Published: 05/02/2004, Volume II4, No. 5891 Page 7

Trusts which receive too many complaints could be fined in a future inspection regime, in a notion floated by the chair of the Commission for Healthcare Audit and Inspection.

During the annual lecture of the Centre for Public Scrutiny, Professor Sir Ian Kennedy spoke about learning from complaints - 'otherwise we repeat that which gives rise to them'.

And though Sir Ian has said the current star-ratings system will be scrapped from 2006, he suggested that some kind of ratings system could be used to penalise organisations which got too many complaints.

'We might even use a tactic of zero-rating hospitals in terms of having to pay for the complaints procedure... [If] the number of complaints reached a certain threshold, they may have to pay for CHAI to deal with them.'

During the lecture, Sir Ian outlined his approach to measuring NHS performance. He said he expected the government's standards against which CHAI will measure performance to be 'generic' and set out broad domains to be scrutinised.

Sir Ian said they would fall into two areas: core standards, and those of a developmental and aspirational nature.

CHAI would then provide the criteria against which performance would be measured.

As an example he said that while the government could set out a standard to 'respect patients', CHAI might define the need for patients to provide consent as a key criterion against which performance was measured.

Last July, Sir Ian urged the government to publish the generic standards as soon as possible.

Asked last week whether he was getting impatient - with less than two months until CHAI goes live - he told HSJ: 'We cannot do what we are statutorily obliged to do until we have the tools we need to do it. That is as much as I will say.'

lNHS ombudsman Ann Abraham has raised serious concerns about the government's draft proposals to reform the complaints procedures.

Ms Abraham, whose organisation acts as the final recourse for patients dissatisfied with the NHS, described them as 'excessively prescriptive'. In written evidence to the Commons public administration committee's inquiry into complaints procedures, she also criticised the clinical negligence scheme outlined in chief medical officer Professor Sir Liam Donaldson's Making Amends consultation paper.

She said: 'The government must consider redress in a much wider sense than in its current proposals if it truly wishes to make amends for poor service or service failure.'