healthcareprovidersinterpretthisrequirementverynarrowly±anapproachfrom
asolicitor, a request for medical records with a possible claim in mind, a brief
reference to compensation or legal remedy in a letter ± and the work on the
complaint immediately stops.
Butmostpatientsonlyknow,orsuspect,somethinghasgonewrong.Theymay
wantcompensationbutoftenthatisnotintheforefrontoftheirmindsandinany
eventitisonlyonepartofwhattheyareseeking.Morecommonly,andtodaythisis
generally recognised, what they seek is an opportunity to air their concerns; if
appropriate, further treatment to resolve the medical problem; a full and open
explanation of what has happened and why; and, if there has been a mistake or
unacceptable service, an apology and assurances that lessons will be learned for
the future. Compensation is often only an issue if the other remedies are not
provided, or not quickly enough, or the damage suffered by the patient is very
serious.
Mostpatientshavenopreviousexperienceofmakingcomplaintsorclaims,and
havelittleornoknowledgeofthecomplaintsorlegalsystem,orofthecost,stress
and difficulty of pursuing a legal claim in particular.
Many of those who seek advice from a solicitor onlydo soout of frustration at
theNHSbody'sseeminginabilitytounderstandandtrytoresolvetheproblem.Yet
the system obliges dissatisfied patients to choose, often artificially and too soon,
which route to follow. Pushing patients into litigation which they do not really
want makes very little sense from any perspective. But patients need incredible
staminatofollowfirstthecomplaintsprocedure,andpossiblyallthreestagesofit,
and then, if they want or need compensation, to go down the legal route.
Both the Health Service Commissioner and the Health Select Committee have
stronglycriticisedthesystem.Theformernotedthatwhenpeopledidcomplain,it appeared they often became even more dissatisfied with the process and the outcomeofthecomplaintandconfusedbyaregulatorysystemwhichgavethema numberofoptionsfortakingaction'[8].TheOmbudsmanhasreferredtopatients' complaint fatigue' [9].
BestpracticeintheNHShasgivenastrongpointerastohowcomplaintsshould
behandled.Enlightenedclaimsmanagerswillidentifyquicklywhatthepatientis
after and will not only ensure that the complaint is adequately and expeditiously
dealt with but will also ensure that if she is entitled to a small amount of com-
pensation, thatthisispaid.Theprovisionthatallclaimsorcomplaintsmanagers
adopt a similar course and that if the unresolved complaint proceeds to an inde-
pendentreviewanawardoflimitedcompensationcanbepartoftheremitofthat
review,wouldhaveadramaticeffectforpatientsandthehealthserviceproviders
alike. Patients would be satisfied that all their grievances had been dealt with
within a reasonable time; both patients and clinicians involved would be spared
the distress of protracted legal proceedings and the NHS itself would save the
considerable costs of litigation.
4.6.1 A case study
The case of Mrs B clearly illustrates how the system fails patients. It also demon-
strates how that failure results in unnecessary litigation.
The Complaints Dimension: Patient Complaints in Health Care Provision 57