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Hospital admissions - Public vs Private

In Australia we are fortunate to have two healthcare systems - the public and private systems. Mum and daughter waiting for surgery

The Public System

The Public System is basically a free system (funded by the government), where your child will be treated according to how sick they are assessed to be. In the public system, doctors of various levels will treat your child and you are not able to choose which doctor will provide your child’s care. The public hospital system is also a teaching system where students and junior doctors are taught medicine. When your child is admitted to the public system they will be admitted under the care of a unit e.g. Neurology, Respiratory Medicine. A Consultant is always the head of a unit and oversees the care that Residents, Registrars and Interns carry out on his/her behalf.

The Private System

The Private System is where you pay to be treated by the doctor of your choice. This doctor is a specialist in his/her field (Consultant). When admitted as an inpatient to hospital, your child will be treated by your chosen Consultant only, and you may choose which hospital you wish your child to be treated in. Remember, that most private health insurance companies will not reimburse you for hospital stays relating to pre-existing conditions until you have been a member for 12 months. They also have lists of preferred ‘member hospitals’ with whom they are affiliated.

Your private health insurance may also only cover the costs of your child’s hospital stay. Your child’s treating doctor may charge you for visits and treatments carried out while they are an inpatient. As these arrangements vary from doctor to doctor, please check with the treating doctor and your health fund about any out of pocket costs.

Both the public and private systems have their advantages/disadvantages, but there are ways that you can utilise both effectively. Naturally, this will depend on your child’s situation.

As an Inpatient

Being a private patient doesn't necessarily mean your child will have a single room. It only means that you can choose your hospital and treating Consultant. Single rooms are allocated based on the clinical needs of a patient. They may also be used to isolate patients with serious infections.

There are few advantages to being admitted as a private patient in a public hospital. There is no difference in your care, and Interns will still treat your child because it is a public hospital. Private admission is worthwhile if you want to choose your own Consultant, or if you want your child to be treated in a private hospital for elective procedures.

Your child has the right to be admitted as a public patient even if you have private health insurance. Public admission is advisable when your child gets sick and you do not know what is involved in treatment and tests.

If choosing to be admitted as a private patient in a public hospital you need to do your research. Check what post discharge supports will be available to your child. As a private patient your child may not be able to access programs such as Hospital In The Home or Post Acute Care. This may impact on your child’s length of stay in the hospital and effect the level of support you may be entitled to on discharge.

As an Outpatient

If you see your Consultant privately for out of hospital appointments, you will have the advantage of him/her knowing your child’s history (and getting to know you). The costs are usually greater, but some specialists bulk bill children with a disability or chronic illness, others reduce their rate. It is wise to ask about costs before you make appointments. You do not need private insurance to see a specialist privately. In fact private health insurance may not cover the costs of outpatient specialist appointments, however some rebate may be available from Medicare. With Private Insurance Extras, you may get a rebate for some allied health professions, such as physiotherapy, speech pathology, occupational therapy, psychology, dentistry.

If you are using the public system for outpatient appointments, there will be no cost for the consultations, but there are often long waiting periods on the day, and you may see a different doctor each time. If you need to see more than one doctor, it may be useful to try and book multiple appointments on one day, so you can reduce the number of trips to the hospital.

Here are some tips from parents who have had outpatient appointments:

  • Arrive early to allow for your child’s check in and weighing, if needed
  • Bring snacks/activities for the waiting period, especially for young siblings who may be with you 
  • Allow about 3 hours per clinic appointment (to allow for parking, waiting, the appointment, any extras required by the doctor that day e.g. x-rays) 
  • Try to get your other children cared for on the day so you can concentrate on your child who is seeing the doctor 
  • If your child needs a prescription on the day, ask if it will be available at your local pharmacy (an ‘outside script’). This may be more convenient for you, especially if there are repeat scripts to be collected in the future. The alternative to an outside script is a prescription that is available only at the hospital pharmacy, which may be convenient to collect on the day you are there, but not if you have to collect repeat scripts at a later date.

Note:

Sometimes with rare conditions or specialist clinics you may only be able to be seen in the public system, for example; Hip Surveillance Clinic, Saliva Management, Genetics etc. As these are specialised areas it is often best that you are under the care of the public system. The doctors working in these units will have more experience in these areas. Often your case will need to be discussed with a team of health professionals. This can happen quickly and seamlessly under the care of these units.

“I have moved between both the public and private systems for my son’s care. I feel this has enabled me to get the best of both worlds. His consultants know him and me very well, which has proved very beneficial when caring for him when he has been unwell.” (Lisa E - parent)

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Extract from " There's no such thing as a silly question", produced by interACT and published by Very Special Kids. 
Reproduced with permission.
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08-Dec-2015 5:09 AM (AEST)