Health care and teenagers

As children mature, they’ll become more responsible for different parts of their lives, including their health care.

The balance between guiding your child’s health care needs and encouraging your child to be independent will change as your child gets older. For example, the health care guidance your child needs at 12-14 years will be different from what they need when they’re 15-17 years or 18-19 years.

While your child is still in early adolescence, it can be a good idea for them to see the GP alone for part of a consultation. Together you and your child can work out when the time is right for your child to start developing independence in this part of their life.

Consent to health care treatment: rights

As your child matures, health professionals will start taking into account your child’s opinions and ability to make independent health care decisions. When your child is involved in decisions about their health, it helps to prepare them for health independence. The law also 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 teenage child’s treatment.

Your child’s rights around 14-16 years
At around 14 years, young people can consent to simple health care treatments without involving parents or guardians. This means your child can start making decisions by themselves and for themselves if health professionals believe your child can understand:

• the health problem
• the consequences of treatment choices
• any potential risks from procedures or interventions.

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

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

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

Health professionals will encourage your child to talk to you. You’ll always be contacted if a health professional thinks your child isn’t mature enough to consent to their own treatment.

In general, when your child is 18 years old they’re considered to have full legal capacity to give consent to and refuse medical treatment. If your child can’t make health care decisions, they can have a medical treatment decision maker. This might happen if your child has an intellectual or developmental disability.

Confidentiality in health care: rights

Confidentiality means keeping health and personal information private and safe. Health information includes things that people and health professionals talk about, and things that professionals write in computer files or on paper, as well as treatment details.

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. They also can’t tell you the results of any tests your child has. Sometimes health professionals ask patients to sign a consent form before they contact or talk with family or other professionals.

Confidentiality is a legal requirement for doctors and other health professionals, but confidentiality may be broken in some circumstances.

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

• at risk of self-harm or suicide
• being seriously harmed or at risk of being seriously harmed
• seriously harming someone else or at risk of seriously harming someone else.

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

Where possible, health professionals will talk with your child about breaking confidentiality beforehand, to explain what they’ll share, who they’ll tell and why.

Confidentiality is one of the biggest concerns for teenagers. If they feel that confidentiality might be broken, it can stop them from seeking help. Also, private time with health professionals can build trust and help teenagers feel confident to talk about personal issues. You can help your child feel comfortable about seeking support for their health by respecting their right to privacy and talking with them about confidentiality.

Responsibilities in teenage health care

Your child can take responsibility for their own health care by:

• having appointments on their own
• answering questions and giving information about their health in an open and honest way
• letting health professionals know about changes in their health or circumstances that might put their health care at risk
• letting health professionals know if they decide 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 their health care decisions and asking questions if they’re not sure about what’s happening to them
• speaking up when they’re not happy about the care they’re getting so that issues can be dealt with quickly and fairly
• asking for support with any aspect of their health care.

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 My Health Record
Australia has a national electronic My Health Record system. This is a secure, personally controlled online summary of a person’s health information.

From the age of 14 your child can control what goes into this record and who has access to it. This record allows your child and their doctors, hospitals and other health professionals to view and share your child’s 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 information only when it benefits your child’s treatment and care. Professionals will usually ask for your child’s permission to share information. If there are particular things your child doesn’t want shared, encourage your child to tell health professionals.

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 therapies.

Public hospitals also usually pass on relevant information about treatment to the patient’s GP – for example, information about visits to emergency departments or hospital admissions.

Health care providers will share information when your child moves from one provider to another – for example, when your child moves from child to adult health services. This will often be a detailed summary or referral letter with copies of recent and relevant diagnostic tests or results.

Your child needs to give permission for health information to be shared between public and private services or between private health professionals.

How teenagers can raise health care concerns

If your child has any concerns about privacy, confidentiality, type of treatment, length of treatment or the way they’re being treated, it’s best if your child 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 Regulation Agency (AHPRA). AHPRA manages the governing boards of many health professions.

Your child can also contact the Australian Healthcare Complaints Commissioner for your state or territory. This agency can look into complaints about medical and health care.

Teenagers and Medicare

Medicare is Australia’s universal health care scheme, funded by the Australian Government. It gives all Australian citizens access to a wide range of health services at little or no cost.

You need a Medicare card to get Medicare benefits. Your child can get their own Medicare card when they’re 15, or younger if you ask for it. Your child can also choose to stay on your family Medicare card and have a copy made to keep with them.

Bulk billing is when Medicare pays the whole cost of seeing a health professional, but not all health professionals and services use bulk billing. If your child is making their own medical appointments, remind your child to ask whether the service or professional bulk bills. If they don’t, your child can ask whether they can get a Medicare rebate.

A Medicare rebate is when you pay a fee to see a health professional and then get part of the fee or the whole fee back from Medicare. Many GPs and specialists reimburse Medicare rebates when you see them, providing you’re registered with Medicare.

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.