Health System Complaints (VCE SSCE Health and Human Development): Revision Notes

Health System Complaints

Introduction to health system complaints

As a patient in Victoria, you have the right to make a complaint if you are unhappy with the health service you receive. The Health Complaints Commissioner (HCC) is the organisation responsible for handling these complaints.

The HCC works under the Health Complaints Act (2016), which gives the commissioner greater powers to investigate complaints and applies to a wider range of health services than previous legislation.

The commissioner's role is important because it helps protect the public and supports safe and ethical healthcare practices throughout Victoria.

Who can make a complaint

The HCC accepts complaints from a wide range of people, including:

• Patients who have received health services
• Friends or family members of patients
• Guardians or carers
• Other health service providers
• Concerned community members

You can make a complaint about any health service provided in Victoria. Additionally, you can complain about any organisation that holds health records (such as schools or gyms) regarding how they manage personal information.

Types of complaints the HCC manages

The HCC handles complaints relating to various aspects of healthcare. These include:

• Access to services – difficulties getting the care you need
• Quality and safety – concerns about the standard of care or safety issues
• Care and attention – inadequate care or lack of attention from providers
• Respect, dignity and consideration – being treated without proper respect
• Communication – poor information about treatment, options or costs
• Involvement in healthcare decisions – not being included in decisions about your care
• Privacy and confidentiality – concerns about how your personal health information is handled
• Complaint handling – issues with how the health service provider dealt with your initial complaint

Who can be complained about

Complaints can be made about both health service organisations and individual health practitioners.

Health service organisations include:

• Public or private hospitals
• GP clinics
• Community health services

Individual health practitioners can be divided into two groups:

Registered health practitioners:

• Doctors, dentists, nurses and surgeons
• Midwives, physiotherapists and chiropractors
• Psychologists, pharmacists and Chinese herbalists
• Occupational therapists, optometrists and osteopaths
• Podiatrists, radiographers and Indigenous health practitioners

Non-registered health practitioners:

• Audiologists, naturopaths and dietitians
• Speech pathologists, homeopaths and counsellors
• Paramedics, masseurs and alternative therapists
• Other providers of general health services

How to lodge a complaint and possible outcomes

Wherever possible, you should first try to resolve the issue directly with the health service provider, as this is often the quickest and easiest solution. The HCC is legally required to recommend this approach before taking further action.

If direct resolution doesn't work, you can submit a complaint to the HCC through:

• Writing
• Phone
• Online form

Through the HCC, depending on your complaint, you may be able to obtain:

• An explanation about what happened and why
• An apology
• Access to treatment
• Access to or amendment of health records
• A refund or compensation
• A change in policy or practice to prevent similar problems in the future

The HCC also has the power to launch formal investigations and warn the public about dangerous health service providers.

The complaint process

When the HCC receives a complaint, they first determine whether they are the appropriate agency to handle it or if another organisation would be better suited. They also confirm that the complainant has attempted to resolve the issue directly with the service provider first.

Once the HCC accepts a complaint, they aim to use the least formal approach possible to resolve it efficiently. There are three possible pathways for complaint resolution:

Early resolution

This is the least formal and often the quickest way to resolve complaints. The HCC discusses the complaint with both parties over the phone to clarify the problem and identify an acceptable solution.

If no resolution is reached through phone discussions, the HCC may be unable to assist further. However, if the complaint is too complex for phone resolution but can still be resolved, the HCC may move to formal resolution or initiate an investigation.

Formal resolution

This process involves a series of documented steps that work towards finding an acceptable solution. The process includes:

1. Working with the complainant to write a formal description of the complaint
2. Sending this description, along with a resolution plan, to the health service provider
3. The resolution plan may request meetings, medical records, reports or independent opinions
4. Documenting any improvements the provider agrees to make
5. Sharing these documented improvements with all parties

Investigation

An investigation is a formal and detailed examination used for handling large or highly complex matters. The HCC can investigate:

• Public and private organisations
• Individual practitioners (both registered and non-registered)

HCC statistics and impact

In the 2017-18 reporting year, the HCC received 6,835 complaints. Of these:

• 68% were resolved through informal processes within three months
• The remaining 2,183 cases required handling by resolutions officers or investigators, reflecting their complexity

Beyond resolving individual complaints, the Health Complaints Commissioner uses the information gathered from complaints to help improve health services across Victoria in the future.