Telehealth and outreach models are good, but they won’t be enough, says the RDAA.
Chronic non-GP specialist shortages in rural and remote communities are creating bottlenecks that leave patient care in limbo, the Rural Doctors Association of Australia says.
It’s also creating additional demand for rural hospitals, and driving up costs for patients, the RDAA said in a preview of its submission.
In April, the Standing Committee on Health, Aged Care and Disability announced its inquiry into the affordability of medical specialists in Australia, chaired by Dr Mike Freelander.
The inquiry is examining the availability, cost and equity of access to specialist medical services across Australia, alongside the impacts of delayed care on patient outcomes.
RDAA president Professor Sarah Chalmers said it was time for key structural reforms to be made, rather than small, ineffective, and expensive tweaks at the periphery.
“The shortage of consultant specialists in rural and remote Australia is leading to lower rates of preventative screenings, more potentially preventable hospitalisations, and an increased need for retrievals – including for emergencies where timely care is critical,” Professor Chalmers said.
The RDAA’s submission called for the “gold standard” expansion of end-to-end training positions for consultant specialists, supported by incentives to encourage them to remain in rural areas after completing their training.
It’s an ask that existing evidence has long pointed to, Professor Chalmers said.
“If you train in the bush, you are much more likely to stay there to work after completion of your training – and this is just as true for consultant specialists as it is for GPs,” she said.
The second ask was reforming the “key investment” in non-GP training – the Commonwealth-funded Specialist Training Program (STP).
According to a February 2025 Department of Health, Disability and Ageing report, the program cost taxpayers upwards of $700 million between 2022 and 2025 alone and provides salary support to about 920 non-GP registrars each year.
The RDAA called for urgent reform of the STP to redirect existing funds from misallocated metro posts and tighten evaluation and compliance, ensuring the program develops a regional and remote specialist workforce.
Council of Presidents of Medical Colleges (CPMC) chair Dr Sanjay Jeganathan previously expressed similar sentiments, telling TMR the 2024 STP evaluation report, which found over 80% of specialists will still concentrate in cities, demonstrated the need for better program design and more funding.
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Equally important, the RDAA flagged the use of more flexible employment models that better enable specialists to remain in these underserved areas.
“Rather than offer zero-dollar [visiting medical officer] contracts by health services, as we’ve seen in New South Wales in particular, we should offer contracts that provide specialists with job security and the ability to settle in the community,” RDAA chief executive Peta Rutherford told TMR.
Rural communities are more likely to retain specialists with home ownership or established private practices, but this becomes increasingly difficult when non-GP specialists are on contracts with regular sessions but unstable income, Ms Rutherford said.
Their final ask was to embed models of care that can better deliver complementary services.
“We need to look at hybrid models where visiting specialists work alongside rural generalists with advanced skills in that area, to increase access and ensure that patients with the greatest need can receive consultant-level specialist care,” Ms Rutherford said.
“For example, a Consultant Surgeon may establish a surgical practice in a rural town if they already know a local RG Anaesthetist who can work with them,” the RDAA’s statement read.
They also called for Medicare rules to be reformed so credentialled rural GPs and RGs could refer directly to a broader range of second-line specialist services or diagnostic tests, which were omitted from this year’s 2026–2027 Federal Budget.
It’s been over a year since the RDAA and other rural health groups submitted a blueprint to the government for their request, but progress remains slow.
The RDAA warned that while transparency was important, given rural and remote patients’ limited capacity to absorb specialist fee increases, it shouldn’t remain the sole focus of the inquiry, as the choice is often not in specialists’ hands.
When it came to rural towns, Ms Rutherford told TMR there was an economy of scale issue.
“If a [non-GP specialist] consultant in a small town is charging slightly more than what their colleague in the city is, the overall cost would be significantly cheaper,” she said.
For rural patients, costs are much higher than the doctor’s fee alone once travel, accommodation, time off work, and care for their family or business are factored in, leading some to opt not to seek treatment at all, Ms Rutherford said.
The RDAA’s submission to the inquiry is currently restricted under Parliamentary privilege.
As it stands, 26 submissions have been received. Submissions close on Friday, 16 October.
