Our Fellows’ focus is on ensuring that their patients have the best possible outcomes, and this is only achievable if patients have access to the medical devices best suited to their particular clinical circumstances.  

RACS is supportive of reforms to the Prosthesis List, which reduce costs to insurers as long as clinicians (in consultation with patients) continue to have access to the most appropriate medical devices in order to deliver the best long-term patient outcomes. 

RACS is concerned that the DRG system proposed would lead to a loss of access to the best medical devices, and as a result potentially lead to reduced patient outcomes. If DRG funding is capped (and the prosthetic cost incorporated within the DRG ) RACS is concerned that there will be an incentive to choose a prosthetic item that is cheaper but may not be appropriate for that particular patient's care. Clinicians therefore may be pressured to use a cheaper prosthetic device when it may not be appropriate clinically. We thus do not support Option 1 in the consultation paper. 

As such, Option 2 is RACS’ preferred model, with the Commonwealth Department of Health reviewing and grouping the items. RACS supports this option as long as certain principles are followed, namely that surgeons maintain independence of choice with regards to prosthetics, and that choice is neither taken from them by Government nor by private health insurers, and that any panel convened by Government to look at the Prosthesis List in the future has appropriate clinical representation so that requirements of clinicians and their patients remain paramount in discussions. 

A number of specialist surgical societies and associations with which RACS works in relation to surgical training and other matters also intend to make submissions to this consultation. RACS refers you to these submissions, and in particular would like to endorse the submissions made by the Urological Society of Australia and New Zealand (USANZ), the Australian Orthopaedic Association (AOA) and the Australian Society of Plastic Surgeons (ASPS); those groups having consulted with us in relation to their submissions.