The Council of Procedural Specialists (COPS) supports affordable specialist care, clear information about treatment costs and action against exploitative behaviour.
However, in its submission to the consultation on Specialist affordability—options for addressing excessive fee charging, COPS raises concerns about the evidence underpinning the proposed interventions and whether they would improve patient access.
Its submission, dated 19 October 2026, calls for more detailed analysis, a properly structured peer review, and stronger public hospital outpatient services.
Distinguishing high fees from unjustified charging
COPS questions whether the consultation paper’s analysis provides enough information to determine when a fee is unjustified.
The submission identifies several methodological concerns. The data includes some services delivered by practitioners who are not qualified medical specialists. It also measures individual services, which does not show how many specialists routinely charge high fees or whether a small group of providers concentrates those services.
COPS further notes that different benchmarks—such as multiples of the median fee or the Medicare Benefits Schedule (MBS) Schedule Fee—can identify different services as excessive.
Its concern is that a statistical outlier should prompt examination of the circumstances, rather than automatically establish inappropriate charging.
Affordability pressures need a broader explanation
COPS recognises that some Australians delay specialist care because of cost. However, it argues that evidence of financial hardship does not establish that the consultation's targeted high-fee services caused those delays.
The submission maintains that the consultation paper has not demonstrated a causal link between the fees it describes as excessive and the broader affordability difficulties experienced by patients.
COPS also points to longstanding constraints on public outpatient services. It argues that patients unable to afford private care need a properly resourced public alternative, supported by expanded specialist clinics and greater public hospital capacity.
Clinical circumstances matter when assessing fees
Procedural care varies in complexity, duration and the expertise required. COPS warns that services involving significant patient comorbidities or highly specialised treatment may appear as fee outliers without that context being visible in the data.
The submission also questions the use of MBS Schedule Fees as a benchmark for identifying excessive charges. It compares selected AMA fees with MBS Schedule Fees to illustrate how a simple multiple-based threshold could capture fees consistent with established professional fee guidance.
COPS argues that assessing a particular fee requires appropriately qualified peers to examine the individual circumstances.
Peer review needs clear safeguards
COPS supports profession-led, appropriately structured peer review, but asks how any proposed assessment process would operate.
Who would conduct the review? What expertise would assessors need? How would they consider clinical complexity and the patient’s informed agreement to the fee? What safeguards would ensure procedural fairness?
COPS also warns that labelling fees excessive without appropriate review could damage practitioners’ reputations before they have an opportunity to explain their billing.
Protecting access, choice and informed consent
The submission raises concerns that fee caps or approval requirements for higher fees could increase administration, delay treatment or discourage the provision of complex services.
COPS supports patients receiving and consenting to clear information about treatment costs before care begins. It also advocates preserving patient choice and clinical independence.
COPS argues that existing consumer protection legislation should address exploitative conduct, while broader reform should improve patients’ ability to understand costs and access care.
COPS’s recommendations
The submission recommends:
- Conduct further detailed peer reviews of outlier fees to establish the circumstances behind them.
- Removing restrictions on medical associations publishing indicative fee schedules.
- Exempting practitioners from ACCC prosecution for discussing fees at registered medical association meetings.
- Working with medical colleges to standardise informed financial consent within the Council of Presidents of Medical Colleges’ ethical framework.
- Using existing consumer protection legislation to address specific exploitative business practices.
COPS’s central message is that reform must demonstrate how it will improve affordability and access. It supports working with governments on policies that protect patients, expand access to specialist services and preserve the capacity to deliver safe care.
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