World-wide, inequitable access to safe and effective surgical care is estimated to account for 11 per cent of the global burden of disease. The poorest third of the world’s population suffer from a disproportionate burden of disability-adjusted life-years resulting from surgical conditions, yet are estimated to undergo only 3.5 per cent of the world’s surgical procedures; conversely, the wealthiest third of the global population receives up to 75 per cent of all surgical procedures. This imbalance is a direct result of differential access to surgical services, with high-income countries having up to ten-times as many operating theatres and 100 times as many surgeons per capita as low-income countries.

Despite possessing much more robust health systems, inequitable access to surgery is still a considerable issue within advanced economies. It is estimated that across Australia and New Zealand up to one million people still do not have access to adequate and timely surgical care. Aboriginal, Torres Strait Islander and Māori populations, ethnic minorities, individuals in low socio-economic situations, and those living in remote areas are over-represented in this group.

As part of its commitment to standards and professionalism, the Royal Australasian College of Surgeons (RACS) strives to take informed and principled positions on the provision of quality healthcare services for the people of Australia and New Zealand. A Fellowship of RACS stands for quality in surgical care; but quality cannot be truly present unless equity is accepted as an integral component.

RACS cannot uphold its principles without acknowledging and actively seeking to remedy inequities of access, treatment and health outcomes suffered by the disadvantaged and disempowered populations of Australia and New Zealand. Failure to do so risks these patients receiving delayed or inferior care, unnecessary suffering and worse outcomes. Consequently, RACS has a responsibility to advocate for the provision of equitable access to surgical services, both for the populations of Australia and New Zealand, and for those people who they are charged to protect including those in involuntary detention.

To this end, RACS has taken the positions relevant to provision of equitable access to surgery in the following areas:

  • Access to elective surgery
  • Aboriginal, Torres Strait Islander and Māori health
  • Rural health
  • Health of people under involuntary detention, and
  • Global health.

Read the complete position paper at the link below.