NHS patients to get review of complaints: Bottomley says health service needs system which encourages 'openness and dialogue'

A FULL review of patients' complaints procedures was announced yesterday by Virginia Bottomley, the Secretary of State for Health, a week after she issued guidelines for NHS 'whistleblowers'.

Her guidelines for unhappy NHS staff were criticised for being too restrictive. They advised employees only to go to their MPs or the media as a last resort or expect disciplinary action.

Speaking in Bournemouth, Dorset, at the annual conference of the National Association of Health Authorities and Trusts, she said that complaining patients felt the system was often stacked against them, and that the NHS needed a system which equally encouraged 'openness and dialogue', as did her new guidelines for NHS staff.

New complaints systems should be fair to patients and staff and avoid litigation in favour of 'informal mechanisms', she said.

The review will also look at clinical complaints - usually the most difficult since they often question the clinical judgement of an individual doctor rather than, for example, complaining after a drug has been wrongly administered. For the patients these are the most difficult cases to pursue with doctors, health authorities or through the courts.

'There is no point encouraging people to express their views unless their complaints will be dealt with promptly and fully. People's expectations of the NHS have changed . . . NHS complaints procedures have not kept up with these changes,' she said.

Mrs Bottomley's move came the day after two health authorities were criticised by the High Court for failing to consult over the closure of the pioneering bone marrow transplant unit at Westminster Children's Hospital in London.

The shutdown prevented an operation on two-year-old Rhys Daniels, of Epping, Essex, who is suffering from a rare genetic disorder.

Mrs Bottomley admitted that patients' complaints were not always well received and acknowledged the criticisms made by William Reid, the Health Commissioner, of the way some managers handled complaints. However, she added: 'On the whole the NHS has stopped seeing complaints as threatening and a reason to act defensively. But an open approach among staff is not always evident.'

She told health service managers that a complaints precedure should 'satisfy the patient; help managers to improve the service; ensure fair treatment of staff and, if possible, avoid litigation wherever possible'.

Professor Alan Wilson, vice-chancellor of the University of Leeds, will head her review of complaints, which will be carried out by an independent team to be announced. Its remit will be to look at all aspects of complaints procedures and clinical complaints. It will look at the way the family health service handles complaints and at the independent role of the Health Service Commissioner.

Fluoride in water supplies is likely to be increased, Mrs Bottomley indicated yesterday.

The time was right for 'urgent and rather forceful discussions' with water companies opposed to the idea. She is expected to outline the benefits of fluoridation in protecting teeth in a speech to the Water Companies Association next month.