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Filing a complaint against a health establishment
Health Care Users and Professionals
Rose, Erica’s grandmother, just left the hospital after spending three weeks there because of a broken hip. Erica thinks that the hospital staff treated her grandmother without any respect or compassion. For example, a staff member brusquely took Rose from one department to another, without giving her the time to put on her hospital robe decently. Also, after returning to her long-term care center, Rose wasn’t served the menu prescribed by her doctor, which caused her health to deteriorate. Erica wonders if her grandmother has the right to complain, and if yes, to whom? Is there anyone who can help her grandmother?
The health and social services system has developed a process to handle complaints made by its users whose rights have not been respected. In this Infosheet, Éducaloi informs you about the reasons for making a complaint, how to do it, the time limits, and the available resources.
The law sets out the rights of users of health or social services establishments. The user can file a complaint if one of these rights was not respected. Here are the main rights:
Right to be informed
Right to receive care
Right to decide
You can file a complaint against an establishment, an employee, or a professional who doesn’t respect these rights. The context (for example, the resources and staff available to the establishment), the organization of work, and the applicable laws and regulations all help determine if a right was not respected. The establishment cannot restrict a user’s rights, for example, by forcing him to sign a discharge.
The complaint process described in this Infosheet applies to CLSCs, hospitals (including psychiatric hospitals), youth centers, residential and long-term care centers (CHSLDs), and rehabilitation centers.
In general, any public or private establishment is a health establishment if it offers diagnostic services, general medical care, health services at the primary level of care, and lodging services.
This complaint process does not apply to certain private establishments that offer care for your health, for example: certain vaccination clinics, assisted reproduction clinics, dermatology clinics, and physiotherapy clinics. A Centre d’aide et d’accompagnement aux plaintes (CAAP), which is an organization whose mission is to help and support users, can tell you if the complaint process applies to a particular establishment (see the question “Who can help me file my complaint?”).
If you want to complain about the services you received in an establishment to which the complaint process does not apply, you must contact a person who is in charge of this establishment: person in charge of customer service, ombudsman, director. Sometimes, you can also have other recourses. See the question “Is this the only complaint process that exists?”
Any user who thinks that one of his rights has not been respected can file a complaint.
If the user is dead, his heirs can file a complaint on his behalf. If the person whose rights were not respected is a child or is unable to file a complaint himself, a representative can file a complaint on his behalf. This representative can be the person’s parents, his tutor, his curator, his mandatary in case of incapacity, a close relative, or someone else who shows a particular interest for the person. To find out more about these representatives, read our Infosheets: Curatorship to persons of full age, Tutorship to persons of full age and Mandates given in anticipation of incapacity.
The user can complain verbally, or he can write down his complaint. He can get help from a Centre d’aide et d’accompagnement aux plaintes (CAAP), which is an organization whose mission is to help and support users (see the question “Who can help me file my complaint?”). The complaint is addressed to the local complaints commissioner of the establishment (“the commissioner”). When she receives the complaint, the commissioner first informs the user that his complaint has been received (she has three days to do this). She then carries out a first evaluation of the complaint. If she finds that the complaint is without foundation – for example, if the user’s complaint is not related to the one of the rights described above or if the user is complaining just because he dislikes an employee of the establishment – she rejects the complaint and informs the user about her decision.
But if the complaint seems serious, the commissioner investigates what happened. She questions the user and the other people involved, and she checks the facts. She must send her decision, including the results of her investigation and a detailed report, to the user (or his representative) within 45 days. The decision is sometimes accompanied by recommendations made to the establishment’s board of directors, its management and/or the person in charge of the relevant services at the establishment. The local complaints commissioner must also inform the user that he has two years to contact the Health and Social Services Ombudsman, if he is dissatisfied with the commissioner’s decision. (See the question “What is the role played by the Health and Social Services Ombudsman?”)
A little. If the complaint concerns a doctor, a dentist, or a pharmacist, the commissioner sends the complaint to the medical examiner of the establishment. The medical examiner carries out the investigation. He has 45 days to examine the complaint and provide a decision to the user and the professional. The medical examiner also informs the user about how the user can ask the review committee to review (check) the medical examiner’s decision.
If the user wants the decision to be reviewed, he must start the review procedures within 60 days after receiving the decision. The review committee then has 60 days to review the decision and to communicate its conclusions to the user, the professional, the medical examiner, and the local complaints commissioner of the establishment. The medical examiner cannot handle complaints in which a doctor, a dentist, or a pharmacist seriously violated their respective codes of ethics; for example, a doctor who sexually touches a patient. In such cases, the medical examiner sends the complaint to the relevant professional order.
No. When a user files a complaint in good faith (i.e. without an intention to harm), the person against whom the complaint is filed cannot use the information provided by the user against the person in a law suit. Moreover, the user cannot be sued for the consequences of his complaint, and no one has the right to take reprisals against him. The answer is the same whether the complaint was rejected or accepted.
For example, Aimée filed a complaint against an employee who mistreated her: the employee was harsh to her despite a recent surgery and insulted her. After an investigation, the commissioner realised that the employee had been involved in such incidents in the past, so the commissioner recommended to the board of directors to fire the employee. The employee does not have the right to sue Aimée for losing her job and the establishment does not have the right to take reprisals against Aimée, for example, by refusing to provide her with care in the future.
When a user is not satisfied with the decision made by the local complaints commissioner or when a user does not get an answer from the commissioner, he can file a complaint with the Health and Social Services Ombudsman. The Health and Social Services Ombudsman first examines the complaint to see if he will handle it or reject it. He can reject the complaint if he finds that:
The Ombudsman gives the establishment and the user the chance to explain their positions. He can ask them for any documents that he thinks will be useful to making his decision. The Ombudsman promptly communicates his conclusions and recommendations to the user and the establishment. The establishment then has 30 days to inform the Ombudsman and the user of the solutions it has adopted.
The complaint process is relatively the same as that for health establishments. You or your representative can file a complaint with the relevant health agency, which is the organization that coordinates the health services available in a particular territory. The complaint is then sent to the regional complaints commissioner named by the board of directors of the agency.
After receiving the complaint, the regional complaints commissioner examines it. Within 45 days after receiving the complaint, she sends her conclusions and her recommendations to the agency or the relevant establishment and to the user or his representative. She informs the user that the user can ask the Health and Social Services Ombudsman to review her decision. In the Laval and Montreal areas, you should file your complaint regarding ambulance services with the Service Quality and Complaints Commissioner for Corporation urgences-santé.
The Centres d’assistance et d’accompagnement aux plaintes (CAAP) are organizations whose mission is to support users and their representatives who want help during the complaint process in the health sector. The CAAPs are present in all administrative regions of Quebec and most of them are a part of the Regroupement provincial des organismes communautaires d’assistance et d’accompagnement (an organization that groups together many CAAPs).
The CAAPs are not the legal representatives of the users, but they:
To get help, the user can contact the CAAP of the area where he lives. If he was not treated near his home, the user can choose to contact the CAAP of the area where he lives or the CAAP of the area where he was treated.
The earlier the better. As time goes by, the parties involved in the complaint may forget what exactly happened, which makes processing the complaint more difficult.
Also, as explained above, if a user is dissatisfied with a commissioner’s decision, the Health and Social Services Ombudsman cannot review that decision, if more than 2 years have passed between the decision and the complaint made to the Ombudsman.
No. A person who lives in the areas of Northern Quebec (Nord du Québec) can also file a complaint with the local complaints commissioner or regional board of his area, so that these organizations can take the necessary steps with the appropriate local and regional commissioners located in other areas.
No. Other recourses are available depending on the situation that led to the complaint. To find out more, read our Infosheets called Medical liability, Civil liability, and Professional disciplinary committees: The complaint process.
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