Surgeons warn: Private hospital fee hike threatens patient access amid stalled negotiations

The Royal Australasian College of Surgeons (RACS) is urgently calling for renewed negotiations between Australia’s sole national private hospital operator and private health funds to prevent escalating out-of-pocket costs for patients.

From 26 November 2024, Healthscope plans to introduce out-of-pocket fees for Bupa and Australian Health Service Alliance members across its 38 hospitals. The decision comes after failed negotiations with the health funds, sparking concerns over the impact on patients and healthcare providers.

RACS warns that the collapse of these discussions could have severe repercussions nationwide.

“At a time when cost-of-living pressures are hurting Australians, this is a terrible outcome,” said RACS President Associate Professor Kerin Fielding. “This will result in healthcare costs going up and may lead to patients deferring or cancelling their surgeries or opting to undertake them in the public hospital system. This would only create issues downstream, or add significant pressure to an already under pressure public health system.”

Highlighting the importance of affordable, accessible care, Associate Professor Fielding emphasised, “Our primary concern is ensuring patients get the care they need when they need it. We also want to feel confident that surgeons have the necessary resources to provide that care, in an appropriate, high-quality manner. Patients would rightly be confused about why they are being charged an out-of-pocket fee on top of the insurance premiums they are paying, which they were told would cover the cost of these surgeries when they were needed.”

RACS is appealing for an immediate return to the negotiation table. Associate Professor Fielding added, “We ask that they resume negotiations in good faith and find an agreement that balances the needs of patients, surgeons, and healthcare providers, while recognising the increasing costs of delivering quality surgical care.”

In related news, the financial challenges impacting the private health sector have drawn attention from the Council of Presidents of Medical Colleges (CPMC), which represents Australia’s specialist medical colleges. The government’s inaction relating to the Private Hospital Sector Financial Viability Health Check remains a key concern for RACS.

“Private hospitals have long been a critical component of the Australian healthcare system, providing timely access to elective surgeries and reducing the burden on public hospitals,” Associate Professor Fielding stated.

“As these facilities struggle financially, the availability of surgical services is at risk, potentially leading to longer wait times and reduced access to essential procedures for patients. The financial instability of private hospitals may also impact the professional environment for our membership, who rely on these facilities to be able to provide high-quality care.”

To better understand the impact of financial instability on surgeons, RACS has launched a member survey to track any cancellations or reductions in surgical lists.

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