Complaint proposals for NHS welcomed: One procedure will replace nine, Nicholas Timmins reports

PROPOSALS for a single, simpler and quicker NHS complaints system to replace the present nine different procedures were published yesterday to an almost universally warm welcome.

While the Patients' Association and the Association of Community Health Councils wanted the proposals to go futher than those outlined by a committee chaired by Alan Wilson, the Vice-Chancellor of Leeds University, they, doctors' organisations and health authorities welcomed the package as a marked improvement on the existing system.

The report was supported by Virginia Bottomley, Secretary of State for Health, who hopes to legislate on its principles in the autumn after a three- month consultation period. The existing systems - which differ for GPs, hospitals, clinical complaints, ambulance services and other parts of the NHS - were 'too fragmented, confusing, cumbersome and slow', she said.

At the heart of the changes are proposals for GPs, hospitals and health authorities to establish internal complaints procedures which should include conciliation and within three weeks give patients an answer and details of any action to be taken.

If the complaint is more serious or the patient dissatisfied, three-strong panels with a lay chairperson and lay majority should investigate and normally report in writing within five weeks. If the complaint involves clinical judgement, two members from the relevant profession should be added as assessors, including social services staff where community care is involved. The majority on the committee should remain lay, however.

The complaints system should be separated from disciplinary procedures - the two operate as one for GPs, pharmacists and opticians - but any relevant information that comes to light should be fed into disciplinary procedures which will need to be re- vamped.

In addition the Ombudsman's role should be widened to include complaints about GPs and about doctors' clinical judgement. Mrs Bottomley, at a press conference to launch the report, said there were 'strong arguments' for that.

As many complaints as possible should be resolved 'simply and speedily, by listening to the complainant's concerns, apologising if necessary and providing explanations and assurances of action as appropriate', the report's summary says. Professor Wilson added that 'a good complaints system should reduce litigation' rather than increase it.

He hoped also that the system would reduce the number of formal investigations. These have risen by more than half in two years for hospitals and in recent years have risen for GPs.

One key issue to be resolved is who will appoint the independent panels now that regional health authorities are disappearing.