By Raising Children Network, with NSW Kids and Families
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Doctor examining teenaged girl's throat
 
As your child gets older, he can begin to use the health care system on his own. When it comes to teenage health care, your child has responsibilities as well as rights.

Health care and your teenager

As your child matures she’ll become more responsible for different parts of her life, including her health care. It might be tricky to find a balance between guiding your child’s health care needs and encouraging her to be independent.

The balance will keep changing too. The health care guidance your child needs at 12-14 years will be different from what he needs when he’s 15-17 years or 18-19 years.

While your child is still in early adolescence, it can be a good idea for her to see the doctor on her own for part of a consultation. When your child should start seeing a health professional alone is something you and your child can work out together.

Teenage health care: your child’s rights

Consent for treatment
As your child matures, health professionals such as GPs, specialists, psychologists, physiotherapists and dentists will start taking into account your child’s opinions and ability to make independent health care decisions. In fact, the law recognises that teenagers become more able to make health care decisions as they move towards adulthood.

In Australia parents and teenagers both have rights to consent to a teenager’s treatment. The age at which a young person can consent to simple health care treatments without involving a parent or guardian is around 14 years. This means your teenage child can make start making decisions by himself and for himself, if health professionals believe he can understand the health problem, consequences of treatment choices and any potential risks from procedures or interventions.

From the age of 16 years, your child can consent to medical and dental treatment with the same authority as an adult. But she doesn’t have an automatic right to refuse medical treatment, particularly life-saving treatment.

As a parent, you have rights in relation to your child’s treatment. Parents or health professionals can mount a legal challenge if a teenager has refused medical treatment in life-threatening circumstances.

Similarly, if the legal position of consent isn’t clear, or if there is a dispute about treatment, the court can make a decision based on the ‘best interests’ of the child.

In general, when your child is 18 years old she’s considered to have full legal capacity to give consent to, and refuse, medical treatment.

Confidentiality and teenagers
Confidentiality means keeping health and personal information private and safe.

In most situations, doctors and other health professionals can’t tell anybody else – including you – what your child tells them during a consultation, unless your child says that it’s OK. Health information includes things that are talked about and written in computer files or on paper, as well as treatment details.

Confidentiality is a legal requirement for doctors and other health professionals.

Health professionals can break your child’s confidentiality if they believe that your child is:

  • at risk of harming or killing himself
  • being harmed, or at risk of being harmed
  • harming someone else or at risk of harming someone else.

Confidentiality might also be broken for legal reasons such as a court subpoena or other statutory requirements like child protection. This would only happen in very serious cases.

Where possible health professionals would talk with your child about breaking confidentiality beforehand, explaining what they will share, who they will tell and why.

Confidentiality is one of the biggest concerns for teenagers. If they feel that confidentiality might be broken, it can stop teenagers from seeking help.

Time alone with health professionals can help teenagers feel confident to talk about personal issues, and build trust that the health professional will keep their health information private.

You can help your child feel comfortable about seeking help by respecting her right to privacy and talking about confidentiality.

Teenage health care: your child’s responsibilities

Your child can take responsibility for his health care by:

  • going to appointments and telling services when he can’t
  • answering questions and giving information about his health in an open and honest way
  • letting health professionals know about changed circumstances that might put his health care at risk
  • letting health professionals know if he decides to change or stop treatment
  • respecting health care staff and other people using services, and thinking about other people’s rights and needs
  • taking an active part in his health care decisions and asking questions if he’s not sure about what’s happening to him
  • speaking up when he’s not happy about the care he’s getting so that issues can be dealt with quickly and fairly.

Health records and sharing information

All health professionals keep records of appointments. These records are kept confidentially, and there are laws and guidelines about how they’re shared.

Your child’s e-Health record
A national electronic health (e-Health) record system is now operating in Australia. Your child can create a secure, personally controlled online summary of her health information.

Your child can control what goes into his record and who has access to it. The e-Health record allows your child and his doctors, hospitals and other health professionals to view and share his health information.

Sharing your child’s health information
So your child can get the best possible health care, health professionals might need to share information with treatment team members.

Health professionals share only information that benefits your child’s treatment and care. On most occasions the professional will ask for your child’s permission to share information. If there are particular things your child doesn’t want to be shared, encourage her to tell the health professional.

In public hospitals relevant health care information can be shared among treating health professionals (without formal consent) when it helps patient care – for example, test results and information about treatments or interventions.

Sharing health information between public and private services or between private health professionals requires your child’s permission.

Raising teenage health care concerns

If your child has any concerns about privacy, confidentiality, type of treatment, length of treatment or the way he’s being treated, it’s best if he raises them with the health professional at the time.

If this doesn’t sort out the concern, your child can lodge a complaint through the Australian Health Practitioner Registry Association (AHPRA). AHPRA manages the governing boards of many health professions.

Your child’s health care entitlements

Medicare card
Your child can get her own Medicare card when she’s 15, or younger if you request it. Your child can also choose to stay on your family Medicare card and have a copy made to keep with her.

The Pharmaceutical Benefits Scheme (PBS)
The PBS helps to cover the cost of prescription medicines. It includes over 4000 brands of prescription medicines.

If the doctor writes a non-PBS or private prescription, you or your child will need to pay the full price for the medicine. Also, if your doctor prescribes a higher-priced brand of medicine, you might need to pay more.

If your child is an Australian resident or visiting from a country that has a Reciprocal Healthcare Agreement with Australia, he can get medicine at a lower cost under the PBS.

If you’re a veteran and your child is dependent on you, she can get PBS medicines and some other medicines at a lower cost under the Repatriation Benefits Scheme (RPBS).

If your child is eligible, or as a family you’re eligible, for an Australian Government concession card, your child will also pay less for PBS medicines.

Bulk billing
This is when Medicare pays the whole cost of seeing a health professional.

Medicare covers the cost of all public hospital clinics and treatment as a public (Medicare) patient in a public hospital.

Medicare sometimes covers the whole cost of treatment by health professionals such as doctors, including specialists, participating optometrists and dentists. Not all health services or professionals bulk bill.

If your child is making his own appointment, remind him to ask if the health care service or professional bulk bills. If they don’t, your child can ask about costs and whether he can get some of the fee or the whole fee back from Medicare.

Medicare rebates
This is when Medicare pays part of the cost of seeing some health professionals, as part of the Medicare Benefits Scheme. It’s called getting a Medicare rebate.

Many GPs and specialists can reimburse Medicare rebates at the time of the consultation, providing you’re registered with Medicare. Otherwise your child will have to go to a Medicare office with the receipt for her consultation.

There’s often a gap between what health professionals charge and what Medicare pays. This is called a ‘gap fee’ and varies depending on what the health professional charges.

Private health care

As your child matures and takes on more responsibility for his own health care, you could consider arranging for him to have his own private health fund card (as part of a family policy, if you have private health insurance).

This would send a strong message that you value your child’s right to health care privacy and confidentiality, and that you trust her to make decisions about her own health.

Before taking this step, you might want to think about some of these questions:

  • Is my child ready to have his own private health fund card?
  • What do I need to discuss with my child before starting this arrangement?
  • What support might my child need to navigate and use health care systems?
  • What financial arrangements might I need to put in place to ensure that my child can use the card effectively, such as paying gap fees?
  • Am I ready to let go and encourage my child to access health care on her own?
  • How do I negotiate with my child to tell me about any serious health conditions so that I can support him?
 
 
 
  • Last updated or reviewed 14-01-2014
  • Acknowledgements This article was developed in collaboration with the Youth Health and Wellbeing Team, NSW Kids and Families (formerly Centre for the Advancement of Adolescent Health).