Northern Ireland Ombudsman publishes Annual Report

The 2006-2007 Annual Report of the Northern Ireland Ombudsman, Dr Tom Frawley, was laid before the Northern Ireland Assembly on Tuesday 26^th June 2007.

Key aspects of the Ombudsman’s report:

Tom Frawley believes that complaints can lead to real improvements to the delivery of public services and this should provide some assurance to the public, their elected representatives and the staff of public bodies.

“Northern Ireland has embarked on a period of significant change through the restoration of the Assembly and the implementation of the Review of Public Administration. There will be inevitable pressure on all public servants as they come to terms with new demands, new organisations and developing initiatives. A key factor in securing the public’s confidence during this period of change will be ensuring that public services are delivered to the highest standards.”

Within his “Year in Review” Tom Frawley identifies a number of areas which give him cause for concern

“In my 2003/04 Annual Report I referred to my concern about an increasing number of complaints from those who had been arbitrarily removed from the patient list of their general practitioner. Despite further written communication and meetings, to date the Department has failed to initiate any action to address this significant deficit in the legislation. It is therefore with some frustration that three years later I find myself having to highlight a similar complaint and with possibly a worse outcome.

“A second area of concern … is the limitation on the authority vested in the Planning Service to cancel planning permission where inaccurate material information has been provided by the applicant. Closely related to this point is the issue of planning permission which effectively has been granted in error. While these situations are not common, there is no straightforward mechanism available to deal with them. I appreciate that a solution to these matters may not be straightforward, however it is important to understand that these situations create significant anxiety and concern for third parties who are affected by them.”

Mr Frawley also highlights a number of areas where he has been pleased to note improvements and good practice.

“In my 2005/06 Annual Report I referred to a case which caused me concern around deficiencies in the amenity standards required under current planning policy. In response to my investigation of that case the Planning Service undertook a review of its policy on residential extensions/alterations. I am pleased to record that consultation on amendment to the amenity standards was initiated in January 2007 and has now been completed and I await with interest the outcome of the process.

“In my last Annual Report I referred to my positive experience of reaching a number of early settlements of complaints with the Northern Ireland Housing Executive. I am happy to record that this positive approach has continued this year. It is an approach which I commend to all other bodies in my jurisdiction”

Background notes on the role of the Ombudsman:

The Ombudsman provides a free service dealing with complaints from people who claim to have suffered injustice because of maladministration by government departments and public bodies in Northern Ireland. He is independent of the Assembly and of the government departments and public bodies which he has the power to investigate.

The Northern Ireland Ombudsman is the popular name for two offices – the Assembly Ombudsman for Northern Ireland and the Northern Ireland Commissioner for Complaints.

Complaints submitted to the Ombudsman covered the full spectrum of the public services in Northern Ireland.

Examples of Complaints and Investigations:

The Report contains summaries of a range of complaints investigated by the Ombudsman during the year. A number of selected case summaries are contained in the annex below.

Notes:

· This is Tom Frawley’s seventh Annual Report as Ombudsman.

· Copies of the Report will be available on the Ombudsman’s website (www.ni-ombudsman.org.uk) or from the Ombudsman’s Office, Progressive House, 33 Wellington Place, Belfast (Tel: 028 9023 3821; Fax 028 9023 4912)

Ends.

Annex

A complaint against the Rate Collection Agency (see page 26 of the Report):

The complainant had previously been unemployed and claiming Job Seekers Allowance (JSA) from the Social Security Agency (SSA). When he subsequently obtained employment he notified the SSA that he would no longer be claiming benefit. Nine months later, the Rate Collection Agency (RCA) wrote to him stating that his Housing Benefit (HB) claim had been cancelled as he was no longer in receipt of Income Support or JSA and that he had been overpaid a total of £433.42 in HB. The complainant failed to understand how the overpayment had occurred given that he had told the SSA of his employment.

In correspondence with the RCA the complainant was informed that he was legally obliged to notify the RCA that he had gained employment and, because he did not, it was unaware that his entitlement to HB had ceased and did not cancel his entitlement. However he was later informed that when he notified the SSA that he had found employment, the SSA had sent a notification to the RCA which, due to “an administrative failure”, was not actioned until eight months later.

I accepted the legislation required the complainant to notify the RCA of any change in his circumstances and that this duty had been clearly pointed out to him. However I found the failure of the RCA to take action on information received from SSA for a period of almost 9 months to constitute maladministration and to be a major contributory factor in the accumulation of the overpayment. Given that the complainant also bore some responsibility towards the overpayment I was of the view that a reasonable remedy for the injustice of confusion and annoyance caused would be for the RCA to seek to recover only £100 of the overpayment.

I am pleased to record that having re-examined the process for exchange of information between the SSA and the RCA and in light of other criticisms I had concerning the quality of its correspondence with the complainant, the Chief Executive of the RCA agreed to write off the entire overpayment. I regarded this action to be a welcome and suitable outcome to the complainant’s justified complaint.

A complaint against the Newtownabbey Borough Council (see page 45 of the Report):

The complainant stated that a workman, whom he had employed, informed him that the damp-proof course (DPC) on his house was beneath ground level. He stated that he sent emails and made telephone calls to Newtownabbey Borough Council’s Building Control (BC) department seeking assistance with this problem but he was told that it was a matter between him and the developer. The complainant contended that the Building Control department should have initially identified the DPC problem during its statutory inspection of the construction of his house.

My investigation established that the Council’s BC department had responded promptly to a report about the DPC from another resident whose property had been similarly affected. The documentary evidence clearly showed that the BC department had subsequently acted without delay in notifying the developer of the breach of the Building Regulations which it had determined affected a number of properties and in securing proposals to remedy the situation.

I established that the BC department does not have the statutory authority to direct a developer to implement a particular method of construction to achieve compliance with the Building Regulations. I accepted that the BC department did not have any remit to advise the complainant or other residents on the various options of construction to remedy the problem.

With regard to the BC department’s initial inspection of the DPC during construction of the dwelling, I accepted, as being likely, that it had not been possible to establish the exact measurement of the DPC above ground level at that stage of construction. Moreover, I noted that the Building Regulations do not require the BC department to secure conclusive evidence in this respect. Therefore, having considered the wording of the Building Regulations I accepted that the onus of responsibility for achieving compliance with the Building Regulations rests with the developer. Consequently, I did not uphold this aspect of the complaint.

My investigation of this complaint highlighted that the public’s perception of the role of a Council’s Building Control department is not as clearly understood as it should be. I therefore recommended that the Council consider publishing an explanatory leaflet with particular reference to its remit regarding statutory inspections of new build. I wish to commend this practice to Building Control departments within all Councils.

A complaint against the General Practitioners in Bangor (see page 72 of the Report):

The complainant had accompanied her son, who had a history of psychological difficulties and suffered from dyslexia, to a consultation with Dr A at Bangor Health Centre because she was concerned that there had been a marked deterioration in his mental health. The complainant was very unhappy with the way Dr A had managed the consultation. She alleged that Dr A had been cruel, belligerent, very patronising and unprofessional towards her son. She subsequently made an appointment to see Dr B to ask him to try to have her son admitted to hospital. She also wanted to complain about Dr A. Although Dr B, whom she described as very pleasant and a lot more interested in her son than Dr A, had listened to her concerns, she got the impression that he did not want to deal with her complaint about Dr A. As Dr B failed to respond to her verbal complaint the complainant decided to make a formal written complaint. On contacting the Practice to confirm the date of her son’s original consultation with Dr A the complainant related her intention to make a written complaint. Following that contact her son was removed from the Practice list. The complainant alleged that the decision to remove her son from the Practice list was a direct response to her having indicated her intention to make a formal complaint. The Practice dismissed the validity of the complainant’s concerns about Dr A and it claimed that the complainant’s son had been removed from the patient’s list because of his “persistent aggressive behaviour towards females.”

In examining the issue of the Practice’s handling of the complaint I took into account the principles and statutory responsibilities relating to the HPSS Complaints Procedure and the 2001 General Medical Council’s (GMC) Guidance on the Duties and Responsibilities of Doctors. I established that Dr B had failed to meet his statutory obligation to deal with the complainant’s verbal complaint in that he had failed to properly investigate the allegations made about Dr A and had failed to issue a written response. I regarded Dr B’s failures as constituting maladministration.

In relation to the management of the written complaint I formed the view that the Practice had abdicated its statutory responsibility to ensure that the complaint had been investigated properly particularly since it had failed to ensure the complaint was investigated by someone other than those named in the complaint. I concluded that the whole creditability and objectives of the HPSS Complaints Procedure, and the Practice’s commitment to it, had been compromised by the way the Practice had dealt with the complaint.

The complainant subsequently requested the Convenor of the Eastern Health and Social Services Board (the Board) to examine her complaint by way of Independent Review. During the period that the complainant’s request for an Independent Review was being considered, Dr A took the opportunity to relay to the Board’s Complaints Officer comments about the complainant’s psychiatric state of mind notwithstanding the fact that she had never been his patient. I regarded Dr A’s discussion with the Board’s Complaints Officer as inexcusable.

In relation to the removal of the complainant’s son from the Practice list, I explored extensively the issue of his alleged “persistent aggressive behaviour towards females”. I was not presented with any evidence to substantiate the allegation. On the basis of the evidence available to me I concluded that the decision to remove the complainant’s son from the Practice list had been based on the fact that the complainant was going to make a formal complaint. I found that Drs A and B, in making and implementing the decision, had breached all the relevant professional guidance, including the GMC guidelines, in relation to the ending of a professional relationship. I regarded Drs A’s and B’s handling of the matter, including their subsequent attempts to justify their decision, as gross maladministration.

I have dealt with a number of complaints against General Practitioners who have removed patients from their Practice list because they have exercised their right to complain. It gives me no satisfaction to record that this particular case rates as the worst case I have ever considered relating to General Practitioners.

I recommended that a letter of apology should be issued to the complainant in recognition of the distress caused to her by the doctors’ actions. I also recommended that the doctors should issue a consolatory payment of £2,000 to the complainant in recognition of the distress and annoyance caused to her since the unfortunate consultation between her son and Dr A. I recognised that I had no statutory authority to enforce such a recommendation, however, I believed that Drs A and B must offer tangible recognition as, by their conduct and behaviour in this case they had completely failed to adhere to the professional and personal standards that all patients have a right to expect from their doctors.

I was anxious to ensure that the complainant was spared any further hurt or distress and I therefore specifically requested that a draft copy of the letter of apology be sent to me so that I could endorse it before it was sent to the complainant. A copy of a draft apology was forwarded but I was unable to endorse it as it was drafted in terms which I considered fall well short of what a meaningful apology should contain. Drs A and B have refused to make any meaningful apology to the complainant. They have also refused to implement my recommendation regarding the consolatory award of £2,000.

Ends.