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Published: 27/06/2002, Volume II2, No. 5811 Page 20

As outgoing health ombudsman Sir Michael Buckley leaves his seven days a week post, he talks to Lynn Eaton about who - or what - will replace him It is an uncertain time to be an ombudsman. The government announced last July that it intends to replace the health, local government and parliamentary ombudsmen with a single official.

The future for NHS complaints procedures is still unclear and, after an unexpected announcement by health secretary Alan Milburn in the wake of the Budget, no-one quite knows what role the new Commission for Healthcare Audit and Inspection will have.

No wonder Sir Michael Buckley, who has performed the roles of both health and parliamentary ombudsman for the past five years, has decided to step down this year. At 63, he says, the time has come for him to stop working seven days a week and for the some new blood to come in.

A somewhat world-weary Sir Michael says 'There is no sign yet' of the necessary legal changes which will combine all three scrutiny posts into one body. 'But my view is that AN Other - whoever gets my job - needs a clear run. It would not be satisfactory for me to start taking decisions that some other person would have to put into effect.'

Phrases like 'would not be satisfactory' and 'in due course' slip off the former civil servant's tongue with practised ease. Friendly enough, he is nonetheless a little formal, perhaps even shy. He answers with a polite, and equally well-practised, smile that he 'really wouldn't know' and 'couldn't really comment' when the questions become too political.

Ombudsman reports are, inevitably, going to be bad news.

His latest, valedictory offering is just as critical of the NHS as the previous ones.

'By definition, people do not come to me unless something has gone wrong. What worries me is that even with the relatively small number of cases we see, the same mistakes are being made several times over.

'Time after time after time we come across examples of bad communication, bad recordkeeping and things going wrong which needn't have gone wrong.'

He cites one case of a woman who was expecting a baby, but it was going to be a difficult birth so she was transferred to another hospital.When she got there, they did not have the information from the first hospital alerting staff to potential problems.

Messages were not relayed and the woman's notes were lost.

'The upshot, I am afraid, was the baby was lost. It was terribly distressing. That is something that really needn't have gone wrong.'

He often talks of being 'upset' and 'distressed' at some of the cases he has to deal with, particularly where GPs have struck off patients who complain about the service they receive - the biggest single type of grievance they have received.

'Let's not be hypocritical about this. I do not lose any sleep, but I do feel quite strongly about it. It seems the sort of thing that can so easily be avoided.

'It is distressing when you see treatments that have gone wrong - It is not just cases on paper, it is real live people out there. But that treatment was well intended and went wrong. It is when you see things that - well, for heaven's sake - really didn't have to happen.'

Though the number of complaints reaching the ombudsman has steadily risen - a 3 per cent increase last year, for example - Sir Michael is reluctant to draw the conclusion people are becoming more likely to complain overall. 'I do not think there is any good evidence for saying that, ' he says. 'But complaints are not a bad thing, ' he counters. 'It may not be a million miles away from quite a reasonable suggestion for an improvement.'

So if complaining is such a good thing, why is the new complaints procedure taking so long to be finalised?

He lets out a long sigh of frustration. 'I think you need to ask the Department of Health that. I find it surprising because there is quite a high measure of agreement on what is wrong with the procedure - that it takes too long and nobody thinks we have got the second tier right. I do not think it would be too difficult to sort something out on that.'

Obviously a sore point.He eventually admits that though he does have a voice on DoH discussions, it hasn't been easy.

'I have found it odd that we have had to push quite hard to get consulted about the complaints procedure, about which I do think we know quite a lot.'

That is tough talking for Sir Michael. As for the suggestion in Mr Milburn's post-Budget speech that CHAI takes on 'independent scrutiny' of complaints in future, he reverts to true civil servant style: 'I do not know what that means. If it means things like CHAI will keep an eye on the way trusts handle complaints, I've got no problem. If it is that CHAI is going to get involved in handling individual complaints, I think there are some pretty big issues.

'There is a difficulty for an auditing and inspecting body then looking at an individual complaint. Say they recommend a trust should do something in a particular way, then there is a complaint from a mother who has lost her baby.Will that mother feel she is getting a fair hearing from CHAI?'

He claims to have no better idea of how it will pan out than anyone else - and seems unhappy about that.

'It is important that we should be clear. Hopefully, the DoH will clarify it. It is really important for us to know what the future is just for planning our own business.'

As for the future, Sir Michael gives off a vague air of uncertainty which surely masks a hidden knowledge of something else - possibly better - around the corner. 'I do not know what I'll do next, ' he says, nonchalantly.

'Presumably, something will turn up.'