Ombudsman, the HSE and complaints


Sir, – Arising from the article by Jacky Jones (Second Opinion, “Complaining to the HSE can be a pointless business”, Health + Family, March 29th), the Ombudsman Peter Tyndall has asked me to write to you in relation to the legal constraint in place at present which prevents him from examining complaints about clinical judgment decisions. This constraint applies in relation to complaints received by the ombudsman against the Health Service Executive (HSE) and private nursing homes.

As Dr Jones pointed out, it is a matter of some frustration to the ombudsman and complainants that this constraint is in place. The vast majority of care and treatment complaints to the ombudsman involve a mix of clinical judgment and administrative actions. This means that the ombudsman cannot deal with these complaints in their totality.

However, your readers may be interested to learn that steps are in train that may lead to the removal of the current restriction. In May 2015, the ombudsman published his systemic investigation report into complaint-handling systems in the acute hospital sector. At the time, the HSE accepted all 36 recommendations contained in the report, but the changes to the ombudsman’s remit is a matter for government, rather than the HSE. Recommendation 15 called for a review of the clinical judgment exclusion.

In July 2015, the ombudsman met Minister for Health Leo Varadkar to discuss the report and the clinical judgment exclusion. In November 2015, Mr Varadkar announced a major package of patient safety reforms, including plans to simplify the HSE complaints procedures. In doing so, the Minister indicated his support for the removal of the clinical judgment exclusion. He had earlier initiated a consultation process with interested parties on the issue.

Throughout 2015, the Joint Oireachtas Committee on Public Service Oversight and Petitions had been conducting a general review of the role and remit of ombudsman offices in Ireland. In January 2016, it published its findings and recommendations. This included a recommendation that the clinical judgment exclusion should be removed.

In light of the foregoing developments, the ombudsman is hopeful that the necessary legislative amendment will be made to give him unfettered remit in this area. This would benefit the health system by unearthing and highlighting clinical errors which may occur and help to bring about systemic improvements. It would also give greater assurance to patients and their families that they will be given full information and explanations when adverse events happen. – Yours, etc,


Head of Communications,

Office of the Ombudsman,

18 Lower Leeson Street,

Dublin 2.