Mr. Peter Tyndall:

We have made clear that we have provided guidance as to how signposting should be done. For instance, we have provided standard text for use on websites and letters which makes clear that, in the first instance, people should try to resolve the matter locally, and if they fail to resolve the matter locally, it should come to my office. We have been worried about inconsistencies in referral by hospitals to the HSE review process. Some hospitals were referring while others were not and, by and large, the HSE review process was not proving an effective channel. We are content, therefore, that once there has been an attempt to resolve the matter once locally, it should come to my office. The bigger advantage for us is that the subject matter of the complaint is usually fresher in the minds of those concerned than if it has gone through a lengthy process.

The biggest problem we have hit in terms of dealing with consistency has been the number of people dealing with complaints within the HSE. In the longer term, we think it is better that there should be some professionalisation of that process and that the people dealing with complaints should be of sufficient seniority because many of the people we were dealing with could not get responses, for instance, from consultants who would not deal with somebody whom they felt was insufficiently senior to ask questions of them about their practice. In the longer term, we need to get the sense of having a smaller number of better qualified people doing it as their full-time job rather than many people doing it as a small part of their other duties and who have no expertise or clout. We will take time to move them from where they are to where they need to be.

Coming back to the Chairman's point, I have not noticed greater delays for us in getting responses. It is very much a curate's egg. Some people are prompt and they are the same people who have always been prompt while others are slow and they are the same people who have always been slow. Our IT systems are elderly and creaking and I want to introduce a measure of how long it takes me to get responses from individual bodies within remit and to publish the statistics about that in order that we can highlight areas of consistent bad practice - a league table - and then tackle the areas where it is worst. However, I am interested in the Chairman's comment and I appreciate he does not, for the moment, want to mention the particular group. I am happy to have some conversations outside of the meeting to see if there is anything we can do to address the problem.