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Scottish Public Services Ombudsman

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The Scottish Public Services Ombudsman ( SPSO ) is the organisation that handles complaints about public services in Scotland. The Ombudsman service is independent of government and with a duty to act impartially.

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69-667: The SPSO is responsible for looking at complaints made by individual members of the Scottish public about most organisations providing public services in Scotland including councils, the National Health Service , housing associations , the Scottish Government and its agencies and directorates, universities and colleges, prisons and most Scottish public authorities . The SPSO examines complaints where

138-822: A "unified medical service" can be dated back to the Minority Report of the Royal Commission on the Poor Law in 1909. Somerville Hastings , President of the Socialist Medical Association , successfully proposed a resolution at the 1934 Labour Party Conference that the party should be committed to the establishment of a State Health Service. Following the 1942 Beveridge Report 's recommendation to create "comprehensive health and rehabilitation services for prevention and cure of disease", cross-party consensus emerged on introducing

207-542: A 3.4% increase in funding every year to 2024, which would allow it to receive an extra £20bn a year in real terms funding. [dead link] There is concern that a high proportion of this money will go to service NHS debts rather than for improved patient care. In June 2018, it was reported that there were calls for the government to write off the NHS debt. Saffron Cordery of NHS Providers said that hospitals needed help to do their work without being up in deficit, as two-thirds were in

276-512: A National Health Service of some description. Conservative MP and Health Minister, Henry Willink later advanced this notion of a National Health Service in 1944 with his consultative White Paper "A National Health Service" which was circulated in full and short versions to colleagues, as well as in newsreel. When Clement Attlee 's Labour Party won the 1945 election he appointed Aneurin Bevan as Health Minister . Bevan then embarked upon what

345-502: A complaint. Reports of investigations that are laid before the Scottish Parliament are sent to the complainant, the body complained about and Scottish Ministers. The Ombudsman may make recommendations to the body to address failings identified in the investigation. The recommendations may be designed to provide redress to the individual complaint (for example, an explanation, an apology or re-imbursement of costs incurred as

414-495: A comprehensive range of health services , provided without charge for residents of the United Kingdom apart from dental treatment and optical care. In England , NHS patients have to pay prescription charges ; some, such as those aged over 60, or those on certain state benefits, are exempt. Taken together, the four services in 2015–16 employed around 1.6 million people with a combined budget of £136.7 billion. In 2024,

483-622: A division, must be voted for by at least two-thirds of members. The Ombudsman remains independent from the bodies which they investigate. To safeguard the independence of the SPSO, under the provisions of the Scottish Public Services Ombudsman Act 2002 , in the exercise of the SPSO's statutory functions, the SPSO is not subject to the direction or control of any member of the Scottish Government or

552-612: A lot of coverage in the media. The Welsh and UK governments announced a partnership on 23 September 2024 to reduce NHS waiting lists in England and Wales during the Labour Party Conference in Liverpool. This collaboration aimed to share best practices and tackle common challenges. Previously, Eluned Morgan rejected a Conservative proposal for treating Welsh patients in England. The Welsh Conservatives welcomed

621-465: A member of the public claims to have suffered injustice or hardship as a result of maladministration or service failure. The SPSO is the 'last resort'; investigating cases after the complainant has already exhausted the formal complaints procedure of the organisation concerned. The SPSO also shares learning from its work to improve service delivery across the public services spectrum in Scotland. The office carries out awareness-raising activities with

690-546: A result of the organisation's fault), or to improve general working practices within the organisation (for example, a change in procedure). The Ombudsman accompanies the reports laid before the Parliament with a monthly commentary. which summarises the reports and highlights any issues or trends to which the Ombudsman wishes to draw attention. The current Scottish Public Services Ombudsman is Rosemary Agnew . The Ombudsman

759-575: A specific time frame. Some organisations will have more than one stage in their complaints procedure so there may be a series of responses between the complainant and the body before reaching the end of the process. The final response from the organisation should contain an explanation that the complainant can contact the SPSO. Complaints arrive at the SPSO in the form of letters, emails, complaint forms and by phone. The SPSO receives large numbers of enquiries and complaints which are not within its remit or not ready for it to look at – in these cases, members of

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828-490: Is appointed by Her Majesty , on the nomination of the Scottish Parliament , for a period not exceeding five years. The Ombudsman is eligible for a second term but re-appointment for a third term is allowed only if desirable in the public interest due to special circumstances. The Ombudsman may be relieved of office by Her Majesty upon request or following a resolution of the Scottish Parliament which, if passed on

897-545: Is regardless of whether they derive a salary or wage from the organisation, or receive any type of funding or assistance from the organisation for the purposes of working overseas. This is in recognition of the fact that most missionaries would be unable to afford private health care and those working in developing countries should not effectively be penalised for their contribution to development and other work. Those who are not ordinarily resident (including British citizens who may have paid National Insurance contributions in

966-539: The European Health Insurance Card . Those from other countries with which the UK has reciprocal arrangements also qualify for free treatment. Since 6 April 2015, non-EEA nationals who are subject to immigration control must have the immigration status of indefinite leave to remain at the time of treatment and be properly settled, to be considered ordinarily resident. People not ordinarily resident in

1035-583: The Institute for Fiscal Studies had stated a 5% real-terms increase was needed for real change. Paul Johnson of the IFS said the 3.4% was greater than recent increases, but less than the long-term average. In July 2016, health experts said the money would "help stem further decline in the health service, but it's simply not enough to address the fundamental challenges facing the NHS, or fund essential improvements to services that are flagging." In November 2018, it

1104-486: The Office for Budget Responsibility said that "the rising trend in health and social care spending and pensions will be adding something like another £75 billion spending over the next five years, £150 billion, potentially over the next decade" as if treatments are available to keep people alive longer, then people will want them. In July 2022, The Telegraph reported that the think tank Civitas found that health spending

1173-476: The 'Centre for Health Economics' at the University of York found that between 2004/05 and 2016/17 the productivity of the NHS has increased nearly two and a half times as quickly as the larger economy. Between 2010 and 2017, there was a cap of 1% on pay rises for staff continuing in the same role. Unions representing doctors, dentists, nurses and other health professionals have called on the government to end

1242-589: The Civil Service to keep medicine supplies available in the case of a no-deal Brexit had to sign 26 Non-Disclosure Agreements (NDAs) to prevent them from giving the public information. The figures were given on 21 December 2018 after Rushanara Ali asked a parliamentary question. Scottish Public Services Ombudsman Act 2002 Too Many Requests If you report this error to the Wikimedia System Administrators, please include

1311-516: The EEA coming to the UK for a temporary stay of more than six months are required to pay an immigration health surcharge at the time of visa application, and will then be entitled to NHS treatment on the same basis as a resident. This includes overseas students with a visa to study at a recognised institution for six months or more, but not visitors on a tourist visa. In 2016 the surcharge was £200 per year, with exemptions and reductions in some cases. This

1380-608: The EU holding a valid European Health Insurance Card and persons from certain other countries with which the UK has reciprocal arrangements concerning health care can get emergency treatment without charge. The NHS is free at the point of use, for general practitioner (GP) and emergency treatment not including admission to hospital, to non-residents. People with the right to medical care in European Economic Area (EEA) nations are also entitled to free treatment by using

1449-451: The GP's health and that of their patients at risk. The Royal College of Physicians surveyed doctors across the UK, with two-thirds maintaining patient safety had deteriorated during the year to 2018: 80% feared they would be unable to provide safe patient care in the coming year while 84% felt that increased pressure on the NHS was demoralising the workforce. In June 2018, at a time when the NHS

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1518-698: The NHS England published the NHS Long Term Plan . The Guardian reported that data for 2020 suggests a change, and that the doctors' trade union and professional association , the BMA , say this was largely due to raised spending during the pandemic and the effect of Covid on the whole economy, since the GDP of the UK dropped more than that of all other G7 nations. The BMA also said in December 2022 that

1587-400: The NHS experienced "historical underfunding and under-resourcing" during the ten years before COVID. The King's Fund maintains The investment in services started in 2021 was badly needed, but despite it restoring key services and performance standards will require years. Shortages of workers and growing staff numbers experiencing burnout and thinking of leaving the NHS may stop progress. If

1656-446: The NHS has among the lowest numbers of doctors, nurses and hospital beds per capita in the western world. In May 2018, it was said that nurses within the NHS said that patient care was compromised by the shortage of nurses and the lack of experienced nurses with the necessary qualifications. In June 2018 it was reported that the NHS performed below average in preventing deaths from cancer, strokes and heart disease. In September 2018 it

1725-738: The NHS. The NHS is the largest employer in Europe, with one in every 25 adults in England working for the NHS. As of February 2023, NHS England employed 1.4 million staff. Nursing staff accounted for the largest cohort at more than 330,000 employees, followed by clinical support staff at 290,000, scientific and technical staff at 163,000 and doctors at 133,000. In June 2018, the Royal College of Physicians calculated that medical training places need to be increased from 7,500 to 15,000 by 2030 to take account of part-time working among other factors. At that time there were 47,800 consultants working in

1794-476: The Ombudsman may make recommendations to redress problems identified. Organisations do not have to comply with the SPSO's recommendations and are not bound by the law to do so . If an organisation failed to implement recommendations the Ombudsman could, but in most cases won't, lay a 'special' report before the Scottish Parliament highlighting any concerns, which effectively makes the SPSO a toothless organisation with no real powers. The Trustpilot reviews. In 2013

1863-777: The Ombudsman's role and terms of appointment. The legislation established the ombudsman as a 'one-stop-shop' assuming statutory duties that had previously been the remit of three previous offices – the Scottish Parliamentary Ombudsman, the Health Service Ombudsman, the Local Government Ombudsman for Scotland. It also took over non-statutory duties from the Housing Association Ombudsman for Scotland. The first Scottish Public Services Ombudsman

1932-512: The SPSO worked with NHS Education for Scotland to develop complaints handling training materials for NHS staff. The SPSO worked closely with Healthcare Improvement Scotland (HIS), taking part in their working group looking at new guidance for adverse incident reviews. In August 2023, BetterCareScotland reported that the SPSO has been asked to investigate claims that Care Inspectorate inspection processes routinely fail to identify and, therefore, address risk-taking by care providers or recognise

2001-531: The Scottish Parliament. The SPSO is a member of the Ombudsman Association. The Scottish Parliament pays the salary and expenses of the Ombudsman and any expenses incurred in the exercise of the Ombudsman's function. The Ombudsman is accountable to the Scottish Parliament and must lay an annual report and their investigation reports before the Parliament. If an investigation finds maladministration, which it won't properly define, or service failure,

2070-442: The UK are in general not entitled to free hospital treatment, with some exceptions such as refugees . People not ordinarily resident may be subject to an interview to establish their eligibility, which must be resolved before non-emergency treatment can commence. Patients who do not qualify for free treatment are asked to pay in advance or to sign a written undertaking to pay, except for emergency treatment. People from outside

2139-464: The UK can use the NHS without being asked to pay the full cost of the service, though NHS dentistry and optometry do have standard charges in each of the four national health services in the UK. In addition, most patients in England have to pay charges for prescriptions though some patients are exempted. Aneurin Bevan , in considering the provision of NHS services to overseas visitors wrote, in 1952, that it would be "unwise as well as mean to withhold

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2208-456: The UK had increased by more than any country despite the significant drop in national income due to the COVID pandemic. The Labour Government elected in 2024 stated that their policy was that the "NHS is broken". They announced an immediate stocktake of current pressures and the reasons for them led by Labour peer Lord Ara Darzi. This was to be followed by development of a new "10 year plan" for

2277-456: The UK of which 15,700 were physicians. About 20% of consultants work less than full-time. Brexit , in 2020, was predicted to affect medical practitioners from EU countries who worked in the NHS, accounting for more than 1-in-10 doctors at the time. A 2017 survey suggested 60% of these doctors were considering leaving, with a record 17,197 EU staff leaving the NHS in 2016. The figures led to calls to reassure European workers over their future in

2346-491: The UK. A study by the Centre for Progressive Policy called for NHS trusts to become "exemplar employers" by improving social mobility and pay especially for those "trusts in poorer places where they can play a particularly large role in determining the economic wellbeing of the local population." They found the NHS to be " a middle ranking employer in comparison to other large organisations and falls short on social mobility and

2415-546: The cap on health service pay, claiming the cap is damaging the health service and damaging patient care. In 2017, the pay rise was likely to be below the level of inflation and to mean a real-terms pay cut. In 2017, the House of Commons Library research predicted that that real-terms NHS funding per head was to fall in 2018–19, and stay the same for two years afterwards. In January 2018, The Guardian reported that GPs faced excessive workloads throughout Britain and that this put

2484-592: The department is making 4,000 training positions available for GPs every year, which help create an extra 50 million appointments annually. In 2023, a report revealed that NHS staff had faced over 20,000 sexual misconduct from patients from 2017 to 2022 across 212 NHS Trusts. Some of the claims included rape, sexual harassment, stalking, and sexualised remarks at staff from patients. In the report, female staff members were told by hospitals to continue caring for patients even after there were issues regarding abuse or harassment without further safeguards in place. Other parts of

2553-512: The first of many controversies over changes to the NHS throughout its history. From its earliest days, the cultural history of the NHS has shown its place in British society reflected and debated in film, TV, cartoons and literature. The NHS had a prominent slot during the 2012 London Summer Olympics opening ceremony directed by Danny Boyle , being described as "the institution which more than any other unites our nation". Everyone living in

2622-663: The free service from the visitor to Britain. How do we distinguish a visitor from anybody else? Are British citizens to carry means of identification everywhere to prove that they are not visitors? For if the sheep are to be separated from the goats both must be classified. What began as an attempt to keep the Health Service for ourselves would end by being a nuisance to everybody." The provision of free treatment to non-UK-residents, formerly interpreted liberally, has been increasingly restricted, with new overseas visitor hospital charging regulations introduced in 2015. Citizens of

2691-511: The general public, and bodies under jurisdiction and promotes good complaints handling by public service providers in Scotland. The SPSO has a separate website to support best practice in complaints handling. On 23 October 2002 the ombudsman service, headed by the Scottish Public Services Ombudsman, was established by the Scottish Public Services Ombudsman Act 2002 . This Act of the Scottish Parliament outlines

2760-649: The indicators of "closed cultures" in the sector and stonewalls serious complaints about the Care Inspectorate's operations. National Health Service The National Health Service ( NHS ) is the umbrella term for the publicly funded healthcare systems of the United Kingdom , comprising the NHS in England, NHS Scotland and NHS Wales . Health and Social Care in Northern Ireland

2829-700: The needs of everyone, that it be free at the point of delivery, and that it be based on clinical need, not ability to pay. Three years after the founding of the NHS, Bevan resigned from the Labour government in opposition to the introduction of charges for the provision of dentures, dentists, and glasses ; resigning in support was fellow minister and future Prime Minister Harold Wilson . The following year, Winston Churchill 's Conservative government introduced prescription fees. However, Wilson's government abolished them in 1965; they were later re-introduced but with exemptions for those on low income. These charges were

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2898-451: The new funding is to be efficiently used the NHS will need a comprehensive and fully funded workforce strategy to ensure future supply of staff. In March 2022, Rishi Sunak doubled the annual efficiency target for the NHS in England. The 2.2 per cent target would deliver annual savings of saving of £4.75 billion. At the same time the additional Covid funding is being removed in 2022–23. At the same time Sir Charles Bean , recently leader of

2967-592: The new partnership as overdue, while Plaid Cymru criticized it as insufficient for addressing deeper issues within the Welsh NHS. There was a concern that a disorderly Brexit might have compromised patients' access to vital medicines. In February 2018, many medical organisations planned for a worst-case Brexit scenario because "time is running out" for a transition deal to follow the UK's formal exit that occurred in March 2019. Pharmaceutical organisations working with

3036-467: The number of GPs has fallen by 1,622. Some family doctors have 2,500 patients each, forcing patients to attend A&E instead. Certain regions have fewer than 50 GPs per 100,000 people, while other regions have more than 70, presenting a challenge to the NHS's founding principle of equal treatment. A growing number of family doctors are reporting unsustainable workloads, and many have chosen to work part-time. A Health and Social Care spokesperson said that

3105-544: The official historian of the NHS, Charles Webster , called an "audacious campaign" to take charge of the form the NHS finally took. Bevan's National Health Service was proposed in Westminster legislation for England and Wales from 1946 and Scotland from 1947, and the Northern Ireland Parliament 's Public Health Services Act 1947. NHS Wales was split from NHS (England) in 1969 when control

3174-420: The past) are liable to charges for services. There are some other categories of people who are exempt from the residence requirements such as specific government workers and those in the armed forces stationed overseas. In 2016, the systems were 98.8% funded from general taxation and National Insurance contributions, plus small amounts from patient charges for some services. As of 2016, about 10% of GDP

3243-538: The patients. In wards which had not closed staff sometimes worked under stress due to staff shortages. It was also predicted then, that Brexit was likely to aggravate those problems. In November 2019, it was reported that due to the shortage of nurses the NHS was then relying on less qualified staff like healthcare assistants and nursing associates. For the period between 2010 and 2018 the Health Foundation funded research by Birmingham University said there

3312-425: The personal relationship between doctor and patient. Conservative MPs voted in favour of their amendment to Bevan's Bill to maintain local control and ownership of hospitals and against Bevan's plan for national ownership of all hospitals. The Labour government defeated Conservative amendments and went ahead with the NHS as it remains today; a single large national organisation (with devolved equivalents) which forced

3381-417: The public are directed to the appropriate body or Ombudsman service. The SPSO Act 2002 states the Ombudsman's powers, outlining what the Ombudsman can and cannot do. The Act stipulates that certain requirements must be met before it can investigate a complaint. The Ombudsman's service incurs no charge. The SPSO is not a watchdog or a regulator – their role is to give an independent and impartial decision on

3450-448: The real Living Wage", and ranked trusts using a 'good employer index'. Ambulance trusts were ranked worst. On 6 June 2022, The Guardian said that a survey of more than 20,000 frontline staff by the nursing trade union and professional body, the Royal College of Nursing , found that only a quarter of shifts had the planned number of registered nurses on duty. The NHS is facing a shortage of general practitioners . From 2015 to 2022,

3519-419: The remaining 20% split between buildings, equipment, training costs, medical equipment, catering and cleaning. Nearly 80% of the total budget is distributed by local trusts in line with the particular health priorities in their areas. When the NHS was launched in 1948 it had a budget of £437 million (equivalent to £20.07 billion in 2023). In 2016–2017, the budget was £122.5 billion. In 1955/56 health spending

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3588-437: The report showed that staff were pressured into not reporting grievances. In June 2023, the delayed NHS Long term Workforce Plan was announced, set up to train more doctors and nurses and create new roles within the health service. In 2024, multiple NHS hospitals started mandating radiographers to ask all male patients aged 12 to 55 if they were pregnant. This policy was instated as part of an 'inclusivity' drive and received

3657-590: The total health sector workforce across the United Kingdom was 1,499,368 making it the seventh largest employer and second largest non-military public organisation in the world. When purchasing consumables such as medications, the four healthcare services have significant market power that influences the global price, typically keeping prices lower. A small number of products are procured jointly through contracts shared between services. Several other countries directly rely on Britain's assessments for their own decisions on state-financed drug reimbursements. Calls for

3726-431: The transfer of ownership of hospitals from local authorities and charities to the new NHS. Bevan's principle of ownership with no private sector involvement has since been diluted, with later Labour governments implementing large scale financing arrangements with private builders in private finance initiatives and joint ventures. At its launch by Bevan on 5 July 1948 it had at its heart three core principles: That it meet

3795-413: The year to 2018. It was also said that some expressed doubt over whether May could carry out this proposed increase in funding. The next day, Health Secretary Jeremy Hunt backed the extra £20bn annual increase in NHS funding and responded to criticism by stating that taxation would be used to carry out the funding and that details would be revealed at the next budget. In June 2018 it was reported that

3864-454: Was 11.2% of the public services budget. In 2015/16 it was 29.7%. This equates to an average rise in spending over the full 60-year period of about 4% a year once inflation has been taken into account. Under the Blair government spending levels increased by around 6% a year on average. Between 2010 and 2017 spending growth was constrained to just over 1% a year. A 2019 report said that a study by

3933-495: Was Professor Alice Brown . Complaints can be taken to the Ombudsman service once a person has gone through the complaints process of an organisation that comes under SPSO's jurisdiction. Most organisations have a formal complaints procedure that afford them an opportunity to resolve the complaint. An aggrieved member of the public must usually write to the body concerned to explain their dissatisfaction and how they wish their complaint to be resolved. A response should be issued within

4002-417: Was born out of the ideal that healthcare should be available to all, regardless of wealth. Although being freely accessible regardless of wealth maintained Henry Willink 's principle of free healthcare for all, Conservative MPs were in favour of maintaining local administration of the NHS through existing arrangements with local authorities fearing that an NHS which owned hospitals on a national scale would lose

4071-588: Was costing about £10,000 per household in the UK. This, they said, reflected the third highest share of GDP of any nation in Europe. This was said to show that the UK "has one of the most costly health systems – and some of the worst outcomes". The findings were made before the government increased health spending significantly, with a 1.25% increase in National Insurance , in April 2022. Civitas said this showed evidence "runaway" spending as health spending in

4140-496: Was created separately and is often locally referred to as "the NHS". The original three systems were established in 1948 (NHS Wales /GIG Cymru was founded in 1969) as part of major social reforms following the Second World War . The founding principles were that services should be comprehensive, universal and free at the point of delivery—a health service based on clinical need, not ability to pay. Each service provides

4209-482: Was increased to £400 in 2018. The discounted rate for students and those on the Youth Mobility Scheme will increase from £150 to £300. From 15 January 2007, anyone who is working outside the UK as a missionary for an organisation with its principal place of business in the UK is fully exempt from NHS charges for services that would normally be provided free of charge to those resident in the UK. This

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4278-547: Was insufficient and falling NHS capital spending that put patient care and put staff productivity at risk. The Health Foundation said that £3.5 billion more a year would be required to get capital spending to the OECD average. Spending limits were effecting service efficiency, and patient care. Shortages of equipment and equipment failures had an impact as did relying on ageing diagnostic equipment. In 2018, British Prime Minister Theresa May announced that NHS in England would receive

4347-699: Was passed to the Secretary of State for Wales . According to one history of the NHS, "In some respects the war had made things easier. In anticipation of massive air raid casualties, the Emergency Medical Service had brought the country's municipal and voluntary hospitals into one umbrella organisation, showing that a national hospital service was possible." Webster wrote in 2002 that "the Luftwaffe achieved in months what had defeated politicians and planners for at least two decades." The NHS

4416-551: Was reported that Cancer Research UK maintained that more NHS cancer personnel were needed to enable the UK to catch up The NHS in England was expanding early diagnosis services with the goal of increasing the proportion of cancers diagnosed early (at stages 1 and 2) from 53% to 75% in the decade to 2028. In September 2018, it was reported that the NHS was the first health service in Europe to negotiate coverage for novel CAR-T cancer therapy, with agreement reached within 10 days of its European marketing authorisation. On 7 January 2019,

4485-517: Was reported that death rates from breast cancer were falling faster in Britain than in any other of the six largest countries in Europe, and were estimated then to have improved beyond the European average. In October 2018, according to Breast Cancer Care , 72% of NHS trusts across the UK did not provide dedicated specialist nurses for patients with incurable breast cancer." In September 2019 it

4554-479: Was reported that staff shortages at histology departments were delaying diagnosis and start of treatment for cancer patients. In England and Scotland cancer wards and children's wards have to close because the hospital cannot attract sufficient qualified doctors and nurses to run the wards safely. In November 2018 it was reported that cancer patients and child patients were having to travel very long distances to get treatment and their relatives had to travel far to visit

4623-480: Was short of doctors, foreign doctors were forced to leave the UK due to visa restrictions. A study reported in November 2018 found that a fifth of doctors had faced bullying from seniors in the previous year due to pressure at work. In May 2018 it was reported that the NHS was under-resourced compared to health provisions in other developed nations. A King's Fund study of OECD data from 21 nations, revealed that

4692-540: Was spent on health and was the most spent in the public sector. In 2019, the UK spent roughly 10.2% of GDP on healthcare compared to 11.7% in Germany and 11.1% in France. The money to pay for the NHS comes directly from taxation. The 2008/09 budget roughly equated to a contribution of £1,980 per person in the UK. Some 60% of the NHS budget is used to pay staff. A further 20% pays for pharmaceuticals and other supplies, with

4761-501: Was thought that inflation may erode the real value of this funding increase. As part of the 2018 funding increase the UK Government asked the NHS in England to produce a 10-year plan as to how this funding would be used. In September 2019, it was reported that cancer survival rates in the UK had been rising fast but probably still lagged behind the best results internationally, mainly because of late diagnosis. In March 2019 it

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