About the Complaint Process
Each complaint is unique. We assess every complaint carefully, considering the issues you raise and the evidence available.
An overview of the Complaint Process
- You send your complaint to HDC.
- Our Complaints Assessment Team reads and reviews your complaint.
- There are a range of actions HDC may take, including:
- We may ask the provider to resolve your complaint with you directly, or with the help of the Advocacy Service. Complaints are often resolved at this stage. The provider or the Advocacy Service will report back to HDC on the outcome to ensure that your concerns have been addressed.
- We may decide another agency is better placed to handle the complaint, e.g. the Privacy Commissioner or the District Inspector.
- We may ask for more information, from you and others, to help us with your complaint. We may also seek clinical advice from someone who works in the same field as the provider you’ve complained about.
- We may close your complaint without a formal investigation, if we find that the care you received was largely appropriate. If this is the case, we will often make recommendations for change or educational comment to the provider. Factors relevant to taking no action on a complaint.
- In a small number of cases, HDC carries out a formal investigation. If this is going to happen to your complaint, we will let you know. Factors that may warrant an investigation.
- Our Commissioner (or Deputy Commissioner) decides the outcome of your complaint. We send you a written explanation about the outcome.
- The provider is asked to act on the recommendations from our Commissioner.
How we assess complaints
First, we confirm whether our Commissioner can act on your complaint — that is, whether it is within HDC’s jurisdiction. See What can I complain to HDC about below.
If your complaint is within our jurisdiction, we send a copy of your complaint to the provider you are complaining about.
We find that up to one third of complaints are quickly resolved with the provider, sometimes with the help of the Advocacy Service. Other complaints are reviewed by HDC in more detail.
Usually we do one or more of the following:
- Ask the provider to respond to your complaint
- Ask the provider, or sometimes other people or organisations, for more information. For example, we may ask the relevant district health board for a copy of your medical records. Sometimes we make several requests for additional information
- Ask for independent advice about clinical aspects of the care you received.
Answers to your questions about complaints and HDC
Here are some common questions about complaints to HDC.
What should I do before I complain to HDC?
Before you complain to HDC, you have several options. Try these before you complain to HDC.
First, we recommend talking or writing to the person or organisation you’re unhappy with. This can help you resolve your concerns more quickly. Under the Code of Health and Disability Services Consumers’ Rights (the Code), they must respond to complaints in a timely and appropriate way. If they don't, this can also be a cause for complaint.
An independent Health and Disability Advocate can help you to resolve your complaint directly with your health and disability service provider, and talk you through the options for resolving your concerns.
If your concerns still aren’t resolved, you can complain to the Health and Disability Commissioner.
How long does it take to assess a complaint?
Our team’s initial assessment may take anything from a few days to several months. This depends on how complex your complaint is, how long it takes to get relevant information, and what we learn during our assessment. An example of a complex complaint is one that is about several different providers.
Usually, we make a decision about a complaint within six months. We’ll contact you with updates on the progress of your complaint about once every 10 weeks.
For a small number of cases we carry out a formal investigation. This is a longer process, which often takes about two years. Learn about the formal investigation process for complainants.
Who can complain to HDC?
Anyone can make a complaint to HDC. This includes:
- people who use health or disability services
- families and other support people
- other people, such as concerned staff members in a health or disability service.
You can complain for yourself or for someone else. There are complaint forms on our website. If you are complaining for someone else, it helps if you can show HDC that they support you making the complaint and are happy for you to receive their personal health information.
What can I complain to HDC about?
HDC considers complaints about the quality of health and disability services.
We decide whether there has been a breach of someone’s rights under the Code of Health and Disability Services Consumers’ Rights. The Code applies to any person or organisation that provides a health or disability service.
HDC can only look at matters relating to a health or disability service. This includes mental health and addiction services, cosmetic procedures, and complementary medicine, as well as GP and hospital services.
We can’t consider complaints about:
- ACC’s decisions or processes (contact ACC directly)
- health information privacy (contact the Privacy Commissioner)
- fees charged for health or disability services
- medical records or reports submitted to the Court or to other organisations associated with the justice system, such as the Parole Board.
Possible outcomes of your complaint
By resolving complaints, HDC helps people understand and learn from what happened. This reduces the chance of the same thing happening to someone else. We use what we see in complaints to recommend improvements to the health and disability sectors. This helps make the whole system stronger for all of us, and protects consumers’ rights.
When the Commissioner decides the outcome of your complaint, you will receive a letter or email explaining that decision and any actions the Commissioner has taken as a result.
The Commissioner may do one (or more) of the following:
- Ask the provider to apologise
- Recommend the provider make changes so that what happened to you won’t happen again. These recommendations are followed up and assessed to make sure they’ve been implemented appropriately
- Send the complaint to an independent advocate to help resolve your complaint directly with the provider. The outcome of this is reported back to HDC
- Send the complaint to the provider for you and the provider to resolve. The outcome of this is reported back to HDC
- Send the complaint to another agency where that agency is better placed to address your concerns, such as:
- the Ministry of Health
- a registration authority (such as the Medical Council of NZ)
- the Privacy Commissioner
- a Mental Health District Inspector
- Suggest other organisations that could help you, for example, going to the Disputes Tribunal to recover money you are owed
- Carry out a further formal investigation of your complaint.
- In very few cases, refer a person or organisation to the Director of Proceedings to consider taking legal action.
Sometimes, the Commissioner will decide your complaint does not need further action. This may happen if:
- the provider has already addressed the issues raised in your complaint
- the events occurred a long time ago or the evidence needed to make a decision is no longer available
- there is another organisation that is better placed to help you with the issues raised in your complaint
- independent assessment finds your care was appropriate.
Please note that HDC can’t:
- make people pay you compensation or refund you
- have a person “struck off”
- change what is written in your medical notes
- provide a second opinion on your diagnosis
- get you an appointment.
You can contact ACC on 0800 101 996 if you believe you have suffered a treatment injury.
Read how other complaints have been resolved
You can see examples of complaints that have been resolved in our Annual Report.
Learn about formal investigation of complaints
In a small number of cases, the Commissioner formally investigates a complaint. This is a serious step. You will need to work with HDC staff to support the formal investigation. Learn about the formal investigation of a complaint from the complainant's side.