Complaints:do they make a difference?

Written evidence submitted by Rosemary Cantwell (COM 38)

From Rosemary Cantwell, constituent of Mr Andrew Turner MP for the Isle of Wight in response to the PASC.

IN CONCLUSION

I believe that ultimately we need to be empowered as good citizens to help one another to make improvements. There is far too much state control in our lives, and we should be enabled and empowered to have local PHSO groups to help us help everyone. This would be very powerful and instead of having a "complaints system" have a system where we can actively participate in local initiatives and make suggestions how we can both have labour-saving devices and systems that are ergonomic but also workable. Money is at the root of all evil - the lack of it so they say. But Government streamlining of services could enable people to help themselves if the PHSO is there to help them and the providers of public service at first instance and locally and in an atmosphere of positive engagement and remove all mention of "complaint".

Complaints: do they make a difference?

1. What objectives should Ministers adopt when considering how complaints about Government and about public services provided by Government are handled?

What gaps in the complaints systems exist; and how should ministers ensure they are addressed?

 The Nolan Principles should be at the forefront of all work across the country so that Truthfulness, Candour, Honesty, Integrity and Propriety are woven into all work by all civil servants, all people who provide a public service, and in Government itself across all departments.

 There should be an openness and transparency and not a "blame culture" on any one individual, necessarily, unless there is criminal intent. Instead, there should be an attitude of how can we do better? And what can be done to help us do better? And above all, how can the majority of citizens participate in the supervisory role of assisting public services to improve without seeking to "blame" or even "criticise" but actually offer their own views which might seem trivial in one specific hospital, for example, but which might make a dramatic difference to the people who use the services in that hospital. Instead of having an adversarial complaints process which goes through lawyers and courts, there should be an independent assessment so that if a person suffers injury from a hospital, then the Government should foot the compensation bill to put the matter right, or give monetary redress to that person, or to their grieving relatives where there might be a dependant of the deceased patient, for example.

2. How effectively do Government departments and public service providers use complaints to improve the service provided?

Who should be accountable for leadership and governance of complaints systems across government and its agencies?

How should data on complaints be gathered and monitored?

How should information about complaints be used to lead and drive improvement?

What do complaints cost; and how much money could be saved by learning from complaints?

 Whilst it is difficult to quantify how effectively Government departments and public service providers use complaints to improve the service provided, I believe that the emphasis should be on how to improve the service rather than how to make complaints, as it is essential to make this a world-class service where a "whistleblower" is not being hounded out of a job because of telling it as it is. Instead, I believe that we have an excessive "blame culture" which in turn leads to people being so scared to tell the truth and so fearful that they will lose their jobs, that real dangerous practice is swept under the carpet, and instead a culture of "it does not happen here – I’m not to blame" is being engineered. I am very concerned about the issue of corporate manslaughter and how employees can now be arraigned under the HSE and face possible imprisonment for failings under HSE provisions. I believe that something that has gone from being "regulatory" has now become "punitive" as per a recent law blog has reported in an email service I received.

3. How quickly do complaints systems deal with legitimate grievances and provide redress?

 I believe that there should be a very speedy turnround because if a "concern" is acted upon very quickly, local resolution and mediation can be helpful and assistance given. It is when there is an air of secrecy and covering up in the medical records where doctors and nurses and social workers say don’t tell the family this or that, keep it to yourself, that this is where mistrust and distrust grows and discontent is bred and becomes a major scandal of cover-up and smear campaign.

4. How easy is it to make a complaint about a Government department or agency, and how could this be improved?

Can people easily find their way around complaints systems?

Do complaints systems provide proper access for vulnerable, disengaged, or excluded groups?

How welcome are complaints to government departments and agencies, compared to complaints to a department store or to a mobile phone company for example? What should government learn from the private sector?

Do complaints systems succeed in making public services and government departments more accountable and responsive to service users?

 Whilst it is not physically difficult to make complaint about a Government department or agency, it is difficult in the sense that if your email is blocked or the fax machine number is blocked by that department or agency, there is no way that many people can make their views known. Furthermore, there are so many agencies and so many departments that it really needs to be simplified into one single process so that we just have the PHSO for everything, and then people can choose for themselves whether they wish to make known their concerns - or indeed praise as there is a lot of praise as well as negative feedback - for specific issues such as Mental Health, Mental Capacity, Physical Health, Surgery, Childbirth etcetera. And also for issues pertaining to the other regulators so that for example the Law Commission should be able to have a far greater say in the way that Government works, as Mental Capacity is a major issue that the House of Lords Select Committee is considering at present as to how well the Mental Capacity Act 2005 is working – and this is across the board, for the intention is to empower people to have their views and wishes and decisions known.

5. Do complaints-handling systems achieve the right balance between nonjudicial and judicial investigations and remedies?

What is the right balance?

How can ministers reduce litigation costs and defensive behaviour in favour of informal redress and openness?

 I believe that Shakespeare’s famous quote about lawyers is extreme - and clearly not one I recommend - but it does purvey an undercurrent of disquiet that has apparently been in the psyche of our kinsmen for centuries that somehow we would do better without involving the law and lawyers at all. And this is the key issue here, once lawyers and courts and Tribunals and Court of Protection and High Court and Supreme Court all get involved, the attitudes and parties’ views become entrenched and there is no reconciliation or meeting of minds with a properly conducted mediation system across the board in all areas of public life. Mediation can and does pay dividends as we can see in other countries where wars have been resolved by means of mediated settlement.

6. How aware are service users of the various ombudsmen (such as the Local Government Ombudsman, Financial Ombudsman and the Housing Ombudsman)?

How do they coordinate their respective roles?

 I have very little confidence in these ombudsman services and believe that they should all be disbanded in favour of just one regulator across all departments so that there is a unified and uniform approach, and then have sub-departments for Health, Law, Housing etcetera.

7. What lessons for complaints handling in the NHS are emerging from the Francis Report into failing at Mid Staffordshire Hospital?

Which lessons have relevance to complaints handling processes elsewhere in Government and public services?

 There must be a genuine desire to help to make things better. We must get away from the "blame culture" and stop seeking to get "scapegoats" because innocent people are wrongly accused and this destroys lives. People who make deliberately malicious allegations should be held to account for what they have said. The problem is though that what one person believes to be the truth can be what someone else believes to be a malicious allegation. And this is where there really is a major conflict of interests. And one for which I have no solution.

8. How well do Ministers and senior officials deal with complaints raised by MPs on behalf of constituents?

What do Ministers and senior officials learn from complaints and how do they use complaints as feedback on departmental policy and implementation?

 I believe that Ministers are possibly overwhelmed by complaints as are MPs. I believe though that it all stems from having a culture of blame as opposed to a "can do" policy of openness and fairness, so that if something does go wrong, that people should be helped and if necessary be given monetary compensation without going to court at all, but should be set aside in the "public pot" so that the vast sums currently being used in the courts system across England and Wales should be diverted to assisting people in hospitals and care homes to make their lives better.

9. How should complaints about complaints systems be handled?

How should departments and government as a whole monitor performance of complaints handling systems?

Do tribunals systems work effectively; and how could they be improved?

Should there be a single point of contact for impartial information on where to make a complaint or to seek redress? How should this be provided?

 I agree that there should be a single point of contact but that it should be for both raising a concern and get away from the word "complaint" altogether as it immediately strikes a negative emotion and makes people go on the defensive. A concern or a wish for an improvement in service is a far better way of working, and could lead to constructive discussion so as to help make things better. Flies are attracted to sweets and are repelled by vinegar so the saying goes.

10. How do other countries handle complaints and what could the UK Government learn from them?

Not applicable.

August 2013

Prepared 13th September 2013