Comparing the systems: working and studying overseas

Traveling for a year between school and starting university or between finishing university and starting work was and is not that unusual nowadays (the gap year). Traveling the world with a backpack or inter railing around Europe staying in hostels is a romantic and exciting idea. I myself spent a long 7 week summer inter railing around Italy with a friend in 2001. Lira was still the local currency and I was a young and carefree student, happy to survive on a diet of cheap bread, with an endless summer holiday that needed filling. Holidaying in a place is, however, a far cry from living it. In 2005 I moved to Melbourne and lived and worked and studied there. I was there for 5 years in total and I worked as a speech and language therapist for almost all of that time. I also did my Masters over there – through Flinders University.

Living and working in Melbourne – which is in the state of Victoria (Australia has six states- New South Wales, Western Australia, South Australia, Queensland, Tasmania and Victoria) was a great experience in all different ways. I worked at two large health networks over that period – Dandenong Hospital, part of Southern Health, and Royal Park Hospital, part of Melbourne Health. I worked across inpatient neuro-rehabilition, outpatients and homebased neuro-rehabilitation. My favourite was working in people homes. I got to meet so many people within the local community. I met Greek, Italian, Croatian, Lebanese, North African, Vietnamese and Chinese migrants. I met one pound poms who had famously traveled here by boat in the 50s, I met Australians who had been there for generations descended from explorers. I met a survivor of the Tiananmen Square Massacre in China and Australian indigenous people who were living in Melbourne. Working in another culture is a great experience. Not least that I got to understand the different social and political systems.

The health service in Victoria works differently to here. It is a public-private partnership. The unions negotiate the terms of employment for the health care professionals within the state. And each state is different. Consequently the networks employ everyone on these same terms- which are renegotiated every four years. Being a union member or representative as an allied health professional is usual in Victoria. In general patients are able to access acute and hospital care with no immediate costs to them. But to see a GP, or to have some non-acute services (e.g. maternity scans) you had to pay and then submit for a rebate through the Medicare system. If you didn’t have the means you could go to certain GP services who bulk billed the Medicare system, but this was not usual. Most of my friends had private healthcare and received tax rebates in compensation for this.

As a therapist working in an inpatient setting I was able to provide services in much the same way as I had done previously. Although in some outpatient and community settings we charged attendees a small nominal fee per week and we “sold” them the thickeners we prescribed. Selling thickener was a little tricky- occasionally I had to ask myself if someone was refusing to buy it because they didn’t have the money, because they didn’t have capacity or because they were making an informed decision not to follow my recommendations. As a therapist I was also happy to provide a much more evidence based and consistent service- I had annual leave cover when I went on leave and I had less constraints on the intensity and length of services I provided. We applied for funding to set up groups and delivered innovative multidisciplinary interventions for people with dementia.

I applied to do a masters in Clinical Rehabilitation at Flinders University and was able to complete the qualification via distance learning- much of the higher education post undergrad is delivered in this way over there. On this course we learnt a bit about delivering all types of services, even about telepractice to rural and remote settings. I found this a useful course to develop my clinical and research skills. I learnt about research methods and statistics. I completed a project supported by a local neurologist who acted as a mentor and celebrated my desire to undertake research.

When I returned to the UK I brought with me knowledge of a different approach to healthcare commissioning and delivering education. There are pros and cons to both the UK and Australian models. Neither are perfect but I certainly feel better off for having experienced both. Working and studying in Australia afforded me experiences that boosted my confidence and expanded my horizons. I wouldn’t hesitate to do it again. But, for now I am happy to be back in the UK, in London, at UCL.

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