Committee Reports > List of Committees > Dáil > 1988 > Committee of Public Accounts > Report - Appropriation Accounts 1984

APPENDIX 18

NOTE FOR PUBLIC ACCOUNTS COMMITTEE FROM OFFICE OF THE OMBUDSMAN

HEALTH BOARD COMPLAINTS.

1. The Ombudsman carries out specific statutory functions in examining and investigating complaints. He does not make representations to organisations. Very often the first reply from an organisation is merely the start of the Ombudsman’s work. Even in the cases where a formal statutory investigation does not take place, extensive enquiries are very often necessary. These enquiries involve written communication with the organisation complained about, securing all relevant documents from that organisation, interviewing the official involved, getting legal advice where necessary and contacting the complainant at various stages of the examination.

2. Formal investigations are more time-consuming and, following detailed analysis of all the evidence, culminate in a formal recommendation by the Ombudsman to the body complained against.

3. These procedures apply across-the-board to all complaints but in some respects complaints against the Health Boards take longer to process than do comparable complaints in other areas of the public service. This is not a reflection on the Health Boards; it merely indicates that the problems dealt with are more complex. There are a number of reasons for this:

(i) Frequently complaints relate to areas of discretionary decision-making (e.g. Supplementary Welfare Allowances, Medical Card eligibility); testing the reasonableness of such decisions is less clear cut than checking decisions where there is a clear statutory entitlement.

(ii) The relevant legislation governing Health Board activities is frequently less specific than is the case with other areas of public administration. For example, there can be lack of clarity as to what in law constitutes a “hospital service”; or how means should be assessed for the Disabled Persons Maintenance Allowance; or what is the definition of “dependants” in the context of eligibility for services.

(iii) Health Boards employ a wide range of professional staff in medical, para-medical and social work areas who work outside the administrative mainstream. Frequently, dealing with a complaint involves contact with the professional and/or field staff, in addition to the administrative staff.

(iv) Sometimes it is necessary to contact the Department of Health when examining a Health Board complaint. This would arise, for example, in a situation where the Department had issued guidelines covering the area under examination.

(v) Very many of the Health Board complaints relate to the various means-tested cash payments (e.g. Supplementary Welfare Allowance, Disabled Persons Maintenance Allowance). These payments by definition, are availed of by the least-advantaged. In many instances complaints in this area are not very clearly presented and complainants may not have a clear idea of their entitlements.

Office of the Ombudsman

12 December 1986.