Not upheld, no recommendations

Summary

Mrs C complained to the Commissioner for Ethical Standards in Public Life in Scotland (CESPLS) about a member of a public body. CESPLS decided not to investigate, and she complained to us about their handling of her complaint.

CESPLS have broad discretion under the Ethical Standards in Public Life etc. (Scotland) Act 2000 to decide whether, when and how to carry out an investigation.

We found that CESPLS' investigation procedures allowed them to carry out an initial assessment to decide if a complaint was relevant and admissible. In Mrs  C's case, CESPLS decided that her complaint was neither relevant nor admissible. CESPLS' communication with Mrs C explained their intentions and decisions clearly. We considered that CESPLS acted in line with their investigation procedures, and we did not uphold Mrs C's complaint.

Summary

Mrs C complained about the council's policy on kinship care allowances. She and her husband are kinship carers for their granddaughter and previously obtained a residency order. The council pays approved/formal kinship carers the same additional four week holiday allowance that is paid to foster carers. However, they do not pay this to previously approved/informal kinship carers, which is the category that Mrs C falls into. Mrs C feels that a council committee report proves that she should be paid the four week allowance, as it states that approved/informal kinship carers should not be disadvantaged by obtaining a residence order (now known as a kinship care order).

We made a number of enquiries to both the council and the Scottish Government. Although we were not satisfied by the council's initial response, they eventually provided a more robust justification for why they reached their decision within the existing legal framework. The Scottish Government also provided a far clearer explanation of their intentions than was contained in the letter detailing the funding agreement which led to the changes to kinship care allowances. They stated that the funding agreement only applied to regular weekly allowances and was intended to bring allowances for eligible kinship carers in line with foster carers. Therefore, local authorities had discretion to make additional payments as they saw fit. In addition to this, we saw no evidence to support the statement in the council's committee report which stated that kinship carers should not be disadvantaged by obtaining a residence or kinship care order. On this basis, we did not uphold Mrs C's complaint. However, we did provide feedback to the Scottish Government as they are currently carrying out a national review into kinship and foster care payment arrangements.

Summary

Mr and Mrs C's child (child A) was a pupil in a primary school. Child A started to show signs of difficulty with reading and writing, which became more apparent when they moved into the next school year. Mr and Mrs C removed child A from the school as they believed that the school had told them that they could no longer support their child. Mr and Mrs C complained that the school failed to assess their child for dyslexia and to provide the appropriate support.

We found that the school had acted appropriately in line with the council's "Dyslexia Guidelines". The evidence we received showed that the school assessed child A's needs as they progressed through the school years and that support was provided. We found no evidence to corroborate Mr and Mrs C's view that the school stated that they could no longer support child A. We did not uphold the complaint.

Summary

Mrs C complained to the association about problems with insects in her home and the water quality, after it was confirmed by the provider that there were high levels of lead in the water. The association responded to the complaint about insects by instructing specialists, who reported that there was no infestation but carried out preventative treatments. With respect to water quality, the association said that they checked internal pipework and confirmed there was no lead present. They also contacted the water provider and, following a re-test of the water supply, it was confirmed that the levels of lead were now at safe levels. The association considered that there was nothing else they could do on the matter. Mrs C was unhappy with this response and brought her complaint to us.

We found that the association had acted reasonably in instructing proper inspections of her property which confirmed that there was no insect infestation. There was a delay with respect to organising preventative treatments, however, these were not the fault of the association. Therefore, we did not uphold this aspect of Mrs C's complaint.

In relation to the problems with respect to the water quality, the association had taken appropriate steps to liaise with the water provider and had undertaken checks with respect to the pipework which was their responsibility. The association made reasonable enquiries with respect to the cause of the initial high lead readings and acted on the advice of the water provider. We found the actions of the association were reasonable and did not uphold this aspect of Mrs  C's complaint.

Mrs C also complained about how the associaton handled her complaint. We found that there had been a small delay in responding to her complaint, however, the association's reponse provided a detailed account of the actions they were taking to understand and address the complaint. Therefore, we did not uphold this aspect of Mrs C's complaint.

Summary

Ms C has an adult son with autism and she is his main carer and financial welfare guardian. Ms C complained that the partnership did not respond reasonably to a complaint she made about various elements of her son's care and her position as carer and guardian.

We found that the partnership had issued a lengthy stage two complaints response. Whilst we noted that this response was quite strongly worded and that this tone may have been upsetting to Ms C, we found that the content of the response was reasonable. We considered that it adequately answered all of the issues Ms C had raised, including evidence of the efforts that had been made to work with Ms C regarding various elements of her son's care. We did not consider the partnership's position on any of these issues to be unreasonable. We did not uphold Ms C's complaint.

Summary

Ms C received treatment at a dental service run by the partnership and was unhappy that, for one instance of specific dental treatment, the partnership referred her treatment to the Practitioner Services Division (PSD) for approval. Ms C said that if she had been a patient at a high street dentist, she would not have needed the treatment referred.

We took independent advice from a dental adviser. We found that both high street dentists and the partnership's dental service were regulated in exactly the same way, including carrying out treatments in line with the Statement of Dental Remuneration (SDR). The SDR sets out the rules defining the types of filling, denture or other restoration, and what type of material can be used. It also defines the timing of treatment types and the costs of those treatments. Some types of material, or restoration, are not included in the SDR, and so require prior approval from PSD.

The treatment Ms C wanted was not included in the SDR and, therefore, the partnership had to apply to PSD for approval. This was not a policy of the parternship's making, but applies across Scotland. We concluded that the partnership acted reasonably in referring Ms C's treatment to PSD for approval, and we did not uphold her complaint.

Summary

Mr C complained about the way NHS 24 had handled a phone call from him when he reported that he had been experiencing headaches for over three weeks and was told that he was suffering from migraines. Mr C subsequently went on to develop vertebral artery dissection (a tear to the inner lining of an artery in the neck which supplies blood to the brain and can cause a blood clot) three weeks later. Mr C believed that the call to NHS 24 was not managed appropriately and that he was unreasonably only advised to rest and increase his fluid intake.

We took independent advice from a practitioner experienced in out-of-hours services. We found that NHS 24 had treated Mr C's concerns seriously and they had conducted a clinical investigation report. Mr C had contacted NHS 24 during the hours when GP surgeries are open and, during such periods, the remit of NHS 24 is to provide advice and to direct patients to contact their GP. We were satisfied that, in view of Mr C's reported symptoms at that time, there was no requirement for him to attend hospital or arrange an emergency ambulance and that it was appropriate to direct him to his GP surgery. We did not uphold the complaint.

Summary

Mrs C complained that, following a foot operation at the Golden Jubilee National Hospital, she continued to suffer pain and discomfort. During the surgery a bone fractured and had to be fixed by a wire. Mrs C reported continuing problems and was reviewed at both the Golden Jubilee National Hospital and the orthopaedic department of her local hospital, where it was established that she had also suffered a further complication of the surgery where there was a non-union of the bone. Mrs C believed that the original surgery had not been performed properly and that she had not been told of the risks of surgery prior to her operation.

We took independent advice from a consultant orthopaedic surgeon. We found that both the bone fracture during the surgery and the subsequent non-union of the bone were recognised, but rare complications, of the surgery. We found that there was no indication that the original surgery was not performed to a satisfactory standard. The fracture was caused when inserting a screw in order to fix a bone into place and we found that it was appropriate to change the fixation method to wire when the bone fractured. The two complications of the surgery which affected Mrs C were not specifically mentioned in the operation consent form as they were rare; however, it was found that the actual risks mentioned on the form were adequate as they had identified the most common types of complications. We did not uphold the complaints.

Summary

Mr C complained that the practice had failed to provide appropriate care and treatment to his daughter (Miss A). He said that the practice had failed to provide Miss A with an emergency appointment when a phone call was made to them one morning advising them that Miss A was showing symptoms of severe mental health issues, including self-harm and suicidal thoughts. The practice said that they were unable to see Miss A until later in the evening and gave advice that Miss A should attend the local accident and emergency department. Miss A was taken to the hospital and subsequently was transferred to another hospital for patients with mental health issues. Mr C believed that the practice should have made arrangements to see Miss A as an emergency that morning rather than her having to wait a number of hours at the hospital for an assessment. Mr C also complained about a previous consultation Miss A had with a GP at the practice where she was complaining about depression. Mr C said Miss A was not given any medication, but advised to make another appointment and to bring her mother with her and that a discussion would take place then about medication. Mr C felt that, as Miss C was of adult age, she did not require her mother to be there.

We took independent advice from an adviser in general practice medicine and concluded that the practice had provided a reasonable level of care. We found that the practice gave appropriate advice that Miss A should attend the nearest accident and emergency department as this way she was seen quicker than had she waited for the first available practice consultation slot later that day. We also concluded that a reasonable clinical assessment had been carried out at a previous GP consultation where the GP had taken an appropriate history and gave Miss A reasonable advice. Miss A had mentioned to the GP that her mother may not agree with the GP's proposed treatment plan and it was decided that she should make a review appointment after discussing the situation with her mother. The records did not indicate that Miss A's mother had to be present at the review appointment. We did not uphold the complaints.

Summary

Miss C complained that the board unreasonably refused to perform liposuction (a  cosmetic procedure used to remove unwanted body fat) for her lipoedema (a  chronic fat tissue disorder in which fat cells build up, typically on the thighs, buttocks and lower legs, which causes tissue enlargement, swelling and pain. This tissue cannot be lost through weight loss). The board had criteria in place for providing this procedure and Miss C did not meet the criteria. Miss C complained that the criteria were unreasonable.

We took independent advice from a plastic surgeon. We found that it was reasonable for the board to have criteria in place for providing liposuction for lipoedema, and that the criteria was appropriate in order to balance the benefits and potential risks of the procedure. We did not uphold Miss C's complaint.