Mr Behren's apology re report on Averil Hart's death

D. Moore made this Freedom of Information request to Parliamentary and Health Service Ombudsman

This request has been closed to new correspondence from the public body. Contact us if you think it ought be re-opened.

The request was refused by Parliamentary and Health Service Ombudsman.

Dear Parliamentary and Health Service Ombudsman,

The Ombudsman comes in for some criticism in this harrowing story concerning Averil Hart, a young anorexic woman who died:

http://www.dailymail.co.uk/health/articl...

Averil's father "criticised the ombudsman for taking three and a half years to produce the report and for relying on the word of clinicians rather than actual medical records.'

The Ombudsman, Mr Behrens, apologised for the delay in producing the report.

1. On what date did you first receive a complaint about the death of Miss Hart?

2. On what date did your investigation into her death begin?

3. On what date did you conclude your investigation into her death?

4. On what date was the complainant notified of the outcome of your investigation?

5. Please send me a copy of any information compiled by PHSO staff to inform Mr Behren's:

a. of the circumstances surrounding the delay; and
b. how he might respond publicly to it.

Specifically, check his email account using the search terms 'Averil Hart' and 'apology' for emails sent to or received from PHSO staff. Please provide me with copies of these emails and any attachments.

6. If PHSO engaged lawyers to deal with the complaint please state:

the date they were first contacted;
the name of the legal practice; and
the total amount paid to them/due in respect of dealing with the case.

Yours faithfully,

D Moore

informationrights@ombudsman.org.uk, Parliamentary and Health Service Ombudsman


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InformationRights, Parliamentary and Health Service Ombudsman

Dear D Moore,

 

Request for information under the Freedom of Information Act 2000

 

Further to your email dated 8^th December, in which you request the
disclosure of information under the provisions of the above Act, we are
now in a position to respond.

 

The Ombudsman comes in for some criticism in this harrowing story
concerning Averil Hart, a young anorexic woman who died:

[1]http://www.dailymail.co.uk/health/articl...

Averil's father "criticised the ombudsman for taking three and a half
years to produce the report and for relying on the word of clinicians
rather than actual medical records.'

The Ombudsman, Mr Behrens, apologised for the delay in producing the
report.

1. On what date did you first receive a complaint about the death of Miss
Hart?

2.  On what date did your investigation into her death begin?

3.  On what date did you conclude your investigation into her death?

4.  On what date was the complainant notified of the outcome of your
investigation?

5.  Please send me a copy of any information compiled by PHSO staff to
inform Mr Behren's:

a.  of the circumstances surrounding the delay; and
b.  how he might respond publicly to it. 

Specifically, check his email account using the search terms 'Averil Hart'
and 'apology'  for emails sent to or received from PHSO staff.  Please
provide me with copies of these emails and any attachments.

6.  If PHSO engaged lawyers to deal with the complaint  please state:

the date they were first contacted;
the name of the legal practice; and
the total amount paid to them/due in respect of dealing with the case.

We refer you to our published report Ignoring the alarms: How NHS eating
disorder services are failing patients:
[2]https://www.ombudsman.org.uk/sites/defau....

 

Any information held by the PHSO beyond what has been published in the
report is exempt from release under Section 44 of the Freedom of
Information Act. Section 44 of the Act states that information does not
have to be disclosed under the Act if another Act of Parliament states
that the information requested cannot be disclosed. Section 15 Health
Service Commissioners Act prevents us from releasing to you the
information that you have requested. Section 11(2) of this Act states that
the Ombudsman’s investigations must be carried out in private. Section
15(1) (a) of the Act provides that information obtained by the
Commissioner or his officers in the course of or for the purposes of an
investigation shall not be disclosed except for the purposes of the
investigation and any report to be made in respect of it.

 

Please see the recent ICO decision notice on our application of section 44
of the Freedom of Information Act
[3]https://ico.org.uk/media/action-weve-tak...
. This recognises our duty to investigate in private which is vital to our
independence as an Ombudsman Service.     

 

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information request, it is open to you to request an internal review.  You
can do this by writing to us by post or by email to
[4][Parliamentary and Health Service Ombudsman request email]. 

 

You will need to specify what the nature of the issue is and we can
consider the matter further. Beyond that, it is open to you to complain to
the Information Commissioner’s Office ([5]www.ico.org.uk).

 

 

Yours sincerely

 

 

Freedom Of Information/Data Protection Team

Parliamentary and Health Service Ombudsman

W: [6]www.ombudsman.org.uk

 

 

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D. Moore left an annotation ()

More information can be found here:

http://www.averilhart.com/

J Roberts left an annotation ()

The PHSO has described its handling of Mr Hart's complaint in the following terms ('Memorandum to the Public Administration and Constitutional Affairs Committee by the Parliamentary and Health Service Ombudsman' – ref. HOS 22 published on 5 May 2020):

“In 2019, we carried out a review of PHSO’s handling of a complaint made by Mr Nic Hart following the tragic death of his daughter Averil. This review was carried out so that we could learn from failings in our investigatory process and account for that learning publicly.

The review found failings ranging from the length of time it took to conclude the case, to failings in the way PHSO communicated with Mr Hart. We have apologised unreservedly for the difficulties and stress these caused Mr Hart and his family at an already distressing time when they were grieving for their loved one.”

It specifies tardiness and communication problems only.

Mr Hart (HOS 33 page 4) has presented detailed evidence to PACAC:

“It was clear right from the start that this PHSO review was not going to be either independent or impartial, being controlled and edited by the Chief Executive.

Although this PHSO review claims to have involved Averil’s family, we did not take part in the process. The PHSO refused to visit us, they refused to pay for any travel to their offices, and they effectively cut us out of the process. This was typical of the unfair way that the PHSO deals with families and patients. (Please do not believe for one moment, page 5 of the PHSO review, section 4.4, this is typical PHSO spin).

To add insult to injury, the PHSO published the report before we were able to see it and did not give us the Egress access code to read the report until some time after publication. We were finally given a copy of the report by a journalist from the British Health Service Journal, who asked for a comment on the PHSO’s investigation into Averil’s death.”

On page 20 he wrote:

“The worst meeting with the PHSO was at the Royal Society of Medicine, where we had suggested a meeting to include Katherine Murphy (then head of the patient’s association). The current Ombudsman agreed to meet Averil’s family there, but then at the last minute, insisted that I pay for the hire of the room myself. The Ombudsman was in a foul mood at the prospect of leaving his Millbank offices. He treated us all with total disdain and contempt throughout the meeting, insisting that the PHSO would publish the final report into Averil’s death, even though as we pointed out, there were still numerous errors in the report. An arrogance which I still find astounding.”

Parliamentary and Health Service Ombudsman Scrutiny:

https://committees.parliament.uk/work/69...

J Roberts left an annotation ()

In a comment left on 'Trustpilot'* dated 4 November 2019, Mr Hart detailed the difficulties he experienced with the PHSO:

https://www.trustpilot.com/review/www.om...

* Trustpilot includes over 100 reviews of the PHSO. 96% of the reviews fall into the 'bad' category.

J Roberts left an annotation ()

At today's PACAC annual PHSO scrutiny hearing Rob Behrens was questioned on the PHSO's handling of this case. He was asked why the investigation was led by a senior PHSO person and not someone independent. Mr Behrens conceded:

'PHSO got this case badly wrong.'

J Roberts left an annotation ()

The Char of PACAC, William Wragg, said that he would be writing to the Ombudsman about certain matters because of limited time (PHSO Scrutiny hearing 18 May 2020). His letter has now been published.

A fair portion of his questions concern the Ombudsman's handling of Mr Hart's complaint e.g. his case being passed to ill-informed caseworkers, caseworkers failing to communicate appropriately, personal information being misused and evidence not being properly weighed. He has also asked for details of the actions proposed by the Ombudsman to remedy failings found by the review.

https://committees.parliament.uk/publica...

J Roberts left an annotation ()

Mr Behren's response to PACAC - further training for casework staff is 'under development':

'10. Mr Hart explained to us that the PHSO failed to assure him that evidence he submitted was given the proper weight. How do the PHSO’s caseworkers seek to assure complainants that their evidence has been given proper weight? (For example, is all evidence the complainant submitted commented on, to actively demonstrate it has been considered?)'

'In decision letters and investigation reports,we set out the evidence we relied on when explaining the decision we have made. On 7 May this year, we published guidance for complainants explaining the approach we take when considering and assessing evidence. Further training for casework staff about how to effectively balance evidence and explain our decisions is also under development as part of our commitment to continuous improvement.'

https://committees.parliament.uk/publica...