Example 22

Office of the Health and Disability Commissioner (Te Toihau Hauora, Hauātanga), Statement of Intent 2008/09, pages 17-21

6.1 Output 1 – Complaints Resolution

Value 2008/09 $3,844,438

The Commissioner has various options when a complaint is received to secure a fair, simple, speedy and efficient resolution. He may decide to take no action, for example, where the passage of time makes it impracticable to take any action, or where a complaint is made by someone other than the consumer and the consumer does not wish the matter to proceed.

The other options open to the Commissioner include:

• gathering additional information and sharing this with the parties concerned, which can often resolve the matter for the complainant
• writing an educational letter to the relevant party
• referring the complainant to the provider to work with the complainant to resolve the concerns raised, and asking both the provider and the complainant to report back on the outcome
• referring the complainant to advocacy for assistance in resolving his or her complaint
• referring the parties to formal mediation to resolve the complaint
• referring the complaint for investigation
• referring the complaint to an agency who is better placed to manage the complaint, for example, the Privacy Commissioner or the Human Rights Commission.

Where complaints are outside jurisdiction, the Commissioner’s approach is always to assist the complainant or enquirer to identify the correct agency, as many callers find it difficult to discern the Commissioner’s role from the name of the office, and often expect the office to be able to deal with any matters related to the broader health and disability sector issues.

HDC responds to enquiries from the public, health and disability service providers, and from a range of other associated bodies and organisations in the health and disability sectors. In responding to enquiries, HDC offers advice and information in order to assist consumers to better understand health and disability services and systems and to participate more fully in their care. The information and advice is provided both verbally and in writing. It can assist people to take their own action in managing concerns they have with a health or disability service provider. Sometimes it simply helps to clarify a matter and no further action on the part of the enquirer is needed.

When someone makes a complaint about a health or disability service, HDC looks for the lessons from the complaint and uses this to encourage improvements to the service in question. Complaints help consumers to have their needs and expectations known and understood. They assist in identifying poor practice and poor systems and allow remedial action to be taken. Complaints help to keep people safe by offering a learning opportunity to all involved, especially the health or disability service provider. Complaints offer insight into the reasons for near misses, preventable injuries, emotional harm and preventable deaths.

Serious complaints that are upheld offer an opportunity not only for learning but also for accountability. An individual or organisation that has seriously breached the Code of Rights may be censured by the Commissioner and face disciplinary action. Very serious cases are referred to the Director of Proceedings for prosecution, and this may result in loss of the right to practise as a registered health professional. This protects the public from providers whose practice is significantly below the acceptable standard and at risk of causing harm.

Where the Commissioner makes recommendations for improvements to services or an individual provider’s practice, he follows up to ensure that action has been taken. Information about the Commissioner’s findings, recommendations, and resulting action, is widely circulated to professional bodies and relevant organisations in order to share the learning from this work.

1: All requests for the Commissioner to reconsider his decision result in a closed file review.

6.2 Output 2 — Education

Value 2008/09 $888,505

Through education HDC aims to have providers understand their responsibilities and comply willingly with the requirements of the Health and Disability Commissioner Act 1994, and have consumers know their rights under the Act and feel free from fear to exercise those rights. The Advocacy Service is the primary vehicle for promoting awareness of the Code of Rights to the public, both to consumers and providers of health and disability services. However, the Commissioner’s Office also focuses on several types of promotional and educational initiatives:

• Presentations at conferences and seminars, both nationally and internationally, on specific areas of interest to provider and consumer audiences. Findings from the Commissioner’s complaints resolution work are used to facilitate a deeper understanding of issues providers and consumers need to be cognisant of, along with suggestions for service improvement. Staff from the Commissioner’s Office often work in a co-facilitation role with advocates and consumers to deliver educational sessions to special interest groups.
• Customised training working with consumers to help them build support networks in situations where they are likely to need ongoing help to work in partnership with a particular provider or a number of providers. Customised training is also developed and implemented with individual providers and group providers to address their specific needs in relation to better meeting their obligations under the Code, whether it is changes to their practice or their systems.
• Opinions given by the Commissioner provide information for the public and, in particular, professional bodies on issues for improvement in the delivery of health and disability services. The opinions outline areas for learning around professional accountability and systems failure. Case studies are also available. These can be found on the Commissioner’s website, www.hdc.org.nz.
• Publications in a range of media are available from the Commissioner’s Office and can be ordered on-line or by post or fax. These publications explain the role of the Health and Disability Commissioner, the processes used in carrying out the Commissioner’s functions, and information about the services offered by the Commissioner’s Office. Many of these publications are available in languages other than English and Māori. There are easy-read versions of the key publications. All information produced is free to the public.
• Articles written by the Commissioner and members of his senior management team are published regularly in a wide range of health and disability journals, magazines and newsletters.
• Media interviews and releases are given where there are opportunities for wider learning as a result of HDC findings or where there is a perceived public safety issue.
• DVD movies are provided for use as training and awareness-raising tools and for providing general information.