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Annual Report of the Ombudsman 2005

Date released: 19.07.2006

The Ombudsman, Emily O'Reilly, has today published her Annual Report for 2005. This report covers her second full year in office since taking up duty as Ombudsman on 1 June 2003. The Ombudsman reports annually to the Oireachtas and the general public on the work of the Office and on issues and cases of interest arising during the year.

In view of a number of significant developments in the health sector, Emily O'Reilly has devoted a special chapter (chapter two) to the public health service. These developments include the radical re-structuring of the health service and the creation of the Health Service Executive (HSE), the imminent extension of the Ombudsman's remit to the public voluntary hospitals and the publication earlier this year of the Ombudsman's special report to the HSE on her experiences to date of dealing with complaints in the health service and her suggestions for making the health service more patient focused in the delivery of health care.

Also in this chapter, the Ombudsman describes the role which her Office will have in dealing with complaints about the scheme to repay nursing home charges which is to be introduced shortly by the HSE and her new role under the Disability Act, 2005 in dealing with complaints from people with disabilities about access to public buildings and services.

The full text of the Annual Report is available at www.ombudsman.gov.ie  

Main features of the Annual Report:

Chapter 1 - Introduction

In her Introduction Emily O'Reilly comments as follows on the her Office's approach to dealing with complaints in the health sector.

"In the health area, my Office's handling of complaints will be guided by its recently published Statement of Best Practice for the Health Service. This was drawn up as part of my recently published report to the HSE outlining my Office's experience to date of the health system and making recommendations for an improved service. It is my view that the patient must be at the centre of that service and that primacy must be given to patient care, patient safety, patient dignity, patient confidentiality and to the issue of informed consent in relation to treatment plans and other matters. The quality of palliative care in public healthcare institutions will also be a priority."

Chapter Two: The Ombudsman and the Health Service Sector

Commenting on her thematic report to the Health Service Executive on her experience of health sector complaints Emily O'Reilly says;

"I approached this review in the context of Quality and Fairness, the National Health Strategy. I share the vision and desire of that strategy to achieve a health system that supports and empowers the individual to achieve full health potential, that is available, that is fair and is one in which the individual can have trust and where the views of the individual will be taken into account."

Commenting on her Office's positive role in dealing with health sector complaints and improving the quality of health care provision she goes on to say;

"Over the years my Office has engaged with the agencies in the public health services in developing better quality decision making in the delivery of their services to the public. My staff engaged with the former health boards, and specific professional groups, in seminars and training exercises on the issues which are of importance to me in the examination of complaints, principles of good administration, best practice for public servants, the rights of users of the health service and the management of complaints. The emphasis in all of these interactions was always positive i.e. how to improve the quality of the health service delivered. This educative role casts the Ombudsman in the role of a "critical friend" and I look forward to the further development of this role with the Health Service Executive (HSE) and the other agencies providing public health services."

She reports on a number of health sector complaints including:

A woman complained about her post-operative care in hospital, following surgery for breast cancer, and the way her concerns were dealt with by the Health Service Executive (HSE), Western Area. She said she had not been seen by either the surgeon or his senior team as a patient for a period of five days after her operation. The surgeon commented that the complainant had been seen every day by his senior team and that he had been kept informed of her progress, which had been quite satisfactory.

She got an initial written response to her concerns but remained dissatisfied and addressed a complaint on the matter to the Chief Executive Officer (CEO) of the HSE, Western Area. The HSE, wrote to the complainant outlining the points made by the surgeon, which reflected his initial comments The complainant was dissatisfied and contacted the Ombudsman

The Ombudsman was not happy about the way the HSE had investigated the matter. There was no evidence that the patient/hospital records had been examined, or that other personnel involved in the complainant's post-operative care had been interviewed either in the investigation or re-investigation of the complaint. In fact, it was only after she had contacted the HSE's CEO that the records were examined. It appeared that there were some direct conflicts of evidence in relation to the attendance by the surgical team which could only be reconciled by the HSE's investigation team conducting its own examination of the issues, which would include interviews with the relevant staff.

The HSE accepted that it was evident that its investigation was not as thorough as it ought to have been. It apologised to the complainant for the hurt, inconvenience and hardship caused. It went on to say that it had since revised its local complaints policy and had put the lessons learned into action.

Individual cases reported on in Chapter Three include:

Civil Service

A farmer complained against the Department of Agriculture & Food regarding his application to have the reference years (i.e. the years on which his level of payment would be based) for his Single Farm Payment changed from 2000-2002 to 1997-1999, on the basis of the force majeure provisions of the scheme. The basis of his application was that he had Hodgkin's Disease. The Department had agreed to exclude the year 2001, the year in which he was diagnosed but would not accept the exclusion of the years 2000 and 2002.

The Ombudsman's Office spoke to the complainant and got a detailed medical report from his doctor on his condition. This showed that the complainant's illness would have had very adverse effects on him both before diagnosis and after treatment. It was clear that his condition had a major impact on his functional capabilities for a considerable period prior to the formal diagnosis and also for a long period after the diagnosis as a result of the disease and the intensive treatment he had to received.

Following the Ombudsman's intervention the Department agreed to exclude both the year before the farmer was officially diagnosed and the year after he had received chemotherapy. This resulted in the reference years being changed with a potential difference of €15,000 over the period of the scheme.

Health Service Executive

A woman complained about an application she made, on behalf of her elderly mother, to the Health Service Executive (HSE), Eastern Region, Northern Area, for assistance towards the cost of her mother's care, under the Nursing Home Subvention Regulations. The application was refused on the grounds that her mother was a home owner, even though it was also the complainant's home. The decision to refuse assistance, coupled with the erratic nature of the complainant's employment, left the complainant and her mother in difficult financial circumstances. The elderly woman had exhausted all of her savings to fund her care and her daughter found herself in a situation where she had to consider selling the family home to fund her mother's care.

In calculating the mother's entitlement, the HSE assessed her State pension, her small occupational pension, and an estimated rental value of her stake in the family home (50%). This was in accordance with the subvention regulations. However, this provision is not mandatory and the HSE has, in fact, a discretion to assess or disregard a property when calculating an applicant's entitlement. The Ombudsman felt there were grounds for the HSE to consider the exercise of this discretion in favour of the complainant.

The HSE accepted that the continued assessment of the property would cause her undue financial hardship. It agreed to disregard the property and award a subvention of €203.97 per week.

Local Authorities

A 93 year old woman who suffered from osteoporosis complained to the Ombudsman regarding the rejection of her Disabled Persons Grant (DPG) application by Navan Town Council. She had great difficulty climbing the stairs and had to be aided in doing so. On professional advice given to the complainant and her family, they installed a chair lift for the stairs, as they were advised that the stairs were a danger to the complainant and those aiding her. The stair lift allayed the complainant's fears at negotiating the stairs and as a result it provided her with a form of independence. The Council advised the complainant that works could not commence prior to written approval and as a result her application could not be approved.

Following the Ombudsman's intervention the Council re-examined the case without delay. The Council, having had regard to the urgency of the case, the proven need for the facility provided for the complainant and in the special circumstances of the case, decided to approve the payment of a DPG in respect of the work carried out on her behalf.

Statistics: Chapter 5

Emily O'Reilly received a total of 2,243 valid complaints during 2005 compared to 2,064 complaints in 2004, which was an increase of almost 9% on the previous year. In addition to actual complaints, Ombudsman staff also dealt with 9,704 enquiries from members of the public. Between valid and invalid complaints and enquiries, almost 13,000 people contacted the Ombudsman's Office during 2005.

Adding on complaints carried forward from 2004, which totalled 788, the Office had 3,031 valid complaints on hands for 2005.

Of the 2,193 complaints concluded in 2005: 343 (15.6%) were resolved; and in 422 (19.2%) cases assistance was provided. In effect, 35% of complainants were better off as a result of having contacted the Ombudsman. As regards the distribution by sector of valid complaints received, 42.9% related to civil service departments and offices, 33.3% involved local authorities, 19.9% related to the Health Service Executive, and 3.8% to An Post.

The Annual Report of the Ombudsman 2005 is available in pdf and html formats.

Website: www.ombudsman.ie

Further Information: Tom Morgan at 01-6395600, Fax 01-6395674, e-mail: tom_morgan@ombudsman.gov.ie

Note for Editors:

The Ombudsman - A Brief Guide

What is the Ombudsman's Role?

The Ombudsman investigates complaints from members of the public who feel they have been unfairly treated by certain public bodies. Her Office is impartial and completely independent of Government. If she finds a complaint justified she may recommend appropriate redress.

What Can the Ombudsman Do?

The Ombudsman has extensive powers in law. She can demand any information, document or file from a body complained of and can require any official to give information about a complaint. She can look into all administrative actions including:

• decisions
• refusal or failure to act
• administrative procedures

Who Can Complain and How?

Any individual, public representative, company, or organisation can make a complaint. Complaints can be made in writing, by telephone, fax or email, or by calling to the Ombudsman's Office.

Which Public Bodies are Subject to Investigation?

• Government Departments and Offices
• Local Authorities (County Councils, City Councils etc.)
• Health Service Executive
• An Post

When Should You Complain?

Before you contact the Ombudsman you must first try and solve your problem with the public body concerned. If you fail to resolve your problem and feel that the public body has not treated you fairly, contact the Ombudsman. When making a complaint try to give as much information as possible including any copies of letters and reference numbers.

What Will it Cost?

Nothing. There is no charge for dealing with complaints.

How Will the Ombudsman Deal With Your Complaint?

The Ombudsman's staff will screen the complaint to see if it falls within her remit and whether there is a basis to take it up with the public body. In the majority of cases complaints are resolved satisfactorily in a very informal way, for example, by discussing the problem with the public body or by examining the relevant files. In the more complex cases a formal investigation may be required.

If the Ombudsman finds that your complaint is wholly or partially justified, she will report this to the public body concerned. She may recommend that it should review its action, change its decision, or offer some form of appropriate redress.

Will the Recommendation of the Ombudsman be Accepted?

The Ombudsman has no power to force a body to accept or act upon her recommendation. If it does not, she may find it necessary to report on the matter to the Houses of the Oireachtas.

Are There Areas That the Ombudsman Cannot Investigate?

Yes, she cannot investigate:

• the actions of private companies or individuals, private practitioners, dentists, opticians, pharmacists, etc.;
• actions taken in connection with clinical judgement by doctors;
• the "reserved functions of Local Authorities", for example, those functions exercised by elected members of local authorities;
• complaints relating to recruitment, pay and conditions of employment;
• court decisions, matters which are already the subject of court proceedings,
• the actions of the Gardaí or actions taken in the running of the prisons;
• where there is a right of an appeal to an independent tribunal or appeal body such as the Appeal Commissioners of Income Tax.

The Ombudsman and the Disability Act 2005 

The Ombudsman is

- impartial

- independent

- a free service

The Disability Act 2005, which became law on 8 July 2005, imposes significant obligations on Government Departments and on Public Bodies to work proactively towards the improvement of the quality of life of people with disabilities.

The Act also gave the Ombudsman new powers to investigate complaints about compliance by public bodies and others with Part 3 of the Act (i.e. accessibility of buildings, information and services).

The Ombudsman does not have any role in relation to other Parts of the Disability Act, 2005 (for example, assessment of needs [Part 2] or public service employment [Part 5] ). The Act contains separate complaints and/or monitoring arrangements for these.

 

List of Special Reports on Systemic Issues Published by the Office of the Ombudsman

Non-Payment of Arrears of Contributory Pensions March 1997

Provision of School Transport for a Child with Disabilities February 1998

Passengers with Disabilities August 2001

Redress for Taxpayers November 2002

Care of a Patient at Sligo General Hospital July 2005

Complaints Against the Public Health Service May 2006

 

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