The Grattan Institute has released a new report examining high specialist fees and options to improve affordability and access to specialist care in Australia.
The report, Out of control: How to rein in runaway specialist fees, builds on consistent themes raised in Grattan’s June 2025 report on access to specialist care. Read ANZCA’s summary of the June 2025 report here.
The report identifies five reforms to make specialist care affordable and available (refer page 12):
- Train the specialists Australia needs.
- Expand public clinics in areas with too little care.
- Modernise public clinics.
- Give every GP easy access to specialist advice.
- Rein in extreme fees.
ANZCA supports efforts to improve transparency, affordability and access to specialist care. However, we recognise these challenges are complex and require a broader, multi-lever response, including appropriate Medicare rebates, stronger public specialist services, workforce planning and distribution, training capacity, and better information for consumers. For pain medicine, improving access also requires sustainable multidisciplinary pain services, stronger primary care capability, and appropriate specialist capacity across metropolitan, rural and regional settings.
The college has written to the Grattan Institute to raise concerns about the report’s proposal that workforce targets be used to hold specialist medical colleges accountable for expanding training.
The Grattan Institute was reminded that ANZCA does not control the numbers of anaesthesia or pain medicine trainees in Australia. ANZCA has consistently said it will train as many anaesthetists and pain medicine specialists as health departments are willing to fund. This same point was raised with the Grattan Institute in July last year.
ANZCA strongly supports evidence-based workforce planning and targets and considers that these should be developed collaboratively by governments, health services and specialist medical colleges, with accountability reflecting the respective roles of each party.
To help support this, ANZCA has already written to all Australian Health Ministers via the Health Ministers’ Meeting, proposing anaesthesia as an early specialty workforce planning pilot under Schedule G of the 2026–31 National Health Reform Agreement. The proposed pilot would bring together government and ANZCA data to better understand current and future anaesthesia workforce needs, identify workforce and training pressures, and support more coordinated planning and distribution, particularly in regional and rural communities. ANZCA has asked Health Ministers to endorse the pilot and work with the college to develop its scope, governance, data requirements and deliverables.
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