
New tool to improve diagnosis of lifelong condition
New guidelines will help to reduce stigma and improve access to diagnosis and services for a lifelong disability in Australia, researchers say.
Arising from prenatal exposure to alcohol, fetal alcohol spectrum disorder (FASD) can cause difficulties with attention, learning and memory, communication and behavioural and emotional regulation.
The condition was typically diagnosed in specialists clinics, often based in metropolitan areas and families faced long waits for an assessment, University of Queensland Child Health Research Centre senior fellow and clinical psychologist Natasha Reid said.
But after years of work, researchers, led by Dr Reid, have developed the first guidelines in the space to be approved by the National Health and Medical Research Council.
Dr Reid said she hoped the guidelines would mean more practitioners across the country felt comfortable to be involved in assessing the condition.
"These guidelines are of a really high standard," she told AAP.
"We hope what that means is that they're more trustworthy for clinicians and we'll have more clinicians who are wanting to take these guidelines into clinical practice.
"What that means for people with FASD is there's more access to services because that's still a challenge for a lot of people."
Researchers reviewed more than 300 research papers and consulted health professionals, cultural experts, families and carers of people with the disorder over a four-year period.
"The really challenging thing in this space is that internationally there's no agreed set of diagnostic criteria for FASD," Dr Reid said.
"So what we've tried to do here is really have evidence-based diagnostic criteria as part of these guidelines."
Dr Reid said having better access to diagnosis and assessment processes would reduce stigma and improve the lives of people with the condition.
"The primary use of these guidelines are for health professionals but we also hope the guidelines can provide information to people about what is involved in an assessment, and help raise more awareness," she said.
"A big thing we want to do is reduce stigma around FASD, making it so it doesn't matter where you go to access services, it can just be considered a part of routine assessments that are provided in those settings."
More than 40 organisations were involved in the development of guidelines.
New guidelines will help to reduce stigma and improve access to diagnosis and services for a lifelong disability in Australia, researchers say.
Arising from prenatal exposure to alcohol, fetal alcohol spectrum disorder (FASD) can cause difficulties with attention, learning and memory, communication and behavioural and emotional regulation.
The condition was typically diagnosed in specialists clinics, often based in metropolitan areas and families faced long waits for an assessment, University of Queensland Child Health Research Centre senior fellow and clinical psychologist Natasha Reid said.
But after years of work, researchers, led by Dr Reid, have developed the first guidelines in the space to be approved by the National Health and Medical Research Council.
Dr Reid said she hoped the guidelines would mean more practitioners across the country felt comfortable to be involved in assessing the condition.
"These guidelines are of a really high standard," she told AAP.
"We hope what that means is that they're more trustworthy for clinicians and we'll have more clinicians who are wanting to take these guidelines into clinical practice.
"What that means for people with FASD is there's more access to services because that's still a challenge for a lot of people."
Researchers reviewed more than 300 research papers and consulted health professionals, cultural experts, families and carers of people with the disorder over a four-year period.
"The really challenging thing in this space is that internationally there's no agreed set of diagnostic criteria for FASD," Dr Reid said.
"So what we've tried to do here is really have evidence-based diagnostic criteria as part of these guidelines."
Dr Reid said having better access to diagnosis and assessment processes would reduce stigma and improve the lives of people with the condition.
"The primary use of these guidelines are for health professionals but we also hope the guidelines can provide information to people about what is involved in an assessment, and help raise more awareness," she said.
"A big thing we want to do is reduce stigma around FASD, making it so it doesn't matter where you go to access services, it can just be considered a part of routine assessments that are provided in those settings."
More than 40 organisations were involved in the development of guidelines.
New guidelines will help to reduce stigma and improve access to diagnosis and services for a lifelong disability in Australia, researchers say.
Arising from prenatal exposure to alcohol, fetal alcohol spectrum disorder (FASD) can cause difficulties with attention, learning and memory, communication and behavioural and emotional regulation.
The condition was typically diagnosed in specialists clinics, often based in metropolitan areas and families faced long waits for an assessment, University of Queensland Child Health Research Centre senior fellow and clinical psychologist Natasha Reid said.
But after years of work, researchers, led by Dr Reid, have developed the first guidelines in the space to be approved by the National Health and Medical Research Council.
Dr Reid said she hoped the guidelines would mean more practitioners across the country felt comfortable to be involved in assessing the condition.
"These guidelines are of a really high standard," she told AAP.
"We hope what that means is that they're more trustworthy for clinicians and we'll have more clinicians who are wanting to take these guidelines into clinical practice.
"What that means for people with FASD is there's more access to services because that's still a challenge for a lot of people."
Researchers reviewed more than 300 research papers and consulted health professionals, cultural experts, families and carers of people with the disorder over a four-year period.
"The really challenging thing in this space is that internationally there's no agreed set of diagnostic criteria for FASD," Dr Reid said.
"So what we've tried to do here is really have evidence-based diagnostic criteria as part of these guidelines."
Dr Reid said having better access to diagnosis and assessment processes would reduce stigma and improve the lives of people with the condition.
"The primary use of these guidelines are for health professionals but we also hope the guidelines can provide information to people about what is involved in an assessment, and help raise more awareness," she said.
"A big thing we want to do is reduce stigma around FASD, making it so it doesn't matter where you go to access services, it can just be considered a part of routine assessments that are provided in those settings."
More than 40 organisations were involved in the development of guidelines.
New guidelines will help to reduce stigma and improve access to diagnosis and services for a lifelong disability in Australia, researchers say.
Arising from prenatal exposure to alcohol, fetal alcohol spectrum disorder (FASD) can cause difficulties with attention, learning and memory, communication and behavioural and emotional regulation.
The condition was typically diagnosed in specialists clinics, often based in metropolitan areas and families faced long waits for an assessment, University of Queensland Child Health Research Centre senior fellow and clinical psychologist Natasha Reid said.
But after years of work, researchers, led by Dr Reid, have developed the first guidelines in the space to be approved by the National Health and Medical Research Council.
Dr Reid said she hoped the guidelines would mean more practitioners across the country felt comfortable to be involved in assessing the condition.
"These guidelines are of a really high standard," she told AAP.
"We hope what that means is that they're more trustworthy for clinicians and we'll have more clinicians who are wanting to take these guidelines into clinical practice.
"What that means for people with FASD is there's more access to services because that's still a challenge for a lot of people."
Researchers reviewed more than 300 research papers and consulted health professionals, cultural experts, families and carers of people with the disorder over a four-year period.
"The really challenging thing in this space is that internationally there's no agreed set of diagnostic criteria for FASD," Dr Reid said.
"So what we've tried to do here is really have evidence-based diagnostic criteria as part of these guidelines."
Dr Reid said having better access to diagnosis and assessment processes would reduce stigma and improve the lives of people with the condition.
"The primary use of these guidelines are for health professionals but we also hope the guidelines can provide information to people about what is involved in an assessment, and help raise more awareness," she said.
"A big thing we want to do is reduce stigma around FASD, making it so it doesn't matter where you go to access services, it can just be considered a part of routine assessments that are provided in those settings."
More than 40 organisations were involved in the development of guidelines.
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Psychiatry has topped the list of extreme fee-charging medical specialties, with those seeking vital mental health care among the hardest hit. A report from a public policy think tank has found about 1.9 million Australians are delaying or skipping critical medical care due to exorbitant fees for specialist doctors. The Grattan Institute report also highlights access to specialist care in Australia is a "postcode lottery", with people living in well-served areas receiving about a third more services than disadvantaged communities. Average out-of-pocket costs for extreme-fee-charging specialists in 2023 reached $671 for psychiatry services and more than $350 for endocrinology, cardiology, paediatrics, immunology and neurology services. The fees are resulting in "too many people are missing out on specialist mental health care", according to the Royal Australian and New Zealand College of Psychiatrists. "Access to psychiatric care is a major issue ... along with workforce shortages, high out-of-pocket costs and maldistribution of psychiatrists in rural and remote parts of the country," the spokesperson said. About 28.7 per cent of people who needed to see a psychiatrist either delayed or did not see one due to costs in 2023/24, according to the Australian Bureau of Statistics. In March, concerns over access deepened when it was revealed that more than 140 of 433 psychiatrist positions were vacant in NSW, following a stand-off over pay in the public health system. Grattan's Health Program director Peter Breadon told AAP the system was broken from start to end. The report outlines recommendations to address these growing issues, including scrapping Medicare subsidies for specialists who charge excessive fees and publicly naming those practitioners to increase accountability. It also urges governments to fund additional specialist appointments annually in under-serviced areas, and invest $160 million to expand training in undersupplied specialties and rural regions. The RANZCP spokesperson told AAP it supported several of the recommendations, including the need for structural changes to improve the affordability of psychiatric care in private outpatient clinics and consulting rooms. "Medicare is meant to be the backbone of our health system, and yet mental health services are chronically underfunded," they said. Australian Medical Association president Danielle McMullen supports most of Grattan's recommendations, but said removing Medicare funding from specialists who charged excessive fees was not practical. She urged leaders to sort out longer-term funding for public hospitals and develop a health workforce data tracker to show where investment was needed. Federal Health Minister Mark Butler said private health insurers and specialists needed to do more to protect patients from exorbitant bills. Psychiatry has topped the list of extreme fee-charging medical specialties, with those seeking vital mental health care among the hardest hit. A report from a public policy think tank has found about 1.9 million Australians are delaying or skipping critical medical care due to exorbitant fees for specialist doctors. The Grattan Institute report also highlights access to specialist care in Australia is a "postcode lottery", with people living in well-served areas receiving about a third more services than disadvantaged communities. Average out-of-pocket costs for extreme-fee-charging specialists in 2023 reached $671 for psychiatry services and more than $350 for endocrinology, cardiology, paediatrics, immunology and neurology services. The fees are resulting in "too many people are missing out on specialist mental health care", according to the Royal Australian and New Zealand College of Psychiatrists. "Access to psychiatric care is a major issue ... along with workforce shortages, high out-of-pocket costs and maldistribution of psychiatrists in rural and remote parts of the country," the spokesperson said. About 28.7 per cent of people who needed to see a psychiatrist either delayed or did not see one due to costs in 2023/24, according to the Australian Bureau of Statistics. In March, concerns over access deepened when it was revealed that more than 140 of 433 psychiatrist positions were vacant in NSW, following a stand-off over pay in the public health system. Grattan's Health Program director Peter Breadon told AAP the system was broken from start to end. The report outlines recommendations to address these growing issues, including scrapping Medicare subsidies for specialists who charge excessive fees and publicly naming those practitioners to increase accountability. It also urges governments to fund additional specialist appointments annually in under-serviced areas, and invest $160 million to expand training in undersupplied specialties and rural regions. The RANZCP spokesperson told AAP it supported several of the recommendations, including the need for structural changes to improve the affordability of psychiatric care in private outpatient clinics and consulting rooms. "Medicare is meant to be the backbone of our health system, and yet mental health services are chronically underfunded," they said. Australian Medical Association president Danielle McMullen supports most of Grattan's recommendations, but said removing Medicare funding from specialists who charged excessive fees was not practical. She urged leaders to sort out longer-term funding for public hospitals and develop a health workforce data tracker to show where investment was needed. Federal Health Minister Mark Butler said private health insurers and specialists needed to do more to protect patients from exorbitant bills. Psychiatry has topped the list of extreme fee-charging medical specialties, with those seeking vital mental health care among the hardest hit. A report from a public policy think tank has found about 1.9 million Australians are delaying or skipping critical medical care due to exorbitant fees for specialist doctors. The Grattan Institute report also highlights access to specialist care in Australia is a "postcode lottery", with people living in well-served areas receiving about a third more services than disadvantaged communities. Average out-of-pocket costs for extreme-fee-charging specialists in 2023 reached $671 for psychiatry services and more than $350 for endocrinology, cardiology, paediatrics, immunology and neurology services. The fees are resulting in "too many people are missing out on specialist mental health care", according to the Royal Australian and New Zealand College of Psychiatrists. "Access to psychiatric care is a major issue ... along with workforce shortages, high out-of-pocket costs and maldistribution of psychiatrists in rural and remote parts of the country," the spokesperson said. About 28.7 per cent of people who needed to see a psychiatrist either delayed or did not see one due to costs in 2023/24, according to the Australian Bureau of Statistics. In March, concerns over access deepened when it was revealed that more than 140 of 433 psychiatrist positions were vacant in NSW, following a stand-off over pay in the public health system. Grattan's Health Program director Peter Breadon told AAP the system was broken from start to end. The report outlines recommendations to address these growing issues, including scrapping Medicare subsidies for specialists who charge excessive fees and publicly naming those practitioners to increase accountability. It also urges governments to fund additional specialist appointments annually in under-serviced areas, and invest $160 million to expand training in undersupplied specialties and rural regions. The RANZCP spokesperson told AAP it supported several of the recommendations, including the need for structural changes to improve the affordability of psychiatric care in private outpatient clinics and consulting rooms. "Medicare is meant to be the backbone of our health system, and yet mental health services are chronically underfunded," they said. Australian Medical Association president Danielle McMullen supports most of Grattan's recommendations, but said removing Medicare funding from specialists who charged excessive fees was not practical. She urged leaders to sort out longer-term funding for public hospitals and develop a health workforce data tracker to show where investment was needed. Federal Health Minister Mark Butler said private health insurers and specialists needed to do more to protect patients from exorbitant bills. Psychiatry has topped the list of extreme fee-charging medical specialties, with those seeking vital mental health care among the hardest hit. A report from a public policy think tank has found about 1.9 million Australians are delaying or skipping critical medical care due to exorbitant fees for specialist doctors. The Grattan Institute report also highlights access to specialist care in Australia is a "postcode lottery", with people living in well-served areas receiving about a third more services than disadvantaged communities. Average out-of-pocket costs for extreme-fee-charging specialists in 2023 reached $671 for psychiatry services and more than $350 for endocrinology, cardiology, paediatrics, immunology and neurology services. The fees are resulting in "too many people are missing out on specialist mental health care", according to the Royal Australian and New Zealand College of Psychiatrists. "Access to psychiatric care is a major issue ... along with workforce shortages, high out-of-pocket costs and maldistribution of psychiatrists in rural and remote parts of the country," the spokesperson said. About 28.7 per cent of people who needed to see a psychiatrist either delayed or did not see one due to costs in 2023/24, according to the Australian Bureau of Statistics. In March, concerns over access deepened when it was revealed that more than 140 of 433 psychiatrist positions were vacant in NSW, following a stand-off over pay in the public health system. Grattan's Health Program director Peter Breadon told AAP the system was broken from start to end. The report outlines recommendations to address these growing issues, including scrapping Medicare subsidies for specialists who charge excessive fees and publicly naming those practitioners to increase accountability. It also urges governments to fund additional specialist appointments annually in under-serviced areas, and invest $160 million to expand training in undersupplied specialties and rural regions. The RANZCP spokesperson told AAP it supported several of the recommendations, including the need for structural changes to improve the affordability of psychiatric care in private outpatient clinics and consulting rooms. "Medicare is meant to be the backbone of our health system, and yet mental health services are chronically underfunded," they said. Australian Medical Association president Danielle McMullen supports most of Grattan's recommendations, but said removing Medicare funding from specialists who charged excessive fees was not practical. She urged leaders to sort out longer-term funding for public hospitals and develop a health workforce data tracker to show where investment was needed. Federal Health Minister Mark Butler said private health insurers and specialists needed to do more to protect patients from exorbitant bills.


The Advertiser
a day ago
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Special care changes needed as costs push patients away
High specialist medical costs cause almost two million Australians to delay or skip appointments, but a report suggests stripping public funding to doctors charging excessive fees could be part of the remedy. About 1.9 million Australians are delaying or skipping critical medical care due to exorbitant fees for specialist doctors, a report by public policy think tank the Grattan Institute has found. Some private specialist doctors charge patients two to three times more than the rate Medicare sets for those services, the report found. It said patients of one specialist forked out an average of $300 per year in 2023 - up 73 per cent since 2010. Average out-of-pocket costs for extreme-fee-charging specialists in 2023 reached $671 for psychiatry services and more than $350 for endocrinology, cardiology, paediatrics, immunology and neurology services. The high costs leave critical health care out of reach for millions, causing patients in poorer pockets of Australia to wait months or years for urgent appointments, and leading to missed diagnoses, avoidable pain and added pressure on hospitals. About four in 10 Australians visited a specialist in 2023/24. About two-thirds across all specialties are private appointments, with patients receiving a Medicare rebate and paying a gap fee. Grattan's Health Program director Peter Breadon said the system was broken from start to end. "Everywhere, from how the system is planned and how training is funded through to how we target public investment and integrate the system between primary care and specialist care, it all really needs a lot of change," he told AAP. Grattan's recommendations include scrapping Medicare subsidies to specialists who charge excessive fees and publicly naming them. "Hopefully it would discourage those specialists who are charging really unreasonable fees, but this is a problem that needs many solutions," Mr Breadon said. The report also recommends governments provide one million extra specialist appointment services every year in areas that receive the least care, a system in which GPs can get written advice from other specialists, modernise public specialist clinics, and allocate $160 million to expand specialist training for undersupplied specialties and rural training. Australian Medical Association President Danielle McMullen said public hospital underinvestment and lagging Medicare rebates made it harder for patients. "The risks of delaying medical care are that the health problem gets worse," she said, adding it also puts pressure on GPs and hospitals in public and private clinics. The doctors' association supports most of Grattan's recommendations, but said removing Medicare funding from specialists who charged excessive fees was not practical. As governments negotiate the National Health Reform agreement, Dr McMullen urged leaders to sort out longer-term funding for public hospitals and develop a health workforce data tracker to show where investment was needed. Federal Health Minister Mark Butler said private health insurers and specialists needed to do more to protect patients from exorbitant bills. He said the Albanese government would upgrade the Medical Costs Finder, which helps patients find the best value for specialist medical advice, and was committed to working with stakeholders to improve cost transparency. High specialist medical costs cause almost two million Australians to delay or skip appointments, but a report suggests stripping public funding to doctors charging excessive fees could be part of the remedy. About 1.9 million Australians are delaying or skipping critical medical care due to exorbitant fees for specialist doctors, a report by public policy think tank the Grattan Institute has found. Some private specialist doctors charge patients two to three times more than the rate Medicare sets for those services, the report found. It said patients of one specialist forked out an average of $300 per year in 2023 - up 73 per cent since 2010. Average out-of-pocket costs for extreme-fee-charging specialists in 2023 reached $671 for psychiatry services and more than $350 for endocrinology, cardiology, paediatrics, immunology and neurology services. The high costs leave critical health care out of reach for millions, causing patients in poorer pockets of Australia to wait months or years for urgent appointments, and leading to missed diagnoses, avoidable pain and added pressure on hospitals. About four in 10 Australians visited a specialist in 2023/24. About two-thirds across all specialties are private appointments, with patients receiving a Medicare rebate and paying a gap fee. Grattan's Health Program director Peter Breadon said the system was broken from start to end. "Everywhere, from how the system is planned and how training is funded through to how we target public investment and integrate the system between primary care and specialist care, it all really needs a lot of change," he told AAP. Grattan's recommendations include scrapping Medicare subsidies to specialists who charge excessive fees and publicly naming them. "Hopefully it would discourage those specialists who are charging really unreasonable fees, but this is a problem that needs many solutions," Mr Breadon said. The report also recommends governments provide one million extra specialist appointment services every year in areas that receive the least care, a system in which GPs can get written advice from other specialists, modernise public specialist clinics, and allocate $160 million to expand specialist training for undersupplied specialties and rural training. Australian Medical Association President Danielle McMullen said public hospital underinvestment and lagging Medicare rebates made it harder for patients. "The risks of delaying medical care are that the health problem gets worse," she said, adding it also puts pressure on GPs and hospitals in public and private clinics. The doctors' association supports most of Grattan's recommendations, but said removing Medicare funding from specialists who charged excessive fees was not practical. As governments negotiate the National Health Reform agreement, Dr McMullen urged leaders to sort out longer-term funding for public hospitals and develop a health workforce data tracker to show where investment was needed. Federal Health Minister Mark Butler said private health insurers and specialists needed to do more to protect patients from exorbitant bills. He said the Albanese government would upgrade the Medical Costs Finder, which helps patients find the best value for specialist medical advice, and was committed to working with stakeholders to improve cost transparency. High specialist medical costs cause almost two million Australians to delay or skip appointments, but a report suggests stripping public funding to doctors charging excessive fees could be part of the remedy. About 1.9 million Australians are delaying or skipping critical medical care due to exorbitant fees for specialist doctors, a report by public policy think tank the Grattan Institute has found. Some private specialist doctors charge patients two to three times more than the rate Medicare sets for those services, the report found. It said patients of one specialist forked out an average of $300 per year in 2023 - up 73 per cent since 2010. Average out-of-pocket costs for extreme-fee-charging specialists in 2023 reached $671 for psychiatry services and more than $350 for endocrinology, cardiology, paediatrics, immunology and neurology services. The high costs leave critical health care out of reach for millions, causing patients in poorer pockets of Australia to wait months or years for urgent appointments, and leading to missed diagnoses, avoidable pain and added pressure on hospitals. About four in 10 Australians visited a specialist in 2023/24. About two-thirds across all specialties are private appointments, with patients receiving a Medicare rebate and paying a gap fee. Grattan's Health Program director Peter Breadon said the system was broken from start to end. "Everywhere, from how the system is planned and how training is funded through to how we target public investment and integrate the system between primary care and specialist care, it all really needs a lot of change," he told AAP. Grattan's recommendations include scrapping Medicare subsidies to specialists who charge excessive fees and publicly naming them. "Hopefully it would discourage those specialists who are charging really unreasonable fees, but this is a problem that needs many solutions," Mr Breadon said. The report also recommends governments provide one million extra specialist appointment services every year in areas that receive the least care, a system in which GPs can get written advice from other specialists, modernise public specialist clinics, and allocate $160 million to expand specialist training for undersupplied specialties and rural training. Australian Medical Association President Danielle McMullen said public hospital underinvestment and lagging Medicare rebates made it harder for patients. "The risks of delaying medical care are that the health problem gets worse," she said, adding it also puts pressure on GPs and hospitals in public and private clinics. The doctors' association supports most of Grattan's recommendations, but said removing Medicare funding from specialists who charged excessive fees was not practical. As governments negotiate the National Health Reform agreement, Dr McMullen urged leaders to sort out longer-term funding for public hospitals and develop a health workforce data tracker to show where investment was needed. Federal Health Minister Mark Butler said private health insurers and specialists needed to do more to protect patients from exorbitant bills. He said the Albanese government would upgrade the Medical Costs Finder, which helps patients find the best value for specialist medical advice, and was committed to working with stakeholders to improve cost transparency. High specialist medical costs cause almost two million Australians to delay or skip appointments, but a report suggests stripping public funding to doctors charging excessive fees could be part of the remedy. About 1.9 million Australians are delaying or skipping critical medical care due to exorbitant fees for specialist doctors, a report by public policy think tank the Grattan Institute has found. Some private specialist doctors charge patients two to three times more than the rate Medicare sets for those services, the report found. It said patients of one specialist forked out an average of $300 per year in 2023 - up 73 per cent since 2010. Average out-of-pocket costs for extreme-fee-charging specialists in 2023 reached $671 for psychiatry services and more than $350 for endocrinology, cardiology, paediatrics, immunology and neurology services. The high costs leave critical health care out of reach for millions, causing patients in poorer pockets of Australia to wait months or years for urgent appointments, and leading to missed diagnoses, avoidable pain and added pressure on hospitals. About four in 10 Australians visited a specialist in 2023/24. About two-thirds across all specialties are private appointments, with patients receiving a Medicare rebate and paying a gap fee. Grattan's Health Program director Peter Breadon said the system was broken from start to end. "Everywhere, from how the system is planned and how training is funded through to how we target public investment and integrate the system between primary care and specialist care, it all really needs a lot of change," he told AAP. Grattan's recommendations include scrapping Medicare subsidies to specialists who charge excessive fees and publicly naming them. "Hopefully it would discourage those specialists who are charging really unreasonable fees, but this is a problem that needs many solutions," Mr Breadon said. The report also recommends governments provide one million extra specialist appointment services every year in areas that receive the least care, a system in which GPs can get written advice from other specialists, modernise public specialist clinics, and allocate $160 million to expand specialist training for undersupplied specialties and rural training. Australian Medical Association President Danielle McMullen said public hospital underinvestment and lagging Medicare rebates made it harder for patients. "The risks of delaying medical care are that the health problem gets worse," she said, adding it also puts pressure on GPs and hospitals in public and private clinics. The doctors' association supports most of Grattan's recommendations, but said removing Medicare funding from specialists who charged excessive fees was not practical. As governments negotiate the National Health Reform agreement, Dr McMullen urged leaders to sort out longer-term funding for public hospitals and develop a health workforce data tracker to show where investment was needed. Federal Health Minister Mark Butler said private health insurers and specialists needed to do more to protect patients from exorbitant bills. He said the Albanese government would upgrade the Medical Costs Finder, which helps patients find the best value for specialist medical advice, and was committed to working with stakeholders to improve cost transparency.


West Australian
a day ago
- West Australian
Special care changes needed as costs push patients away
High specialist medical costs cause almost two million Australians to delay or skip appointments, but a report suggests stripping public funding to doctors charging excessive fees could be part of the remedy. About 1.9 million Australians are delaying or skipping critical medical care due to exorbitant fees for specialist doctors, a report by public policy think tank the Grattan Institute has found. Some private specialist doctors charge patients two to three times more than the rate Medicare sets for those services, the report found. It said patients of one specialist forked out an average of $300 per year in 2023 - up 73 per cent since 2010. Average out-of-pocket costs for extreme-fee-charging specialists in 2023 reached $671 for psychiatry services and more than $350 for endocrinology, cardiology, paediatrics, immunology and neurology services. The high costs leave critical health care out of reach for millions, causing patients in poorer pockets of Australia to wait months or years for urgent appointments, and leading to missed diagnoses, avoidable pain and added pressure on hospitals. About four in 10 Australians visited a specialist in 2023/24. About two-thirds across all specialties are private appointments, with patients receiving a Medicare rebate and paying a gap fee. Grattan's Health Program director Peter Breadon said the system was broken from start to end. "Everywhere, from how the system is planned and how training is funded through to how we target public investment and integrate the system between primary care and specialist care, it all really needs a lot of change," he told AAP. Grattan's recommendations include scrapping Medicare subsidies to specialists who charge excessive fees and publicly naming them. "Hopefully it would discourage those specialists who are charging really unreasonable fees, but this is a problem that needs many solutions," Mr Breadon said. The report also recommends governments provide one million extra specialist appointment services every year in areas that receive the least care, a system in which GPs can get written advice from other specialists, modernise public specialist clinics, and allocate $160 million to expand specialist training for undersupplied specialties and rural training. Australian Medical Association President Danielle McMullen said public hospital underinvestment and lagging Medicare rebates made it harder for patients. "The risks of delaying medical care are that the health problem gets worse," she said, adding it also puts pressure on GPs and hospitals in public and private clinics. The doctors' association supports most of Grattan's recommendations, but said removing Medicare funding from specialists who charged excessive fees was not practical. As governments negotiate the National Health Reform agreement, Dr McMullen urged leaders to sort out longer-term funding for public hospitals and develop a health workforce data tracker to show where investment was needed. Federal Health Minister Mark Butler said private health insurers and specialists needed to do more to protect patients from exorbitant bills. He said the Albanese government would upgrade the Medical Costs Finder, which helps patients find the best value for specialist medical advice, and was committed to working with stakeholders to improve cost transparency.