Some upheld, recommendations

Summary
Mrs C had root canal treatment from her dentist. She complained that the dentist did not tell her that there was a risk that, if the root canal treatment failed, Mrs C could lose the tooth and ultimately need a crown. Mrs C did lose her tooth and felt that the treatment was unnecessary and that the tooth could have been saved had another form of treatment been given. She also complained that other possible treatment options were not discussed with her and the response to her complaint was unreasonably delayed and contained inaccurate information.

Dentists have a duty to explain any commonly encountered or serious risks and any risks of particular concern to the patient. We found that there was no evidence to show that the dentist had done so in Mrs C's case. Nor was it clear whether the dentist discussed other treatment options (in this case, extraction of the tooth) with Mrs C. We upheld this complaint.

We did not uphold the complaint that root canal treatment was inappropriate. Although the results of such treatment can be uncertain, our dental adviser said that it was the only long term treatment with any possibility of success for the symptoms Mrs C was experiencing.

Finally, we upheld the complaint about the dentist's complaints handling. We found that ten weeks was an unreasonable length of time for Mrs C to wait for a response to her complaint, that she had not been proactively updated on its progress by the dentist and that the letter contained inaccuracies.

Recommendations
We recommended that the practice:
• apologise for unreasonably failing to explain the risks associated with root canal treatment or to discuss other options available with her;
• apologise for the unreasonable time it took to respond to her complaint; and
• ensure complainants are updated on the progress of their complaint in a timely manner and advised of the date by which they can expect a response.

Summary
Mr C told us he had a history of chest tightness, chest pain and severe heartburn. He said he twice raised concerns about these symptoms with his GP. Shortly afterwards, while working overseas, Mr C suffered a heart attack and had a coronary artery bypass graft (a surgical procedure to improve blood supply). When he came back to the UK, he asked his GP to refer him to a cardiologist (heart specialist) for review. His GP felt that this was unnecessary as Mr C had already received the best treatment for his condition and appeared to be recovering well. As Mr C needed a fitness to work certificate, he was ultimately referred to a cardiologist, but this was done privately.

Mr C complained that the practice failed to appropriately assess the symptoms that he had reported before he had the heart attack. He also complained that it was unreasonable of them not to refer him to a cardiologist after he returned to the UK.

We found no evidence in Mr C's clinical records that he had told the practice about his chest tightness and heartburn. Whilst recognising that he may have provided this information without it being recorded, we were unable to say conclusively that the records were deficient or that the practice failed to act on information that Mr C provided about these symptoms. We did not uphold this complaint.

We did, however, uphold his complaint about referral. Mr C was ultimately referred to a cardiologist and we did not find it unreasonable that this was done privately, given his desire to return to work. However, we found that it would have been good practice for a referral to have been made when he returned to the UK, as a cardiologist was able to perform specific tests that would highlight the extent of residual damage to the heart. The cardiologist ultimately found that Mr C had a blood clot which necessitated a change in treatment plan. We felt that this highlighted the benefit of referral to cardiology but also considered that there was a strong argument for referral in the circumstances of Mr C's case, particularly as his surgery was performed overseas where practices may be different.

Recommendations
We recommended that the practice:
• apologise for their failure to refer him to cardiology; and
• share our adviser's comments with their GPs with a view to identifying any points of learning that can be taken from this case.

Summary
Mrs C visited a hospital accident and emergency department, where she was diagnosed as having suffered an allergic reaction. Medical staff advised her to visit her GP the next day. When she did so, she was dissatisfied with the care and treatment she received and the attitude displayed towards her.

She made a number of complaints about the GP, including that he questioned the diagnosis she had received (because the doctor who had seen her was a junior doctor); refused to look at the rash on her neck or to prescribe the anti-histamines that she said she had been advised to ask for; pulled her prescription away when she tried to take it from him and laughed at her, and referred to headaches she had been suffering as ‘supposed headaches.’

The GP whom Mrs C had complained about responded to her. He apologised that she had been caused upset and distress by the consultation. He explained that he had referred to ‘the headaches the neurologist is calling chronic migraine’. He also said that he understood Mrs C had been given advice by a junior doctor, but that he was not bound to agree with that advice. He apologised if his communication of this had caused upset. Mrs C was not satisfied with this response and raised her complaints with us.

The accounts of what happened at the consultation differ considerably and there were no independent witnesses to what happened. We found no evidence that could help us reach a conclusion on Mrs C's complaint about the care and treatment she had received, so we did not uphold that complaint. We did, however, uphold her complaint about the response she received from the practice, as we found evidence that they had considered matters that Mrs C had complained about but had not addressed these in their response to her.

Recommendations
We recommended that the practice:
• apologise to Mrs C that they did not reasonably respond to all the issues she raised in her complaint to them; and
• take steps to ensure that all issues raised in complaints are reasonably addressed in their written responses to complaints.

Summary
Mr C complained about the procedures adopted by Scottish Enterprise to investigate his complaints about what happened when, some time ago, a Scottish Enterprise regional office was involved with Mr C and his companies in an advisory capacity. He made serious allegations of conflict of interest against former employees of the regional office. Because of the nature of the allegations, a senior officer was appointed to investigate. The officer met with Mr C at the start of the investigation.

Over a year later, Mr C was provided with a copy of the investigator's report. Mr C complained that the written statement to the investigating officer was not reasonably considered during the investigation, that the final report did not acknowledge his views, and that the time taken to investigate and to provide a final response was unreasonable. We did not uphold Mr C's first complaint as we found no evidence that his statement was not reasonably considered. We upheld the other complaints, however, as we found that Mr C was not given the opportunity to comment on issues of fact before the end of the investigation, and that the length of time taken was unreasonable.

Recommendation
We recommended that Scottish Enterprise:
• seek to agree with Mr C a set of points he believes to be outstanding and to answer those points within a timescale of three months

Summary
Mr C complained that Business Stream had failed to install a temporary water connection that he had applied for on a building site. He had to obtain water for the development from another site. Business Stream have to refer applications for connections for building water to Scottish Water for the connection to be made. However, in this case Business Stream were the licensed provider and were responsible for handling the application.

We upheld part of Mr C's complaint. Although it was Scottish Water who failed to install the temporary connection, we found that that Business Stream had failed to adequately monitor Mr C's application or keep him updated. There was clearly a communication failure between Business Stream and Scottish Water. Business Stream were not aware that the connection had not been installed until Mr C contacted them about this several months later.

Mr C also complained that Business Stream failed to respond appropriately to his request for a refund. If we decide that someone has suffered because of something an organisation has done wrong, we will ask that organisation to put the person in the position they would have been in had they been dealt with correctly in the first place. However, we would only do so where there is demonstrable loss or costs. Although Business Stream had not refunded all of the money that Mr C had paid, we were satisfied that they had taken steps to put him back in the position he would have been in had the failing not occurred. We considered that their response to Mr C's request for a refund had been reasonable.

Recommendation
We recommended that Business Stream:
• ensure that there is now an adequate process in place for monitoring the new connection applications that they are responsible for handling.

Summary
Mr C was cycling on a designated cycle-path in a public park when a dog ran into him. As a result, Mr C was thrown from his bicycle. Five months later, he reported the accident and asked the council to serve a warning notice on the owner of the dog. Some seven months after that, the council responded advising that their management rules for parks did not allow for notices to be served on dog owners.

Mr C was dissatisfied with the council's response and the time they took to provide it and raised his complaints with us. On investigating, we decided that the council's position regarding the enforcement of management rules was reasonable but that they had taken an unreasonable time to respond to his enquiries. As the council had already apologised for the delay itself, however, we recommended only that they apologise further to Mr C.

Recommendation
We recommended that the council:
• apologise to Mr C for not providing him with an explanation for their delay in responding to his contact or outlining the steps they had taken to ensure the delay would not be repeated.

Summary
Mr C complained about the council's handling of two planning applications for the construction of a new house on a plot of land neighbouring his home.

Planning permission was initially granted for the build, despite the council's failure to notify neighbours of the development as required by planning regulations. Although the developer had the council's permission to build the new house, this was vulnerable to legal challenge due to this failure to notify neighbours.

To remedy this, the developer submitted a new planning application so that neighbour notification could be carried out. Planning permission was subsequently approved again.

Mr C felt that the original planning permission should have been revoked while the second application was being considered. He believed that the failure to do this meant that any objections submitted would be dismissed in favour of confirming the existing planning permission. Mr C submitted objections based on the impact the new development would have on his own property's privacy. He did not feel that his objections were taken into account when planning permission was granted for a second time.

We upheld Mr C's complaint that the council granted planning permission without neighbour notification. However, we did not find it necessary for the original planning permission to be revoked while the resubmitted planning application was being considered. The planning officer's report showed that due consideration was given to Mr C's objections with reference to local planning policy and we were, therefore, generally satisfied that the second planning application had been properly processed.

Mr C was told by the planning committee's vice convenor that he would be invited to attend a pre-determination hearing. This did not happen and he was subsequently told that planning permission had been granted without his attendance at such a meeting. On looking at this issue, we found that it was beyond the vice convenor's powers to make this promise to Mr C. However, there was no obligation on the council to hold a pre-determination hearing for this planning application or to invite Mr C to it. We recommended that the council remind elected members of the process for notification of and invitation to pre-determination hearings.

Mr C raised further concerns about the council's handling of his formal complaint. We found that the complaint was properly investigated but that there were delays to the council's responses.

Recommendation
We recommended that the council:
• remind elected members of the process for notification of and invitation to pre-determination hearings.
 

Summary
Since 2007 Mr C has run a concrete business from a yard owned by his brother. In 2006 his brother objected to a planning application for four houses on a site adjoining the yard. The application was refused but was granted conditional consent on appeal and the housing development was begun. In 2008 Mr C placed a cement silo in the yard. The occupant of the house nearest to the yard told the council about this. The council inspected the site and asked Mr C to apply for planning consent, which he did. However, it was refused. The council then served an enforcement notice on Mr C telling him to remove the silo, but neglected to serve the notice on Mr C's brother.

Mr C appealed against the refusal of planning consent and the enforcement notice, but his appeals were dismissed. Mr C then instructed a planning consultant, who pointed out that the enforcement notice had not been served on Mr C's brother, and was successful in having the decision notice quashed in the Court of Session. A possibility remained that the council could re-serve the enforcement notice. However, after eighteen months of correspondence with Mr C's consultant on whether planning consent for the silo was actually needed, the council said that they did not consider that pursuit of enforcement action was in the public interest.

Mr C complained that the council handled the planning application for the houses inadequately and that it was inappropriate for them to have taken enforcement action. We did not uphold the complaint in respect of the residential application. We did, however, uphold the second complaint. While we did not find it inappropriate for the council to exercise their discretion, firstly to take enforcement action and then, more than two years later, to decide not to, we found that the processing of the application was flawed as the council did not follow a robust and correct process.

Recommendations
We recommended that the council:
• apologise to Mr C for the failure to ensure that the enforcement notice was properly served; and
• expedite any claim that Mr C decides to submit in the light of this decision.

Summary
The council carried out a survey of a sample of tower block residents about the service provided on estates. It asked for views on services, security and amenity issues.
About a couple of years later, they told residents that they had decided to make changes to improve service and security. This included removing existing residential caretakers and installing a CCTV (camera) monitoring system linked to a control room.

Mrs C and Mrs B complained on behalf of a number of tower block residents, who had signed a petition against the change. They complained that the council failed to consult with all residents before making changes to residential caretaking services and that residents were denied an opportunity to take part in the survey on which the decision was made. Mrs C and Mrs B said that the council had not addressed their complaint fully and properly and that there was a delay in responding. They wanted the council to undertake a further survey with all residents.

We upheld two of the complaints. We found that the council had failed to respond fully to Mrs C and Mrs B's request for details of the criteria used for the survey and the breakdown of the results. There was also a delay in responding to the complaint. We did not, however, uphold complaints that the survey was not properly carried out; that the majority agreement of residents should have been obtained; or that the council failed to address the residents' request for information about the survey and the cost involved, and for a review of the decision.

When we told the chief executive of the council of the decision, we also pointed out that the council had failed to provide us with all the information we asked for; and we sought assurances that there would not be a recurrence of this in future.

Recommendations
We recommended that the council:
• write to Mrs C and Mrs B with a full response to the outstanding issues from their letter of complaint and offer them an apology for their failure to do so when responding to their complaint; and
• review the handling of this complaint to ensure that the council's complaints procedure is being effectively managed.

Summary
Mr C complained that the council did not act in response to his concerns about dog faeces in his neighbour's garden and flooding caused by concrete slabs that his neighbour had laid in both front and rear gardens. There was no natural drainage and when it rained, water ran off the slabs, flooding Mr C's garden. As his neighbour did not clean up their dogs' faeces, this caused a foul smell and when it rained the faeces were also washed into Mr C's garden. Mr C also said that piles of rubble were pushed up against his fence from his neighbour's side.

We upheld part of Mr C's complaint. We found that the council investigated the issues he had raised and confirmed that there was a problem with the slabs and dog faeces. As the next-door property was scheduled to be extended, plans were put in place to re-lay the slabs and introduce drainage while the tenants were decanted. Although this caused some delay to the matter being addressed, and the nature of the work to be carried out changed periodically, we felt that this was a reasonable solution to the flooding problem. However, the council failed to clarify whether they had taken steps to remove the rubble. We recommended that they ensure that this issue had been addressed.

The council's neighbourhoods team leader had also advised staff to monitor the situation weekly. If any faeces were witnessed, the council would clear this and charge the tenants for the work. We found that weekly monitoring took place, but that when faeces were found staff simply asked the tenant to clean these up. The council did not take the specific action proposed by the neighbourhoods team leader, which may have resulted in prolonged monitoring and the situation being allowed to become drawn out. We also found that there was initially a significant delay in action being taken to address the issue of dog faeces.

Recommendations
We recommended that the council:
• apologise for the delay in dealing with the dog faeces issue;
• consider reviewing their approach to monitoring and acting upon complaints of dog fouling at their properties; and
• ensure that the issue of the chips and rubble reputedly piled against Mr C’s fence has been addressed.