Second Opinion: HSE turns complaining into a difficult operation

Do you have a complaint about the health services and want to make it in person? First, you must find the complaints office, which may not be easy.

Recently, a relative of mine waited three years and eight months for an outpatient urology appointment and wanted to complain but did not have the energy, time or assertiveness to do so.

I offered to do it on his behalf and he signed the form nominating me as his advocate. So far, so good, making a complaint seemed easy.

The form had to be returned within a few days, otherwise, according to the letter from University Hospital Galway (UHG), “the matter would be considered closed”. Not wanting to risk the form getting lost in the post, I hand-delivered it to the complaints office in UHG.

The complaints office was in the old nurses’ home. No, the receptionist in the main building did not know where or which floor. The nurses’ home was not signposted nor was the complaints office. I wandered around the ground, first and second floors. There were no clues, no signs.

I asked four people, who clearly worked in the building, for directions, before finally finding a HSE staff member who could help.

The office was on the second floor and had a typed sheet of A4 paper on the door saying Quality and Safety Department.

Waste of time
By then I had wasted 30 minutes and felt ready to complain about trying to make a complaint.

Fortunately, the two helpful women in the office agreed to hand the form to the right person, who was actually located in the main building, not the nurses’ home.

This, admittedly one-off, experience raises questions about the HSE’s culture of managing complaints. No one I met on my tour of the nurses’ home knew where the complaints office was located or seemed interested in finding out.

The old nurses’ home is not a huge building and most of the ground floor is taken up by a large canteen (great menu) frequented by staff on a daily basis. The human resources office on the first floor is signposted twice.

Does the lack of signage and ignorance about the location of the complaints office indicate a culture of not taking complaints seriously?

Or worse, are complaints seen as an issue for Quality and Safety only and nothing to do with rank and file workers? Citizens are at a higher risk than they need be unless all HSE workers see complaints as learning opportunities.

Very few people complain about health services. A 2013 report from the Irish Society for Quality and Safety in Healthcare showed that 65 per cent of hospital inpatients were not aware of the complaints procedure in the hospital they attended.

Almost 18 per cent wanted to complain and didn’t know how or did not feel assertive enough.

In 2012, only 6,813 complaints were recorded by the HSE. This is less than 0.1 per cent of all services provided, excluding GP services.

Complaint categories
Complaints are now categorised by the eight principles of the National Healthcare Charter: access; dignity and respect; safe and effective care; communication and information; participation; privacy; improving health; and accountability.

Most complaints (3,818) recorded in the eight Dublin hospitals that piloted the new categorisation scheme in 2012 related to communication and information (32 per cent); safe and effective care (30 per cent); and access (27 per cent).

Less than 1 per cent complained about the principle of improving health.

Does this mean all patients got “information and advice on how to stay as healthy as possible” as described in the charter or did not know they were entitled to this information so did not complain?

The Hiqa investigation into the death of Savita Halappanavar found that, "There was no national integrated approach to collating, disseminating and implementing the learning and recommendations gathered from . . . complaints and patient feedback". Have things changed?

Culture
My experience suggests the culture surrounding the management of complaints is not systemic. People working in organisations always know the important stuff such as where to get the best coffee.

If complaints were taken seriously by the HSE, everyone would know where the complaints office is, in the same way all workers know the location of the canteen. Know your rights.

Read the National Healthcare Charter, You and Your Health Service , and make your complaint or send a compliment to yoursay@hse.ie.

In the meantime, I am waiting to hear why my relative had to wait nearly four years for an outpatient appointment.

Dr Jacky Jones is a former HSE regional manager of health promotion
drjackyjones@gmail.com