How to make a complaint (FAQs)
A list of commonly asked questions.
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.
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.
No, the OHO is unable to provide you with any medical advice or assistance.
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.
Before making a complaint with us, talk with the health service provider. This can often be the most effective way to reach a solution.
You can make a complaint about any health service, provided by any health service provider, anywhere in Queensland.
Before making a complaint with us, talk with the health service provider. This can often be the most effective way to reach a solution.
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.
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.
Talking with your health service provider can often be the most effective way to reach a solution.
For those who prefer communicating in writing, our sample complaint letters and letter templates are a useful guide on how to structure your complaint.
In certain cases we may refer you to make your complaint to another organisation. If you are unhappy with the response provided to you by the organisation we refer you to, please contact them directly to discuss your concerns. The organisation will be able to provide you with details about their internal complaints and review processes.
If you are not satisfied with their response, contact us. We will ask you to provide evidence of the steps you have taken to resolve your complaint with the health service provider. You will also be asked to provide a copy of any response you have received from the health service provider. We will review this information to determine if anything further can be achieved.
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.
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.
Before making a complaint with us, talk with the health service provider. Talking with your provider can often be the most effective way to reach a solution.
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).
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.
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.
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.
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.
Yes, the service is free.
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.
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.
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.
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.
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.
Yes, in most circumstances a copy or summary of your complaint will be given to the health service provider for their response.
If giving notice of the complaint to the health service provider risks the health and safety of the complainant or another person, results in possible harassment or intimidation, or prejudices an investigation or inquiry, notice to the health service provider may be withheld.
Yes, in most circumstances a copy of the health service provider’s response will be given to you.
However, the OHO has the right to use discretion when releasing a health service provider’s response to complainants and in some circumstances will decide to release limited information.
If the response is not provided to you, you may make an administrative access request for non-sensitive information by contacting the Release of Information Officer at rti@oho.qld.gov.au.
If you decide to withdraw your complaint, call 133 OHO (133 646).
The OHO still has the power to take relevant action to pursue a withdrawn complaint when we believe it is necessary to protect the health and safety of the public.
Yes, the OHO can obtain any information relevant to managing a complaint, including medical records.
Yes. Contact the Release of Information Officer at rti@oho.qld.gov.au or call 133 OHO (133 646) to request access to records obtained by the OHO as part of the complaints management process.
The OHO adheres to legislated timeframes and will not allow extensions to be granted past the due date.
Failure to provide requested information by the due date may result in your complaint being closed.
Contact your case officer if you need more time.
In certain cases the OHO will require further information from an independent health service provider to advise whether the treatment received was reasonable or unreasonable. If we seek clinical advice, you will be advised of the outcome.
Yes, in most cases you will be advised of the complaint outcome unless circumstances exist in which it is inappropriate to disclose the notice of the decision.
Under the Health Ombudsman Act 2013, the Health Ombudsman must retain and assess and/or investigate health complaints or notifications about registered practitioners that involve:
- alleged conduct that may amount to professional misconduct
or - where another ground may exist for the suspension or cancellation of the practitioner’s registration.
When complaints or notifications about registered practitioners are not likely to meet the above criteria, they are referred to Ahpra to assess and/or investigate.
Referral of a complaint or notification to Ahpra is not an escalation of the complaint and does not mean that a more serious outcome is being considered. Referral does not indicate that the concerns or allegations in the complaint have been substantiated.
Ahpra and the Board for the relevant profession will assess the complaint and may investigate the matter, before the Board makes a decision about whether any regulatory action is taken.
After receiving the referral from the OHO, Ahpra will deal with the complaint and may contact the complainant, the relevant parties, or another entity directly to obtain further information. Ahpra will provide the complaint to the national board that registered the practitioner to decide what action—if any—is required.
Once a matter is referred, the OHO will close the matter. If you would like an update about Ahpra’s handling of the matter, please contact Ahpra on 1300 419 495.
The OHO is committed to protecting public health and safety and examines all aspects of a complaint. This can include other health service providers, even if you did not make a complaint specifically about them.
When a complaint is more complex or requires more analysis it may be referred for further assessment.
Once we decide to assess a complaint it must be completed within 30 days, although an extension of 30 days may apply in some instances.
Local resolution is a process where we work with you and the health service provider, in an informal way, to resolve your complaint as quickly as possible.
Once we decide to facilitate local resolution it must be completed within 30 days, although an extension of 30 days may apply in some instances.
Conciliation is a confidential and free complaint resolution service. It is an effective way to resolve complex complaints, particularly those that require detailed explanations or confidential dispute resolution.
We have a conciliation timeframe target of six months, however we will work with all parties to achieve resolution as quickly as possible.
We are committed to:
- providing Queensland with a transparent, accountable and fair complaints management system
- protecting the health and safety of the public
- providing exceptional service to stakeholders
- identifying ways to improve our business process.
If you believe the decision made in relation to your complaint is not correct, you are encouraged to discuss your concerns with the case officer listed on the email or letter we sent you (i.e. the notice of decision). This officer will explain how the decision was reached and answer any questions you may have.
If you still believe the decision is incorrect, you can request an external review by the Queensland Ombudsman.
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 Queensland Human Rights Commission.
Health service providers can decide whether to prescribe and administer medications where the prescriptions or supply of this medication is clinically appropriate for your circumstances.
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.
In Queensland, health service providers are required to operate under the Health (Drugs and Poisons) Regulation 1996.
In Australia there is considerable evidence of widespread misuse of prescribed medication. Levels of prescription opioid and benzodiazepine overdose are at record levels. The Queensland Office of the Health Ombudsman and the South East Coroner have recommended that Queensland Health implement a real-time prescription monitoring system.
Providing real-time prescription information directly to treatment providers is one means of significantly improving prescribing and dispensing decisions and reducing harms from inappropriate and/or unsafe use of higher risk prescription medicines. You can read more here.
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.
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.
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.
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, it is not an indication of how much your doctor can or should charge you.
Most medical services attract a specific Medicare Benefits Schedule item number.
Not all health services or procedures attract a Medicare Benefit. For example, Medicare does not cover most private dental services or physiotherapy.
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.
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.
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.
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’.
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.
No, the OHO is unable to intervene in waiting lists for surgery or appointments. If you have concerns that you have been categorised incorrectly or your situation has changed, please contact your medical practitioner in the first instance.
In the public system elective surgery waiting lists are managed by Queensland Health.
Click here for more information on waiting lists and categorisation.
If you believe you have been incorrectly categorised, contact your referring medical practitioner. They may be able to provide further information which is relevant to the categorisation process.
Alternatively, by updating your medical practitioner with changes in your health may allow them to provide another referral to the hospital to re-assess your case.
Click here for more information on waiting lists and categorisation.
If you are unsatisfied with public waiting lists, you may choose to pay for specialists directly, or obtain relevant private health cover adequate to your needs. You can talk with your medical practitioner about other options.
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 Release of Information Officer at rti@oho.qld.gov.au
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.
If the person is accessing medical records from a Queensland Health hospital and they are refused, then they can contact the Office of the Information Commissioner (OIC).
If the person is accessing medical records from a private hospital or practice and they are refused, then they can contact the Office of the Australian Information Commissioner (OAIC).
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.
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.
Yes, the OHO can access your clinical records without consent.
The OHO accepts complaints about any health service, provided by any health service provider, anywhere in Queensland.
Information about the Mental Health Act 2016 (the Act), including patient rights and support is available on the Queensland Health website.