The following letter, issued on behalf of the Ombudsman, was published in the Irish Times.  The letter refers to an earlier article by the newspaper on the problems faced by the public due to the fact that the Ombudsman is prohibited from examining complaints about clinical judgement in health cases.

1 April 2016

The Editor

Irish Times

Dublin

Ireland

Sir,

Arising from the article by Ms Jacky Jones (Irish Times 29 March 2016) the Ombudsman, Peter Tyndall, has asked me to write to you in relation to the legal constraint in place at present which prevents him from examining complaints about clinical judgement decisions. This constraint applies in relation to complaints received by the Ombudsman against the Health Service Executive (HSE) and private nursing homes.

As Ms Jones pointed out it is a matter of some frustration to the Ombudsman and complainants that this constraint is in place. The vast majority of care and treatment complaints to the Ombudsman involve a mix of clinical judgement and administrative actions. This means that the Ombudsman cannot deal with these complaints in their totality.

However, your readers may be interested to learn that steps are in train which may lead to the removal of the current restriction. In May 2015 the Ombudsman published his systemic investigation report into complaint handling systems in the acute hospital sector. At the time, the HSE accepted all thirty six recommendations contained in the report, but the changes to the Ombudsman's remit is a matter for Government, rather than the HSE. Recommendation number 15 called for a review of the clinical judgement exclusion.

In July 2015 the Ombudsman met with the Minister for Health, Leo Varadkar to discuss the report and the clinical judgment exclusion. In November 2015 http://health.gov.ie/wp-content/uploads/2015/11/psf1.png Minister Varadkar announced a major package of patient safety reforms including plans to simplify the HSE complaints procedures. In doing so the Minister indicated his support for the removal of the clinical judgement exclusion. He had earlier initiated a consultation process with interested parties on the issue.

Throughout 2015 the Joint Oireachtas Committee on Public Service Oversight and Petitions had been conducting a general review of the role and remit of Ombudsman Offices in Ireland. In January 2016 it published its findings and recommendations. This included a recommendation that the clinical judgement exclusion should be removed.

In light of the foregoing developments the Ombudsman is hopeful that the necessary legislative amendment will be made to give him unfettered remit in this area. This will benefit the health system by unearthing and highlighting clinical errors which may occur and help to bring about systemic improvements. It will also give greater assurance to patients and their families that they will be given full information and explanations when adverse events happen.

Yours etc.

David Nutley

Head of Communications

Office of the Ombudsman

18 Lower Leeson Street

Dublin 2