Select Committee on Public Administration Minutes of Evidence

Examination of Witnesses (Questions 120 - 123)



  120. It is with Ministers but there is no connection between what a Bill might say and the results of a study. The results of a study sit by themselves.
  (Mr Thompson) Indeed, and we think it is very important that we try to connect whatever comes out of the evaluation of the complaints procedure with the new structures that will emerge within the NHS. We feel we have a responsibility to try and make those connections as integrated and as sensible as possible because this will be quite a significant change to the way in which the NHS, I believe, connects with patients who wish to make complaints and the public at large.

  Chairman: I understand and agree with all that.

Mr Trend

  121. You mentioned earlier the advocacy arrangements that have been made in the Bill, which were very controversial in both Houses of Parliament. A cynic might say that Ministers were holding back the review in order to present both a problem and a solution. If Parliament cannot analyse the problem before it looks at the proposals for the solution, I think that is a bad deal.
  (Mr Thompson) Certainly Ministers are very keen to make sure that sensible proposals emerge from the evaluation. It is important that you try to integrate the two particular processes together. We have heard several examples from the Ombudsman's office of how difficult it often is for patients to enter into the complaints process. I personally believe that the intention around a lot of the proposals within the Health and Social Care Bill is to provide that support and advocacy for patients in the future. In that sense I personally believe that the two processes do need to be closer together. There will be a consultation process, as I say, once the Bill is completed. No doubt the public at large and others will make their representations at that time.

Mr Turner

  122. As far as I have understood them, the proposals you have put forward seem to me to be quite good and on the right lines to ensure that we get a better NHS than we have had in the past. The difficulties we had with the earlier session were on enforcement. How can we be assured that the kinds of things that you want to do are going to be enforced? How can we be convinced that what you want to achieve will actually be achieved?
  (Mr Thompson) Certainly I think parts of the review of the complaints procedure show a sense that patients do not always feel empowered within the processes that we have at the moment. The setting up of the patients and advocacy liaison service within trusts (which will include primary care trusts for example) and the independent advocacy service, which will be available to all patients, are two very concrete ways in which patients in the future should be able to be supported through the complaints procedure. We are keen that that consultation takes place. No doubt primary care and the way in which out-of-hours services work may well come up as an issue within that consultation period.

  123. Are you absolutely happy that, at the end of the day, if the organisation—the patients and advocacy liaison service—comes up with a decision, that that decision will be able to be enforced? The Chairman was referring to the problem of a patient being struck off a GP's list. You accepted that that was not natural justice. Are you happy that natural justice will apply?
  (Mr Thompson) I think there is a much greater chance of that now. In addition to the patients and advocacy liaison service, each trust, for example, will have a patients' forum and a panel service will elect a non-executive director to sit as a member of that particular trust board. I cannot comment on the individuals in these particular cases with Healthcall. For example, in those trusts in the future one of the non-executive directors will emerge from the Patients Forum. I think there is a much greater chance within the current and future structures of the NHS for patients to have a say and be directly involved in the decision-making processes in each primary care trust. Yes, I do believe there is a much greater chance.

  Chairman: We will provisionally end there. We would like to have you back when we see the review and what the shape of the new complaints system is going to be. The Committee is extremely interested in this matter. It notes that the only bit of the complaints system that applies is that the NHS should be covered by traditional competencies, and that is the Ombudsman, because of its conspicuous independence. We shall be looking carefully at what is proposed to make sure that it passes tests of that kind. We are grateful for this first conversation and we look forward to our next one. Thank you very much indeed.

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