Leaving Queensland Health for private practice, and going back: what changes for OTs, speech pathologists and physios

Written by Callum Trevorrow. Last checked 28 October 2026 against official sources.

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If you leave Queensland Health for a private practice, you usually lose the public hospital salary packaging cap, if your role has access to it (A$17,000 grossed-up a year, about A$9,010 of benefits, per the ATO for the FBT years ending 31 March 2026 and 2027) and you start long service leave again from zero. In the Queensland public sector, long service leave builds at 1.3 weeks a year (13 weeks at 10 years) and moves with permanent staff between Queensland public sector employers; with a private employer it’s 8.6667 weeks after 10 years with that same employer.

The base salary is only part of the comparison. This page covers the rest: packaging, long service leave, professional development, the award floor, how private caseloads are funded, and what happens if you want to go back.

This is general information, not tax, financial or legal advice. Check your own figures with your HR team, an accountant or the Fair Work Ombudsman. I’ve worked in government roles and rural hospitals, and today I run a multi-site paediatric allied health practice in South East Queensland.

What you give up, and what you gain, at a glance

The rest of this page goes through each row.

Salary packaging: the cap usually stays behind

Queensland Health uses RemServ and SmartSalary for salary packaging. Permanent and temporary staff (full or part time) and long-term casuals can take part. Queensland Health’s examples of what can be packaged include super contributions, rent or mortgage repayments, novated car leases and travel expenses. Queensland Health also says “your actual working arrangements will determine if you can access the Fringe Benefits Tax exemption cap”, so check that you actually have it before you count it as something you’d lose.

The cap you’d be leaving is the ATO’s public hospital cap: A$17,000 grossed-up per employee, about A$9,010 of benefits (FBT years ending 31 March 2026 and 2027). The other employer types with their own caps, and what each is worth, are set out on pay by setting. Whether a particular NGO or NDIS provider is a public benevolent institution is specific to that employer, so ask the employer directly. If you’re moving from a role with packaging to one without it, ask an accountant what the change does to your take-home pay before you compare salaries.

Long service leave: the clock restarts

Two practical points:

• If you’re close to 7 or 10 years in Queensland Health, ask HR what happens to your accrual if you resign, before you resign. Fixed-term temporary staff are generally paid out when they move, unless both entities agree to transfer.
• Don’t assume private or interstate service will count towards Queensland public sector long service leave if you come back. The Queensland Health award lets you “seek to have” previous service recognised for sick leave, long service leave and paid parental leave, but that is a request, not an automatic credit.

Professional development: an agreement term that doesn’t follow you

Under the Queensland Health health practitioners agreement (HPDO4), permanent health practitioners get a professional development allowance paid into their fortnightly salary. From 17 October 2024 it’s A$2,034 a year for most staff, with higher rates for Category A (A$2,714) and Category B (A$3,395) positions. Part-timers working at least 15.2 hours a fortnight get it pro rata; temporary staff qualify after more than 12 months’ continuous service. You also get 3 days’ professional development leave a year, which can accrue for up to two years.

HPDO4 expired on 16 October 2025, but Queensland Health says its terms continue until the Queensland Industrial Relations Commission decides the matters in dispute. Arbitration for HPDO5 began in June 2026, so these figures may change.

In private practice, PD days and any budget are what your contract or the employer’s policy says. Get them in writing, and ask whether PD days count against a client-hours target.

The award floor in private practice

A private employer covered by the Health Professionals and Support Services Award (MA000027) must pay at least the award minimum. From 1 October 2026:

• Level 1 (practising clinicians, by years in the profession): A$1,308.80 a week in year 1, rising to A$1,689.50 a week (about A$87,854 a year) from year 7, on the AQF Level 7 scale.
• Level 2 (Senior Clinician, Specialist, Supervisor or Educator): from A$1,945.40 a week (about A$101,161).
• Level 4 (Manager): A$2,499.10 a week (about A$129,953).

Annual figures are the weekly rate × 52. Compare those with Queensland Health HP3 (A$83,824 to A$120,740) and HP4 (A$132,689–142,315). An employer can pay above the award, but the award is the only figure a private employer must meet. The full tables, with super and leave loading, are on pay by setting.

By profession:

• Occupational therapists and physiotherapists: the award pays on the AQF Level 7 scale only, so a master’s degree doesn’t lift your award minimum. See OT jobs in Australia and physio jobs in Australia.
• Speech pathologists: the award pays by the qualification you hold (AQF 7, 8 or 9), so an honours or master’s degree does raise your minimum. See Certified Practising, not Ahpra.

Where a private caseload’s money comes from

In Queensland Health your caseload is funded from the public health budget. In private practice, each client is funded by someone, and that shapes your day: what you can bill, how long sessions run and what paperwork comes with them. These are prices a practice charges, not your pay.

• Medicare chronic condition items need a GP referral under a GP chronic condition management plan. Each service must be at least 20 minutes, face to face and individual, and a patient gets at most 5 allied health services a calendar year across all professions under these items.
• Private health extras cover pays benefits for ancillary treatment such as physiotherapy, depending on the policy. Policies vary, so the practice will know what its clients’ funds pay.
• Speech pathologists: Certified Practising status with Speech Pathology Australia is what lets you provide Medicare, NDIS and private health funded services, and registered NDIS providers and their staff must hold it. It’s yours, not your employer’s.
• OTs and physios: your Ahpra registration (Occupational Therapy Board or Physiotherapy Board) is in your own name. WorkCover Queensland’s OT table requires an Ahpra-registered OT.

Ask any practice what share of its work is NDIS, Medicare, WorkCover and private, because that tells you more about the job than the job title does. For how to weigh a client-hours target against salary, see comparing two job offers.

Going back to Queensland Health

You come back the same way anyone else applies.

• You apply for an advertised role. Queensland Health says “To progress to a higher HP level, you’ll need to apply for jobs as they are advertised”, and appointments are on merit. Roles are listed on SmartJobs and you apply through the Queensland Health Careers Portal, which needs its own account.
• Your pay point is at the employer’s discretion. Under the Queensland Health award (2020 reprint, cl. 12.2(d)), an appointee “may, at the discretion of the relevant employer, be offered and appointed to any paypoint within a classification level based on recognition of skills, knowledge and abilities”. The award doesn’t say private experience must count. Put your private-practice experience in your application in terms of skills and responsibility, and ask about the pay point before you accept.
• Your HP level comes from the role you apply for, not from your private-practice title. A “senior” or “clinical lead” title in private practice doesn’t map automatically to HP4. See HP3 to HP4 and beyond for what the levels mean.
• Long service leave: ask in writing whether any earlier Queensland public sector service will be recognised, and don’t count on private service.

Your next step

• Occupational therapists: check whether you currently have access to the public hospital FBT cap, and ask any practice what share of its caseload is NDIS, Medicare (10958) and WorkCover.
• Speech pathologists: check your Certified Practising status with Speech Pathology Australia is current, and check your degree’s AQF level, because it sets your award minimum.
• Physiotherapists: ask what share of the work is NDIS (A$183.99 an hour, A$10 below OT and speech), Medicare (10960), WorkCover and private health, because that mix drives what the practice can pay.
• Everyone: write down your years of continuous Queensland public sector service, your PD allowance and days, and whether you package, before you compare an offer.

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