Specialist colleges support Minister Butler tackling extreme fees but call for multi-levered approach to improve access and affordability of care
Australia’s specialist medical colleges are calling for a comprehensive, system-wide approach to improve access to affordable specialist care, warning that focusing on fees alone will not solve growing patient challenges.
“We agree with Health Minister Butler that every Australian should be able to access affordable, high-quality specialist care without risking financial hardship,” said A/Prof Kerin Fielding, Chair of the Council of Presidents of Medical Colleges (CPMC).
“While we strongly oppose extreme fees, and recognise this as a problem, addressing fees alone will not fix our broader access challenges.”
The Grattan Institute’s data shows that fewer than 4 per cent of specialists are responsible for extreme fees – less than 1,500 across 29 specialties. While specialist colleges do not set fees, they play a central role in setting professional expectations to safeguard access to care.
“Our responsibility is to ensure the highest standards of ethical practice,” A/Prof Fielding said.
“The CPMC Professionalism Framework reinforces clear expectations around ethical billing, transparency and informed financial consent.”
“The Framework isn’t just a set of paper promises on our part, they are tangible guardrails that all our 80,000 specialists are expected to adopt – which the vast majority do.”
However, a key affordability challenge is the limited access to public outpatient services and workforce shortages.
“Too many Australians are being pushed into private care because they cannot access timely treatment in the public system,” A/Prof Fielding said.
“In some areas, specialist care has effectively become a postcode lottery.”
Furthermore, CPMC has identified that urgent reform is required to reflect the realities of modern medical practice, where Medicare rebates have not kept pace with the complexity and cost of care, often entailing specialists delivering increasingly complex services in a system designed decades ago.
To this end, the colleges are advocating for a coordinated reform agenda, aligned with findings of the Grattan Institute, including:
- Investment in public outpatient specialist services
- Expansion and modernisation of specialist training
- National workforce planning to address shortages and distribution
- Ensuring Medicare settings reflect contemporary care
- Targeted action on extreme outlier fees
“No single reform will solve this challenge,” she said.
“We need a multi-lever approach to improve access. Accordingly, we are ready to work constructively with the Commonwealth and the states to deliver practical solutions that will ensure every Australian has timely access to affordable, high-quality specialist care,” she said.
