While doctors who obtained their undergraduate and postgraduate training in Australia are likely to have a reasonable understanding of the Australian health-care system, overseas-trained doctors may have more difficulty negotiating the Australian system to adequately meet the needs of their patients and to avoid legal problems for themselves. This chapter outlines the Australian health-care system in simple terms and describes in more detail the two main elements relevant to doctors: Medicare and the Pharmaceutical Benefits Scheme (PBS).

Medicare and the PBS are managed by Medicare Australia, formerly known as the Health Insurance Commission. These two elements are central to the clinical practice of medicine outside the public hospital system, as they provide government payments for medical services and pharmaceuticals and include centralised monitoring, enforcement and disciplinary procedures related to payments to doctors for medical services. Doctors who deliberately or through ignorance breach the regulations of these systems may face heavy fines and/or disqualification from participation. They are also likely to be subject to disciplinary action by medical boards. This chapter focuses on health services provided by doctors and does not canvas regulations relating to dentists, pharmacists or other health-care providers.

AN OVERVIEW OF THE HEALTH-CARE SYSTEM

People seeking medical attention in Australia are free to attend any general practitioner of their choice or to attend a public hospital to see a doctor employed by the hospital. General practitioners are part of what is called the ‘private’ component of the Australian health-care system.