About the complaints process – providers

Key features of the complaint process

  • It is impartial and confidential
  • The Commission does not charge fees
  • Participation in the complaints process is voluntary from the perspective of consumers
  • Complaints are resolved through co-operation
  • HSC encourages open discussion, with all parties asked to give their point of view
  • It can be an alternative to legal proceedings

Who can be complained about

A complaint can be made against any health service provider, which is broadly defined. This includes hospitals, individual registered health professionals, alternative health providers, and anyone who collects, holds or discloses personal health information.

What happens when a complaint is made

Once a complaint is received, it will be assessed by the Commissioner or senior staff. An initial decision will be made as to how the matter will be dealt with. Options include:

  • Commission investigation
  • Conciliation
  • Referral to the Australian Health Practitioner Regulation Agency for their assessment, if the matter relates to a registered health professional
  • Referral back to the provider, with a request from the Commission that they engage with you in a complaint resolution process

Many complaints are resolved through the provision of an explanation, detailed information or an apology where needed. Most people who complain to HSC want to know what went wrong and why, and they want to know that there have been improvements made to prevent similar incidents in the future.

If the complainant is not satisfied with the response

If the response does not satisfy the complainant’s concerns, HSC will identify the unresolved issues. The complainant may be asked to provide information to support their complaint. This can include reports from current treating doctors, copies of hospital records etc. The Commission will determine whether further action is appropriate, or whether the complaint should be closed.

Joint consideration with the health profession boards

The Health Services Commissioner must send complaints about registered health professions, and all material relevant to that complaint to AHPRA. Likewise, AHPRA must send to the Commission any complaints that it receives. The Health Services Commissioner and the relevant National Boards are obliged to jointly discuss complaints and reach agreement as to how matters are to be dealt with. The involvement of AHPRA and the Boards do not indicate an adverse finding – the law requires this information sharing and joint decision making for all relevant matters, not just situations where it is found that a provider acted unreasonably.

Referral for conciliation

The complaint may be referred to the HSC conciliation section for confidential and impartial conciliation. This might happen where there is a claim for damages or remedial treatment, or where there is a need for a meeting between the consumer and the health service provider. At this point you will receive more information about what conciliation involves.