Assessment
You may receive a letter from us saying that your complaint will be assessed through a formal assessment process. We aim to complete your assessment within 45 days.
To assess a complaint, we will gather relevant information. For example, we might:
- send a copy of the complaint to the health service provider and ask them to respond to the issues
- ask you to provide us copies of your medical records that relate to your complaint and that you feel comfortable providing us
- ask for information from other health service providers
- ask for clinical advice in relation to the complaint
- send you a copy of the provider’s response for your comment
- look for ways to resolve the complaint.
Early resolution
Some complaints can be resolved quickly and informally by speaking with you and with the health service provider over the phone. We try to clarify the problem and work out a way to resolve the issue.
Early resolution may occur at any stage of the assessment process. If the complaint is too complex to resolve informally, we may continue assessing the complaint and consider other options available under assessment.
Outcomes
After gathering and assessing this information, the Health Complaints Commissioner may decide to:
- refer the complaint to a registration board responsible for registering health service providers
- recommend the complaint for conciliation (conciliation is explained below and in more detail on our conciliation page)
- investigate the complaint further
- take no further action on your complaint.
Sometimes, more than one option may be chosen. You and the health service provider will be told about our decision.
Refer the complaint to the relevant health registration board
If your complaint is about a registered health practitioner, we will contact the Australian Health Practitioner Regulation Agency (Ahpra). This is because the relevant health registration board will deal with matters relating to the performance and conduct of a registered health practitioner.
A decision will be made whether the relevant board or the Health Complaints Commissioner will manage all or part of your complaint.
How the Health Complaints Commissioner interacts with Ahpra and the health registration boards.
Refer the complaint to another agency
We may also refer complaints to another agency where that agency is better placed to deal with the issues raised.
Recommend the complaint for conciliation
Conciliation is a process in which we help you and the health service provider to meet and talk about your complaint and what can be done about it. It’s an opportunity for more detailed explanations. Compensation may be discussed. Conciliation allows parties to resolve the complaint in a cooperative way.
If you are seeking compensation, this process may be an alternative to taking action through the courts.
Investigate the complaint further
An investigation is a detailed examination of the complaint. Usually, the Health Complaints Commissioner only investigates complex matters where complaints may reveal wider problems or where there are public interest issues.
An investigation report will be prepared and published on our website.
Take no further action on the complaint
We may decide to take no further action on your complaint if the health service provider gives a reasonable explanation for the concerns raised in your complaint. There would be no benefit in continuing the complaint process.