What is it really like to work as a physio in Australia? Is it really that different from the UK? Do they have a public health system? Is it all private practice work? Here are some answers to your questions from a UK trained physio who now lives and works in Australia.
The Health System in Australia
Having trained, qualified and worked for almost 10 years as a physiotherapist in the UK, relocating to live and work in Australia as a physiotherapist was a big step and a big change. The health system in Australia is quite different from the UK. In the UK we have a fully funded, public health system. Healthcare is free at the point of access. The NHS really is a special and amazing system that is often not fully appreciated by those with access to it. In Australia, they have some free healthcare, often referred to as Medicare or bulk-billed (more on that later!). But it is commonplace for people to pay for private healthcare to top up and improve their access to healthcare. So it is kind of a ‘half and half’ system – there is free healthcare, but often with long waiting lists (waiting up to 12 months to see a consultant for your initial appointment and then another 12 months wait for surgery/intervention) but most people also pay for private health insurance and you can then be seen by your choice of consultant within a week for any type of condition or illness.
What is Medicare?
Medicare is the equivalent to our NHS services, but with quite a few differences! Medicare is the government scheme which gives Australians access to healthcare. From an outpatients perspective, Doctors, physio’s, psychologists, dieticians and any other health professionals can see people under the medicare scheme (they usually require a referral from a GP for allied health treatment under Medicare). Medicare sessions can be ‘bulk-billed’, this means the patient/client doesn’t pay anything for the service. It is up to the provider (GP or allied health professional) if they will ‘bulk-bill’ a Medicare session. Providers are paid a set amount by the government for Medicare sessions. (Physio sessions are currently paid at a rate of approximately $53 and a session has to last at least 20 minutes). Some GP’s will ‘bulk-bill’ (but not many!) for their services but the majority will actually charge more than Medicare pays them. So essentially you have to pay for your GP appointment. Here’s an example to make it a bit clearer; A GP or Physio is paid $53 by the Government as their Medicare rebate, but the practitioner actually charges $90 for the session, Medicare pays them the $53, so the patient is left with a ‘gap fee’ of $37.
There are 2 other things to note with Medicare and outpatient physiotherapy services. These are; 1) Each person is only entitled to have 5 allied health services per calender year. This is for ALL allied health, so physio, OT, speech and language therapy, dietician, chiro, osteopath, exercise physiology etc. After this they have no Medicare entitlement and will need to fund their physio/allied health services privately. 2) You can only be referred and access your 5 sessions if you have a chronic disease eg. diabetes, osteoarthritis, Parkinson’s etc. You cannot use these sessions if it is an acute problem and/or you do not have a long term condition.
The Hospital System in Australia
Medicare covers the hospital system in Australia too and they have an excellent free health service with regards to hospitals and emergency medical treatment. One thing that isn’t actually covered is the ambulance service (more on this later – for those of you moving over here you need to make sure you get ambulance cover otherwise you could find yourself with a large bill if you ever need an ambulance!)
So Australian residents and citizens are fully covered for free emergency healthcare within the public hospitals. Anyone from overseas who isn’t a resident or citizen will have to pay to use these services. There are also a lot of private hospitals (as so many people have private healthcare there is a lot of choices). Private hospitals will often have their own A+E departments (known as Emergency Departments/ E.D) and will cover everything from oncology to maternity services. And this is all big business over here. I have worked in a few private hospitals in the UK, and they are usually tiny in comparison to our NHS hospitals. In Australia this is not the case, they are huge private hospitals with their own intensive care units.
Working in the hospital setting in Australia as a Physiotherapist
Hospital jobs for physiotherapists in Australia in the public sector are not quite as abundant as they are in the UK. This is for a couple of reasons. Firstly, the population of Australia is about a quarter of the size of the UK, so they don’t have as many public hospitals as we do in the UK. Also, because we have this ‘half and half’ system (of public and private healthcare) they, therefore, have more private hospitals which are also an option for physio’s to work at.
The work within the hospital system is essentially the same as the UK from a clinical perspective, however, you will find lots of differences with regard to discharge into the community and what community services they have to offer (if any in some regional and remote areas). In the UK our healthcare system allows us to discharge people back home with whatever equipment they may need in order to get them home. I have found, since working here (in a private setting) I have come across people who have been discharged to Aged Care facilities/Nursing homes despite wanting to be discharged to their homes as they have had a lack of discharge planning and support n order to make this happen. I have also noticed a big difference in provision of equipment (e.g. wheelchairs, hoists etc) in the UK we have access to these for patients without having to worry about the cost, whereas in Australia, a lot of people will have to self fund these important and essential pieces of equipment.
Working in Private Practice
There is an abundance of jobs for physio’s working in private practice in Australia. Due to the fact that a lot of people have private health insurance (and possibly a slightly different mindset to the British with regard to healthcare?), the Aussies have a great pool of private practice physio’s waiting to treat them. So there are plenty of jobs out there.
When working in private practice (which is usually MSK) you may also get a bit of a mixed caseload as some private practices also dip their toe in the water and provide some Aged Care physio too. ‘Aged care’ physio here in Australia is basically attending an Aged care facility/Nursing home and providing (government funded) physio. However….. it isn’t your regular physio. The government funds certain residents of Aged Care Facilities for “physiotherapy”, BUT, they (the government) are very specific about what this physio treatment must consist of. And to be specific, basically, you have to give the resident a 20-minute massage, 4 times a week in order for the Aged Care facility to access the funding for physio. Not quite what we would call “physiotherapy” but unfortunately the system in place at the moment only allows the care homes to access this funding if the physio’s do as they are supposed to (20min massage 4x week). However, a lot of care homes will pay for a bit extra physio and you find you get a few hours a week doing your proper physio management things (falls assessments, balance classes, mobility etc).
Where to find jobs as a physio in Australia?
For physio’s wanting to work in the public hospital setting here in Australia the first place to look for jobs is on the local State’s government website. So there will be one for each State (NSW, QLD, ACT, VIC, WA, NT, SA and TAS). For example, the government website for Queensland (QLD) can be found here and you can search for physio jobs throughout Queensland.
For other physio jobs (both in private hospitals and in private outpatient clinics) there are a few websites to try (they all tend to have the same jobs on though:
Last but not least….. Ambulance Cover
In Australia, depending on which State you live in, you may have to pay if you ever need to use an ambulance. So on a personal note, when you move here make sure you get your ambulance cover sorted!
If you live in Queensland or Tasmania you are covered for the use of ambulance services (you are covered throughout Australia if you reside in either of these 2 states). However, if you live in NSW, VIC, SA, WA, NT or ACT you need to have private insurance to cover this (otherwise you will receive a bill ranging from 400 (NSW) up to $900 (WA) for any ambulance trip you might have to take!) So it’s definitely worth getting your ambulance cover sorted when you arrive so you aren’t caught out with a hefty bill in the event of an accident!