Australian Health Care Reform Alliance

29/05/2026

Are specialist fees hurting everyday Australians?

Dr Tim Woodruff, President of the Doctors Reform Society, has written a thought-provoking piece on why so many Australians are missing out on specialist care — and what we can do about it.

From skyrocketing co-payments to years-long public hospital wait times, the gap between those who can afford care and those who can't is growing. Dr Woodruff argues it comes down to something deeper than policy — a sense of entitlement among some specialists, and a fading commitment to the common good.

His solution? Publicly funded, bulk-billing specialist clinics — similar to the Urgent Care Clinics already rolling out for GPs. Salaried specialists. Accessible care. No financial barrier at the door.

It's a conversation Australia needs to have. Read the full article and share your thoughts. https://www.dropbox.com/scl/fi/e50hd6x7jknvnp6t44735/High-Specialist-Fees-Australian-Doctor.pdf?e=1&fbclid=IwY2xjawSGhghleHRuA2FlbQIxMQBzcnRjBmFwcF9pZBAyMjIwMzkxNzg4MjAwODkyAAEe9Qqjl117k9FMssQW1Zu2nAmc7BkQn3JqO3IMDUR5tQLxKS-EI4c6bNvGHjg_aem_UCxKKnv3g8c9B-6QAxmUsQ&rlkey=oxcf4r5dozxhd55tvlusiei00&dl=0

27/05/2026

Not much 'reform' in the National Health Reform Agreement

professor John Dwyer writes that with or without integration of all health services, efficient and enhanced workforce planning is more important than ever.

Our failure to better use the skills of the workforce we have is lamentable. Nurse practitioners, for example, are trained to provide care that currently requires access to a doctor. Many universities training the next generation of healthcare providers include inter-professional team education so that future graduates will know more about the skills acquired by a range of health providers. Team medicine would make our health system so much more efficient.

While our hospitals and those they serve will undoubtedly benefit from the $25 billion available from the new NHRA, we still urgently need ambitious evidence-based strategies that decrease the incidence of disease and so improve Australians’ quality of life.

Ahcra supports strategies that will enhance preventive and interdisciplinary care that better uses the skills of our available allied health practitioners including paramedics.

Australia needs an integrated health service model that is able to focus on the prevention of illness rather than just more money for hospitals, welcome though this is.

22/05/2026

Why diphtheria, whooping cough and measles have returned in Australia

AHCRA strongly supports vaccination as one of the most effective public health measures ever developed. Disease control is not a one-off achievement. It depends on maintaining the systems that keep transmission low.

Vaccines work best alongside strong surveillance systems, rapid public health responses, accessible to primary care (such as GPs or via Aboriginal-led health clinics), safe housing and sanitation.

Diseases once thought confined to history are making a comeback in Australia. And vaccination is only part of the story.

18/05/2026

The 2026-27 Federal Budget

Health policy analyst Charles Maskell-Knight's forensic analysis of the Budget papers reveals questions about budget savings, a decline in real funding for public dental, no real increase in funding for Aboriginal and Torres Strait Islander health services and little overall growth in health spending given inflationary trends and demographic growth. https://insightplus.mja.com.au/2026/19/budget-2026-27-analysis-urgent-care-public-dental-aboriginal-and-torres-strait-islander-health

Charles Maskell-Knight writes:
The latest Federal Budget provides little overall growth in health spending given inflationary trends and demographic growth.
According to Budget Paper 2, total gross new spending in the Health, Disability and Ageing portfolio resulting in policy decisions since the Mid-Year Economic and Fiscal Outlook amounted to $10.9 billion.

Of this, $5.3 billion over the four years 2026-27 to 2029-30 was due to decisions to list new medicines on the PBS.

As I have written before, if Government policy is to maintain the PBS as an up-to-date formulary of cost-effective medicines, decisions to add new medicines should not be regarded as new policy decisions.

Leaving aside PBS listings, gross additional spending in the portfolio announced in the Budget amounted to $5.5 billion over the four years.

Much of this additional spending related to decisions already announced, such as Urgent Care Clinics.

In relation to Aged Care, Budget Paper 2 stated that “the Government has also provisioned $1.1 billion to be held in the Contingency Reserve for future spending to increase the Accommodation Supplement and introduce an additional payment for high supported resident ratios, subject to finalising implementation details.”

Savings decisions announced in the portfolio in the Budget totalled $41.8 billion, including $36.6 billion from NDIS and $3.0 billion from reduced private health insurance rebates for older Australian, both previously announced.

The balance of $2.2 billion came from the innocuously named “Reinvesting in Health, Disability and Ageing programs.”

Budget Paper 2 described this measure as “the Government has identified a further [$2.2 billion over four years from 2026-27] from health, disability and ageing programs which will be reinvested in new or expanded health, disability and ageing services.”

The Department of Health, Disability and Ageing budget pack doesn’t mention the savings, nor does Minister Butler’s media release.

I foresee some pointed questions on this at Senate estimates.
Aboriginal and Torres Strait Islander Health Services

The 2026 Report on Government Services also showed that Commonwealth spending on Aboriginal and Torres Strait Islander health services in constant 2024 dollars was almost the same in 2024-25 ($981 million) as in 2022-23 ($980.6 million).

While this Budget includes a number of minor new policy announcements, total spending on Indigenous health services is essentially flat into the future.

This is not how to Close the Gap, as Senator Lidia Thorpe has already noted.

She has said while she welcomes “the government finally acting to exempt Stolen Generations redress payments from residential aged care means testing”, she sees the Budget as another missed opportunity to “properly invest in healing and self-determined solutions led by our people, or measures to prevent our people being criminalised and harmed.”
Public dental funding

In past Budget analyses I have written about the ongoing renewal of the agreement under which the Commonwealth contributes to public dental services operated by state and territory governments.

The agreement provides continued funding following the expiry of a three-year agreement in 2014-15, and it has now been extended for one or two years over a half a dozen times.

The amount of funding has been frozen for most of that time, meaning the actual assistance provided to the States and Territories has declined in real terms.

In its response to the Senate inquiry into dental services almost three years ago the Federal Government said that: “Governments are working together to progress dental reform priorities including long-term funding options which would offer funding stability, enhance service accessibility, and assist state and territory governments in achieving oral health outcomes by means of improved service design, implementation, and workforce recruitment and retention”.

People expecting major policy reform will be disappointed: the Budget only included yet another roll-over of the current level of funding, but in perpetuity rather than one year at a time.

The 2026 Productivity Commission Report on Government Services shows median waiting time for a first visit to a public dental service ranging from between six months and seven months in three jurisdictions, through to a year or eighteen months, almost three years, and up to a maximum of three years and seven months in Tasmania.

In every jurisdiction 10 percent of people waited a year or more, up to six years in Tasmania.
Health Budget aggregates

The following table drawn from Budget statement 6 shows aggregate spending on the health function rather than the Health, Disability and Ageing portfolio for the 2026-27 Budget, and how it has changed relative to the 2025-26 Budget.
Screenshot 2026 05 12 at 10 40 45 pm 768x626

Several points are worth noting:

The reduction in Medical services and benefits is due to the private health insurance premium rebates which are classified under this heading.
The growth in Assistance to the states for public hospitals reflects the final National Health Reform Agreement deal reached with the states earlier this year.
The growth in Health services reflects increases in a wide range of areas, including increased spending on medical research, vaccines, and health protection.
Spending on Aboriginal and Torres Strait Islander health has increased by a total of $106 million across four years.

Overall, health expenditure is forecast to grow by an annual average of about four percent over the forward estimates – and this is a conservative estimate as it excludes the cost of inevitable new PBS listings.

However, given current levels of inflation and underlying demographic pressures from ageing, growth at this level is probably not addressing underlying demand.

This article was originally published by Croakey Health Media on May 13, 2026.

The latest Federal Budget provides little overall growth in health spending given inflationary trends and demographic growth.

21/04/2026

What implications for Australia?

New Zealand’s recent rejection of amendments to the WHO’s International Health Regulations (IHR) has raised more questions than answers—not because of the technical content, but due to a lack of clear, unified rationale from government.

Health Minister Simeon Brown cited unfinished domestic processes. Foreign Minister Winston Peters framed it as a sovereign stand against “globalist bureaucrats.” Two reasons. One decision. No Cabinet approval.

But what’s often missing from the commentary is what the amendments actually do:
- Clearer definitions of pandemic emergencies
- Stronger preparedness expectations
- Better coordination on vaccines, tests, and treatments
- More transparent, timely information-sharing.

By opting out, New Zealand avoids new reporting and compliance obligations—but also loses influence over global rules and access to pooled resources. And in the Pacific, where health security depends on cooperation, the NZ decision risks diplomatic and practical fallout.

As Helen Clark noted, the risk is being seen as “irrelevant and quirky.” Collin Tukuitonga put it more bluntly: “worse than burying your head in the sand.”

The rejection is reversible. But before the next health crisis hits, policymakers may want to ask: is this sovereignty win worth the cooperation cost?

Read the analysis by Sharon McLennan here:

World Health Organization regulations are not a threat to national sovereignty, and they apply lessons learned from COVID. So why did NZ opt out?

16/04/2026

The value of private health insurance

Feeling confused or frustrated about whether private health insurance is really worth it—especially when you're on a lower income? You're not alone.

This new article pulls back the curtain on Australia's private health system: heavily subsidised, increasingly unaffordable, and offering poor value for many people - particularly those with modest incomes. https://johnmenadue.com/post/2026/04/health-a-symptom-of-gutful-response/?utm_source=Pearls+%26+Irritations&utm_campaign=a409f4f996-Daily&utm_medium=email&utm_term=0_0c6b037ecb-a409f4f996-583183175

The author asks an important question:
If you can’t afford the specialist fees inside a private hospital, what’s the point of paying for the insurance for a bed in a private hospital? The article doesn't discuss the matter of 'extras' offered by insurers or the added cost of overheads from another layer of administration.

The article also explains how government rebates and surcharges (costing billions) essentially shifts money away from the public system - and why that matters for all of us.

Whether you're hanging onto private cover because you feel you have to, or you've already let it go, this is worth a read. It might just validate what you've been suspecting for a while.

Australia’s private health insurance system is heavily subsidised, increasingly unaffordable and delivers poor value – especially for those on lower incomes.

03/04/2026

Rethinking how Australia classifies remoteness for aged care

Where you live shouldn’t limit the quality of care you receive – but right now, the system for classifying remoteness isn’t keeping up.

A new report has been released on the consultation phase of the review into the Modified Monash Model (MMM) – the tool used to help allocate funding and support for aged care across regional, rural, and remote Australia.

What were the messages?
- The MMM is a useful starting point – it’s simple and nationally recognised.
- On its own, the MMM is too blunt. It doesn’t capture local workforce shortages, housing availability, transport costs, or community disadvantage, all of which have a huge impact on access to safe, quality aged care.

Feedback came from online surveys, site visits to 6 locations, and discussions with peak bodies, NGOs, and government agencies.

Key themes addressed included:
- Workforce recruitment & retention is the #1 issue outside major cities.
- Liveability factors like housing, transport, and local infrastructure are critical.
- We need more than just geography to decide where support goes.

This feedback will now inform further investigations and recommendations. Read the full report here: https://tinyurl.com/5yyvvpy3

Let’s build a remoteness framework that works for every older Australian – no matter what their postcode. For more background go here https://www.health.gov.au/topics/aged-care/aged-care-reforms-and-reviews/review-of-the-remoteness-classification-system-for-aged-care?language=ne

16/03/2026

AMA releases 2024 Public Hospital Report Card

The AMA’s latest report on Australia’s public hospital system is here, and it highlights a system under strain.

The key findings:
The (small) wins: A slight increase in public hospital beds and a marginal reduction in median planned surgery wait times.

The reality: Overall performance is still significantly worse than 10 years ago.

The pressure point: Emergency Departments are seeing record low performance, with just over half of patients treated within the four-hour benchmark.

AMA President Dr. Danielle McMullen expressed deep concern over planned surgery, noting that while wait times have dipped slightly, Australians are waiting far longer than they did a decade ago. "These are medically necessary procedures that prevent deterioration and improve quality of life," she said.

The AMA is also questioning whether the recent $25 billion federal funding boost will be enough, suggesting at least $34 billion is needed to break the cycle of crisis.

Read the full story here:https://www.ama.com.au/sites/default/files/2026-03/AMA_Public_Hospitals_Report_Card_2026.pdf

07/03/2026

Gender Equality Isn't Ideology - It can be a matter of life and death.

This International Women's Day, we need to talk about what’s happening to health rights around the world and the Lancet has an editorial: https://tinyurl.com/5dzszuba

From the Trump administration’s recent cuts to diversity and inclusion programs, to the expansion of the global gag rule, and the growing influence of anti-gender movements - health is on the line.

When we erase the word "gender" from policy or stop funding for equity, we aren't just playing politics. We are ignoring the reality that 608 million women have experienced intimate partner violence, and that maternal health crises are worsening in places like Afghanistan.

The message from The Lancet is clear: You cannot improve health outcomes by pretending disparities don’t exist. Whether it’s cancer research, maternal care, or safety from violence—gender and s*x differences matter. It's something we see every year in the Closing the Gap reports.

The good news? There is a better way.
In places like Rojava, Syria, and in local governments in India, inclusive leadership has led to better healthcare access and stronger protections for women.

We need a gender equity approach - in health, in policy, and in society. Not just for the sake of equality, but for the survival and dignity of all.

05/03/2026

Urgent care clinics in the spotlight

An assessment of effectiveness. https://theconversation.com/australia-now-has-137-urgent-care-clinics-are-they-working-276880

The Second Evaluation Report.https://www.health.gov.au/sites/default/files/2026-02/medicare-urgent-care-clinics-program-evaluation-second-interim-report_0.pdf