Patient rights and complaints about health services

The Nordic countries all have systems in place to allow patients to put forward complaints regarding care, treatments, patient fees and other circumstances. Complaints and questions should be addressed primarily to the specific care provider, practice or practitioner responsible, but can also be referred to local health authorities or specific supervisory functions. Patient Ombudsman functions are common to safeguard patients’ rights.

Denmark

Both the National Agency for Patients’ Rights and Complaints (Sundhedsvæsenets Disciplinærnævn) and the Danish Safety Authority can deal with complaints, but complaints cannot be dealt with by both these authorities at the same time. 

The National Agency for Patients’ Rights and Complaints (Sundhedsvæsenets Disciplinærnævn) deals with complaints concerning authorized health care personnel. The Danish Safety Authority deals with complaints concerning the place of treatment but can alsohandle complaints against health care personnel and place of treatment.

Faroe Islands

To a certain extent, the Faroese health system is covered by the regular Danish complaints system. Complaints about health services carried out by authorised health personnel in the Faroe Islands are dealt with by the National Agency for Patients’ Rights and Complaints (Sundhedsvæsenets Disciplinærnævn) in Denmark. Complaints about cases regarding rights or access to patient records are dealt with by the Danish Patient Ombudsman. Complaints about coercion in connection with mental health care are dealt with by the Faroese Psychiatric Complaints Board (Psykiatriska kærunevndin). The decisions of the Complaints Board can be appealed to the Psychiatric Appeal Board (Det Psykiatriske Ankenævn) in Denmark. Complaints about non-health professional services are dealt with by the Faroes Complaint Board for Social, Family and Health Care (Kærunevndin í almanna-, familju og heilsumálum) except complaints about the right of access to patient records, which, as already mentioned, are dealt with by the Danish Patient Ombudsman.

Patients who have been referred by the Faroese health care system who receive treatment in the Danish hospital services, are fully covered by the Danish complaints system.

Greenland

Complaints concerning health issues must be addressed in writing to the National Board of Health, which prepares the case and makes recommendations about a decision on the complaint. The cases are then sent to the Danish Patients’ Complaints Board where the Disciplinary Board decides about the cases. Complaints concerning services are submitted to the Health Management, and questions concerning compensation are dealt with by the Directorate of Health and Infrastructure. 

Finland

The status and rights of medical patients and clients of social services are protected by The Act on the Status and Rights of Patients 785/1992 and The Act on the Status and Rights of Social Welfare Clients.

The legislation defines the legal principles under which patients and clients of social welfare services must be treated.

Rights: Medical patients and clients of social services have the right to appropriate and high-quality service from social and health care services. Options for treatment or measures to be taken must be explained openly and in an understandable manner. Patients and clients of social services must be treated in a manner that does not infringe on their human dignity, convictions, or privacy.

Availability: Those requiring help have the right to get health care services within the time set by legislation, as described in Organization and Responsibility for the Health Sector.

Confidentiality: Documents of social welfare and health care services and the information that they contain must be kept confidential. Patients and clients of social welfare services have the right to know when their information is being used.

Complaints or legal protection for patients and social welfare clients: If a patient or a client of social welfare services is not satisfied with service, care, or treatment that he or she has received, the patient or client can submit a complaint to the person in charge of the operating unit or file an official complaint with a supervisory official. In social welfare services the client can also appeal for a change in the decision he or she has received.

In the case of treatment injury, the patient can apply for compensation from the Finnish Patient Insurance Centre.

Patient Ombudsman and Social Ombudsman

If clients feel that they have been treated improperly by social and health care services, or if they need advice about their rights, they can consult the Patient Ombudsman or Social Ombudsman.

Patients have several options when they wish to complain about the treatment or services they have received. The simplest way is to express dissatisfaction to the physician who provided the treatment, or to contact the physician in charge of the hospital department or health centre. If further assistance is needed in order to solve the problem, there are two possibilities. The patient can contact either the Regional State Administrative Agency or the National Supervisory Authority for Welfare and Health (Valvira). Both these bodies can give a written expert opinion, and give sanctions if necessary.

Finnish Patient Insurance Centre: https://www.pvk.fi/en/

Regional State Administrative Agencies: https://www.avi.fi/en/web/avi-en/

Åland

Complaints concerning treatment must be addressed to the institution providing the treatment, to the national authorities, or to the Åland Government, as in Finland. The Patient Ombudsman is employed by the Åland Government and is thus independent of the treatment institutions. The Patient Ombudsman may take up issues of principal significance with the "Patients Board of Trust" where the issues may be discussed and form the basis for decisions, although the Board cannot decide in individual cases. 

Iceland

In accordance with the Patients’ Rights Act, patients have the right to complain about health services. If service related, patients can direct their complaint to the respective healthcare institution. In case of alleged negligence or error in provision of health service (See article 12 in Medical Director of Health and Public Health Act, No. 41/2007 (government.is, complaints can be made to the Directorate of Health. Handling of a case by the Directorate of Health may be appealed to the Minister of Health.

Norway

Patient rights in Norway are well-defined legal rights and can be actionable against specific parties. Every county has a Health and Social Services Ombud, whose purpose is to safeguard patients’ rights, interests and legal rights in relation to primary and specialist health care. The Ombud determines whether a request provides adequate grounds for investigation.

Parliament has decided that there should be a patient Ombud in each county who can help patients and clients who do not get the help or treatment they need. The patient Ombud is an organisation for dealing with complaints within the health care system. Main tasks are to answer and clarify questions regarding health- and social services. To hear about patient’s experiences. Provide advice and guidance regarding patient’s rights, inform about methods for compensation claims and complaints, assist you in meeting with service providers and help to formulate a compensation claim. All services are provided free of charge.

Patients can make a complaint if they think that they have not received health services to which they are entitled to, or if they disagree with the assessment of the treatment needs. Complaints should be addressed to the person or body who took the disputed decision. Decisions made at the county level can be appealed at the national level (the central office of the board). The board has the powers to issue warnings to health personnel and to revoke licenses authorisation. The Norwegian System for Patient Injury Compensation (NPE) handles compensation claims for patients who have sustained an injury while receiving health care.

Sweden

Patient integrity, self-determination and participation in health care is the purpose of the Patient Act (Patientlagen). This Act covers patient rights regarding accessibility, information, consent, choice of treatment and aids, second opinion, choice of provider, individual care plan, handling of personal information and complaints. The Patient Act does not apply to dental care.

As a rule, complaints about care should be made directly to the responsible health care service provider or with the local Patient Advisory Committee. The Act on Support for Handling Complaints Regarding Health Services (Lagen om stöd vid klagomål mot hälso- och sjukvården) states that the regional and local health authorities must have Patients’ Advisory Committees to handle and facilitate complaints about care given by publicly financed health care providers, including dental care, and provide information on patient rights. The Patients’ Advisory Committee has no disciplinary powers but can provide patients with information and advice on what to do next. Many regional and local authorities also offer the services of a patient ombudsman who can give practical advice and refer to the appropriate authorities, if the complaints are not taken care of properly. The Health and Social Care Inspectorate (IVO) is responsible for investigating complaints with care providers.

Patient Act (Patientlagen) https://www.riksdagen.se/sv/dokument-lagar/dokument/svensk-forfattningssamling/patientlag-2014821_sfs-2014-821

Act on the Support for Handling Complaints Regarding Health Services (Lagen om stöd vid klagomål mot hälso- och sjukvården) https://www.riksdagen.se/sv/dokument-lagar/dokument/svensk-forfattningssamling/lag-2017372-om-stod-vid-klagomal-mot-halso-_sfs-2017-372

Health and Social Care Inspectorate (IVO) https://www.ivo.se/