How can I make a complaint about a health service I received?

In Plain English

If you're not happy with the health service you received, here's how you can complain, based on the provided information:

Private Health Insurance Issues: If your complaint is about a private health insurer, a healthcare provider, or a broker related to your private health insurance, you can complain to the Private Health Insurance Ombudsman. This includes issues about health insurance arrangements or Chapter 2 of the Private Health Insurance Act 2007.
Aged Care Services: If your complaint relates to aged care services, you can make a complaint to the Complaints Commissioner. This could be about a registered provider, a responsible person, or an aged care worker and their compliance with the Aged Care Act 2024 or actions that go against the Statement of Rights. You can give feedback too.
Online Safety Issues: If the issue relates to cyberbullying or offensive online content, you can complain to the eSafety Commissioner under the Online Safety Act 2021.
My Health Record System: The material does not specify how to make a complaint about the My Health Record system.
NHMRC Reviewable Action: If your complaint relates to a reviewable action by the National Health and Medical Research Council, you can make a complaint to the Commissioner according to the National Health and Medical Research Council Act 1992.
Medicare Issues: If your complaint relates to a health practitioner, you can complain to the Chief Executive Medicare according to the National Health Regulation 2016.
Human Rights Issues: If your complaint relates to human rights violations, you can complain to the Australian Human Rights Commission according to the Australian Human Rights Commission Act 1986.

Detailed Explanation

The legislative context provides several avenues for lodging complaints related to health services, depending on the nature of the complaint:

Private Health Insurance Ombudsman:
- Who can complain: Individuals insured or seeking insurance, private health insurers, healthcare providers, and private health insurance brokers (Private Health Insurance Amendment Act 2015, section 20E).
- Who can be complained against: Private health insurers, healthcare providers, and private health insurance brokers (Private Health Insurance Amendment Act 2015, section 20F).
- Grounds for complaint: Matters arising from private health insurance arrangements or Chapter 2 of the Private Health Insurance Act 2007 (Private Health Insurance Amendment Act 2015, section 20G).
- The Ombudsman can deal with complaints through mediation, referral, or investigation (Private Health Insurance Amendment Act 2015, section 20J).
- The Ombudsman may refer the complaint to the Australian Competition and Consumer Commission or another relevant body if it can be dealt with more effectively elsewhere (Private Health Insurance Amendment Act 2015, sections 20K and 20L).
- The Ombudsman may decide not to deal with a complaint if it's older than 12 months, if the complainant hasn't tried to resolve it themselves, or if the complainant doesn't agree to a referral (Private Health Insurance Amendment Act 2015, section 20M).
Aged Care Complaints Commissioner:
- Who can complain: Any person can make a complaint about a registered provider, responsible person, or aged care worker's compliance with the Aged Care Act 2024 or about actions incompatible with the Statement of Rights (Aged Care Rules 2025, section 361-10).
- How to complain: Orally or in writing, and anonymously (Aged Care Rules 2025, section 361-10).
- The Complaints Commissioner must acknowledge receipt of the complaint within 3 business days, unless the complaint is anonymous, the complainant requests no contact, or the complaint has been withdrawn (Aged Care Rules 2025, section 361-25).
- The complainant can withdraw the complaint at any time (Aged Care Rules 2025, section 361-15).
- The Complaints Commissioner must deal with and resolve the complaint and prepare a written statement (complaint determination) within a period specified in the rules (Aged Care Act 2024, section 361).
eSafety Commissioner:
- Cyberbullying: An Australian child, or a responsible person on their behalf, can complain about cyberbullying material targeted at the child (Online Safety Act 2021, section 30). An adult who was the target of cyberbullying as a child can also complain under certain conditions (Online Safety Act 2021, section 30).
- Online Content: A person can complain about class 1 or class 2 material accessible to end-users in Australia (Online Safety Act 2021, section 38).
- Breaches: A person can complain about breaches of service provider rules, civil penalty provisions, industry codes, or industry standards (Online Safety Act 2021, sections 39, 40).
- For complaints about material on social media, relevant electronic services, or designated internet services, evidence of a prior complaint to the service provider is required if a removal notice is sought (Online Safety Act 2021, sections 30, 36).
NHMRC Commissioner:
- Grounds for complaint: The grounds for complaint concerning a reviewable action are outlined in the National Health and Medical Research Council Act 1992, section 58.
- How to make a complaint: A complaint must be in writing, signed by the complainant, describe the action complained about, specify the nature of and grounds for the complaint, and be lodged with the Commissioner (National Health and Medical Research Council Act 1992, section 59).
Chief Executive Medicare:
- Grounds for complaint: A person can complain to the Chief Executive Medicare about a health practitioner (National Health Regulation 2016, section 2).
Australian Human Rights Commission:
- How to make a complaint: A complaint must be in writing, signed by the complainant, and set out the details of the alleged acts, omissions, or practices (Australian Human Rights Commission Act 1986, section 46P).

The Ombudsman Act 1976 is mentioned in the context, but not directly related to making complaints about health services.