What the Ombudsman Found — And What It Could Not Enforce

What the Ombudsman Found

The Ombudsman’s role is not to decide whether a policy is “right” or “wrong” in principle — but whether it was created and implemented properly, fairly, and in line with standards .

What they found was extensive.

🔴 Failures in Decision-Making

• The NHS did not properly balance the evidence when making the policy decision
• It failed to fully explore relevant evidence that was available to it
• It did not justify why it departed from clinical guidance (NICE, WHO, etc.)
• The reasoning behind the decision was not clearly documented or explained

⚖️ Equality & Fairness Failures

• The policy did not treat women and men in a fair and consistent way
• Male sterilisation remained funded, while female sterilisation was restricted
• Similar risks (such as regret) were handled differently depending on gender

📊 Cost & Evidence Failures

• The NHS failed to demonstrate that alternatives were more cost-effective
• Evidence actually suggested sterilisation can be more cost-effective long-term

They did not properly consider indirect costs , including:

• long-term contraception use
• side effects
• wider health and societal impacts

🧠 Regret Argument Failures

• The policy relied heavily on “regret”

But:

• regret was acknowledged as subjective and difficult to measure
• evidence on regret was contradictory
• it was applied inconsistently between men and women
• The NHS failed to consider the role of informed consent , despite legal and ethical requirements

🩺 Clinical & Risk Assessment Failures

• The NHS did not properly weigh the risks of alternative contraception

It failed to:

• fully assess side effects
• consider patients who cannot tolerate alternatives
• follow through on its own plan to review these groups

🗣️ Consultation & Process Failures

• The NHS did not carry out proper consultation , despite stating it would
• It did not follow its own ethical framework and processes
• Key steps in decision-making were not documented or evidenced

📩 Complaints Handling Failures

They:

• did not follow complaint timelines
• did not keep me updated properly
• did not engage with my actual concerns
• Instead, they repeated the policy without addressing the issues raised

What This Actually Means

The Ombudsman did not say the NHS cannot set policies like this.

But they did say — very clearly — that:

• The decision-making process was flawed
• The evidence was not properly handled
• The reasoning was not transparent
• The policy was not applied fairly

And that matters.

Because once the process fails, the policy itself becomes very difficult to defend.

The Outcome — And The Reality Of It

After more than two years of investigation, the Ombudsman partly upheld my complaint .

That means they formally confirmed that:

• the decision-making process was flawed
• the evidence was not properly balanced
• the policy was not applied fairly
• and the complaints process itself failed

The NHS acknowledged this. In writing.

• They apologised.
• They accepted the failures.
• They agreed to review the policy.

And yet — despite all of that — the outcome stops there.

Because the Ombudsman does not have the power to enforce change.

They can:

• investigate
• document failures
• make recommendations

But they cannot compel the NHS to change policy , and they cannot take legal action on your behalf .

The Hard Truth About This Process

This is something I think people need to understand before they even begin a journey like this:

You can:

• spend years researching
• build a fully evidenced case
• prove systemic failures
• have those failures independently confirmed

…and still walk away without actual change.

That is incredibly disheartening.

Because what it means in practice is that accountability still sits with the same system that failed in the first place — under the same leadership, the same structures, and often the same people.

• Even now, after the investigation, I am not seeing the level of correction I would expect.
• I am seeing process. I am seeing movement. But I am not seeing the core issue being resolved.

What This Leaves Me & Other Women With

At this stage, the only path that could create enforceable change is legal action .

Taking the NHS to court.

But that comes with its own reality:

• it is expensive
• it is time-consuming
• it requires legal backing and resources

And in the UK, we do not have a straightforward mechanism for collective legal action in cases like this. There is no easy way for all affected women to come together and challenge this as a group.

Which means that, once again, the burden falls on individuals.

Why I’m Still Pushing This Forward

This policy affects women across the region — and likely reflects wider issues across the UK.

Most of those women will never:

• read policy documents
• analyse meeting notes
• understand their legal position
• or take a complaint this far

And that’s exactly why these systems continue.

So the reason I’m sharing all of this — in this level of detail — is because I want this case to be useful beyond me.

With this, I want it to:

• support organisations that are already working to protect women’s rights
• give legal teams something concrete to work with
• provide evidence that this is not just a personal complaint, but a systemic issue

If you are a legal firm working on a no win, no fee basis , or an organisation focused on healthcare rights, reproductive rights, or equality law — I am open to being contacted. Just email me with your thoughts, ideas, agenda and we can go from there.