20 MARCH 2026

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Push for overhaul of referral system divides doctors.

Jamie Thannoo and Paul Smith HEALTH officials have proposed extending the default referral period from 12 months to several years or even making indefinite referrals standard.

The draft plan reflects the Federal Government’ s desire to clamp down on non-GP specialists who bill Medicare’ s better-funded items for initial attendances whenever a referral is renewed.

The current 12-month default time limit can also mean unnecessary outof-pocket costs as patients renew referrals, according to a Department of

Longer referrals risk GPs falling out of the loop.

Health, Disability and Ageing consultation paper published last month.

But while there is support for change, serious concerns remain from both GPs and non-GP specialists about the impact of the proposal.

The paper cites a 2020 report from the Deeble Institute for Health Policy Research that argued the referral system was set up for acute illness, not chronic conditions, with reforms to the system having the potential to cut

$ 220 million in Medicare rebates( see box, page 3).

Under the proposals, the default GP referral could be two years, three years or indefinite, while a referral from another non-GP specialist could be six or 12 months or likewise indefinite.

The department acknowledged that longer referral periods risked GPs falling out of the loop.

The consultation paper suggested the government could mandate that specialists notify GPs whenever they change medications or treatment plans to offset these risks.

It also said that increased information sharing via My Health Record could play an important role.

“ Regardless of referral length, once a patient is referred for non-GP specialist care, the non-GP specialist is responsible for managing treatment and communicating critical developments to other involved practitioners, including the patient’ s GP,” the paper said.

In a discussion on the AusDoc website, Dr Helena Smetana wrote:“ What seems to be forgotten by proponents of only indefinite referrals is that it’ s a major safety issue.”

A GP in Banora Point, NSW, added:“ Referrals are a communication between the patient’ s usual doctor and another subspecialist, who can then make assessments about potential drug interactions if starting new treatments, bleeding risk for procedures, and medication contraindications due to certain conditions.

PAGE 3

Heather Saxena DR Nick Carr has many achievements to choose from when nominating his proudest, from pushing to ban temazepam gel capsules to fighting the Federal Government in court over its definition of voluntary assisted dying as suicide.

But the 69-year-old says his resolve to work four days a week tops the list. It was a decision he made so he would never neglect his wife, Sarah, whom he met in the NHS, nor his children, Simon, Isabelle and Olivia.“ When my son was born, in 1989,

I took a day off in the middle of the

week to be with him,” Dr Carr says.

“ I remember going along to the mothers’ group— I was the only dad there— and it was fantastic.

“ I am most proud that I didn’ t dedicate my entire life to work while neglecting my kids.”

Dr Carr graduated from the University of Cambridge and did his GP training in London, where he met his Australian wife during a paediatric placement. She was a social worker on the ward. They moved to Melbourne in 1988. After turning down partnership offers at two practices, Dr Carr joined the St Kilda Medical Group, which has

‘ I’ ve never had a bad day at work. How many people can say that?’

– Dr Nick Carr

been running since the 1930s.

“ I went to this weird little practice with lino floors, and it felt right,” he tells AusDoc.

“ I had worked in Camden, a grungy part of London, which was like St Kilda without the beach.

“ Lots of people were on the margin of society; there were lots of substance abuse and psychiatric issues.“ I liked that mix of patients.“ In St Kilda, you can have wealthy employed people in the waiting room with someone who has fallen asleep from drug addiction who has psychiatric ills. And everyone PAGE 4

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