Background
A woman complained to me about the way she had been treated at a HSE mental health out-patient clinic in Dublin. She had attended the clinic previously but on this occasion she did not have a scheduled appointment. She had been assured by the receptionist, however, that she would be seen by a doctor if she was prepared to wait. Her file was handed to a particular doctor. He left for lunch some two hours later, without talking to the woman or explaining to her why he could not see her.
At my complainant’s request, her file was handed to another doctor at the clinic who, according to her, was aggressive towards her and told her that she was very late in attending the morning clinic. When she tried to explain her situation and that she had been waiting for over two hours, the doctor allegedly became very annoyed and the woman left the clinic in a distressed state.
My complainant told me that when she arrived home that day, she discovered that the second doctor had telephoned her mother and had divulged medical information about her condition to her mother, information which she did not want her mother to know. She said that after the incident, nobody from the clinic followed up with her to see whether she wanted to be seen again or if she needed any advice or assistance.
My complainant had written a letter of complaint to the HSE in May, 2009 but had received no response. It was not until my Office pursued the complaint that the HSE replied to my complainant in June, 2010. In that letter, the mental health services manager (HSE) apologised that her experience at the clinic had been so upsetting. She said that while she had obtained a report regarding the incident from the consultant psychiatrist in charge of the clinic, this had not been forwarded to my complainant due to an administrative oversight. The HSE's letter, however, failed to address any of the issues which had caused the woman such distress and she remained dissatisfied with the body's response.
Investigation
My Office wrote to the HSE seeking a review of the woman's complaint. The mental health services manager informed my Office that she intended to meet with the consultant and the complainant in November, 2010 to discuss her key concerns. Regrettably, no meeting took place.
In January, 2011 the woman received a further letter from the mental health services manager indicating that the doctor who had seen her at the clinic had left the service and she apologised once again for the distress she had experienced during her attendance at the clinic. At that stage, my Office decided to meet with the consultant psychiatrist and the HSE area manager with a view to progressing the woman's complaint and to see what training was provided to staff within the HSE who deal with complaints about mental health issues.
Outcome
In discussion with the consultant psychiatrist, he agreed that poor communications between himself and the mental health services manager resulted in the woman's complaint being inadequately addressed. He said that he had not been made aware that the complaint was still ongoing. He undertook to write directly to the woman and to explain, from the records, what had transpired at the clinic and why the doctor had contacted her mother, which he said, was done out of genuine concern for her. The consultant told my complainant that he would ensure that future training of doctors within the service would include advice and teaching about how to deal with circumstances, such as hers. He said that training would also help doctors to deal with situations in out-patient units where at the very least, doctors should have the common courtesy to inform a patient if they cannot see them on that day and explain the reasons for it.
The HSE said that as a result of this complaint, arrangements were being made for staff of the mental health services to avail of refresher awareness training on the complaints policy “Your service Your Say”. It advised me that more comprehensive training would take place for the dedicated complaints officers in that service.
I was especially pleased with the tone and content of the consultant's letter to my complainant, and, among other things, his acknowledgement of:
- The delay in the complaint reaching him, which he commented, must have exacerbated my complainant’s sense of anger, grievance and upset,
- The failure to address her concerns, which, coupled with the full extent of the delay, was only finally addressed after she had to eventually resort to the Office of the Ombudsman, adding that this was clearly unacceptable,
- The need to reply to complaints in an appropriate and professional way, and his undertaking on future training for doctors about dealing with patients appropriately in out-patient clinics and in dealing with circumstances like those of my complainant.
While apologising for the upset caused by contact with the mother, he explained that the contact in question involved a judgement call by the doctor concerned. Making a quite reasonable point, he stated that doctors have been seriously criticised in the past for failing to alert close relatives about a patient’s condition in particular circumstances of concern for the patient.
These acknowledgements and explanations enabled me to bring a satisfactory closure to the complaint.
I hope that in future people like my complainant, who turn up in distress at HSE out-patient clinics looking for help, will be treated with the dignity and respect to which they are entitled. After all, courtesy and a caring approach, on the part of medical personnel when engaging with people who are not well, costs nothing. Having customer charters and codes of conduct are all very well but it is the day-to-day practice that counts in patients’ lives. My complainant was badly let down by the system and I am glad that I was able to get action on her complaint and an apology as well as changes to the system to stop the same thing happening again.