When something goes wrong with your care — healthcare rights, complaints bodies and Ahpra
Your options if you have a complaint about care or a health service in Australia: the 7 rights in the Charter of Healthcare Rights, state and territory health complaints bodies, reporting to Ahpra and requesting your medical records, based on official guidance.
Overview — what you can do if care goes wrong
If, while receiving care in Australia, you were not given enough explanation, were not treated with respect, or have concerns about your treatment or its outcome, you have more than one pathway available. You can raise it first with the hospital or clinic's own complaints process. You can lodge it with the health complaints body in your state or territory. If the problem is the conduct of an individual practitioner, you can report it to the national regulator, Ahpra (the Australian Health Practitioner Regulation Agency). Whichever pathway you use, the agency assesses each matter case by case and no outcome is guaranteed. If English is difficult for you, you can use the government interpreting service (TIS National 131 450).
What this guide covers, and what other guides cover
This guide covers complaint pathways and rights from the patient's point of view. A practitioner's own registration and licensing is in 'Professional Registration & Licensing', booking and bulk billing in 'How to See a Doctor', interpreting in 'Free Interpreting & Translation', and legal action or compensation in 'Getting free legal help'. For aged care, NDIS and private health insurance complaints, this guide only points you to the relevant agency. If it is urgent now, call 000 (emergency) or go to an emergency department first.
The 7 rights in the Charter of Healthcare Rights
The Australian Charter of Healthcare Rights was developed by the Australian Commission on Safety and Quality in Health Care (ACSQHC), and the second edition was published in 2019. The Charter describes the rights that everyone can expect wherever healthcare is provided in Australia. The 7 rights are Access, Safety, Respect, Partnership, Information, Privacy and Give feedback.
What kind of document is the Charter?
The Charter sets out the standards that health services are expected to meet. Australia's national safety and quality standards for health services require them to use this Charter or one consistent with it. However, you should not assume that the Charter itself is a legal right that a court can enforce directly. If you need an interpreter, use TIS National (131 450) and the 'Free Interpreting & Translation' guide.
- Access, Safety, Respect — care that meets your needs, safe care, and care that respects your culture and beliefs
What to check before you complain
Check three things before you lodge a complaint: first, whether you are in danger now; next, whether to raise it with the health service first; and last, the time limit for lodging. Wording and rules differ between agencies, so what follows is only an outline. Confirm the exact conditions in the official guidance of the agency for the state where you received care. If a family member or supporter will lodge the complaint for you, also check the agency's authorisation process.
- If it is dangerous, call 000 or go to an emergency department first — a complaint comes after that. If you are in distress or crisis, call Lifeline (crisis support) 13 11 14
- Raise it with the health service first — agencies' wording ranges from 'recommended' to 'required', and they make exceptions if it is hard or unsafe
4 complaint bodies — where should you go?
The right place depends on the problem: a service in general, an individual practitioner, or aged care, the NDIS or private health insurance. If you are unsure, phone the agency and ask. Several agencies, including those in VIC, QLD and WA, say their complaints service is free.
Speak directly to the complaints officer or manager at the hospital or clinic. Health services must have a complaints process, and the ACSQHC also recommends starting here. Keep a record and ask for a written reply.
The health complaints body in the state or territory where you received care takes service complaints and handles them through conciliation, investigation or referral. VIC public mental health services come under a separate body, the Mental Health and Wellbeing Commission. The names of all 8 bodies are in the questions below.
Takes concerns about individual practitioners only (not complaints about facilities, fees or access to records). It cannot order compensation or an apology, and NSW and QLD have different contact points. Phone 1300 419 495
Aged care complaints go to the Aged Care Quality and Safety Commission (1800 951 822), problems with the services of NDIS providers and workers to the NDIS Quality and Safeguards Commission (1800 035 544), complaints about NDIS plans, funding and NDIA decisions to the NDIA (National Disability Insurance Agency), and private health insurance complaints to the Commonwealth Ombudsman.
Tips for making a complaint
Several agencies' guidance recommends the same preparation and tips. Record the facts, work out the outcome you want, and ask for an interpreter and support if you need them.
- Record the facts — write down what happened, when, where and who was involved, and what effect it had, and keep copies of letters, emails and receipts.
- Work out the outcome you want — choose what is realistic from an explanation, an apology, access to care, access to your records, a refund or fee waiver, or steps to prevent it happening again.
Myths and mistakes
The misunderstandings below often lead people to complain in the wrong place or run out of time.
- 'Hospital complaints go to Ahpra too' is a myth — Ahpra only takes concerns about individual practitioners. Complaints about services such as hospitals and clinics go to the state or territory health complaints body.
- 'A complaint gets you compensation, a refund or an apology' is a myth — agencies are not courts and do not guarantee an outcome, and Ahpra cannot order compensation or an apology.