NHS complaints compensation plans rejected

Mark Gould

Friday, 22 August 2008

Plans to make the NHS complaints system faster and more responsive to patients by introducing financial compensation have been rejected by a medical indemnity organisation.

In May this year the Parliamentary and Health Service Ombudsman Ann Abraham published a consultation document which proposes linking complaints to compensation.

But in its response issued yesterday the Medical Protection Society says that while there is scope for financial sanctions and reimbursement  in specific circumstances, "we remain firmly opposed to bringing compensation more generally into the complaints procedure".

The MPS says that the complaints system and the compensation system " serve different and distinct purposes".  

"And that a link between financial compensation and complaints may shift the focus away from providing a full and clear explanation and action to resolve the issues highlighted by the complaint, towards a more limited and cautious response. This would be detrimental to the complainant and would undermine the valuable role that complaints have in improving patient care through learning and openness."

However it says that in some exceptional circumstances such as where a complaint has been handled very poorly it would support a payment of financial redress to the complainant.

And it gives the example of one of the Ombudsman's own cases where  the maladministration in the handling of the complaint exacerbated the stress and worry of the complainant.

The complaint was upheld and the trust paid £250 to the complainant in recognition of the worry and distress caused by poor complaints handling. "In this situation the use of financial redress as a sanction for an inadequate complaints procedure is an appropriate response," the MPS says.

" We would support a system which awards financial redress for very poor complaints handling and reimbursement to ensure that patients do not end up out-of-pocket for care that should have been provided."

It wants clear guidelines for  situations where financial redress should be considered and the process must be transparent and well reasoned with guidelines to reduce the risk of confusion, false hopes and of unmeritorious cases being pursued to the detriment of all involved.

It also supports  reimbursement of expenses in very specific circumstances such as where  patients who have paid for treatment to which they were entitled and which they should have received on the NHS; or where there has been direct financial loss due to an acknowledged failing on the part of the treating doctor, trust or healthcare organisation.

But it stresses its "opposition to the payment of financial redress in other circumstances and strongly believe that allowing financial compensation for complaints will lead to blurring of the separate and distinct functions of the complaints and clinical negligence systems".

It says this would cause confusion and dissatisfaction where unrealistic expectations are not met. "We would suggest that, in the majority of cases, compensation should be directed to redress through the clinical negligence scheme or the NHS Redress Scheme, once it has been established."