How The Healthcare System Operates and Provides Support in Australia?

Medicare bears the cost of public hospitals for the Australians and the overseas workers who are under the Reciprocal Agreement. For others, Overseas Health Insurance is required. Read More.

How The Healthcare System Operates and Provides Support in Australia?

The Australian healthcare system has many layers. It provides a broad range of services from population health, general practice to emergency services, hospital care, palliative care, rehabilitation and so on.

The healthcare system of Australia is known as one of the best globally. According to reports, in 2016-17, Australia spent nearly $181 billion on healthcare, and the Australian federal government expended 41% of it.

Despite that, the country is about to face some substantial challenges in the coming years. Those include, but are not limited to:

  • Ageing population. By 2053, it is projected that 23% of the population will be above 65.
  • An increasing rate of chronic diseases
  • Medical research and innovation costs

The Australian government is hoping to cope with the challenges through a well-defined medical structure. Through this article, we will try to delve into the layers of healthcare structure, so that you understand what type of health services you require and how to access the service.

The main gateway to receive other treatments such as diagnostic tests, admission in hospitals, specialist consultation etc. happen through General Practitioners (GP) and Emergency Departments (ED).

  1. General Practice and Primary Health Care
  2. After-hours General Practitioners  
  3. Emergency Department (ED)
  4. Specialist Services
  5. Public and Private Hospitals
  6. Prescriptions and Medicines
  7. Primary Health Networks (PHNs)
  8. Local Hospital Networks (LHNs)
  9. My Health Record 

1. General Practice and Primary Health Care
Primary health care is the first service you avail when it requires medical attention for most of the cases. The care is delivered through general practice, community centres or at home.

This service is provided by the doctors, nurses in the community, pharmacists, dentists or other allied health practitioners.

Allied Health Professionals

Allied health professionals are not doctors or nurses. They are trained professionals who help the patients with physical and mental health through diagnosis, rehabilitation etc.

2. After-hours General Practitioners  

Many GPs are only available at the busy hours. However, if you need medical attention after hours, there are options as well. The free-government funded GP Helpline can help you. You can speak to a nurse over the phone, and if required, a GP will contact you. This is a private service, and some of them are covered under Medicare.

3. Emergency Department (ED) 

The ED treats patients who need immediate medical treatments with acute or life-threatening conditions or surgical care. They are mostly located in public hospital across Australia.

The Emergency Department number in Australia is Triple Zero (000).

4. Specialist Services

Specialists work in a defined area like cardiology or dermatology etc. They can be associated with both private or public hospitals. To get full coverage of specialist services under Medicare, your GP must refer to it.

5. Public and Private Hospitals

Both Public and Private hospitals provide treatment all over Australia. State and territory governments own and manage public hospitals.

Medicare bears the treatment costs in Public hospitals for the Australians and also the Overseas Visitors who are under Reciprocal Healthcare Agreement with Australia. Other Overseas Temporary Visa holders (including students and workers) require to buy Overseas Health Insurance because they cannot avail the Medicare facilities.

You can rely on Medicare, or you can purchase a Private Health Insurance along with Medicare to cover your medical expenses. Private insurance covers some costs of care in private hospitals.

6. Prescriptions and Medicines

The Pharmaceutical Benefits Scheme (PBS) makes it sure that the Australians need not pay the full amount on prescribed medicines and can access a wide range of medicines within affordable rates. PBS subsidises the prescription medicines cost.

You can also avail medicines over the counter, which may not be necessary under the PBS. Therapeutic Goods Administration (TGA) must approve the medicines to be under PBS. TGA also regulated vaccines, sunscreens, medical devices, minerals etc.

7. Primary Health Networks (PHNs)

July 2015 onwards, the government has started 31 PHNs across Australia as an independent primary healthcare organisation. Not-for-profit organisations operate the PHNs. These decide what type of healthcare needs to be provided and who provides those.

This is mainly to help the disadvantaged groups. The aim is to reform the healthcare system in Australia by taking a patient-centric approach in their region.

8. Local Hospital Networks (LHNs)

Local Hospital Networks are known by different names across Australia, like ‘Local Health Districts’ in NSW, ‘Hospital and Health Services’ in Queensland, and more. LHNs mainly link the medical services in the region through a group of local hospitals or a single hospital.

9. My Health Record

My Health Record is an online summary of the tour health record. You can share information about your health to the doctors, healthcare providers, etc. The information is classified, and you can control who can see the information.

Availability of some of the medical facilities depends on where you live, unlike Medicare, which is the same nation-wide.