New HSE push to hear service complaints

Patients are invited to contact the health executive directly with complaints or comments

COMPLAINING ABOUTthe health services sometimes seems a national pastime, but now the Health Services Executive wants people to make their complaints directly tothe organisation.

This week, the HSE is running a public information campaign for its “Your Service, Your Say” comments and complaints initiative, and claims it will welcome any increase in customer feedback, whether positive or negative.

Given the level of public dissatisfaction with our health system, as expressed daily on the airwaves and in print, it might come as a surprise that the number of complaints filtering through to the HSE is relatively modest.

In the first half of this year, 4,104 complaints were received, though this may be an under-estimate because industrial action hindered the collection of data in some areas.

That compares to almost 8,000 complaints received in 2009, which was a 63 per cent increase on the previous year.

So are we in fact happier with our hospital, clinics and social services than might seem apparent from media coverage? Or are people too scared, or even too indifferent, to follow up their grievances with a formal complaint?

Mary Culliton, director of advocacy with the HSE since last year and the driving force behind the new campaign, believes there is under-reporting of complaints.

“People are sometimes afraid to make a complaint or raise a concern. They’re especially nervous when they are in hospital, because they fear there may be repercussions. Some also buy into a culture where the medics know everything and you don’t ask questions.”

She acknowledges that the health services could be more customer friendly. “There isn’t a sense of ‘We welcome your feedback’ in our services,” she says.

Since a succession of reports called for a change in attitudes, Culliton’s office has worked to overcome resistance within the health service. Specific issues have arisen which have helped break down the barriers – a greater emphasis on handwashing, for example, has encouraged patients to demand that staff too disinfect their hands.

The legal underpinning for a complaints policy was put in place in the 2007 Health Act, which allows people to complain about a wide variety of issues, though some areas, such as matters of clinical judgment, are excluded.

In the first place, complaints can be made to a member of staff, though complaints offices now exist in all areas of the health services. Complaints can be made face to face, by phone, or by letter, e-mail or fax. If a complaint is in respect of or on behalf of another person, that person’s permission is generally required.

There is a 30-day period for processing complaints and if the person is unhappy with the outcome, he/she can appeal to Culliton’s office.

Unresolved complaints can end up with the Ombudsman, professional regulatory bodies or the courts.

Ombudsman Emily O’Reilly has recently delivered two savagely critical reports on aspects of the HSE’s work. She accused the service of attempting to gag her office over a threat to take legal action to prevent publication of a report on guardians’ fees.

The decision to go to court was “a frustrating, wasteful, dispiriting and, ultimately, useless process” that had led to significant public expenditure, according to O’Reilly.

If the State’s official watchdog feels so put out, what hope is there for ordinary citizens taking on the HSE?

Culliton responds that the Ombudsman’s criticisms were confined to two specific issues and that O’Reilly is “broadly happy” with the way the executive deals with cases. “We get a fair old bashing sometimes, but we do also get positive comments.”

O’Reilly has welcomed the “Your Service, Your Say” initiative and reminds public bodies they have a duty to let people know about internal complaints and feedback procedures.

The reason it has taken three years to ramp up the complaints process is because staff had to be trained and stakeholders canvassed for their views beforehand, Culliton says.

One-third of the 8,000 complaints received by the HSE last year related to waiting times and delays, and another third were complaints about treatment or the delivery of services.

Just over 150 cases ended up being reviewed by Culliton’s office, prompting the HSE to claim that “only 2 per cent” of complainants were unhappy with the response they received from local investigation.

However, the executive was unable to provide further qualitative information about the outcome of individual complaints, apart from saying that 79 per cent were dealt with in the 30-day timeframe.

Complaints to the HSE can be made to yoursay@hse.ie, tel: 1850-241850.