Making a complaint about the Health Service Executive
Information
On 1 January 2007 a new statutory complaints system for the HSE came into effect. This system allows anyone receiving public health or personal social services in Ireland to make a complaint about the actions or failures of 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
• Adversely affects you, or someone on whose behalf you are making a
complaint.
What is fair or reliable administrative practice?
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, or
• 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, or
• 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 Social Welfare Acts, for example the Supplementary
Allowance Scheme. (These are dealt with through the Social
Welfare Appeals Office)
• 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).
Rules
How does the HSE complaints procedure operate?
The complaints procedure is now in place and complaints officers may be appointed by the HSE or by a service provider. The HSE has appointed and trained complaints officers in the relevant areas throughout the HSE.
These 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
Section
14 of the Disability Act 2005 provides for a statutory complaints system
for people with disabilities who are dissatisfied with decisions about:
• How their needs are assessed
• The contents of service statements and
• The delivery of services outlined in service statements.
This complaints system is not yet in place. It is unclear
whether the same complaints officers will deal with complaints under the
disability legislation AND complaints relating to the general
health and personal social services.
Furthermore, the rules under which the disability complaints officers are to
operate differ from those under the general system:
- The disability complaints system has a dedicated appeals officer – this is not available under the general system.
- The disability complaints system provides for appeal to the courts in relation to the implementation of recommendations.
Remember however, this complaints system is not currently in place.
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. This means contacting the Local Health Office manager for
complaints about community
care services. You should contact the hospital administrator for formal
complaints about hospital
services.
If you wish to make a complaint about a service provider providing services on
behalf of the HSE, you should contact the complaints officer for the service
provider.
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 new 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.
Where to apply
Contact information for the manager of your Local Health Office is available from your Local Health Office. Contact information for the hospital administrator, will be available directly from the hospital concerned.The HSE leaflet Your Service, Your Say is available in all health service locations throughout the country and sets out the formal complaints process. You may also make comments and observations on these, or email your comments to yoursay@hse.ie or register a complaint through the HSE website.
The HSE’s national information line is CallSave 1850 24 1850 for more information.
Further information
The Health Act 2004 provided for the setting up of the Health Service Executive (HSE).
The statutory basis for the HSE complaints procedure became law in 2007 through Statutory Instrument 651/2006. The detailed Regulations, are contained in the Health Act 2004 (Complaints) Regulations – SI 652/2006.
Language
Related Documents
- Office of the Ombudsman
The main duty of the Irish Ombudsman is to investigate complaints made by members of the public about how they have been treated by public bodies in Ireland. - European Ombudsman
The European Ombudsman safeguards the fundamental rights of citizens living in Europe by ensuring open and accountable administrations within the European Union. - Garda Síochána Ombudsman Commission
The Garda Síochána Ombudsman Commission or Garda Ombudsman is an independent agency that deals with complaints from the Irish public about members of the Gardaí.
Contact Us
If you have a question relating to this topic you can contact the Citizens Information Phone Service on 0761 07 4000 (Monday to Friday, 9am to 9pm) or you can visit your local Citizens Information Centre.