NHS Complaints: Healthcare Commission

– in the House of Lords at 11:16 am on 24 November 2005.

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Photo of Baroness Tonge Baroness Tonge Liberal Democrat 11:16, 24 November 2005

My Lords, at the request of my noble friend Lady Neuberger and with her consent, I beg leave to ask the Government the following Question standing in her name on the Order Paper:

What is their view of the recent finding that nearly a third of complaints to the Healthcare Commission are referred back to the National Health Service because the issue has not been dealt with adequately.

Photo of Lord Warner Lord Warner Minister of State, Department of Health, Minister of State (Department of Health) (NHS Delivery)

My Lords, in its first year of operation, the Healthcare Commission received more than 8,000 requests for independent review, which was three times the level of requests under the previous system. One fifth of those requests were outside the commission's jurisdiction and no attempt at a local resolution had been made in half of those requests. I understand from the Healthcare Commission that 32 per cent of cases are now referred back to the NHS for further action. This enables more cases to be resolved satisfactorily locally, and quicker. I understand that 90 per cent of those cases which are referred back to the NHS are then resolved at local level, giving the right outcome for patients and supporting learning for the organisation concerned. This is very much in line with the approach in the NHS Redress Bill which is currently before the House.

Photo of Baroness Tonge Baroness Tonge Liberal Democrat

My Lords, in light of that rather depressing view of how NHS trusts are able to deal with complaints, how confident can the Minister be that trusts will be able to deal with the investigation of complaints and the financial compensation under the new NHS redress scheme? Would it not be much more efficient and reassuring for the general public if the overseeing authority, at least for the investigation of complaints, could be the much respected Healthcare Commission?

Photo of Lord Warner Lord Warner Minister of State, Department of Health, Minister of State (Department of Health) (NHS Delivery)

My Lords, this is a success story, believe it or not. This is a result of this Government putting in place a sound basis for a second tier for complaints. The Healthcare Commission is respected. As I said in my Answer, it is producing far more requests for intervention but, as I also said, the referral back shows that 90 per cent of those cases are satisfactorily resolved for patients at the local level. That shows that the NHS is learning and getting better at handling complaints. That should be celebrated in this House. The fact that patients are able to come forward and have these matters dealt with satisfactorily is a tribute to the NHS's ability to change its culture.

Photo of Lord Skelmersdale Lord Skelmersdale Deputy Chief Whip, Whips, Spokespersons In the Lords, Work & Pensions & Welfare Reform

My Lords, the Minister said that half the complaints that went to the commission had not been dealt with at local level; in other words, the local level is passing back its buck. It appears that the complaints are then going back to the local level and being settled. What on earth is going on?

Photo of Lord Warner Lord Warner Minister of State, Department of Health, Minister of State (Department of Health) (NHS Delivery)

My Lords, we introduced a new system in the Health and Social Care (Community Health and Standards) Act 2003, in which we put the responsibility very clearly on the Healthcare Commission—and as I recall the noble Lord was part of the team on his Benches discussing that legislation. The commission has accepted a lot of requests—a fifth of them—when it did not have any jurisdiction, so it had to deal with them, and a proportion of them had to be settled locally. That proportion is now about one-third, which is being dealt with satisfactorily at the local level, with a good deal of help, support and learning from the Healthcare Commission, which is making the local systems more effective.

Photo of Lord Chan Lord Chan Crossbench

My Lords, while it is encouraging to hear that patients and the community are willing to put their complaints forward to the Healthcare Commission, what arrangements do primary care trusts and hospital trusts make to make the process of local resolution clear to all patients? There are means at every level—for example, when patients are given assistance and advice. Is that advice being made available to patients? Also, how strong is public and community participation in the care of patients in terms of trusts? What is the process and to what extent does the Department of Health encourage a more open policy with patients?

Photo of Lord Warner Lord Warner Minister of State, Department of Health, Minister of State (Department of Health) (NHS Delivery)

My Lords, a good deal of work has gone into improving the process at local level. We now have, as a result of the 2003 changes, patient advice and liaison services—or PALS—which are playing a big part in advising people and helping them to address their concerns on the spot at the local level. Trusts are being more outward going. There is a cultural change of less defensiveness, which shows up here in the sense that people are resolving these complaints at local level. It demonstrates that the Healthcare Commission itself is encouraging that local resolution.

Photo of Baroness Howarth of Breckland Baroness Howarth of Breckland Crossbench

My Lords, I welcome the work of PALS and the work that the health service is doing in the community to listen to the community, rather than just looking at complaints. We know of one group of patients that does not make complaints; that is, children. What is the health service doing to ensure that the difficulties that children face are heard when they do not make complaints directly?

Photo of Lord Warner Lord Warner Minister of State, Department of Health, Minister of State (Department of Health) (NHS Delivery)

My Lords, the thing about PALS and other support services is that they enable the voice of children to be heard better. I would not want to claim that we have a perfect situation; we need to carry on working hard in that area. But we are seeing an NHS that is becoming much more responsive to addressing and redressing concerns when things go wrong, and learning from those experiences, and I believe that it will continue to develop in that area.