1. What does the Health and Disability Commissioner do?

The Health and Disability Commissioner is an independent agency set up to:

• promote and protect the rights of consumers who use health and disability services

• help resolve problems between consumers and providers of health and disability services.

2. Are all health and disability services covered?

Yes. All health and disability services are covered.

This includes public and private services, paid and unpaid services, hospitals, individuals such as general practitioners, dentists, naturopaths and caregivers, and even people who care for family members.

3. What rights are covered?

The Commissioner enforces a Code of Consumers' Rights (the Code), which gives all consumers of health and disability services ten rights.

These are:

1. You should always be treated with respect.
2. No one should discriminate against you, pressure you into anything, or take advantage of you.
3. Services should help you live a dignified, independent life.
4. You should be treated with care and skill and receive well co-ordinated services.
5. Service providers should listen to you and give you information in a way you can understand and that makes you comfortable to ask questions if you don't understand.
6. You should have your condition explained to you, including benefits, risks, alternatives and costs of treatment, and have any questions answered honestly.
7. You can make your own decisions and are free to change your mind.
8. You can have a support person with you at most times.
9. All these rights apply if you are asked to take part in research or teaching.
10. Your right to make a complaint about services must be taken seriously.

4. What can I do if I think a health or disability service provider has not complied with my rights under the Code?

First, you should speak to the person who provided you with the service. Explain what you think the problem is and how you would like it to be put right. You can ask a family member or friend to help you with this.

If you are not comfortable going directly to the provider, a Health and Disability advocate may be able to help you. In order to help resolve complaints, a free, independent advocacy service is available throughout New Zealand. Advocates are trained to help consumers resolve complaints with providers.

The advocate will listen to your complaint, give you information about your rights, help you choose an option to settle your complaint, and support you in deciding what course of action to take.

5. Do I have to pay for an advocate?

Advocates are free.

An independent Director of Advocacy contracts advocates for the work they do for consumers. Advocates are on the side of the consumer.

6. What if my complaint doesn't get settled or I don't want to go through advocacy?

An advocate may report an unresolved complaint to the Commissioner.

You can also take your complaint directly to the Commissioner's Office.

The Commissioner may consider it appropriate to refer a complaint back to advocacy.

7. What will then happen to my complaint?

Senior members of the Commissioner's staff will carefully review your complaint, and the Commissioner will decide the best way of dealing with it.

This may include a referral to another appropriate body (eg, the Ministry of Health), advocacy, investigation, or no action.

8. What happens if there is an investigation?

The Commissioner may decide to start a formal investigation into your complaint.

If this happens, an investigation officer will be appointed to your case. This person will contact all the parties involved to gather the relevant information about your complaint.

Once all the necessary information has been gathered the Commissioner may ask an expert in the area to review the information and advise whether the services provided met expected standards. The Commissioner will use this advice and the other evidence to decide whether the rights in the Code have been breached.

The Commissioner must act impartially - like a judge - and not take sides. Depending on the provisional findings, you may be given an opportunity to comment and to raise any further points relevant to the investigation.

The Commissioner looks at all the information and then makes a final decision. The final decision is a written report on the case.

You can view some of the Commissioner's reports here.  Reports published on the website have identifying features removed to protect the privacy of the people involved.

9. Can I have legal representation throughout the investigation process?

If you wish you may seek representation from a lawyer during the investigation process.

This would be at your own cost as there is no provision in the legislation for the Commissioner to provide legal representation for complainants.

However, legal representation is not necessary and is not sought by the majority of complainants.

10. How long will the Commissioner take to investigate my complaint?

The length of time an investigation takes depends on the complexity of the complaint, the number of parties involved, and how long ago the events took place.

A simple investigation usually takes six to nine months; a complex investigation can take eighteen months to two years. This is to allow time for all involved to have their say and for all the relevant information to be obtained.

11. What can happen after the final opinion is released?

Usually the final opinion makes some recommendations. The most common recommendations for a provider who has not met the obligations under the Code are:

• an apology
• a change in the way he or she does things
• changes to organisational policies to make it easier for individual providers to meet the Code of Rights requirements.

The Commissioner also sends copies of the final opinion to relevant professional groups or organisations so that they know about the Commissioner's decision and can tell their members about it.

The Commissioner can ask the Ministry and the Minister of Health to take steps to improve a service if an investigation reveals a problem or if new rules are needed to protect consumers. The identity of the parties is usually protected.

The Commissioner can also ask an independent prosecutor, the Director of Proceedings, to decide whether the provider should be disciplined or taken to court.

This step is taken in only a small number of serious cases.

12. Can I appeal the Commissioner's decision?

The Commissioner's opinion is final, so it cannot be appealed.

However, the Office of the Ombudsmen and the High Court can review the way the complaint was investigated to ensure that everyone has been treated fairly.

13. What happens if the Director of Proceedings decides to take action?

Providers will be told that the Director of Proceedings may take a case against them. They will be given an opportunity to explain their position, and your views will be sought.

The Director will then decide whether to take a case to the Human Rights Review Tribunal and/or to the provider's disciplinary body, or to take no further action.

If a case is taken, you will probably be called as a witness.

14. What happens if the Director of Proceedings decides to take no action?

An individual is able to take his or her own case to the Human Rights Review Tribunal.

15. Will I get compensation if my rights have been breached?

The Commissioner doesn't have any power to give you compensation.

The Commissioner may advise you to take your complaint to ACC, to see whether you are entitled to compensation if you have suffered personal injury following an accident or as a result of treatment you have received.

The Human Rights Review Tribunal can also award compensation to an "aggrieved person" in some circumstances.

16. Will I be able to get money from the provider through the Commissioner?

No. The Commissioner does not usually ask providers to pay complainants.

Occasionally, the Commissioner may recommend that a provider refund some or all of the money a consumer has paid for services that are found to be below expected standards.