Complaints Process

We promote the early resolution of complaints by encouraging the parties to resolve the complaint directly or with our assistance.

When we receive a written complaint we may contact the complainant to:

  • Ask for more information
  • Let them know how we may be able to help
  • Talk through our complaints process

A formal acknowledgement letter will be sent to the complainant.

A copy of the complaint form and relevant accompanying documents are sent to the provider to give them the opportunity to respond.

If the complaint is against a provider who is registered with a professional registration board, a copy of the complaint is provided to the board. (In the case of a national registration board, it will be provided to the Australian Health Practitioner Regulation Agency (AHPRA), which will act on behalf of the board).

When the provider's response is received, a copy is usually sent to the complainant, for comment. Where a registration board is involved, it will also usually be sent to the board.

If the response does not resolve the complaint, we make an assessment decision about what should happen next. This will depend on the circumstances of the complaint and what outcomes the consumer is seeking.

Assessment

A complaint must be assessed within 45 days of receipt by us, although the Commissioner can extend the time by a further 45 days if necessary. You will be notified if further time is required.

The options available on assessment are:

  • Refer the complaint to a relevant health registration board
  • Refer it to a conciliator
  • Investigate the complaint
  • Dismiss the complaint

More than one of these options may be chosen.

The case officer may discuss the assessment decision with you. You will be notified by letter of the decision and the reasons for it.

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Referral to a health registration board

Complaints that raise serious issues about the health, conduct or performance of a registered practitioner will generally be referred to the relevant health registration board.

All but one of the health registration boards with which we deal are national boards, which have been in operation since 1 July 2010.  Consultation with these boards takes place through the Australian Health Practitioner Regulation Agency (AHPRA).

Click here for more details on how the Health Complaints Commissioner interacts with AHPRA and the National Boards.

Investigation

Our investigations are generally confined to complaints that give rise to systemic or public interest issues, rather than individual grievances against individual health service providers.

Conciliation

Conciliation provides both parties with an opportunity to resolve a complaint in a collaborative way. This does not always involve face-to-face meetings. Conciliation is confidential and privileged and is usually an alternative to litigation in cases where parties are seeking compensation. Other outcomes that can be achieved through conciliation are the provision of an explanation, an apology and improvements in the safety and quality of health services.

Dismissal

If the Commissioner is satisfied that the complainant has been given reasonable explanations and information and there would be no benefit in continuing the complaints process, the complaint may be dismissed.

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