Archaic Health Services in Australia? Another Visit to the Doctor

Some time ago a reader called Shaun posted several comments (if this link breaks, please let me know in the comments below and I will fix it) on my website listing all the reasons why he returned to Europe after just five months of living in New South Wales.

Clearly Australia didn’t work out for him and his family, and he wanted to warn others of the potential dangers of a move down under.

He provided lots of information about the kinds of things he was unhappy with here in Australia, including the remark “…poor medical model, looks good to the layman, but to senior healthcare professional like myself it’s bordering archaic…

It’s difficult for me to argue with that claim as the statement itself suggests only a senior healthcare professional can truly understand the state of Australia’s medical model.

As a layman though, I sure can explain how it looks from my point of view.

Australian health services archaic?

Doctor ArchaicThis is a true story of what happened to me recently. It all began very late on the night of Saturday 25th of July this year. At about midnight, I noticed that my left arm had started to ache.

I had no idea why, so it was a little disconcerting.

A couple of hours later the pain had increased quite dramatically, to the extent where I took a painkiller that had previously been prescribed to me by my doctor for a shoulder problem that I have.

Yes, I’m currently going through the ‘falling apart years’.

These were strong painkillers, you only need one every 24 hours. I went to bed, but the pain continued and I couldn’t sleep. I got up at around 5 o’clock in the morning, paced around a bit, and took another one of those ‘once in every 24 hours’ painkillers.

Finally got to sleep at about 8 o’clock in the morning. Lucky it was Sunday.

When I eventually got up on Sunday the constant pain had gone, but there was clearly something wrong with my arm and certain movements made me yelp.

Here’s how it went from then on in through the Australia health system:

  • Monday morning, first thing, rang the doctor for an appointment
  • Appointment given for 11 AM the same morning
  • Appointment goes ahead on time, my doctor requests ultrasound on the arm and an x-ray of my left shoulder are
  • As soon as I got home, which would have been just before midday, I telephoned the nearest Queensland Diagnostic Imaging department to where I live for an appointment.

Similar to, but not exactly, this one…

The X-Ray Shop.

  • I explained that I really wanted a same day appointment, if possible, as I had been selected for jury service over the next two weeks (that’s another story) and would only know on a day-to-day basis whether I would be needed in court or not
  • They said if I couldn’t get an appointment in any of the other two imaging departments within 30 minutes’ drive of my house, to just turn up at their place after 1 o’clock and they would ‘fit me in’
  • I couldn’t get an appointment elsewhere, so I did turn up at 1 o’clock, and I was walking out with my x-ray and my ultrasound images under my arm by 2:15 PM
  • Luckily at 5 PM I discover I’m not required in court the next day either, so I booked a follow-up appointment with my doctor for 12:30 PM on Tuesday
  • By 1:20 PM I was back home again and my problem had been diagnosed as ‘tenosynovitis of the bicep tendon’

Suggested treatment; anti-inflammatories for a few weeks and if it doesn’t get better, consider an ultrasound guided steroid injection into the left bicep’s tendon sheath.

The doctor also wrote out a prescription for that injection in case I needed it; I haven’t used it yet.

How much did all this cost?

I had to pay for two visits to the doctors at $82 per visit. Medicare though gave me a refund of $37.05 for each of those visits, so net they cost me $45 each.

There was no charge to me for the x-ray or the ultrasound.

Total cost all in, $90.

Do bear in mind an important point here. I could use a ‘bulk billing doctor’ in which case the cost to me would have been zero. You can read more about bulk billing here…

I like my doctor though, I think he’s very good, so I’m happy to stick with him and pay the extra. It is also possible that if I did switch to a bulk billing doctor, they would be busier and therefore it would probably be more difficult to book appointments at such short notice.

Conclusion

It’s hard to imagine how that would have panned out in the UK. I would have either had to go private to receive that sort of speedy treatment, in which case the costs would, I’m sure, have soared dramatically.

Or I could have waited for free NHS ultrasounds and x-rays in which case I believe the timescale would have been vastly extended.

Or, I imagine I could have just turned up at A and E and queued up for the ultrasound and x-ray if it was felt to be urgent enough, but if I had done that, I’m pretty sure the waiting time would have been exhausting.

I mean several to many hours. It’s hard for me to know for sure, I haven’t used the NHS since 2007.

The way I see it though, and yes, I am only a layman, there is nothing archaic with the Australian medical model.

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{ 21 comments… add one }
  • Trevor June 5, 2017, 7:43 pm | Link

    Bob, what happened to Shaun’s comments about his experience of the ‘archaic’ health system in NSW? The link at the top of this page merely links to New South Wales generalities. Thanks.

    While I’m here, how do you find the general service, in terms of reception, with Aussie GPs? Here in the UK we suffer from baking-hot waiting rooms in summer, without fans or aircon. Even the doctors are reluctant to turn on their private room a/c’s (seem to feel a chill, or don’t know how to adjust). Plus receptionists can be miserable and unfriendly: a Radio-4 phone-in had a former doctor’s receptionist saying the other staff told her, “Not to be so nice to the patients”. She left after 6 months. Appalling. But then, within socialist systems there is no incentive to give good service.

    • BobinOz June 5, 2017, 8:43 pm | Link

      Sorry about the broken link Trevor, it is fixed now. It’s a problem to do with comment pagination, so it might happen again at some point in the future. I’ve now made a note above, just in case it happens again.

      My experience of going to the doctors is a good one, but I’ve had the same doctor the 10 years here, I don’t know what all of the doctors waiting rooms are like.

      If you want to read about my experiences though, it’s on the following post…

      http://www.bobinoz.com/blog/19624/going-to-the-doctors-australia-and-uk-compared/

      I am very happy with the service I get from my doctor here.

      • Trevor June 6, 2017, 6:59 pm | Link

        Thanks for fixing the link Bob. Apparently Shaun is of African ethnicity, working in the health service. Whereas the UK encouraged Caribbean and African immigration since the late 1940s, the Australians had a strict whites-only policy until 1966. Hence the British, today, are used to and accepting of such ethnicities, whereas the Aussies lag behind and may still display what Shaun perceived to be intolerance or even racism. Shaun is now happy on the Med, presumably Spain or France which, like the UK, has experienced long-term third-world immigration.

        The age of the host population may also be a factor: my late mother used to make the cultural observation (of third-world immigrants in the UK), “They are just not like us.” I, too, observe some, not all, third-world immigrants, or their descendants, insisting on doing things ‘their way’, rather than in concordance with our established culture and norms. Ethnic concentrations in cities like London (now less than 60% white), Leicester and Bradford do not help integration; in Australia such ‘self-zoning’ is much less of an issue. Apparently cooler Tasmania has the lowest proportion of non-white immigrants.

        • BobinOz June 6, 2017, 8:30 pm | Link

          My pleasure Trevor.

          Yes, Shaun certainly works in healthcare, but I don’t know why you think you know what his ethnicity is, he never mentioned it as far as I’m aware. I’m also not sure why you think it might be relevant to this conversation. May I remind you that this is 2017 and not post-World War II.

          The vast majority of us have moved on, and those who haven’t yet should try and catch up 🙂

  • Trevor June 5, 2017, 6:41 pm | Link

    For visitors seeking private treatment there’s a clause in the regulations that (paraphrasing) : “Visitors must not delay or prevent any Australian from being treated.” In other words, you can’t jump the queue; Australians (and presumably foreign residents) take precedence.

    Has anyone heard of that one, or been affected by it?

    • BobinOz June 6, 2017, 8:39 pm | Link

      No, I’ve not heard of that at all, but if it’s private treatment then that means the patient has to pay for it in full or that their health insurance helps to pay for it. On that basis, as long as the visitor has the money one way or another, I’m sure they will get treated very quickly.

      If this were a rule for the public system, the state hospitals, then yes, maybe it might be in place but I’ve never heard of anyone mentioning it, being affected by it or coming across it.

  • Nick March 18, 2016, 11:42 pm | Link

    I am amazed about all those success stories which unfortunately I can’t apply to me or any of my family. Let me tell you my story. I live in Cairns, by the way.
    I don’t have private insurance, I always use everything that’s medicare covered. Probably few years ago I had an accident by lifting a heavy weight-something fractured in my spine. I was overseas at the time, and doctors here told that this condition is uncurable and will stay for life. After a few years of living with painkillers, I decided that it is enough, and saw my bulk billing doctor. He sent for Xrays, which showed almost nothing serious, so I was prescribed for another round of painkillers.
    After one months when those new painkillers also stoped working, here I am again to the same doctor. I demanded for MRI, but it is not covered by Medicare, so I paid $250. Next week results came in and they showed three discs degenerated and two of them were fractured and leaking, causing inflammation and pain.
    So from here the fun begins.

    Doctor said that this condition is not curable and suggested me to quit my job and go on a cronic disease pension(I am 41 y.o) and get a social housing(because without job I won’t be able to pay rent). I of course considered this as a nonsense. Looking up on internet I found that there could be some steroid injections done to eliminate pain and inflammation. I went back to the doctor and requested this. He sent an email to then hospital and said now I need to wait.

    After waiting for 5 months, I heard nothing and went back to him, stressing that my condition highly deteriorated and I can’t sit or bend already. He said that I the reason I waited for 5 months and heard nothing from them is that I must have been on the non urgent list. They determine this by reading what the doctor wrote to them. This time I told him to write more aggressively. Surprisingly, after just 6 weeks, I got a letter confirming my appointment with the neurosurgeon, which will come to Cairns after 4 weeks from Townsville. I was surprised Cairns do not have any neurosurgeons.

    So here we go-after those 4 weeks I took the day off from work and after waiting for 3 hours, I saw a real doctor. He looked at my MRI and said surgery would only harm me even more and prescribed me steroid injection. After another 4 weeks I got a letter, which said that my next appointment to see a specialist is after another 4 weeks. Ok, I already got used to it.

    So when time came, I again took a day off and went to see a doctor which will be holding a needle. He asked many questions is order to determine whether I need this kind of treatment, despite neurosurgeon already stated that I do. I insisted as well and finally got ok for steroid injection. I was a bit in mood that finally this nightmare of waiting will end soon, but it not. After 2 weeks from this visit, I got another letter saying that after another 4 weeks(what a magic number) I have to come and register for day surgery. Another day of work. I sat down of about 5 hours near reception, got a thousand pages of application forms, filled them in and of I go. I was told to wait for another letter. This time I waited only 1 week and got a letter, which stated that my day surgery will be after another 2 weeks.

    I took two days off and finally got a needle in my back. The next month after steroid injection the pain actually increased significantly, but I was told it is normal. After about 6 weeks from injection one day I got up and here you go-no pain at ALL. It was like I was newborn. I lived 5 years with it and it was something amazing, life got back to, I started thinking about opening by own business, I was in full strength. But that lasted not for long.
    5 months passed and pain started again. Slowly, increased but I understood that I need to sing the same song again.

    The timeline is a follows-after first visit to a GP I had to wait about 12 months to get an injection. The costs were-$250 for MRI. That’s all. Now that I know how difficult is to get to the hospital, even if pain is only mild, I’ll go and request another injection. By the time I get it, the effects of previous one already be gone.

    I understood that only if you have a condition that can be cured by tablets-only then everything works fast-you go to GP, do xrays or MRI’s at your convenient time and get prescription from GP. But if you need appointment with real doctor-expect to wait months and years. By the time you get it, you can be dead.

    I don’t know maybe everything could have worked faster if I went through A&E.

    Sorry for not being able to share a success story, but to me Australian health care is truly archaic. I lived in Europe before coming here and even here in public system you can get appointment with a specialist in days, and surgery in weeks, not months and years.

    But despite this, I enjoy living in Cairns. For the healthy people it is a good country to live.

    • BobinOz March 20, 2016, 11:43 pm | Link

      Well, you and I appear to have had vastly different experiences with the health service. I have absolutely no idea why everything has taken so long for you when for me everything moved very quickly. It’s bewildering why you had to wait 12 months for a simple injection.

      It doesn’t make sense to me. Maybe our health service works better in the capital cities and not so good regionally, but that’s no excuse. You should have had better and quicker treatment than you got.

  • Frank Gilling September 2, 2015, 10:48 pm | Link

    Bob, I pay about $300 per month. My wife whinges about the outlay…until one of us needs medical attention. This year I also had a colonoscopy which again meant seeing a specialist and a hospital visit including time in theatre, recovery and a meal.Constant care by the staff, I paid the $400 excess or co-payment as it is known plus a portion of the specialist fee. I expect physio will continue for up to 6 months but at some point the health fund contribution will cease. The idea of insurance is it is there when needed. Some people like to spend their money on other things. I look after my health first. I do not believe there is a universal free healthcare anywhere in the world. At some point we all have to pay, one way or another. Basically as Popeye used to say, “ya gets what ya pay for”.Cheers

    • BobinOz September 3, 2015, 6:39 pm | Link

      Yes, indeed, at some point you have to pay. The NHS may look like it’s free, but taxpayers money funds it.

      I just want to point out, your $300 covers your family, so $3600 a year, about £1800, not a huge amount, I think you get it back in time saved alone.

      Thanks Frank, you’ve given us lots of good stuff here.

  • Ronny September 2, 2015, 6:17 pm | Link

    Hi there,

    Being a health professional myself, I would not be partial but the truth is, in a matter of surgery, the less you wait, the quicker you recover.
    Having that said, the main difference in the public/state system compared to private is the fettering, not the qualifications. What I mean is when you go in the public system everything sounds confined : you go in the ambulance, they do a first check and give it to the A&E hospital reception. Then a new assessment of your status is made and given to the main nurse. This one puts you in a row and then the on-call doctor (often junior) makes another check, he calls the supervisor, who makes the final assessment and forwards his conclusions to a liaison intendant (a health allied who looks for a bed to keep the inpatient). Then a junior specialist comes to see you, makes a new assessment, and finally the senior consultant decides whether it’s too late or too early in the night to operate and puts you on the next day program (at the end of this program, of course).
    This happens in ALL countries, that’s the way it is. Whereas, the private health system skips most of the intermediates and this shortens drastically the timeline.

    Considering the price paid, this is really something to consider individually (and regularly) when you subscribe for a private health insurance.

    cheers

    • BobinOz September 3, 2015, 4:41 pm | Link

      I think I understood what you’re saying Ronny, sounds like what we have going on here is a good thing. It certainly seems good to me and it makes sense that the sooner you get everything looked at, the sooner you can be on the road to recovery.

      Cheers, Bob

  • J.Frost September 2, 2015, 7:32 am | Link

    Wow either case sound fantastic compared with the UK equivalents. I have high praise in general for the NHS and when you need them for the serious stuff they are spot on but for things in between be prepared to wait. Roughly a year ago I broke my foot after slipping at work. Dragged myself ( literally) from taxi to a & e and sat for 3hrs and 55 mins (just below the guidelines I might add) in excruciating pain to be seen by doctor to be then sent to wait for an xray for another hour. Waited again for another hour to be seen and told the news and advised non displaced so take pain relief and off you go. No repeat checks, no physio advice etc, out the door in under 7 hours with no drugs! I have no doubt the teams were working on more serious cases than mine but still not much fun. All free of course! Private health care is unaffordable for your average family and there is no in between to speak of. Hope your arm is improving Bob.

    • BobinOz September 2, 2015, 4:36 pm | Link

      Yes, my arm is getting better, thanks for asking.

      I have a lot of respect for the NHS as well, but the waiting is hard to deal with. You spent 7 hours in there, last time I went I think I was in there for about 10 hours. I’d much rather pay a bit of $$ and get seen quick, and that’s what I can do here.

      What we have here, I think, is the ‘in between’ that you mention that you don’t have.

  • Frank Gilling September 1, 2015, 7:10 am | Link

    Hi Bob, I would like to echo and back up your comments. On Sunday morning 2nd August I fell from my bicycle and was taken by ambulance to the hospital. I was seen within minutes, pain relief injections given and xrays taken. I broke my wrist…badly. I was given pain medication to take home and was home shortly after lunch. Next day I had an appointment with a surgeon who ordered an MRI. Within an hour we had the results and an appointment for surgery on 5th August. On 6th August I was fitted with a splint and sent home. For personal reasons I had to be in Sydney for a month so needed follow up care. I chose a local bulk billing doctor who saw me the same day and prescribed pain relief. After two weeks they removed the bandages and sutures. The same day I was given an appointment for phsyiotherapy and have been going twice weekly since. No drama, easy to make appointments. Costs are a different story but the xrays and MRi cost nothing, the bulk billing doctor costs nothing. The aneasthesiologist cost me nothing. My meds are subsidised. My hospital stay and the surgeon cost me a good deal but I had the best surgeon on the Gold Coast and have been given great care at all times.My phsyio costs me but I believe some of my out of pocket expenses may be tax deductible. I am still in pain but that is diminishing. Archaic? I hardly think so. I shudder to think of waiting to be seen every step of the way. I return to the Gold Coast this weekend and already have an appointment with the surgeon on Monday and my local phsyio the same day. BTW I am typing this one handed.

    • BobinOz September 1, 2015, 4:31 pm | Link

      Sounds like you’ve received pretty fast and efficient service Frank, not archaic at all is it? My experience suggest it’s not as well.

      Most of your stuff was free, but you have clearly paid for an op, many of my readers will be interested to know why and how much.

      You don’t have to say, but can you tell us if you were offered a free option if you were prepared to wait? Or did you have insurance that covered some of the costs of the private op?

      Actually, it’s not my readers, it’s me being nosey 🙂

      • Frank Gilling September 2, 2015, 6:54 am | Link

        Hi Bob, OK. I am still in Sydney and do not have all my accounts to hand so will give you an idea of what it cost although somewhat inaccurate.
        From the start the ambulance asked if I had private health. They could take me to the Gold Coast public hospital where I would be assessed and then wait. I could wait hours, sitting in a waiting room OR I could go private. Although I did wait a little I was looked after, constant checking and given sandwiches and tea between xrays and a temporary cast etc.All that time I was made comfortable on a gurney and had warm blankets.I was not sitting, in agony in a waiting room. Actually I went into shock early when I arrived. There was a cost most of which my health fund covered and I paid about $200,
        Private surgeon cost $200 for consultation. The surgery fee was $2500 of which I paid $1595. I paid $400 excess on the hospital bill which included theatre costs, meals, overnight care, pain relief injections etc. I have no idea of total costs.
        Physio costs $75 per visit and after my health fund covers the rest… about $26 I pay $49.
        Medication is mostly covered by PBS and my pension so I pay a maximum of $6.10 per prescription.
        Local doctor is bulk billed.
        I estimate without my health fund and government assistance I would have paid $7000.
        If I had gone public I would have waited a lot longer to be seen, had no choice of surgeon, may have waited longer for surgery and again had no choice of physio and could not transfer to another state easily, would need to visit the local hospital for physio but still would have some out of pocket expenses.I would be worse off mentally.

        • BobinOz September 2, 2015, 4:10 pm | Link

          Thanks for this Frank, sounds like you had a choice, you could have got free treatment, but you would have had to wait. Or you could go private, get sorted quicker, but have to pay.

          You went for the private option. Because you have a health fund, or as I would call it, health insurance, you ended up paying about $2450 instead of more than $7000 and you were all fixed up pretty good and very fast.

          Is that a fair summary?

          Just leaves on last question, how much do you pay each month for your health fund?

          • Emma January 14, 2017, 4:28 am | Link

            $7000 still sounds like a lot of money that most people would not have spare or willing to pay.

            There is nothing stopping you from paying thousands in the UK for faster/better private service too, it’s just the the vast majority of people do not want to, because they feel they are already paying in their UK taxes.

            I would like to ask if you get an equivalent discount on your taxes in Australia if you have private medical insurance? Are taxes cheaper because more people pay for insurance? If not, then aren’t you essentially paying public and private health insurance in Australia, same as you can choose to in the UK?

            • Emma January 14, 2017, 4:35 am | Link

              Apologies, I see that the poster paid “only” $2450 instead of $7000 because of his private medical insurance.

              However, if someone paid for private medical insurance in the UK, wouldn’t it be the same?

              • BobinOz January 14, 2017, 8:54 pm | Link

                I think the private health system in the UK is really quite similar, I wrote an article about it which you can read here…

                http://www.bobinoz.com/blog/19818/health-insurance-in-australia-and-going-to-hospital/

                The difference here in Australia is that far more people take up private healthcare cover than they do in the UK, but for those who don’t take up cover, just like in the UK, you will get treated for free.

                Private healthcare just gives you more choices, and usually quicker treatment, but you will pay for it and yes, there are tax incentives for getting it.

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