Complaints against medical practitioners

Complaints against medical practitioners

With complaints, it’s not a case of ‘if’ but ‘when’. And while they are always unsettling, knowing what to expect can make the process a little easier. 

UNFORTUNATELY, most medical practitioners will be the subject of at least one complaint during their career. If you are the subject of a complaint, it is important to seek support from peers and professional advisors. You are not alone.

How are complaints managed in NSW?

Prior to the commencement of the National Registration and Accreditation Scheme (NRAS) in 2010, medical practitioners were registered by the individual State or Territory where they practised.

When the NRAS commenced in New South Wales, New South Wales opted out of that part of the NRAS concerned with managing concerns and complaints about health practitioners (including medical practitioners) and instead opted to continue with its co-regulatory model under which the investigation and prosecution of serious complaints is undertaken by the Health Care Complaints Commission (HCCC), and the Medical Council of NSW (the Council) manages non-disciplinary matters.

Regardless of whether that complaint is made to AHPRA, the Medical Council or the HCCC, the Medical Council and the HCCC must consult about how the complaint should be managed.  

What happens when a complaint is made?

In general terms, when a complaint is made against a medical practitioner, the following process will be followed:

• The HCCC will assess the complaint. This may or may not involve obtaining an initial response from the medical practitioner. Some complaints result in a decision to take no action and without the practitioner being informed of the fact of the complaint.
• At the assessment stage, the HCCC will consult with the Medical Council of NSW regarding the management of the complaint.
• The most common outcomes of the assessment process are a decision to take no further action, or a decision that the HCCC will investigate the complaint to determine whether the medical practitioner has engaged in unsatisfactory professional conduct or professional misconduct, or referral of the complaint to the Medical Council.

What will happen if the HCCC decides to investigate a complaint?

If the HCCC investigates a complaint the investigation process can take some time. The investigation will include gathering records and information and obtaining an expert opinion. At the conclusion of the investigation, the medical practitioner will be afforded the opportunity to respond to the findings and proposed action which may include prosecution of a complaint before the NSW Civil and Administrative Tribunal or a Professional Standards Committee.

Referral of matters to the Medical Council of NSW

Matters that are managed by the Council will be matters where the behaviour or conduct in question is unlikely to amount to unsatisfactory professional conduct or professional misconduct. 

Conduct Pathway

Complaints about behaviour and conduct that are less serious may be referred to the Medical Council for management. A response and / or further information will be sought. Having considered the response / information, one of the following options will be taken:

• • No further action; or
• • Written advice will be provided to the medical practitioner; or
• The doctor will be required to attend an interview at the Council; or
• Referral to the health or performance program; or
• Referral to a section 150 Inquiry; or 
• Referral to the HCCC for investigation or to another body, e.g., the Office of the Australian Information Commissioner.

Impaired Practitioners

Medical practitioners who participate in the Impaired Registrants’ Program will be required to engage with their treating doctors and Council-appointed practitioners. The medical practitioner’s treating practitioners are not required to routinely report to the Medical Council and the relationship between patient and treating doctor remains confidential.  

Medical practitioners in the Health Program will have private Health Conditions on their registration which are not publicly published. They may also have Practice Conditions which will be publicly available on the AHPRA Register of Practitioners. 

For many practitioners, the outcome of the program is to return to unconditional medical registration, although some with chronic or recurring illnesses may remain on the program for a longer period, or perhaps even indefinitely. Many practitioners will be able to continue to practise, albeit subject to conditions, and participation in the Health Program does not mean that a practitioner cannot work.

Performance Pathway

Complaints about performance that do not meet the threshold of unsatisfactory professional conduct or professional misconduct may be managed in a non-disciplinary manner under the Medical Council’s Performance Program.

The Medical Council will seek a response from the medical practitioner, and having considered the response may decide:

• no further action is necessary, or 
• the doctor be provided with advice about his or her professional responsibilities, or 
• the doctor may be asked to attend an interview to discuss the complaint, or
• the doctor be required to undergo a Performance Assessment, and / or
• be referred to a Performance Review Panel.

If you are the subject of a complaint, please contact the AMA (NSW) Workplace Relations Team at workplace@amansw.com.au or +61 2 9439 8822 for support and assistance.