Mr. Peter Tyndall:

I thank the Senator. This has been an issue for me because I am unusual in having served as an ombudsman in two jurisdictions. The first thing I noticed when I came back to Ireland was that a large source of complaints for me in Wales related to clinical jurisdiction but I could not even consider such complaints here. Let us say my office receives a complaint from a person in a nursing home during Covid. Such a complaint may relate to end-of-life care, a failure to look after a possession or access for relatives, as we have seen. I can consider all of those issues. However, the person may have become ill as a result of another person being discharged from hospital. If that is the case, I cannot examine that issue. Neither can I examine issues relating to decisions taken on the care of that person. The family do not want half an answer; they want somebody to look comprehensively at the whole of it.

This became an even bigger issue in Ireland when a decision was properly made by the courts that professional standards bodies and regulators, including the Medical Council, could not consider issues unless they suggested there was a prima facie case for a gross breach of professional standards. That is my paraphrasing of the decision. As such, a tranche of complaints have no home. Many of the issues my office considers do not suggest at all that a person was in gross breach of his or her professional standards, but there may well be issues relating to clinical care from which lessons could be learned. On some occasions, I have considered cases and simply raised them with the HSE as, even though I could not investigate them, I could see there were problems. There was an issue regarding equipment in use in emergency departments and it was obvious to me that lives were at risk. I was able to raise that issue but I could not formally consider it.

It is important to note that north of the Border, the complaints considered by the Northern Ireland Public Service Ombudsman fit into the broad range of public service complaints. Here, no one can look at them. To be fair to the HSE, it does its best, but having the HSE consider an issue is not the same as having access to independent redress. That is why this is so important. The Government has accepted on several occasions that this is an important issue and has agreed to move it forward, but that has not transpired in practice as yet. I know the Department of Health is considering it again, but it is time to get it over the line. It is an obvious gap in the landscape of access to independent redress and it needs to be filled.