Seeing a specialist keeps getting more expensive, and a new Grattan Institute analysis shows the problem is getting worse, not better.

After years of inaction, reform may finally be on the agenda.

At the end of last year, Health Minister Mark Butler said fees to see medical specialists – such as paediatricians, dermatologists and psychiatrists – were “out of control”. The government has launched a parliamentary inquiry, and the federal health department has consulted on a range of reform options.

To make specialist medical care affordable, the consultations and inquiry must trigger overdue reform to train more specialists, fund more free public clinic appointments, and rein in the most extreme fees.

Specialist fees are out of control

Our 2025 report, Special Treatment, found that between 2010 and 2025, fees for specialist care outside hospitals grew 73% in real terms (meaning adjusted for inflation). That is many times faster than for GPs or other Medicare services. Since then, fee growth has continued unchecked. In the past year alone, specialist fees rose 4% faster than inflation.

Some specialties have seen especially steep rises. The median out-of-pocket fee for an initial psychiatry appointment is now A$351, up $90 in real terms in the past two years. The median initial dermatology appointment costs $217, up $28.

At the same time, fee-free care is dwindling. Fewer than a quarter of initial specialist appointments are now bulk-billed, down from about a third a decade ago. In urology,........

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