One of the most important roles of our College is to advocate for surgeons, the profession, and the patients and communities we serve.

Over recent months, RACS representatives have continued to meet with ministers, health departments, regulators, health services and other stakeholders across Australia and Aotearoa New Zealand. These conversations are an important opportunity not only to raise issues affecting surgery, but to understand the priorities and challenges governments and health systems are navigating and communicate how the College and profession can contribute constructively.

Effective advocacy starts with good evidence and a strong understanding of what is happening on the ground.

While many of the challenges facing our health systems are shared, they are experienced differently across jurisdictions, specialties and communities. Workforce requirements, training capacity, access to theatres and beds, service configuration and the needs of individual communities can all vary considerably.

Our strength as a College is our ability to bring those perspectives together.

Through our Fellows and Trainees, specialty societies and associations, and state, territory and Aotearoa New Zealand committees (STANZ), RACS has access to a considerable depth of professional experience and local insight. Bringing this together with our data, workforce analysis and policy expertise allows us to provide governments and health services with informed, practical perspectives on the issues affecting surgical care.

Advocating for access to surgical care
We are seeing the importance of this approach in our current advocacy on access to specialist care.

RACS recently surveyed more than 700 Fellows across Australia as part of our submission to the House of Representatives Inquiry into Access to and Affordability of Medical Specialists.

The results provide a powerful picture of the pressures facing surgeons and their patients.

The findings highlight the complexity of improving access to surgical care.

Fellows identified public hospital capacity and funding, access to operating lists and theatres, private health insurance settings, hospital bed capacity, and workforce distribution among the factors affecting patient access. 

They also highlighted the growing financial pressures on surgical practice. When asked which reform would most improve access, 67 per cent of Fellows nominated modernisation of Medicare rebates to better reflect the time, complexity, expertise and resources required to provide contemporary surgical care. 

These findings are now informing our advocacy to government.

Importantly, our submission makes clear that workforce cannot be considered in isolation. Having the right number of surgeons is only one part of ensuring patients can access surgery. Sustainable surgical services also require operating theatres, beds, anaesthetic and diagnostic services, multidisciplinary teams, and appropriate referral and support networks.

That is why RACS is advocating for national workforce planning that is also specialty—and region—specific, greater investment in public hospital surgical capacity, improved reporting of waiting times and theatre utilisation, reform of Medicare and private health insurance settings, and better support for rural and regional surgical services.

These are not challenges with simple solutions, nor are they issues that any one part of the health system can resolve alone.

Our submission therefore focuses on practical opportunities for governments, the profession and the broader health sector to work together. These include more sophisticated workforce planning, investment in surgical capacity, better data on access and service utilisation, and consideration of Medicare and private health insurance and funding settings.

Importantly, we have argued that workforce planning needs to look beyond workforce numbers alone.

A sustainable surgical service requires not only surgeons, but appropriate theatre capacity, beds, anaesthetic and diagnostic services, multidisciplinary teams and referral networks. Planning workforce, training and service capability together provides a better basis for ensuring communities have access to the care they need.

Read the RACS submission to the Inquiry into Access to and Affordability of Medical Specialists

Local insight, collective expertise
This is also why our connections across Australia and Aotearoa New Zealand are so important.

Local insight helps us understand where challenges are emerging and how national policy settings are being experienced in different health systems and communities. Specialty expertise helps us understand where the circumstances of one area of surgery may require a different response from another.

The College can then bring these perspectives together, identify common themes and contribute a coordinated, evidence-based surgical perspective to discussions with governments and other stakeholders.

This is not simply about raising problems. RACS has an important role in helping develop solutions.

We have significant expertise across surgical education and training, workforce, standards and professional practice. By combining that expertise with the experience of our members, we can be a valuable partner to governments and health services as they consider some of the difficult questions facing our health systems.

As president, I want us to continue strengthening that contribution—listening closely to our members, understanding the different needs of our communities, working collaboratively with our specialty partners, and bringing the collective expertise of surgery to the table.

That is advocacy at its most effective ...  informed by our members, grounded in evidence and focused on working with others to improve surgical care.

Warm regards
Dr Phil Morreau
President