havenoknowledgeofwhatinvestigationsweremadenorseethestatementsmade
byotherparties./SeetheevidenceofAVMAtotheenquiryandtheircommentson
the recommendations made by the Review Committee.)
Furthermore, there was no opportunity for the complainant to hear the expla-
nationoftheclinician,letalonecross-examinehimorher.Theconsultantswereat
libertytoobtaintheinformationtheyrequiredinwhatsoeverwaytheyconsidered
appropriateandthecomplainantwouldhavenowayoftestingorchallengingthat
information. At the conclusion of the review' the patient would simply be told what had been decided. If the decision was unsatisfactory there was no appeal. Whileonthefaceofitthereviewmightseemindependentbecausecliniciansfrom outside the hospital concerned were making the decision, to the complainant it couldnotappeartobeanythingotherthanthedoctors,ortheNHSitself,sticking
together'.Iftheaimofthecomplaintsprocedureistosatisfycomplainants,which
itisself-evidentitshould be,thenitcanclearly beseen thatsuch a situation was
unacceptable.
What is more, even if the complaint were upheld the complainant would not
necessarily be told what action had been taken to ensure that similar incidents
wouldnotberepeatedforotherpatients.Inparticular,ifthecomplaintwasagainst
an individual clinician or other employee of the Trust, no information would be
given to the complainant as to what action, disciplinary or otherwise, had been
taken against that individual.
Itistheexperienceofallthoseinvolvedindealingwithcomplaintsonbehalfof
patientsthatfewaremotivatedbyfeelingsofrevenge.Itiswidelyrecognisedthat
one of the major considerations on the part of those complaining about care,
particularly where that care led to considerable distress for the patient or their
family, is to ensure that others do not have to suffer in the same way. In many
complaints, therefore, failure to inform the complainant of what action had been
taken remained a cause of great dissatisfaction and resulted in the complainant
feeling that the complaint had been a waste of time.
Itisrecognisedthatthisisnotastraightforwardissueasmattersofemployment
law and, now, human rights are involved. Nevertheless the health care provider
must provide the complainant with reassurance thatappropriate actionhas been
taken if the whole complaints procedure is not to be undermined.
AsfarascomplaintsagainstGeneralPractitionerswereconcernedtheproblem
wasadifferentone.Theactualprocedurewasfarmoreopen,withthepatientable
to confront the doctor and ask him or her questions before a tribunal. The basic
flaw with thatprocedure,however, was thatit was not a system aimed at dealing
with dissatisfied patients but with the relationship between the doctor and the
Family Health Services Authority as employee and employer. Patients were
therefore misled into believing that their grievances were going to be addressed
whereas in fact the enquiry was simply to establish whether there had been a
breach of the doctor's terms of service.
Nevertheless there were major advantages to this procedure over that for
hospitalcomplaints.Inthefirstplacethetribunalincludedanumberoflaypeople
includingalaychair;secondlytheproceedingswereopen,withthedoctorsubject
to cross-examination ± although not by lawyers as they were not allowed to
represent either party ± and often findings that a doctor had been in breach of
52 Nursing Law and Ethics