No buts? This has got to be utterly better.

A while ago in a fit of enthusiasm brought on by my experience with Eurostar I promised to tell you about my experience with the butter.  This is a simple tale of how to complete the feedback loop and turn a complainant into a fan.

A change for the worse

For several years I have been buying a particular sort of butter which, despite containing no oils and remaining pure butter, spreads pretty much straight from the fridge without being horribly greasy.  Such a product is a huge asset in a house like mine where at any time of the day or night someone can be found eating toast somewhere.  Sometimes these people even live here.  All hell broke lose last Spring when Fussiest Daughter pointed out that the butter had changed and now, if left out of the fridge for more than a minute or two would turn “vile and slimy” (her words, not mine, but none the less accurate for that).  To reinforce the horror of this, the packet now bore the legend “now even softer”.

And so I emailed the company and asked them what had happened.  They wrote me a charming letter on very highly quality creamy coloured paper explaining that they had had complaints that the butter was sometimes a little harder than people liked when it came out of the fridge.  They sent me three shiny pound coins and hoped I would continue to buy their product (which, rather than incur the wrath of the Daughter, I didn’t).

Buttering me up – or just common sense?

Several months later I received another letter and this is what it said,”Since the launch of the new product, and due to feedback we have received from you and other customers, we have sought to improve Kerrygold Softer Butter even further. Our aim has been to maintain the softer consistency we have achieved when used from the fridge, but to make sure it stays firmer longer if it needs to be kept out of the fridge during mealtimes.  We are now delighted to announce an further improvement – our new butter is still significantly more spreadable from the fridge than our original formula, but is firmer for longer when left at room temperature….Once again thank you ever so much for your feedback.”

Now I am happy.  They even sent me a voucher so I could try their new product for free.  And Fussiest Daughter is happy too as are all the other people who eat toast in our house at mealtimes and toast-times.

Wouldn’t it be nice if other organisations could treat our comments and complaints like this?  How common is it to get a letter from the NHS or the bank saying “Remember when you complained a while ago?  Well although we explained why we could not do anything then, we have thought about what you said and decided to try to do things a bit differently and take account of what you said.  Hope you agree and here is a few quid as a gesture of goodwill.”

Given decent complaint management software and a properly maintained database, this should be easy. In these days of data protection and difficulty in collecting customer details, complainants freely offer theirs and turning them from critics to advocates remains the great goal of complaint departments.

STOP PRESS:  someone known to MAC has discovered a secret department of BT that can actually sort problems out. He had been wrongly disconnected and faced an enormous struggle to contact BT customer services since the first prerequisite for dialogue was an existing telephone number. On giving his old one, he was told that number was no longer in service and was disconnected. Heroically he persisted and eventually a unit so secret that it has no address or telephone number on its writing paper – he thinks it is in Doncaster – sorted his problem out – block of flats, someone leaving, asks for disconnection, wrong flat disconnected.

The November Newsletter

Dread Moment, Dead Time – the Roots of Laughter and the Prompt to Action

I was in the queue at the Post Office – two positions open for business; 12 people in the queue; having to pay £5 for special delivery because of strike. The message on the QTV? ‘The only real laughter comes from despair’ attributed to Groucho Marx. Nothing could have better fitted the mood of existential gloom at the prospect of 20 minutes queuing while South London people sort out their complicated lives clutching half-filled-in forms and expired passports. None were laughing. It was the most apposite message I have ever seen on that medium but the best was yet to come two seconds later with the name and location of a photocopying shop new to me and just up the road. The ad worked – 20 minutes later I was in there and their sales figures leapt up by 0.72p.

Partners’ Prose

Schools

Of course had I been connected to the internet. the time in the queue would pass in a flash because I could read the Partners’ blog entries in October and November. Caroline Millar sends politicians to stand in the corner for wilfully getting the important Cambridge Review wrong.

It seems to be open season on schools and the question of how they should be run and who should run them. Caroline documents the candidates in some detail in the following terms:

“whether it be local authorities, faith groups, used car salesmen or aspirational lasagna-eating anxiety-monkeys who are running the schools of the future, it should be a requirement for all of them to demonstrate that they know what their pupils, parents and local communities think of them and to show that they are responsive to their needs.”

Read the full post to see where they all come from.

Governance

Val Moore updates us with tales of a Norwegian state pension fund seeking to persuade large American concerns of the advisability of separating the post of chief executive from that of chairman – a central tenet as it happens of Policy Governance®. Val had recently attended one of a series of workshops being run by Caroline Oliver and the UK Policy Governance Association and this separation of function and titles still seems to be causing problems for many organisations.

Val wrote

“Many of these organisations are struggling to see the unique role of the Chairman and Board and want to avoid that well known situation where the Board usurp the role of the Executives and the Executives second guess the Board.  Policy Governance separates the two roles and maintains that the Chairman and the Board are ‘owners one step down’ and not ‘management one step up’.  This thinking frees the Board to concentrate on the ‘ends’ or goals of the organisation and to allow the CEO and executive team to work out the ‘means’.”

Politicians’ promises and social care

Ends and means were very much part of Andrew Craig’s piece musing on how strange it was

“that with little over a month to go for people to have their say about the government’s social care proposals for England, the Prime Minister pulled a monster rabbit out of his capacious hat which made roadkill of the consultation process.  Mr Brown pre-empted discussion by giving a personal care pledge to adults under 65 -  later clarified as also extending to younger disabled people aged 18-64 needing personal care at home.  That’s a lot of people and a awful lot of bawbees, Gordon, even if the Government is still around after 2010.”

If the consultation is to have any useful effect, it should provide some insights into what Andrew identified as the three main issues around social care:-

• First and foremost, we need one, integrated system of health and social care not two
• Second, the social care debate must be widened to include younger adults with disabilities and chronic conditions and people who care for them
• Third, while raising the universal standard of social care we must reclaim the Beveridge principle of individual initiative to make extra provision.

Complaints – Opening Up on Complainant Satisfaction

Back to where we started with a moment of existential despair in a Post Office queue – the mood seems right when comtemplating the Kafka-esque world of a complaint about service at our bank. We take a look  at the experience of having a problem with banks, specs and teeth – and no the NHS does not feature in any of them. The world of the banking back office and that modern contradiction in terms ‘the customer service team’ – neither a team or much to do with service -  and how best intentions and efforts can still go wrong even when all are trying harder than Avis.

But we finish on a good note – if you have a complaint about your private dentist’s service, find your way to the Dental Complaints Service and your complaint stands a good chance of getting sorted according to some new data. Well done Derek.

Complaints – Despair, Specs and Teeth

Coming in Threes

You know how it is – life is ok for a while and everything more or less works. Some minor niggles, something goes wrong perhaps but it is soon fixed or can be parked for the future and then bang! like the proverbial No 11 bus they all come at once.

Banging our Heads against Banks

The MAC Partnership has been involved in a prolonged and head-banging dialogue with Barclays our bankers for over a year trying to achieve a simple administrative task – adding a person to our internet account with the authority to make payments. The saga of lost pieces of paper and endless delay while the ‘customer service team’ conferred and promised to phone back will be familiar to all who have gone a few rounds with their banks but the unexpected one that amazed us all was the sending of our data, equipment and PIN to a local Park User Group. This rang a chord with me since in the summer I had asked for a replacement bank statement and some time later found I had been sent the statements for a football club in Wales and a Somali refugee centre in Birmingham. Where my statement went, no one knows. A nice man called Alec took my details, gave me a reference number and disappeared. We still have no solution after a year to letting one more Partner use the internet banking facility.

The key block to solutions here is that when the team – see ‘customer service’ above – is in charge, no one is in charge. When no one is in charge, no one ever phones you back or if they do or you phone again, they know nothing. Also since they have no history or experience of the account, they tell us that it is impossible to do things which we have been doing for 5 years. This is the world of the customer service team – unable to connect with or comprehend a world that is not on their screen, unable to call with confidence on other parts or people in the bank to help them sort out their – well not their actually – customer’s problem. The internal emphasis of Barclays as experienced is to end the call not resolve the case. The customer is always someone else’s.

We have been passed from relationship manager to complaint department to special services team to web development to branch business manager. For over a month we have been trying to get our Business Manager to ring us.   Every time we are told she or he will call back in 3 hours and a week later there is still silence.  We have spent an estimated 5 or more hours on 0845 numbers. In the meantime Barclays are as far as we can tell in serious breach of data protection regulations. In the meantime of course we still cannot get the third partner permission to use the site. View it – OK. Do anything useful with it – no. Ombudsman as well I think. Of course if we had wanted a loan or an overdraft they would have been all over us.

Complaints and Sod’s Law – how bad things keep happening to good people

Of course it is not just banks that get it wrong – even when complaint handlers are trying hard, taking responsibility and sorting stuff out, their lack of success in getting something sorted can still provide a decent anecdote or two for the Sod’s Law training session. Specs handed in for repair to Boots were not returned and no one could tell me where they were or when they migth be back. Central customer service was involved since I am a lazy man and thought that they would be able to pull the strings and sort stuff out while I was away. Also I have reason to know that they are a well-trained and professional bunch.

Emails were exchanged and promises made and then the final call that they were ready and in the shop. Except they could not be found when I turned up. The manager had them in her drawer – eager no doubt to make the handover herself but alas she was not around. Another phone call and a second visit since the postie’s strike made posting them problematic and I have my specs plus a cost waived and a Boots Gift card. There was a solution and I think I will go back to Boots for the next pair but even here in spite of efforts to resolve, Sod’s Law meant that once one thing had gone wrong, lots went wrong. Even the generous gesture of refund plus gift card funds came over as rather hesitant since the person who finally saw me had to pick the story up by reading post-its and bits of paper atttached to the spectacle case.  I got the glasses but felt glum and as for Boots Optician in Croydon, all that effort and expenditure with what result – a customer rescued and twice as loyal as they were before? Don’t know.

Opening Wider on Dentists’ Complaint Data

This was all prompted by seeing a survey done about complaints about private dental care. I know the man who was instrumental in getting their Dental Complaints Service – the escalated complaint handling system for private complaints set up – Derek Prentice ex of Consumers’ Association and a long time believer in the power of an effective way of resolving complaints.

They got some uncomfortable answers but were brave enough to publish them. All the data is actionable and useful – the 26% with a problem who did not complain plus the reasons why not – fear of the consequences, ‘not worth it’, did not have the confidence to see it through. The % satisfied amongst those who did complain to the practice?  Low at 53%.

The central service was seen as doing better with 85% rating them as good or excellent when it came to responding with the time promised; 98% rating the overall attitude and courtesy as excellent or good (84% excellent). Encouragingly enough, the dental professionals liked them too. Too often those on the ground, the front line see themselves as shafted by the people at ‘head office’ flinging money around and agreeing solutions which appear ludicrously biased towards complainants, all too often labelled as ‘vexatious’. On the attributes of attitude and courtesy 98% rated them as excellent or good (79% excellent.) So once people get to the escalated service they are OK.

However the main point I wanted to make was that it is good to see the data – I am sure Boots collects data about satisfaction and probably Barclays too. Let us see that data and then we can tell what is going on and more importantly so can the people within the company who either do not see the data at all or bin it when they do. The thought that it might emerge into the public domain would concentrate minds.

Bye Bye WM

Which reminds of the great achievement – one of many – of Walter Merricks at the Financial Ombudsman Service where his service now names the worst offenders. I missed his leaving party on 8th October and so must say our farewells in this blog. Great work and we hope to be in touch again soon.

Early Apples – an early harvest after a glorious summer of posts

Boundless Blogs

We may not have published a newsletter since June but the blogs abound. Over the summer, the creativity and productivity of Partners ( and one in particular – the indefatigable Andrew Craig)  has produced a bumper crop of posts addressing the topical, the public and the personal at home and abroad – all active issues in the world of public engagement, healthcare costs and reform and good old complaint handling.

Who are you going to call?

Back in June we were reminded of the power of the personal anecdote – link – and picked up on what remains the most used way of contacting health services – 999 is now embedded in the national consciousness as the number to call. Can we be weaned off 999 in favour of numbers such as 111?

Find out about ‘Thought Bubbles’

Telephone access and response was not on the list of comparators in the recent row about comparing NHS and US health care – cost was the main bone of contention. Rachel Piper (Caroline Millar’s daughter) pointed us in the direction of a great website where the US debate about healthcare is summarised wittily and pithily. Take a look – short and fun which is more than you can say about most of the interventions in the health debate especially when national pride is involved.

Forget Global Warming – Prepare to get cold

Undaunted and perhaps indeed inspired by this technological tour de force, Andrew’s blog about future NHS financing floated off in a cloud of meteorological and geophysical images – what happens to the NHS climate when the warm Gulf Stream of funding is switched off? Answer: the NHS becomes Labrador. Not a dog but that chilly island unvisited by the Gulf Stream. This makes making the health service more efficient even more important – there is money that can be saved not by firing and closing but getting all in the NHS to perform as well as those in the top quartile. Beyond that, it is time to address the fundamentals:

• what is a health system for?
• who should own it? and then and only then
• how should it be paid for?

Best Practice Customer Recovery

If you are feeling that you may drown in this sea of debate – be it warm or or be it freezing – Caroline Millar’s piece about the modern art of customer recovery as practised by Eurostar will be straightforward and encouraging. Read all about how Eurostar complaint handling turned her into one of the company’s greatest fans.

They do things differently in Wales

The NHS is notorious for not paying much attention to what other people are doing and for its slowness in absorbing best practice from elsewhere. For all those engaged in user representation in health and social care, there are lessons to be learned in Wales where Community Health Councils have survived to become a key ingredient in the future development of NHS Wales. Andrew identifies the key ingredients for success for “CHCs Mark 2″ in England. .

Leadership is one theme that recurs frequently in any discussion of successful change and improvement. So we finish by raising a question asked by Colin Adamson prompted by the regime changes at both the Office of the Information Commissioner and the Financial Services Ombudsmen where both Richard Thomas and Walter Merricks have already or are moving on.

New Leaders Needed

Under the heading ‘Ubi Sunt?’ we wrote in July:
Just a few weeks ago, we blogged about Richard Thomas throwing off his crusader cape as the Information Commissioner and now Walter is handing in his SuperOmbuds costume. Last week I attended a leaving party for Allan Asher ex-head of Energywatch and chair of the BSI’s Consumer and Public Interest network just before he headed back to Australia. Ou sont les consumer heroes d’antan? More to the point. Ou sont les consumer heroes d’avenir?

If you know of any, we would be interested to hear who they are. Self-nomination is fine.

England needs a Welsh lesson

The Conservatives created them in England and Wales without appreciating their full potential.  Labour neglected, belittled, callously fragmented their functions and then destroyed them in England as an afterthought in the NHS Plan, despite widespread agreement that they could and should have been reformed and refocused. But in Wales , Community Health Councils (CHCs) survived.  

It’s time England learned a lesson about this. As Carol Jones, Director of the Board of CHCs in Wales wrote recently in the Cardiff Western Mail, CHCs have never been more vital as that country embarks on a new approach to its heath services .  

A Welsh lesson would be timely with a new Government on the horizon.  MAC believes now is the time to recover our inheritance, dust off the organisational memory and move on.  In effect reinvent CHCs for England. This isn’t a homage for just doing things as before.  First and foremost, we must keep the expanded health and social care remit of LINks, which is the one good thing to come out of Labour’s chaotic “reforms” of patient and public involvement.  

England needs unified geographical authorites to integrate local commissioning of health and social care.  We also need local statutory consumer bodies mirroring the health and social care commissioning spectrum.  Their job would be to co-produce, enable, articulate and advocate based on the views of the public, users, clients and carers.  To start fleshing out this role, we’ve identified the following chacteristics of “CHCs Mark 2″: 

• comprehensive strategic and collaborative remit with NHS and local authorities balanced with attention to quality and detail of service delivery which matters to patients, clients and carers
• professional staff to continuously engage with their communities, co-produce intelligence for action and support their members
• sufficient real budgets including recognition and reward for lay people’e time carrying out public duties
• access to all premises and services where publicly-funded patients and clients go
• one stop complaints and redress advice across health and social care
• visibility on the high street as well as the web
• national operational standards and an independent regulator and auditor to ensure probity and compliance
• independence in governance and funding from the services scrutinised
• democratic control and accountability to local people for their policies and actions
• access and rights of referral to overview and scrutiny bodies and ministers when issues cannot be resolved locally.

Rights and influence are the trade off for responsible and accountable behaviour.  We want new-style CHCs in England to be the informed and critical friends of the statutory services.  Too often in some places in the past they were allowed to become the neighbours from hell in confrontational relationships with local services.  A governance approach reflecting the suggestions above would go a long way to ensure that did not happen again.

MAC would like to see people elected to new-style English CHCs as independent members without party affiliation for the individual contribution they could make because of their knowledge, skills, local networking and other attributes. Public money should fund election hustings and “town meeting” type events where candidates would be voted on to CHCs and where on a regular basis reports would be made back to the public about the body’s activities.  It is good that the NHS in England now has a statutory duty  to listen and engage, but without a stronger voice the listening ear is just an appendage.  Let’s try some real localism for a change, because centralism doesn’t work when it comes to getting things down “down our way”.

As Carol Jones rightly observed, “If we want to avoid another Mid Staffordshire catastrophe, learning from the Welsh experience and building on it for the English NHS and social care system seems an obvious way to go.”  Let’s not quibble over names; it is roles that matter. Whether it is called “Healthwatch”   or something else, a new-look English CHC rose by any other name would smell as sweet, so long as it was up to the job.

That’s the way to do it: Eurostar shows us the way

Taking the Train: Big Strain

Nothing spoils a holiday quite as much as a stressful and unpleasant journey.  This year we decided to take the family to South West France for a couple of weeks.  Big mistake.  Getting there and back was so bad it took us a couple of weeks to remember that we had actually had quite a nice time in the middle.  I knew I should complain (my MAC partners were breathing down my neck) but I could hardly bring myself to relive the whole ghastly experience.  Still, I am glad I did.  Whereas I have spent the last month telling anyone who would listen how bad our experience was, I have now become one of Eurostar’s biggest fans.  What do we at MAC always say?  Good complaint handling can turn the grumpiest complainant into the your biggest fan and here I am, unexpectedly singing the praises of Eurostar.

No Relief for Family of Refugees from Ryanair

After a series of nightmarish experiences with Ryanair we decided to go by train this year.  What could be better?  Comfortable, calm check-in just down the road at the Eurostar terminal at St Pancras International, two hours to hop across Paris on the Metro and maybe have a bite to eat and swishing down to the south of France on a highspeed train – tickets and seats all booked through Rail Europe100 days in advance as recommended by our friend the man in seat 61.  And all with only the tiniest contribution to my global footprint.  Or at least that is how it should have been.

Un Complète Cockup

Turning up at St Pancras an hour before departure, we discovered that the 6.25am we were booked onto did not exist and that the first train was leaving 25 minutes later.  I went to collect the tickets from the machine but without success.  In the ticket office the charming staff entered my booking reference and found our booking but soon discovered that the computer would not “release” the tickets.  We would have to wait five minutes.  While everyone else effortlessly collected their tickets I stood waiting, and waiting and waiting.  Check-in opened.  Check-in closed.  An hour after our arrival at the station my anxious mob of six, ranging in age from one to forty four were getting fretful.  The minutes ticked by and with check-in officially closed and the train leaving in fifteen minutes I tried to get someone to talk to me.  They kept telling me it would be ok and that they would give us duplicate tickets if necessary.  To cut a long and stressful story short, we were finally issued with a handwritten duplicate ticket less than ten minutes before departure and had to run through check-in and security only just reaching the train in time.  At Paris, the change of train time having reduced our time to cross Paris by half an hour, I had to spend another twenty minutes waiting for them to laboriously print out the pack of cards that represented return tickets to Agen for seven people and for the nice French lady in the severe suit to find her post-it pad and write an immaculately transcribed note to the train guard in case we missed our connection.  This left us with about forty minutes to cross Paris.  Never had an underground system so many stairs (and so few escalators).   We made it – but only just.

Our return journey ought to have been less stressful but it wasn’t.  Our beautiful SNCF train – the symbol of how much better they do it in France – was held up for two hours owing to what the English call a “person on the line” but which the French appear to refer to more discreetly as “un incident”.  As it gradually became apparent that we were not going to catch the last train from Paris to London I rang Eurostar only to be told that as our tickets were non-refundable and non-exchangeable they would not be honoured on a later train and we would have to buy new tickets at £200 a go.  With our now expanded party of 9, that would have meant a cool £1800 on the credit card.  I decided to wait.  When I rang again an hour later I was told that our tickets would after all be honoured on the next available train.

Is this a record?

But here is the real point of my tale.  A couple of weeks after my return I plucked up the energy to email my complaint to Eurostar asking for an explanation, an apology and some compensation.  Within six hours I had received a full reply, a reply which for those familiar with the MAC mantra on complaint handling could almost be seen as a model of how to do it.  Here are some edited highlights:

Apologies, empathy and explanation

I am sorry to learn of the difficulties that you all experienced in collecting you tickets and the advice you appear to have been given by telephone. I can fully understand the stress and inconvenience, as well as the disappointment that this caused you all. Having to rush through stations and on the underground is far from ideal and I realise that this was far from your expectations.

Having explained in detail what he found when he investigated the complaint and how the booking had somehow become corrupted, the writer goes on to say:

This is an extremely rare error to encounter, and has not been experienced by anyone at the ticket office or the helpdesk that I have spoken to. Therefore, this is being treated very seriously and will be investigated fully in order to determine the cause of the problem. I cannot say when this will be concluded but I can assure you that it will ensure this issue does not arise again in the future.

Further apology and offer of compensation

In light of the ticketing problems, I would like to offer you a gesture (of) my concern for your experience and of goodwill, which I hope will assure you of our intentions. Therefore, please accept my personal apologies and if you can supply your address, I would like to send you each a Eurostar journey voucher, which will entitle you each to a free single leg journey or a 50% discount on a return trip. They are fully transferable and valid for one year.

Happy customer – returning customer

So here I am with a prompt, detailed and polite response to my email, a sense that others will probably not have to suffer as we did, a recognition of our emotions and their validity and a very decent level of compensation.  I copied my email to Rail Europe through whom we booked the tickets and they too have now admitted that they had made an errror somewhere along the way which had helped to confuse the Eurostar computer and they have offered me an additional £50 voucher.  For a moment I had toyed with returning to Ryanair, but given they don’t even have a complaints department, I will be sticking with Eurostar (at least for as long as it takes us to use up all those vouchers).

All aboard?

Now, if Eurostar can do it why can’t the public sector?  Why do the NHS, schools, local authorities and all those other public bodies find it so hard to empathise with their customers and handle their complaints properly so that complainants get what they want: to know they have been listened too, to know that someone cares about their bad experience, to know that something will be done and to know that maybe, as a result, the same bad things won’t happen to them again or to others?

Coming soon – what happens when you complain about your butter? Meanwhile, take a look at the MAC credo on complaint handling and how we can help on our website

Ombuds Off – Merricks CBE Moves On

Walter Merricks told me at the end of June saying that he was moving on after 13 years an Ombudsman – 10 at the Financial Services Ombudsman Service and 3 before that as the Insurance Ombudsman. He is going to do adjudication in the Health Professions which is no doubt important but is not enough I would have thought to keep Walter engaged and interested.

Ombuds Idol?

We look forward to the book and indeed the spin-off TV series – why not some reality TV with Walter as the judge in a consumer small claims court televised live. Walter was always a bit of a thesp – a star of TV and before that he trod the boards in student drama with perhaps his finest hour as a member of the cast of the original 1966 Edinburgh Festival Fringe Oxford Theatre group production of Rosencrantz and Guildenstern.

Surprised by another record breaking year

In his final Annual Review Walter points out how wrong he and his team had been in their expectation that complaints would fall in 2008/9 (after the big boom associated with endowment mortgages died away). 2007/8 had been a record year but 2008/9 saw even higher figures. That may not be a surprise with all the crashes and crunches of recent times in financial services but what is disappointing is that almost 6 out of 10 were justified. This is an increase in the proportion upheld in the past which ran fairly steadily at 30-40%. It would seem that business is not ready to use its complaints data to learn lessons and avoid repeating the same mistakes – and the chances of these mistakes becoming public are increasing.

The impact of claims management companies

The chances of companies getting away with it are lessening as the activities of claims management companies grow in parallel with changes in consumer complaint behaviour. Walter has been grappling with the question of why consumers should use these companies and pay them a hefty chunk of any winnings when the Ombudsman service is free? Lazy? Frightened? Too busy? Whatever the reason consumers have for using these companies, the prospect of profits gives these companies the energy to dig up and expose lots of cases involving ‘legacy-issues’ that can severely dent profitability if companies have made no provision for such cases. Remember that if in retrospect it becomes clear that a business has broken FSA rules, then all the customers who have been disadvantaged by that breach have to be given redress whether or not they have bothered to complain.

Over half the complaints received about payment-protection insurance (PPI) were sent in to the Ombudsman from claims management companies and a very high proportion of the cases were upheld by the FOS. So the claims companies are doing good for their customers. The consumer who would otherwise have got nothing still gets something even after paying the claims companies’ costs.

Collective Action – one idea for reform

Reform is needed with Walter listing the objectives of any reform as well as citing proposals of great current interest to governments and regulators that would allow a collective claim to be made on behalf of all consumers adversely affected without them having to make an individual claim. This should achieve two aims – redress for individuals who have suffered and speedier market improvement action because the size and nature of the problem have been identified earlier than would have been the case with complaints brought by individuals being tracked and aggregated over time.

Ubi Sunt..?

Just a few weeks ago, we blogged about Richard Thomas throwing off his crusader cape as the Information Commissioner  and now Walter is handing in his SuperOmbuds costume. Last week I attended a leaving party for Allan Asher ex-head of Energywatch and chair of the BSI’s Consumer and Public Interest network just before he headed back to Australia. Ou sont les consumer heroes d’antan? More to the point. ou sont les consumer heroes d’avenir?

If you know of any, we would be interested to hear who they are.

Richard Thomas – the last Hurrah?

Richard Thomas’s Farewell Do

Two Partners went to Richard Thomas’s last appearance in public as the Information Commissioner. He is off to pastures new in the next 4 weeks. Some heavy hitters on stage like Jack Straw and some serious issues discussed. The discussion could have been even more participative and interesting had Jonathan Dimbleby not been gripped by the same conviction as he demonstrates on Any Questions – namely that his own questions are much more interesting than those composed by the stumblebums in the audience.

The Minister with an Advantage and in the Club

Jack Straw showed an impressive grip of modern life in spite of his recent acknowledgement of weakness in family accounting matters by waving around both his Boots Advantage Card and his key ring Tesco Club Card while making a point about the reputational disciplines and pressures that kept private sector database managers  both careful and honest – pressures and disciplines absent in the public sector with its monopolies on areas like social security and tax gathering. A civil servant could not loose a warehouse of personal data when it really was a building with miles of shelving and paper files but could do so all too easily when the warehouse has shrunk into a memory stick or CD. He acknowledged a point made by Richard about the false comfort of mass data collection. Ministers post 9/11 have undertaken to keep us all safe in a world of threats. This is a decent bit of political narrative but one where the Information Commissioner had to set some boundaries when MInisters latched onto monster databases as comfort blankets hoping that they could deliver on the safety thing by having all the digital bits and pieces of our identities and lives in one big box. Then surely they would actually know not only who the bad guys were but what they were going to do next. But the boxes have proved difficult and expensive to build. The point was made that if you are looking for the proverbial needle in the haystack why build a bigger haystack?

Google and 1984

Actually said the man from Google, we don’t care how big your haystack is. Google can still find your needle in a nano-second but even their database engineers baulked at the technical challenge of building on the scale needed to meet the ambitions of the politicians to reduce risk.  Jack Straw felt it was necessary to issue a robust denial of any suggestion that the government were looking to Orwell’s 1984 as a manual of statecraft in the digital age.

Citizen Not Much Involved?

The MAC take on this is how little people appear to be thinking about involving citizens in these debates. The great and the good, Ministers and advocacy group leaders occupy the platforms and argue the issues. The citizen does not appear to be involved and consulted much. One speaker summarised the citizen view as one where individuals were happy if their own privacy was protected and did not much care what happened to everyone else’s.

Government Best Seller

Pub Quiz Bore Fact of the day – the Data Protection Act is the best selling Act of Parliament. I don’t suppose the MP’s Guide to Claiming Allowances is actually on public sale and you may even have missed the boat if you decided to shop for a  member of the House of Lords instead.

Which? Richard

This is not of course Richard’s last Hurrah – he is off to head up something grand and paralegal. More interestingly for us old consumer hands is his position as Deputy Chair of the Council of Management of Which? Ltd or is it Consumers’ Association – the governance arrangements of CA have got a lot more complex since Partner Adamson was a member of the Council back in .. I will withhold this piece of data in full confidence that it is held somewhere on a piece of paper and who on earth could be bothered to look for that?

MAC Buds in May – why health is different from a PlayStation®

There has been only a couple of articles on our blog since the last newsletter – one was a review of Christine Hogg’s up to the minute history of public involvement in the NHS. I have bought my copy and would urge you to do the same if you are trying to make sense of the structures and techniques you need to do public involvement better and to understand why you are finding achievement so elusive. I read it to get some thoughts going for a training course for GP practices and their staff on understanding and engaging with customers.

Citizen vs Consumer

The point that struck home for me with my background working for Which? and other consumer bodies is the one where Christine argues that health is a more complex business than the consumerist model can accommodate. The example she chooses to make her point is that of mental health services users whose rights as citizens are more important to them than their role as a consumer of health services. Their choices are few and in some cases, they have to rely on their rights as citizens to exit the system or refuse treatment. She goes on to see a situation where expert patients and others who care for themselves ‘break out’ (in Christine’s words) out of the role of patient and become providers. She sees that service that is truly user-centred is the one where the users work with equal status with professionals.

Health is Different

This is a radical and ambitious view that goes well beyond the conventional consumer model of market influence where user and producer interract but remain separate. Christine’s view takes into account the fact that health is different from other things that people want. Jonathan Miller has written “Of all the objects in the world, the human body has a peculiar status: it is not only possessed by the person who has it, it also possesses and constitutes him. Our body is quite different from all the other things we claim as our own. We can lose money, books and even houses and still remain recognisably ourselves, but it is hard to give any intelligible sense to the idea of a disembodied person. Although we speak of our bodies as premises that we live in, it is a special form of tenancy; our body is where we can always be contacted ( Miller J The body in question Random House 1978 quoted in The World Health Report 2000 Health Systems: Improving Performance so ably edited by our Associate Angela Haden ) So being a consumer of health is different from being a user of a PlayStation®. We do not live inside something made by Sony – not yet anyway.

Better Customer Care

The reason for this revisiting of this debate is to explore my idea that the tensions embodied in the arguments about differences between being a user of a consumer good or service and being a consumer of health impact on complaint handling. A couple of the many things we have failed to blog about recently are the latest initiatives on complaint handling from the Department of Health and the Health and Public Services Ombudsman. The Better Guide to Customer Care represents a great leap forward in its simplicity, clarity and freedom from an obsession with process. There is an explicit overlap with the work of Ombudsmen and the six principles of good complaint handling. One of the unacknowledged things that make complaint handling – never easy – more difficult in the NHS is the difference between the complaint about health-related service received and the one about your electronic gizmo. As we have written before, emotion is the driver and the emotion involved in complaining about the place ‘where we can always be contacted’ is of a different order and magnitude than a complaint about an object external to us. The only example in the world of consumer goods and services when the emotional temperature came close to rising into the health temperature range in my complaint consultancy experience, was men complaining about repeated quality failures in their Range Rovers. The letters and calls made Jeremy Clarkson look like the soul of reasonableness.

While the Treasury’s advice about financial redress is worth reading, the question of money while it can no doubt help resolution, is not the clincher – recognition of how close to home any complaint about our health and the body we live in remains the best route to resolution.

Owning and Using Data

And if our body is our own, we argue in Andrew’s blog on Real Patient and Public Power, so is the data that we give the NHS by filling in questionnaires and being available to be measured and counted is data which patients and their families should be able to understand and use in any initiative to improve health and social care services. We would like to see the definition of expert patient extended to include an expertise in how user data can be put to work and create action for improvement and change.

Data Delusions

We are reminded how open to interpretation, questions on a checklist can be in one of the final publications of the Healthcare Commission as it morphs into the CQC – Listening, Learning, Working Together? The question mark indicates uncertainty about some of the findings – what the Healthcare Commission calls ‘mixed evidence’ about the standards of patient and public engagement. 98% of healthcare organisations claimed in their annual health check returns that they met core standard 17 which is the one about taking the views of patients and others into account when designing services. The snag is that there were a lot of negative comments from patient forums, voluntary organisations as well as the relevant local government committees (OSCs)  that trusts were failing to seek the views of patients and public. Mixed not to say contradictory evidence indeed. Which is the correct view?

Management – Delusions, Comfort and Safety

Christine Hogg tells us that it is a mistake to ‘believe that user involvement can be managed and voices captured’. She is worried that participation ’seems to be a management tool to be disposed of when it does not produce the goods’. Actually it is not being ‘disposed of’ that is the problem and of course the activity has to be managed – it costs money and involves resources so how else would organisations behave? No – what we have to be wary of is delusion. And the delusion amongst public and patient involvement managers is that the performance of the function – attended 10 meetings, produced 4 newsletters and ran a stand at the local fair or whatever and printed 5000 leaflets on topic X – is enough to tick the box. Delusion of this sort is after all a much more comfortable and safer place for managers to be than copping the comeback from relaying rude and disruptive comments from outside, uncensored and un-deodorised – a terrible assault on the sensitivities of one’s superiors whose lives are difficult enough without this vulgar din.

Thank you and farewell Health Commission – we knew you when you were still CHAI. How short institutional life is in the NHS, we Partners muse.

‘Real Patient and Public Power’ based on prising the lock off comparative data in the NHS

Access and Understand Data

Knowledge is power – but only if you know how to use it. MAC champions the ownership of data by the service users who generate it so they can make decisions and choices based on their and others’ experiences. This means they must not only have access but also the tools to make use of comparative data.

Avoid Unnecessary Deaths – Pay Attention to Patients and Families

More reports appeared in recent days into the deadly debacles in Mid Staffordshire: clinical, managerial and governance failings at the local Foundation Trust Hospital; shortcomings by PCT commissioners and pretty much everyone else – except of course the patients and families using the hospital who weren’t listened to in the first place.  As David Colin Thome’ makes clear in his report, “national approaches were being followed but local signs were missed”. 

He concludes: “Real patient and public power, information and choice are strong drivers for improving the NHS and making it a dynamic, responsive service rather than a service that gives patients the message that they should accept what they are given. Patients should be seen as equal partners in their own care described as ‘the meeting of two experts’ when a patient meets their clinician.”

Unlock the Data Treasure House

When these “two experts” meet they must have access to the same data.  To make this happen, we say prise the lock off the treasure house of data in the Information Centre’s “NHS Comparators” resource and provide public number crunching units so people can relate the comparative data to their local situation and inform their potential choices.

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