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Putting Patients First (1995 Patient Charter)

Page contents: Access | Choice and participation | Information | Quality | A complaints resolution mechanism

The following is an earlier charter (produced in 1995). View the current Public Hospitals Patient Charter.

Public Hospitals: What Do They Offer You?

Access

A Wide Range of Public Hospital Services

As an Australian resident you have access to a wide range of public hospital services. If you are away from home, any public hospital in Australia will provide quality care for you.
Public hospitals provide different types of care depending on their size and role. Some common services such as general surgery and obstetrics will be available in nearly all hospitals. More complex services such as heart surgery and burns units are usually only available in teaching and/or specialist hospitals.
Patients requiring specialised inpatient care that is not available locally will be transferred or referred appropriately to another hospital.
In an emergency patients will usually be taken to the nearest public hospital with the necessary services. Some private hospitals in the city can also treat emergency patients.
Doctors have admitting rights at certain hospitals. Patients who want to receive care at a particular public hospital should speak with their doctor about whether they can be treated in that hospital.

Treatment Regardless of Ability To Pay or Health Insurance Status

Public hospitals treat both public and private patients Admission to public hospitals and treatment in emergency departments is based on health needs of patients.
Where urgent treatment is required to prevent loss of life in an emergency, immediate treatment will be provided in a public hospital. Non-emergency health needs will be treated in a reasonable time, according to the condition.
Public hospitals have introduced improved ways of managing waiting lists. If you are put on a waiting list, the doctor/hospital may be able to tell you the estimated waiting time and whether there are shorter waiting times at other hospitals.
In emergency departments, hospital staff will advise patients of the approximately waiting time before receiving treatment. However waiting times may change suddenly if patients with more urgent requirements arrive.

People should use emergency departments responsibly. Local GPs provide efficient and effective health services to meet most primary or initial health needs.

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Choice and participation

Participation in Making Decisions About Your Treatment

Patients will be asked to sign a consent form on admission to hospital or before an operation. Patients should receive all necessary information on their treatment options including the benefits, side-effects and any risks, before signing consent forms.
There are some limited cases where hospital staff may not seek your consent for treatment. This includes emergency situations and people with a mental illness who are being admitted on an involuntary basis. When a patient is incapable of giving consent, this will be sought from an Enduring Power of Attorney (Medical Treatment) or next of kin. Consent for procedures involving children will be sought from parents/legal guardians.
Although patients will generally be asked to sign a consent form only once during their hospital stay, patients should be aware that they can change their mind at any time. Patients refusing medical treatment may be asked by the hospital to sign a form accepting responsibility for their decision.
Medical research and health student education are important elements in maintaining and improving the standard of health care and health services in Victoria. The consent of patients will be sought if staff wish to bring in medical or other students. Patients can also decide whether to participate in medical research. Your co-operation would be highly valued, although there is no obligation on you to take part in these activities.

Participation in Decisions and Information About Your Discharge From Hospital

Doctors, together with nursing and allied health staff, make the decision to discharge patients. Decisions about discharge and continuing health needs will be made in consultation with patients. While patients can discharge themselves from hospital against the advice of hospital staff, they may be required to sign a form accepting responsibility.
Before patients are discharged from hospital a decision will be made about their continuing health needs. Information will be provided on the need for further medical care including any necessary medicines, or services such as physiotherapy, and where services such as home nursing and delivered meals can be obtained.
An Aged Care Assessment Team will assess patients who may be suitable for nursing home care. The Team will decide whether patients are eligible for nursing home admission. Admission to a nursing home can then be arranged in consultation with the individual patient/guardian.
On discharge, public hospitals will send information on each patient's medical condition and hospital stay to the patient's GP and/or specialist, unless specifically advised by patients that this should not happen.

Treatment as a Public or a Private Patient

On admission the hospital will offer you the choice to be treated as a public or a private patient. People with private health insurance can be treated publicly. Similarly, people without private health insurance can be treated privately, if they so choose.
Patients choosing public care will be treated by hospital doctors and will normally receive care in a shared ward. The hospital will provide all your medical and hospital care free of charge, including any medicines, x-rays or physiotherapy. There may be a charge for some personal services such as telephone calls and the use of crutches or other appliances which are supplied by the hospital for patients to use at home.
Patients choosing private care will be treated by the doctor of their choice, providing that the doctor has the right to practise at that hospital. Services for which patients will be charged include hospital accommodation, medical fees including pathology and radiology and any prostheses (such as heart pacemaker). Patients are advised to check the level of these charges and, where relevant, the benefits paid by their health fund. People who are private patients but without health insurance are responsible for all bills.
The process to decide whether to receive care as a public or private patient may be postponed when patients are admitted on an emergency basis or require assistance with this decision. Once a decision is made, it is expected that the status of the patient will remain the same throughout the admission.

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Information

Information About Which Hospital Staff Will Provide Your Care

To improve communication, public hospital staff will introduce themselves when providing care to patients. Patients should also treat hospital staff with respect.
Patients will be seen by a range of doctors including specialists and doctors who are in different stages of training
Public patients will be under the supervision of specialists, although most daily care will be provided by another doctor, often a registrar who is a fully qualified doctor training to be a specialist. Public patients will be informed about which doctors are responsible for their care.
Private patients receive care from the doctor of their choice but may also be seen by other hospital doctors, depending upon the availability of their private doctor.
Doctors in public hospitals make regular visits at scheduled times. They may also visit patients immediately before or after an operation or if a complication arises. Patients wanting to speak to their doctor outside these times should first ask the nurse to contact the doctor.

Information About Your Health Care and, Where Necessary, a Second Medical Opinion

The medical staff provide full information about your medical condition and the treatment options including the benefits, side-effects and any risks. They will also give you sufficient time to ask questions, get more information and talk with family and friends, before making a decision.
To help hospital staff provide the best possible care, patients should provide full information about their current medical problem, previous illnesses, medicines, visits to hospital, allergies and other health related matters.
Private patients can ask for a second medical opinion, and , if desired, change their doctor.
Public patients are assigned doctors with appropriate training and experience from a team of hospital doctors. In the event that a public patient wishes to obtain a second opinion, the hospital will arranged for the patient to be seen by another appropriately trained and experienced doctor for an independent opinion and/or management.
Patients cannot refuse treatment from specific doctor, nurse or other health professional, because he or she is of a particular gender, race or ethnic group or any other factor related to discrimination. However patients can request that care be provided by another health profession if there is a major breakdown of trust between the patient and the health professional.

Access to Your Medical Records and Confidentiality for Your Personal Information

Under the Freedom of Information Act patients are entitled to see and get a copy of certain public hospital records about their treatment. This includes hospital records, but does not cover records held by private doctors which are not part of the hospital record. Access to records unde FOI may not be immediate and may involve some charges.
In many public hospitals, patient charts are kept at the foot of each bed with details of medicines, tests and the results of treatment. Patients are encouraged to discuss their care with hospital staff and if they wish, to read their patient chart and medical record and ask staff for further explanations.
Every health professional is legally and ethically obliged to treat your health information as confidential. However doctors may need to share this information with other health professional to ensure patients receive the best treatment. Sometimes information about patients may be used for research purposes. If this occurs, patient confidentiality will be protected.
There is a small number of exceptions to the confidentiality requirement. This includes the mandatory reporting by health professional of suspected child abuse or where a court requires hospital staff to provide personal health information on patients.

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Quality

Treatment With Respect, Dignity and Consideration for Privacy

Health services will be provided in surroundings which allow privacy, including privacy to undress and only be seen by the doctor, nurse or other health care staff providing care.
Patients will have freedom to wear their own clothes and nightwear, to have privacy while bathing and, generally, to be treated in a manner which respects their individuality. Sometimes a patient's specific health problem or medical treatment might mean this is not possible.
Patients are encouraged to speak with the doctor or nurse if they are having problems with pain and need more pain relief medication.
In consideration of the needs of other patients, co-operation with the directions of hospital staff on not making unreasonable noise and limiting the number of visitors is important. Usually visitors are only permitted at certain times to allow patients adequate time to rest and receive medial treatment.

Where Necessary, an Accredited Interpreter and Services Provided In a Culturally Sensitive Way

Public hospitals will offer patients where possible the use of accredited interpreters for essential communication. This includes use during admission to hospital and the taking of a medical history, for informed consent and for making an enquiry or a complaint.
Hospital staff will respect the cultural and religious background of patients. This includes attempting to meet the dietary needs of people from various backgrounds.
Where possible, hospital staff will attempt to ensure that care is provided by a health professional of the same gender, if there are specific religious or cultural factors requiring this
Public hospitals will endeavour to make provision for patients to engage in prayers, attend religious services or meet with chaplains and other religious personnel.

High Quality Services and Information About What Steps the Hospital Takes to Improve Quality of Care

Public hospital staff will look after patients with care and skill in keeping with recognised standards, practices and ethics to ensure that health care provided in public hospitals is of high quality.
People can sometimes see ways to improve services or solve problems which are not apparent to hospital staff. Your suggestions are welcome. This is one of the most effective ways of improving health services for the whole community.
Patients may be asked to complete a Patient Satisfactions Survey during or after their stay in hospital. This is a questionnaire which asks about your experiences, including any problems, in hospital. Patients completing this survey can decide to remain anonymous. The information will be used to improve the way in which care is provided.
Most hospitals have a Patient Care Committee which examines any problems in patient care to ensure that the way care is delivered is improved. All Victorian public hospitals are also required to develop a quality assurance plan which covers issues such as discharge planning.

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A complaints resolution mechanism

An Opportunity to Discuss Any Questions or Complaints You May Have Concerning Your Stay in Hospital

All patients are encouraged to raise questions or discuss any problems as soon as they occur. Hospital staff are committed to solving problems quickly, but they need information from patients before they can take action.
In the first instance, patients should speak to the doctor, nurse or other health care professional involved.
All public hospitals in Victoria have Health Services Liaison Officers, sometimes called patient representatives or complaints officers. Where a problem cannot be resolved through discussion with the health care professional, patients are encourage to speak to the patient representative.
Another option is the Health Services Commissioner who acts as a "health ombudsman". The Health Services Commissioner will listen to complaints and advise how they might be resolved. This might include further discussion with the hospital, conciliation or investigation undertaken by the Health Services Commissioner or through referral to health professional registration boards.