Hansard

Members may think that the bill is fairly straightforward, but we should not forget those who are pursuing complaints in the system. As Sylvia Jackson spoke, I could not help thinking about a lady who came to my surgery. Her mother, who was in a local authority home, had dementia and was taken into a psychiatric hospital where she was to be assessed and where it was to be decided where she would go. The lady went to the council, which said that the matter had nothing to do with it, as the mother was in a primary care trust. The lady went to New Craigs hospital, where her mother was being assessed. The hospital said that the matter had nothing to do with it, but concerned the social workers. The lady tried to get a social worker, but was told that the matter had nothing to do with them. She went to her doctor, who said that it was not their responsibility. She went to see her councillor, who said that it was nothing to do with them, but was a hospital matter. Members are saying that the bill is okay, but we should not forget the trauma that people go through in finding their way through the system.

I support the proposal to have one ombudsman and a one-stop shop. However, at stage 2, I ask the minister to take into account the complaints procedures for the Scottish Commission for the Regulation of Care and the Scottish Social Services Council. There may be no overlap and things may be crystal clear, but this morning I found out that the Executive is still deliberating on consultation responses—we still do not know the details of the complaints procedures for the Scottish Social Services Council or the Scottish Commission for the Regulation of Care. I ask the minister to be open to amendments at stage 2 and to clarify that matter.

I will make two small points before I come to my main one. The first relates to Scottish Health Advisory Service reports. They are first class, but I have often seen reports that say that recommendations were made three years ago but nothing has been done. I ask the minister to ensure in the bill that the public sector ombudsman's recommendations are monitored and acted on.

The second point is that I was shocked that Michael Buckley said almost proudly that the time taken to process complaints had been reduced from 45 to 42 weeks. Any move in that direction is welcome, but I know the trauma that many people go through in pursuing complaints. I hope that thoroughness can be maintained, but that the time taken to process complaints can be reduced.

My main point was raised by Trish Godman. It concerns the joint-working aspect of care in the community. If a person who receives care complains about their treatment, is not satisfied with the local resolution and goes to the public sector ombudsman, who is to say whether the complaint is a health complaint or a local government complaint? The difficulty arises from the fact that the ombudsman can consider only those complaints that are based on clinical judgments that relate to health service personnel and, in respect of social workers, can examine only the process followed and maladministration. The best submission that the Health and Community Care Committee received was from the Mental Welfare Commission, which said:

"This Bill contains many provisions which will achieve the objectives of the Executive that the public sector complaints system will become simpler and more effective".

We all agree with that. However, the commission also said that the bill

"will also mean that the decisions and actions of professionals who do not operate clinical judgement, but who do use other forms of professional judgement, will not be open to the same scrutiny as those of their colleagues within the health service. This does not seem to be in the public interest."

There will soon be even greater emphasis on joint working and joint decision making: for example, there will be multidisciplinary teams and care plans will be jointly decided. Moreover, both the Regulation of Care (Scotland) Act 2001 and the Community Care and Health (Scotland) Bill stress joint working. We can see how difficult it will be to assess who has made a decision when that decision has been made jointly.

It is surely unfair if a health service employee must be more accountable for a decision than a local government employee is. For example, a person could complain about being refused a home care service, about not being referred to a day centre, about respite care to help the carer or because, as a carer, they disagree that their mother should be taken into care. Are the judgments that would be involved in those situations clinical or administrative? Do those judgments take into account all factors, including social and clinical factors and the health of the rest of the family? That point was raised in the Health and Community Care Committee.