Australia’s Healthcare System
As a performer, it can be difficult to find your way through the health system, especially if you are feeling vulnerable, have little money, or haven’t had much experience of the system before. You may be unsure where to find health practitioners who understand performers’ specific needs and appreciate your determination to resume your arts practice without restriction as quickly as possible. Before we start, some simple but important advice: Don’t suffer illness or injury alone! First and foremost, you need the help of a health professional to ensure you recover quickly and completely. You may want to ask a family member, friend, or colleague, to be with you. It can make a world of difference to have someone help you negotiate better care, to hear and remember the information and advice you receive, and even just to support you at this vulnerable time.
There are two main systems – public and private
The public system
The public system is based around public hospitals and community health centres across Australia. All public health services are free, so waiting times may be long. Depending on your needs, the hospital or health centre decides which doctor or health worker you will see, and the services you will receive. Due to cost constraints, some health services that are considered non-essential or “elective” may not be available through the public system. If this case, the public system will make sure you are safe, and then may advise you to seek further care through the private system.
In a medical emergency, you should seek help at the Accident and Emergency Department of any public hospital. If the situation is urgent, ring 000 for an ambulance to take you there. An operator will ask you whether you need Fire, Police or Ambulance. When you have been connected to the right service, explain the situation as clearly and as calmly as you can and give your address. They will advise you what to do until the ambulance arrives. If you need to stay in hospital (as an ‘inpatient’), or if you need to return to see a doctor or healthcare worker in the hospital (as an ‘outpatient’), the service is free.
The private system
Private healthcare practitioners are those who work outside the public system. They charge patients for their services, but their fees can be subsidised in various ways, including Medicare and other health insurance options. For further information on Medicare and other health insurance options, please see the ASPAH Guide: Healthcare Insurance Options.
To access an appointment with a healthcare professional in the private system, you need to obtain a referral from your general practitioner (GP). You can choose to be treated in a private hospital, where the waiting lists are usually shorter. However, private hospitals and private health practitioners are very expensive, so most people who use them have private insurance. However, private insurance doesn’t cover all your expenses, so always ask about any excesses , “gaps” or additional fees you may need to pay before you make a decision. See the ASPAH Guide “Health Insurance Options” for further information.
General practitioners (GPs)
GPs (doctors) have a broad range of training and experience, so they can diagnose and treat many health problems without you needing to go anywhere else. If you do need further care, they can recommend appropriate services and practitioners. If you need a specialist, the GP can refer you to a public hospital, but the GP cannot choose which specialist you will see, or ‘speed things up’ unless your condition is urgent. The GP can also refer you to a private specialist who is likely to see you sooner. Private specialists are expensive, but it is fine to ask the fee before confirming the appointment. For more information about GPs’ skills and services, see the ASPAH Guide: Healthcare Professionals: Who does what?
Approximately 85% of GPs “bulk bill”, which means they use your Medicare card to charge Medicare directly and you do not have to pay. If your GP does not bulk-bill, you need to pay the difference between their fee and the Medicare subsidy. This “gap” fee averages about $35-$40 for a standard 20-minute consultation.
Other healthcare professionals
There are many other types of healthcare professionals who are trained in different treatment methods. Many of these are described in the ASPAH Guide: What Healthcare Professionals do. However, it can be overwhelming trying to work out who is best for your needs, so it is usually better to ask your GP for advice.
The public system:
Allied health professionals: Public hospitals employ a broad range of registered allied health professionals, including nurses, physiotherapists, social workers, speech therapists, podiatrists and occupational therapists. These services are sometimes available to the community without charge through a doctor’s referral. There is usually a waiting list.
Alternative practitioners: Services such as acupuncture, Alexander Technique, Feldenkrais, Chinese Medicine, massage therapy, Pilates and yoga are never available through the public system.
Mental and sexual health: Recognising the very personal nature of these health issues, most public hospitals offer free support in both areas. Go to Accident and Emergency at a public hospital or make contact with the relevant service by phone. Contact details for a range of services are available in the ASPAH Guide: Safety in the Performing Arts.
Optometrists: Optometrists usually bill Medicare directly for an eyesight check-up, but you have to pay for frames and lenses.
Dental: Many public hospitals have free dental clinics for urgent care, but access may be limited to those who have a Health Care card.
Emergencies: Go straight to any public hospital or call 000 for an ambulance.
The private system:
Allied health professionals: You can go to any allied health professional without a referral, but they all charge fees. Your GP may be able to help you access some subsidies, and some private insurers cover part of the fee for some services.
Alternative practitioners: Acupuncture, Alexander Technique, Chinese Medicine, Feldenkrais, massage therapy, Pilates, yoga and similar practitioners charge fees. Some private health insurance cover some of the costs for a few of these services. Private health insurance companies vary in cost and in which services they cover. Check which services are included in a specific policy before you buy private health insurance. You can compare policies on www.privatehealth.gov.au/.
Optometrists: These services are covered by Medicare. Optometrists usually bulk-bill for an eyesight check-up but you have to pay for frames and lenses.
Audiologist: The government subsidises hearing checks for children and people over 65. Subsidies for hearing aids are available to the bearers of certain concession cards.
Dental: Most dental treatment is by private practitioners, but government subsidies are available for child dental checks.
What if I have a problem or a complaint?
Health professionals by law have to be registered with the Australian Health Practitioners Regulatory Agency (AHPRA), and it is possible to lodge complaints through this agency. Alternatively, the Medicare Act requires each state and territory to have its own Health Care Complaints Commission with particular focus on their public health system. Search online for details for your state.
Version June 2018 Contributors: Janet Karin, Mark Seton, Paul Duff, Amy Naumann