Complaints about NHS at record levels: Main grievances are poor communication and careless medical record-keeping

PATIENTS' complaints to the Health Service Ombudsman rose to record levels last year, with poor communication and slapdash medical record-keeping topping the list of serious grievances.

William Reid, the Parliamentary Commissioner for Administration, upheld more than half the 1,176 complaints he received. Many stemmed from 'undated, untimed and illegible' entries - or none at all - to patients' records, often concerning significant events in hospital stays.

In a report published yesterday on the Ombudsman's work during 1991- 92, the Commons Select Committee on the Parliamentary Commissioner for Administration says chairmen and non-executive board members running health services must carry final responsibility for 'systematic failures' of internal complaints procedures. 'The sad repetition of failures in areas such as the handling of complaints, record-keeping and communication demonstrates that some lessons are still not being taken to heart by sections of the health service.'

The sharpest rise in the number of complaints lodged with the Ombudsman came from patients in the South East Thames health region - up 68 per cent on the previous year. In spite of the increasing workload on the Ombudsman's office, the average time taken to investigate and adjudicate on complaints fell to 48 weeks.

The lack of centrally determined procedures for categorising complaints and reporting on outcomes was partly to blame for lax attitudes among NHS managers and doctors at the sharp end of health care provision, the select committee says. 'Too much has been left to local discretion. It is out of keeping with the recent emphasis in all sections of public service on . . . complaints systems being seen as an index of performance and a vital right for the individual.'

The select committee, which is currently reviewing the powers of the Ombudsman, echoes Mr Reid's own view that the recent market-led overhaul of the NHS must not be allowed to undermine his jurisdiction.

The Ombudsman has no authority to investigate complaints about GPs and the family health service authorities with whom they contract to provide services. In the absence of independent supervision of such grievances, is not uncommon for them to drag on unresolved for years.

Ian McCartney, a Labour health spokesman, described yesterday's report and the steep rise in complaints as 'a serious indictment' of the way the Government has been running the health service. 'Patients are clearly noticing the deterioration resulting from government underfunding of the NHS and the removal of accountability.'

Consumer groups have long protested that health service complaints systems are poorly understood, cumbersome and biased in favour of professionals. The Department of Health last month established an NHS complaints review committee, chaired by Professor Alan Wilson, vice-chancellor of Leeds University, which will report by the end of the year. Virginia Bottomley, Secretary of State for Health, said yesterday the select committee and the Ombudsman had highlighted 'disappointing failures' of the service.

Professor Wilson's team would look at how procedures could be made uniformly 'fair and thorough, as well as speedy and accessible'.

Report of the Health Service Commissioner for 1991-92; Select Committee on the Parliamentary Commissioner for Administration; HMSO; pounds 18.40.