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Patients

Osteopathic practitioners (osteopaths) are now regarded in New Zealand law as being on the same playing field as all other registered health practitioners. Registration means your health practitioner is competent, fit to practise and accountable. As such, it provides a framework for ensuring that your health and safety as a patient or consumer is paramount.

These pages are designed to provide information to anyone using the services of a registered osteopath about your rights, and what to do if you feel that your rights may have been breached.

What is Osteopathic Medicine?

Osteopaths use a variety of techniques to help correct abnormal physical conditions which include back and neck pain, headache, physical injuries to bones, joints and muscles, and many other physical and functional disorders.

A wide variety of treatment techniques are used, which could include manipulation and mobilisation to joints and soft tissues, muscle energy stretches, and cranial-sacral therapy. The Osteopath will use appropriate treatment, after fully assessing the patient.

Osteopaths are front line health professionals and work with other registered health professionals including general practitioners, specialists and radiologists to provide the best service to their patients.

Osteopaths are able to treat ACC claims patients without referral from a medical doctor and refer for x-rays and to other health professionals if required.

History

Osteopathy is a well established method of treatment that was founded and developed by Dr Andrew Taylor Still M.D., in the United States of America in 1874. He opened his first school, the American School of Osteopathy, for the training of Osteopaths in 1892 in Kirksville, Missouri. To give some understanding of the philosophy of Osteopathy we should read a quotation from the Founder himself who said quite simply:-

"Osteopathy is based on the perfection of Nature's work.  When all parts of the human body are in line we have health.  When they are not the effect is disease.  When the parts are readjusted disease gives place to health. The work of the Osteopath is to adjust the body from the abnormal to the normal; then the abnormal condition gives place to the normal and health is the result of the normal condition." A. T. Still

Making a complaint

Complaints against practitioners should be made in writing and be sufficiently detailed. It is recommended that complaints be sent to the Health and Disability Commissioner, PO Box 1791, Auckland.

The Council must determine whether the complaint concerns patient care (that is, a complaint alleging that the practice or conduct of a health practitioner has adversely affected a health consumer), or whether the complaint is based solely on issues of competence or fitness and there is no identifiable health consumer.

If the complaint relates to a health consumer it must be referred to the Health and Disability Commissioner. If the scope of the complaint is not clear, the complaint will be referred to the Commissioner for a preliminary assessment.

The Commissioner may refer complaints to the Council.

If the complaint does not relate to a health consumer, the Council may decide to refer the complaint to a Professional Conduct Committee.

Professional Conduct Committees can make various determinations and recommendations. Some of the determinations and recommendations are:

  • that the Council counsel the practitioner;
  • that the Council review the competence of the health practitioner;
  • that the Council review the practitioner's scope of practice;
  • that a charge be brought against the health practitioner in the Health Practitioners' Disciplinary Tribunal; or
  • that no further steps be taken.

Professional Conduct Committees

The Council may appoint these committees from time to time to investigate the complaint and make recommendations and/or determinations. They are composed of 2 health practitioners who are registered with the Council, and 1 layperson. Members of the Council may also be on Professional Conduct Committees.

Health Practitioners Disciplinary Tribunal

The HPCA Act has established a Health Practitioners Disciplinary Tribunal to hear and determine charges brought before it for any health practitioner covered by the HPCA Act. The Tribunal is a separate body from the Council. It is likely that the Tribunal will consider only the most serious of complaints.

The Tribunal membership is composed of the Chairperson (Barrister or Solicitor of the High Court), or a deputy Chairperson and four others, three of whom must be professional peers of the health practitioner and one of whom must be a lay person.

The source of charges before the Tribunal is either the Director of Proceedings (Health and Disability Commissioners Office) or a Professional Conduct Committee.

Making Complaints - A Guide for Patients

Patients who wish to make a complaint about an osteopath must provide sufficient information so that an investigation can be carried out and it can be determined that the complaint is genuine.

Sufficient information is likely to include:

  • The names of all of the people involved, including any witnesses,
  • The date(s) that the incident(s) occurred;
  • The place(s) where the incident(s) occurred;
  • A description of what happened including the particular factors that led you to complain;
  • Whether you let the practitioner know of your complaint and if so his/her response;
  • Any additional information that will assist an investigation.

Note: Anonymous complaints are very difficult to respond to, given that the Registrar and the Council are unable to confirm or clarify the course of events.

Where to make the complaint

You can complain to the Council, but it will be immediately forwarded to the appropriate agency.

The following process is required by the Health Practitioners Competence Assurance Act 2003 (HPCA Act)

Health and Disability Commissioner (HDC)

If the practitioner is registered and holds a current Practising Certificate

Registered Practitioners

(Complaints to HDC)

Ministry of Health (MOH)

If the practitioner is not registered and/or does not hold a current Practising Certificate

Unregistered Practitioners

(Complaints to MOH)
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What happens next?

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What happens next?

Step 1

The HDC notifies the Osteopathic Council that a complaint has been received and does a preliminary investigation (which might be quite detailed) of the complaint. This investigation will involve the practitioner and the person making the complaint.

Step 2

  • If it considers that the matter is not serious it may take no further action.
  • If further investigation is warranted, the complaint will probably be referred to the Council under section 34(1) of the HPCA Act. Note: The complaint could be referred to the Health Practitioners Disciplinary Tribunal (HPDT), but this would be for a very serious matter.

Step 3

The Council assesses the complaint and decides whether to:

  • refer it to a professional conduct committee (PCC) under s65(2)
  • Review the osteopath's competence under Part 3
  • Address concerns about the osteopath's fitness to practice under Part 3
  • Take no further action.

Step 1

The MOH notifies the Osteopathic Council that a complaint has been received and does a preliminary investigation (which might be quite detailed) of the complaint. This investigation will involve the practitioner and the person making the complaint.

Step 2

  • If it considers that the matter is not serious it may take no further action.
  • If it considers that the matter is serious, it will prosecute the practitioner.

    Council’s Involvement
    The Council will provide any or all of the following:

    • expert advice
    • confirmation that the practitioner is not registered and doesn’t hold a practicing certificate
    • information about any previous complaints the Council may have received about the practitioner.

    Complainant’s Involvement
    The person who made the complaint is likely to be required to give evidence in court.
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Professional Conduct Committee

Step 1

A professional conduct committee (PCC) set up, under section 71(1) of the HPCA Act, must consist of two registered health practitioners and one layperson.

Section 76 gives the PCC the right to:

  • receive evidence,
  • hear oral evidence and
  • receive statements and submissions from:
  • the practitioner
  • the practitioner's employer
  • the practitioner's associates
  • the complainant
  • any clinical expert.

Step 2 Professional Conduct Committee

The PCC reports and makes one or more of the following recommendations to Council:

  • review the osteopath's competence
  • review fitness to practice
  • review the osteopath's scope of practice
  • refer the matter to the Police
  • Counsel the osteopath

The PCC may determine that:

  • no further steps be taken under the HPCA Act
  • a charge be brought before the HPDT
  • the complaint is to be submitted to conciliation.

Competence Review

Step 1

  • A competence review committee (CRC) consists of at least 1 person and up to 2 osteopaths and a layperson.

    The role of the CRC is to determine whether the osteopath:

    • meets the required standard of competence, or
    • fails to meet the required standard of competence (section 36(5))
  • The Council determines the terms of reference for the review. These may require a specific area of the competency framework to be reviewed, or for the osteopath's competence to be reviewed more broadly.

Step 2 Competence Review Committee

The CRC meets with the osteopath, usually in the osteopath's place of practice to gather information. This information is subject to any express process set out in the terms of reference, and may include:

  • Statements from the complainant (if any) or any other relevant person (i.e. employer, colleague etc)
  • A review of clinical files (section 42)
  • Interviews with the osteopath
  • Interviews with colleagues and employers
  • Observing the osteopath's practice.

Step 3 Competence Review Committee

  • The CRC reports to Council using the terms of reference to guide the report.
  • If the Council has reason to believe that the practitioner fails to meet the required standard of competence it can make one or more of the following orders (section 38):
  1. that the practitioner undertakes a competence programme
  2. that conditions be included in the practitioner's scope of practice
  3. that the practitioner sits an exam or undertakes a specified assessment
  4. that the practitioner is counseled or assisted by 1 or more nominated persons.

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Glossary of Terms

Term

Description
ACC Accident Compensation Corporation
APC Annual Practising Certificate
CPD Continuing Professional Development
CRC Competence Review Committee
GOsC General Osteopathic Council (UK)
GST Goods and Services Tax
HDC Health & Disability Commissioner
HPCA Act Health Practitioners Competence Assurance Act 2003
HPDT Health Practitioners Disciplinary Tribunal
HRAS Health Regualtory Authorities Secretariat
HRANZ Health Regulatory Authorities of New Zealand
IELTS International English Lanaguage Testing System
ISOP International Society of Osteopathic practitioners
MOH Ministry of Health
NZQA New Zealand Qualifications Authority
OCNZ Osteopathic Council of New Zealand
OSNZ Osteopathic Society of New Zealand
PCC Professional Conduct Committee
TTMRA Trans Tasman Mutual Recognition Act 1997 or Trans Tasman Mutual Recognition Agreement
WMA Western Medical Acupuncture

 


 


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