Speeches

Address by Mr. Tim O’Malley, Minister of State at the Department of Health and Children, to the National Complaints Managers’ Conference

Introduction

I am very pleased to have the opportunity to speak to you today at the National Complaints Managers’ Conference and I would like to congratulate the Health Service Executive and everybody involved in this conference and in the launch of the draft guidelines for handling complaints “People Matter- Complaints Matter”.

As you are all aware this is a time of major change in the Health Services arising from the Government’s Health Service Reform Programme and the Health Strategy “Quality and Fairness”.  With the introduction of the Health Act 2004, this year has seen the establishment of the Health Service Executive which has replaced the health boards and a number of other health agencies in order to streamline the services and provide for a more efficient management of the health and personal social services.  In addition to successfully managing the transition to the new organisation, the services will continue to face other major challenges. In recent times there have been many developments in the area of health care.  New treatments have been developed to treat and cure previously incurable illnesses, and treatments are available to improve the quality of life of ill patients and to help extend their lives.  We are also experiencing for the first time in over a century a growth in our population and, as with other countries, an increase in our ageing population.  We are now investing very large sums of money in our health services which puts an added onus on us to ensure that this funding is used wisely, efficiently and effectively to meet the health needs of our population.  It is critically important therefore that in re-organising the management of our health services that we ensure the patient is at the centre of the health and personal social services.

The Health Act 2004 contains many elements that are designed to put the service users at the centre of the services. The two central features ensuring this are the provisions providing for user participation and the statutory framework for handling complaints. I will just touch briefly on the issue of user participation. The Health Strategy set as one of its objectives greater community participation in decisions about the delivery of services including the establishment of consumer panels to allow the public to have their say on matters that concern them locally.  In 2002, the Health Boards Executive, in association with the Department, issued guidelines on community participation. By the end of last year almost all health boards had established consumer panels and two boards had established regional advisory panels for older service users and their carers. Under Part 8, which governs public representation and user participation, section 43 provides the statutory basis for the Health Service Executive to take such steps as it considers necessary to consult with local communities and other groups about the services and also provides that it may establish advisory panels on any aspect of the services. I envisage that many more of these panels will be established in the near future to underpin the participation by users and their carers in decisions regarding the services.

The Act also puts on a statutory basis the National Consultative Forum. The Forum is convened on an annual basis to monitor implementation of the Health Strategy and to comment on priorities in the light of progress and emerging trends.  The Forum is broadly based and includes patient and client groups, service providers, senior management in the health system, the voluntary sector, trade unions and organisations with an interest in the health system and relevant government departments.  The Forum has met three times since the launch of the National Health Strategy most recently on 24 November, 2004. The Forum has focused on progress in implementation of the Strategy and the Health Service Reform Programme.

Another aspect of putting users at the centre of the provision of services is striving to improve and maintain high quality standards in the delivery of the services. As part of the Health Reform Programme it is intended to establish the Health Information and Quality Authority, but this will be provided for in legislation which the Tanaiste has indicated she will bring forward this year and which will also address issues arising from the National Health Information Strategy.

Statutory Complaints Framework

Many people and groups have been calling for some time for the establishment of a statutory framework for complaints.  In the Health Strategy, the Government made a commitment to put in place such a framework.  Part 9 of the Act provides for the establishment of a statutory complaints framework, which initially seeks to resolve the complaint at local level, but with access to independent review if the complainant is dissatisfied with the outcome of the complaint.  It also provides for access to the Office of the Ombudsman or the Office of the Ombudsman for Children if the complainant is still dissatisfied following the outcome of a review.  This statutory framework will also apply to all service providers providing services on behalf of the Executive and they can either avail of the Executive’s complaints system or establish their own if the Executive is satisfied that its standards are comparable to that of the Executive.

If a person is unable to make a complaint because of illness or age or disability, a complaint may be made on his or her behalf by certain specified persons.  Complaints must be made within 12 months of the actions giving rise to the complaint.

Complaints cannot be made about certain issues which include matters which are or have been the subject of legal proceedings, matters relating to clinical judgement, matters relating to the recruitment and appointment of employees.

The details regarding the procedures relating to the operation of the statutory framework will be set out by way of regulations which the Tanaiste intends to put in place later this year.  There will be extensive consultation with the Health Service Executive, the Ombudsman’s Office and other interested parties before the regulations are finalised.

Of course the Act and the regulations can and will only provide the statutory framework for a complaints procedure.  It is a matter for the Executive and people such as you to put the procedures into operation.     I think that we should not lose sight of the fact that every day the health services provide care and treatment to thousands of people who are happy with the service they receive – however, human nature being what it is, their stories are rarely heard.

All organisations providing services to people, especially the health services who deal with people when they frequently are at their most vulnerable, need to have an ethos of welcoming and dealing effectively and efficiently with complaints.   Individuals are at the core of the service provided by the health services, and the principles of equity and fairness, a people-centred service, quality of care and clear accountability underpinning the vision of the Health Strategy are intended to reflect this.   Complaints therefore should not be seen as a threat to an individual within an organisation or to the organisation itself, or seen as a failure or an opportunity to allocate blame.  They should be seen as a positive opportunity to put something right for a service user and his or her family.

Complaints should also be seen as a learning opportunity for the organisation to ensure that the action causing the complaint does not occur again.  They are also an opportunity to put new or improved systems in place to avert future similar complaints.  They can also serve as a monitor of the quality of services provided by an organisation and serve as a useful check list on areas where improvement is required.

It is therefore important that complaints are taken seriously, dealt with in an impartial and professional manner and dealt with efficiently and effectively. Handling and resolving complaints should be seen as everybody’s responsibility, not just that of a Complaint’s Manager.  People are generally less likely to escalate a complaint if it is dealt with as quickly as possible once it has been made.  Often the front-line staff are in the best position to deal with this situation.  This is why the legislation is designed in such a way as to put the emphasis on local resolution of complaints.

It is very important that the public should be aware that a complaints procedure exists.  And I think that it is important that the Executive makes it widely known that a system exists that will vindicate the right of patients to complain if they are unhappy with the service which they have received and that it has procedures in place to handle such complaints in a professional and efficient manner.

It is also important that procedures are put in place to ensure feedback to employees of the organisation on lessons learned from the investigation and resolution of the complaints so that the quality of the service provided can be improved from the findings of the complaint.

Conclusion

The draft guidelines “People Matter-Complaints Matter”, which was launched yesterday, and which has been the subject of much discussion over the last two days will I believe, complement the statutory complaints framework and provide comprehensive guidance on dealing with complaints.  I would like to take this opportunity to welcome this national initiative which is one of the many benefits of having the health services managed on a unitary basis.

I would also like to congratulate the organisers and you on this conference and I wish you well in finalising the guidelines for handling complaints and wish you well in your work in the future.