Advocacy - here to help

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Advocacy — here to help

Having a problem with a health or disability service?
Our advocacy service can help.

Where can I find an advocate?

Click here to find a local advocate in your region.

What does an advocate do?

An advocate:

• listens to your concerns
• gives you information about your rights
• helps you to explore the options available
• supports you in the actions you take to resolve your concerns.
  

Background

The Nationwide Health and Disability Advocacy Service was formally established in 1996 under the Health and Disability Commissioner legislation. The need for such a service had been identified by Judge Silvia Cartwright during a major independent inquiry into the treatment of patients at an Auckland hospital. The Cartwright Report, released on 5 August 1988, outlined the findings of the inquiry and made key recommendations about how to address the need for a focus on consumer rights and the quality of services provided to consumers.

Although the Inquiry looked specifically at carcinoma in situ treatment for women with cervical cancer, as well as research that occurred at National Women's Hospital during the 1950s and up until the early 1980s, the problems identified were recognised as features of a health system in which patents were marginalised. The Inquiry report identified the need for widespread changes to the way patients were treated and services provided. The report emphasised the need for services to have a patient- or consumer-centred approach, where the focus of the service shifted from the practitioner/provider to the patient/consumer.

Two key recommendations were for a Health Commissioner to promote and uphold consumer rights, and for advocates who would be on the side of the consumer to ensure that their rights were upheld. The initial focus on health was later extended to also include the disability sector and consumers using disability services.

Consequently, the Health and Disability Commissioner Act 1994 was enacted. It requires the appointment of an independent statutory officer, the Director of Advocacy, to contract for the provision of a nationwide health and disability advocacy service.

Purpose

The nationwide health and disability advocacy service is available free to any person in New Zealand who has a concern or complaint about a health or disability service. Advocates are on the side of the consumer, and the service operates independently of the Commissioner, practitioners/providers, government agencies and organisations that fund services.

When should I contact an advocate?

Complaints and enquiries can be made directly to an advocate when you need information or want assistance. The majority of complaints are successfully resolved with the assistance of an advocate, and the experience can be very positive for both providers and consumers. It provides an opportunity for both parties to discuss concerns or complaints and, where possible, come to some resolution. This process can help consumers and providers deal with troubling matters quickly and rebuild damaged relationships. Face-to-face meetings with consumers can be very educative for some providers, particularly where their manner and attitude have unintentionally caused distress.

How can an advocate help?

Advocates are keen to assist consumers to resolve their complaints as soon as possible. They can help consumers get their questions answered, and have explanations provided and actions taken (where appropriate) so that the matter does not drag on. Taking action at an early stage and dealing directly with the provider is often referred to as resolving the matter at a low or local level.

Consumers may, for example, be confused about what is happening with their care or by what a provider has told them. Others may have concerns about the standard of the care, the attitude and manner of a provider, and that they have been treated disrespectfully. Some may feel uninformed and not sure what to do or who to talk to.

Dealing with the matter early at the local level takes less time than a formal investigation and is more likely to achieve an outcome consumers are satisfied with. A face-to-face meeting, for example, can provide an opportunity for the consumer to tell the provider why they are upset about what happened and what their concerns are. Most consumers want acknowledgement of what has happened to them, an explanation and apology where this is indicated, and to hear what steps will be taken to prevent what has happened to them happening to someone else. The provider is often able to address these matters at the meeting and also receives important feedback to help improve the quality of his or her service.

What does an advocate do?

HDC advocates use a consumer-centred empowerment model that involves standing alongside the consumer and assisting in the manner the consumer identifies as being most helpful.

As well as providing consumers with information about their rights, advocates act on the instructions of the consumer and can support and assist them in a variety of ways. These include:

• guidance and information on how to advocate for yourself, for those who wish to deal with the matter themselves
  
• assisting to identify and clarify the key issues
  
• support for consumers wanting to resolve concerns or complaints at a low or local level with the provider.
  

This practical support covers a range of assistance, such as helping to write a letter or accompanying a consumer to a meeting with the provider.

Advocates are expected to set a good example and model a consumer-centred quality service. They have a Code of Practice, competencies, and guidelines, which describe their role and what consumers can expect from the service and from an individual advocate. Their practice is also evaluated on a regular basis. Complaints about an advocate or the service are reviewed to see where improvements can be made.

What contact do advocates have with the Health and Disability Commissioner?

Complaints made to a health and disability advocate that remain totally or partially unresolved after advocacy assistance, and are not withdrawn, are referred to the Health and Disability Commissioner. The Commissioner is also able to refer complaints that he has received to an advocate, to assist the consumer to resolve the matter. If a referral is made by the Commissioner to the Nationwide Health and Disability Advocacy Service, all parties are notified and the process is explained, including the time frame for action expected by the Commissioner. The advocate is required to report back formally to the Commissioner on the outcome.

Advocates may also report to the Commissioner from time to time on any matter concerning the rights and safety of consumers that they consider should be brought to the Commissioner’s attention. In this way, advocates perform an important function of being the Commissioner’s “eyes and ears” in the community.

Although advocates are on the side of the consumer, the Commissioner is required to be impartial and does not take sides.

Why are complaints an important part of improving services?

Making a complaint is an important way of improving the quality of services. Whether consumers make a complaint directly to the service, to the Commissioner, or seek the help of an advocate, they usually say they don’t want what happened to them to happen to someone else. They expect and find it reassuring to hear what steps the provider will take to improve their service. Most providers find it helpful to know about a consumer’s concern so that they can take action to sort it out. Sometimes this leads to changes in practice and the way services are provided that will benefit other consumers.

Although the key objective of advocacy is the timely resolution of the consumer’s complaint, the process also identifys opportunities for providers to take steps to improve the quality of the service they provide to consumers. The statutory authority of the Commissioner, his emphasis on service quality, and the link advocates have to the Commissioner are all helpful incentives for providers to make changes.

Informing consumers of their rights and providers of their responsibilities

In addition to assisting consumers to resolve their complaints, advocates have a key educational and networking role. They provide education sessions and training workshops for consumers and providers to promote awareness and understanding of the rights of consumers and the responsibilities of providers as outlined in the Code of Health and Disability Services Consumers’ Rights.

Contact the advocacy service or your local advocate to arrange a general education session, a self-advocacy training programme, or a workshop on a particular rights area.

You can either contact the advocate in your area directly or call the free-phone advocacy contact number:  0800 555 050.