The Council of Presidents of Medical Colleges (CPMC), representing Australia’s 16 specialist medical colleges and over 80,000 specialists nationwide, welcomes the opportunity to contribute to the House of Representatives Standing Committee on Health, Aged Care and Disability Inquiry into access and affordability of medical specialists in Australia.
CPMC has consulted with its member colleges to develop a submission focused on a collective objective: ensuring Australians can access timely, affordable and high-quality specialist care, regardless of where they live or their capacity to pay.
Every day, our specialists see the human cost of a system under strain: patients waiting months while their condition deteriorates; patients delaying or skipping appointments because they cannot afford the cost; and patients travelling hundreds of kilometres because the specialist care they need is simply not available closer to home.
Access and affordability cannot be considered separately. Specialist fees are an important part of the affordability discussion, but they are not the whole story. For patients, the real cost of accessing care can also include long waits, travel and accommodation, time away from work and family, and limited choice about where and how they receive care. We strongly believe that where you live should not determine whether you can access care.
For patients who cannot afford private specialist care, access to a timely and effective public specialist service is critical. Equally, Australia needs a sustainable private health system that provides patients with choice and reduces pressure on already stretched public services. Reform must consider the whole patient journey and how these systems work together rather than addressing individual parts of the system in isolation.
There is no single cause of Australia’s specialist access and affordability challenges, and there is no single solution. Australia needs a coordinated reform agenda that strengthens public specialist services, trains and retains specialists where patients need them, improves national workforce planning, ensures workforce reform maintains quality and safety, addresses the affordability of contemporary specialist care, improves fee transparency and informed financial consent, simplifies referral pathways, and supports sustainable public and private specialist services.
Specialist medical colleges are already part of the solution. Through initiatives including the Specialist Training Program (STP) and Flexible Approach to Training in Expanded Settings (FATES), colleges are developing and delivering innovative approaches to training, supervision and workforce distribution in regional, rural and other areas of workforce need. Colleges are also supporting the existing rural specialist workforce and developing practical approaches to improve workforce distribution and access to care. However, colleges do not control many of the critical levers that determine access to specialist care, including the number and location of funded training positions, health service capacity and infrastructure.
The opportunity now is to build on what is working, moving successful models beyond short-term pilots, expanding training where communities need specialists, and better aligning training investment with long-term workforce and health service planning.
CPMC’s recommendations focus on the practical reforms that will make a difference to patients: earlier access to care, more specialist services closer to home, a workforce planned around future community need, affordable care and greater transparency about costs, simpler pathways to specialist care, and a sustainable health system that provides patients with genuine choice. Australia’s specialist medical colleges and CPMC stand ready to work with governments, patients and the broader health sector to deliver these reforms – so that everyone can access the specialist care they need, when they need it, regardless of where they live or their capacity to pay.
