There are two formal ways in which complaints may be made about practitioners or health care services in Victoria. A complaint may be lodged with the Office of the Health Services Commissioner or with a registration board. These processes are described in greater detail below.
It should be noted that most public hospitals also have complaints liaison officers who may be able to assist in the resolution of a complaint. Such an officer may be able to short-circuit the need to resort to a more formal mechanism.
Another channel of complaint is to make use of Community Visitor, who are appointed under the Mental Health Act 1986 (Vic) and who may inspect mental health services for people with a mental disorder and ask questions of residents or patients and employees and inspect documents or medical records. They submit a joint report to the Public Advocate on their visits, and an annual report of Community Visitors is laid before Parliament each year. They may inquire into any complaint by a resident or patient.
Where there has been a significant problem with management of a health service, a complaint may be made to the Department of Human Services.
The Health Services Commissioner is appointed under the Health Services (Conciliation and Review) Act 1987 (Vic). The objects of this Act are to:
- enable users of Victorian health services to have their complaints about health services resolved by an independent and accessible mechanism;
- encourage health service providers to follow guiding principles that promote prompt, considerate, high quality health care that respects privacy and dignity, provides adequate and understandable information, encourages participation in decisions about treatment and an environment of informed choice; and
- lead to improvements in the quality of health care and the extent to which the guiding principles of providers and users are followed.
The types of health services the Act covers include "alternative" as well as "orthodox" health services, and welfare services necessary to implement certain health services. Health services are defined broadly and include:
- medical, hospital and nursing services;
- dental services;
- psychiatric services;
- pharmaceutical services;
- ambulance services;
- community health services;
- health education services;
- associated welfare and social work services;
- therapeutic counselling and psychotherapeutic services;
- laundry, cleaning and catering services, where those services affect health care or treatment;
- services provided by chiropodists, chiropractors, osteopaths, dietitians, optometrists, audiologists, audiometrists, prosthetists, physiotherapists and psychologists;
- services provided by optical dispensers, masseurs, occupational therapists and speech therapists;
- services provided by practitioners of naturopathy, acupuncture and in other alternative health care fields;
- services provided by Chinese herbal medicine practitioners, acupuncturists and Chinese herbal dispensers; and
- health services prescribed under the Act.
Services provided by the Department of Human Services and the Secretary to the Department of Human Services are also covered by the Act.
When a complaint is made and is to be acted upon, it is forwarded to the provider, who is asked to reply to the patient. If no satisfactory reply is received, the Commissioner will examine the complaint to assess why the dispute has not been settled and whether it warrant further attention. A recommendation may be made that the dispute be referred for conciliation, or to a registration board where a disciplinary breach on the part of the practitioner may be formally considered.
Serious matters are referred for conciliation and, ideally, resolution. Conciliation is seen as having certain advantages over litigation: it is cheaper and quicker, and an outcome satisfactory to both parties may be negotiated. All proceedings during conciliation are confidential and information obtained cannot be used as evidence in court. If a settlement is reached at the end of conciliation, a deed of release may be prepared, which will set out the obligations of both parties. In some cases, this may involve the provider paying compensation to the patient. A patient may seek legal advice before signing the release but, once it has been signed, they will be unable to take any legal action against a provider who is observing the terms of the settlement.
A complaint that is unsuitable, or unable, to be conciliated, and is beyond the jurisdiction of a registration board, may be investigated by the Commissioner. The Commissioner may question the patient and the provider on oath, and the parties may be legally represented. If the Commissioner finds that the complaint is justified, they may propose appropriate remedies, such as a compliance notice (ss.66 and 71). However, there is no power to enforce the Commissioner's recommendations, other than naming the provider in Parliament.
To make a complaint contact:
Registration boards are established under Acts of Parliament. Members of boards may be appointed to their positions or elected by members of the practitioner group, depending on the terms of each Act. Increasingly, boards include legal and/or community-based members.
Recently, there have been extensive amendments to the procedures for registration and the handling of complaints against health professionals. The purpose of the Health Professions Registration Act 2005 (Vic) is to provide a common system of investigations into:
- the professional conduct, professional performance and ability to practise of registered health professionals;
- the registration of students;
- the regulation of advertising of regulated health services; and
- the operation of pharmacies (s.1(a)–(c),(e)).
Not all health practitioners have registration boards. In Victoria, the following groups are regulated in this manner:
- acupuncturists, Chinese herbal dispensers and Chinese medicine practitioners;
- chiropractors;
- dentists and dental prosthetists, dental auxiliaries and dental students;
- medical practitioners;
- nurses;
- optometrists;
- osteopaths;
- pharmacists;
- physiotherapists;
- podiatrists;
- psychologists; and
- radiographers.
A person may make a complaint to a board about the conduct of a health practitioner or about a practitioner's health, including alcohol and drug-dependency, or professional performance. A board may investigate the complaint and, depending on the nature of the complaint, conduct a hearing or refer it for further investigation. If the disciplinary process finds that a health practitioner has behaved in a manner that may amount to professional misconduct, or is unfit to practise, sanction may be imposed on the practitioner. These include a reprimand, conditions on the person's practice and a fine, but the ultimate sanction is deregistration.
The role of boards is not to achieve an outcome for the consumer by virtue of compensation or an apology. It is to investigate practitioners' practices in order to achieve higher standards for the community as a whole. The consumer is simply a witness at a board meeting.
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MAKING A COMPLAINT :: Last updated: Wed Jul 1st 2009