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Health consumers

OHO Frequently asked questions

  • About the Office of the Health Ombudsman

    • What is the role of the Office of the Health Ombudsman?

      The Office of the Health Ombudsman:

      • Receives and manages complaints about health services and health service providers, including registered and unregistered health practitioners.
      • Decides what action to take in relation to those complaints and, in certain instances, takes immediate action to protect the safety of the public.
      • Monitors the health, conduct and performance functions of the Australian Health Practitioner Regulation Agency and national health practitioner boards.
      • Provides information about minimising and resolving health service complaints.
      • Reports publicly on the performance of the office’s functions.

      Download our factsheet

    • Can the OHO assist me in getting immediate medical help?

      No, the OHO is unable to assist you in getting medical help.

      The OHO’s goal is to protect the health and safety of the public within the legislative requirements of the Health Ombudsman Act 2013. This legislation does not allow for direct intervention with an individual’s immediate care requirements.

      If you need immediate medical assistance please call 000.

    • Can the OHO advise me on my medical condition, or help me make a decision about my care?

      No, the OHO is unable to provide you with any medical advice or assistance.

  • I am thinking of making a complaint

    • Who can make a complaint?

      Anyone can make a complaint, including:

      • a patient who received a health service
      • a parent or guardian of a patient
      • a relative, friend or representative chosen by the patient
      • a health service provider
      • any other concerned person.

      Complaints about health services are important as they can identify areas for improvement and prevent problems from reoccurring.

    • Who and what can I complain about?

      You can make a complaint about any health service, provided by any health service provider, anywhere in Queensland.

      Click here for more information.

    • The health service provider is no longer registered, can I still make a complaint?

      Yes, you can still make a complaint. However, if the health service provider has retired or is no longer practising, we may be limited in what we can do.

    • Can I make a complaint about medical reports?

      The OHO does not intervene in decisions made about medical reports when you either disagree with the report or would like to make an amendment. However, the OHO may accept a complaint in relation to the conduct of the health service provider in certain circumstances.

    • How do I complain directly to a health service provider?

      Talking with your health service provider can often be the quickest and easiest way to address your concerns or fix a problem. Click here for more information about talking with your health service provider.

    • Why do people make complaints?

      There are many reasons for lodging a complaint with the OHO. People generally make a complaint to ensure that health service provider is aware of their concerns or an incident. Making a health service complaint also encourages health service delivery improvements by preventing the issues or incidents from reoccurring.

      Other people would like a health service provider to be disciplined, or they would like to receive compensation.

      The OHO will consider your desired outcomes in the complaints process, however we are unable to guarantee they will be achieved.

      Possible outcomes:

      • an acknowledgement, explanation, apology, policy/process change, compensation or refund from the health service provider
      • disciplinary action in relation to the health service provider by the Health Ombudsman, the National Board or another entity.

    • Does my complaint need to be in writing?

      No, your complaint does not need to be in writing. You can call 133 OHO (133 646) and we will take your complaint over the telephone.

      Although there is no requirement to make your initial complaint in writing, the OHO may request further written information to assist in managing your complaint.

      Click here to make a complaint online or in writing.

    • How do I make a health service complaint?

    • What information do I need to provide with my complaint?

      Any complaint lodged with the OHO should include:

      • Who was involved?
      • Where did the incident occur?
      • What happened and when?
      • What are you concerned about?
      • Have you done anything else to address this matter?
      • What do you want to happen now?
      • Any supporting documentation (where available).

      Click here for more information about making a health service complaint.

    • Can I make a complaint on behalf of the patient without their knowledge?

      Anyone can make a complaint about any health service provided in Queensland.

      The OHO is required to carefully consider how the consumer’s privacy could be affected by information that is provided to the complainant.

      Personal information can include health information, other information contained in health records or the health service provider’s response.

      This means specific details of the consumer’s treatment and health information may not be provided to the complainant in the notice of decision, however this information will have been carefully reviewed and considered by the OHO when making the decision.

      The following circumstances may require additional documentation to allow the OHO to freely disclose information:

      • You are an appointed guardian of an individual and have authority to make medical decisions.
      • You have Enduring Power of Attorney–Medical for an individual.
      • You are a Statutory Health Attorney.

      For further information relating to guardianship refer to the Public Guardian website.

    • Can I make a complaint about my child’s medical treatment Court order?

      If you have questions or disagree with the Court order, the OHO cannot assist you. If you want to challenge a report that influenced the Court order, we cannot assist you.

      However, if you are concerned about the conduct or performance of the health service provider who drafted the report, then we may be able to assist you. Please contact us to discuss the matter.

    • What if I am a health service provider, how do I make a notification?

      As a health service provider, you can make a complaint to the OHO if you have concerns about the health, conduct or performance of another health service provider.

      The mandatory notification requirements under the Health Practitioner Regulation National Law Act 2009 are unchanged, however notifications are made to the Office of the Health Ombudsman as of 1 July 2014.

    • Can I make an anonymous complaint and what response will I receive?

      Yes, you can make an anonymous complaint.

      To assess the issues raised in your complaint, the OHO usually seeks a response from the health service provider and is required to notify them of the nature of the complaint and who made it.

      The OHO will only be able to request relevant records and information if the consumer’s name and date of birth are disclosed.

      Remaining anonymous may make it difficult to obtain a relevant response to the specific issues you have raised. The OHO will not be able to clarify any information you have provided, or ask for further information that may be needed to assess the complaint, and may have to close your complaint.

      If you choose to make an anonymous complaint, the decision made by the OHO will not be provided to you.

      When making an anonymous complaint, you must provide sufficient information for the OHO to determine:

      • when the incident occurred i.e. dates, times
      • where the incident occurred
      • the patient’s name
      • the patient’s date of birth
      • the name of the health service provider i.e. doctor, facility
      • details of the incident.

      You may request your identity to be withheld instead of remaining anonymous (See next question below). If you are considering making an anonymous complaint, contact us to discuss your options.

    • Can my personal details be withheld from the complaint?

      Yes, you can request your identity be withheld. This is different to remaining anonymous, as the OHO will retain your personal information and will not provide it to the health service provider involved in your complaint. However there may be some circumstances where this is not possible. Contact us to discuss your circumstances.

      Withholding your identity still allows the OHO to contact you throughout the process and provide a formal outcome to your complaint.

      The OHO respects your right to privacy, however due to the nature of your complaint, it is possible a service provider could unintentionally identify who is making the complaint.

    • Is it free to make a complaint?

      Yes, the service is free.

    • Can I be sued for making a complaint?

      No, you cannot be sued for making a complaint unless you intentionally make false allegations or provide false information to the OHO.

      It is an offence to knowingly provide false information to the OHO.

    • Can I complain about health service provider fees?

      Yes, you can make a complaint about fees you have been charged and the OHO may be able to assist you. However, the OHO cannot compel a health service provider to alter their fees or make any recommendations in relation to their fees.

    • What if I want a refund or compensation?

      The OHO cannot compel a health service provider to compensate you for pain, suffering or loss of income. Should you wish to pursue compensation, you can seek legal advice. However, in some instances a complaint may be referred to conciliation or local resolution where refunds or the costs for future treatment may be negotiated with the health service provider.

    • How can the OHO protect me if I make a complaint?

      When you make a complaint the Health Ombudsman Act 2013 anti-reprisal legislation provides protection for the complainant, unless you intentionally make false allegations or provide false information to the OHO.

      Contact us for more information.

    • I’m a patient and a health service provider, can I make a complaint? Is the process different for me?

      Yes, you can make a complaint. The process for managing health service complaints from health service providers in their capacity as a patient is the same.

  • I have made a complaint

  • Refusal to treat

    • What can I do if a health service provider refuses to treat me?

      A health service provider is required to provide treatment in an emergency situation.

      However, in non-emergency situations a health service provider can refuse to treat you. This can include their decision not to prescribe certain medication or accept new patients.

      If you have been refused treatment, be respectful in your contact with the health service provider. Ask for their reasons for refusing to treat you and attempt to discuss your concerns. If this is unsuccessful, request your care be transferred to another health provider.

      If you believe a health service provider has refused to treat you because of your race, age, sex, sexuality, impairment, or another discrimination factor, you may wish to complain to the OHO or the Anti-Discrimination Commission Queensland.

    • My health service provider claims they aren’t allowed to prescribe me the medication I want/need, is that true?

      Health service providers can use their discretion when administering or prescribing medication.
      In Queensland, health service providers are required to operate under the Health (Drugs and Poisons) Regulation 1996.

      If you have been refused medication, be respectful in your contact with the health service provider, ask for their reasons for refusal and seek possible alternatives.

  • Fees in your health care

    • In the public system

      Treatment as a public patient in the Queensland public health system, such as a public hospital or community health centre, is provided to you at no cost.

      Some people may also be eligible for treatment at public dental clinics at no cost.

    • In the private system

      If you consult a doctor or other health service provider privately, there will be a charge. When accessing any private health service, you can ask what the cost of the service will be and how much you will be refunded by Medicare (if it is a service covered by Medicare) before your consultation.

      The government does not regulate fees charged for private health care services including doctors, dentists, denture makers, optometrists, physiotherapists and podiatrists). Private practitioners, private hospitals, day surgeries and nursing homes can decide what they will charge for their services in the same way as any other business.

      If you have private health insurance, you can make enquiries with your insurer prior to accessing a specialist to ensure you are fully aware of the out-of-pocket charges.

    • Recommended fees

      Some health service providers belong to professional associations, such as the Australian Medical Association (AMA), that suggest ‘recommended’ fees. However doctors are not obliged to charge this fee—they may charge more or less.

    • The Medicare Benefits Schedule

      For many health services, the government sets a Medicare Benefits Schedule (MBS) fee, often referred to as the schedule fee. Medicare pays a percentage of this fee—this is called the Medicare benefit. The Medicare benefit is usually less than the amount your doctor will charge, itis not an indication of how much your doctor can or should charge you.

      Most medical services attract a specific Medicare Benefits Schedule item number.

    • Services not covered by Medicare

      Not all health services or procedures attract a Medicare Benefit. For example, Medicare does not cover most private dental services or physiotherapy.

    • Know the full costs

      If you have private health insurance, you should seek information about what your private health fund will cover and what you may have to pay yourself (the gap). Before you contact your health fund, please ask your doctor or provider about:

      • the Medical Benefits Scheme (MBS) item number
      • the name of the hospital or facility where the procedure will be performed
      • charges of all attending doctors
      • charges for tests, such as pathology or x-rays.

      With this information, contact your health fund to ask about the full costs and any gap that may apply. The gap is the difference between what the practitioner charges and what Medicare plus your health insurance will cover you for. It is often called ‘out-of-pocket expenses’.

      If you agree to a service without asking about costs and charges, it is difficult to complain after you have received the service.

    • Clarify and confirm the total costs

      You have a right to know what the costs will be. A health care provider should be prepared to discuss charges with you before providing the services. If it is complicated, ask for written information about the costs:

      • If you are given an ‘estimate’ of the cost, it could increase if there are unexpected complications.
      • If the care is to be provided in a private hospital, you should also ask about hospital and other charges.

      It is best to have any verbal quotes confirmed in writing. Some health providers request payment prior to treatment. You may also be charged a cancellation fee, if you miss your appointment.

    • Cost for other services

      Be aware that there may be other practitioners involved in your care also expecting payment. Examples of these might be the surgeon’s assistants or anaesthetists. Your doctor or other health service provider should be able to tell you who will be involved in your care, and how to find out what other providers charge.

    • Financial consent

      When your health service provider gives full explanations about the fees and you agree to go ahead with the treatment, you are giving ‘informed financial consent’.

    • What is bulk-billing?

      A doctor can choose to charge a patient only the Medicare Benefit amount, this is called ‘bulk-billing’. For more information, visit the Department of Human Services.

      Always check if your GP will provide a bulk-billed service when you make the appointment and when you arrive at the practice. This can save any misunderstanding and alert the practice staff that you are to be bulk billed.

  • Waiting lists

  • Clinical Records

    • How do I access my records?

      Accessing your health information will require different actions depending on who provides the service for example a health practitioner, a public or private hospital, or a nursing home.

      Access to the information can be provided in different ways:

      • looking at the record
      • asking for a copy
      • having the information sent to a new hospital, doctor or health service.

      Ask your provider if you need help understanding your clinical records.

      It is a good idea to call them or visit in person to ask:

      • Is there an application form?
      • What proof of identity is required?
      • What are the fees? Are there any concessions on the fees (for example as a student, or pensioner)?
      • How long will it take for the application to be processed?
      • Is someone available to assist in reading or interpreting the records, and is there a fee for this?

      Follow up with a written request (and keep a copy).

      Things to include:

      • Your full name (include any name changes), date of birth and present address.
      • If you have moved since your health records were compiled, include alternative addresses.
      • Give the approximate dates your health information was compiled. For example, if you want records made while you were in hospital, give the dates you were admitted and discharged from hospital.
      • Details of the health information you want. You may need to discuss this with your health provider or doctor, as you may not need or want all the records.
      • If you are the next of kin or an administrator of a will, you need to provide documentation to prove that you are eligible to act on behalf of another person.

      If you would like to access your records that are held by the OHO, please contact our RTI officer at rti@oho.qld.gov.au

    • The health service is charging me to transfer my records to my new practice, are they allowed to do this?

      Yes, privately operated health service providers such as doctors, dentists and private hospitals cannot be compelled by the OHO to alter their fees or make any recommendations in relation to their fees.

      Like any privately owned business, health service providers are entitled to charge for reasonable operational costs associated to the request.

    • Can access to my records be refused?

      Access to your records can be refused when you or another person is at risk. In this case, the health service provider should give reasons for their refusal and let you know which records have not been given access.

      For further information refer to the Office of the Australian Information Commissioner or
      Right to Information.

    • Can I access someone else’s records?

      The Privacy Act 1988 regulates how personal information is handled, including the release of information.

      To access someone else’s record, you will need to obtain and provide appropriate consent from the individual. If adequate consent is not provided, access to the records will not be granted.

      The following circumstances may require additional documentation to allow free disclosure of information:

      • You are an appointed guardian of an individual and have authority to make medical decisions.
      • You have Enduring Power of Attorney–Medical for an individual.
      • You are a Statutory Health Attorney.

      For further information relating to guardianship, refer to the Public Guardian, Right to Information or Office of the Australian Information Commissioner.

    • Can the OHO request a health service provider change/correct my records?

      The OHO does not have the power to alter or delete entries in your clinical records or compel a health service provider to do so.

      If you believe the information in your clinical record is incorrect, you can request that it be corrected by submitting your own comments to the health service provider.

    • Can the OHO obtain my clinical records without my consent?

      Yes, the OHO can access your clinical records without consent.

  • Mental Health

    • Mental Health

      The OHO accepts complaints about any health service, provided by any health service provider, anywhere in Queensland.

      If you have a complaint regarding a mental health service or provider, you may choose to refer to Queensland Health for more information about the Mental Health Act 2016 (the Act).

      If you are a public mental health patient, you can also access information from one of the Independent Patient Rights Advisors (IPRAs).

      It is a requirement under the Act for Hospital and Health Services (HHSs) to appoint IPRAs to advise persons and their nominated support persons, family, carers and other support persons of their rights under the Act.

      The IPRAs liaise between patients, family, carers, support persons and clinical teams.

      Their main functions are to:

      • Ensure that a patient, and the patient’s nominated support persons, family, carers and other support persons are advised of their rights and responsibilities under the Act.
      • Help the patient, and the patient’s nominated support persons, family, carers and other support persons to communicate to health practitioners the patient’s views, wishes and preferences about the patient’s treatment and care.