Advocacy in action: Finding common ground in private healthcare

After decades working as a specialist obstetrician and gynaecologist across both our public and private health systems, I understand how Australia's dual health system can deliver world-class care. Unfortunately, we’re all now seeing just how quickly things can fray when policy reform becomes adversarial rather than collaborative.

The government has made health reform a signature priority.  With GP bulk-billing ‘reforms’ now in place, focus is shifting to non-GP specialist billing and the viability of the broader private health system – private hospitals in particular.

The financial collapse of Healthscope, Australia's second-largest private hospital operator, alongside nationwide closures of maternity and psychiatric services, provides evidence of something deeper than just isolated business failures. These are symptoms of systemic strain that demands urgent and evidence-based attention.

The public conversation about private healthcare's future will have been disappointing for many Avant members, as well as others invested in Australia’s healthcare system. Unfortunately, the adversarial point-scoring, with different parts of the sector shaping up against each other in the serves no one – least of all patients – and provides the Government a fractured set of stakeholders to deal with.

Australia's dual health system remains one of our great national assets, and the question shouldn’t be whether to preserve this system, but how to strengthen it.

Avant is in a unique position when it comes to understanding the perspective of the practitioners who work in the private system and the health funds who provide insurance for private patients. We support more than half of Australia’s doctors with medical indemnity cover, and also offer private health insurance through Doctors’ Health Fund.

This combined perspective was invaluable when I recently led a roundtable convened by Avant that brought together over 30 representatives from across our healthcare ecosystem – medical colleges, private health insurers, hospital operators, patient advocacy groups, and federal government representatives. What emerged was the recognition we need to agree on how we work together before debating what we do.

Two distinct perspectives shaped the discussion. The first emphasised defining our destination before plotting the route. Establishing what patient care should look like in the future and agreeing on guiding principles for reform.

The second focused on practical reforms the health system needs now – addressing issues relating to cost structure, workforce challenges, and digital infrastructure. Both approaches have merit. The challenge is integrating them.

The conversation confirmed what many already knew: the challenges facing healthcare are complex, interconnected, and won't yield to simple solutions or siloed thinking. Yet it also revealed something encouraging – a genuine appetite for collaboration grounded in a system-wide perspective.

Government participants acknowledged the dialogue as a constructive step forward. Now the task is to build momentum by finessing opposing views and proposing frameworks to guide this ongoing work.

Avant has drafted a three-tier framework that emerged from themes expressed during the forum: systems design principles to frame reform discussions; operational priorities identified through discussion, and implementation mechanisms to test and operationalise agreed directions.

Not every idea will have universal support, nor should it.

The goal isn't unanimity but, instead, identifying areas of genuine agreement where the sectors – doctors, hospital groups and insurers – can present a united front to government for meaningful policy reform.

This matters because the current fragmented approach has been noticed - and not favourably. When healthcare stakeholders can't find common ground amongst themselves, it's unreasonable and potentially harmful to expect government to navigate those divisions for us.

The alternative to collaboration isn't the status quo, it's decline by default. Private healthcare might not survive if driven by market forces alone. But if it continues contracting, the public system won’t be able to absorb the capacity loss .

After decades in this sector, I've learned the best clinical outcomes emerge from multidisciplinary collaboration, where different specialties contribute their expertise toward shared goals.

Healthcare policy should work the same way. Avant is now building on the roundtable momentum by documenting what was heard, clarifying areas of convergence, and continuing to convene stakeholders around evidence-based dialogue focused on patient outcomes. The roundtable was a start. Whether it becomes a turning point depends on our collective willingness to prioritise collaboration over competition.