Our complaints process is
- Impartial: We do not advocate for either party.
- Voluntary: We cannot force participation in complaint resolution.
- An alternative to legal proceedings: You don't need a lawyer.
When we receive a complaint, the first step is to decide whether our office should deal with the complaint or if another agency is more appropriate.
Our next step is to confirm that the person making the complaint has tried to resolve their issue directly with the service provider. This is often the quickest and easiest way to resolve an issue and we are legally required to recommend this happens before we deal with it. Some people may have a good reason why they cannot contact the service provider.
If the complaint is appropriate for us to deal with, and the complainant and the service provider could not resolve it directly, we may take further action. When deciding how to handle a complaint we must apply the least formal process appropriate for the complaint.
It is against the law to threaten or intimidate anyone from making a complaint or try to persuade anyone not to make a complaint.
In special cases, a person's identity can be withheld when forwarding details of the complaint to the provider. If you are still concerned about your privacy, you can lodge a complaint anonymously. If you do choose to make a complaint anonymously, it will be more difficult for us to look into the issue. If we don't have your name and contact details, we will be unable to contact you for more information and we won't be able to provide you with updates if the complaint proceeds.
Complaint process options include:
Early resolution is the least formal – and often the quickest – way to resolve complaints. In most cases, we discuss the complaint with both parties over the phone to clarify the problem and to identify an acceptable solution. If no resolution is reached through this process, we may be unable to assist you further. However, if we find the complaint is too complex to resolve over the phone, but that it can be resolved, we may attempt a formal resolution. We may also decide to initiate a formal investigation.
The formal resolution process involves a series of documented steps, each leading towards finding an acceptable solution. First, we work with the complainant to write a formal description of the complaint and develop a resolution plan, which may include requests for meetings, medical records, reports or independent opinions. We then send the formal description of the complaint to the health service provider for a response.
Any improvements the provider agrees to make in response to the complaint can be documented and shared with all parties. We may check with the provider later to confirm these improvements have been made. If no resolution is reached we may be unable to assist further. The complaint may also be considered for investigation.
As with formal resolution, the conciliation process involves a series of documented steps with the goal of resolution. However, in the conciliation process, all discussions are privileged and confidential. This means all information or documents obtained in this process cannot be discussed outside the process, and cannot be used in any future legal proceedings. Our role is to enable open and frank discussion of the issues in the complaint. These complaints are typically resolved in less than 12 months, but may take longer.
At any stage we may choose to investigate a complaint. An investigation is a formal and detailed examination, often used in handling large or highly complex matters. We may investigate public and private organisations as well as individual practitioners.
While investigating a general health service provider, we may issue an interim order prohibiting them from delivering all or part of a service. A final prohibition order may then be issued following investigation, if appropriate to do so. General providers are those not regulated under the national scheme by the Australian Health Practitioner Regulation Agency (AHPRA) and are also known as non-registered providers. Following an investigation into a registered or non-registered provider, we may issue a public warning statement to alert people to serious risks to their health, life, safety or welfare.