SPSO investigators may need to be informed on the issue of querulous behaviour shown by some complainants. However Accountability Scotland believes that the article Querulous Complainants (2017) by Dr. Gordon Skilling will do more harm than good. We explain below, but first comment on a paper published in 2013 in an academic journal by Skilling and associates. This establishes how very muddled their thinking can be on this issue. This raises doubts both about the later article. A notable feature of Skilling et al. (2013) is serious terminological confusion. In another context, one of us has written of the serious effects on psychological research of confused word usage (e.g. RF Burton and JW Hinton, entitled: Up the Tower of Psychobabel: Does lexical anarchy impede research into 'psychological stress'?, 2010). It is published at: https://www.medical-hypotheses.com/article/S0306-9877(09)00722-1/fulltext(09)00722-1/fulltext

Here are our comments on the earlier paper:

Early warning signs of persistent complainants

Gordon Skilling, Marianne Øfstegaard, Sara Brodie, Lindsay Thomson

British Journal of Healthcare Management 2013, Vol 19, No 5: pages 233-241.

This paper is extraordinarily confused and inconsistent in regard to the words ‘persistent’ and ‘querulous’. These do not mean the same thing in ordinary speech. Some complaints handlers outside of the police seem to be similarly confused, so it is worthwhile analysing this aspect of the paper in detail. Moreover, with careful reading some useful ideas are to be found.

The title indicates that this paper is about persistent complainants. Yet it is stated that an aim of the project “is to devise a set of early warning signs to allow for the identification of complainants likely to become querulous”. Some previous authors, as well as complaints handlers, have used ‘querulous’ and ‘persistent’ almost interchangeably despite their very different meanings.  Appropriately, the project of Skilling et al. made use of three distinct categories of complainant – querulous, persistent and ‘control’, the latter being random individuals neither querulous nor persistent. Moreover, much of the paper is about querulous complainants. There is no acknowledgement that a complainant might be in both of the first two categories, although it is obviously possible.

The paper has sections on the early and late signs of querulence. No evidence is presented in text or table on the early recognition of persistence, as promised in the title. That is unsurprising, as time is obviously needed for persistence to become manifest. Whether ’querulous’ complainants, generally identifiable at the outset, are likely to be persistent is not discussed.

      Actually there is one thing that predisposes to persistence - and that is bad complaint handling. Persistence may culminate in a complaint to the SPSO and the SPSO often confirms the persistence to have been appropriate.

The paper would make better sense if the second category were ‘persistent but not querulous’ and if the title were changed.

      Another deficiency in the paper is that there is no mention of whether complaints were upheld and, if so, whether this was a result of (justified) persistence.

Regarding the identification of querulousness, “In the absence of agreed operationalised or research criteria defining querulousness we relied upon the subjective judgement of experienced complaints handlers to select those cases they deemed the most complex, challenging and time consuming …. the individuals identified were a comprehensive list agreed upon by multiple complaints handlers.” Thus there does seem to be a real category of querulous complainants, and the paper does contribute to the established list of querulousness symptoms.

      Whether querulence (querulousness) pre-exists as a tendency in some individuals, or is brought on by the process of complaining, is discussed (with literature references), but the project was not designed to investigate this. However, it was recommended that “the focus of new work should …. involve devising a valid tool for the early identification of those at risk of becoming querulous.” (This seems to acknowledge that the complaints process can make some people querulous.)

      A major concern of Accountability Scotland is the suffering of complainants, whether due to the supposed initial injustices they complain of, to ultimate failures of justice, or to the frustrations of dealing with complaints handlers. In this paper Skilling et al. give little emphasis to this, but here are relevant quotations with our comments italicized in square brackets:

 “These complainants experience significant adversity as a result of their persistent engagement in the complaints process (Lester et al, 2004)”

[This is true, but incomplete; adversity is a spur to persistence.]

 “In more than half of the querulous cases, the complainants described suffering adverse financial, social, occupational, relationship or health consequences. Though it was not possible to conclude that these adverse consequences were a direct result of the complainants’ excessive engagement with the complaints process, it was clear that the complainants themselves attributed many of their various losses or harms suffered to the complaints process. [This is true of some non-querulous complainants too.] This finding is of crucial importance when making the case for improving the experience and the outcomes for both complainants and complaints handlers.”

Comments on the article Querulous Complainants

The article is an overview written in December, 2017, “for the SPSO by Dr Gordon Skilling who is a psychiatric specialist adviser to SPSO with a research interest in this area. It was produced in support of the report Making Complaints Work for Everyone.”

There is one issue that is completely ignored and makes the whole article dangerously misleading. There is much emphasis on the difficulties and frustrations of complaint agencies/handlers in dealing with querulous or persistent complainants, but there is no acknowledgment of the undoubted generality that some complaints are justified, whether or not they are judged as querulous; complainants may well be right (Hillsborough!). Indeed the Netherlands ombudsman starts by applying to all complainants a ‘presumption of honesty rule’.

Also ignored by Skilling is the fact, well-known to the public and to SPSO investigators, that many wrongdoers (or those in charge of them) defend themselves with denials, lies etc. The latter naturally cause anger and frustration in complainants and sometimes a determination to persist. That the SPSO is aware of the tendency of bodies under their jurisdiction (BUJs) to ‘cover up’ is evident in the SPSO’s support of NHS whistleblowers. Moreover, the SPSO favours employment of former complaints handlers.

Skilling has written as if there are just two parties involved, the complainant and the complaints handler. However, there are commonly two other individuals or groups of individuals: one that is believed by the complainant to be guilty (of maladministration, incompetence, corruption etc.) and one that is concerned to defend the reputation of the organization (and may or may not know the truth of the matter).

In short, the article reveals poor understanding of the subject and could lead investigators seriously astray.

Skilling wrote “The role of the complaint handler is to manage the complaint and, if necessary, the complainant…..”

Surely another role is to put right anything that is validly complained about.

Yet another deficiency of the paper is that more attention is given to the well-being of complaints handlers than of complainants. This is despite the fact that the latter (and sometimes their families) generally suffer more intensely and for far longer from real or perceived injustice - e.g. ill health, loss of employment and sometimes suicide.

Skilling does recognize the harm done to complainants, but only in scattered sentences (see Appendix A). That harm can result from injustice and complaints mishandling is not acknowledged.

Skilling wrote [page 5] “Available evidence suggests that querulousness exists at the outset of the complaints process and is not caused by the complaints process.” We are not convinced of this. Perhaps it does sometimes, but not always. The evidence is not stated.

Skilling wrote of “different terms. These include but are not limited to: unusually persistent complainants, querulants, vexatious litigants, unusually persistent petitioners, unreasonable complainant conduct and unacceptable actions.”

That persistence is not querulence is discussed above in relation to Skilling et al. (2013). BUJs too often cut communications with persistent but non-querulent complainants – i.e. persistent because justice is not being achieved.

Skilling wrote: “by the mid-20th century there was a view that querulous behaviour could be ‘normal’ (transient and precipitated by an individual’s situation or circumstances at a particular time),”     Yes, indeed!

Appendix A.

  • “The term ‘querulous complainants’ refers to individuals that pursue complaints with an unusual degree of persistence and in ways that can cause harm to themselves and the agencies they engage with.”
  • “In addition, there is evidence that querulous complainants themselves experience significant adversity as a result of the way they engage in complaints processes (Lester et al, 2004, Skilling et al, 2012)”.
  • “Skilling et al (2012) identified high rates of self-reported negative consequences for the querulous complainants. In more than half of the querulous cases, the complainants described suffering adverse financial, social, occupational, relationship or health consequences which they themselves attributed to their engagement in the complaints process.”

What does this ‘engagement’ refer to? Is it their querulous behaviour or the frustration of dealing with complaints handlers? Whistleblowers can lose their jobs.