What if a complaint is made about me?

It is unsettling to be on the receiving end of a complaint. However, consumers making complaints and providing comments about their experience is an important way of improving the quality of services. Managed well, complaints can help us to learn from mistakes, identify gaps in services, and restore trust and mend relationships.

Will I be given an opportunity to resolve the issues with the person who complained?

In some situations, where the complaint is suitable for resolution between the parties, the Commissioner may refer a complaint to the Advocacy Service, which will support the consumer in addressing his or her concerns directly with the provider. The Commissioner also has the option of referring a complaint to the provider, who can then respond directly to the consumer. HDC maintains a "watching brief" over these complaints. The Advocacy Service, or the provider if the complaint was referred directly to the provider, is required to report back to HDC on the outcome of the referral. 

The Medical Protection Society provides advice on responding to complaints.

Providers who handle consumer complaints sensitively are more likely to:

  • Achieve low level resolution;
  • Obtain consumer confidence in their process, sincerity, and intention to do the right thing;
  • Receive a greater proportion of complaints directly from consumers; and
  • Receive future complaint referrals from HDC for resolution.

What do people hope to achieve by making a complaint?

Information gathered by the Commissioner's office indicates that the most common reasons for people complaining are the need for an explanation about what happened; accountability for what went wrong; and a desire to prevent recurrence, so others will not have to go through a similar experience. Resolution for individuals may involve obtaining answers to questions about the care received, acknowledgement of a patient's concerns and, where necessary, review and rehabilitation of a substandard practice or system. However, what often matters to complainants as much as any of these factors is an acknowledgement and an apology for any inadequacies in the care they received. 

What is the purpose of an investigation?

An investigation is undertaken to determine whether there has been a breach of the consumer’s rights under the Code of Health and Disability Services Consumers’ Rights. The purpose of an investigation is to gather sufficient evidence to establish what occurred and whether the actions taken by providers amount to a breach of the Code. 

What are my rights if I am subject to an investigation?

Although the Code of Health and Disability Services Consumers’ Rights focuses on consumers’ rights, the Health and Disability Commissioner conducts its investigations in accordance with the Act and administrative law. Providers should seek independent legal advice if they would like more information about these requirements.

Will I be given the opportunity to tell my side of the story?

Yes. You will be asked for a written description of your version of events. In some cases the investigator will also request an interview with you. 

What happens during an investigation?


First, providers under investigation must be informed of the intention to investigate, and of the details of the complaint or the subject matter of the investigation. In practice, providers are almost always sent a copy of a written complaint. The notification letter will set out the key facts that have been alleged and what the investigation will cover. You will then be invited to make a written response, which is usually required within 15 days. It is a good idea to seek collegial support at this stage.

Your response is a key part of the information the Commissioner will consider in deciding how to deal with a complaint.

Evidence gathering

Under the HDC Act the Commissioner has the power to obtain any information relevant to an investigation. In the letter notifying you of the investigation, the Commissioner will often set out information you are required to provide, eg, a summary of the service provided, clinical notes, relevant internal reports, policies or procedures, or the name of other providers involved. The investigator will probably also obtain information from other sources such as hospital records, other providers who treated the patient, or witnesses to the events.

Staff are asked to ensure you are contacted every two months to keep you informed about progress on the investigation. However, you may request an update at any time.

After the initial fact-gathering stage, the next step is usually to request expert advice from a peer who is an independent expert in the relevant field. The Commissioner’s advisors are highly respected professionals in their field and, in the majority of cases, have been recommended by the relevant professional College.

Alternative ways of resolving complaints

Sometimes during an investigation it becomes clear that parties may be able to resolve the dispute by agreement. If this is the case the complainant may be referred to advocacy. Advocates act on behalf of the consumer and often facilitate resolution of complaints involving issues of communication or misunderstanding. Alternatively, a formal mediation conference may be called. Mediation offers a structured forum in which to work through issues of concern to the consumer, and enables the parties to agree on their own resolution of the complaint.

Response to provisional opinion

In the event that the Commissioner forms a provisional opinion that the Code of Rights was breached, the provider is entitled to a reasonable opportunity to respond before the Commissioner finalises an opinion. Current practice is to send a covering letter with the provisional breach opinion inviting comment on the findings and recommendations, usually within 15 working days of receipt. This is the provider’s opportunity to clarify any factual errors and to respond to the Commissioner’s provisional view that the Code of Rights was breached. In accordance with HDC’s Naming Policy, all parties will have the opportunity to comment on any proposed naming at this point.

A provider’s response to provisional findings and recommendations is carefully considered in preparing the Commissioner’s final report. If requested, the provider’s written response, or a fair and accurate summary of it, will be appended to the final report.

Commissioner’s final report

Ultimately, the Commissioner will form an opinion, on the basis of all the evidence gathered, whether a consumer’s rights have been breached.

The Commissioner’s report will set out all relevant information gathered during the investigation. In some cases where there is a conflict of evidence, the Commissioner may make findings of fact based on the available evidence. The report will state whether the provider has breached the Code, and outline the reasons for the decision.

After the final report

The final report is sent to the complainant and the provider, and to any relevant persons or bodies. An anonymised copy of the report may be placed on the HDC website for educational purposes. Where the Commissioner has found a breach of the Code, the Commissioner may refer the provider to the Director of Proceedings.

Recommendations follow-up

When an investigation is concluded, the Commissioner’s recommendations are followed up to ensure that appropriate changes occur.

How long will the investigation process take?

This depends on the nature and complexity of the complaint. While some complaints may be straightforward and able to be completed to report stage within six months, other matters are complex, involving many providers and wide-ranging issues. Such investigations may take more than 18 months to complete. In any event, we will keep you updated on progress at least every two months.

Will I need a lawyer?

This is something you will have to decide yourself. It may help to discuss the complaint with colleagues. Your professional body may be able to help or to put you in touch with someone who has been through the investigation process. Some health professionals use lawyers but many do not.

Can I appeal the Commissioner's decision?

No. The Commissioner’s opinion is final, and cannot be appealed. However, the Office of the Ombudsman and/or the High Court can review the way the complaint was investigated to ensure that everyone has been treated fairly.