Healthcare
Australia
The Australian healthcare system
Understand how the Australian healthcare system works for children with IBD, including Medicare, public and private healthcare, GP referrals, paediatric gastroenterologists, hospitals, medications, healthcare costs and finding IBD services across Australia
If your child has Crohn’s disease or ulcerative colitis (IBD), understanding the Australian healthcare system can make appointments, referrals, hospital visits and treatment a little easier to navigate.
Australia has a public healthcare system through Medicare, as well as private healthcare. Many children and families with IBD use a combination of both.
Here’s how it works. 👇
🩺 Where do you start?
For many families, the GP (general practitioner) is the first step when a child develops symptoms that could be IBD.
A GP can:
Talk through symptoms and medical history
Arrange blood tests and stool tests
Request investigations such as faecal calprotectin
Refer your child to a paediatric gastroenterologist
Help manage your child’s health while you are waiting for a specialist appointment
If IBD is suspected, your GP may refer your child to a specialist for further investigation and diagnosis.
👩⚕️ Who looks after a child with IBD?
IBD care can involve a whole team of healthcare professionals.
This may include:
🩺 GP – provides general healthcare and helps coordinate care.
👨⚕️ Paediatric gastroenterologist – specialises in digestive conditions in children and teenagers and manages IBD treatment.
👩⚕️ IBD nurse – may provide education, support and help coordinate care, depending on the service.
🥗 Dietitian – can help with nutrition, growth, deficiencies and food-related concerns.
🧠 Psychologist or mental health professional – can help children manage anxiety, stress, body image and the emotional impact of living with IBD.
🩸 Other specialists – your child may also see other healthcare professionals depending on their symptoms, treatment and individual needs.
Not every hospital or IBD service has access to the same team. Access to multidisciplinary IBD care can vary across Australia, particularly between metropolitan, regional and private services.
🏥 Public healthcare and Medicare
Medicare is Australia's public healthcare system.
If your child is eligible for Medicare, they can receive treatment as a public patient in a public hospital without being charged for hospital treatment.
For children with IBD, this can include things such as:
Blood tests and investigations
Hospital treatment
Specialist hospital clinics
Some prescription medications through the PBS
Investigations and procedures, depending on where they are performed
However, not every healthcare service is completely free, and some appointments, tests and specialists may involve an out-of-pocket cost.
🏥 What is the difference between public and private care?
💙 Public healthcare
If your child is treated as a public patient, Medicare covers eligible hospital treatment.
Public hospitals can provide access to specialist teams and are often equipped to manage complex or emergency medical conditions.
However, waiting times can vary, particularly for non-urgent appointments and procedures.
💜 Private healthcare
Private healthcare may allow you to:
Choose your specialist
Access private gastroenterology clinics
Potentially have shorter waiting times for some planned care
Choose a private hospital if required
Private care can also involve specialist fees, hospital fees, anaesthetic fees and other out-of-pocket costs, depending on your insurance and the service.
Having private health insurance does not mean you have to use the private system. You can still access public healthcare as a public patient.
📋 Do you need a referral?
If you want to see a specialist gastroenterologist, you will usually need a referral from a GP or another doctor.
For specialist IBD services, a GP referral is commonly required.
💡 Tip: If your child has ongoing symptoms, ask your GP whether a referral to a paediatric gastroenterologist or IBD service is appropriate.
🔬 What happens when IBD is being investigated?
There isn't one single test that diagnoses IBD.
Your child's healthcare team may use several types of investigations, including:
Blood tests
Stool tests, including faecal calprotectin
Stool tests to check for infection
Colonoscopy and/or gastroscopy
Biopsies
MRI, CT or other imaging when appropriate
These tests help doctors look for inflammation, rule out other causes of symptoms and determine whether IBD may be present.
🚨 What if my child is having a severe flare?
Sometimes IBD symptoms become severe enough that a child needs urgent medical assessment or hospital care.
If your child is seriously unwell or you are concerned about an emergency, seek urgent medical attention.
A public hospital emergency department can provide emergency care, with eligible patients covered by Medicare.
If you aren't sure what to do, you can contact healthdirect on 1800 022 222 for health advice from a registered nurse.
💊 What about IBD medications?
IBD medications can be expensive, particularly when they need to be taken long term.
Some medicines are subsidised through Australia's Pharmaceutical Benefits Scheme (PBS), which can make eligible medicines more affordable.
However, not every medication is covered in the same way, and some medicines may have additional eligibility requirements.
Your child's gastroenterology team or pharmacist can explain how their particular medication is supplied and what it will cost.
💰 What about healthcare costs?
Even with Medicare, families can sometimes have out-of-pocket healthcare costs.
These may include:
GP appointments
Private gastroenterologist appointments
Specialist tests
Private hospital fees
Anaesthetist fees
Some allied health appointments
Medications and pharmacy costs
If your family has significant out-of-pocket medical expenses, the Medicare Safety Net may help increase the Medicare benefit for some eligible out-of-hospital services once the relevant threshold is reached.
🗺️ What if you live outside a major city?
Access to IBD services can be different depending on where you live.
Children living in metropolitan areas may have easier access to large paediatric hospitals and multidisciplinary IBD teams.
Families in regional and rural areas may need to travel to access specialist IBD services.
Some hospitals have developed outreach programs to support regional patients, but access to specialist and multidisciplinary IBD care can vary between locations.
📍 If you're looking for an IBD service near you, Crohn's & Colitis Australia has an IBD Service Locator.
❤️ You don't have to navigate it alone
Having a child diagnosed with Crohn's disease or ulcerative colitis can feel overwhelming.
You may suddenly find yourself dealing with:
🩺 GPs
👩⚕️ Gastroenterologists
🏥 Hospitals
🔬 Tests and procedures
💊 Medications
🥗 Dietitians
🏫 School
💰 Healthcare costs
📅 Regular appointments
It can take time to understand how everything fits together.
The good news is that you don't need to know everything at once.
Your child's IBD team can help you understand their diagnosis, treatment and ongoing care.
Remember: Every child's IBD journey is different. Your child's gastroenterology team is the best source of advice about their individual diagnosis, treatment and healthcare needs.
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