Dr Rachel David spoke with 2SM radio in Sydney about why access to specialist doctors in the community is affecting private hospitals

10 Jun 2025Interviews and Transcripts

Transcript

Station: 2SM
Program: Breakfast
Date: 10/6/2025
Time: 7:35 AM
Compere: Ron Wilson

Interviewee: Dr Rachel David, CEO, Private Healthcare Australia

RON WILSON:	Another troubling revelation concerning Medicare. New data revealing that the number of Australians attending initial consultations with medical specialists has dropped by 10 per cent over the past five years, despite the population growing by more than 7 per cent. With some specialists now charging upwards of $900 for a first appointment and Medicare doing very little to scratch the surface of that, many patients are delaying or simply foregoing care entirely. Dr Rachel David is Chief Executive of Private Healthcare Australia on the line with me right now. Rachel, good morning.
RACHEL DAVID:	Morning, Ron.
RON WILSON:	Look, this is very concerning. We’re seeing some specialists charging, is this right, $950 for a first consultation? Medicare, of course, covering only a fraction of that. And that’s just the cost of a consultation before we talk about any kind of intervention such as surgery. Why are these costs blowing out so much?
RACHEL DAVID:	Look, there are a number of reasons, and I want to be very clear. We’re not trying to morally judge doctors who might be charging these fees. There are many factors that are contributing to this. One is inflation in the whole economy. The other one is some workforce shortages that are occurring in some treatment areas like mental health. And then, you’ve got local factors like, well, this is just what the market can bear because household incomes are high. And like I mentioned, the number of doctors in some particular areas is low, so there’s very little competition. But what it does mean, even though I’m not judging these people, it does mean that people who are seeking treatment, who’ve got a referral from their GP, in many ways, they’re thinking twice about going. And we’ve seen data from a couple of the patient organisations and also from the Bureau of Statistics that suggest between 10 per cent and 20 per cent of people referred to a specialist are not attending because they’re worried about the cost.
RON WILSON:	Yeah. Well, that’s a staggering figure, $900, $950. What percentage of that would private health insurance normally pick up?
RACHEL DAVID:	Well, if you see a doctor in their private rooms, it’s not covered by private health insurance. That’s part of the laws around the Medicare system. Private health insurance pays most or all of what you are charged when you go into hospital, but if you see a person in the doctor’s rooms, that’s only Medicare.
RON WILSON:	So you’re literally locked out of seeing a specialist. I mean, $950, that’s not something a lot of families can come up with at all, so they just have to miss these completely. They just miss out on specialists.
RACHEL DAVID:	Yes. Well, data from the Australian Patients Association and La Trobe University suggested that one in five people referred to a private specialist don’t attend because of the cost.
RON WILSON:	Heavens above.
RACHEL DAVID:	Yeah, so we’re pretty concerned about what’s happening to people that are in the community that are in that situation. We’re assuming that if they do get sick, they’re ending up in a public emergency department, which is not great for anyone. We also think that a number of these people that are not attending have not even checked what the price is. They’ve just assumed that it’s going to be too much, which means that the Federal Government just before the election made an announcement about something called the Medical Costs Finder website, which is a government website, and they said they’re going to put up all specialist fees and charges on that site. This is incredibly important because it means that people when they’re at their GP, if they raise the issue that cost is going to be a problem for them, their GP can look at the website and pick a more affordable specialist.
RON WILSON:	Yeah. Well, the private hospital sector itself is actually struggling at the moment, so this turn of events must be impacting private hospital demand and capacity at the same time.
RACHEL DAVID:	Yes, particularly for overnight hospitals. The amount that the overnight hospitals have been paid by health funds to keep going is increasing. So we’re paying an additional 4.2 per cent for every patient that gets admitted. But the number of patients that they’re getting through has only grown very slightly at 1.8 per cent, and we think this is actually a major factor that’s constraining demand for private hospital beds.
RON WILSON:	Just explain the link between community-based specialist access and the viability of the sector, and what it means for Australia’s healthcare system.
RACHEL DAVID:	Well, look, the private hospital sector has been struggling, like every other business, because of inflation and because of the pandemic when there were lockdowns. But what this is doing is it’s actually- the only people that can admit patients to a private hospital in the cities are private medical specialists. So if people can’t afford even to see the specialist for the first time, it’s going to constrain demand for private hospitals. And they are experiencing very flat growth in admissions, and we think the cost of seeing a medical specialist is one of, if not the major factor in causing that problem.
RON WILSON:	Well, apart from just the cost of seeing a specialist, the cost of private health insurance itself is out of reach for many people now. Do you have any figures on the number of people actually leaving the private health insurance field?
RACHEL DAVID:	No, we actually, in net terms, are seeing the number of people that are taking out private health insurance grow. So people are actually choosing it, mainly because of public hospital waiting lists and what they’re seeing in the public system. So the private system, at least it has beds available, and there are people available to see people who might be in pain or living with some kind of injury or mental health condition. But there are still very long wait times in the public sector, so we’re actually seeing growth in private health at the moment.
RON WILSON:	Are there ways for patients to get affordable care without compromising on quality?
RACHEL DAVID:	Look, absolutely. And I think one thing that’s very important to remember here, Ron, is that quality is not determined by how much you pay your medical specialist. Medical specialists in Australia have all had a very high level of training, and the expensive ones aren’t better than the affordable ones. So I think that the most important thing, while the Government is getting their Medical Costs Finder website up and running, is if you see your GP and you’re told that you might need to see a medical specialist, you should raise at that time that cost is an issue for you and discuss your options. It can be awkward, but it’s important to do it at that point because once you’re actually sitting in front of the specialist, it can be very difficult to raise issues about cost.
RON WILSON:	Well, when you’re talking to your GP, why is there like a two-speed system as far as cost is concerned, and how does that work? Why are some so much cheaper than others?
RACHEL DAVID:	Look, it depends on a couple of things. One is in areas where household incomes are generally high, they tend to get charged more. The second thing is, in areas where there are fewer doctors and less competition, people get charged more, and also some specialties charge more than others. So that’s why I think the Medical Costs Finder website is a very important initiative. It will enable people to find specialists that might be maybe a bit further away from where they live but a bit more affordable, and we certainly think it’s a very important first step to addressing this issue.
RON WILSON:	But Rachel, I think the important message we need to get out here, despite the costs and everything else, you can’t compromise on healthcare. There is no way you can compromise on healthcare.
RACHEL DAVID:	Well, look, that’s exactly right, and I think we’re seeing people really make that decision. The number of people in private health insurance is growing, which is why we need to make this system as accessible and affordable as possible. So we’re going to continue to work on that.
RON WILSON:	When would you think that new government website would be up and running?
RACHEL DAVID:	Look, it was announced before the election campaign, so I think it is going to take a few months. It needs legislation to go through to allow that process to take place. So I’m thinking that it’s probably not going to happen this year, but maybe next year.
RON WILSON:	All right. Look, thank you so much for coming on and explaining all of that for us this morning. I appreciate it.
RACHEL DAVID:	No problem. Thanks, Ron.
RON WILSON:	Dr Rachel David there, Chief Executive of Private Healthcare Australia.
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