The Office of the Independent Adjudicator (OIA), in the UK, is an independent body that is set up to review student complaints against Higher Education Institutions in England and Wales.<sup>53</sup> Any complaints or appeals procedures of the higher education institution must be exhausted before bringing a complaint to the OIA. An application must be made within 3 months of the date of the completion of any complaints or appeals procedures at the institution. The OIA has a comprehensive complaints process but it only applies to higher education institutions.

Challenges to income support and related social decisions in Canada may appeal to a third level of review, which, as described above, consists of the Income and Employment Support Appeal Board. For health insurance appeals in France, there is also an ombudsman system through an official and ̳independent‘ _Conciliateur_ who can be contacted through the local _Caisse_ or RSI. The ombudsman‘s decisions are non-binding but are generally respected.<sup>54</sup> There is also a main independent ombudsman, the _Médiateur de la République_ . The _Médiateur_ helps settle disputes with civil service departments but his jurisdiction is much broader than health or social welfare.<sup>55</sup> In France there is a special tribunal that is called the _Tribunal des affaires de sécurité sociale (TASS)_ . The TASS judges conflicts between social security agencies and the insured and contributors and between social security and health professionals. Applications may be made to TASS if the insured is not satisfied with the decision of the CRA or if the CRA did not make a decision within a month of receipt of all necessary documents (an implied rejection).<sup>56</sup> Brazil‘s Programa Bolsa Família is explicitly subject to external monitoring by several organizations, including the Tribunal Contas da União, the Controladoria-Geral da União, the Minsitério Público, and publicly constituted councils at the municipal level. While the first two organizations focus on transparency and accountability more generally, the last two have the attributes of external redress processes in which individual transactions are reviewed. Data on complaints with the program do not appear to be aggregated into easily available and standardized datasets. A survey of 5,604 families in 2006 found that 9% should have been paid but were not (or were paid improper amounts), but it is not clear if these were uncovered on the basis of regular complaints or on the basis of the administrative review and the survey. Overall, the focus of the agencies that monitor irregularities in the PBF appears to be on families improperly included in the program, rather than those improperly excluded.<sup>57</sup>

> 53 The Office of the Independent Adjudicator for Higher Education, homepage, _available at_ : <u>http://www.oiahe.org.uk/.</u>

> 54 ―French Health System – Complaints,‖ _available at_ :  http://www.french-property.com/guides/france/public- <u>services/health/complaints/</u> _<u>.</u>_

> 55 <u>http://www.mediateur-republique.fr/en-20-citoyen-Contact</u>

> 56 ―Tribunal des affaires de securite sociale,‖ _available at_ :  http://www.legislation.cnav.fr/doc/cont/cxgen/tass/BNL- <u>EX_CONT_CXGEN_TASS.htm</u>

> 57 Controle e transparencia na gestao do Programa Bolsa Família, 1 Mostra Nacional de Estudos sobre o Programa Bolsia Familia.

18