The fee transparency bill explicitly leaves room for the government to publish a national dataset of quality indicators for medical practitioners.
Planned changes to non-GP specialist doctor fee transparency not only risk introducing “perverse incentives”, but also overlook the expertise of GPs themselves, medical indemnity firm Avant warns.
If passed, the Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026, which is before the House of Representatives, will allow the government to publish information relating to Medicare-eligible professional services rendered by or on behalf of a specific doctor.
While the explanatory notes say that the focus of the legislation is on the charging practices of non-GP specialists, the bill specifically leaves room for GP fees to be published and for the information published to extend beyond fees alone.
“For example, if a national dataset relating to quality indicators of medical practitioners became established later, this could be a valuable complement to the existing information about medical practitioners’ charging practices,” the explanatory memorandum reads.
“There may be also pertinent information about professional services of medical practitioners that has not been included in the proposed provisions but could be specified in a legislative instrument.”
These inclusions sent some alarm bells ringing at Avant.
“Quality improvement projects work because they’re designed to identify where you sit in relation to various benchmarks, and how you might make changes to improve quality,” Avant chief medical officer Professor Steve Robson told The Medical Republic.
“But we were extremely concerned that if the government raided quality improvement databases … it would make some of the best doctors in the country look like the worst … we all know that there are certain people who look after complex, multi-morbid, high-risk patients, and they’re dealing with a really risky cohort.”
Avant commissioned statistician and former senior public servant Trevor Sutton to write a discussion paper examining what adding individual specialist quality measures to the Medical Costs Finder website might look like.
His analysis concluded that it the context in which such measures would be presented mattered just as much as the metrics themselves.
“Metrics such as complication, infection and readmission rates are valuable tools for improving care,” Mr Sutton wrote.
“The problem is publishing them against named individuals rewards favourable-looking numbers, which, in turn, discourages clinicians from taking on complex patients, and would potentially steer GP referrals toward the top of a statistically fragile table.
“What can fairly be shown publicly is not a performance score, but an indicator that a specialist is engaged in the quality-improvement programs through which good practice is sustained.”
These fears are not theoretical either; the infamous NHS “league tables” have been roundly criticised for shifting hospital managers’ attention away from broad quality and for causing overstretched hospitals to be called out as poor performers.
“GPs acting as co-ordinators of care steer their most complex cases to the specialists they judge best able to handle them. The data penalises the clinicians taking the hardest work,” Mr Sutton said.
“Some measures depend on voluntary participation and can carry selection bias, meaning those who do not participate in a registry or dataset may be the very performers of most concern, which could make a low participation-based score self-undermining as a quality signal.”
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What’s more, other research commissioned by Avant found that GPs already act as a quality filter and were overwhelmingly satisfied with and confident in the non-GP specialists they sent referrals to.
“The same research found little appetite for a government-sponsored specialist quality rating website,” the discussion paper read.
“GPs were markedly more negative than positive about the concept, and their intended use of it was low.”
Mr Sutton’s key recommendation was for the Medical Costs Finder website to display a simple indicator of whether a doctor participates in a nationally consistent quality improvement program, rather than having doctors ranked against each other.
This could benefit the medical profession in more ways than one, Professor Robson said.
“Rather than do something that dissuades doctors from participating in quality improvement activities, or publishing data, we should do the opposite,” he told TMR.
“We should put a mark on the cost finder website that says ‘actually this is a doctor who’s actively involved in quality improvement, that’s the kind of doctor you should want to see’, and it would give the government an incentive to invest properly and coordinate profession-led quality improvement projects.”
Avant held a roundtable in Canberra with various industry stakeholders and Department of Health, Disability and Ageing representatives earlier this week.
The Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026 still needs to pass both houses of parliament.
