Survey Promotes Value Despite Ophthalmology Fee ‘Attacks’

Australian ophthalmology performs “exceptionally well by international standards”, despite the “gross failures of the public hospital system”, according to the Australian Society of Ophthalmologists (ASO).

It was responding to the latest data from the Australian Bureau of Statistics (ABS), which showed that fewer Australians were delaying or not using selected health services when needed compared with two years ago.

The data, from the ABS Patient Experiences survey, provides a snapshot of access, barriers and people’s experiences with various healthcare services.

James Eynstone-Hinkins, ABS head of health statistics, said: “In 2024-25, 27% of people delayed or did not see a GP when needed. In 2022-23 this figure was higher, at 30%.”

The survey also revealed an increase in the number of people visiting a medical specialist, including ophthalmologists.

It showed a rise to 40.4% in 2024-25, up from 39.2% in 2023-24, with those delaying seeing a specialist dropping to 18.3% compared with 20.5%.

Those visiting their specialist recorded high ratings on core measures of respectful, attentive care: 78.5% of people reported that specialists always listened to patients carefully (ranked #2), and 83.4% reported specialists always showed respect (ranked #2).

Close to one in 10 people, or 8%, cited cost as a reason for delaying or not seeing a GP when needed, while just 8.6% said that stopped them from visiting their medical specialist, compared with 9.8% two years previously.

Dr Peter Sumich, ASO president, said that showed medical specialists, including ophthalmologists, remained a “value proposition very popular with patients who value time efficiency, a specialist rather than a training registrar, and a location convenient for them”.

Private ophthalmology fees have been criticised this year, with the Grattan Institute calling them high and extreme.

Alternatively, there is a lengthy wait for tertiary eyecare in the public system, placing them in “a painful dilemma”.

Dr Sumich said the ABS survey supported the idea that “ophthalmology consultations provide great value for patients who can access expert specialist opinion in their local suburb with little waiting time”.

He said the “attacks” on specialist fees were a “smokescreen to camouflage public health failure” in ophthalmology.

“Unfortunately, the disastrous state of public hospital outpatient clinics, long surgery wait times and time-inefficient services has meant more people have been forced into the private system where they are placed in financial stress.”

The survey also showed a decline in the use of telehealth services, with 22% using that option in 2024-25, compared with a peak of 31% in 2021-22.

“While telehealth maintains a stable presence for patients facing distance barriers, in-person consultations remain the gold standard for ophthalmic care,” said Dr Sumich.

The ABS highlighted access to dental services to demonstrate challenges across Australia and in different socio-economic groups.

“The survey found that 65% of Australians living in areas of least socio-economic disadvantage saw a dental professional in 2024-25,” said Eynstone-Hinkins. “This compared with only 42 per cent of people living in most disadvantaged areas.”

And experiences of health services also differed by remoteness.

Nearly one in two people (46%) living in major cities were seen by a GP for urgent medical care within four hours, compared with 30% of those living in outer regional or remote areas.

Dr Sumich said: “It is invariably the most disadvantaged who miss out on medical care.

“The gross failures of the public hospital system in delivering ophthalmology services leave patients with few options. We have witnessed department closures at St Vincent’s Hospital and the shuttering of St George Hospital’s cataract service.

“Hospitals routinely target ophthalmology budgets because it is a high-overhead specialty to provide,” he said.

“Without adequate representation on medical staff councils, ophthalmologists are rarely at the table when critical decisions are made, which means public ophthalmic care falls under the auditor’s axe.”

Providing adequate services to remote regions of Australia remained an ongoing challenge, he said. 

This article has been republished courtesy of Insight.