The review by Ann Clwyd MP is the latest in a series of reports recommending changes to the patient complaint system.
Hospital complaints review: name and shame trusts that do not comply
Ann Clwyd’s recommendations to make hospitals more accountable must be enforced by patient champions
Last month Ann Clwyd MP published a review of NHS hospitals’ complaints systems with the subtitle “Putting patients back in the picture”. You will remember that last year she described, in tears, on the floor of the House of Commons, the inhuman treatment her dying husband received in a Welsh hospital. Afterwards, she received 2,500 letters and emails from patients and relatives of those who had received similar treatment in UK hospitals – it’s their stories that form the basis of her subsequent review.
The final report is a horror story. It shows how lackadaisical some hospital staff can be, and how dysfunctional many complaints procedures are. “I found a confused system, where the NHS was judge and jury, and where the strategic intent seemed to be to destroy the complaint,” writes one respondent. “I tried to attract the attention of the nurses, but found the entire nursing team bidding at the end of an eBay auction,” adds another.
It wasn’t just nurses Clwyd’s respondents find wanting: “The attitude of the consultant varied between pompous, arrogant and condescending. This was a man with a trail of young doctors in tow, moulding them… in the same uncaring way,” says one person. It would be interesting to know the names of the hospitals concerned – and whether these appalling practices are clustered in a few places – but the report does not reveal that.
Across the board, those surveyed by Clwyd felt they were “outgunned by a powerful and monolithic organisation”. Many people were too nervous to complain about the treatment they’d received, with 40% saying they feared retaliation. Perhaps it’s no surprise – an octogenarian sister-in-law of mine was confronted in a Cambridge hospital after a serious car accident by a furious nurse, who said: “You have lodged a complaint against me.”
When patients do pluck up the courage to raise concerns, the typical hospital reaction is to deny, defend and delay. It’s a terrible situation, and it’s nothing new.
Over the years there have been many reports trying to mend this culture: in 1994, 1999 and 2001. The weightiest research was in 2004, Dame Janet Smith’s fifth report of the Shipman inquiry, which made many of the points that Ann Clwyd makes today. It cites a lack of fair procedures and a failure to give adequate explanations or to take account of the imbalance of power between healthcare professionals and patients, including the patient’s feat of retribution. A lack of impartiality in organisations investigating their own conduct and an absence of accountability to an external body was also reported.
That was 2004. I can’t help but wonder: do hospital managers or Royal College of Nursing top brass ever pay any attention to reports that uncover scandals, and demand inconvenient action?
Clwyd has made some attempts to ensure that these reluctant and defensive bureaucrats do implement her findings, persuading several NHS organisations to sign pledges to act on her recommendations. Most of these are the great and good of the health service: the NHS Confederation, the General Medical Council, Monitor and the Care Quality Commission. But really, she needs pledges not from such august (and rather toothless) bodies, but from the hospital trusts – these are the organisations that have ignored the need for a patient-friendly complaints system in the past.
I would like to see every local Healthwatch, patient assembly or patient champion across the country investigate the complaints procedures of all the hospital trusts in their area to see whether they are compliant with Clwyd’s recommendations. They should kick up a hell of a fuss if they aren’t. Otherwise, her report will go the way of all the previous complaints procedures reviews – and be totally ignored.
The original article was published by Dick Vinegar For the Guardian on Monday 18 November 2013.
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