1. What are my options when I make a complaint?

1. We recommend that, in the first instance, you talk to the provider you're unhappy with.

2. If that doesn't resolve your complaint, you may like to contact a Health and Disability Advocate.

Their job is to help consumers to resolve complaints with health and disability providers.

3. Providers are required under the Code of Health and Disability Services Consumers' Rights  to respond in a timely and appropriate way to complaints.

If they don't fulfil these requirements, this can also be a cause for complaint. Your advocate can help you with this, too, if it should happen.

4. Taking your complaint to the HDC. If the matter still isn't resolved, you can complain to the Health and Disability Commissioner.

You can do that here on our website, using our online complaint form.

2. When does the Commissioner get involved in a complaint?

The Commissioner does not have to receive a complaint in order to take action.

Complaints can be referred by an advocate.

The Commissioner may also undertake an inquiry on his own initiative, where serious public concerns have been raised about the safety of a service.

3. What happens when I make a complaint?

1. Complaints resolution staff will take your complaint by phone, or after receiving your online complaint form , fax or letter. They'll assess your complaint and contact you if they need any more details. You'll then receive a formal acknowledgement, including an idea of how long it will take to respond to your complaint.

2. Your complaint is likely to be sent to your provider, to seek a response from him or her.

3. Complaints staff will recommend to the Commissioner how the complaint should be handled. The Commissioner has various options. He may decide to:

• take no action - if it's clear that the provider has already responded appropriately or for other reasons;
• take an educational approach, and ask for an apology or recommend action;
• formally refer the complaint to the provider, or to advocacy or formal mediation - for resolution between you and the provider. The outcome of these referrals will be reported back to HDC.

4. What is an investigation?

• This is an impartial and independent process to which the rules of natural justice apply.
• It can take up to 12-18 months.
• Around 10% of complaints received by HDC are formally investigated.
• Before commencing an investigation, HDC will inform both the consumer and the provider of the intention to investigate, and will advise the provider of the details of the complaint.
• HDC must also let the provider know of the right to submit a written response to the complaint.

5. How does the investigation process work?

• The complaints file is assigned to an investigator, who must identify the facts to be proved (such as what happened, when, where, and so on).
• The investigator collates all the evidence and presents it to the Commissioner, or the Deputy Commissioner who has been delegated the investigation.
• During an investigation, HDC may consider oral evidence obtained during interviews with witnesses and parties; documentary evidence such as correspondence, clinical notes, policy and practice manuals; and any other relevant evidence such as labelled medication containers.
• Where the quality of care is an issue, HDC will obtain independent expert advice from a peer of the provider with knowledge of, and experience in, the matters under investigation.

6. What happens after the investigation?

• After an investigation, the Commissioner or Deputy Commissioner forms an opinion whether the provider has breached the Code, and notifies the parties of his or her findings.
• If the provisional finding is adverse to any provider, the provider will be given an opportunity to make a written submission; if the complaint is provisionally not upheld, the complainant is given an opportunity to make a written submission.
• The Commissioner or Deputy Commissioner forms and reports his or her final opinion after consideration of any responses to the provisional report and any further expert advice that has been obtained.

7. Is there ongoing learning from the investigation?

• While distribution of HDC's final opinion signifies the end of the investigation, the Act provides HDC with a range of options for using the report to promote change, both in respect of the conduct of individual providers and in the sector generally.
• Options on finding a breach of the Code include making of reports and recommendations to the provider, the appropriate authority (eg. a registration body), the Minister of Health, or any other person HDC thinks fit. This may include the professional colleges, the Ministry of Health, District Health Boards, ACC, and consumer and provider groups. It may also be published on the HDC website for educational purposes.

8. What kind of outcomes are there from an investigation?

Recommendations to providers vary from case to case, but may include:

1.     a written apology to the consumer
2.     undertaking specific training
3.     implementing and reviewing systems to prevent further breaches.

When any recommendations are made, HDC follows up to confirm that they have been implemented.

Where a final report suggests that there may be concerns about the competence of a registered health practitioner, HDC may recommend to the registration authority (eg. the Medical Council for a doctor) that it consider whether a review of the practitioner's competence is warranted.

The Commissioner or Deputy Commissioner may refer the matter to the Director of Proceedings, to consider whether to bring disciplinary and/or other proceedings.

9. What can the Director of Proceedings do?

The Director's main options to address the matter are one or both of:

1. A claim before the Human Rights Review Tribunal

2. Disciplinary proceedings before the Health Practitioners Disciplinary Tribunal.

10. What matters are under HDC's jurisdiction?

The Health and Disability Commissioner can only look at matters involving the provision of a health or disability service to a consumer.

Matters relating to access to services and funding are outside his jurisdiction.

HDC cannot award compensation.

11. Who can complain to HDC?

Anyone can make a complaint to HDC, orally or in writing.

This includes not only consumers, but also their families/whanāu and other support people, and other third parties such as concerned staff members in a health or disability service.

12. Taking a complaint to other people

At any time, the Commissioner has the discretion to refer matters to another person or authority where he considers it in the public interest to do so.

He must refer matters to the appropriate person or authority (eg. the Director-General of Health) when an investigation has revealed a significant breach of duty or misconduct; and at any point during the complaint handling process when he has reason to believe that the practice of a health practitioner may pose a risk of harm to the public.

It is also important to note that all complaints made directly to professional registration bodies must be referred by them to HDC. This includes all complaints about doctors, nurses, dentists, pharmacists, and so forth.

Once referred to HDC, no disciplinary action can be taken by the professional body until the Commissioner, or the Director of Proceedings, has dealt with the matter or decided to take no further action.

Only at this point can the professional body take up the matter itself. (It is only disciplinary action that is suspended. Professional bodies can still consider a member's fitness or competence to practise.)