This section provides information about the scope and function of, and complaints to, the following:
The Australian Health Practitioner Regulation Agency (AHPRA) is the organisation responsible for the registration and accreditation of 16 health professions across Australia.
AHPRA supports the 15 National Boards in implementing the National Registration and Accreditation Scheme.
National Boards
Each health profession that is part of the National Registration and Accreditation Scheme is represented by a National Board.
While the primary role of the Boards is to protect the public, the Boards are also responsible for registering practitioners and students, as well as other functions, for their professions.
The 15 National Boards are:
All Boards are supported by AHPRA.
Complaints to AHPRA
AHPRA can investigate complaints about the conduct, health and performance of a registered health practitioner.
Activities considered as breaches of professional conduct are categorised as professional misconduct, unprofessional conduct, and notifiable contact. Practitioners are health impaired if they have a physical or mental impairment, disability, condition or disorder that detrimentally affects, or is likely to detrimentally affect their capacity to practise their profession. The professional performance of a registered practitioner is defined to be unsatisfactory if it is below the standard reasonably expected of a practitioner of an equivalent level of training or experience.
Notifications (includes Complaints)
Members of the public may make a notification or complaint to AHPRA about the conduct, health or performance of a practitioner or the health of a student.
Practitioners, employers and education providers are all mandated by law to report notifiable conduct relating to a practitioner or student. Registered practitioners who fail to report notifiable conduct may face disciplinary action by their National Board.
AHPRA will assess all notifications/complaints to determine whether a Board must consider taking immediate action to protect public health or safety.
This may result in changing the registration status of a student or practitioner. If immediate action is not required, AHPRA will asses the notification thoroughly to enable the relevant Board to make an informed decision about it. Each investigation is tailored to the complaint received, and complex matters take more time. AHPRA aims to complete most investigations within six months.
Stages of the Notification/Complaint Process
All notifications/complaints pass through stages 1-2, and depending on the outcome of the preliminary assessment may pass through any of the following stages, 3-5.
Stage 1: Receipt of Notification/Complaint
AHPRA receives notification/complaint either by online form, hardcopy form (available to download on the AHPRA website) letter or telephone.
Stage 2: Preliminary Assessment
A preliminary assessment determines if the matter will be handled by AHPRA or referred to another health complaints entity.
Preliminary Assessment Outcome
The outcome of the preliminary assessment may be for the Board to:
Stage 3: Investigation
An investigation may need to be conducted to determine the appropriate course of action, which may be to:
A decision may be made to:
Where an undertaking or condition applies, the registrant will be subject to monitoring to ensure compliance.
Stage 4: Panel Hearing
A panel hearing will be conducted to determine the appropriate course of action, which may be to:
A decision may be made to:
Where an undertaking or condition applies, the registrant will be subject to monitoring to ensure compliance.
Panel hearing outcomes are published.
Stage 5: Tribunal Hearing
A tribunal hearing will be conducted to determine the appropriate course of action, which may be to:
Where an undertaking or condition applies, the registrant will be subject to monitoring to ensure compliance.
Tribunal hearing outcomes are made available to the public.
Telephone 1300 419 495 8am to 6pm (EST), Monday to Friday
The Health and Community Services Complaints Commissioner(HCSCC) is an independent statutory authority established under the Health and Community Services Complaints Act 2004 (SA). The role of the HCSCC is to help people to resolve complaints about health and community services where a direct approach to the service provider is either unreasonable, or has not succeeded. It covers health and community services across the public, private and non-government sectors.
The HCSCC assists service users and carers who wish to complain about health and community services. In certain circumstances, it will also deal with complaints made on behalf of another person. The HCSCC also assists service providers to respond to complaints. The HCSCC is obliged by law to treat everyone involved in a complaint equally.
The HCSCC may be able to deal with complaints about:
Since 18 December 2017, complaints in relation to most child protection matters have been dealt with by Ombudsman SA. This is pursuant to section 28A of the Health and Community Services Complaints Act 2004 (SA). See Complaints about child protection services
HCSCC can help to resolve complaints:
HCSCC cannot handle complaints about :
How to complain
The HCSCC recommends that it is often most effective to complain to the provider first. They provide some guidelines as to the suggested process for making a complaint to the provider. If the provider does not respond, or if the complainant feels that the response is unsatisfactory, they may contact the HCSCC by telephone or by completion of a complaint form. See more on the HCSCC -Making a Complaint website.
The telephone enquiry service provides advice in relation to the complaints process. Interpreters are available. The HCSCC may require the complainant to provide further information or documents in relation to a complaint, or to verify the complaint by statutory declaration.
The HCSCC also provides guidelines to assist service providers to respond to a complaint.
How complaints are resolved
The HCSCC may use one or more of a broad range of alternative dispute resolution processes including informal mediation, investigation and conciliation. There is flexibility in adopting the most appropriate process for a particular matter. Any agreement reached in the course of a conciliation process may be made in a binding form.
Information disclosed in a conciliation process is confidential and cannot be used as a process of discovery for potential litigation.
If, after investigating a complaint, the HCSCC decides that the complaint is justified but appears to be incapable of being resolved, the HCSCC may recommend that the service provider take particular action to remedy the grievance. The complainant may be notified of the recommendation.
Code of Conduct for Certain Health Care Workers
Certain health practitioner who are not otherwise regulated are bound by a Code of Conduct, which is contained in the Health and Community Services Complaints Regulations 2019 (SA).
The Code covers health practitioners who are not required to be registered under the Health Practitioner Regulation National Law (South Australia) Act 2010 (SA), and to registered health practitioners who provide health services unrelated to their registration [see Health and Community Services Complaints Act 2004 (SA) s 56A(1); Health and Community Services Complaints Regulations 2019 (SA) reg 2]. The health practitioners covered by the Code can include, for example, counsellors, social workers, speech pathologists, disability support workers, audiologists, sonographers, naturopaths and homeopaths.
The Code has been implemented as part of the National Code of Conduct Regime whereby each State and Territory has enacted, or will enact, the Code (or a variation of the Code) in their own state-based legislation or regulations in order to enable a nationally consistent approach.
The Code allows for certain interstate orders to be recognised and enforceable in South Australia [s 56EA]. It is an offence for a person to engage in conduct in South Australia that would constitute a contravention of any corresponding interstate order that they are subject to [see Health and Community Services Complaints Act 2004 (SA) s 56EA]. See Regulation 9 of the Health and Community Services Complaint Regulations 2019 (SA) for a list of interstate orders that are covered by section 56EA of the Act.
Maximum penalty: a fine of up to $10 000, or two years imprisonment, or both [s 56EA].
What can the HCSCC do if the Code is breached?
Complaints about unregistered health practitioners and breaches of the Code are made to the Health and Community Services Complaints Commissioner (SA), who has investigative powers and the ability to impose conditions on the person's provision of service [s 56B].
The Commissioner can commence an investigation upon receipt of a complaint or on their own motion [s 43].
The Commissioner has the ability to take interim action (in the form of an interim prohibition order) against a person once an investigation has been commenced, and to make final orders once an investigation has been completed.
An interim prohibition order can be made for a period of up to 12 weeks and may impose certain conditions on the person [see s 56B]. At the conclusion of an investigation, a final order can be made which can apply for an indefinite period of time and which can impose similar conditions on the person [see s 56C].
To impose either an interim or final order, the Commissioner must have a reasonable belief that the person has breached the Code and that action is necessary to protect the health or safety of members of the public [see ss 56B(1) and 56C(1)].
The Commissioner has the power to impose conditions (whether interim or final) on a person that prohibits them from:
See ss 56B(2) and 56C(2).
It is an offence to contravene an interim order or final order.
Maximum penalty: a fine of up to $10 000, or two years imprisonment, or both [ss 56B(5), 56C(4)].
In addition to issuing interim or final orders, the Commissioner also has the power to publish a public statement identifying the person and giving warnings and other information to the public that the Commissioner considers appropriate [see ss 56B(2)(c) and 56C(2)(c)].
Where prohibition orders are made, the Commissioner must provide the person (and any complainant) with a written statement outlining the Commissioner's findings, any material on which the findings were based, and the reasons for the action [s 56D].
The Commissioner may at any time vary or revoke the orders made and/or statement published [s 56C(3)].
Can an order of the Commissioner be appealed?
A person may appeal an order to the South Australian Civil and Administrative Tribunal SACAT. A time limit applies and legal advice should be sought before commencing any appeal.
Are volunteers covered by the Act?
Volunteers are generally excluded from the general complaints provisions of the Health and Community Services Complaints Act 2004 (SA). However, if a code of conduct applies in respect of the volunteer and the conduct of a volunteer has posed a risk to the health or safety of members of the public then they can be subject to an investigation by the Commissioner [see s 25(6)].
Complaints against Commonwealth-funded aged care services can be made to the Aged Care Quality and Safety Commission (the Commission). The Commission was established under the Aged Care Quality and Safety Commission Act 2018 (Cth) and the Aged Care Quality and Safety Commission Rules 2018 (Cth). The Act and Rules apply to both approved providers of residential aged care or home-care services, and Commonwealth-funded aged care service providers.
Since 1 January 2019, the Aged Care Quality and Safety Commission replaced the former Aged Care Complaints Commissioner and the former Australian Aged Care Quality Agency, combining the functions of the two former agencies into a single service that oversees aged care compliance monitoring, complaints, and customer service.
From January 2020, the Commission has responsibility over the Commonwealth Department of Health's aged care compliance responsibilities.
The Serious Incident Response Scheme 'SIRS' part commenced on 1 April 2021 (full commencement on 1 October 2021) and requires aged care providers to have an effective incident management system in place and to identify, record, manage, resolve and report all serious incidents that occur, or are alleged or suspected to have occurred.
There are eight types of reportable incidents under the SIRS: unreasonable use of force, neglect of a consumer, psychological or emotional abuse, unexpected death, stealing or financial coercion by a staff member, inappropriate use of restrictive practices, and unexplained absence from care. Under the SIRS, an allegation, suspicion, or witness account of any of the above serious incidents must be reported to the Commission.
From 1 July 2021, approved providers have updated and specific responsibilities under the Aged Care Act 1997 (Cth) and the Quality of Care Principles 2014 relating to the use of any restrictive practice in residential aged care or short-term restorative care in a residential care setting. A restrictive practice in relation to a care recipient is any practice or intervention that has the effect of restricting the rights or freedom of movement of the person.
From 1 September 2021, it is a requirement for all residential aged care providers to have Behaviour Support Plans ('BSP') in place for care recipients that need them. A BSP forms part of an existing Care and Services Plan and are required for any person:
The Commission's role includes:
Aged care service providers subsidised by the Australian Government must meet the responsibilities and standards of care set out in the Aged Care Act 1997 (Cth). They are also required to comply with the Aged Care Quality Standards (from 1 July 2019). Information on the Aged Care Quality Standards can be accessed via the Aged Care Quality and Safety Commission website.
A person who has a concern or complaint about a service provider's responsibilities under the Aged Care Act 1997 (Cth) should attempt to raise any concerns with the aged care service provider in the first instance. If they are unable to do this or the provider is unable to resolve their concern, they should then contact the Aged Care Quality and Safety Commission online via the Commission's website, or by telephoning 1800 951 822. Complaints can be made confidentially or anonymously and all complaints are taken seriously. Any person can raise a complaint or concern with the Commission.
The Commission may be able to assist with a concern or complaint relating to:
A complaint or concern may relate to wide range of matters including the health care or personal care assistance that a consumer is receiving, their living environment, or a concern that their personal choices or preferences are not being followed. It may relate to concerns about a staff member's role or actions, the communication of information to the consumer, or to certain fees and charges contained in care agreements.
Complaints may be resolved using one or more of the following methods:
For more information on the process of aged care complaints, see the Aged Care Complaints Process on the Aged Care Quality and Safety Commission websiteor contact the Commission 1800 951 822.
Medicare is administered by the Commonwealth Government under the Health Insurance Act 1973 (Cth).
Complaints about Medicare and medical refunds can be made by telephoning the Department of Human Services Medicare and Centrelink Feedback and Complaints line on: 1800 132 468 or online at the Department of Human Services website.
The Complaints Resolution and Referral Service(CRRS) is a free service for people with a disability who are users of Disability Employment Services (DES), Australian Disability Enterprises (ADE) and Advocacy Services and wish to complain about these services.
CRRS offers an independent complaints resolution and referral service.
Complaints can be made by telephone on 1800 880 052 (toll free). This line is available Monday to Friday from 9.00 am to 7.00 pm (AEST). For callers with a hearing or speech impediment, contact the National Relay Service on 1300 555 727 and ask for 1800 880 052. All users must be registered to make and receive calls through the National Relay Service (NRS).
Complaints can also be lodged online using the CRRS Online Complaints Form.
National Disability Abuse and Neglect Hotline
The National Disability Abuse and Neglect Hotline is available for reporting abuse and neglect of people with a disability.
Telephone 1800 880 052 Monday to Friday from 9.00 am to 7.00 pm (AEST) to report abuse. For people with a speech or hearing impediment contact the National Relay Service on 1300 555 727 and ask for 1800 880 052. All users must be registered to make and receive calls through the National Relay Service (NRS).
The National Disability Insurance Scheme Quality and Safeguards Commission ('NDIS Commission') is an independent body established to improve and monitor the quality and safety of NDIS supports and services.
The NDIS Commission can receive and respond to concerns, complaints and reportable incidents, including abuse and neglect of NDIS participants. Specifically, the NDIS Commission is empowered to review and investigate complaints about NDIS funded services or supports that were not provided in a safe and respectful way, or which were not delivered to an appropriate standard.
The functions of the NDIS Commission are to:
As of 1 December 2020, residents in all states and territories are able to lodge complaints about NDIS services and supports with the NDIS Commission.
Any NDIS participant, their family, friends, carers, advocates or other workers can make a complaint to the NDIS Commission about NDIS funded services or supports. Complaints can be made by contacting the NDIS Commission on 1800 035 544 or by using the NDIS Commission Online Complaint Form via the NDIS Commission website.
Once a complaint is lodged, the NDIS Commission can liaise with the NDIS funded service provider to try to resolve the issue, can seek more information from both parties, can investigate the matter, or can suggest that the parties participate in conciliation.
The NDIS Commission may take compliance and enforcement action against an NDIS provider where it has determined that the NDIS provider has not met its conditions of registration, or the NDIS Code of Conduct.
The NDIS Commission's core functions and framework is set out in Chapter 6A of the National Disability Insurance Scheme Act 2013 (Cth).
More information on the NDIS Commission can be obtained from the NDIS Commission website.
For information on the NDIS and the NDIA, see the National Disability Insurance Scheme NDIS.
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