Health care complaints

Importance of feedback

The safety of the health care system requires the active participation of health professionals, patients and carers. Feedback helps to improve care by supporting what is being done well, highlighting what can be done better, and improving safety. You can provide feedback in several ways.

Compliments – Positive comments show health professionals that you value their service and standard of care.

Suggestions – General feedback allows minor problems to be dealt with to improve patients’ treatment experience.

Complaints – If health professionals and services have not met your expectations, negative feedback can help them improve service gaps or problems in treatment, communication, processes and behaviour.

How to give feedback or complain

All health care facilities should have procedures for patients to provide feedback and complaints. Check with the cancer care coordinator, nursing unit manager or social worker. Some hospitals have a patient representative or patient advocate who looks after patient concerns. You can usually find their details on the hospital’s website.

Raising the issue may mean you get a different view of why something occurred, and talking about it may make you feel better. You can also ask a friend or relative to raise an issue on your behalf.

If you have a problem with a particular person, it is often best to talk to them face-to-face or on the phone. This may help to resolve the issue quickly. If you find it difficult to raise the issue directly, or your initial discussions were not satisfactory, you may prefer to send an email or write a letter.  Remember that putting feedback in writing means you will have to wait for a response. Health professionals are bound by a strict code of conduct to maintain confidentiality about any complaints you lodge.

If you have concerns about your health fund and have been unable to resolve these issues with the fund, the Commonwealth Ombudsman looks after private health insurance complaints and may be able to help.

If you feel unable to provide feedback or complain immediately, you can still raise your concerns at a later date. Keep in mind that organisations may not assess complaints after a certain amount of time has elapsed since the event, and there are strict time limits for medical negligence. complaints.

Steps for resolving a health care issue

1. Identify the problem and what you would like to happen to resolve it.
2. Talk to your specialist, a nurse or other health professional so they have the chance to resolve the issue immediately. A quick conversation may help to sort out a simple misunderstanding.
3. If your complaint is about a particular person and you don’t want to talk to them directly – or you have spoken to them and the issue remains  unresolved – speak to the cancer care coordinator, nursing unit manager or social worker at your hospital or treatment centre.
4. If you’re not happy with the response from a health professional, or if you want to talk to someone neutral, contact the hospital’s independent patient representative, complaints officer or patient advocate.
5. If you’re not satisfied with the patient representative’s investigation, contact the hospital’s quality assurance department or the clinical governance unit of your public hospital. Smaller or private hospitals may not have a patient representative, but you can contact the nursing unit manager or general manager.
6. If you’re still not happy with the outcome – or you don’t want to raise the issue with the health care facility – contact your state or territory health complaints organisation or the Australian Health Practitioner Regulation Agency. If you have a serious complaint that you want to take to a health complaints organisation, you may wish to obtain independent legal advice.

Making a formal health care complaint

To make a formal health care complaint, you need to contact your state or territory health complaints organisation. It can be helpful to check if there are any time limits or other conditions you have to meet before making a complaint.

Health care complaints should be in writing and can often be made by filling in an online form. If you are unable to make the complaint yourself, a relative, friend, guardian or health professional may be able to lodge the complaint on your behalf.

In most cases, you will be assigned a case officer, who may provide a copy of the complaint to the health care provider and ask them to give their version of events. With your consent, your case officer may also obtain your medical records or other relevant information from the health care provider.

Once the case officer has completed their assessment, the relevant state or territory ombudsman or commissioner will write to tell you how they will deal with your complaint. They may decide to refer it for mediation or conciliation, which is an informal meeting to try to resolve problems.

Serious issues

Issues relating to public health and safety are referred elsewhere within the ombudsman’s or commission’s office for formal investigation. Serious cases against health practitioners may result in prosecution, and some cases may be referred to a registration board or another organisation for further consideration.

Health complaints organisations

Australian Capital Territory – ACT Human Rights Commission (Health Services Commissioner) Ph: 02 6205 2222

New South Wales – Health Care Complaints Commission Ph: 1800 043 159

Northern Territory – Health and Community Services Complaints Commission Ph: 1800 004 474

Queensland – Office of the Health Ombudsman Ph: 133 646

South Australia – Health and Community Services Complaints Commissioner Ph: 08 8226 8666 or 1800 232 007

Tasmania – Health Complaints Commissioner Tasmania Ph: 1800 001 170

Victoria – Health Complaints Commissioner Ph: 1300 582 113

Western Australia – Health and Disability Services Complaints Office Ph: 08 6551 7600 or 1800 813 583

Regulation of health professionals

Some health professionals are required to be registered and accredited; others are not.

Registered health professionals

The Australian Health Practitioner Regulation Agency (AHPRA) and 15 National Boards regulate the health practitioners listed below. Health  practitioners must meet certain standards before they can be registered and accredited with a National Board. Registration helps ensure only trained and competent health professionals practise within these professions. Students in an approved study program or doing clinical training must also be registered with the relevant National Board.

AHPRA works with the National Boards to investigate complaints about health practitioners. If you have concerns about the health, performance or conduct of a registered health practitioner, you can notify AHPRA. It is unlawful for a person to pretend to be a registered health practitioner.

You can check a health practitioner’s registration by visiting the Australian Health Practitioner Regulation Agency (AHPRA).

Registered health practitioners

The following health professionals must be registered:

• Aboriginal and Torres Strait Islander health practitioners
• Chinese medicine practitioners
• chiropractors
• dental practitioners
• medical practitioners (GPs and specialists)
• medical radiation practitioners
• nurses and midwives
• occupational therapists
• optometrists
• osteopaths
• paramedics
• pharmacists
• physiotherapists
• podiatrists
• psychologists

Unregistered health practitioners

Allied and complementary health practitioners who are not required to be registered with a National Board are known as unregistered health  practitioners. They must follow the National Code of Conduct for health care workers, which sets minimum standards of conduct and practice. This code must be displayed in the premises. Unregistered health practitioners may also join a professional association that sets minimum standards of conduct and practice (further to those covered in the National Code). If you have an issue with an unregistered practitioner, talk to them first. If you’re not satisfied with the outcome, you can lodge a complaint with a health complaints organisation or with their professional association (if they are a member).

Medical negligence

Health professionals have a duty to treat patients with reasonable care and skill. If you have been injured or suffered financial loss as a result of inadequate treatment or care, you may be able to make a claim for compensation (medical negligence claim). Inadequate treatment may include failure to diagnose or treat promptly, failure to advise you of risks of procedures, or giving you the wrong medicine. Medical negligence claims about cancer diagnoses and care are uncommon.

In most states and territories, the time limit for making a negligence complaint is generally 3 years from the date the injury occurred. Exceptions may apply where an injury was not discovered until later.

Proving negligence can be hard; you may have to go to court, and the process can be expensive. If you think you may have a case, it’s important to get advice from a lawyer who specialises in medical negligence. To find a suitable lawyer, contact the Law Society in your state or territory.