A new public services ombudsman should be established, with powers to probe the decisions of councils and clinical commissioning groups even if no complaints have been made, the parliamentary and health services ombudsman has said.
Ombudsman Dame Julie Mellor made the appeal alongside local government ombudsman Jane Martin in an exclusive joint interview with LGC’s sister title Health Service Journal.
Dame Julie said both ombudsmen supported the idea of a new single public sector ombudsman with new powers, to ensure it “has the right tools in the toolbox”.
Powers should include the ability to investigate councils’ commissioning decisions and their approaches to personal budgets, she said.
At present, the Care Quality Commission can raise concerns about local authority commissioning practices if its inspections of care services reveal potential problems. However, it can only inspect local authority commissioners in ‘extreme’ cases of concern.
Dame Julie denied the extra powers would create a new regulator for health and social care.
“We would need to make sure we weren’t duplicating regulation and it would be up to us what we investigated,” she said.
“The most likely things would be commissioning decisions and personal budgets – the kinds of things that are still issues around service failure but don’t happen to be the ones covered by the regulator in terms of safety and quality.
“You would need prima facie evidence of an issue and clear criteria.”
As part of a pitch for an extended remit and combined watchdog, Dame Julie suggested the merged body should be able to instigate investigations as it saw fit, instead of them being triggered by patient complaints.
She revealed the health watchdog was on track to handle 10 times as many complaints this year as it did in 2012.
Ms Martin said: “We all recognise the core business of an ombudsman is to remedy individual injustice and that remains our core business, but it’s also how we make sure we have appropriate powers so that people, particularly the most vulnerable, have access to a remedy.
“We certainly don’t want to trample on the role of the regulators nor, in my case, do I want to trample on the absolute sovereignty of local authorities. I’m very mindful of that.”
The pair said a single public sector ombudsman was the right response to the changing landscape in health and social care, with multiple providers between the NHS and local authorities.
Such a situation left complainants unsure where to turn, they said.
While primary legislation will be needed to bring about the main changes, both ombudsmen are already working more closely together and have set up a joint team to investigate health and social care.
They sit on each other’s boards and are looking at sharing more back office systems.