The posts of Parliamentary and Health Service Ombudsman are attached to the Westminster Parliament, with additional posts at the Scottish Parliament, the Welsh Assembly and other government institutions.
The creation of the post of the Parliamentary Ombudsman was spurred on by the 1954 Crichel Down affair and by the activism of pressure groups, including the Society for Individual Freedom. The position was created, and his or her powers are documented in, the Parliamentary Commissioner Act 1967, the most notable section of which is section 4 and Schedule 2, which constrain the powers of the incumbent ombudsman. Amongst other things, the ombudsman cannot investigate crime, national security, foreign affairs, the armed forces and other civil services. The position of HSC was created later, under the Health Service Commissioners Act 1993. The office of the Parliamentary and Health Service Ombudsman emphasises that it looks into complaints "that government departments, their agencies and some other public bodies in the UK – and the NHS in England – have not acted properly or fairly or have provided a poor service." The first UK Ombudsman was Sir Edmund Compton who had previously been the Comptroller and Auditor General. He was succeeded by Sir Alan Marre, a career civil servant. He was the first Ombudsman appointed for the National Health Service and combined that role with that of the Parliamentary Ombudsman as have all his successors. He later became chairman of Age Concern and the post is currently held by Ann Abraham (since 2002). She is a former director of the National Association of Citizens Advice Bureaux.
Those seeking the assistance of the PCA generally find the process to be difficult. Firstly, all complaints have to go through a Member of Parliament (MP); this is known as the 'MP filter', which checks the legitimacy of complaints. In many cases, an MP attempts to solve the problem themselves, though the effectiveness of this can be called into question. Secondly, the Ombudsman rejects nearly 50% of his received applications (once that have passed through the filter) at first instance. Finally, the ombudsman will not investigate complaints where recourse to an alternate remedy (tribunal, internal complaints etc) exists. This can be extremely offputting for complainants, most of whom do not want to get involved in this process. If a complainant can plough through all this, complaint resolution normally takes about 40 weeks.
Putting a complaint to the HSC is simpler in that no MP filter is operated. However, it is generally expected that complaints have been first put to the NHS body complained about. Following that is the "independent review" stage of the complaints process. This formerly took the form of a three-person independent panel usually convened by a non-executive NHS Trust director. The responsibility for this stage of the procedure was taken over in 2004 by the Healthcare Commission. The HSC is the third and final (non-judicial) port of call for complainants.
The Ombudsman's powers are completely non-binding upon any authority. He or she may publish a report, but that is all the coercion he can assert, relying instead upon credibility. Usually, this does exert sufficient moral influence to make an authority change its decision. The Ombudsman does not exist to complain about the merits of a decision. For example, in 1996 those suffering 'planning blight' on their houses due to the creation of the Channel Tunnel were eventually awarded compensation without admission of fault or liability.
Finally, the Ombudsman's decision may be challenged by judicial review under normal public law grounds. This happens rarely, but does occur. For example, in R v PCA, Ex Parte Dyer , a complaint was investigated and a report issued. The complainant to the Ombudsman was not satisfied with the report or the process leading to it and challenged the Ombudsman's actions. The Ombudsman viewed the matter as concluded. The complainant commenced a judicial review action. The judge confirmed that the Ombudsman was amenable to judicial review but the court would not readily interfere with the Ombudsman's exercise of his discretion as the intended width of his powers was clear from the Parliamentary Commissioner Act 1967. The Rules of Natural Justice did not require that the applicant should see his report before he had sent a copy to the Department complained of. The discretion conferred on him by the Act did not include the power to reopen an investigation. It should be noted that the Ombudsman's processes have changed under the tenure of Ann Abraham and reports are to be shared with both the complainant and the public body prior to the conclusion of the matter.