Australian Health Care Reform Alliance

06/11/2026

Have your say on AI in health care

The Australian Commission on Safety and Quality in Health Care (ACSQHC) has released draft Artificial Intelligence (AI) Guidance for Health Services and is asking for feedback.

The Guidance covers how health services should adopt, use and govern AI. That includes building clinician and consumer trust, transparency and informed consent, and making risk-based decisions informed by evidence. It will also support implementation of the third edition of the NSQHS Standards. https://tinyurl.com/2667b4tm

Why this matters to everyone

AI is already part of everyday care, including booking and triage tools, AI scribes, imaging and pathology reads, risk prediction and decision support. It’s used in hospitals, general practice, allied health, pharmacy, aged care, ambulance and community services. Used well, it can free up time for care. When it gets something wrong, patients bear the harm, sometimes before anyone notices.

Guidance written with one setting in mind won’t automatically fit the others. An AI scribe built for a quiet consulting room may not cope with a busy emergency department, a home visit, a remote clinic, or a consultation with an interpreter or family members in the room.

Questions worth considering:
- When AI shapes a decision, how will patients know, and how will consent be handled?
- Who is accountable for an AI-assisted record or decision, and how will AI use be documented?
- Will AI tools be tested across every care setting, profession and community, and not just in large hospitals?
- Will clinical harms and near misses involving AI be reported to the Commission, the TGA and Ahpra and learned from?
- How will Aboriginal and Torres Strait Islander data sovereignty and cultural safety be protected?
- How will rural and remote communities, older people, people with disability and culturally and linguistically diverse communities be included, rather than left behind by tools trained on other people’s data?

Who should respond?

The Commission wants to hear from health service leaders, from health professionals in acute, primary and aged care, and from consumers. Every profession and every community touched by AI-enabled care has a stake in getting this right. The survey takes only about 15 minutes.

Closes: 11:59pm, Monday 30 November 2026
https://tinyurl.com/mps79apu

02/11/2026

AHCRA Weekly Update — 2 November 2026

A short, once-a-week roundup of what AHCRA is doing and what's moving in Australian health reform.

In the system
**6,000 providers out of the NDIS.** The NDIA told Senate estimates it has removed around 6,000 providers since its fraud crackdown began. Those providers had claimed about $7.5 billion from the scheme. https://www.healthservicesdaily.com.au/ndia-seizes.../55042

**More serious cases reaching tribunals.** Ahpra's 2025-26 annual report shows notifications about registered practitioners fell 4.7% to 12,698, and a record 13,171 were closed. Referrals to tribunals, the most serious outcome, rose 53.6%, their highest level since 2013-14. https://www.medicalrepublic.com.au/?p=130484

**Bulk billing up, but watch the gaps.** The RACGP's Health of the Nation 2026 finds the share of GPs bulk billing every patient rose from 12% to 26% in a year, and nearly two-thirds of patients were fully bulk billed. The college warns some patients face higher out-of-pocket costs, and wants higher rebates for longer consultations and an independent primary care pricing authority. https://newshub.medianet.com.au/.../share-of.../178307/

**Health is now the biggest industry.** Revised ABS national accounts make health care and social assistance Australia's largest industry: $265.2 billion in value added in 2025-26 (9.6% of GDP), and 2.58 million jobs, or 15.8% of the total. https://www.abs.gov.au/articles/improvements-measurement-health-care-and-social-assistance-australian-national-accounts

Worth watching
**Victoria heads to the polls.** Ahead of November's state election, AMA Victoria is asking every party to sign up to 10 health pledges and will run a live scorecard of their responses.
https://www.healthservicesdaily.com.au/put-your.../55023

Read full post as a Flipbook: https://online.fliphtml5.com/eeyoy/rvcd/

That's all for this week. We'll be back soon with next week's update.
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27/10/2026

Who regulates our health practitioners – and for how long?

Health Ministers have announced appointments and reappointments to 7 of the 15 National Boards that regulate Australia’s registered health practitioners (Health Ministers’ Meeting communiqué, 19 October 2026).

National Boards set the registration standards, codes and guidelines that protect the public. Who sits on these Boards, and for how long, matters to every patient and every community.

Some points of public interest from this round:
- Strong community interest. Of 73 applications received, 51 were for community member vacancies and 22 for practitioner vacancies. Community members bring the patient and public perspective to health regulation.
- Limited renewal. 8 of the 11 appointments are reappointments, 2 of them to a third term. Under the National Law each term can last up to three years, with no legislative limit on the number of terms.
- Dual role for Chairs. The law requires each Board Chair to be one of the practitioner members, so the Chair also holds a seat representing a state or territory.
- Shared representation. The ACT, the Northern Territory and Tasmania share a single practitioner seat on each Board.

Ministers thanked members retiring after three consecutive terms. That cap on terms is good practice, and it could be made a clear rule.

As Health Ministers consider the future structure of National Boards, AHCRA believes the public interest is best served by:
- clear limits on total years of service
- fair representation of all states and territories
- an independent Chair
- open, easily found information on Board websites for who sits on each Board and when their terms end.

Congratulations to all new and returning members, and thanks to those retiring for their service.

Communiqué:https://www.health.gov.au/sites/default/files/2026-10/health-ministers-meeting-hmm-communique-19-october-2026.pdf

22/10/2026

PREPARE OR PAY

Bushfires cost Australia $6 billion a year, and health carries the largest share. Emergency Leaders for Climate Action (ELCA) and the Climate Council have released Prepare or Pay: Counting the Cost of Climate-fuelled Bushfires. AHCRA commends it to readers and to everyone with an interest in health policy. https://emergencyleadersforclimateaction.org.au/resources/prepare-or-pay-counting-the-cost-of-climate-fuelled-bushfires/

Modelling by ConnellGriffin puts the average cost of bushfires at $6.04 billion a year over the next 30 years, or $181.7 billion in total. The authors call these figures conservative. They leave out harm to wildlife, ecosystems and cultural heritage, and they assume no growth in the number of people and homes exposed to fire.

What the report establishes:
- Southeast Australia now has 14 more extreme fire weather days a year than before 1998.
- Fire seasons are 21% longer than in 1979.
- Fire-generated storms (pyroCbs) rose from 20 in 1983–2003 to 121 in 2004–2024.
- Australia had 10,336 fewer firefighting volunteers in 2023/24 than four years earlier.
- Cutting bushfire damage by 20% would avoid $39.4 billion in GDP losses over 30 years and protect about 5,600 jobs a year.

Health is the biggest cost
Harm to health and wellbeing is the largest single part of the bill, at 32% or about $1.9 billion a year. That is more than lost homes (17%) and more than damaged business and public buildings (20%). The modelling also lists health care and social assistance among the sectors where better preparedness saves jobs.

That cost lands across the whole health system:
Hospitals and ambulance services absorb surges in smoke-related respiratory and cardiac presentations, burns and heat illness.
General practice, pharmacy and allied health have to keep chronic and routine care going while clinics, supply chains and transport systems are disrupted.

Mental health services carry a burden that lasts for years after the fire front has passed.

Public health has to manage months of smoke exposure, a risk that the National Climate Risk Assessment expects to grow.

Equity matters
The report recommends a household resilience program focused on the people most at risk: older people, people on lower incomes, and people with limited mobility. These are the same groups who carry the heaviest burden of chronic disease and have the least capacity to evacuate or recover.

The report also notes that an estimated 1.6 million households were in insurance affordability stress in 2024. When homes go uninsured, more of the cost of recovery, including health and social costs, falls on households and governments.

Health is still at the edge of disaster planning
The 2020 Royal Commission into National Natural Disaster Arrangements examined health and mental health frameworks, primary care and the health effects of bushfire smoke.

The Senate Select Committee on Australia’s Disaster Resilience reported in Boots on the ground: Raising resilience. It examined workforce models in detail, including the ADF and volunteers, but gave limited attention to the health workforce. Prepare or Pay puts a figure on health harm for the first time at this scale, yet its workforce analysis and recommendations centre on fire agencies.

AHCRA would add one recommendation. The dedicated bushfire sub-plan the report calls for under the National Adaptation Plan should include a health component. It should cover:
- surge capacity in hospitals and ambulance services
- continuity of primary and chronic care, with PHNs playing a coordinating role
- mental health support that continues well into recovery
- public health protections against smoke and heat

The report also asks for at least 48 hours of backup power for mobile towers in high-risk areas. That decides whether people can reach Triple Zero, telehealth and emergency warnings when the power fails.

ELCA’s members include 37 former fire and emergency chiefs. Their message is plain: prepare now, or pay far more later. The El Niño now underway is tracking as the strongest on record. Health system preparedness needs to start before this summer, not after it.

ABC News: https://www.abc.net.au/news/2026-10-22/bushfires-costing-australia-6b-annually/107272000
Senate final report, Boots on the ground: Raising resilience:https://parlinfo.aph.gov.au/parlInfo/download/committees/reportsen/RB000053/toc_pdf/BootsonthegroundRaisingresilience.pdf

The cost of bushfires in Australia averages $6 billion a year. Our report shows how better preparation and cutting climate pollution can save lives and money.

17/10/2026

Rural health spending gap blows out to $9.23 billion

Same taxes. Same Medicare levy. But $9.23 billion less spent each year on the health of rural Australians.

The National Rural Health Alliance’s (NRHA) 2026 edition of The Forgotten Health Spend (produced with Nous Group) shows the gap between rural and city health spending has grown again. It was $6.55 billion in 2023 and $8.35 billion in 2025, and it now sits at $9.23 billion, up $880 million in a single year.

For each of the more than 7.4 million Australians living in rural, regional and remote areas, that works out to an average of $1,218 less in health funding every year than city residents receive. People in small rural towns fare worst, at an average of $6,368 less per person, per year.

The shortfall shows up in real outcomes. Disease burden rises with remoteness. Potentially avoidable deaths in Very Remote Australia are 2.5 times the Major Cities rate for males and 3.7 times for females. Communities are left to fill the gaps themselves, sometimes raising up to $600,000 a year just to keep a local clinic open. City communities are not asked to do that.

As NRHA Chief Executive Susi Tegen puts it: “This is a health equity crisis… Rural people are being let down by a universal health system that should support them when they need it most.”

The report makes the point that matching city spending dollar for dollar still wouldn’t close the gap, because care costs more to deliver in the bush. Bulk billing alone can’t keep services alive where markets are thin.

The NRHA is calling for:
- block and blended funding as part of a holistic change to Medicare
- long-term, place-based solutions designed for rural communities - investment in rural training, clinician support, housing and infrastructure.

Last year we called these figures a wake-up call. The gap has widened since then. Rural Australians aren’t asking for special treatment. They’re asking for access and equity.

Read the report: https://www.ruralhealth.org.au/publication/the-forgotten-health-spend-a-report-on-the-expenditure-deficit-in-rural-australia-2026/

06/10/2026

AMA Aged Care Report Card 2026

The AMA's first Aged Care Report Card puts numbers to what clinicians, families and older Australians have been saying for years: when aged care can't take people in, hospitals become the waiting room. https://www.ama.com.au/resource?resource=327 #:~:text=AMA%20Aged%20Care%20Report%20Card%202026%2Epdf

The key findings

Hospital patient days used by people approved and waiting for residential aged care rose from 286,050 in 2020–21 to 460,122 in 2023–24. That's an increase of more than 60% in three years.

The national median wait for an aged care assessment more than doubled between 2018–19 and 2024–25.

One in 10 people entering residential aged care after approval waited more than three and a half years to get there.

Why this matters for the whole health system

Every day an older person spends in a hospital bed they no longer need is a day that bed is unavailable to someone in the emergency department. It's also a day of reduced mobility, higher infection risk and lost independence for the person waiting.

Access block, ramping and elective surgery delays are often treated as hospital problems. Reports like this show they are system problems. Aged care, primary care, community care and hospitals are funded and governed in separate silos, so the gaps between them become places where patients get stuck.

AHCRA's view is that fixing this needs more than additional beds in one sector. It needs:

- Timely, adequately resourced aged care assessment
- Home care and residential capacity planned against real demand
- Joint Commonwealth–state accountability for patients caught between systems
- Investment in community-based care that helps people avoid hospital admission in the first place

Older Australians should not have to spend months in hospital because the next step in their care doesn't exist yet.

Read the AMA Aged Care Report Card 2026: https://www.ama.com.au/library

15/09/2026

Aged care report card: 4/10 – not good enough

The wicked problem: mandatory staffing requirements have raised the amount of care provided to residents – an important achievement for which the government deserves credit.

But there is a sting in the tail. Providers increasingly report that, when they staff homes to the required standard, funding does not cover their costs. They cannot break even, let alone earn a reasonable return on invested capital, which even non-profits need.

Nearly a year into Australia’s aged care reforms, access remains difficult, waiting lists persist and costs are unaffordable for many, while flawed assessment and funding systems continue to undermine care.

10/09/2026

The value of private health insurance

We're sharing a must-read analysis by John Menadue today. Private health insurance (PHI) is propped up by around $13 billion of taxpayer money annually – but what are we actually getting for it? https://johnmenadue.com/post/2026/09/private-health-insurance-costs-taxpayers-13-billion-a-year-what-for/

The article lays out what many of us at AHCRA have been saying about PHI for years:
- A subsidy for the wealthy – The rebate and Medicare Levy Surcharge exemptions flow disproportionately to higher-income earners. Around 55% of Australians – mostly lower-income people without hospital cover – miss out entirely.
- No real relief for public hospitals – University of Melbourne research found little evidence that subsidising PHI eases pressure on the public system. Both sectors draw from the same clinical workforce, and PHI rarely covers emergency care.
- The US path we don't want to follow – The article warns we're heading down America's disastrous road – a system that delivers high-quality care for a few while ranking dead last among wealthy countries for overall performance. https://tinyurl.com/3t6sb4nv
- Inefficient and top-heavy – PHI management costs run at 11%, compared to just 3–4% for Medicare. That's billions going to marketing, product design, and executive salaries – not patient care.

This article echoes many of the issues that AHCRA has highlighted before: taxpayer money being funnelled into an inequitable, inefficient system that delivers questionable value. Here are three posts:
$25 billion for public hospitals — but patients still pay the price https://www.facebook.com/AusHealthReform/posts/pfbid0mtxzrY9iiHwVkVZJzgrZ3FTuHyCBmwD6FfXTR7pzbbMAbQhSLRbLMGzeys64ZKUsl
Private health insurers are failing both patients and hospitals https://www.facebook.com/AusHealthReform/posts/pfbid02Ed6SPCrmzTzh1YYQgZwdD4feXxyDWwCHNYdXPANts2AYR85ibHiReVcMwDMjt2HQl
Evaluating private health insurance https://www.facebook.com/AusHealthReform/posts/pfbid02REbusSYaH9HtLYiUov5N5HxNFpgPwMhdUgfjnALehxt1vb86xuCyXJBvKLWb3wtGl

Imagine what $13 billion could do if redirected to mental health, public hospital specialist services, or adding dental to Medicare. What do you think? Should Australia phase out the PHI subsidy, or does private insurance deserve this continued level of public support?

04/09/2026

In uncertain times for public health and prevention, what lessons can be drawn from the history of the now-defunct Australian National Preventive Health Agency?

04/09/2026

Victorian promise for free public dental clinics

The urgent need to improve equitable access to oral healthcare across Australia has been highlighted by a Victorian Labor election campaign announcement.