By Dr Minh Alexander NHS whistleblower and former consultant psychiatrist 19 May 2017
Rules and standards are the heart of civilisation and public service.
They are the means by which fair play can be assured.
In public life, healthy complaints processes are an important part of upholding rules and standards.
The NHS is rotten at dealing with complaints, and has especially designed dead ends and endless Mobius loops to frustrate and deter complainants.
Even the body that is supposed to provide ultimate oversight of NHS complaints, the Parliamentary and Health Service Ombudsman, has been repeatedly mired in scandal and is seen by many as a purpose built obstacle. 1
Bill Kirkup concluded from his investigation into the maternity safety failures at Morecambe Bay that governance by central NHS bodies was ‘circular’, with these bodies wrongly passing flawed and unjustified assurance amongst themselves. 2
It is no surprise then that the National Guardian’s office, a public relations vestige flapping on CQC’s bum, has no published complaints policy.
It is also no surprise that there are no coherent and fit for purpose arrangements for investigating complaints about the National Guardian’s office.
CQC claims that the National Guardian’s office is operationally independent and free to hold bodies such as CQC, NHS England and NHS Improvement to account for their failures of whistleblowing governance. 3 3b
This is brought into severe doubt by the fact that:
- These bodies fund the National Guardian
- The National Guardian is employed by CQC and reports to David Behan, CQC’s chief executive, meeting with him frequently 4 5
Adding to the impression that the National Guardian is in reality beholden to its funders, the CQC informed me in January that complaints about the National Guardian’s office will be adjudicated by the National Guardian’s Accountability and Liaison Committee – which comprises board members from CQC, NHS England and NHS Improvement:
“Complaints about the NGO are handled under their own governance structure with the NGO Accountability and Liaison Board (ALB) acting as an independent reviewer of complaints made against the NGO.” 6
I have now written to Rob Behrens the new Parliamentary and Health Services Ombudsman to question why the National Guardian office has complaints arrangements that could potentially subvert its core purpose, and await his response. 7
In the meantime, a current whistleblower who has made a complaint about the National Guardian has received a letter from the National Guardian’s office of 18 May 2017 which states:
“Your complaint about Dr Henrietta Hughes will be dealt with under the National Guardian Office complaints procedure. This will involve Tom Grimes and the complaints team at NHS Improvement looking into your complaint and coordinating a response will be sent to Sir Robert to agree as the current Chair of the accountability and liaison board.”
In addition, this whistleblower was provided with a distinctly thin document, that purports to be the National Guardian’s complaints policy:
This document extraordinarily says nothing about the National Guardian’s complaint procedure, and does not provide even the most basic information. For example, who will investigate, who will adjudicate, what is the standard for response times, how adherence to the policy will be audited or how complainants’ experience will be tracked.
The Public Interest Disclosure Act is even wrongly referred to as the “Public Information Disclosure Act”.
In short, one could be forgiven for suspecting that this document was hurriedly knocked up in response to the complaint.
And irregularly, the document does not appear on the CQC website.
Importantly, what the document exposes is that those running the National Guardian’s office are by no measure experts in governance.
Which is a great pity given that this office is supposed to police a critical matter of governance – the honesty and probity of the NHS in handling criticism and concerns.
But then, if the intention is that the office should not be effective, that suits government just fine.
1 Patients Association. The ‘People’s Ombudsman and how it failed us. November 2014
2 The report of the Morecambe Bay Investigation by Dr Bill Kirkup March 2015
3 CQC Board paper July 2015
“The FTSU review states that the National Guardian must be independent of both providers and national bodies so it is able to review their practices and make recommendations without fear of interference.”
3b National Guardian Independence: The CQC denies some more. Minh Alexander 19 January 2017
4 CQC Position Specification for the National Guardian September 2015
“The National Guardian will be an appointment by the Chief Executive of CQC on behalf of the Board. The appointee will be managed by the Chief Executive…”
5 Agreed records of meetings with the National Guardian on 23 January 2017 and 2 February 2017
6 Email 24 January 2017 from Caroline Dale, Deputy National Complaints Manager – Corporate Complaints Team, Governance and Legal Services Directorate, CQC
7 Letter 8 May 2017 to Rob Behrens Parliamentary and Health Services Ombudsman