Concerns and complaints

We receive information about a practitioner's practice, conduct, fitness, and competence from any person. We are contacted by other oral health practitioners, employers, organisations as well as patients. 

Patient’s right to complain

The Code of Health and Disability Services Consumers' Rights (the “Code”), grants a number of rights to all consumers of health and disability services in New Zealand, and places corresponding obligations on the providers of those services.

Right 10 of the Code, clearly spells out that it is every patient’s right to complain about an oral health practitioner, in any form appropriate to the patient. A patient may make a complaint to:

• the oral health practitioner or practitioners who provided the services complained of; and
• any person authorised to receive complaints about the oral health practitioner; and
• any other appropriate person, including -
  • an independent advocate provided under the Health and Disability Commissioner Act 1994; and
  • the Health and Disability Commissioner.

Your obligations under the HDC Code

Right 10 of the Code sets out the procedures you must have in place for managing complaints, and what you must do when a complaint is received.

As an oral health practitioner, you are required by the Code to:

• facilitate the fair, simple, speedy and efficient resolution of complaints
• inform the patient about progress on the complaint, not less than monthly
• comply with all other rights contained in the Code when dealing with a complaint

Unless you are an employee of a heath provider, you must have a complaints procedure that ensures that -

• the complaint is acknowledged in writing within five working days of receipt, unless it has been resolved to the satisfaction of the patient; and
• the patient is informed of any relevant internal and external complaints procedures, including the availability of -
  • independent advocates provided under the Health and Disability Commissioner Act 1994; and
  • the Health and Disability Commissioner; and
• the patient's complaint and your actions regarding that complaint are documented; and
• the patient receives all information held by you that is or may be relevant to the complaint.

When you receive a complaint you must acknowledge it in writing to the patient within 10 days of its receipt, advising whether or not you accept that the complaint is justified.  If you require more time to investigate the complaint, you must advise the patient how much additional time you require, and if it is more than 20 working days you must advise the patient why.

Once you have made a decision whether or not the complaint is justified, you must advise the patient as soon as practicable, giving the reasons for your decision, any actions you propose to take, and any appeal procedure you have in place.

If you fail to comply with the requirements of the Code, you may be investigated by the Health and Disability Commissioner, which could result in referral to the Director of Proceedings and charges being laid against you before the Health Practitioners Disciplinary Tribunal.

Complaints received by the Dental Council

If we receive a complaint about the conduct of a practitioner that has affected a health consumer, we must refer it to the Health and Disability Commissioner ("Commissioner") in the first instance.

We cannot take action on a conduct issue while the Commissioner is considering a complaint. However, if the complaint raises an issue about your competence or health, we can investigate that and take the appropriate steps while the Commissioner is considering your conduct.

See the Commissioner’s website for the process they follow 

The Commissioner will encourage consumers who are unhappy about the care provided by their oral health practitioner to talk or write to their provider first. See Concerns about your Dental Treatment 

The Commissioner can decide to:

• take no action
• refer the matter to the Director of Proceedings, who may decide to lay a charge before the Health Practitioners Disciplinary Tribunal (HPDT)
• refer a complaint to us to decide the action required. 

When a complaint is referred to us by the Commissioner, we will act promptly to decide what action should be taken.

Complaints when a health consumer has not been affected

We may receive a complaint about the practice or conduct of a practitioner that does not appear to have affected a health consumer. In this case, we will review the complaint in the first instance, not the Commissioner. Such complaints may allege that a practitioner has:

• practised outside of his or her scope of practice
• practised without a practising certificate
• committed a disciplinary offence
• been convicted in the courts.

We will decide the appropriate action to be taken.

How we act on information received, including complaints and notifications

Below we outline three categories of complaints — competence, conduct, and health concerns — and talk about anonymous complaints.

The three categories: competence, conduct, and health

Concerns and complaints about oral health practitioners fall into one of three categories:

• Competence  – is the practitioner competent to practise?
• Conduct – is the practitioner’s conduct appropriate and safe?
• Health – is the practitioner with a physical or mental health issue fit to practice?

For each of these, we have a range of ways to respond, depending on the nature and seriousness of the concern or complaint.

We examine each notification made under the Health Practitioners Competence Assurance Act 2003 (the Act), and decide whether it should be handled as a competence, conduct or health issue.

Possible outcomes of a complaint

Public safety is our absolute priority in all cases. We do not have any powers to award compensation or costs, or to impose discipline. We decide whether a risk of serious harm exists, and if we do, we have interim powers to restrict your scope of practice or suspend your registration during an investigation.

In deciding what action to take, we have several powers under the Act.

We may:

• refer the practitioner for a competence review
• refer the matter to a professional conduct committee 
• order that the practitioner undergo a medical examination or testing
• establish a competence programme for the practitioner
• establish an individual recertification programme for the practitioner
• apply an interim suspension (in certain circumstances)
• apply an interim condition on the practitioner’s scope of practice.

See the Policy on Acting on information from any person about oral health practitioners.

Competence

The Act requires us to ensure the competence of all practitioners.

This approach is unique to New Zealand. Unlike other countries, we do not treat such concerns as a disciplinary matter. We do not set out to establish guilt or fault. We do not aim to punish those who fall short.

Instead, we look to assess competence. If we find that the practitioner’s practice falls short in some way, we aim to help them meet the required standards. We use a supportive and educative process, putting in place the training, education and safeguards needed to make sure the practitioner comes up to Council’s minimum standards, while remaining safe to practice.

What is a competent practitioner?

A competent practitioner is one who uses their knowledge, skills, attitudes, communication and judgement to deliver appropriate oral health care in the scope of practice within which they are registered. Performance is the output, and its measurement assesses how well a practitioner is actually working.

Practitioners report on their own competence when applying for their annual practising certificate. We check a random selection of practitioners each year through our compliance monitoring process compliance monitoring process.

What happens when someone expresses a concern about competence?

From time to time, people express concerns about a practitioner’s competence.

When we receive a complaint or notification of a competence concern under section 34 of the Act, we must inquire into the competence of the practitioner under section 36(1) of the Act. Initial inquiries are completed by one of our professional advisors.

After initial inquiries, the Council reviews the professional advisor’s report. If appropriate, a review of the practitioner’s competence will be conducted.

See competence reviews for more information. 

Conduct

Oral health practitioners must respect patient rights and follow the principles of ethical conduct for oral health practitioners. Failing to provide good care or behaving in a way that shows a lack of professional integrity are matters of conduct. These could result in the practitioner facing a disciplinary process before a professional conduct committee appointed by us.

Its role is to investigate the practitioner’s conduct and decide whether the matter should be referred to the HPDT for a hearing.

Read more about professional conduct committees

Read more about the Health Practitioners Disciplinary Tribunal  

Health concerns

Council's primary objective is to ensure that the health and safety of patients is protected.  We do however, endeavour to support practitioners to continue in practice, while making sure that patients and colleagues remain safe. We put supports and safeguards in place to help practitioners with mental or physical health issues affecting their ability to practise their profession.

See Health for more information 

Anonymous information

We may act on anonymous information where the information is serious and there are ground for protecting the disclosure or identity of the complainant. We will also consider whether the matter can be progressed while observing the rules of natural justice. In most cases, Council will not usually take further action, except to retain the information.