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13:47 GMT, Wednesday, 25 June 2008 14:47 UK

How to complain about private healthcare

Making a complaintWhat happens nextIf you're still not happyTaking legal action

Doctor taking pulse If something has gone wrong with your private healthcare or if you're unhappy with the service you received, you can complain about the healthcare professional, hospital, clinic or private care home concerned.

There's no standard complaints procedure for private healthcare, so you'll often have to rely on the hospital, clinic or care home's in-house complaints system. If you have private health insurance, you should contact your insurer for advice.

If you had private treatment paid for by the NHS, you must follow the private company's own complaints procedure.

But you can follow the NHS complaints procedure if you're unhappy with the way the private treatment was arranged by the NHS, rather than the treatment itself.

MAKING A COMPLAINT

Complaints made on the spot to the person dealing with you can often be sorted out quickly and easily. But if you want to complain more formally, ask for a copy of the complaints procedure for the hospital, care home or private healthcare insurer. You should write directly to the person in charge of complaints.

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You can get independent advice on pursuing a private complaint from the Patients' Association, an organisation representing the interests of patients, and Action against Medical Accidents, a charity helping patients who have suffered from medical accidents and clinical negligence.

Writing letters and keeping notes
If the complaint becomes drawn out or if it is complicated, you'll need to keep a full record. Make a note of conversations, phone calls or meetings you have about your complaint. Note the date, time, the name of the person you phoned or met, what was said and make a copy of all emails and letters.

The Patients' Association recommends that letters include:

A statement of what you are complaining about, giving details of when and where it happened, and the names and positions of members of staff involved.
Details of why you are not satisfied.
An explanation of anything you have already done (for example, an informal oral complaint), and what happened as a result.
Questions you would like answered.
Details of what you would like to happen, for example an explanation or apology.
A request that you would like your complaint investigated and responded to in accordance with the NHS complaints procedure.

The Patients' Association also says your letter should contain all the relevant information and should be clear and concise so your complaint is easy to understand.

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WHAT HAPPENS NEXT?

There are no rules governing the exact process for complaints about private healthcare as there are no standard procedures.

However this doesn't mean that each hospital will have its own unique complaints process. Most private health organisations are members of umbrella bodies and will follow their complaints procedures as standard practice.

Independent Healthcare Forum hospitals
Over 90% of private hospitals are members of the Independent Healthcare Forum, a representative body, and follow its standard code of practice for complaints. So if you're complaining about an Independent Healthcare Forum hospital:

You'll receive a written acknowledgement of your complaint from staff at the hospital within seven working days.
You will get a full response, possibly after an investigation, after five weeks. If the investigation is drawn out, you'll get updates every five weeks.
You'll receive an explanation of what happened, and if your complaint was upheld, an apology and details of how the situation will be avoided in future.
In some cases where you have experienced disappointment, annoyance or inconvenience you may be given compensation.

If you're not happy with the hospital's response, you can ask for an internal appeal where a senior member of staff will review your complaint.

Blood pressure test

If you're not happy with this review you can ask for the Independent Healthcare Forum's 'external adjudication panel' to look into your case. You must do this within a month of the internal appeal. The panel will give you a full written decision within two months. If your complaint is upheld, the panel can order hospitals to pay you compensation or to take particular action.

Other hospitals, clinics and care homes
If you're complaining about a hospital or care home that is not a member of the Independent Healthcare Forum, you'll need to follow the organisation's own procedures.

It may be that you have a separate contract with the doctor, rather than the hospital concerned. So if the complaint touches on different aspects of your care such as food quality, cost, and the treatment itself, you may need to complain to several different people.

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IF YOU'RE STILL NOT HAPPY

Healthcare Commission
The Healthcare Commission is an independent public body responsible for standards and complaints in private and NHS healthcare, set up in April 2004. It is developing a review procedure for unresolved complaints about private healthcare, including care paid for by the NHS. For more details, contact the Healthcare Commission.

Local health authority
Private hospitals have to register with local health authorities. These authorities are required to inspect them twice a year, so they have some powers to investigate complaints. Action against Medical Accidents has more advice on how to go about this.

Commission for Social Care Inspection
The Commission for Social Care Inspection is the regulator for the care home and social care sector. They can investigate your complaint about a care home. Here is more from them on how to complain.

Professional bodies
If you have a serious complaint about a health professional acting in a private capacity, you can complain to the relevant professional body, which will cover both private and NHS professionals.

There are separate regulators for nurses and midwives, doctors, dentists, opticians, osteopaths, chiropractors, pharmacists, and other health professionals, such as physiotherapists or dieticians.

Operating theatre Get further advice
If you think the complaint is serious enough, you may be tempted to withhold payment - but be aware that the doctor or hospital could sue you to recover the payment. You should take legal advice before choosing this course of action.

If you suspect that medical treatment or lack of treatment may have caused or contributed to the death of a friend or relative, you should contact the local coroner as soon as possible as a post-mortem examination may be needed.

Private healthcare insurance
If you're privately insured and unhappy with how your healthcare claim was dealt with, you can complain to your healthcare insurer. If you are still unhappy, you should go to the Financial Ombudsman.

If you're privately insured and unhappy with the care you received at a hospital or clinic, you can complain to your insurer and they may stop using the practice or practitioner concerned.

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TAKING LEGAL ACTION

If you are not satisfied with the way your complaint has been resolved, you can take the doctor or the hospital to court. Private healthcare professionals, like any doctors, have a 'duty of care' and you can sue them if they are negligent in how they treat you. You can also sue a private doctor or hospital for breach of contract.

But you should think hard about whether legal action is the right course of action for you and what you want to achieve from going to court. Is it an admission of liability and apology that you require or monetary compensation? The Patients' Association has more information on taking legal action and how to fund it.