How to complain about a doctor or hospital

Ahpra is the agency responsible for implementing the National Registration and Accreditation Scheme across Australia, working with the National Boards that register each profession. When you raise a concern with Ahpra it is called a notification, and the machinery it can reach for attaches to registration: conditions on practice, suspension, an undertaking from the practitioner, or referral to a tribunal. That machinery is aimed at protecting the public from a practitioner, not at repairing what happened to you.

The health complaints entity in your state or territory is aimed at the other thing. Its statutory job is the service — access to it, the quality and safety of it, the care and attention, the respect and dignity, the communication about treatment and costs, your involvement in decisions, and the way the provider handled your complaint when you first raised it. Victoria's Health Complaints Commissioner lists exactly those categories, and every other state's list reads much the same.

The bridge between them is legislated, not discretionary. The Northern Territory Commission sets it out clearly: its own Act requires the Commissioner to notify the National Board whenever a complaint arrives about a registered provider, and the National Law requires a Board to notify the Commissioner whenever a notification arrives that falls within the Commissioner's jurisdiction. Both Acts then require the two to consult about how the matter will be managed. The joint decision is not a finding; it is a decision about which agency is better suited.

The factors that drive that decision are worth knowing, because they tell you what to emphasise when you write. The Northern Territory names them: the seriousness of the complaint and any risk issues, whether the matter would be better resolved informally or more formally at conciliation, the outcomes the complainant is seeking, and whether the issues appear to relate to systems rather than to one person's practice. Say which of those you are describing and you help the triage rather than fighting it.

The Australian Capital Territory works the same way through different words. The Health Services Commissioner sits inside the ACT Human Rights Commission and, under the Human Rights Commission Act 2005, must advise Ahpra about complaints concerning registered health professionals and send all relevant material across. Ahpra must do the same in reverse. The Commission is explicit that the involvement of Ahpra and the Boards does not indicate an adverse finding — the law simply requires the information sharing for all relevant matters.

Queensland and New South Wales are the two structural exceptions. Queensland funnels everything through the Office of the Health Ombudsman, which triages within seven business days and jointly considers registered-practitioner matters with Ahpra before deciding. New South Wales runs a joint assessment between the Health Care Complaints Commission and the relevant health professional council, and where a matter needs intervention of a non-disciplinary nature, the Commission refers it to the council's conduct, health or performance pathway rather than investigating it.

Almost every state expects you to try the provider first, and several treat it as a precondition rather than a courtesy. Tasmania's Health Complaints Commissioner states that it is a requirement under the Health Complaints Act 1995 to make a reasonable attempt to resolve concerns directly before submitting a complaint, and suggests putting it in writing and allowing at least twenty business days for a response. Western Australia's HaDSCO requires the concern to have been raised with the provider before it will accept a complaint. Queensland's Health Ombudsman may decline to accept a complaint on the same basis.

The carve-outs matter as much as the rule. Tasmania tells you to contact its office if you are unable to attempt direct resolution, and Victoria's Health Complaints Commissioner says that if you are unable to take your complaint to the provider directly, you should ask the Commissioner for help. Queensland's Health Ombudsman says it will consider whether support is needed, or whether there are risks it should deal with, before deciding not to accept a complaint on that ground. You do not have to grit your teeth through a conversation with someone you are frightened of in order to preserve your rights.

In a hospital, the person you want is the patient liaison officer or patient representative. Victoria's Commissioner notes that complaints about care, treatment or billing by a hospital are usually managed by that role, and NSW Health's guidance follows the same ladder — tell staff directly first, then contact the hospital or health service formally, then seek an independent organisation. Ask for the complaint to be logged, ask for a reference, and ask for the response in writing.

In a general practice or a small clinic there may be no dedicated officer. Victoria's Commissioner puts it directly: smaller providers may not employ a dedicated complaint liaison officer or health records manager, but they still need someone in charge of handling complaints, and in practice that is usually the practice manager. Victoria also advises writing rather than talking if the issue is complex or serious, and is blunt about the timeline — the provider may take up to three months to respond, so a fortnight of silence is not yet a failure to respond.

If something went wrong clinically, the process you are owed has a name — open disclosure. The Australian Commission on Safety and Quality in Health Care describes it as an honest conversation in which the service apologises for what went wrong, explains the known facts, listens to your experience, explains how it may affect you and your care, and explains the steps being taken to prevent it happening again. You can bring a support person, and you can request interpreters, Indigenous liaison officers, counsellors and payment of out-of-pocket expenses.

Keep the paper from day one. Note dates, the names and roles of everyone you spoke to, reference numbers, and what was promised. Two protections are worth knowing while you do it: NSW Health states that feedback is never linked to a health record, and the national Commission confirms that complaints information is kept separate from medical records. Complaining does not put a mark on your file, and it is within your rights to complain even if you have signed a consent form or already received a refund.

Australian privacy law gives you a general right to request access to the health information a private health service provider holds about you. Only you, or a person you have authorised such as a legal guardian or representative, can make the request. You may be asked to put it in writing, to identify yourself, and to say how you want to receive the information — by email, as paper copies, as an electronic record, or simply by viewing it.

There is no statutory deadline, but the Office of the Australian Information Commissioner says a provider should respond within a reasonable period and that it generally regards thirty days as reasonable. Quote that back if you are being stalled. If you ask for access in a way that is impractical, the provider can give it to you another way — on a USB stick rather than paper, as a summary, or by letting you view it — but they must tell you in writing why, and how to complain about it.

A fee can be charged, but the OAIC is specific that it cannot be excessive and cannot be used to discourage you from asking. It may cover staff time searching for, locating and retrieving the information, deciding what is relevant, reproducing and sending it, and postage or materials. The provider should tell you the likely amount up front and should discuss changing the request to reduce it — asking for an emailed copy rather than a printed one is the usual lever.

Access can be refused, but only on stated grounds: where it may threaten your or someone else's life, health or safety, where it would impact another person's privacy, or where giving access would be unlawful. Where the problem is a third party's privacy, the provider can redact that part and give you the rest. A refusal must come with a written notice saying why and telling you how to complain about it — that notice is itself useful evidence.

Public hospitals are a different regime. State and territory laws cover health information held by a public hospital, not the Commonwealth Privacy Act, which means the request usually goes through the hospital's health information or freedom of information unit. In the Australian Capital Territory, access and integrity of health records sits under the Health Records (Privacy and Access) Act 1997, and complaints about refused access, transfer, inappropriate sharing or incorrect information go to the ACT Human Rights Commission.

Retention rules decide whether the records still exist. The OAIC notes that in the ACT, New South Wales and Victoria, privacy law requires a health service provider to keep records for seven years, or in the case of a child, until the child turns twenty-five. If your doctor has retired, ask where the practice records went — they are usually transferred rather than destroyed. Ask for the complete record, including clinical notes, imaging reports, pathology and correspondence, not a summary letter.

Every complaints body in the country asks for the same six things, and the Queensland Health Ombudsman lists them almost as a form: who was involved, where the incident occurred, what happened and when, what you are concerned about, what else you have done to address it, and what you want to happen now, plus any supporting documentation. Answer those six in order and you have written a competent complaint. Victoria asks for the same material plus the name, address and contact details of the provider or organisation you are complaining about.

Build a chronology and stick to it. Dates, times, who said what, which room, which shift. Name people and their roles where you know them, and say where you do not know a name so the assessor can find it. Quote what was actually said rather than characterising it — 'I was told the results were normal and no further action was needed' does more work than 'they were dismissive'. Assessment officers are reading for a sequence of events they can put to the provider.

Attach the evidence rather than describing it. The Victorian Commissioner asks for your original complaint letter or email to the provider, their response, and supporting documents such as letters, referrals, photos and invoices. Discharge summaries, appointment confirmations, prescriptions and text messages all count. A complaint with attachments moves; a complaint that promises documents on request stalls.

State the outcome you want, because it changes which pathway the complaint takes. Victoria's list of what a complaint can achieve is the clearest published version: an explanation of what happened and why, an apology, access to treatment, access to or amendment of health records, a refund or compensation agreed between the parties, or a change in policy or practice to prevent it happening again. Asking for an explanation and a policy change is far more achievable than asking for a person to be punished.

Feelings belong in the complaint, but as consequence rather than as the claim itself. 'I was left in a corridor for six hours without pain relief and vomited twice before anyone came' is a fact with a consequence attached. 'The staff did not care' is a conclusion the assessor cannot test. The distinction is not about being polite — it is about giving the assessor something a provider can be asked to answer.

Decide about anonymity deliberately. Queensland's Health Ombudsman says you can remain anonymous or use a pseudonym when making a complaint or notification, but warns this may limit its ability to manage the matter or communicate with you about it. Victoria accepts anonymous complaints but says doing so limits its ability to look into the issue and means you will not receive progress updates. The Aged Care Quality and Safety Commission offers a middle option — a confidential complaint, where it knows who you are but takes reasonable steps not to reveal your identity to the provider. That middle setting is usually the right one where you fear consequences but still want an answer.

You are protected for complaining, and this is worth reading twice if you are still a patient of the provider. Victoria's Commissioner states that you cannot be dismissed, disciplined or disadvantaged in any other way for making a complaint, and that you are protected from legal actions such as defamation and civil liability. The Aged Care Commission puts it as plainly: a provider, worker or responsible person cannot punish you or treat you differently for raising a concern.

The body you want is set by where the care was provided, not by where you live. Tasmania's Commissioner spells this out — it can only help with health services in Tasmania, and refers everything else to the entity in the relevant state or territory. If you were treated interstate on holiday, the complaint goes to that state's commission.

In New South Wales the Health Care Complaints Commission takes complaints about health organisations, registered practitioners and non-registered practitioners. All complaints must be made in writing, the Commission aims to assess them within sixty days, and you are given a case reference number and the name of your case officer. Its inquiry line will help you write the complaint if you are struggling with it, and you can track the case online afterwards.

Victoria's Health Complaints Commissioner takes complaints about any health service provided in the state, or a service that was requested and not delivered, and also about anyone holding your health records — including schools and gyms — and about how they handle that information. Complaints about registered practitioners involving professional conduct issues may be referred to Ahpra, which the Commissioner describes as better placed to deal with some of them. Its own resolution process is voluntary, and the Commissioner states that it remains impartial and does not take sides.

Queensland's Office of the Health Ombudsman is the single entry point for both complaints and notifications. It has seven business days to decide whether to accept a complaint and how to deal with it, and that timeframe can move slightly for registered practitioners because of the joint consideration with Ahpra. Assessment and local resolution are each generally completed within twenty-two business days, extendable to forty-four in circumstances the Health Ombudsman Act 2013 prescribes.

Western Australia's HaDSCO covers health, mental health and disability services that are not covered by the NDIS, across the state and the Indian Ocean Territories. It accepts complaints only in writing, and it applies a two-year window — the incident must have occurred in the past two years and must already have been raised with the provider. Where a registered practitioner is involved it consults Ahpra to decide the most suitable agency, and Ahpra may ask for a formal referral.

South Australia's Health and Community Services Complaints Commissioner covers both health and community services and asks you to complain to the provider first. Tasmania's Commissioner will usually not accept a complaint where you became aware of the issue more than two years ago, and specifically cannot help with the contents of a medical report, fees charged by private practitioners, Medicare or health insurance, Mental Health Tribunal or Guardianship and Administration Board orders, or workers compensation decisions.

The Australian Capital Territory's Health Services Commissioner, inside the ACT Human Rights Commission, deals with all health services in the territory, public and private, and with access to and integrity of health records. It generally tries to resolve health complaints through conciliation. In the Northern Territory the Health and Community Services Complaints Commission takes the complaint and consults Ahpra, with the joint decision determining whether the matter is referred, retained or split.

A complaint to Ahpra is a notification, and anyone can make a voluntary one. The Queensland Health Ombudsman — which receives all Queensland notifications in Ahpra's place — publishes the grounds, and they are broader than most patients realise: poor professional conduct, sub-standard knowledge, skill, judgement or care, lack of suitability to hold registration, impairment, a breach of the National Law, a breach of a condition of registration, registration improperly obtained, or any other issue of concern.

A mandatory notification is a different animal and it is not something a patient makes. The duty falls on registered health practitioners, employers and education providers, who must notify as soon as possible if they reasonably believe a practitioner has engaged in notifiable conduct. If you are a nurse worried about a doctor, or a practice manager worried about a locum, that duty is yours — and in Queensland it is discharged to the Health Ombudsman, not to Ahpra.

Notifiable conduct has four limbs and they are narrow on purpose: practising while intoxicated by alcohol or drugs; engaging in sexual misconduct in connection with the practice of the profession; placing the public at risk of substantial harm in the course of practice because of an impairment; and placing the public at risk of harm through a significant departure from accepted professional standards. Conduct that upset you but does not meet one of those four is a voluntary notification or a complaint, not a mandatory notification.

The remedies attach to the registration, which is why they can feel beside the point. In the most serious cases the Queensland Health Ombudsman can take immediate action — imposing conditions on a registered practitioner's registration, suspending it, accepting an undertaking, restricting an unregistered practitioner's practice, or prohibiting them from providing a health service. These are interim, protective measures taken on an urgent basis, not findings against the practitioner.

Unregistered practitioners sit outside registration entirely, and the state bodies handle them through a code. Massage therapists, naturopaths, counsellors, dental assistants and anyone practising outside their registration must comply with the National Code of Conduct for health care workers. Where an investigation finds a breach and a risk to public safety, the state commission can issue and publish a prohibition order or a public warning — a real and public consequence that Ahpra has no role in.

What Ahpra and the Boards cannot do is worth stating flatly. They cannot order a refund, award damages, compel a practitioner to treat you, change or correct your medical record, or resolve a billing dispute. Nor is a notification a fast process — the assessment involves asking the practitioner to respond and gathering material, and outcomes are reported to you at the end rather than negotiated with you along the way.

Assessment is where most complaints end, and the New South Wales Commission publishes the fullest list of where they end up: referred to the relevant health professional council for a non-disciplinary conduct, health or performance pathway; discontinued; discontinued with comments to the provider; referred to another body; resolved directly by the assessment officer; referred to the Commission's Resolution Service for assisted resolution; referred back for local resolution by the hospital or facility; or referred for investigation. Discontinuation is not a finding that nothing happened.

Queensland structures the same territory as 'relevant actions' — assessment, local resolution, referral, conciliation, immediate action and investigation — and a matter can move through more than one before it finishes. Local resolution there is voluntary and generally completed within twenty-two business days, extendable to forty-four. New South Wales uses local resolution for much the same material and publishes examples: a patient discharged without the discharge summary reaching their GP, inadequate communication with a patient or family, rudeness by staff, waiting times in the emergency department, and facility issues such as cleanliness, parking and food. The Commission is not involved in that process, and receives only a summary of the outcome from the health service afterwards.

Conciliation is the most under-used option and the most likely to produce something you actually want. Tasmania's description is the clearest: it is free, confidential, informal, non-adversarial, an alternative to legal action without the need for legal representation, and either party can withdraw at any time. It suits complaints where communication has broken down, where explanations are required, where you want the quality of the service improved, or where there is a claim for damages, compensation or remedial treatment.

Its confidentiality cuts both ways, and this is the trap. Queensland states that information disclosed during conciliation, including anything about agreements or negotiations, is confidential and privileged, meaning it cannot be admitted as evidence in a proceeding before a court, tribunal or disciplinary body. Western Australia says evidence of anything said or admitted during its resolution process is not admissible before a court or tribunal, excluding investigations. Tasmania is blunter still: you retain your right to go to court subject to limitation periods, but information provided in conciliation cannot be used as evidence in a subsequent legal action. Weigh that before you conciliate a matter you may later litigate.

On compensation, be clear-eyed. Western Australia's HaDSCO states that it cannot assist with compensation claims at all and recommends independent legal advice from a personal injury specialist. Tasmania's conciliator can explore and negotiate a payment but cannot decide or award one. Victoria lists a refund or compensation as a possible outcome of its voluntary process, which means the provider has to agree. Service NSW's guidance on the Health Care Complaints Commission is equally direct: it cannot order refunds, compensation, specific treatments or changes to documents.

Investigation is the serious end and it is rare. In New South Wales an investigation can result in referral to the independent Director of Proceedings to decide whether to prosecute for unsatisfactory professional conduct or professional misconduct, referral to a council, comments to the practitioner, or no further action; possible criminal conduct goes to the Director of Public Prosecutions. Queensland's Director of Proceedings performs the equivalent role for referrals to the Queensland Civil and Administrative Tribunal.

Your care should not change because you complained. The national Charter of Healthcare Rights gives you a right to provide feedback or make a complaint without it affecting the way you are treated, and it applies in all places where health care is provided in Australia. If the relationship has broken down anyway, you can change providers and ask for your records to be transferred — the OAIC notes that a provider may prefer to transfer the record to the new provider rather than hand it to you, which is fine if that is where it needs to go.

Aged care has its own regulator and the state health commissions will refer you there. The Aged Care Quality and Safety Commission takes concerns about a provider, a worker or a 'responsible person' — someone responsible for or with significant influence over the services delivered. It draws a useful distinction between feedback, where you tell it something without being involved in the resolution, and a complaint, where you want to be part of how it is handled.

It also offers the clearest published treatment of anonymity anywhere in the system. An open complaint means the Commission and the provider both know who you are. A confidential complaint means the Commission knows but takes reasonable steps not to reveal your identity to the provider, and involves you as far as it can without doing so. An anonymous complaint means nobody knows, which also means it cannot keep you informed or tell you the outcome.

Disability supports funded through the NDIS go to the NDIS Quality and Safeguards Commission rather than to a state health body, and Western Australia's HaDSCO makes the boundary explicit by excluding NDIS-covered services from its own disability jurisdiction. Where a person receives both health care and NDIS supports, the complaint may need to be split — describe both and let the two bodies sort out the referral rather than choosing for them.

Mental health is jurisdictionally messy and worth checking before you write. Western Australia folds mental health services into HaDSCO's general jurisdiction, which covers health, mental health and disability services not covered by the NDIS. Victoria runs a separate Mental Health and Wellbeing Commission for public mental health and wellbeing services, so a Victorian complaint about a public mental health service may belong there rather than with the Health Complaints Commissioner. Tasmania cannot deal with orders made by the Mental Health Tribunal or by the Guardianship and Administration Board, which are separate statutory decision-makers.

Money complaints mostly sit outside all of this. Tasmania cannot look at fees charged by private practitioners, Medicare or health insurance. Private health insurance disputes — including disputes with insurers, brokers, hospitals and practitioners about insurance matters — go to the Commonwealth Ombudsman, free of charge. Suspected incorrect or fraudulent Medicare billing goes to Services Australia, which runs a dedicated reporting channel for it.

Finally, there is a regulator of the regulator. If your problem is how Ahpra or a National Board handled your notification — the delay, the process, the communication, the decision-making rather than the clinical merits — the National Health Practitioner Ombudsman is independent of Ahpra and takes complaints about it. It also reviews registration decisions, assessment of overseas-qualified practitioners and accreditation processes, and it has run system-wide reviews of matters including vexatious notifications.