About the Advocacy Service
History of the Service
The Nationwide Health and Disability Advocacy Service (the Advocacy Service) was formally established as a free and independent service for consumers of health and/or disability services in 1996.
Judge Silvia Cartwright had identified the need for such a service during a major independent inquiry into the treatment of patients at an Auckland hospital. The Cartwright Report, released on 5 August 1988, outlined the findings of the inquiry and made key recommendations. These included how to address the need for a focus on consumer rights and the quality of services provided to consumers.
Although the inquiry looked specifically at carcinoma in situ treatment, as well as research that occurred at National Women’s Hospital during the 1950s and up until the early 1980s, the problems identified were recognised as features of a health system in which patients were marginalised.
The inquiry report identified the need for widespread changes to the way patients were treated and services provided, and emphasised the need for the services to have a patient- or consumer-centred approach. Two key recommendations of the report were:
1) For a Health Commissioner to promote and uphold consumer rights
2) For independent advocates who would support consumers to ensure that their rights were upheld
The initial focus on health was later extended to include the disability sector, and consumers using disability services.
Following the Cartwright Report, the Health and Disability Commissioner Act 1994 was enacted to establish the role of an independent Health and Disability Commissioner and an independent advocacy service, and to provide for a code of consumer rights.
The Advocacy Service today
Since 2007, the National Advocacy Trust (a charitable trust) has been contracted to provide the Advocacy Service, as the HDC Act requires HDC and the Advocacy Service to operate independently of each other.
The Advocacy Service has 23 community-based offices throughout New Zealand. Each year the Advocacy Service expects to receive and close over 3,000 complaints, deliver more than 2,000 education sessions to consumers and providers on the Code of Health and Disability Services Consumers’ Rights (the Code), and respond to an estimated 10,000 enquiries.
After 15 months in the Advocacy Service, advocates work towards the Advocacy Service’s NZQA approved qualification. Through their training, advocates achieve positive outcomes for consumers, and develop professional and respectful working relationships with providers and consumers of all backgrounds and abilities.
Advocates apply defined complaint resolution processes and use interactive adult education skills when promoting the rights set out in the Code, and they demonstrate a thorough knowledge and understanding of the Code, including its application and impact, along with other relevant legislation and standards.
Role of the advocate
The role of the advocate in complaint resolution is to assist consumers to identify what is needed to achieve resolution, and then to support them in their chosen actions. Advocates are not investigators or mediators, nor do they make decisions on whether there has been a breach of the Code.
Effective and timely resolution
The Advocacy Service process is a very successful way to achieve early resolution. Advocates follow an alternative dispute resolution process that has several advantages for consumers and providers. The process is flexible and time-effective, and gives the consumer more control over the process and the results. In addition, frequently advocates are able to support consumers to rebuild relationships with providers. This is particularly important where the consumer and provider need to have on-going contact.
Advocates consistently assist consumers to resolve 90–94% of the complaints made to the Advocacy Service, with 85% of complaints being closed within three months and the majority of complaints being resolved within six months.
Satisfaction with the Advocacy Service process
People who resolve their disputes through the Advocacy Service process are generally very satisfied because they have been given the opportunity to participate directly in working out their own resolution. Consumers often want to ensure that what happened to them will not happen to someone else. It is helpful for providers to hear this. Many providers comment on how profound it is to hear from the consumer, as they had not realised the impact of their actions or remarks. Overall, providers are also usually satisfied with the Advocacy Service process, as they are given the opportunity to explain their actions fully and, if appropriate, to apologise directly to the consumer.
In 2016/17 88% of consumers and 86% of providers who responded to satisfaction surveys said they were satisfied or very satisfied with their contact with the Advocacy Service.