Advocacy Update (Australia)

Health Policy and Advocacy Committee sessions at the 2025 RACS Annual Scientific Congress 

The Health Policy and Advocacy Committee (HPAC) sessions at the 2025 RACS Annual Scientific Congress (ASC) covered significant issues including Ahpra reform, the accelerated specialist pathway and Specialist International Medical Graduates’ (SIMGs) registration. Dr Susan O’Dwyer, Chair of the Medical Board of Australia, addressed regulation reforms, while a session on professional behaviour examined bullying and power dynamics in health care. Environmental sustainability was discussed with conversation about replacing single-use surgical gowns to reduce waste. Congress highlighted rising costs and staff shortages putting financial pressure on private healthcare. It called for urgent reforms, including national pricing and more transparency about private equity’s role in hospitals.

RACS advocacy priorities ahead of the federal election: survey

In the lead up to the Australian Federal Election, HPAC conducted a survey of RACS members on their individual priorities and their practice. The survey received 687 responses, with the five most important priorities identified as:

1.    Reserving the title ‘surgeon’ for those medical practitioners holding specialist registration in recognised surgical specialties (16 per cent)
2.    Maintaining surgical standards in light of fast-track registration pathways, like the SIMG Expedited Pathway, which bypass the College and the profession.  (16 per cent)
3.    Ensuring private sector sustainability and the importance of clinically led governance (12 per cent)
4.    Guaranteeing timely access to essential surgery and addressing waitlist concerns (10 per cent)
5.    Expanding surgical training and workforce retention, particularly to address the maldistribution between rural and urban areas (8 per cent).

The survey responses will ensure RACS’ advocacy reflects the needs of our members while strengthening the collective voice of the surgical profession to improve patient care and community outcomes.

Submission to the National Health Practitioner Ombudsman

In June 2024, the National Health Practitioner Ombudsman, Richelle McCausland, launched an investigation into delays faced by health practitioners under immediate action. The inquiry also examines whether proper procedural safeguards are in place by the Aphra and National Boards. 

This follows a rise in complaints, increasing from 24 in 2020-21 to 84 in 2023-24, as practitioners cite delays, lack of feedback, and severe impacts on their careers and wellbeing. Interested parties, including the Australian Medical Association and Australian Medical Professionals’ Society, highlight concerns over vexatious complaints, stress-induced retirements, and suicides linked to protracted investigations. RACS has long advocated for procedural fairness, warning that prolonged suspensions harm surgeons’ reputations, financial stability, and mental health. 

Read submission.

Submission on the proposed Simplified Billing Regulations and System Changes

This submission from RACS responds to proposed changes under the Health Insurance Legislation Amendment (Assignment of Medicare Benefits) Act 2024, due to begin in January 2026.

RACS supports efforts to simplify billing but raises concerns the reforms may increase administrative burdens on surgeons, particularly in small private practices. There is also a risk of shifting towards managed care models that could compromise clinical independence. The submission calls for:
•    improvements to the Online Eligibility Check system 
•    clearer rules for Medicare benefit assignment 
•    stronger safeguards for Informed Financial Consent 
•    faster claims processing to ensure fair, transparent, and practical implementation that supports both surgeons and patients. 

Read submission.  

Submission to the Medical Services Advisory Committee Regarding MSAC Application 1754: Surgical Procedures for Gender Affirmation in Adults with Gender Incongruence

RACS made a submission to the Medical Services Advisory Committee (MSAC) regarding MSAC Application 1754: Surgical Procedures for Gender Affirmation in Adults with Gender Incongruence.

In its submission, RACS supported the creation of new MBS items for surgical procedures applicable to gender affirmation in adults diagnosed with gender incongruence. 

RACS recognised the leadership of the Australian Society of Plastic Surgeons and the Urological Society of Australia and New Zealand in this important area and appreciates their commitment to the ongoing work on improving access to healthcare for transgender and gender-diverse people in Australia. 

Read submission. 

Rostering of theatre nurses within NSW Health

RACS’ immediate past president Associate Professor Kerin Fielding wrote to the Australian College of Perioperative Nurses (ACORN) regarding the rostering of theatre nurses within NSW Health.

RACS voiced its concerns on the common practice in NSW Health of rotating theatre nurses
through specialties like pre-operative and recovery units. While this practice is intended to create a flexible workforce to fill roster gaps whenever required, it also potentially discourages nurses from upskilling in their specialist areas, which can impact team dynamics and the delivery of optimal patient care.

RACS indicated that it was keen to receive ACORN’s feedback on the practice and explore potential mutual strategies to eliminate these issues. 

Read letter.

Consultation on proposed amendments to the Health Insurance Act 1973 to improve Medicare Integrity

RACS provided feedback on the Australian Department of Health and Aged Care’s consultation regarding amendments to the Health Insurance Act 1973.

RACS expressed its appreciation for the Australian government’s amendments to the Health Insurance Act 1973 to enhance Medicare by strengthening their compliance processes. Maintaining public confidence in the system and ensuring Medicare sustainability are the key aims. But while the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2024 is imposing radical changes to deal with non-compliance and fraud, it may also create issues relating to regulatory oversight, fiscal prudence, patient consent and administrative burden on surgeons. 

Read submission.

Australian Medical Association advocacy on the risks of telehealth driven cosmetic prescribing

RACS’ immediate past president Associate Professor Kerin Fielding wrote to the Australian Medical Association (AMA) to express its concerns regarding the misuse of telehealth to prescribe cosmetic injectables. 

Media reports indicated that some providers are providing telehealth consultations in mere seconds and then issuing prescriptions. This approach is falling far short of professional expectations, which may compromise patient safety.

The medical profession holds the view that all medical practitioners, including surgeons, should provide a full examination, address patient questions, apply treatment, and follow up as appropriate, whether the consultation is face-to-face or by telehealth.

RACS conveyed that the AMA should lead advocacy on this matter and is willing to endorse an appropriately drafted response. 

Read letter.

NSW Roundtable on Surgical Planning and Patient Outcomes

An HPAC staff representative was invited to attend the NSW Roundtable on Surgical Planning and Patient Outcomes. The roundtable looked to improve access to surgical care, particularly for rural and disadvantaged groups. Presentations highlighted key problems, including equitable access to surgical care, recovery pathways for elective surgery, and technology to enhance efficiency. Increasing public clinics, lengthening elective surgery lists and enhanced opportunities in surgical training were emphasised. The need for workforce planning, resource management, and planning for future surgical demand was also raised. The roundtable concluded with an appeal for ongoing strategic planning to improve rural surgical services, with the intention of having a follow-up meeting next year. 

Educator Studio Session – May 2025

For the Educator Studio Session on Wednesday 21 May, HPAC chair, Professor Mark Frydenberg, spoke on ‘Artificial Intelligence in Surgery 2025, Where are we now and where 
are we going?’

Professor Frydenberg explored how artificial intelligence is transforming the healthcare market, with the market value of medical AI projected to reach USD188 billion by 2030. He  shared various uses of AI in surgery and practical examples of how surgeons have successfully deployed AI during surgical operations while highlighting its current limitations and how to exercise caution when operationalising AI.

Advocacy update – Aotearoa New Zealand

RACS makes submission regarding speed limit consultation on 16 Urban Connectors

The Minister of Transport and New Zealand Transport Agency (NZTA) are undertaking a program of reversing speed limit reductions put in place by the previous government. 

Near the end of the program, the speed limits on 16 designated Urban Connector sections of state highway were open to consultation. For these, the Setting of Speed Limit 2024 Rule requires, alongside community consultation, consideration of technical and safety data and a Cost Benefit Disclosure Statement. This opened the opportunity for a submission based on significant road trauma data available to RACS.

The AoNZ Trauma Committee made a submission on 13 May 2025, co-signed by the RACS 
president and chair of the Binational Trauma Committee. The Ministers of Health and Transport were also copied in the submission. 

RACS submitted: 
•    the proposed reversal of speed limit reductions on the 16 designated Urban Connectors would be unsafe 
•    NZTA cannot decide to reverse these speed limit reductions until adequate Cost Benefit Disclosure Statements are available 
•    the current speed limits for the 16 designated roads should be in place beyond 1 July 2025. 

Read submission.

RACS provides briefing to newly appointed Director General of Health for Aotearoa New Zealand

Audrey Sonerson was appointed as the new Director General of Health on 7 April 2025, heading Manatū Hauora – Ministry of Health.

Ros Pochin, chair of the Aotearoa New Zealand National Committee, provided a written briefing on the current issues facing surgical services, the role of RACS in the healthcare system, and a request to improve communication and collaboration.

RACS used the leadership change at Manatū Hauora as an opportunity to brief the new leadership on current surgical service challenges and RACS' healthcare system role. They also requested better communication and collaboration going forward.
 
We advised the biggest priorities needing action by the government with support from RACS are:
•    health reforms – stabilisation and funding
•    workforce – supply, training, and retention
•    needs-based equitable healthcare – access, service delivery, and outcomes
•    maintenance of and improvements to existing health infrastructure
•    planned care – meeting targets to reduce waiting lists
•    sustainability – reducing emissions, reusing and recycling surgical waste.

Read briefing.

RACS Aotearoa New Zealand Trauma Committee writes to Ministers about ‘Run It Straight’

RACS Aotearoa New Zealand Trauma Committee Chair, Dr Chris Wakeman, wrote to the Minister of Health and Minister for the Accident Compensation Commission to express profound concern regarding the increasingly prevalent informal activity known as ‘Run It Straight’. This practice, characterised by two players charging directly at each other in a high-speed collision, poses significant risks to participants, leading to severe injuries, and tragically, fatalities.

The letter called on the Ministers to:
•    raise awareness to ensure participants understand the potential for serious injuries and the long-term consequences of high-speed collisions
•    introduce regulatory measures such as medical evaluation, age restrictions, and safety protocols to minimise risks
•    promote safer alternatives for fundraising events that do not involve high-risk physical competition
•    encourage education about the risks, and help young athletes protect their health
•    engage with healthcare professionals to provide valuable insights into injury prevention and help inform public policy decisions.

Read letter.