The Australian Society of Ophthalmologists (ASO) has “welcomed” the release of the Grattan Institute Report highlighting a number of concerns within the sector but warns it paints a one-sided picture of the challenges posed to ophthalmology in Australia.
The ASO has long called on state, territory, and the federal governments to increase public hospital funding towards clearing eye surgery waiting lists, especially as the public hospital sector is the training ground for the next generation of all Australian surgeons.
The report from the Grattan Institute, an independent research organisation that provides public policy recommendations in Australia, noted ophthalmology has an under-supply problem, requires more training capacity and features a significant proportion of practitioners charging patients high or extreme fees.
It said patients faced “a painful dilemma” – “pay out-of-pocket, sometimes double or triple the Medicare schedule fee, or join the queue for an appointment in the public sector”.
But the ASO has responded to those claims, saying specialists are trained in public hospitals and not inside medical colleges.
“If public hospitals are not delivering enough surgery or outpatient clinics, then we cannot train more specialists,” it said in a media release.
The Medicare rebate was another point of contention.
The ASO said It had not been indexed from its inception in 1980, effectively frozen and cut and never aligned with inflation or average wages.
“As a metric of a medical service, it is unreferenced and meaningless,” the ASO said.
“When looking at costs, specialist fees are driven by real-world overheads such as wages, insurance, electricity, leasing, IT expenses, and the increasing cost of medical equipment. If medical services were cheap to provide, governments would not have trouble funding them.”
ASO CEO Ms Katrina Ronne said tangible solutions to the issues were needed instead of losing sight of the patient with unproductive “mudslinging”.
“The ASO welcomes meeting with any state, territory, or the federal health minister to unpack and constructively address the complexities prohibiting accessibility and affordability of ophthalmology services for all Australians,” she said.
“Sight matters to Australians. It should matter to our governments too.”
ASO takes issue
These are the ASO’s biggest issues with the Grattan Institute report:
Grattan Institute finding #1: Ophthalmology is a persistently under-supplied specialty in Australia.
ASO fact: “Yes, the ratio of eye surgeons to Australians is roughly one to every 24,181 set of eyes. Yet, only an estimated one in 10 positions are held in the public sector.
Question: “Why is more public health funding not directed to ophthalmology when nine in 10 Australians reported ‘sight’ as their most valued sense in self-reported data from the ABS 2017–18 National Health Survey?”
Grattan Institute finding #2: There are far more applicants for ophthalmology training than there are training places.
ASO fact: “Ophthalmology is one of the smaller craft groups with an estimated 1,100 registered practitioners in Australia. Naturally, this makes it a competitive specialty, especially with just 30–35 government-funded training positions available per clinical year.
“How many people are applying? 154 applied for the 2024 Royal Australian and New Zealand College of Ophthalmologists (RANZCO) Vocational Training Program.
Question: “Why won’t our governments across the country invest in more ophthalmology training positions in our public hospitals — the training ground for the next generation of eye surgeons?
“There is local demand for surgical training in ophthalmology. Why is government not addressing this as a solution to workforce needs?”
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