Introduction

This chapter discusses health complaints entities in Australia and New Zealand. Health complaints entities are responsible for receiving and resolving patients’ complaints about the quality of health care services. In many jurisdictions, such as Australia (Bismark et al, 2013), New Zealand (Dew and Roorda, 2001), Scandinavia (Rosenthal, 1992), the United Kingdom (UK) (Nettleton and Harding, 1994; Chamberlain, 2013) and the United States (Dauer, 2011), there has been sustained interest in patients’ complaints since the 1990s. While research has typically focused on formal complaints, it is recognised that these represent only a small fraction of patients’ concerns about their care (Beaupert et al, 2014).

Complaints from patients have attracted growing interest from policy makers and professional organisations, largely because of the social movement promoting patients’ rights in health care. Factors such as media coverage of medical injuries, the establishment of patient advocacy groups and the increasing availability of information, have heightened health care users’ awareness of patient safety issues, and increased the demand for accountability. In addition to accountability, research suggests that patients who raise concerns about care often seek remedies such as apologies, explanations, and corrective action to prevent harm to future patients (Bismark et al, 2011; Moore and Mello, 2017; Moore et al, 2017). Health complaints entities may provide such remedies. In doing so, health complaints entities have the potential to serve the public interest, particularly with respect to public health and safety, open justice and economic benefits. In this chapter, we explore the extent to which health complaints entities in Australia and New Zealand are maximising their potential to serve the public interest.

While there are variations between health care complaints processes and outcomes depending on the jurisdiction, a similarity that crosses jurisdictional boundaries is that many countries have transitioned from self-regulation to greater external oversight by the state (Beaupert et al, 2014). Health complaints entities represent one regulatory strategy, working alongside clinical governance and professional self-regulation. By encompassing broader concerns and remedies than medical malpractice litigation (Bismark et al, 2011), health complaints entities are now the main avenues for patients and their families who want action to address problems relating to their treatment. Health complaints entities have been likened to patient ombudsman systems that operate in jurisdictions such as Austria, Finland, Greece, Israel, Norway and the UK (Fallberg and MacKenney, 2003; Beaupert et al, 2014).