Case studies - other investigation outcomes

Investigating complaints about public agency decision-making is a core function for this Office. Sometimes complaints come to us too early in the complaints process. We can, with the complainant’s agreement, refer the complaint back to the agency involved for direct action. Some investigations lead to rectification of poor decisions; others confirm an agency has acted reasonably.

Following are examples of investigation outcomes in the 2018-19 annual report by the Queensland Ombudsman.

Too early for this Office – referred to agency for action

Workplace injury procedures

Rachel was psychologically injured at work. She successfully claimed assistance from a statutory authority but was unhappy with how the claim was handled. She made a complaint to the agency and asked for compensation as she had been prevented from returning to work. Rachel did not receive a written response although she was told procedures had changed as a result of her complaint.

Rachel then contacted this Office. Her complaint was assessed as too early for investigation as she had not yet received a formal response. With Rachel’s consent, the Office directly referred her complaint to the agency.

The result

The agency chief executive officer (CEO) wrote to Rachel to apologise. The CEO confirmed the agency had considered her feedback in a review of its processes to improve customer experience. The CEO also provided Rachel with an assurance that her damages claim would be processed promptly.

Pool safety improved

Mandy complained that a pool in her local area was unsafe. The fencing seemed inadequate. The area around the pool was overgrown; branches extended into the pool area and over the adjacent footpath. Mandy said that she had contacted the local council and made follow-up calls over a 12-month period. The situation remained unchanged and council had not communicated with Mandy.

As Mandy had not yet made a formal written complaint to council, it was considered too early to start an Ombudsman investigation. However, as Mandy had made reasonable attempts to have the matter addressed, with her consent, the Office directly referred the complaint to council.

The result

Council investigated the complaint and provided Mandy with information about the actions taken. Council took legal action against the property owner for non-compliant pool fencing and a failure to comply with an enforcement notice. Council also issued the property owner with a hazardous vegetation eradication notice and this led to the removal of the overhanging branches. Council scheduled further site inspections to ensure the property owner’s ongoing compliance with the vegetation notice.

Investigation found agency's original decision was reasonable

Patient Travel Subsidy Scheme decision

Barney was seeking support under the Patient Travel Subsidy Scheme (PTSS) from a Hospital and Health Service (HHS). In an earlier clinical decision, Barney had been excluded from a treatment program for a serious health condition. Barney was advised by the HHS of the appeals process regarding this decision and of his right to seek a second opinion through his treating specialist at the local hospital.

Barney took a different course of action. He sought a referral from his general practitioner to a hospital interstate and he underwent a medical procedure at the interstate hospital. Later, Barney applied to the local HHS for funding under the PTSS. Barney was advised he was ineligible for the PTSS because:

• PTSS has a policy of providing transport and accommodation assistance to patients who need access to essential medical services not available at a local public hospital/health facility or within 50 kilometres of their local public hospital/health facility
• Barney underwent a procedure which is available in two hospitals in his local area in Queensland
• PTSS does not cover travel for second opinions.
  
  

The result

Barney complained to this Office that he was dissatisfied with the decision to deny him support under the travel scheme. Barney had finished the HHS’s internal review process and the Office decided to investigate. The investigation considered Barney’s complaint and information from the HHS about its policies and practice. The investigation found the HHS had correctly applied the relevant policy and the decision to refuse Barney’s application for PTSS was reasonable.

Deferred exam not granted

Ella was due to sit a university exam. In the early hours of the morning of the exam, Ella became unwell. She felt she was too unwell and tired to attend the exam. Two days after the exam, Ella went to the doctor, described the symptoms she had been suffering on the morning of the exam and obtained a medical certificate. The medical certificate stated ‘Ella advised she had a medical condition and was unable to attend her exam on <date>’. Ella applied to sit a deferred exam and the university denied the application.

Ella was not permitted to resit the exam as the medical certificate did not contain the doctor’s medical opinion of her symptoms. Ella argued the doctor was unable to provide an opinion as they did not see her symptoms as the symptoms had passed by the time she visited the doctor.

Ella worked through the university’s complaints management system, including seeking an ‘internal review’. The university told Ella they had considered her complaint, under their Assessment Policy, but they did not agree that she should be allowed to resit the exam.

Ella complained to this Office as she was dissatisfied with the university’s decision. The Office’s investigation considered Ella’s complaint and information from the university about how it had reached its decision.

The result

The investigation found the university’s decision was reasonable and made in accordance with its Assessment Policy. Ella was unable to sit a deferred exam.