Accessing Health Care System in Australia

Now, for comparing it with the Health Care System in Australia. The first thing one needs to get on reaching the shores of Australia is a Medicare card. Medicare is the Australian Health Care System started in 1984 to provide health care to the people, reasonably priced, accessible and high quality care. The people pay for this through their income tax similar to the NHS in UK. The website gives a broad outlook about the health care system but it is hard to find how to access GP services or how the prescriptions obtained and charges for it.

To enroll into the Medicare system you have to fill out a form. There are many things covered by Medicare such as doctor’s fees (both GP and Consultants), any investigations, eye test, some surgical procedures and all those treatments that are necessary as a part of chronic disease management. Also you will be covered for hospital services as a public patient. All other things are not part of this subsidised health care. There is no catchment area for GP surgeries so one can register at any surgery one wants to. This means the popularity of the GP surgery is based on word of mouth. There seem to be no limit to the number of patients going to a surgery. The size of the surgeries also differed from one doctor to a polyclinic with minor surgery attached. We looked up the surgeries around our local area and found a few. One was actually at the end of our road.

So on Saturday we decided to walk down (about a mile) to see if it was open and if we could register. After a trek up hill and down dale we find that the surgery is no longer there. In fact, the next week we found it was up for sale online! There were 2 more surgeries near The Pines Shopping Center. Upon recommendation from the bank staff we decided to go to the one situated in The Pines itself. There are 2 doctors there and appointment was made with one.

When making the first appointment you have to fill a form giving your particulars as well as your Medicare card number and also your health care card number if you happen to be registered for it. The health care card is a benefit provided by the government for people who are unemployed and on any other benefits. This gives the individual a discount on prescription charges. The surgery we went to is a bulk billing one. This means that when you visit the doctor you have to sign a form stating that you have attended and the fees for the visit. This the surgery claims directly from the Medicare. If the doctor does not do bulk billing, you have to make a payment and then put in a claim from Medicare. This when processed will refund that fee into your bank account. However, you need to remember that Medicare rates for doctor’s fees are set and if you happen to go to a doctor who sets their own charges you will not be returned the whole amount by Medicare. This one needs to remember in particular when seeing a private consultant instead of the public hospital one.

The referral service to consultant is also very different. The patient is offered a choice by the GP to go public or private and also to which consultant he wishes to see. Now here is where word of mouth referrals come handy, or else you have to rely on your GP’s knowledge to recommend the best doctor. The GP gives you a referral letter and it is the patient’s responsibility to ring and make appointment. You have to take the referral letter and any other information when you go for the first appointment. Now during this call to make appointment you can inquire about the fees and how the billing is done etc. Just found another thing as I was worrying about the doctors visits’ costs that for people with chronic problems and high needs for out of hospital services there is also a medical safety net where the Medicare provides higher subsistence to cover out of pocket expenses.

The prescription system also is complicated. Like UK there are prescription and non-prescription drugs. However, in UK all drugs could be prescribed even if they were available over the counter. I am referring to drugs like vitamins and anti-histamines. In Australia this does not happen. So for all the vitamins that I need I have to find the best price pharmacy and get it myself. I do hope that this requirement for vitamins will be discussed by the GP or the consultant. For some drugs the doctor can identify a repeat prescription either for 1 or 3 times. Have yet to find out if this means that I have to visit the doctor every time I want one of the non repeat prescriptions? For every visit means a fee! Or does the consultant provide these repeats when dealing with specialised meds? The receptionist said the consultant did indeed give longer prescriptions when I called to make appointment. When you go to the pharmacy with the prescription you can be faced with 4 different prices and you can choose the one you wish to pay. The first is the price if your prescription was private, second if it is to be public prescription. Third if you are having health care card and lastly if you come under the Pharmacy Safety Net. This happens when you have paid a certain amount of money buying drugs in the year. The pharmacy can make note of this by keeping your records and marking your prescription with a sticker. Eventually when you have reached the limit you can get the safety net card and the prescription charge can either be reduced or free. The limit is set every year based I think on inflation rates.

So far so good… will add more as I find out. Seems everyone finds out as they need and so one cannot to get an overall view.

Ovderview of Access to the Health Care System in UK

Within the NHS in UK after so many years I was familiar with the system. The money for the health care comes from the tax which is paid from the salary. When you move into an area you look for the local GP surgeries. The GP surgeries serve specific catchment areas according to the population. Then you can fill in a form and apply to register in the surgery. After that you can make appointment to see any doctor for urgent problems which can be the same day or within 48 hours or routine appointment with a specific doctor within the month.

You can put a note for repeat prescription which does not require you to see the doctor every time. Most prescriptions are for 1 to 2 months of medication. There is a set charge for each medicine on your prescription which currently is £7.20. If you need medication all year round then you can pay a yearly prescription fee and then be exempt from paying the prescription charge every time. If you are on medications that you must take to avoid further health problems that will then cost the NHS more such as medication for hypothyroidism you can fill a form to get exemption from paying you prescription charges.

In case you felt ill outside the surgery hours you called the NHS Direct where someone would ask you questions and advice you what to do. If they were unable to decide then you would get a call from the nurse of duty or even the doctor. The GP does not carry out home visit except for the elderly and infirm. In an emergency you can either take yourself to the hospital A&E or call an ambulance. There is no charge for calling an ambulance. In A&E you get seen according to the urgency of your condition. There used to be a time limit of 4 hours by which all patients would be seen but this has been removed when the current government came into power. You can have any necessary investigations carried out and if need be hospitalisation. All this is free at the point of access.

If you need it the GP can refer you to a consultant who also used to be in the catchment area hospital, but now patient can choose the consultant he wishes to see. Also earlier there was a time limit of 8 weeks by which the patient had to be seen upon referral. There were also time limits regarding waiting lists for surgery, additional support services like Physiotherapy, Occupation Therapy etc. All these services are being stretched considerably now with the changes and cuts to the NHS. However, the process of access to service is reasonable straight forward as easy to plug into when moving to the UK. However all this will probably be totally different with the changes and cuts being made to the NHS.