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What is the Role of the Health Ombudsman or Complaints Commissioner?

In most instances, complaints against Australian health care professionals are managed at a local level by the employer, such as a medical practice or hospital. In such instances the doctor or health professional is notified of the complaint and given an opportunity to respond. If the patient or complainant is unsatisfied with the outcome, or if the complaint is of a serious nature, complaints may be forwarded to the health ombudsman or complaints commissioner. Because each state and territory in Australia has an individual health care complaints act, they each have their own a health care ombudsman or commissioner who manages high-level complaints against medical professionals accordingly.
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The commissioner or ombudsman in each state is:

  • Victoria – Office of the Health Services Commissioner
  • New South Wales (NSW) – Health Care Complaints Commission
  • Queensland – Office of the Health Ombudsman (OHO)
  • South Australia – The SA Ombudsman
  • Western Australia – Health and Disability Services Complaints Office (HaDSCO)
  • Tasmania – Health Complaints Commissioner
  • Australian Capital Territory (ACT) – ACT Community and Health Services Complaints Commissioner
  • Northern Territory – Health and Community Services Complaints Commission (HCSCC)

The role of the health ombudsman or complaints commission

The main role of the health ombudsman or complaints commission is to receive and assess complaints relating to health service providers and resolve or assist in the resolution of complaints. Complaints can be made about any aspect of treatment, rights, communication, behaviour or administration in relation to a health service or community service such as services for the aged and disability service providers. Commissioners and ombudsman manage complaints against all types of practitioners including alternative and natural therapies as well as psychologists and counsellors.

Complaints submitted to the ombudsman or commission have different outcomes. They may be dismissed, or the mediation between doctor and patient may be recommended. Serious cases that involve public health and safety might be referred for investigation by a regulatory body or the medical board. The commission or ombudsman may also prosecute serious complaints and in some cases has the power to take immediate action to protect the safety of the public through for example, suspending registration while undertaking investigations.

Patients rights and safety promotion

Another role of the commissioner / ombudsman in most states and territories is to promote and protect the rights of patients and consumers, and improve the safety and quality of health service through monitoring of service providers.

Patients also have the option of taking legal action against a professional if they wish to seek damages for injuries resulting from treatment. Around 90% of such cases are settled out of court and managed in conjunction with a doctor’s medical indemnity insurance provider.