame Julie Mellor: I am not sure I recognise those particular figures.

Q34 Paul Flynn: The figure of 75% was taken from your poll. One third is the figure you have just quoted to us. The other one was in the Health Committee’s NHS Complaints and Litigation report: 1.7% went through to a full investigation.

Dame Julie Mellor: I have two things to say in answer to your question. One is that actually, for 74% of casework last year, it was not that we did not uphold; it was that we added value by helping people make their complaint, either to us or to another organisation, the service provider. Very often people will come to us when they have not had a final response from the service provider and we help them get that final response. That can mean that they are satisfied and do not need to come to us at all.

In those that we do look at-last year this was nearly 5,000-3,500 were ones where, after a detailed look, we felt that there was not a case to answer. You are quite right that we accepted 421 for investigation. We also achieved solutions like the £50,000 for the gentleman who had not received his benefits after an appeal to a tribunal. For 759 cases we managed to get that kind of intervention and sorted things out for people without the need for a formal investigation.

That is one part of the answer. The other part of the answer is to say that this is how we have measured things in the past. We will be changing our approach to investigations; we will be doing more investigations in future and we will be taking a varied approach to those investigations. Those that can be done more quickly than we currently do will be. Those that need the resources will get them. This will not be next year, in terms of managing expectations. Our report next year will be based on the financial year we are in now. Our new strategy comes into effect next April. Next year will have similar metrics to this year, but after that you will see more investigations.

Q35 Paul Flynn: As part of the compensation and blame culture we have now, one innovation I had not seen before was somebody advertising and inviting people to sue if they have ever had a bedsore in a hospital. It follows on all the other attempts to blame all sorts of ills in society on social workers, policemen and other people who are in the front line of these things. This is often done in order to increase the profits of the company, who are ambulance chasers. Do they have an advantage with you if they pursue this line and take up the complaint with you? Is there any increase that is apparent because of the fashion to blame public servants?

For instance, it was commonplace to find the ambulancechaser inviting people to make complaints on accidents. Whiplash is a common one because they make profit and then they take a share of the compensation that is paid. There are certainly new methods. Certainly, social workers are in the firing line; they have an impossible job. I have a case in mind where there were two tragic deaths. Nobody blames the people involved or those who were responsible, but they do blame the social workers for not preventing it, which they could not possibly do. The blame is there and now it is turning to nurses and so on. If we are caught up in that, would it have an impact on your work? It would be an advantage for them, in making a claim, if they could wave a report from the Ombudsman proving negligence.

Dame Julie Mellor: Where someone is able to pursue a legal remedy in the courts, which might be the kind of thing you are talking about, we have a statutory bar on looking at the same thing. That does not mean we cannot look at complaints from people where they have also pursued a remedy through the courts. For example, someone can be pursuing a specific financial remedy through the courts, but actually still feel they have not had a decent explanation of what has happened or the complaint handling was very poor, or they are not confident preventive measures will be taken to make sure the same thing does not happen again. We can look at those aspects; depending on the case we can look at it concurrently or sequentially. In that sense, given that the court remedy is different from ours, it would not have a direct impact. Of course, if it is social services that would be through Local Government Ombudsman, rather than us.

Q36 Paul Flynn: Do you see yourself having a role in a situation like ATOS, which is relatively new? Understandably, people are going to complain if they are losing benefits they have had for many years. However, the level of complaints, the type of complaints and the evidence seem to be very persuasive that something has gone seriously wrong. At which point would you intervene?

The Government is resistant. They are trying to get their policies through and reduce benefits, but when cases are seen where people are judged to be fit for work by ATOS and die within hours-there have been dozens and dozens of these cases-and others where people are clearly not well as far as most of our judgments are concerned, it does seem to be that something is very wrong and is not working. The volume and type of complaints are probably the greatest I can remember for many years against any new institution that has arrived. When do the alarm bells ring? Do they get to your department if the case is going through tribunals and so on?

Dame Julie Mellor: That is the answer, I am afraid, Mr Flynn. Appeals about the decision of whether someone is entitled to benefit would go through the tribunal system.

Q37 Paul Flynn: But when you get a system with 40% wrong decisions that are overturned by tribunals, again-

Dame Julie Mellor: Indeed; one has to ask whether there has been some service failure that is leading to that percentage of decisions being overturned. That is one of the reasons we would very much like to have some additional powers, which would be to conduct investigations on our own initiative where there is some basic evidence of a problem, and to be able to look for those who are least likely to make it to complain to us on their own. Something like ATOS would be an example of where there is the kind of evidence that we could do that.

Q38 Paul Flynn: The MP filter was introduced and was resisted by MPs because they thought the Ombudsman was going to take part of their work over. Very few survive from that time. I do not detect any great jealousy among MPs of the work you do; a lot of them are relieved that you are taking many of the cases that we find insoluble. I cannot understand why the Government does not get rid of it now-particularly, as you suggest, one third of the cases might well be aborted because of the MP filter.

Dame Julie Mellor: We were set up as a Parliamentary Ombudsman service to support you in doing that work. I agree with your point of view; I do not think every MP does. There may be some concern that MPs would be less in touch with their constituents’ issues, but one of the things we could do about that, which we are looking at, is whether we could-in the future, when we have invested in a new casework management system that will enable us to have the knowledge management and draw insight about what has happened-provide every MP with a regular update on the number and nature of complaints we have addressed in their constituency.

Q39 Mr Reed: Your predecessor, talking about the assessment of cases, said, "There are lots of cases where we see clear indications of maladministration and service failure", but you are not necessarily required to take action to resolve them all. I wondered in what proportion of the enquiries you receive you identify substantive maladministration, and whether you have to take action or not?

Dame Julie Mellor: If you go to page 9 of our annual report, where we have figures laid out about the breakdown of cases, of those that we look at more closely because they are in scope and in time etc., 3,500 of those would be ones where we take a detailed look and think there is no case to answer. Of the ones we receive at the moment, I would say it is the 759 where we see evidence of a problem and put it right and the 421 where we actually investigate. We uphold 80% of the investigations.

In the 3,500, we do take quite a detailed look. It can involve talking to the complainant, the service providers, gathering documentary evidence, getting clinical expert advice, comparing what happened to what should have happened and taking a view. A lot of work goes into the assessment at that stage. However, what happens at the end of it is that at the moment we send a letter saying, "We have taken that closer look, we think there is no case to answer-for a variety of reasons-and we are declining to investigate." For the complainant, I understand that they feel they are let down because we are saying that we are declining to investigate. That is one of the reasons we will be changing our approach to investigations and will be doing more investigations in future.

Q40 Mr Reed: In that process, when you find there may not be a case to answer, there may well be learning that could be of benefit to that particular organisation or other organisations. Is there further you could go in sharing that learning, even if you are not saying there is a full case to answer?

Dame Julie Mellor: I am afraid this is a really boring, technical answer. In law, we have to conduct our work in private. Unless we have done a formal investigation and published a report, there is very little we can say about it. We succeeded in getting a change to that in the Health and Social Care Act last year, which means that we can now share more information on that bulk of cases-good and bad practice-with the regulators, for example, in health. We would like to see a similar change covering Central Government Departments and agencies, so that, exactly as you say, we can share more information.

Q41 Mr Reed: I am thinking in particular that, with the insights you are gaining, you may see insipient problems that have not yet grown into big problems. An intervention at that point could be incredibly helpful.

Dame Julie Mellor: Yes.

Q42 Charlie Elphicke: I am trying to work out my own mind-maybe I am being a bit thick-but of the forms you send out, how many are returned so that they are enrolled as a formal complaint or a request for you to investigate? As for the forms the Member of Parliament signs: how many of those do you receive in a year?

Dame Julie Mellor: For the MP referrals, I do not have that precise figure in my head, I am afraid. I am happy to send it to you afterwards.

Q43 Charlie Elphicke: Of those forms that the Member of Parliament signs and of which you receive X number a year, how many do you decide to do an investigation into?

Dame Julie Mellor: Let me see if I can find that. I do not have the figures in my head, I am afraid. I have looked at the Health Service and Central Government together, so the totality that was in our annual report.

Q44 Charlie Elphicke: I mean together: the numbers that Members of Parliament sign, and those for the Health Service, which we do not sign. How many of those forms and their equivalent for Health in total do you receive? You will have a similar sort of form, which constituents, residents, electors of this country can send to you.

Dame Julie Mellor: I do not know. I will have to confirm afterwards, but I think, in the end, the number would be around the near5,000 that we take a closer look at.

Q45 Charlie Elphicke: That is all I am asking. You will take a closer look at 5,000-which is my next question-but in terms of the primary number, which is the number of forms in the door, you would have a look at them; you would flip through the form and you would think, "I will have a further look at that." There are 5,000 in that pile. How many are there in the pile for which you said, "No, we are not going to look at that"?

Dame Julie Mellor: I am not sure that it will all be based on forms, because people can ring us up.

Q46 Charlie Elphicke: Okay. So how many complaints are there for which you would start the process of asking, "Should we have a further look at that procedure?"

Chair: Can I shortcircuit this? It would be very useful for us to have a table, split into Central Government and the NHS.

Dame Julie Mellor: That is probably the information on pages 8 and 9 of our annual report. I am trying to work out which part you are relating to and I am afraid the issue of forms has confused me. For the Health Service there is no need to go through an MP. Where an individual is unable to put it in writing themselves, we will help them do so. The clearest exposition is actually what is here, which is that of the 23,846 enquires we receive, 24%, or 5,859, are ones where we help them make the complaint to the organisation concerned or to us. We then have the net left, which is the nearly 5,000, at which we take a closer look.

Q47 Charlie Elphicke: You are taking a closer look at 5,000. Of the people who use your service-presumably those 5,000, if I am reading this correctly-about 1,884 then complain about your service. If that is a fraction of the 5,000, then it looks like a complaintintensity rate of about 20% for the Ombudsman Service. Am I reading that correctly, or have I completely misunderstood?

Dame Julie Mellor: No, I think there is a germ of an issue in your observations, which is exactly the question we have been asking ourselves. You are absolutely right: it is about 1,000 people who ask for a review of the decision we have made out of the 25,000 that contact us. We have upheld 99, which was 8%, so that is 0.4% of all the decisions we have made. The learning from that is, one of the biggest frustrations and reasons for-

Q48 Charlie Elphicke: Hold on. You say you upheld 99. I may be misreading your resources for 20112012, but I thought it was 147 complaints that were upheld.

Dame Julie Mellor: In respect of decisions, no. I believe it was 99.

Q49 Charlie Elphicke: Of the total complaints made, I think it is about 150.

Dame Julie Mellor: 1,232 people asked for a review of the decision we had made. We upheld 99 of those.

Q50 Charlie Elphicke: That was up 10% from the previous year, 201011, was it not?

Dame Julie Mellor: That is where, as a learning organisation and in looking at what we will be doing next, the big learning is the big frustration with those letters I was describing to Mr Reed, where we say, "Having done all this work, we are declining to investigate." I completely understand why people feel let down. It does not acknowledge all our staff’s work.

Q51 Charlie Elphicke: Do you mean when you write to people and say it is not worthwhile?

Dame Julie Mellor: No, I mean declining to investigate. Also, our staff would like to change this because it does not acknowledge all of the work they have done. That is why we are changing our approach to investigations and will be doing more investigations in future.

Q52 Charlie Elphicke: There were 99 that were upheld where they were not happy about the investigation. There are a further 50 or so who were just unhappy about the service provided by the Ombudsman’s office. It is not simply how you are investigating; it is how they feel.

Dame Julie Mellor: Yes, we look at both. We look at complaints about our service and requests for reviews of decisions. 173 people complained about our service. We upheld those complaints for 49 people, which is a 28% uphold rate. That is similar to the Financial Ombudsman Service and the Scottish Public Services Ombudsman. However, whether it is similar or not, what we are concerned about is what the learning is from that. There, one of the biggest reasons for being unhappy about our service is the time it takes for us to resolve cases.

Again, that feeds in to how, in our new strategy, we will be doing not just more investigations, but taking a proportionate approach, starting investigations much earlier after people have contacted us and taking an approach that means that where things should be done quickly they will be and where they need more resource they will get it.

Q53 Charlie Elphicke: What really surprised me is that, where you uphold someone’s complaint, I would expect that 100% of complainants-I think it is dangerous to call them customers, because customers are people in shops who buy things; I think complainant is probably the right language here-would be over the moon because they would be thinking, "We beat the bureaucrats and had our complaint upheld. We received justice against the system thanks to the Ombudsman." Yet it seems from what I am reading that the satisfaction in relation to investigations upheld was 90% a couple of years ago and has now reduced to 88%. Why is that? Why is not everyone happy? They should be cracking open the champagne and over the moon.

Dame Julie Mellor: There are two things.

Q54 Chair: We are talking about quite a small number of cases. One or two cases makes quite a difference, does it not?

Dame Julie Mellor: It is precisely that. I do not think we should have provided you with that information, because it is of completely spurious accuracy and therefore not meaningful. The sample size means the 6% difference between last year and the previous year-the 201112 year’s difference in satisfaction-is not statistically significant.

Q55 Charlie Elphicke: Of the 5,000 you take a further look at, how many do you then take to the next stage? If we go back, there are 24,000 inquiries per year, and you say you take a further look at 5,000 of them. How many do you then take on to the next stage?

Dame Julie Mellor: There are three stages, outlined on page 9 of the annual report. For 3,500 we do that by talking to the complainant, getting information from the service provider, clinical advice and soon. All 5,000 are taken on to a next stage. 3,500 will stop at the stage of that closer look, where we find there is no case to answer, for a variety of reasons. In 759 of them, we were able either to give people explanations, which sorted out the problem because they wanted to understand what happened and they had not been able to get a decent explanation from the service provider, or we were able to negotiate another remedy like the £50,000 example that I gave. 421 of them we take on as formal investigations.

Q56 Charlie Elphicke: Of the 421 for which you do formal investigations, how many are upheld each year?

Dame Julie Mellor: It is 80%.

Q57 Charlie Elphicke: Basically, you do formal investigations for the cases which you are most likely to uphold, realistically. You are presumably risk-managing these or looking at them on the basis of, "We are most likely to uphold this; we will investigate it properly because we are likely to find there has been wrongdoing." In that case, you are then upholding about 350 cases a year. As the Chairman says, one or two happy or unhappy will cause errors in the figures. For those cases that are not upheld, in your annual report resource accounts, you have satisfaction figures for the notupheld cases. Is that then the 3,800? How many people are in that sample of what is not upheld? Is it the ones for whom you have not taken their case on out of the 759, the 3,800 or the 5,000?

Dame Julie Mellor: I will have to come back to you on that.

Q58 Charlie Elphicke: The reason I ask is because I just wonder whether this is a bigger sample size. It is a much bigger concern to me, because you have a situation where 67% who were not upheld were satisfied, but that has fallen to 50%. That is a really steep decline. I would say it is cause for real worry.

Dame Julie Mellor: Do you mean in terms of satisfaction levels?

Charlie Elphicke: Yes.

Dame Julie Mellor: One of the things we did this year since this year’s figures is look at the difference in satisfaction and whether it is impacted by the outcome of the complaint. There is a huge difference: those who feel they have won are over 80% satisfied and those who feel they have lost are around 50% satisfied. Again, I have done comparisons with other organisations and those figures are almost identical to the figures for the Financial Ombudsman Service.

Q59 Charlie Elphicke: The point is that the satisfaction of those who are not upheld is dropping like a stone. Does that mean you are not showing them the love when you investigate and saying, "I am really sorry; we cannot take this on"? Is it about how you handle the complainants and how you deal with and speak to them? I do not think these are people who are just saying, "My complaint was not upheld, so I am unhappy." The figures have shown dramatic variance. It has fallen from 67% to 50%. If I saw that figure and I was running a business, I would be really concerned.

Chair: These are the people whose investigations are not upheld. In fact, the satisfaction rating has fallen from 67% in 20092010 to 50% in 20112012.

Dame Julie Mellor: I think the combination of the spurious accuracy of low sample sizes, the fact that we have discovered that the levels of satisfaction with our service will vary enormously with their perception of whether they have won or not and the reasons for the frustration with levels of satisfaction and with our decisions add up to exactly the reasons why you are asking these questions. We have been asking ourselves these questions and they are exactly the reasons we will be changing our approach to investigations in the future. We need to look at how we can measure customer satisfaction properly in the future.

Q60 Charlie Elphicke: There is an organisation called Uncaged Campaigns who have given evidence to the Select Committee; they draw attention to the idea that the reason is that you are all captured by Government Departments. They cite evidence from the previous Ombudsman, who said in 2011 that, "Most of the examples I can think of are where the wider public interest is in the possibility of the Ombudsman saying there was not maladministration." She went on to say that, in the Uncaged Campaigns case, "The wider public interest was in the Government Department concerned being able to say. ‘The Ombudsman has looked at this, and this is being done properly.’" They suggest that, "These comments raises questions regarding at what point in the investigation did the Ombudsman decide there was a public interest in maintaining public confidence in public institutions (regardless … of whether they act to deserve that confidence)." I just wonder if you think that might have a bearing on satisfaction-whether people feel you are their defender of last resort or whether they feel that you have become captured by the system.

Dame Julie Mellor: I think our role is neither of those things. We are not a consumer champion; we are an investigator of complaints, looking at evidence and making a final adjudication. In a sense, we flip to being a champion of the consumer if we are at the point where we have upheld and made recommendations for redress, but the process that we undertake is evidencebased, not being a consumer champion.

I recognise that there will always be people who are disappointed in judgments we make because they have been remarkably persistent to pursue their complaint as far as they have and therefore are vested in a view that a service has failed them.

Q61 Charlie Elphicke: The other thing is that there is this business with the Health Committee banging on about the language of "worthwhile outcomes". Do you still use this internally and what exactly constitutes a worthwhile outcome, if you do?

Dame Julie Mellor: No, it has been banned.

Q62 Charlie Elphicke: What do you use instead? That was a test, obviously: what is the new internal test?

Dame Julie Mellor: The language comes from the legislation. The kinds of things we look at in making decisions on whether to take something on for investigation are around whether there is some evidence of maladministration or injustice and whether there is something we can achieve for the complainant beyond anything they might have already achieved.

Q63 Charlie Elphicke: Internally, do you have set criteria that you will weigh to decide whether or not you will make a decision?

Dame Julie Mellor: In the range of work that we do, we have-and should have-huge discretion, but those are the factors that we did and will consider. I think the Health Select Committee was raising a number of issues around how we communicate and whether it is too bureaucratic, inaccessible and inappropriate in that instance. I actually think they were expressing a wider concern about whether people felt they had somewhere to go. That is, again, why we are changing our approach to investigations so that we are doing more investigations in future.

Q64 Charlie Elphicke: Sticking with this worthwhile outcome issue or these new criteria, do each of your adjudicating officers-or officers who make decisions whether to investigate, and then officers who carry out investigations-have, on the whethertoinvestigate side of things, training or any kind of set criteria in relation to which they need to weigh it, or is it just what they feel like? Have you written down any set criteria or set policy as to when to investigate or not?

Dame Julie Mellor: There is policy, guidance and training for our caseworkers. We have processes internally for making decisions about whether to investigate. I have already indicated the three kinds of tests that would be used in the decision on whether to investigate. As I said, I think what is behind your questions is a sense of frustration about the numbers of complaints we investigate and how we go about it. That is why we will be changing the way we investigate in future.

Q65 Charlie Elphicke: Can you write to this Committee about your policy and your criteria, so that we have it set down?

Dame Julie Mellor: It is the three things I said: indications of maladministration, indications of injustice, and whether there is anything else that we can achieve for the complainant beyond what has already been achieved.

Chair: We must move on. You have had a very long time, Mr Elphicke.

Q66 Charlie Elphicke: The last thing is judicial review. It was the case that the courts would automatically throw out a judicial review case against the Ombudsman that was not reviewable. Has this position changed and do you think that the situation is acceptable on the judicial review side of it because of the cost and expense?

Dame Julie Mellor: We receive between eight and 10 applications for judicial review in any one year and one or two are accepted. I recognise that we, like any organisation, can make mistakes. Pursuing a judicial review is expensive. Despite us being, in a sense, the final appeal for independent appeal for individuals who are not satisfied with the way their complaint has been dealt with by the service provider, that is why-because we make mistakes-we have the review mechanisms that we do. Like the courts, we have specific grounds for accepting reviews for consideration, which will be around whether there are new facts, factual inaccuracies or evidence of some reason that our decision may be flawed.

Q67 Kelvin Hopkins: Going on from Mr Elphicke’s points, there are some figures in the Health Service report on page 9 that jump out at me: 61% more complaints about care by independent providers in one year. That is a staggering increase. It might have a bearing on the other statistics that have been talked about.

I wondered whether it might be worth doing some analysis to try and pin down what is actually going wrong. It may be-I have a predisposition to think this way-that shifting to independent providers is causing the problem and that direct services, as I would prefer, would be a better and more accountable way of dealing with health and would actually involve fewer mistakes, more democratic accountability and more transparency. The independent provider figure is really staggering. A 61% increase in one year is very significant. I just wondered if, possibly, some more indepth analysis could be done and you could report back to us at a later stage.

Dame Julie Mellor: I think I can deal with some of it now. We do not know why there has been an increase. It is an increase from a low base and therefore looks very significant, but it is from a low base. One of the reasons is that there are more independent providers. If there are more of them we will get more complaints. However, as I said, because this is new we would like to do some work with those independent providers, as part of us using the insight from the cases to make sure that they learn how to handle complaints properly in the future.

Q68 Chair: What effect do you think "digital by default" in Government will have on your complaint flow? Do you find that people are complaining more about websites, access to information online and online services? Are people complaining about the gov.uk website?

Dame Julie Mellor: There are several things there. One of the things in discussion with Government is about open public services and the desire to make it easier for individuals to complain to Government, and for Government to learn from those complaints. I gather there is an intention to use Directgov-I think it has changed its name-as a way of signposting people in the future, so that they can get to the right place to make their complaints. In that sense, everything being digital will make it easier for people to be signposted and use the system. It is part of what we are looking at in terms of accessibility in our services and how we can make more use of our website to enable people to lodge complaints to us through the website, for example.

There is another thing we are looking at, which is in a completely different direction. That is part of us trying to improve the operation of the health complaints system, which at the moment is very confusing for people to know where to go, sometimes. For example, someone might ring the General Medical Council and say, "I want to complain about this clinician; they are not fit to practise." The General Medical Council will say, "Thank you very much. We will take that information as intelligence for our fitness to practise group." The individual will say, "But what about my complaint?" They will say, "If you want to pursue a complaint, you must go to the Parliamentary and Health Service Ombudsman."

How can we use the digital landscape to make that easier for people? We are at the very early stages of exploring with the regulators in health whether we might band together to create some kind of hub for complaints that would make it easier not just to signpost people but to help them lodge their complaint in the right place.

Q69 Chair: It might be a website that takes you down a decision tree to complain to the right person.

Dame Julie Mellor: Yes. That will help in an enormous number of cases and that is exactly the kind of thing we are talking about. However, there will other cases where people are saying, "I do not understand. I want to complaint to the GMC about this fitness to practise issue and I want a remedy for my individual complaint." We need something that, in effect, conducts triage over the phone and enables the information to go to both places.

Q70 Chair: Do you think you need legislation in order to modernise and improve the service you provide?

Dame Julie Mellor: There is a massive amount we can do anyway and I think we need legislation, but I will not wait for legislation to try to improve things anyway.

Q71 Chair: That is a sensible approach. Do you think there are complaints that fall between stools that have nowhere to go because you cannot pick them up and nobody else does?

Dame Julie Mellor: I am not sure that is the case. I do think it is complicated, as we have discussing, for users of public services. One change in law that I think would make sense in the long term would be for England to have one place for people to go. That would be, in effect, combining ourselves, the Local Government Ombudsman and the Housing Ombudsman. However, being practical, I am not going to wait for legislation. Dr Jane Martin, the chair of the Local Government Ombudsman Service, and we have already committed publically to harmonising our service, so that it is easier for users where the issues go across local government, social care and health.

Q72 Chair: Finally, your strategic vision says that you want to carry out more investigations. Is this just a change in nomenclature to make people feel that they have their complaints investigated? The very tight definition of investigation does make a lot of people feel unreasonably excluded, when in fact their case has been considered on the same basis as everybody else’s.

Dame Julie Mellor: It is a kind of paradigm shift. That is the language and the way we have done things in the past; we will be doing it differently. Yes, it will mean that we will be starting investigations sooner after people get in touch with us, which you could regard as some change in process and nomenclature, but it will also mean that we will be working to make sure that people who are experiencing some of the big service failures can access us-like the example Mr Flynn gave around ATOS. If we had the powers to do owninitiative investigations, we might be able to pick up whether there are issues there.

What we will be doing in the first year of the new strategy is working more with charities, so that people who have come to them for help are able to be referred to us, where there have been significant service failures. We can look at groups of cases, pick out the systemic issues, publish thematic reports and make them available to Select Committees. We will be changing our investigations in a much broader sense than any change in nomenclature.

Sorry, my colleague, Helen, is just reminding me that the other paradigm shift in what we want to do is shift from a focus on investigations to a focus on resolution. Taking the example of the 759, we did not have to do an investigation; we just managed to negotiate a change. We want to do much more on that because we will be resolving things for people much more quickly.

Q73 Charlie Elphicke: The highest number of complaints received is in relation to the Department of Work and Pensions. Does that include the Child Support Agency?

Dame Julie Mellor: I am not sure. I will have to write to you about that, Mr Elphicke.

Q74 Charlie Elphicke: In terms of complaints about the CSA, would it be fair to say you get a lot, or is it less so now? Has it improved?

Chair: Perhaps you can drop us a line.

Q75 Charlie Elphicke: You can write to me about that. The other thing is this: could you write to me as well about ATOS and what you have to say about ATOS? A lot of constituents raise concerns about the CSA and ATOS with me. Those two issues are things that we probably should look at in more detail from the point of view of whether the administration is working in either case.

Actually, I think it could be useful-this is an idea, Chairman-to have your assistance or advice almost as a tool for this Committee to call these groups in and say, "You have not been doing a good job and you need to rethink your systems. Why are things going wrong so often?" I think the CSA and ATOS, particularly, would be interesting on that side of things, because they affect so many people’s lives.

Q76 Chair: I think it would be very useful if you were to write to us about that.

Dame Julie Mellor: I think it is a great idea for us to collaborate in that way.

Q77 Charlie Elphicke: Some might say they "ruined" so many people’s lives, but that would just be a cynical view. I think, however, that it would be a really interesting area, because there seem to be particular, longstanding issues there.

Dame Julie Mellor: I would really welcome working with the Select Committee on the complaint handling performance across the public sector.

Chair: Thank you very much indeed for your very full answers today. We look forward to working with you closely during the next year. Thank you very much.

Prepared 15th April 2013