I know to my cost how shoddy the NHS can be

Our NHS is “suffering from a deficit of accountability and compassion for patients and their families when things go wrong,” says its own ombudsman. I should say so.

The service’s damning report, Broken Trust: Making Patient Safety More Than Just a Promise, goes on to critique a “culture of defensiveness” and a reluctance to learn lessons on the part of NHS managers.

Why am I not surprised? Because I know from painful personal experience that there is an awful lot of shoddy behaviour in today’s NHS. Sometimes it is medical. Sometimes it is just a lack of decency in dealing with patients.

Explaining to one trust that, no, I didn’t have someone available to accompany me to a procedure, the person at the other end of the line snapped: “Well, our other families manage perfectly well.”

We all love the NHS; I owe my life to it, twice over. But we also need to be honest about it.

Like many others with type 1 autoimmune diabetes, I’ve got used to rattling cages and making a fuss just to get the appointments for the regular checks I am supposed to receive as a matter of course. Obtaining a prescription for technology that can radically improve the health of those of us with the condition, meanwhile, involves something more like a bare-knuckle brawl with bureaucracy, even when the drugs are approved and recommended by the National Institute for Health and Care Excellence.

I have lodged complaints to two trusts about the way I have been treated. I have advised others with similar problems to do the same, too. Excuses are simply intolerable when your health is at stake.

One complaint was resolved rather well; the hospital paid attention. I was able to speak to someone and I felt I had been listened to.

However, what if the NHS fails to respond to your initial complaint? Then you may have a problem because the ombudsman service has become so swamped with criticisms that it will only take on the most serious ones.

It grades complaints using a six-tier ‘severity of injustice scale’ in which only cases at level three or higher are taken further. To reach level three, you must suffer something that would have “a moderate impact” in terms of “distress, worry or inconvenience” over a “significant period of time” ... or a “significant” impact but only “for a short period of time.”

If upheld, level three cases attract a potential remedy of between £500 and £999. The most serious level six cases, causing “profound, devastating or irreversible impacts on the person affected,” attract remedies of £10,000 or more.

However, money is not usually the first thing on the minds of patients who contact the ombudsman. It certainly isn’t in my case. I’d just like to be sure I can rely on getting the treatment I need to keep me alive.

On my second complaint, involving my type 1 autoimmune diabetes, the hospital concerned has maintained a delphic silence. Does it qualify as level three yet? I have no idea. If you have an incurable, long-term medical condition and your local hospital goes silent on you, it is profoundly disturbing – the impact is more than just moderate.

The ombudsman is right to prioritise the more serious cases. Sensibly, it is also trying to reduce case waiting times of many months. But its policy leaves hanging a swathe of lesser cases involving normal people with limited means to fight who have often been treated very badly.

Care made free at the point of need is a wonderful thing. One only needs to look across the Atlantic to recognise the value of what Britain has in its NHS.

However, it doesn’t always work as it should, and if a hospital is brushing patients aside, or failing to respond when issues are raised, where does a patient go?

A lawyer? Not a good option. They’re only really for serious medical negligence; for those category sixes or worse.

A local MP maybe? That might work if you’ve got a good one but they aren’t all good. Just ask Nadine Dorries’ constituents.

The ombudsman says it will still try and resolve simple complaints; there is always the prospect of it intervening to tweak the nose of a hospital, clinic, or GP practice. This can sometimes yield results when things have gone wrong. But its lack of resources ties its hands.

Still, it is interesting to compare this situation to that of the Financial Ombudsman Service (FOS), which oversees complaints about banks, insurers, fund managers, brokers and financial advisers. It is funded privately: regulated companies pay a flat fee when complaints reach its doors, which encourages them to resolve issues properly in the first place.

When it emerged that banks had been furiously mis-selling grotesquely over-priced and frequently worthless payment protection insurance, the FOS geared up to tackle thousands of complaints. A process was put in place. Resources were demanded from the banks. Customers were largely put right even if the amount of compensation was moderate.

The NHS Ombudsman must have the resources to do its job, not least because truly terrible “level six” cases often have their genesis in everyday slack practice or bad behaviour. This is why the NHS needs the ombudsman to take on lower-level complaints. Public confidence in the NHS would be boosted along the way. And isn’t that what we all want to see?