The Parliamentary and Health Service Ombudsman (PHSO) is the complaint handler of last resort for individuals who have complaints about public services provided by UK Government Departments and the NHS in England. The Ombudsman is independent of the Government, and is accountable to Parliament through the Public Administration and Constitutional Affairs Committee.
The PHSO is in the middle of a period of significant change. The current Ombudsman, Rob Behrens, took up his role in April 2017 following the resignation of his predecessor. The organisation is required to make a 24% real terms reduction in its spending over the next two years. The PHSO needs mechanisms that provide robust external assurance of its value for money and its impact on improving public services, especially if it wants to argue for increased funding in the future.
The PHSO’s performance in handling complaints has been repeatedly criticised in recent years. The time taken to complete investigations has improved but was described to us as simply unacceptable by its Chief Executive Amanda Campbell. Mr Behrens has made restoring public trust in the Ombudsman one of his priorities. We welcome the introduction of the PHSO’s new service charter, which includes systematic monitoring of complainants’ views, and its new strategic plan. We will hold the Ombudsman to account for delivering the latter.
The legislation underpinning the PHSO is over fifty years old, and prevents it adopting modern corporate governance arrangements. The Government published draft legislation in 2016 that would merge PHSO with the Local Government and Social Care Ombudsman, and modernise its governance. We conclude that the Government should provide clarity about whether it intends to introduce the legislation, and on what timetable, to allow the PHSO to plan effectively.
Eighty-eight per cent of the PHSO’s casework in 2016–17 related to the NHS. The capacity of local complaint handling in the NHS therefore has a substantial impact on the PHSO, as well as on the individual complainants. NHS complaints handling has been the subject of repeated criticism by ourselves and the Health Committee. PHSO has committed to sharing its best practice and developing training for local complaints handlers. However, substantive change will need leadership from the NHS and Department of Health and Social Care. The establishment of the Health Safety Investigation Branch, on the recommendation of our predecessor Committee, is a necessary but not sufficient step to achieve this. It is vital that the draft Health Services Safety Investigation Bill, which will provide statutory underpinning for the new system’ receives pre-legislative scrutiny at the earliest opportunity so momentum is maintained.
There are also a small number of ‘historic cases’ relating to the NHS where it appears injustice remains but that it would not be appropriate for the PHSO to investigate, or in some cases re-investigate. The Government should instead develop a proportionate, time limited, mechanism to independently investigate and address those cases where legitimate questions or grievances remain.
24 April 2018