Complaint against a clinic in Kazakhstan: where and how to file

A person usually faces a situation where the quality of medical care is in question for the first time: it is unclear whom to approach, what to write and which documents to attach. Some limit themselves to an oral complaint at the reception desk, others immediately prepare a claim without collecting documents or obtaining a written response from the clinic. As a result, the application either remains without progress or is returned to the applicant.

In this article you will learn which authorities consider complaints against clinics under Kazakhstan law, how electronic and written forms of filing differ, which deadlines apply and which evidence should be collected in advance. We will separately look at the specifics of applications within the OSMS system and the link between a complaint and possible court proceedings.

Complaint against a clinic: where to start if you are facing a violation for the first time

If you are facing a violation in a medical organisation for the first time, start by recording the facts. Keep the contract, receipts, test results and scans, discharge summaries and conclusions. Write down the dates and times of appointments, the names and positions of staff, and exactly what you were told. Describe the deterioration in your health and visits to other specialists.

Then determine what has been violated: the quality of the service, the timeframes for its provision, an unjustified refusal of care, a breach of ethics or a violation of the procedure for providing information. The claims in the pre-action letter depend on this. At first, the complaint may be pre-trial — a written application demanding that the violation be remedied or documents be provided. If there is no response or it does not satisfy you, the dispute goes to court.

• Record the facts: contract, receipts, medical documents, correspondence, dates and names.
• Describe how you felt and the consequences: when your condition worsened, who you approached afterwards.
• Set out your demand: an inspection, rectification of the violation, a refund, compensation for harm.
• Send a written claim to the clinic and keep proof of delivery.
• If there is no response, file a complaint with the territorial department of the Committee for Medical and Pharmaceutical Control.
• File a claim with the court if the dispute is not resolved out of court.

Where to complain about a clinic: authorities and their powers

The choice of addressee depends on which service you are disputing and what outcome you want to achieve. A complaint can be filed with several authorities in turn. Where to complain about a clinic is determined by whether the care was provided within the guaranteed volume or on a paid basis.

The clinic's management is the first instance for explanations and an internal review. The health department is approached regarding the quality and accessibility of care in the region or city. The department of the Committee for Medical and Pharmaceutical Control considers violations of standards, licensing requirements and the rules for providing services. The medical insurance fund — where the service was provided under OSMS. The territorial body of the Committee for Consumer Protection becomes involved in the case of a paid service.

• Clinic management: internal review, explanation on the facts of the complaint.
• Health department: quality and accessibility of medical care.
• Department of the Committee for Medical and Pharmaceutical Control: compliance with standards and licensing requirements.
• Social Health Insurance Fund: services provided within the OSMS system.
• Consumer protection: paid medical services and the terms on which they are provided.

A complaint may be filed with several authorities at the same time if they consider different aspects.

Complaint against a clinic online: electronic filing methods in Kazakhstan

An online submission saves time and records the moment of filing, which matters in a dispute. A complaint against a clinic online in Kazakhstan is filed through the eGov portal, the websites of the authorities and of the institution itself. The addressee is the Committee for Medical and Pharmaceutical Control of the Ministry of Health of the Republic of Kazakhstan and its territorial departments, as well as the clinic's administration.

To file through eGov, an electronic digital signature in the personal account is required. The complaint is drawn up in free form: the name of the addressee, the applicant's details, the substance of the violation and the request. Scans or photos of documents on treatment and payment are attached.

Complaint against a clinic in writing: content and required details

A written complaint against a clinic is filed in free form, but it must contain mandatory details, without which it may be left unconsidered. In the top right corner, the name of the medical organisation, the position and full name of its head are stated, as well as the applicant's details: surname, first name, patronymic, IIN, address, telephone and email. Below, the heading 'Complaint' is placed and a description is given of who provided the care and when.

The main part sets out the facts: the date and time of the visit, the name of the clinic, the department and the full name of the doctor, the type and volume of medical care, and the circumstances that the applicant considers a violation. Reference is made to specific provisions of the Code of the Republic of Kazakhstan 'On Public Health and the Healthcare System', and the documents confirming the position are indicated.

• name of the clinic, address, contacts;
• date and time of the visit, method of booking;
• full name and position of the doctor, department;
• diagnosis, prescriptions, procedures performed;
• outcome of the visit and consequences;
• copies of the contract, receipts, reports, extracts.

Complaint against a clinic: review periods and procedure for response

A complaint against a clinic is considered administratively by the Committee for Medical and Pharmaceutical Control of the Ministry of Health of the Republic of Kazakhstan and its territorial departments. The period depends on the addressee: an application to a state body is considered under the rules of administrative procedures, while an internal complaint to the clinic is considered under its own procedure; the exact periods are set out in the legislation on administrative procedures and in the rules for the provision of medical services.

The response is given in writing or as an electronic document if the applicant has indicated a method of communication. The body reports on measures to eliminate the violations, on refusal with reasons, or on forwarding the application according to competence. The clinic's internal response is drawn up on its letterhead and signed by the head or an authorised person. On matters of the quality and safety of the service, the supervisory body may conduct an inspection and issue an order.

• keep a copy of the complaint and confirmation of its sending (receipt, notification, acknowledgement of receipt)
• record the date of filing and the date by which the response was due
• send a repeat request stating that no reply has been received
• contact the higher health authority or the prosecutor's office
• after a complaint to the higher authority (the mandatory pre-trial procedure under the Administrative Procedural Code of the Republic of Kazakhstan), prepare documents to challenge the authority's inaction in court

A complaint works when it contains specific facts, dates and supporting documents, not just an emotional description of what happened.

Complaint against a clinic under the OSMS: specifics and procedure

In the OSMS system, a complaint against a clinic is filed when access to or quality of care has been violated: refusal to attach, imposition of paid services instead of guaranteed ones, or breach of waiting times. The relationship arises between the patient, the medical organisation and the social health insurance fund that pays for services under the GBMP and OSMS.

The fund reviews the request by checking compliance with the contract with the medical organisation. At the same time, the complaint can be sent to the health department and the territorial department of the Committee for Medical and Pharmaceutical Control.

• patient details and contact information
• name of the medical organisation and its unit
• description of the violation with reference to the patient's rights
• request for an inspection and for the violation to be remedied
• copies of medical and payment documents
• signature and date of the request

Complaint against a clinic for the protection of consumer rights: grounds and procedure

A complaint against a clinic is filed when a medical service was provided poorly, not in full, was paid for but not provided, or care was refused without a lawful ground. Grounds: refusal to issue examination results, imposition of procedures, care without proper documentation. The complaint records the violation in writing so that the supervisory authority has a verifiable version of events.

The request as a consumer is addressed to the territorial body of the Committee for Consumer Protection, and as regards the quality of medical care — to the territorial department of the Committee for Medical and Pharmaceutical Control. The applicant's details, the name of the medical organisation, the date and circumstances of the visit, the substance of the claim and the request for an inspection are stated. Copies of documents on the fact and terms of receiving the service and correspondence with the clinic are attached.

• The contract for the provision of medical services and cash documents confirming payment.
• Discharge summaries, conclusions, results of tests and examinations.
• Written claims to the clinic and replies to them.
• The clinic's refusal to issue documents or provide the service.
• Witness testimony and lawfully obtained audio or video materials.
• Copy of the applicant's identity document.

Complaint against a clinic and a parallel application to court: how they are connected

An administrative complaint against a clinic and an application to court do not exclude each other: under the Code of the Republic of Kazakhstan on Public Health and the Healthcare System, patients' rights are protected, among other means, through civil proceedings. A complaint to a higher authority or an authorised organisation does not deprive the patient of the right to judicial protection and more often serves as a way to record the violation and obtain the clinic's response rather than as a substitute for a claim.

A complaint before a claim helps to gather evidence: in its reply the clinic sets out its position and refers to medical documents and internal reviews. The results of the inspection and the report can be submitted in civil proceedings as written evidence, but the court assesses all evidence together.

Complaint against a clinic: which documents and evidence to collect

Documents confirming the fact of seeking treatment, the scope and conditions of care are attached to the complaint. The contract, receipts and payment statements establish who accepted the patient and on what terms. The medical record, discharge summaries, reports and test results show the course of treatment and its outcome.

This set forms the basis of both an administrative complaint and a civil dispute. Quality control of services is carried out by the Committee for Medical and Pharmaceutical Control of the Ministry of Health of the Republic of Kazakhstan and its departments. Evidence must be collected immediately, before records and media are lost.

• contract for the provision of medical services and its annexes
• cash receipts, payment slips and payment statements
• medical record, discharge summaries, reports, results of tests and examinations
• images, audio and video recordings of appointments and procedures
• correspondence with the clinic, the Social Health Insurance Fund or the insurance company in the case of voluntary insurance
• written refusals to provide documents or information

Typical mistakes when filing a complaint against a clinic in Kazakhstan

A complaint must be based on facts, not emotions. An emotional letter without dates, a description of events and references to documents is considered formally or left without progress: the applicant talks about the attitude of the staff but does not state which right was violated and how.

A complaint without evidence has almost no prospects. Discharge summaries, test results, the contract, receipts, correspondence, audio or video recordings made without breaking the law are attached. A document issued by the clinic is requested in writing, and a copy of the application is kept with a mark of acceptance: this confirms both the fact of the request and the content of the demand.

• Set out the events chronologically, with dates, positions and names of the clinic's departments.
• Support every statement with a document or indicate where it can be obtained.
• Send the complaint to the body whose competence covers the violation, and keep proof of sending.
• State the demand specifically: conduct an inspection, provide an answer, take measures.
• Observe the appeal deadlines and do not duplicate complaints unnecessarily.
• Verify the accuracy of the information before filing so that the complaint is not rejected on formal grounds.

Complaint against a clinic: comparison of filing methods and authorities

The choice of authority depends on the purpose of the complaint against the clinic: to obtain documents and explanations, to influence the quality of care, to review payment under the OSMS or to recover losses. The comparison is made on three grounds: who considers the complaint, what formatting requirements apply and what result can be expected. The main filing options are summarised below.

Quality control of medical services is carried out by the Committee for Medical and Pharmaceutical Control of the Ministry of Health of the Republic of Kazakhstan and its territorial departments. Complaints about violations of the procedures and standards of care, refusal to provide documents and unjustified charging of fees are sent there. The OSMS Fund becomes involved when the dispute concerns the scope of care within the mandatory social health insurance system.

• Clinic administration: a written request addressed to the head, registration of the incoming document, response deadline under internal regulations.
• Territorial department of the Committee for Medical and Pharmaceutical Control: complaint about the quality and safety of a medical service.
• OSMS Fund: complaint on issues of the scope and conditions of care in the mandatory social health insurance system.
• Consumer protection authority: complaint about violation of the rights of a patient as a consumer of a medical service.
• Court: statement of claim in a dispute over compensation for harm, losses or protection of intangible benefits.

The timeframes for consideration depend on the chosen authority and are determined by the Administrative Procedural Code of the Republic of Kazakhstan and the Civil Procedure Code of the Republic of Kazakhstan.