Annual Report of the Ombudsman 2007

BUSINESS PLANNING ACTIVITY IN 2007

Case Management

We received 2,578 complaints in 2007 and dealt with 9,334 enquiries. The comparable figures for 2006 were 2,245 and 8,103 respectively. Thus, complaint numbers received in 2007 grew by 14.8% and enquiries by 15%. In fact the total number of complaints received in 2007 was the highest annual total since 1999.

The total number of cases completed in 2007 was 2,520 as compared to 2,187 in 2 006 - an increase of 15%. Progress on achieving case targets is monitored at the monthly meetings of the Management Advisory Committee (MAC) and individual staff members have their own targets under their performance management plans to reflect the targets set at organisational level. In view of the high intake of new complaints, the performance in completing more cases than in 2006 was most satisfactory.

Statement of Strategy 2007-2009

My Office’s Statement of Strategy for the period 2007-2009 was drawn up in broad outline at the close of 2006. The Strategy anticipates the challenges facing my Office over the relevant period and identifies priority actions to deal with those challenges. Chief among those is the extension of my Office’s remit in the health sector and I have detailed below (see Complaints Against Hospitals) the work that was undertaken to ensure that my Office was in a position to take on the new complaint areas as smoothly and efficiently as possible while at the same time making sure that the public bodies coming under my remit understand fully my Office’s role and the complaint examination processes which we follow. A further priority is to increase the number of formal investigations carried out by my Office and the publication of reports on those investigations, where appropriate. In this regard, I give details below of the outcome of a number of the investigations completed in 2007 (see Investigations).

In the context of the Strategy there is also a recognition that my Office now deals with a more diverse society and this requires special strategies to reach out to those sectors which are less likely to have an awareness of my Office and the services it can provide to help them in their dealings with the Irish public service. For instance, my Office has been in contact with the Office of the Ombudsman in Poland with a view to providing information on his website in Polish on the work carried out by my Office which will help to raise awareness of my Office among the Polish community in Ireland. It is also proposed to include links between my Office’s website and that of the Polish Ombudsman. My Office is also planning to implement a comprehensive Communications Strategy (see below). Furthermore, my Office is also engaged in a special initiative in relation to access to information on rights for immigrant communities and individuals (see European Year of Equal Opportunities for All below).

Communications Strategy

As my Office’s remit expands and the Irish population increases and becomes more diverse, my potential client base is also growing. This poses fresh communication challenges for the Office in communicating with the wide variety of audiences who need to understand what my Office does and how it does it. These audiences include potential complainants, new bodies falling under my remit and organisations and individuals best positioned to reach out and act as a conduit for persons who need to use my Office’s services and who may need assistance and support in doing so. During the development of our current Statement of Strategy 2007-2009 my Senior Management Team and I quickly recognised that this was an area deserving of special attention. With this in mind, my Office engaged and worked with a consultancy team throughout 2007 leading to the drawing up of an Integrated Strategic Communications Plan. This will lead, over time, to a roll out of a number of communications initiatives. My Office has appointed a new Senior Investigator, as Head of Communications and Research to drive these initiatives.

Survey of Complainant Satisfaction Levels

During 2007, my Office continued with the quarterly survey of complainants’ perceptions of the service provided by my Office. Once again, complainants were surveyed on a broad range of issues in relation to their experience of the service which the Office had delivered in the course of the examination of their complaints. This survey continues to provide valuable feedback on the level of client satisfaction and the identification of areas of activity requiring improvement. Arising directly from feedback received to date, a number of initiatives have been commenced. These include the need to give clearer information to complainants at the outset of the examination of their complaints on the role of my Office, how the complaint examination process is conducted, arrangements to keep them informed of progress as the examination unfolds and the length of time the examination is likely to take to complete. It is hoped that following these initiatives, future survey returns will indicate increased levels of satisfaction in these areas.

Survey of Oireachtas Members

My Office has also conducted a survey of Oireachtas members (see page 30 of my 2006 Annual Report) to gauge their levels of satisfaction with the service my Office provides to them in relation to the handling of complaints which they refer to my Office and I would like to express my thanks to all Oireachtas members who participated. The survey indicated that the members were strongly of the view that they would like the Office to publish more details, including outcomes, of specific cases which they had referred to me, together with information on the types of issues that the Office can and cannot examine. They also wish to receive information on how to go about making a complaint, contact points for making complaints and details of my remit. It was also suggested that a briefing session for members on the role of the Ombudsman should be provided. Work is ongoing in the development of a number of initiatives arising from the survey and I hope to announce more details about these during 2008.

Gender Equality

A Gender Equality Group monitors the Office’s gender balance targets and the factors that may influence the achievement of these targets such as:

§  Staff participation in promotional competitions;

§  Training and development initiatives;

§  The gender makeup of interview boards for internal/interdepartmental competitions;

§  The take up of family friendly (Work/ Life Balance) initiatives (flexitime, work-sharing, term-time, career breaks);

§  The distribution of men and women across the sections of the Office.

It reports on these issues to the Management Advisory Committee twice yearly. The Group also gender proofs relevant new Office policies and documents. The Office’s gender targets apply to grades at Executive Officer level and above in the Offices of the Ombudsman, the Information Commissioner and the Secretariat to the Standards in Public Office Commission. Late in 2007, the remit and work programme of the Committee was expanded to include all of the grounds contained in the Equality Acts, 1998 and 2004, and was re-named the Equality Committee.

 

Civil Service Performance Verification Group

The Civil Service Performance V erification Group (CSPVG) was established under Sustaining Progress to verify that satisfactory progress was being made by Departments and Offices in relation to the modernisation commitments contained in that agreement. The Office reported on two occasions during 2 007 to the CSPVG on progress achieved under the current agreement Towards 2016. On each occasion the CSPVG agreed that the progress achieved warranted payment of the pay increases due under the agreement.

Other Activities

Review of the Irish Public Service

In January 2007, the Taoiseach announced that he had invited the Organisation for Economic Co Operation and Development (OECD) to undertake a major review of the Irish Public Service. The review had two main objectives a) to benchmark the Public Service in Ireland against other comparable countries and b) to make recommendations as to future directions for Public Service reform. The OECD Review Team charged with carrying out the review met with a wide range of organisations and individuals during the year.

In September 2007, in my capacity as Ombudsman, I met with Mr Edwin Lau of the OECD Review Team. Mr Lau, is an International Expert in Assessing and Developing Public Governance Capacity, e-Government and Public Management Reform. We had a wide ranging discussion on issues relating to my Office and its role in monitoring and improving public administration in Ireland through the examination of individual and systemic complaints. We explored issues such as the function, powers and remit of my Office. In addition, we discussed broader issues relating to the public service generally such as the tendency over the years to hive-off functions which were traditionally within the remit of Ministers and their Departments, through the creation of new stand alone single-purpose agencies and the lack of appropriate accountability mechanisms to monitor the activities of such agencies.

As part of a structured dialogue, a Consultative Panel, comprising key stakeholders drawn from the public service, the private sector, academia and the social partners, was established and also met with the OECD Team on a number of occasions. I was a member of the Consultative Panel.

The Review Team published its report in April 2008 and recommended a series of integrated system-wide actions to allow the Public Service to become more focused on its contribution to the achievement of broader citizen-centred societal outcomes.

Investigations Concluded in 2007

The Ombudsman Act, 1980 provides that a complaint can be processed by my Office by means of a preliminary examination or an investigation. The vast bulk of complaints are dealt with by way of a preliminary examination, whereby it is possible to conclude cases, in a consensual manner, with the co-operation of the public bodies. I may decide to open an investigation in a particular case, if I see fit. I do so for any number of reasons but, most commonly, I decide to do so if I consider the case may have some merit but the public body simply does not accept this and no progress towards a resolution is in sight. I am also more likely to open an investigation if I feel there are broad systemic issues involved in the case. It is only on completion of an investigation that I can make formal recommendations to resolve a complaint to a public body. If the response of the public body to any such recommendations is not, in my view, satisfactory I can lay a special report on the matter before the Houses of the Oireachtas, if I see fit. By their nature investigations demand more time and resources compared to preliminary examinations not only because they lead to the production of a detailed written report, but also due to the need to ensure that those who may be adversely criticised in the report are accorded their rights with regard to fair procedures and the principles of natural justice. I normally decide to publish reports of investigations which involve matters of a systemic nature, particularly matters which might serve to improve public administration generally. I provide details here of some of the investigations concluded in 2007.

Fingal County Council – Administration of Disabled Persons Grant Scheme

I initiated an investigation against Fingal County Council regarding its handling of two separate applications under its Disabled Persons Grant (DPG) Scheme after unsuccessful attempts by my Office to resolve the cases by means of a preliminary examination. As it happens, during the investigation the Council revised its initial position and conceded that the DPG would be paid in each case.

In the first case, a disabled man was refused a grant towards the cost of installing a chair lift in his house following a stroke. The application had been made some time after the installation of the chair lift (the complainant had been writing to other state bodies before being directed to the Council) and the Council refused the grant because the application had not been made before the installation, as prior approval is necessary in such cases.

I took the view that under the Housing (Disabled Persons & Essential Repairs Grants) Regulations, 2001 (SI 607 of 2001) the Council had a discretion to pay a grant. I have always held that where public bodies have a discretionary power, they should exercise this power in a reasonable manner having regard to the principles of good administration and all of the circumstances of the case. I am also of the view that, while schemes and services administered by public bodies must have pre-determined criteria of eligibility and other standard conditions, it is equally important that public bodies should be flexible in dealing with unusual cases or unforeseen circumstances.

The Council indicated to me that otherapplicants had been refused on the grounds that work had commenced prior to Council approval. It said that the same criteria are applied to all applicants and it considered that this is the only fair and equitable method of operating the scheme. It said that to pay the grant in this case would be setting a precedent, which would be unfair to other applicants who had been refused in the past.

During the investigation I asked the Council to address the following main points:

§  There was no provision in the relevant Regulations for prior approval compliance as a condition for the payment of a DPG;

§  The works carried out by the complainant (the installation of a chair lift) appeared to be works of a clearly identifiable nature and it would appear that the need for the works could be assessed after installation. It appeared that the Council should still have been in a position to determine whether the works in question were reasonably necessary for the purpose of rendering his house more suitable for his accommodation;

§  The reasons why a particular section of the scheme, as adopted by the Council, appeared to have been applied without allowing for the exercise of discretion which is provided for in the Regulations.

The Council subsequently responded stating that, having regard to the totality of the circumstances that pertained in the case, not least the efforts of the complainant to secure assistance, and his failure to discover, despite his best efforts, from government organizations and non-government organisations, the existence of the Council’s scheme, it was reasonable to accept a late application from him. The Council paid him a grant of €3,150.

In the second case, a disabled man applied to the Council for a Disabled Persons New House Grant in September 2003. Approximately one year later, his application was refused. The complainant stated that when he approached the Council initially he was told that the Disabled Persons Grant was not means tested. He claimed that the Council’s decision in his case was based on a means test, but he was never means tested. I discovered that in May 2004 the Council had adapted a revised Disabled Persons Scheme which enabled it to have regard to “the assets and income” of the disabled person. The Council accepted that it had not means tested the complainant but said that it was not necessary to request income details from him because his accommodation “is in excess of that adequate to accommodate one person and demonstrates that this house is a considerable asset”.

I persuaded the Council to review its position in this case on the following grounds:

§  The scheme adopted by the Council appeared to have been adopted after the complainant made his application. It appeared that new criteria for eligibility were applied after the application had been made and that such criteria did not exist at the time of the making of the application;

§  It appeared that the criteria (guidelines, rules or limits) applied in relation to this application had not been made clear and it appeared that there had been a lack of transparency and a lack of objective priorities in the making of the decision;

§  There was no provision in the Regulations for a means test;

§  There appeared to have been an unreasonable delay by the Council in making the decision.

The Council accepted my arguments and the complainant was paid the maximum grant of €12,700.00 plus interest of €1,203.

The grants in these cases were under the Housing (Disabled Persons & Essential Repairs Grants) Regulations which have since been revoked. However, the administrative issues which emerged in these cases can and do arise in other situations.

Complaint Against a Former Health Board

I received a complaint against a former Health Board regarding the manner in which it dealt with an application by a couple to foster three sibling children in 2001. My investigation report on the matter -which I published in June 2007- dealt with how the actions of the former Health Board (both the social work team and administrative staff) impacted on the couple, and how these actions ultimately affected the three children who remain in residential care. I did not identify the health board in my report in order to protect the identity of the children. The report highlighted the necessity to ensure that people who come forward as possible foster parents are dealt with in a fair and proper manner and the need for improvement in the lines of communication between social worker staff and administrative personnel, so that, in turn, their dealings with potential foster parents are fair and unambiguous. In this case a window of opportunity was lost, an opportunity which might have led to a different outcome for the three young children. The report contained a series of recommendations, all of which were accepted by the Health Service Executive and were aimed at improving communication protocols between professional and administrative staff in dealing with fostering applications. I should point out that complaints relating to children are now the responsibility of the Ombudsman for Children and this complaint came before me before the establishment of that Office. My report on the case is on my Office’s website [www.ombudsman.ie].

General Register Office

The investigation in this case related to my Office’s experience of dealing with complaints against the General Register Office (GRO) in which I highlighted a number of cases where I felt that the actions of the GRO had adversely and seriously affected individuals. The cases referred to in the report exemplify instances where the quality of service provided was below the standard which might be expected from a public service organisation. I made a number of recommendations aimed at improving the quality of service and these have been accepted by the GRO. The cases in the report were chosen with a view to assisting those charged with quality customer service improvement within the GRO and the Department of Health and Children to meet the expectations of members of the public using the important service provided by the GRO in the future. My report was published in October 2007 and can be viewed on my Office’s website [www.ombudsman.ie].

Complaints Against Hospitals

Since 1985, my Office’s jurisdiction was limited to the administrative actions of the health boards and those hospitals which came under the direct control of the boards. As and from January 2007, a statutory complaints procedure for the Health Service Executive (HSE) became effective, in accordance with the provisions of the Health Act 2004. The new statutory complaints procedure applies to actions of the HSE, and service providers who have contracts with the HSE, to provide health and personal social services. Complaints examined under this procedure, which remain unresolved, can then be referred to my Office for consideration.

One outcome of the introduction of the new complaints system is that all bodies providing health or personal social services to, or on behalf of the HSE or who receive assistance from the HSE, now come within my remit. Among these new bodies are the large public voluntary hospitals such as the Mater Misericordiae Hospital, Beaumont Hospital, St James’ Hospital, Our Lady of Lourdes Hospital, Drogheda, Mercy University Hospital, Cork, South Infirmary/Victoria University Hospital, Cork. In addition, bodies which provide a personal social services similar or ancillary to services provided by the HSE or which receive assistance, e.g. a contribution to expenses incurred or the provision or use of premises from the HSE, are also covered by the statutory complaints procedure.

In 2007, my Office received 84 hospital-related complaints. For a breakdown of these please see Tables 7(b) and 12(b) in Chapter 5 of this report. This was the first year of operation of the new statutory complaints procedure and I expect that the number of hospital complaints which will eventually come before me in the future will increase significantly. Under the new scheme, complaints must be made in the first instance to the hospital concerned or other relevant health service provider. If the matter is not resolved satisfactorily at local level, the complainant may refer the case to my Office. Because of the need to go through local resolution in the first instance, the true pattern of annual numbers of cases received by my Office will take some time to emerge but is likely to be higher than the 2007 intake.

The complaints received by me during 2007 include issues surrounding an unexpected death in hospital, lack of courtesy in the care and treatment of patients, communication difficulties in respect of the transmission of urgent medical reports between hospitals, lack of dignity and respect surrounding the death of patients in hospitals, inadequate record keeping and failure to apologise for poor service provided. Details of some of the complaints received are featured elsewhere in this Report.

Following the introduction of the new statutory complaints procedure, my Office hosted a seminar, entitled “Complaints and the Ombudsman” on 1 February 2007. This seminar was primarily aimed at those hospitals which were brought under my remit on 1 January 2007. The target audience was hospital staff who have responsibility for day to day complaint handling and who, by the nature of their work, are most likely to have ongoing contact with my Office. The purpose of the seminar was to introduce my staff to those individuals, and vice versa, and to explain my Office’s role and purpose in the overall complaint handling process. This proved to be a very successful seminar with over sixty five delegates attending from various hospitals around the country. The audience included Chief Executive Officers, Hospital General Managers, Directors of Nursing, Patient Service Managers, Clinical Risk Managers, Consultants, Clinical Nurse Managers, designated Complaints Officers and many more.

In addition, in the period February to May 2007, I met with the Chief Executive Officers and Board of Directors of many of the Public Voluntary Hospitals in Dublin, including Beaumont Hospital, St James’s Hospital, St. Vincent’s University Hospital, Elm Park, Temple Street Children’s Hospital, Holles Street Maternity Hospital, and The Coombe Women’s Hospital. I also met with the Dublin Academic Teaching Hospital’s Group in April 2007 and hosted a meeting of this Group in my Office in October 2007.

The purpose of these meetings was as follows:

§  To introduce myself to the senior hospital managers;

§  To outline my role under the new complaints procedure;

§  To explain how my Office functions;

§  To discuss the extent of my remit;

§  To outline what I expect of the hospitals once my Office approaches them with a complaint;

§  To establish formal communication channels between my Office and the hospitals;

§  To familiarise myself with the hospitals’ internal complaint procedures, and

§  To seek the hospitals views on current best practices.

I would like to take this opportunity to thank the various hospitals for the courtesy which was extended to myself and to my staff during these visits and in particular for their positive and cooperative approach to my Office. I was particularly impressed with the customer oriented approach which many of these hospitals have adopted, an ethos which many have incorporated into their Mission Statements and Business Plans.

Ombudsman (Amendment) Bill

I am pleased to note that, at the time of going to print, the indications are that the long-promised Ombudsman (Amendment) Bill will be taken in the Dáil summer session in 2 008. My officials have been liaising with officials from the Department of Finance about the matter. The enactment of the Bill will be an important milestone for my Office and for public administration generally. The main purpose of the Bill is to widen the remit of my Office to cover a range of additional public bodies which have a significant interface with the public. The Bill includes an important new provision which will enable my Office to state a case to the High Court on any question of law arising from my examination of a complaint. The Bill will also make provision for the protection of the term Ombudsman.

Extension of Ombudsman Link Service

In my 2005 and 2006 Annual Reports I reported on the Ombudsman Link Service which is a new service being provided through Citizens Information Services in certain areas which allows members of the public easier access to the services of my Office. The service assists their staff to identify and submit potential complaints which my Office can take up on behalf of members of the public.

In April 2007, the Ombudsman Link Service was extended to the Immigrant Council of Ireland (ICI). In addition, a series of meetings has been held in various parts of the country with a view to extending the service to the Society of St Vincent De Paul. My Office will also be providing training to Citizens Information Centre (CIC) staff in the North Eastern and South Eastern regions during the first half of 2008 so that the Link Service can be made available to members of the public through all CICs in those regions, and it is hoped that it will be extended throughout the entire country by the end of 2008.

European Year of Equal Opportunities for All

The year 2007 was designated as the European Year of Equal Opportunities for All, with the purpose of celebrating progress made in promoting equal opportunities for all and combating discrimination, to acknowledge significant inequalities that persist and to renew commitment to a more equal society. I was very pleased to accept an invitation from the Equality Authority for my Office to be represented on the Advisory Committee that was convened to support the implementation of the agreed strategy for the year. In 2008, the Advisory Committee will be working on the implementation of the longer term legacy of the actions established on foot of the European Year.

My Office, along with the Equality Authority, the Citizens Information Board, the National Employment Rights Authority, the Reception and Integration Agency, the Department of Social and Family Affairs and the Health Service Executive, was also represented on a Steering Group which commissioned research leading to the publication of a report entitled “Effective and Innovative Strategies for Providing Information on Rights to the Public”. The report, which examined models in a range of other jurisdictions, recommended best practice approaches to the provision of information on redress in Ireland. Arising out of this research, a Working Group has now been established to develop an initiative around access to information on rights for immigrant communities and individuals.

Chapter 4 - Part II