Mr. Peter Tyndall:

I will take the theme of clinical judgment first. All the other ombudsmen on these islands who deal with health matters are able to examine matters of clinical judgment. They do so through the use of a panel of medical experts who are leading experts in their fields. There is a standing panel and in the case of a very specialist area, somebody is sought to give a judgment. I have access to this panel and use it from time to time in the course of the work here, although to a lesser extent than colleagues elsewhere would. Alongside this, each office would have more generalist practitioners coming in from time to time, for example, a practising GP or clinical nursing specialist who would come to the office once a month to examine particular complaints. The panel includes people such as leading oncologists and cardiac surgeons who would be available to examine particular cases and more generalist people to advise on how best to handle a complaint, for example, which specialist advice one needs to seek.

In my previous job, complaints about health care were principally about care and treatment in hospitals but here many of them are about funding issues and they have comprised the largest single proportion of complaints. I do not believe that health care here is so much better than elsewhere as to account for the lower level of complaints. I think it has to do with issues around how the health complaints system works and issues around the lack of capability to get individual redress on issues around clinical judgment. There is a nervousness because of the very litigious nature of some of these issues. There is a nervousness about moving forward. Many people want an explanation and want to know if something went wrong and, if so, why. They are not necessarily looking for financial compensation. They are very concerned about what has happened to themselves or their loved ones. The issues around health care are very close, very emotive for individuals and very significant in their life events. It seems to me that is a gap. There is nothing there at the moment and there should be something short of going to court. Independent redress needs to be available. That is why it is significant. It has not proved difficult to implement in other jurisdictions. There must be a mechanism around it and we should not have to invent something from scratch. This is a well-trodden path and one on which we should embark.