Making a complaint about a health service
This document describes the complaints system for public health services provided by, or on behalf of, the Health Service Executive (HSE).
Private health services
For information about making a complaint about a private health service visit healthcomplaints.ie which provides information on making complaints about private and public health services.
Public health services
There is a statutory complaints system for anyone seeking or receiving public health or personal social services who wishes to make a complaint about the HSE. The complaints system also covers service providers with HSE contracts who provide health or personal social services on behalf of the HSE. The law governing the complaints system is set out in Part 9 of the Health Act 2004.
What can you make a complaint about?
You may make a complaint about any action of the HSE or a service provider that, in your view, doesn’t seem to be fair or reliable administrative practice and that adversely affects you, or someone on whose behalf you are making a complaint.
Administrative practice refers to the way decisions are made and how services operate. Under the complaints system, administrative practice isn’t considered to be fair or reliable if it is:
- Taken without proper authority
- Taken on irrelevant grounds
- The result of negligence or carelessness
- Based on erroneous or incomplete information
- Improperly discriminatory
- Based on undesirable administrative practice
- In any other respect, against fair or sound administration
Who can make a complaint?
If you are unable to make a complaint on your own behalf due to your age, illness or disability, someone else can make a complaint on your behalf. These people include:
- A close relative or carer.
- Anyone appointed by law or the courts to take care of your affairs. (This would seem to include a Committee of a Ward of Court or someone appointed under an Enduring Power of Attorney . It is not however entirely clear as the law which applies to Committees and Attorneys gives them specific and not general powers).
- A legal representative.
- Anyone else with your consent.
- Anyone who is appointed, as set out in the Regulations.
Can a complaint be made on behalf of a deceased person?
Yes. In such cases the complaint may be made by a close relative or carer. A close relative includes a parent, guardian, son, daughter, spouse or cohabiting partner. Remember, the complaint must be made within 12 months of the date of the action giving rise to the complaint or of the person becoming aware of the action. A complaints officer may extend the time limit if there are special circumstances involved.
Which complaints are not covered?
You cannot complain about:
- A matter that is, or has been the subject of legal proceedings before a court or tribunal .
- A matter relating solely to the clinical judgment (medical decision) by a person acting on behalf of the HSE or a service provider.
- An action taken by the HSE or a service provider solely on the advice of someone exercising their clinical judgment.
- A matter relating to the recruitment, appointment or terms and conditions of an employee or advisor of the HSE or a service provider.
- A matter relating to the registration of births, marriages and deaths that could be the subject of an appeal (Section 60 of the Civil Registration Act 2004). A matter that could prejudice an investigation being undertaken by the Gardaí.
- A matter that has been brought before any other statutory complaints procedure. (This doesn’t prevent a complaints officer dealing with a complaint that was made to the Ombudsman or the Ombudsman for Children.)
How does the HSE complaints procedure operate?
The complaints officer will be informed of all verbal complaints that could not be resolved at the first point of contact and will receive a copy of all written complaints. Depending on the nature of the complaint, the complaints officer, with the consent of the people involved, may consider if an informal resolution might be appropriate. As part of the informal resolution the complaints officer may arrange a meeting between the parties concerned or use mediation services. If informal resolution is not appropriate or turns out not to be successful, the complaints officer will start a formal investigation of the complaint.
Complaints officers deal with the complaint and make a recommendation. You may then ask for a review of that recommendation and there will be an internal review. (See ‘How to apply’ for information on how to make a complaint).
Written complaints will be acknowledged within five working days and the complaint will be investigated within 30 working days. You will get a written response to your complaint. You will be told of your right to have an internal review and of your right to go to the Ombudsman.
Service providers may put their own procedures in place by agreement with the HSE. It is a condition of the agreement between the HSE and service providers that service providers will comply with the HSE complaints procedure, or establish its own complaints procedures. It’s also a condition that the service provider will co-operate with the HSE in any review of a complaints officer’s recommendation following the investigation of a complaint against the service provider.
Are complaints officers required to fully investigate every complaint?
No. Complaints officers may stop investigating a complaint for various reasons. For example, if the complaint is trivial or vexatious. Complaints officers do not have to investigate complaints that don’t come within the scheme.
What recommendations can a complaints officer not make?
A complaints officer cannot make a recommendation which would require the HSE to make a material change to its approved service plan. (Approved service plans indicate the type and volume of health and personal social services to be provided by the HSE, they indicate planned capital spending on services, etc.)
Complaints officers cannot make recommendations either that would require a change to be made to the contractual arrangements which the HSE has with a service provider.
If the CEO of the HSE or the service provider considers that a recommendation breaches this rule, they may amend the recommendation as required, or they may reject the recommendation and take other measures to deal with the complaint.
Will details of complaints received be reported?
Yes. The HSE is obliged to publish information about the complaints procedure, as part of its annual report. Service providers must provide the HSE with details about the number and the nature of complaints dealt with, through their own complaints procedures.
Complaints under the Disability Act 2005
The Disability Act 2005 provides for, among other things, the assessment of need of people with disabilities and the consequent drawing up of service statements.
There is also a complaints and appeals procedure under the Disability Act 2005 which you can use if you are unhappy with your child's assessment or service statement or delivery of related services.
There is no fee to make a formal complaint about a public health or personal social service provided by the HSE. There is no fee to make a formal complaint to a service provider, who provides services on behalf of the HSE.
How to apply
If you wish to make a complaint about the HSE you should first of all try to resolve the problem locally. That means, bringing the complaint to the attention of the person in charge of the service, for example the ward sister in the case of a hospital complaint, or the supervisor in charge for other services. Some general advice on how to make a consumer complaint is available here.
If you are still unhappy, you can make your complaint through the formal complaints mechanism. There are a number of ways in which to make a complaint to the HSE, including by mail, phone, email, online, or through advocacy or accessibility services.
It is advisable to make your formal complaint in writing, giving as much detail as you can. Written complaints will be acknowledged within five working days and the complaint will be investigated within 30 days. If the investigation takes longer than 30 days, the HSE will keep you up updated about progress on your complaint every 20 working days.
Following the investigation, you will receive a written response to your complaint and will be advised of your right to have an internal review of the recommendation of the complaints officer. You will also be told of your right to complain to the Ombudsman.
What happens if you exhaust the complaints process?
If you have exhausted the health service complaints process, you may complain to the Ombudsman or the Ombudsman for Children. Their role is not changed by this complaints procedure. Actions taken by service providers under agreements with the HSE will be considered to have been taken by the HSE for the purposes of the legislation governing each Ombudsman. This in effect, extends the Ombudsman’s remit to these service providers.
The law doesn’t provide for a mechanism for implementing the recommendations of a complaints officer or for what is to happen if the recommendation is not implemented.
There is more information about the complaints procedure in Your Service, Your Say – HSE Complaints Policy.
The HSE’s national information line is CallSave 1850 24 1850 or (041) 685 0300.