Unfortunately, not the first line of a joke, rather the day to day reality for many of those who have experienced poor health care. The recent Clwyd-Hart report into NHS hospital complaints found the complaints and feedback system is bewildering and slow, and in many cases it is also downright unhelpful and often unresponsive. As one consumer put it they simply 'deny and defend', they certainly fail to listen to those who often have the best sense of what is wrong - patients and users and their carers.
Ann Clwyd, the Labour MP who co-authored the report, speaks powerfully and emotionally about her husband's experiences, but she is not alone. The failings of the complaints system have been brought to our attention because of the unnecessary suffering of thousands of people and their families over "a decade of failure".
Healthwatch England research shows that over the last three years, more than half of those of us who felt we had cause to complain about health and social care, didn't do so. People have told us they thought there was no point because nobody would listen or because nothing would be done to change things. Perhaps even more worryingly, some people told us they felt unable to speak up; they feared that their future care and treatment (or that of their loved one) would be affected as a result. In other words consumers lack trust and confidence in the health and social care system.
We cannot ignore the need for change.
As the Chair of the new consumer champion for patients and care users, I commend Ann for the strength and courage it clearly took to stand up and be counted. The Francis and Keogh reports, published earlier in 2013 clearly outlined some the systemic problems across health and social care, including those around complaints and feedback. But Clwyd-Hart gives those who have not been listened to, a voice and puts forward some solutions for the future.
The report calls for the NHS to take a more 'consumer focused' approach to complaints. At Healthwatch England we welcome this as a big step toward much needed culture change. In other sectors, complaints are seen as gold dust - a critical source of intelligence about how to improve goods and services. The same should be true for health and social care; complaints are not problems, they provide feedback that doctors, nurses, consultants and managers should welcome as a way to improve the way our hospitals treat and care for people.
From the public's point of view a key report recommendation, is the need to simplify the system by ensuring there is 'no wrong door'. In practice this would mean the end of patients and concerned relatives being passed from pillar to post, because they didn't email the right address or they rang the wrong department.
After all most of us don't know, and frankly shouldn't have to know, who runs, funds or regulates the health and social care service we need. If we have a complaint, we just want the system to deal with it quickly and efficiently and ensure that it doesn't happen again. That is, after all, what most of us want - that others don't have the same experience.
The brief for Clwyd-Hart was hospital complaints, but this is not a wide enough brief for action. More and more of us have needs which span hospitals, GPs and primary care, community and social care services. To truly simplify the system, the new approach urgently needs to be applied across all health and social care services.
The report also says we need a simpler and more straightforward 'advocacy' service; a place for consumers, their friends and family to turn to for help with their complaint. Clwyd-Hart has suggested a central role for the 152 local Healthwatch in making these improvements. It calls for Healthwatch to work more closely, possibly even merge with, the existing NHS Complaints Advocacy Services to create an easily recognisable, independent support service. As well as helping individual consumers, this would give Healthwatch some of the information they need to call for improvements in our hospitals, care homes and GP surgeries. It would also allow Healthwatch to use complaints data to identify wider trends which need action.
The trouble with all of this is that it is easier to say than deliver. Back in 2004 for example, following the Shipman review, there were widespread calls for a streamlined and simplified complaints system. We clearly don't have it yet. That is why Clwyd-Hart is right to focus attention on how the pressure will be maintained to bring about change. Ultimately, they say they will be back in a year to see whether progress can really be seen.
I believe that Healthwatch England has a critical role to play in making the difference this time. Working with our network of local Healthwatch, we will campaign at both a national and local level and use our position as the voice of consumers of health and social care to drive these changes forward, hold the system to account for the promises it has made and spread the work from hospitals across all of health and social care.