Here’s an update on a few of the issues AMA Victoria is working on for members, including:

• Specialist outpatient care: member feedback presses need for reform
• Urgent resourcing required for paediatric services at Eastern Health
• Ozempic (semaglutide) supply update.
   

Specialist outpatient care: member feedback presses need for reform

Last week, we wrote to members inviting feedback on the state of specialist (outpatient) care across Victoria’s public health system. The response has been clear: the current approach is falling short, with outdated systems, rising demand, and limited support delaying care and placing growing pressure on clinicians.

Referral and access remain major sources of frustration. Health services have different processes and criteria, making referrals confusing and inconsistent. GPs describe frequent rejections or long delays over minor technicalities, and rigid eligibility rules that prevent timely care (for example, requiring six months of physiotherapy before surgery, regardless of clinical need). Communication with hospitals is patchy, with GP Liaison Officers often under-resourced and invisible. Despite repeated AMA Victoria advocacy over several years, problems with hospital-to-GP information flow continue to undermine coordinated care. To get patients seen, many GPs resort to workarounds such as duplicating referrals, marking them as “urgent,” or sending patients to emergency departments, further burdening the system.

Infrastructure gaps compound these challenges. In some regions, there is little or no public outpatient clinic capacity, forcing specialists to see public patients in private rooms. Booking systems are clunky and unreliable, making it hard for doctors to control follow-up appointments. When patients don’t attend, the consequences are significant. Members report that relying solely on SMS reminders often doesn’t work, and appointment slots are sometimes wasted.

Workforce issues are also significant. Many clinics rely heavily on junior doctors who may not yet have the skills or experience to manage complex patients or understand community supports. At the same time, while there is pressure to train more specialists, there is little support for supervision and mentoring. Mental health services have been particularly stretched by rushed reforms and funding models that don’t reflect the reality of working with children, families, and people with chronic needs. Clinicians describe this environment as increasingly unsustainable and demoralising.

Funding and reimbursement models remain outdated. Current MBS items don’t recognise the time and complexity involved in managing chronic disease. Members strongly support moving to time-based billing and introducing an annual review item number for patients with multiple conditions.

Administrative and IT burdens are another drag on time and morale. Clinicians report having to log in to multiple platforms to access patient records and results. Excessive paperwork and a lack of administrative support waste hours every week- issues we’re trying to address through our Get Rid of Stupid Stuff campaign to reduce pointless bureaucracy.

Regional access gaps also remain a significant concern. Many communities have limited or no access to specialties such as rheumatology, neurology, dermatology, and plastics. And while telehealth has clear benefits, it is no substitute for in-person assessment in complex cases. Clinicians report high non-attendance rates, technical issues, and frustration with patients joining appointments while driving or distracted, further compounding inefficiencies.

Drawing together members’ insights, the priorities for action are clear:

• Develop a consistent, user-friendly electronic referral system across health services
• Make referral criteria more transparent and flexible
• Enable direct clinician-to-clinician communication
• Expand physical clinic space, especially in regional areas
• Modernise booking and scheduling systems
• Update funding models to better reflect the complexity and time required for chronic care
• Properly resource training and supervision of junior doctors
• Balance telehealth with in-person care for complex or high-risk patients

AMA Victoria thanks the many members who have taken the time to share their feedback and experience. Your insights are shaping our advocacy. We’ll be meeting with the Department shortly to discuss these issues in detail. There is still time to contribute further- please email Lewis Horton at [email protected] if you’d like to share additional reflections or suggestions.
 

Urgent resourcing required for paediatric services at Eastern Health

AMA Victoria has written to the Minister for Health to raise serious concerns about the state of paediatric services at Eastern Health, particularly at Box Hill Hospital, and to call for immediate investment to support safe and sustainable care.

While we supported the Government’s decision to maintain paediatric services at Maroondah Hospital- reflecting the genuine concerns raised by local clinicians and families- this has left critical resourcing issues at Box Hill unresolved. Members at Box Hill have reported severe staff shortages and workloads that are no longer tenable.

Members have also highlighted that Eastern Health’s stretched service model- operating across multiple sites- limits the ability to provide effective, safe care. While the earlier proposal to consolidate services at Box Hill was designed to help relieve workforce pressures, the Government’s decision to pause that process has left the underlying problems unaddressed.

AMA Victoria has emphasised that meaningful improvements cannot be achieved simply by shifting limited resources between locations. Additional funding, staffing, and specialist paediatric emergency capacity are urgently needed to ensure that paediatric services remain safe and accessible for local families.

We will continue to advocate strongly for immediate and substantial investment at Box Hill Hospital and across Eastern Health to alleviate excessive workloads, reduce patient risks, and support a sustainable paediatric workforce.
 

Ozempic (semaglutide) supply update

Ozempic continues to have limited availability in Australia. The TGA has advised that while some stock continues to arrive, available supply is not sufficient to meet the needs of all patients who are prescribed this medicine. Supply limitations are expected to continue until 31 December 2025.

Prescribers are advised to prioritise existing patients using Ozempic for type 2 diabetes wherever possible, avoid starting new patients on Ozempic unless there are no suitable alternatives, and discuss alternative treatment options if Ozempic cannot be sourced. The TGA has also advised that Ozempic and Wegovy should be prescribed only within their approved indications and that patients should be informed that limited availability is likely to continue throughout 2025.

The 1.5 mL Ozempic 0.25 mg/0.5 mg pre-filled pen is being replaced by a 3 mL pen. This change does not affect the shortage status, and both presentations will continue to have limited availability throughout 2025.

To help manage the shortage, the TGA has approved the importation of an overseas-registered semaglutide product under section 19A. This product is supplied by Medsurge Healthcare and contains the same active ingredient as Australian-registered Ozempic. Information about this product, is available here.

Ozempic remains listed on the TGA’s Medicines Shortages Database. For up-to-date information and prescribing advice, members can refer to the TGA’s Ozempic shortage information.

AMA Victoria has been in contact with AMA Federal to ensure continuity of diabetes care remains a national advocacy priority. The AMA is engaged with the TGA’s Medicines Shortages Working Group and the Ozempic Medicine Shortage Action Group. We will continue to monitor developments closely and advocate for clear, timely updates to support patient care and practice planning.