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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

In wondering why UK can't adopt the Australian Healthcare system?

353 replies

chopc · 04/09/2021 09:07

I was talking to some friends abroad and in Australia about frustrations with our wonderful
NHS for both patient and doctor. One of them wondered why we can't adopt the Australian Healthcare system. I thought the same and checked with those using it in Australia, and I can't see any downsides to it ........

What is stopping the UK adopting the same system?

OP posts:
Oceanbliss · 04/09/2021 09:55

I’m from Australia and believe me there are plenty of problems with our health care for both doctors and patients.

My dd needed urgent diagnostic test (not saying as don’t want to reveal too much on the internet) and our referral was knocked back repeatedly. We were unable to get bulk billed care for our child. We ended up having to go private even though we really can’t afford it. The waiting list for one simple test for diagnosis of a potentially serious health issue (not treatment, not surgery) was anywhere between 1 and 2 years at the public children’s hospital.

Waiting lists for treatment or surgery can be years. Going to the emergency department you could be waiting hours even over 24 hours sitting on a plastic seat waiting to be triaged. And it doesn’t seem to matter that it’s a child. I saw a very sick child vomiting and crying and still not getting treatment or a bed.

It also depends on where you live in Australia. Not every city has as many options as other cities. Then there is regional parts of Australia that have a lack of care. Some towns don’t even have any maternity care or hospitals equipped for giving birth at all.

We pay the Medicare levy in our tax to fund universal health care. But so many people are getting less care depending on where they live. They are paying the same Medicare levy in their tax though.

Funding for health care has been cut time and time again. There are less bulk billing doctors available now. Hospitals are understaffed, not enough beds etc.

Parking at hospitals is insanely expensive.

I’ve personally had excellent care and on the other spectrum very poor level of care.

If you are on the receiving end of medical negligence it is very hard to successfully hold them responsible.

Health insurance is expensive, confusing and doesn’t cover everything.

In saying all this, I was under the impression that the Uk’s NHS was better than Australia until I discovered Mumsnet.

echt · 04/09/2021 09:57

Our GPs are gatekeepers to specialists and it can be hard to get referrals

As they are in Australia. And then you pay to have the referral letter sent again. Every. fucking. year. Like you suddenly didn't have cancer in 2002 and the specialist needs reminding. Hmm

Fucking rort.

Oceanbliss · 04/09/2021 09:58

@A2M4 are you in Melbourne or Sydney? Because not every city in Australia is that good.

AllyBama · 04/09/2021 10:00

Really depends on what you’re after. Would you like to see a GP, today or possibly tomorrow? Happy to pay $80ish up front and get just under half of that back on Medicare? No problem. I think that’s where AU wins over UK healthcare.

You can also walk into an emergency department and be seen for free but I think this is the same as the UK?

I work in the public hospital system and have for a long time. I can afford private health care and I would never ever be without it at the risk of ending up in the public system. Yes it is free but it is slow, understaffed and overrun. People can be on very very long waiting lists for catergory 3 and 4 (ie: semi urgent or non urgent) and get cancelled often. So that shoulder recon you’re waiting for, the one that’s stopping you from working and earning money but the system doesn’t consider urgent… yeah you might wait up to 6 months or more for that.

Neither system is perfect, we can all be grateful we don’t have to choose between going to the hospital or feeding our children like they do in the USA.

echt · 04/09/2021 10:01

Funding for health care has been cut time and time again. There are less bulk billing doctors available now. Hospitals are understaffed, not enough beds etc

^^ This. It's scandalous.

TheWeatherWitch · 04/09/2021 10:02

Yeah! Best of luck to any political party that wants to do away with our NHS. It would be political suicide for them.

The NHS is still the envy of the world.

SD1978 · 04/09/2021 10:03

To be honest having been involved with both- yes, the Australian system is much better. If you are a higher earner you either pay for private healthcare (which you don't have to use, or have the top tier) or you pay an extra tax into the public system as you could pay for health care if you chose to. Road taxes pay i to an insurance scheme- TAC and all road accidents are covered by them from a costing perspective- it doesn't come out of health care budget. If you need a CT scan here- you get one, through ED that day, and same with MRI's- not the same delays in the UK. Prescriptions cost more here- if yours on benefits it costs next to nothing if you're not, it can get a bit expensive, but there is a pharmaceutical scheme to keep the cost down. I have never seen any delays to treatment here, and I've never seen anything 'worse' here that the UK system.

A2M4 · 04/09/2021 10:03

This reply has been withdrawn

This has been withdrawn by MNHQ at the poster's request.

Ozgirl75 · 04/09/2021 10:05

I’ve lived in the U.K. and Australia and I think the healthcare system here in Aus is brilliant. I have zero complaints.
You pay insurance if you’re a high earner but that’s for “extras”, it’s nothing to do with emergency care, and if you don’t have it, the care is still excellent.
You can go to any GP you like. Referrals for things are generally possible within a few days.
My husband recently cut his finger washing up a knife. He was in having microsurgery that day (although it wasn’t life threatening) and then was referred to a physio. We have healthcare which covered the physio with a small excess. If we hadn’t, he would have had it for free.
I gave birth in a private hospital but people I know who have given birth public have also had private rooms, with a private bathroom etc.
I can afford to see a dentist twice a year as my insurance covers 90% of it. My insurance also covers optical treatment.
It’s a brilliant system and I’m amazed that people find it complicated - it isn’t in the slightest, it’s really easy to use, user friendly etc.

echt · 04/09/2021 10:05

Really depends on what you’re after. Would you like to see a GP, today or possibly tomorrow? Happy to pay $80ish up front and get just under half of that back on Medicare? No problem. I think that’s where AU wins over UK healthcare

Still paying upfront, which is beyond the means of many.

You can also walk into an emergency department and be seen for free but I think this is the same as the UK?

So why do they ask if you have private insurance?

The answer is: say no.

A2M4 · 04/09/2021 10:05

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This has been withdrawn by MNHQ at the poster's request.

CGWGWOO · 04/09/2021 10:06

My cousin had an eye test and the optician spotted something and urged her to go directly to the doctor. He wrote a note for her to pass to them. Off she popped and the GP refused to see her because she didn’t have enough cash on her and no cards. I understand that this is against the Aussie rules ( sporting pun) even though he had read the note. She went back to the optician and he said she was to go straight to A&E.
Later that day she had surgery for deep vein thrombosis and her surgeon said the optician saved her life. She later made a complaint about the GP and he was subjected to a disciplinary by their medical board.
So the Australian system has its flaws same as ours.

LovelaceBiggWither · 04/09/2021 10:07

@echt, not every state charges for ambulances.

WRT the referral, if it is going to be an ongoing situation with the specialist, ask for a permanent referral. We've got these for all our specialists.

I'm happy enough with the Australian health system. It could definitely be improved but what couldn't? Family member has just spent weeks in hospital with two major surgeries and we've got the community nurse visiting at home for follow up care.

A2M4 · 04/09/2021 10:08

This reply has been withdrawn

This has been withdrawn by MNHQ at the poster's request.

Ozgirl75 · 04/09/2021 10:11

Another anecdote - my husband had some rectal bleeding a few years ago. Went to Doc. They referred him for a colonoscopy. Said he could go private and have it done that week, or go public and there would be a wait…..of three weeks.
He decided to go public and had the scan done, results back soon - haemorrhoids. Again, offered to have them fixed privately (in a private hospital) or public. Decided to go public despite the wait of approx 4 weeks. Great care, in and out that day, now offered follow up colonoscopies every 2-3 years as they picked up a couple of polyps while he was under, even though he’s only in his early 40s.
Could not fault one tiny part of this treatment.

echt · 04/09/2021 10:12

WRT the referral, if it is going to be an ongoing situation with the specialist, ask for a permanent referral. We've got these for all our specialists

I was specifically warned against this by the lovely desk folk who said it worked out more expensive in terms of tax.

Ozgirl75 · 04/09/2021 10:14

I’m in Sydney and we’re also inundated with bulk billing health centres here. The thing that utterly amazed me when I first moved here was that you ring up and ask for an appointment and they have one ……that day! And you go in and if your appointment is at 10.30, you’re seen around 10.30. If you’re kept waiting longer than half an hour they’re massively apologetic. Astounding.

Ozanj · 04/09/2021 10:14

The Australian system, when it works well, is similar to Bupa+NHS in the UK. But Bupa+NHS works out a lot cheaper because for a lot of conditions Bupa consultants will only see you once at the private rate & will bring you back as an NHS patient but you have bypassed the GP. Also for pre-existing conditions and Cancer a ‘GP referral letter’ isn’t needed - several times my consultant has used my medical history in lieu. So you can bypass it.

echt · 04/09/2021 10:16

[quote A2M4]@Ozgirl75. Agreed. Easy system to use. We had excellent care. Hubby did have to wait far too long for a non urgent operation, similar to the NHS. However, I had a non urgent operation and once I had my out patients appointment, had the operation two weeks later.[/quote]
Easy system to use, not easy system to choose.

Oceanbliss · 04/09/2021 10:21

@A2M4 I thought so. I lived in Melbourne for years after moving there from interstate. The health care I received in Melbourne was extremely different from where I came from. So, much better. I moved back to my home state and not much has improved here. (I’m not from Sydney by the way so it’s not the Sydney Melbourne rivalry thing Wink)

The level of care I had in Melbourne I just can’t get here. I need ultrasound for a large cyst in my ovary, I can’t seem to get that here. I had that cyst monitored regularly by ultrasound in Melbourne.

My doctor said that I need a CT scan or MRI (I can’t remember which) for another pre existing condition but I would have to pay a little over $1000 dollars for it. I can’t afford that and I can’t get a referral for it to be bulk billed. So, I live in constant pain. I can’t afford ongoing physio therapy either.

It really does depend on which state or territory you live in to what sort of health care you get.

AllyBama · 04/09/2021 10:23

@echt

Really depends on what you’re after. Would you like to see a GP, today or possibly tomorrow? Happy to pay $80ish up front and get just under half of that back on Medicare? No problem. I think that’s where AU wins over UK healthcare

Still paying upfront, which is beyond the means of many.

You can also walk into an emergency department and be seen for free but I think this is the same as the UK?

So why do they ask if you have private insurance?

The answer is: say no.

In a public emergency department they don’t ask if you have private, it wouldn’t even come up.
Wbeezer · 04/09/2021 10:27

When you look at the world health care rankings the NHS is usually at our very near the top of most of them because the ratio of coverage for money spent is so good compared to other systems. Its not perfect and there is still wastage at times but overall its pretty good.
A lot of the issues the NHS has would be solved at a stroke if health and social care for the elderly was better funded and preventative health care was better (it is getting better but it takes years to show effects and is prone to being cut when austerity is in fashion eg. Surestart centres).
As usual, if you get the private sector involved, services for some will run smoother (note i did not say better, a hip replacement is a hip replacement) but there is usually a cut in services elsewhere to pay for it (and the shareholders dividend s). It's never the poor that benefit.

echt · 04/09/2021 10:39

In a public emergency department they don’t ask if you have private, it wouldn’t even come up

Yes it does. I've been asked every time.

Should you doubt my word, here's some other evidence:

www.smh.com.au/business/consumer-affairs/have-you-got-insurance-the-us-style-question-finding-its-way-to-australian-hospitals-20190314-p5149v.html

theconversation.com/if-youve-got-private-health-insurance-the-choice-to-use-it-in-a-public-hospital-is-your-own-113367

A2M4 · 04/09/2021 10:44

This reply has been withdrawn

This has been withdrawn by MNHQ at the poster's request.

A2M4 · 04/09/2021 10:46

This reply has been withdrawn

This has been withdrawn by MNHQ at the poster's request.