Complaints about the NHS, and the handling of those complaints, were described by the Parliamentary and Health Service Ombudsman as a "toxic cocktail", a combination of a reluctance on the part of citizens "to express their concerns or complaints", and a defensiveness on the part of services "to hear and address concerns". This was no more evident than in the shocking collapse of care at Mid Staffordshire Hospital, which prompted this inquiry.
This shaming case has lessons for the NHS, Whitehall and for public services as a whole. How complaints are handled determines the quality of the relationship between consumers and public services. The best performing organisations welcome complaints as a way of engaging consumers. A failure to recognise the importance of complaints leads to insufficient redress for the individual, limits the impact that complaints have in improving services, and alienates the public. In some parts of public services, there are encouraging signs of increased attention to good complaints handling. However, Government as a whole cannot be said to be complying with best practice in complaints handling or adapting to the needs and expectations of today's citizen.
As so often in our Reports, we highlight that success depends on the right leadership. Government must ensure that leadership of public services values complaints as critical for improving, and learning about, their service. We welcome the Minister for Government Policy's review of complaints handling in Government, and recommend that:
- there should be a minister for government policy on complaints handling;
- the primary objective of the Cabinet Office review of complaints handling in Government should be to change attitudes and behaviour in public administration at all levels in respect of complaints handling;
- in respect of complaints from MPs handled by ministers, replies must be accurate, clear and helpful. Confidential information should not be shared with third parties, and responsibility for responding cannot be delegated (which contributed to the blindness about Mid Staffordshire NHS Foundation Trust);
- the Government should create a single point of contact for citizens to make complaints about government departments and agencies; and
- the Government should provide leadership to those responsible for various parts of administrative justice, to ensure that there is a clear and consistent approach to sharing, learning and best practice.
Achieving change of this nature is a difficult but vital challenge, and one that must be addressed now if we are to avoid the "toxic cocktail" poisoning efforts to deliver excellent public services.
|