Policy and Advocacy: Making lasting change for surgery and patients across Australia  

Over the past few months, the RACS Health Policy and Advocacy Committee (HPAC) and the Health Policy and Advocacy Team (HPAT) have been engaged in shaping national health policy. - We demonstrated a strong and continuous commitment to our membership by informing the government of legislative changes. We also advocated for the highest standards of surgical practice, focusing on patient safety and maintaining public trust in how surgery is conducted as a profession in Australia.

Regulating the title of ‘Surgeon‘: a decade of Advocacy
One of the major landmarks in RACS' policy journey is the successful protection of the title ’surgeon‘. This has been the culmination of more than 10 years of persistent strategic advocacy. In 2023 unprecedented change occurred in Queensland with the passing of the Health Practitioner Regulation National Law (Surgeons) Amendment Act, making it illegal for anyone to use the title of ‘surgeon’ unless they are registered as a specialist in surgery, obstetrics and gynaecology, ophthalmology, or in accordance with an exemption of a health minister.

This historic change, which has now  been enacted across all Australian jurisdictions, ensures that only practitioners who have undertaken accredited specialist training recognised by the Australian Medical Council can use this title. RACS advocated for improved regulation and public confidence in the surgical profession and the protection of the public from harm from practitioners who do not have the appropriate training to perform invasive procedures.

Encouraged by this success, the Australian Health Practitioner Regulation Agency (Ahpra) recently announced that podiatric surgeons will no longer be able to use the title ’surgeon’. By October 2026, they must rebrand themselves as ‘surgical podiatrists’. In the public interest of safety and transparency, this adjustment will raise public awareness whether or not a practitioner is a FRACS qualified surgeon. While RACS accepts that public confusion will not be entirely eliminated, it is a positive step towards safety and standards, with greater reassurance to patients that practitioners using the title ’surgeon’ are indeed trained surgeons. 

Read more.

Enhancing governance and multidisciplinary care
In addition to legislative change, HPAC and the HPAT have engaged in advocacy on a broad range of regulatory and policy matters. One prominent case is their support of the Australian and New Zealand Society for Vascular Surgery (ANZSVS) in its response to the Vascular Interventional Radiology Working Group (VIRWG) and the draft report by the Medicare Benefits Schedule Review Advisory Committee (MRAC).

In our submission, the College raised strong criticisms toward recommendations that threaten to astutely undermine multidisciplinary care, create conflicts of interest, and diminish governance. RACS critiqued various VIRWG recommendations (15, 17, 18 and 19), which allow GPs to refer their patients directly, accessing specialised services implemented through the self-referral of a diagnostic service without a surgeon’s involvement. RACS also critiqued recommendations to modify theatre banding for unprecedented services based on the specialty offering the service, and not complexity.

RACS and ANZSVS argued that these strategies will additionally fragment patients and put them at risk of compromised care coordination. The College instead advocated for transparent alliance decision-making processes that collectively and collaboratively uphold the standards of clinical practice. 
    
Promoting standards in cosmetic surgery
RACS also supported the Australian Society of Plastic Surgeons (ASPS) in response to the proposed introduction of Cosmetic Surgery Standards by the Australian Commission on Safety and Quality in Health Care. RACS strongly condemned the idea of creating new separate standards dedicated to cosmetic surgery that would sit outside the existing National Safety and Quality Health Service (NSQHS) Standards. We highlighted this would cause unnecessary confusion, increase costs, and inconsistent unregulated or offshore cosmetic surgical practice. The position statement was unequivocal: surgery is surgery and all operations—whatever they are, should be performed under the same standards and scrutiny, as any other surgery.

Enhancing Accessibility and Modernising Practice
In another advocacy pursuit, RACS endorsed a joint submission from the Australian and New Zealand Association of Urological Surgeons (ANZAUS) and the Urological Society of Australia and New Zealand (USANZ) for new MBS items for bladder ultrasound scans. These cost-neutral items recognise the procedure as a safe, non-invasive diagnostic tool and provide improved regulatory clarity by moving it from the Diagnostic Imaging Services Table to the General Medical Services Table. This change aligns funding with modern urological practice and improves patient access to necessary diagnostic care. See attachment .

Australian Centre for Disease Control Bill 2025 and the Australian Centre for Disease Control (Consequential Amendments and Transitional Provisions) Bill 2025, and their impact on surgery in Australia
RACS supports the establishment of a national Australian Centre for Disease Control (CDC) while Parliament enacts legislation to support and facilitate surgical care and transparency. However, RACS provided constructive critique as it relates to the collection of peri-operative data in real time, to ensure the continuity of time-critical surgery. Allowing access to the modelling underpinning such public-health decisions and lend voice to the surgical community will assist with the many improvements needed in this space. 

The COVID-19 pandemic saw opaque restrictions leading to cancelled surgery, workforce attrition, and greater mortality due to delay of treatments. To prevent the reoccurrence, RACS advises: 
•    a legally mandated Surgical Continuity Dashboard to delineate theatre activity, ICU capacity, and workforce signals 
•    a narrow definition of ‘protected information’ to avoid misinterpretation of confidentiality clauses 
•    a Surgery Annex to the CDC's protocols to ensure procurement of PPE, oxygen, and ICU surge capacity plan for surgical services and needs. 

RACS also advocates for the safe de-identified reporting of risks on the front line. Together these reforms would ensure that future public-health measures will support, not impede, access to critical surgical services, and demonstrate RACS' steadfast commitment to advocate for the interests of surgeons and patients throughout Australia. See attachment. 

A voice that makes a difference
Through our active advocacy and continual support of our surgical societies, RACS’ HPAC and HPAT illustrate their contributions to the surgical policy paradigm in Australia. From landmark reforms in title protection to submissions that protect standards, improve governance, and improve patient access, they embody the College’s dedication to a position of excellence in surgery.

These accomplishments are proof of the power of ongoing and evidence-informed advocacy. This advocacy serves the profession and supports our Australian patients to receive the safest possible and highest quality surgical care.

For RACS, advocacy goes beyond policy development—it's a commitment to the trust society places in surgeons and to upholding the highest standards of surgical care for all patients