Public service watchdog concerned at high level of healthcare complaints

Interview with Northern Ireland Public Service Ombudsman, Marie Anderson

THE watchdog responsible for scrutinising public bodies in Northern Ireland has raised serious concerns about the number of healthcare complaints lodged with her office.

Marie Anderson was appointed as the first Northern Ireland Public Service Ombudsman in April this year. She can investigate complaints involving health and housing issues as well as education and local government.

The new office combines the work of the Northern Ireland Ombudsman with the power to investigate more organisations and publish reports in the public interest.

The ombudsman role is often seen as the office of last resort, as it can only investigate matters once all other avenues have been exhausted.

In her first in-depth interview since being appointed Ms Anderson revealed to The Detail that 80% of her workload relates to healthcare complaints.

She confirmed that she be would raising the issue with the chief executives of Northern Ireland’s health and social care trusts to bring to their attention the number of complaints about their organisations.

“The high number of healthcare complaints is concerning because people only come to this office when they are dissatisfied that there complaint has not been handled properly to date and they are not getting the answers they need,” she said.

“This raises questions about whether or not the health bodies are learning from the complaints they received first and are they doing anything about it? That is a matter of concern to me.

“These complaints can relate to anything from avoidable deaths, failures to diagnose and how health bodies have been handling complaints.”

In a statement to The Detail the Department of Health (DoH) said that it was regrettable that in some cases patients and their families were unhappy with how health and social care organisations have dealt with their grievance.

However a spokesperson said these cases made up a small proportion of the overall number of complaints dealt with internally by health authorities in Northern Ireland.

They said: “The Northern Ireland Ombudsman Annual Report for 2014-2015 indicated that the number of complaints received by the Ombudsman’s Office in relation to health and social care reduced slightly from a high of 370 in 2013-14 to 337 in 2014-2015.

“The number of complaints being taken to the Ombudsman’s Office over this period represents around 6.5% of the 5,154 complaints received by HSC trusts, board and family practitioner service in Northern Ireland in the same period, the vast majority of which received a substantive response with 20 working days. “


Ms Anderson is a trained solicitor and previously held the role of Deputy Ombudsman in the former office of the Northern Ireland Ombudsman under the leadership of Tom Frawley, who recently retired.

The Northern Ireland Ombudsman could investigate complaints about health, housing, local government and education sectors.

Legislation passed earlier this year means the Northern Ireland Public Service Ombudsman (NIPSO) replaced this office. In addition to its previous powers NIPSO can also investigate complaints about the Northern Ireland Audit Office, the Northern Ireland Assembly Commission and judicial appointments.

In October this year the office will be able to accept complaints about universities and in April next year the remit will cover schools and the decisions of boards of governors.

The new legislation also means NIPSO now has the power to publish reports it deems “in the public interest”.

Marie Anderson believes this is an important power for her office.

She said: “If there is an investigation report which I think is important because there is learning to come out of the failure of public services, then learning needs to be widely disseminated. Basically, so that bodies get to learn from each other’s mistakes.”

The ombudsman has the power to recommend a number of remedies including financial redress.

However the ombudsman does not have the power to enforce recommendations.
Commenting on this, Marie Anderson said: “It’s true I have no power to enforce recommendations, but I’m glad to say in most cases my recommendations and those of my predecessors have been followed.

“Since 2010 there have only been six cases in total where the recommendations haven’t been accepted. However, the Assembly was very keen with the new legislation that there would be some mechanism to draw to their attention instances where public services bodies are not meeting the ombudsman’s recommendations.

“There is a new power which allows me to present a special report to the assembly about that issue. This is about public services being held to account at the highest level by the Assembly.”


At the moment NIPSO can only investigate organisations it has received a complaint about. However, from 2018 it will acquire a new power that will allow it to initiate its own impartial investigations into areas of public life it believes deserve more examination.

Ms Anderson said: “We still find that there are pockets of the public who are frightened to complain or are unable to complain. For example if you have a loved one in an institution such as a residential care home, you might be frightened that if you complain things are only going to get worse for a loved one.

“That’s where I could use my own initiative and say I want to investigate this sector of public services. We want to be a voice for the voiceless if you like.”

The recent legislation states that the ombudsman will only be able to initiate an investigation where there is evidence of maladministration or systems failure.

The new ombudsman said she intends to gather evidence on areas of interest over the next few years while her office waits to acquire this power.

“I will be looking to see if there is a pattern of complaints either from a particular body or in a particular sector and I will also be looking at reports produced by other regulators to see what issues are constantly being red flagged.”

Ms Anderson admits that she has become increasingly concerned with the amount of complaints her office deals with that relate to healthcare.

“When you are dealing with a health complaint there is a high public interest because it usually presents patient safety issues. At the moment 80% of the workload in this office relates to health."

The Detail has previously reported on how hospital deaths are investigated as well as examining what internal mechanisms exist to ensure the same mistakes are not made again.
Since taking up the ombudsman’s position Ms Anderson said of the first 185 new complaints the office have received, 86 of them have related to health.

She said: "The fact that such a high proportion of my workload is dealing with health complaints is concerning to me. I want to find out why people are not happy with how health organisations are dealing with their original complaints.

“It’s my intention to organise an event before the end of this year looking at how we can disseminate the learning from this office with a particular focus on learning from healthcare complaints.”

A Department of Health spokesperson said: “The Department of Health and HSC bodies would welcome working with the Ombudsman’s Office in any event aimed at looking at how health and social care can learn from the Ombudsman’s Office experience.”

The Detail contacted the five health trusts, the department and Health and Social Care Board to ask how they deal with complaints received by families. Click here to read their statements in full.