Restoring affordable access to specialist care in Australia
03.02.2026 - 08:26
In this report, Mandala and Private Healthcare Australia (PHA) studied the affordability of specialist care in Australia. We find that specialist fees are rising, exacerbating cost-of-living pressures on consumers and worsening the affordability of healthcare. We propose a targeted package of measures to improve consumers' ability to access high-quality care, of their choosing, at fair and transparent costs.
Many Australians are not receiving the healthcare they need. About 900,000 Australians over the age of 15 delayed or avoided seeing a specialist because of cost in 2024. This trend is worsening and should it continue, over 1.2 million people will delay or avoid seeking specialist care by 2030.
Even though GP visits are up by 4% compared to before the pandemic (FY19), there have been 8% fewer initial specialist consults.
Without change, many consumers will be facing very expensive out-of-pocket costs when they need to see a specialist. At present growth rates, consumers will collectively find themselves paying $1.7 billion in out-of-pocket costs by 2030.
Consumer survey data from RedBridge provides more insight into the difficulties of accessing affordable specialist care. 61% of rural Australians are unable to get timely appointments with specialists. 1 in 2 consumers are stressed about medical costs. Over 1 in 2 consumers visiting specialists receive unexpected bills and 29% are charged fees of ‘booking’ and ‘admin’, which may be illegal.
We propose a targeted package of measures to ease price inflation, improve transparency, and enable choice. They include:
- Upgrading Medical Costs Finder will give consumers much more transparent information to make choices about their care. It would also support their navigation through the referral process from their GP to specialists
- Alleviating specific shortages in regional Australia with overseas-trained doctors in priority specialities would help close the most severe supply gaps
- Enabling medical professionals to work at the top of their scope of practice would improve workforce capacity
- Strengthening consumer protections to stop surprise billing and hidden costs
Read the full report here.
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