Victory for hospital patients as funding is maintained for surgical items

Catholic Health Australia

Private hospital patients around the country are set to avoid significant extra costs after the federal government announced health insurers must continue funding critical surgical items following a concerted campaign by Catholic Health Australia.

The federal government has today announced it will keep General Use items on the Prescribed List, which specifies the medical items that health insurers must cover for patients.

Hundreds of critical surgical items – which include sutures, adhesives and skin glues – were set to be removed from the Prescribed List on July 1, 2024.

This is a common sense patient-focused approach and we thank Minister Butler for resolving the issue.

“Private hospital patients around the country can today breathe a sigh of relief, knowing their health insurer will still be required to cover critical surgical items,” said CHA CEO Jason Kara.

“The government’s commitment to upholding the funding for general use items is a crucial decision that will help ensure no patient is left behind, especially women and those in regional communities.”

Removing funding for General Use items would have pushed up out-of-pocket costs for patients and put further strain on financially struggling hospitals, particularly in regional areas.

Surgeries which use lots of these items – including breast cancer procedures, caesarean births and bariatric surgeries – could have cost patients thousands of dollars extra out of pocket.

More than 70 per cent of surgeries that would have been impacted by this change are performed on women, and regional hospitals with thin margins would have been worst affected.

Previous CHA advocacy had already resulted in multinational device manufacturers bringing down the prices they charge to insurers for these items by an average 14 per cent.

“The government has stood up to lobbying from some private health insurers,” said Mr Kara.

“We thank the government for its close consultation with the Catholic hospital sector and commitment to ensuring there are no adverse impacts on patients or unintended consequences from these reforms.”

The Department’s Clinical Implementation Reference Group and its own Review of the General Miscellaneous Category of the Prostheses List both stated that before items could be removed from the funding list an alternative funding mechanism must be found.

/Public Release.