Health Policy and Advocacy update

The Health Policy and Advocacy Committee (HPAC) at RACS has recently been engaged on several fronts. This included seeking feedback from RACS members to inform advocacy by the College and making a number of submissions to the Australian government on various proposed legislative reforms. 

RACS survey on access to surgery, sustainability and patient affordability
RACS recently conducted a survey seeking feedback from RACS Fellows, SIMGs and retired Fellows in Australia on access to surgical care, patient affordability and the sustainability of surgical practice across Australia.

This is because governments, insurers, consumer groups and the media are increasingly focused on specialist fees, patient affordability and access to care. At the same time, surgeons are reporting growing challenges associated with workforce shortages, rising practice costs, hospital capacity constraints, regulatory requirements and limitations in public and private funding models.

RACS sought evidence from surgeons to better understand the factors influencing access to surgical care, patient costs and the sustainability of surgical practice. Key findings from the survey include:

-- public hospital funding system constraints were identified as the greatest barrier to timely surgical care by surgeons
-- affordability of private health insurance and theatre access limitations were also major barriers to accessing surgical care
-- primary cost drivers of a surgeon’s practice were associated with medical indemnity insurance, administrative staffing and practice infrastructure/rooms
-- surgeons reported increasing patient affordability pressure, most notably from poor insurance coverage and more patients choosing to get treated within the public hospital system due to the cost
-- the most supported reform is a review of the Medicare Benefits Schedule fees for specialists in order to more accurately reflect the time, complexity and resources involved in providing patient care. This is followed by increased funding to public hospitals and changes to private health insurance.

Health Legislation Amendment (improving Choice and Transparency for Private Health Consumers) Bill 2026
The Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026 introduces amendments to the Health Insurance Act 1973, the Private Health Insurance Act 2007 and the National Health Act 1953, enabling the publication of practitioner-level billing information via the Medical Costs Finder platform. This represents a significant shift from the current use of aggregated data to the public reporting of individual practitioner billing patterns.

RACS supports the provisions within the Bill aimed at strengthening system integrity—particularly those addressing inappropriate practices within the private health insurance sector, including product ‘phoenixing’. However, while the objective of transparency is supported, RACS has concerns regarding the design and implementation of practitioner-level fee transparency measures. As currently structured, the framework risks presenting complex clinical services in an overly simplified manner, which may mislead patients, misrepresent clinical decision-making, and result in unintended consequences for both affordability and access to care.

Read submission.

2026-2031 National Health Reform Agreement Addendum patient election
The National Health Reform Agreement (NHRA) is a national agreement between the Australian government and all state and territory governments outlining the future directions and funding of Australia’s public hospital and health system. 

The 2026-2031 NHRA Addendum further commits Commonwealth, state and territory governments to reforms that strengthen patient choice and informed financial consent. RACS agrees in principle with the proposed NHRA reforms. These reforms are aimed at improving patient choice, ensuring integrity in funding and providing national consistency for the provision of public and private hospital care to patients. However, RACS believes that surgical care is complex due to the existence of multiple providers, locations and different funding arrangements. Therefore, RACS believes the proposed reforms must be flexible and supported by clinical rationale.

Read submission.

Fee Transparency Out-of-Pocket Costs Transparency forum
The Department of Health, Disability and Ageing (the Department) conducted an Out-of-Pocket Costs Transparency by default consultation forum on 18 May regarding the Medical Costs Finder (MCF). The department shared the progress being made towards publishing specialist individual fee information and geographic fee data along with out-of-pocket costs related to different health insurers. The department is also considering displaying fees as a range rather than as a single figure. In addition, it is developing comprehensive procedural package costs that include all the costs associated with surgery, including surgeon, assistant surgeon and anaesthesia fees. These would be presented on a common or indicative basis and include an indicator of how each specialist fee compares with fees for a particular service. 

RACS encourages greater openness and transparency regarding healthcare costs that patients have to pay. At the same time, it cautions that the proposed changes to the MCF may oversimplify the complex nature of surgical care. 

RACS supports the use of fee ranges, however, remains concerned that ‘tier’ to ‘upper tier’ indicators on the MCF could mislead consumers, create obstacles to surgeons who treat patients with complex needs, and negatively impact upon professional reputation. The College recommends that greater clinical context, robust right of review, appropriate disclaimers, procedural fairness and government accountability accompany the use of fee transparency. This will ultimately enhance consumer understanding of surgical services while at the same time ensuring trust in surgeons isn’t diminished.

Read submission.

Therapeutic Goods Amendment (Medicine Shortages and Other Measures) Bill & Therapeutic Goods (Charges) Amendment Bill 2026
RACS understands that the primary Bill amends the Therapeutic Goods Act 1989 to strengthen medicines shortage reporting, enable common biologicals groups, and give Therapeutic Goods Administration (TGA)-authorised officers enhanced powers over clinical trial sites.

RACS supports the Therapeutic Goods Amendment (Medicine Shortages and Other Measures) Bill 2026 and the Therapeutic Goods (Charges) Amendment Bill 2026, recognising their potential to strengthen medicines shortage management, improve regulatory oversight, and reduce administrative duplication.

RACS emphasises that reliable access to medicines is essential for maintaining surgical services, patient safety, and timely access to care. Shortages or discontinuations of critical medicines, including anaesthetic agents, intravenous fluids, antibiotics, opioids and reversal agents, can delay procedures, reduce elective surgery capacity, and increase waiting times. These impacts are particularly significant in rural, regional and remote communities where surgical workforce shortages already exist.

To strengthen the proposed reforms, RACS recommends:

-- a defined and noticeable notice period for the permanent discontinuation of reportable medicines wherever possible, ensuring health services have sufficient time to implement alternative treatment pathways and maintain continuity of care
-- a formal notification mechanism between medicine sponsors, the TGA, and specialist medical colleges to facilitate timely communication regarding critical medicine shortages and medicines listed on the Medicine Watch List
-- monitoring the impacts of biologicals grouping reforms, ensuring any changes to sponsor charges do not lead to increased costs for surgeons, private hospitals or patients, and do not undermine the viability of private surgical practice.

Read submission