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What is the difference between a public and private hospital?

Reviewed and updated 18 November 2024

Public hospitals

In Australia, public hospitals are funded by the Australian, state and territory governments and services are free for anyone with a Medicare Card.

Public hospitals may be your first choice in an emergency or for an acute health problem. They may have better medical facilities than a private hospital for your condition and are usually equipped to handle more complex cases.

In a public hospital as a public patient, your choices are limited:

  • A doctor and/or specialist is allocated to you.
  • If you need elective surgery, you are placed on a waiting list.
  • You cannot choose when you get treated.
  • You do not have the option of a private room and are more likely to have to share.

Private hospitals

In Australia, private hospitals are privately owned and operated. This means you have to pay to be treated in a private hospital. 

You may want to be treated in a private hospital because you will have more choices about your care:

  • You can choose your own doctor or specialist. 
  • You generally have more choice about the care you receive.
  • Your waiting time for elective surgery (such as a knee reconstruction) is usually shorter.
  • If you have health insurance, you may be able to stay in a private room if one is available.

Many Australians decide to take out Hospital Cover because it helps with the cost of being treated in a private hospital.


Comparing public and private hospitals

Question
Public patient in a public hospitalPrivate patient in a private hospitalPrivate patient in a public hospital
Can I choose my doctor?No. Hospital assigns doctor or specialist.Yes. Unless it is an emergency. Yes. Unless it is an emergency
Can I choose my treatment?Yes.Yes (if a number of options are available).Yes (if a number of options are available).
Can I get a private room?Depends on availability and the nature of your admission.Yes but depends on availability and your level of Hospital Cover.Yes (if available).
How quickly can I be treated?When a time becomes available on the public waiting list.When you and your specialist are ready.When you and your specialist are ready (subject to hospital waiting lists).
What if I need complex care?Most complex care is in public hospitals.May not be available in a private hospital.Most complex care is in public hospitals.
Do I have to pay for my specialist?No. Covered by Medicare.Possibly. Medicare and your private health insurer pay some or all of your specialist’s fees.Possibly. Medicare and your private health insurer pay some or all of your specialist’s fees.
Do I have to pay for my accommodation?No.Possibly. This depends on your level of Hospital Cover. An excess or co-payment may apply. Check with your private health insurer.Possibly. This depends on your level of Hospital Cover. An excess or co-payment may apply. Check with your private health insurer.

Here are some examples of how you might decide whether to go into a public or private hospital for a particular procedure:

Maria and Enzo decide to go to a public hospital

Maria and Enzo have Gold Hospital Cover, which includes Pregnancy and Birth. Maria discovers she is pregnant with twins. Maria and Enzo planned to use their Hospital Cover to select the obstetrician of their choice and have the babies delivered in a private hospital. However, since they are having twins and this is now categorised as a high-risk pregnancy, they decide to go into the public system. They decide to have the pregnancy managed by the Royal Hospital for Women’s Multiple Pregnancy Clinic (MPC).

Max decides to go to a private hospital

Max has just discovered he has cataracts, which his doctor thinks may explain why he has had a number of falls in recent months. He has Gold Hospital Cover, which includes cover for cataracts. If he decides to have this elective surgery performed in a public hospital, he will have to join the waiting list. He is informed that, in the area where he lives, the waiting list for cataract surgery is 2 years. Max decides to use his Gold Hospital Cover and have his surgery performed at a private hospital within weeks by the doctor of his choice. He pays the applicable hospital accommodation excess as well as the Medical Gap amount for specialist fees.

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