CHILDREN AS COMPLAINANTS IN THE HEALTH AND PERSONAL SOCIAL SERVICES IN NORTHERN IRELAND

7 FINDINGS: THE PERSPECTIVES OF LAY PERSONS IN THE COMPLAINTS SYSTEM

FINDINGS FROM LAY KEY INFORMANTS

During September and October 2001, eighteen semi-structured interviews with key informants involved in the complaints process were carried out by telephone. Interviews lasted between 15 and 35 minutes with the average being 25 minutes. Interviewees included six panel members, six independent persons involved in the Children Order complaints procedure, three convenors of requests for independent review and three lay chairs. Thirteen of the respondents had been involved in complaints by or about children.

All of the interviewees had been involved with the complaints systems for a minimum of two years and the majority had been involved for four to five years. Three of the eighteen expressed disappointment that they had not been involved in many panel proceedings and had little contact from their Health and Social Services Board since being selected for panel membership.

The majority were satisfied with the amount and quality of training they had received. However a few felt that issues such as ethics should be dealt with as well as legislation and complaints procedures. 'Independent Persons' (the term for lay people involved in the Children Order system) were the only informants who had had training which dealt with handling complaints made by or on behalf of children. For the most part, they were individuals who had had considerable experience working with children and young people in their professional lives for example as social workers or counsellors. Lay people involved in the Wilson system had different backgrounds usually not involving work with children but had not received advice or guidance on dealing with complaints involving children.

Most interviewees were satisfied with the decision-making process involved in the complaints procedures formal stages. However, the independent persons working with the Children Order procedures were much more likely than those involved in the Wilson system to express dissatisfaction with this. Two informants mentioned the "club-like" atmosphere within Trusts and the difficulties for them as "outsiders" in getting their views across. One independent person spoke quite openly about their belief that their opinions were being suppressed.

All of the interviewees felt that the system worked well in making staff accountable for their actions, as one interviewee commented:

Two informants remarked that:

One went on to remark that even in her everyday life she heard stories which were appalling and that although a lot of people do not like to complain about their care or treatment when they know staff are overworked and services are underfunded:

The majority of informants felt that appropriate recommendations were being made as a result of complaints. However they were considerably less sure about whether this actually led to improvements in services as most received very little feedback on this. One panel member went so far as to say:

another remarked

Several interviewees remarked that it was difficult for the process to be seen as independent if review panels and interviews with complainants and/or those complained about were held on Trust or Board property. A number also commented that if they had been employees of a Trust or Board in the past or had a professional background in Health or Social Services, they might not always be perceived by complainants as entirely independent themselves.

One very serious issue has arisen over the subject of indemnity for independent persons involved in the Children Order complaints procedure. One interviewee explained that in return for a Trust's insurance and indemnity being extended to cover independent persons, the Trust had taken the view it had a right to examine reports produced by the independent person so as to ensure that nothing was contained therein which might prove damaging to the Trust in the event of subsequent litigation.

If Trusts or Boards are permitted to have such a right, independent persons could clearly no longer behave as independent persons. Furthermore, bringing a complaint through the Children Order process may end up being detrimental to complainants interests.

As noted above, thirteen of the interviewees had been involved in complaints involving children. In only one case (involving a child in residential care) was the child the complainant. In all other cases the complaint was made by an adult on the child's behalf. The majority of informants felt that a child's best interests could be adequately put forward by an adult acting on their behalf although one remarked that while a lot of individuals may have a say in a child's particular case

Protecting the child was certainly uppermost in most interviewee's mind. Only three of the informants could give examples of instances when children's own views on complaints concerning them were actively sought. Interestingly all of these reported that the process had been successful even when the children were as young as nine or ten, or in (in one case) had a learning disability.

Two informants commented on the number of "professional complainers" they had come across in their experience of the complaints system. Two went on to comment on the danger of malicious complaints being made by children or young people - in particular with regard to complaints of abuse. One interviewee believed that some children were "accomplished liars".

All of the interviewers felt comfortable that young people of sixteen and over were able to give evidence on their own behalf but most had concerns about children who were considerably younger than this, although two noted the "streetwise" and "clued-up" nature of some quite young children. On the other hand, one interviewee believed that evidence given by minors should be considered in the same light as that given by the mentally infirm.

A number of suggestions were made in order to make it easier for children to give evidence in complaints concerning them. These included specially trained interviewers and review panels consisting of people with experience of working with children, interviews being carried out in an environment familiar to the child and the use of video evidence. As one interviewee remarked: