Healthcare

[Justchooseone]

Interested in the current state of healthcare over there, specifically in Sydney. I have heard that hardly any GP’s are bulk billing any more. Not too bothered about that, but over here in the UK we have 12 hour wait times in A&E, 2 year waits for surgeries or years long waits for consultant appointments, and several years for SEN assessments and woeful (it seems) provision. Is it as bad as that over there? Can anyone provide any insights please, thankyou

Our gp clinic (Sydney) is one of the few left I our area that bulk hills and also has private. Since a few others have stopped bulk billing it has become a lot busier.
It's all done by app so you can check in before you actually arrive if not booking a private appointment.
We had to take dd up on Sunday night to be seen and DH waited with her for 2hours to be seen. But the drs are good, pleasant, approachable and not dismissive.
I know which days have more drs on so if possible I will try for one of those days for a shorter wait or book private with Medicare rebate.
Waitlists on the public system do have long waits because of the Covid backlog, but is also based on severity. DH needs his varicose veins seen to in the near future. They aren't bad enough to get him on the public list but with health insurance we can get it done in 4-6 months and approx 2k out of pocket costs.
The outpatient fracture clinics at the large public hospital by us are busy but effective.
A&E times are massively variable depending what time of day and day of the week you show up. I was admitted via a&e with only about an hour wait on a weekday around mid day, and dh was seen to and discharged within about 2hours for a nasty slice to his forehead late at night.
I think it will depend hugely which area you are in - Sydney is very spread out and the hospitals serve different areas.

Also child SEN diagnoses under public have massive wait times and it can be hard to get on a private list.
Adult mental health is struggling and psych lists are often full/not taking new patients.
We seem to have been able to get referrals quite easily for quite a range of things but this is with health insurance or medicare and paying a gap often of a couple of hundred.

@spottygymbag thanks so much for replying!! Any insights into maternity care?

I had a great experience with the midwife group that is run out of local hospital. We looked at private but opted for public so if anything did go wrong there was no delay for transfer.
I had a key midwife but also saw two others throughout pregnancy when she was attending a birth.
The labour ward was quite lovely. I had no issues requesting and getting an epidural.
The only issue I did have was leaving- the need to do a final check before discharge as there had been 11 hours between waters breaking and delivery so wanted to monitor for signs of infection and we had to stay an extra day. On the last day they kept shunting me down the list so in the end I said I'm leaving with or without it (DS had shown no signs of infection and was feeding well, passing meconium etc). Miraculously we were seen next.
Also most rooms were single, with just a few doubles. There were large lazy boy/convertible chair things for partners to sleep in too.
The hearing tests were done on sight too which I appreciated.
We consented to a student dr observing and dh asked her to take some photos meaning once DS was out, which we got, but also got the full range including an amazing one of DH delivering DS. TMI but here you go 😂
This was my second I found it great.

I’m not in Sydney at the moment but when I lived there 5 years ago, it was possible to find a bulk billing doctor but it certainly wasn’t the closest doctor.

Keep in mind that all doctors are essentially private but some charge more (than the Medicare rebate) than others (bulk billing prices). Because of that, you can pick and choose who you want to see quite easily. I was always able to get same day appointments at the practice of my choice, and usually (but not always) with the doctor of my choice.

I went private for maternity care. Again, I could choose my doctor and even choose the hospital I wanted to give birth in.

Even in the public hospitals, the maternity ward is almost all private rooms with facilities for partners to stay over. There also appears to be less of an idealogical attachment to ‘natural birth’ in the staff but that is just based on my own anecdotal evidence.

Any specific questions about maternity care?

I have lived in many countries following DH around. Australia is the only country in which private healthcare doesn't cover you for a doctor (GP) or specialist's visit.
You can't see any of these no matter how top your private health plan is. The only exception is surgeon, but what if you don't need surgery or hospital stay?

DD had to have her wisdom teeth removed. She had to because one was so severely impacted it was pushing and destroying the root of the healthy tooth next to it. It had to be done in general anaesthesia because on position on bone. Dentist said to remove all 4 because the other 3 were on similar track to become destructive.
Private insurance covered 198 per tooth. As PP , I was out of pocket of 2000 $ (total was 2800) + anaesthetist fee + post surgery medication. I can afford it, many can't .
If you go to a specialist, the first visit is anywhere between 280-340 and you get 80 back. That's it . Then if they send you scans , budget 500-800 more.

The Australian medicare system works very well is you are very healthy or very sick.

Even before covid backlog, the waiting time to be seen in public system was 18 months

Just to be more specific, exception is surgeon's fee during surgery. Not the first surgeon's visit or scan he requires.

Thanks so much everyone for your replies.

@DifficultBloodyWoman not really, we would be TTC #2 after a year or so of moving, (if we do) so just interested really. I had a really traumatic birth with DS with utterly shit midwifery and postnatal care, so I’m keen to make it as positive an experience as possible for the second! If we are lucky enough to conceive as I’ll be a bit geriatric by then!

@Cormoran thankyou, that’s helpful. I have lived there before and your info does tie up with my experiences actually, but it’s a good reminder that we will need to be mindful about having emergency money available especially as it’s not just me anymore!

In that case, something to consider is the rules around private health insurance in Australia.

If you earn more than $90,000(ish) as an individual or $180,000(ish) as a family, you will be taxed an additional 2% on your income unless you have some level of health insurance. This is called the Medicare Surcharge.

Depending on your visa type, you may be required to have private health insurance any way.

DH and I have the highest level of cover for ourselves and DD. We are not spring chickens and DH is an ex smoker. We pay $450 per month which is about £240 per month. Our coverage includes ‘extras’ which means there is also some coverage for dental work, remedial massage, physio, contact lenses etc.

As I mentioned earlier, I had private healthcare throughout my pregnancy which I was very pleased with. Health insurance covered all of my hospital bills and post natal physio. It didn’t cover visits to the obgyn before the birth, or prenatal testing or scans. I did get a Medicare rebate for all of those. I’m guessing now but I think the out of pocket expenses for that pregnancy were approximately $3000. But I did have a lot of complications and extra scans and doctor’s visits. I’m a more, ahem, ‘mature’ mother.

Also consider your eligibility for CCS. This reduces the out of pocket costs for daycare which are rising. If you're not eligible you could be looking at approx 165/day per child, and the CCS reduction also applies to after school and holiday care programs.
Will you be working and eligible for govt mat pay? That's available if you have worked 10months in the last 12.
Quite a few companies will pay for your health insurance as part of the overall employment package. We were lucky to get good cover for the whole family.
Economically it looks like aus has another rough 12-24 months ahead, with likely another couple of rate rises this year and all the impacts that will follow. Just worth keeping the big picture in mind if you're looking at moving over.

Thanks very much again to both of you.

We would more than likely get private health insurance through DP’s job as he works in that sort of field. And I’ve done the childcare calculator and we would be eligible and it would save us a lot of money.

I know Aus will not be immune to the difficulties facing, well, the rest of the western world really. But I somehow think it will be better than the UK!