(1)On a complaint duly made to [F2the Commissioner] by or on behalf of a person that he has sustained injustice or hardship in consequence of—
(a)a failure in a service provided by a health service body,
(b)a failure of such a body to provide a service which it was a function of the body to provide, or
(c)maladministration connected with any other action taken by or on behalf of such a body,
the Commissioner may, subject to the provisions of this Act, investigate the alleged failure or other action.
F3(1YA). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
[F4(1ZA)Any failure or maladministration mentioned in subsection (1) may arise from action of—
(a)the health service body,
(b)a person employed by that body,
(c)a person acting on behalf of that body, or
(d)a person to whom that body has delegated any functions.]
[F5(1A)Where a family health service provider has undertaken to provide any family health services and a complaint is duly made to [F6the Commissioner] by or on behalf of a person that he has sustained injustice or hardship in consequence of—
(a)action taken by the family health service provider in connection with the services,
(b)action taken in connection with the services by a person employed by the family health service provider in respect of the services,
(c)action taken in connection with the services by a person acting on behalf of the family health service provider in respect of the services, or
(d)action taken in connection with the services by a person to whom the family health service provider has delegated any functions in respect of the services,
the Commissioner may, subject to the provisions of this Act, investigate the alleged action.
F7(1B). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(1C)Where an independent provider has made an arrangement with a health service body or a family health service provider to provide a service (of whatever kind) [F8, or has undertaken to provide direct payment services,] and a complaint is duly made to [F9the Commissioner] by or on behalf of a person that he has sustained injustice or hardship in consequence of—
(a)a failure in the service provided by the independent provider,
(b)a failure of the independent provider to provide the service, or
(c)maladministration connected with any other action taken in relation to the service,
the Commissioner may, subject to the provisions of this Act, investigate the alleged failure or other action.
(1D)Any failure or maladministration mentioned in subsection (1C) may arise from action of—
(a)the independent provider,
(b)a person employed by the provider,
(c)a person acting on behalf of the provider, or
(d)a person to whom the provider has delegated any functions.]
[F10(1E)Where a complaint is duly made to [F11the Commissioner] by or on behalf of a person that the person has sustained injustice or hardship in consequence of maladministration by any person or body in the exercise of any function under section 113 of the Health and Social Care (Community Health and Standards) Act 2003 (complaints about health care), the Commissioner may, subject to the provisions of this Act, investigate the alleged maladministration.]
(2)In determining whether to initiate, continue or discontinue an investigation under this Act, [F12the Commissioner ] shall act in accordance with his own discretion.
(3)Any question whether a complaint is duly made to [F13the Commissioner] shall be determined by him.
(4)Nothing in this Act authorises or requires [F14the Commissioner] to question the merits of a decision taken without maladministration by a health service body in the exercise of a discretion vested in that body.
[F15(5)Nothing in this Act authorises or requires [F16the Commissioner] to question the merits of a decision taken without maladministration by—
(a)a family health service provider,
(b)a person employed by a family health service provider,
(c)a person acting on behalf of a family health service provider, or
(d)a person to whom a family health service provider has delegated any functions.
(6)Nothing in this Act authorises or requires [F17the Commissioner] to question the merits of a decision taken without maladministration by—
(a)an independent provider,
(b)a person employed by an independent provider,
(c)a person acting on behalf of an independent provider, or
(d)a person to whom an independent provider has delegated any functions.]
[F18(7)Subsections (4) to (6) do not apply to the merits of a decision to the extent that it was taken in consequence of the exercise of clinical judgment.]
Textual Amendments
F1Word in s. 3 heading substituted (1.4.2006) by Public Services Ombudsman (Wales) Act 2005 (c. 10), s. 40, Sch. 6 para. 34 (with s. 38); S.I. 2005/2800, art. 5(1)(3)
F2Words in s. 3(1) substituted (1.4.2006) by Public Services Ombudsman (Wales) Act 2005 (c. 10), s. 40, Sch. 6 para. 35(2) (with s. 38); S.I. 2005/2800, art. 5(1)(3)
F3S. 3(1YA) repealed (1.4.2006) by Public Services Ombudsman (Wales) Act 2005 (c. 10), s. 40, Sch. 6 para. 35(3), Sch. 7 (with s. 38); S.I. 2005/2800, art. 5(1)(3)
F4S. 3(1ZA) inserted (1.4.1998 with effect as mentioned in art. 3(3) of S.I. 1998/631) by 1997 c. 46, s. 41(10), Sch. 2 Pt. I para. 68(5); S.I. 1998/631, art. 2(1)(b), Sch. 2
F5S. 3(1A)-(1D) inserted (1.4.1996 with effect as mentioned in art. 2(2) of S.I. 1996/970) by 1996 c. 5, s. 2(2); S.I. 1996/970, art. 2(1)(2)
F6Words in s. 3(1A) substituted (1.4.2006) by Public Services Ombudsman (Wales) Act 2005 (c. 10), s. 40, Sch. 6 para. 35(2) (with s. 38); S.I. 2005/2800, art. 5(1)(3)
F7S. 3(1B) repealed (1.10.1999 for E. and S. and 1.4.2000 for W.) by 1999 c. 8, s. 65, Sch. 4 para. 85(3), Sch. 5; S.I. 1999/2540, art. 2, Sch. 1; S.I. 1999/90, art. 2(b), Sch. 2; S.I. 2000/1041, art. 2(d), Sch.
F8Words in s. 3(1C) inserted (19.1.2010) by Health Act 2009 (c. 21), ss. 12(4), 40(1); S.I. 2010/30, art. 2(b)
F9Words in s. 3(1C) substituted (1.4.2006) by Public Services Ombudsman (Wales) Act 2005 (c. 10), s. 40, Sch. 6 para. 35(2) (with s. 38); S.I. 2005/2800, art. 5(1)(3)
F10S. 3(1E) inserted (1.6.2004) by Health and Social Care (Community Health and Standards) Act 2003 (c. 43), ss. 118, 199(1)(4); S.I. 2004/759, art. 8
F11Words in s. 3(1E) substituted (1.4.2006) by Public Services Ombudsman (Wales) Act 2005 (c. 10), s. 40, Sch. 6 para. 35(2) (with s. 38); S.I. 2005/2800, art. 5(1)(3)
F12Words in s. 3(2) substituted (1.4.2006) by Public Services Ombudsman (Wales) Act 2005 (c. 10), s. 40, Sch. 6 para. 35(2) (with s. 38); S.I. 2005/2800, art. 5(1)(3)
F13Words in s. 3(3) substituted (1.4.2006) by Public Services Ombudsman (Wales) Act 2005 (c. 10), s. 40, Sch. 6 para. 35(2) (with s. 38); S.I. 2005/2800, art. 5(1)(3)
F14Words in s. 3(4) substituted (1.4.2006) by Public Services Ombudsman (Wales) Act 2005 (c. 10), s. 40, Sch. 6 para. 35(2) (with s. 38); S.I. 2005/2800, art. 5(1)(3)
F15S. 3(5)(6) inserted (1.4.1996) by 1996 c. 5, s. 2(3); S.I. 1996/970, art. 2(1)
F16Words in s. 3(5) substituted (1.4.2006) by Public Services Ombudsman (Wales) Act 2005 (c. 10), s. 40, Sch. 6 para. 35(2) (with s. 38); S.I. 2005/2800, art. 5(1)(3)
F17Words in s. 3(6) substituted (1.4.2006) by Public Services Ombudsman (Wales) Act 2005 (c. 10), s. 40, Sch. 6 para. 35(2) (with s. 38); S.I. 2005/2800, art. 5(1)(3)
F18S. 3(7) inserted (1.4.1996) by 1996 c. 5, s. 6(2); S.I. 1996/970, art. 2(1)