Your options · 12 min read · Published 27 October 2026 · Reviewed 27 October 2026 · Next review April 2027

By Dr Rosemary Listing, PhD (Law) · Medical negligence lawyer since 2013 · Of Counsel, Peter Evans & Associates

Complaint or Claim? Your Options After Poor Medical Care

After poor care, most people want three things: to understand what happened, to hear someone say sorry, and to know it will not happen to anyone else. Some also need help with what the harm has cost them.

Each of those needs points to a different path. Knowing what each one can and cannot do makes it easier to choose, and to avoid putting your energy into a path that cannot give you what you need.

What each path can give you

Before you start: three things that help

1. Write down what happened

   While it is fresh, write a timeline: dates, times, who you saw, what you were told, and what you noticed. Include what you raised at the time and how people responded. Memory fades quickly, and a timeline is useful whichever path you choose.

2. Get your medical records

   Records show what was written down at the time, which may differ from what you were told. Reading them first helps you ask precise questions. Read how to get your medical records.

3. Decide what you want

   An explanation, a meeting, an apology, a change in practice, action on a clinician, or compensation. Knowing what you want tells you which path, or paths, to take, and makes it easier to tell whether a response has given it to you.

1. Tell the hospital or practice

The most direct path is to raise your concerns with the hospital or practice where you were treated. This is usually the quickest way to get an explanation, and it often leads to a meeting with the people involved in your care.

Who to contact

• Public hospitals: the patient liaison officer or consumer feedback service, usually listed on the hospital or local health district website.
• Private hospitals: the patient experience or quality manager, or the director of nursing.
• GPs, specialists, dentists and clinics: the practice manager, or the clinician directly.

How it usually works

Put your complaint in writing, by letter, email or the hospital’s online form. You should receive an acknowledgement, and the complaint is then looked into, which usually means reviewing your records and speaking with the staff involved. You then receive a written response, and often an offer to meet.

In New South Wales, public health services aim to acknowledge a complaint within a few days and respond within about five weeks, although complex complaints can take longer. Private providers set their own timeframes. If you hear nothing, follow up in writing.

If you meet with the hospital

• bring a support person, and a written list of your questions
• ask who will be there, and whether the clinicians involved will attend
• take notes, or ask for a written summary afterwards
• ask what will change, and when you will hear about it

If you are not satisfied

Say so in writing, and explain which questions were not answered. If that does not resolve it, you can take the complaint to an independent body, described in section 3.

2. Open disclosure

Open disclosure is the process of a health service talking openly with a patient and family after something has gone wrong. Under the Australian Open Disclosure Framework, health services are expected to:

• acknowledge that something went wrong
• say sorry
• explain what happened, as far as is known
• listen to your experience and answer your questions
• explain what is being done to stop it happening again

For serious incidents, it should happen without you having to ask. If it has not, you can request an open disclosure meeting. You can bring a support person, ask questions, and ask for a written summary afterwards.

For serious incidents, public hospitals in New South Wales also carry out a formal review of what went wrong. You may be told its findings and the recommendations made. The full review report itself is usually confidential.

In New South Wales, an apology is not treated as an admission of legal liability. This is meant to make it easier for clinicians to say sorry. It also means an apology does not decide whether there is a claim.

After a birth, the equivalent is often a birth debrief. Read how to ask for a birth debrief.

3. A health complaints body or Ahpra

If you are not satisfied with the response, or the concern is serious, you can go to an independent body. You do not have to complain to the hospital or practice first, although it often helps. Which body depends on where you are.

New South Wales: the Health Care Complaints Commission

The HCCC deals with complaints about health services and individual practitioners in New South Wales, including unregistered practitioners such as some cosmetic therapists and counsellors. Complaints are free, and can be made online. The HCCC must generally assess a complaint within 60 days. It can then:

• decline to take it further, with reasons
• refer it back to the provider, or help the parties resolve it through its resolution service
• refer it to the relevant professional council, which can act on a practitioner’s registration
• investigate, and in serious cases prosecute the practitioner before a tribunal

Queensland: the Office of the Health Ombudsman

Complaints about health services and practitioners in Queensland go to the Office of the Health Ombudsman, which has similar powers.

Other states and territories: Ahpra and health complaints commissioners

Concerns about a registered practitioner’s conduct, performance or health are made to Ahpra as a “notification”. The relevant national board can take no further action, caution or reprimand the practitioner, impose conditions on their registration, or refer serious matters to a tribunal. Complaints about a health service go to the state or territory health complaints commissioner.

What to expect

These bodies exist to protect the public. They do not award compensation, and they move at their own pace: complaints can take months, and serious investigations longer. You will usually be told the outcome, although not always every detail. Disciplinary outcomes such as conditions and reprimands often appear on the Ahpra public register.

If someone has died

If a family member has died and you have concerns about their care, the same paths are open to you, and open disclosure should include the family. In addition:

• The coroner. Deaths that were unexpected, or that followed a health procedure where death was not the expected outcome, are usually reported to the coroner. Families can write to the coroner with their concerns, and can ask for an inquest.
• A claim. Family members may be able to claim compensation, for example if they depended on the person financially. Different time limits can apply.

4. A compensation claim

A medical negligence claim is the only path that can bring compensation for what the harm has cost you: pain and suffering, lost income, treatment and care. It needs independent expert evidence that the care fell below an acceptable standard and caused your injury. A complaint response can help explain what happened, but it does not decide whether there is a claim.

Read how a claim works, what compensation covers and how a claim is paid for.

Can I do both?

Yes. A complaint and a claim can run side by side, and many people do both. Two cautions:

• Keep copies of everything you send and receive, and notes of any meetings.
• Get advice before signing anything. If a hospital or practice offers a payment, or asks you to sign a document, it may affect your right to make a claim later.

Common worries about complaining

“Will it affect my care?” It should not. You have a right to raise concerns, and health services are expected not to treat you differently because you have. If you are worried, you can ask to be seen by a different clinician.

“I do not want to get anyone into trouble.” Many people feel this. Most complaints are about understanding what happened and preventing it happening again, not punishment. Regulators act only where there is a risk to the public.

“It was a long time ago.” Complaints can still be made about older care, although the longer the gap, the harder it can be to look into. Compensation claims have strict time limits, so get advice before deciding it is too late.

“I am too exhausted.” That is understandable. You can ask a family member or friend to help, or to make the complaint with your permission.

Free template complaint letter

Use this for a complaint to a hospital or practice. A clear complaint usually gets a clearer response:

• stick to facts and dates, and describe the effect on you in your own words
• list the specific questions you want answered
• say what you would like to happen
• keep it as short as you can, and attach your timeline if it is long

To the Patient Liaison / Consumer Feedback Manager / Practice Manager
[Hospital or practice name]

I am writing to make a complaint about the care I received.

Full name: [name]
Date of birth: [date]
Medical record number (if known): [number]
Date(s) of care: [dates]
Ward, department or clinician (if known): [details]

What happened:
[Describe what happened, in order, with dates and times if you know them.]

How it has affected me:
[Describe the effect on your health, your family, your work and your daily life.]

Questions I would like answered:
[List your questions, one per line.]

What I would like to happen:
[For example: a written explanation, a meeting with the treating team, an open disclosure meeting, an apology, a review of the care, or changes to prevent this happening to others.]

Please acknowledge this complaint in writing and let me know how and when it will be responded to.

Yours sincerely,
[name]
[phone and email]

For a complaint after a birth, read how to complain to a hospital after a traumatic birth. It may also help to get your medical records first, so your complaint is based on what was recorded.

In my practice

Many people come to me after a complaint has not given them what they needed. Sometimes the response was defensive. Sometimes it was kind, but did nothing about the fact that they cannot work, or care for their children, the way they used to.

A complaint and a claim are not competing choices. One can bring answers and change, the other can bring the support you need to live with what happened. You are allowed to want both.

With care,
Rosemary

Frequently asked questions

This page is general information only. It is not legal advice about your situation, and reading it does not create a lawyer and client relationship. If you are worried about your health, please see your doctor. If you are in crisis, call 000 or Lifeline on 13 11 14. Legal services are provided by Peter Evans & Associates.