President's Opening Address

APHA National Congress Opening Address 2026

Christine Gee, President, Australian Private Hospitals Association

Good morning everyone.

To our members, delegates, sponsors, speakers, clinicians, industry colleagues, government representatives, partners and friends, welcome.

It is a genuine privilege to open the 2026 Australian Private Hospitals Association National Congress.

Firstly, I would like to acknowledge the Traditional Custodians of the land on which we meet today and pay my respects to Elders past and present. I also extend that respect to all Aboriginal and Torres Strait Islander peoples joining us here today.

This Congress comes at a critically important time for Australia's private hospital sector.

Many of the pressures confronting providers have existed for years, but what has changed is that those pressures can no longer be dismissed as temporary or isolated. For a long time, people across this sector warned that the trajectory we were on was unsustainable. We warned that rising workforce costs, inflationary pressures, increasing compliance obligations and outdated funding settings were colliding in ways that would eventually threaten service viability.

We warned that hospitals could not continue absorbing greater complexity, rising demand, increasing workforce investment and escalating operating costs while funding growth failed to keep pace with the real cost of care.

Today, those pressures are visible across the country.

Providers have been forced to make difficult decisions. We have seen services reduced or consolidated, maternity programs come under strain, mental health services face ongoing viability challenges and negotiations between hospitals and insurers become more difficult and increasingly public. These developments should not be viewed in isolation. Together, they point to a sector operating under sustained structural pressure while continuing to carry a substantial share of Australia's healthcare demand.

Importantly, governments, regulators, insurers and the broader community now recognise that reality, and that matters because the national conversation around private hospitals has changed significantly over the past 18 months. Nobody seriously disputes the pressures facing the sector anymore. The real question now is whether reform and policy action will move quickly enough to protect one of the most important pillars of Australia's healthcare system.

Before we discuss the challenges ahead, it is important to begin with some perspective. Because despite the pressures facing this sector — and there are many — Australia's private hospitals remain one of the great strengths of our healthcare system.

Every day across the country, private hospitals deliver care that is timely, innovative and compassionate. Behind every statistic are patients, families, clinicians and communities who rely on the strength and stability of this sector.

While much of the public discussion over the past year has understandably focused on viability and reform, we should not lose sight of what private hospitals continue to achieve every single day.

Australia's private hospital system remains internationally respected. It is supported by highly skilled clinicians, strong patient outcomes and significant innovation capability. Australians continue to value choice, timely access to care and the confidence that comes with being able to receive treatment when and where they need it.

Amid all the noise surrounding healthcare policy and reform, it is worth remembering something very simple: Australia's private hospital system continues to perform extraordinarily well. Preserving the strength of that system should matter to all of us because its success directly affects the strength and capacity of the broader healthcare system.

Sometimes the private sector is spoken about as though it sits beside the health system rather than within it, but that simply does not reflect reality.
Private hospitals carry an enormous share of Australia's healthcare workload. Around 70 per cent of planned surgery is undertaken in private hospitals, alongside more than half of all chemotherapy treatment, over 60 per cent of acute mental healthcare and the vast majority of rehabilitation services. Every patient treated within the private system represents additional capacity across the broader healthcare system, whether in elective surgery, mental healthcare, rehabilitation or specialist services.

Yet despite that contribution, policy discussions still occasionally frame the private sector as supplementary rather than essential. That thinking is fundamentally flawed. If private hospital capacity contracts significantly, the public system cannot simply absorb the additional demand because the workforce, infrastructure and bed capacity required to replace large-scale private hospital activity simply do not exist.

This is why the sustainability of private hospitals is not merely an industry concern. It is a national health system issue, and increasingly governments are beginning to recognise that reality.

Over the past year, APHA has worked relentlessly to ensure that message was heard clearly. We have advocated publicly, politically and strategically, engaging with ministers, departments, Treasury, regulators, state governments, insurers, parliamentarians and the media to ensure the challenges facing providers remained visible within the national conversation.

Importantly, the viability pressures affecting private hospitals are no longer confined to internal policy discussions. Providers across the country have spoken openly and credibly about the operational realities they are facing, and as a result the national conversation has shifted significantly.

APHA has secured substantial media attention over the past 12 months, highlighting the growing disconnect between hospital costs and insurer payout ratios, the pressures facing maternity services, workforce sustainability concerns and the increasing prevalence of restrictive insurance products. Most importantly, we have consistently focused on what these issues mean for patients because ultimately this discussion is not simply about hospital balance sheets. It is about preserving access to timely, affordable and high-quality care for communities across Australia into the future.

Mental health is perhaps the clearest example of just how essential private hospitals are to this country's healthcare system, and just how serious the consequences become when that contribution is placed under threat.

Australia's private acute psychiatric hospitals treat patients experiencing moderate to severe mental health conditions. They are not a luxury addition to the system. They are not interchangeable with public psychiatry wards, and they are not replaceable by community clinics or outpatient services. They fill a specific and critical role, and they fill it at scale. In 2023 and 2024, private acute psychiatric hospitals accounted for 61 per cent of all acute mental health admissions across the country.

Sixty-one per cent.

That is not a supplementary contribution. That is the majority of Australia's acute mental health care, delivered by a sector that has simultaneously been managing serious viability pressures, service consolidations and funding uncertainty. When we talk about what is at stake if private hospital sustainability deteriorates, mental healthcare is precisely what we are talking about.

This Congress takes place at one of the most consequential moments for private healthcare in recent decades. Not because the sector is failing, but because the environment surrounding it is changing rapidly and the pressures affecting healthcare are now converging simultaneously.

Healthcare demand is rising at the same time as care complexity, workforce shortages, consumer expectations, technology requirements and operating costs are all increasing. What makes this moment particularly significant is not any single issue in isolation, but the fact that all of these structural pressures are intersecting at once.

That is why the conversations we have during this Congress matter so much because the decisions being made now will shape what Australian healthcare looks like over the next decade.

These are not abstract policy discussions disconnected from operational reality. Funding settings directly influence whether services remain viable, which affects patient access and, in turn, pressure across the broader public hospital system. Ultimately, all of this shapes whether Australians continue to have confidence in our mixed public-private healthcare model.

That is what is at stake.

The financial pressure facing private hospitals today is structural, and it is important that both the sector and government are honest about the scale of the challenge.

While COVID exposed many of the sector's vulnerabilities, a number of the underlying pressures had been building well before the pandemic. In recent years, those pressures have accelerated significantly.
Hospitals are now operating in an environment of sustained cost escalation. Workforce expenses, energy costs, insurance premiums, technology investment requirements and compliance obligations have all continued to rise, while funding settings remain increasingly disconnected from the real cost of delivering care.

The workforce environment also remains extraordinarily challenging. The private sector is competing in a labour market unlike anything we have seen in decades, with recruitment and retention pressures intensified by global competition for healthcare workers. Despite this, private hospitals continue investing heavily in workforce support, training, wellbeing and capability because maintaining a skilled workforce is fundamental to maintaining quality patient care.

However, there is ultimately a limit to how much financial pressure hospitals can continue absorbing before services are reduced, consolidated or become unviable, and when that occurs patients and communities experience the consequences directly.

This is why APHA has consistently argued for reform grounded in the operational reality of running hospitals, not reform driven by ideology or short-term political optics, but reform that reflects the real economics of delivering healthcare safely and sustainably.

One of the most significant developments over the past year has been the growing recognition within government that the pressures facing private hospitals are both real and systemic. That recognition emerged because providers across the country continued speaking openly about what was happening on the ground.

We saw maternity services close, mental health programs scaled back and operators publicly warning about sustainability pressures, alongside growing recognition that these issues were beginning to affect broader health system capacity.

The private hospital financial viability review represented an important moment in that discussion. It did not solve the problem, but it formally acknowledged concerns hospitals had been raising for years. The review confirmed that margins were declining, sustainability was deteriorating and parts of the sector were operating under very significant pressure.

That acknowledgment matters because meaningful reform cannot occur until there is shared recognition of the underlying reality. While there is still much more work to do, there is now a greater level of engagement between government and the sector than we have seen for some time.

The establishment of the Private Health CEO Forum has also created an important mechanism for broader system discussions, and APHA has worked hard to ensure private hospitals remain central to those conversations because decisions being made now will shape the future structure of Australia's healthcare system for years to come.

Private hospitals cannot simply be consulted after decisions are made. We must help shape the reforms themselves.

One of the central economic realities confronting private hospitals is that healthcare inflation has fundamentally outpaced the funding structures supporting the system, and this gap has been building for years.

Hospitals are labour-intensive organisations. Unlike many industries, productivity gains cannot simply be achieved by reducing human interaction because quality healthcare depends on highly skilled people delivering highly specialised care. Healthcare labour costs are rising globally, while hospitals are simultaneously absorbing major increases in utilities, consumables, technology, cybersecurity, accreditation, compliance and infrastructure costs.

Yet funding growth has not kept pace, and that gap is becoming increasingly difficult to absorb. Importantly, this is not isolated to one provider or one jurisdiction. It is systemic.

This is why APHA has repeatedly argued that the conversation cannot focus on efficiency alone. Efficiency matters. Innovation matters. But there comes a point where efficiency cannot offset structural underfunding, and many hospitals are now approaching that point.

One of the central challenges facing the sector remains the disconnect between rising insurance premiums and the proportion of those premiums reaching hospitals.

Australians continue to pay more for private health insurance, yet hospitals continue to face immense difficulty securing funding arrangements that reflect the real cost of care. At the same time, insurer management expenses and profits have continued to grow.

Now, it is important to be clear: this discussion is not about creating conflict between hospitals and insurers for its own sake. Private hospitals and private insurers are interdependent. A sustainable private health system depends on both a strong insurance sector and a strong hospital sector.

But hospitals must receive funding that reflects the actual cost of delivering care, and that should not be controversial. When hospitals weaken, patients lose services, communities lose access and confidence in private healthcare declines.

We have also seen concerning growth in restrictive and exclusionary insurance products. Many of these products shift cost and risk onto consumers in ways that are not always fully understood until treatment is required.

That trend poses a genuine risk to long-term confidence in private health insurance itself. If people feel they are paying more while receiving less, confidence erodes, and if confidence erodes significantly the consequences will extend well beyond the private sector.

Consumers themselves are also under pressure.

Australians are facing cost-of-living pressures across every aspect of daily life, and private health insurance exists within that broader economic reality. The challenge for the sector is ensuring consumers continue to see clear value in remaining insured.

That value depends on affordability, transparency, access and confidence. People need to understand what they are covered for, they need confidence that when they require treatment the system will respond, and they need confidence that private health insurance continues to provide meaningful access and genuine choice.

This is why APHA has consistently raised concerns about the increasing complexity and restriction embedded within some insurance products because if consumers begin losing confidence in the value of private healthcare, that creates risk not only for hospitals but for the broader healthcare system.
Australia's mixed public-private healthcare model depends on maintaining strong private system participation, and that is not simply a private sector issue. It is a national policy issue.

One of the concerns APHA has raised consistently is the growing complexity embedded within some insurance products.

Consumers often believe they are comprehensively covered, only to discover exclusions, limitations or unexpected costs at the point they need care. That experience undermines trust, and trust is fundamental to the long-term sustainability of private healthcare.

Australians take out private health insurance for certainty, access, timeliness and choice. If that experience deteriorates, the consequences are felt throughout the broader healthcare system. Pressure flows directly into public hospitals, waiting lists grow, emergency department demand increases and access to elective surgery becomes more difficult.

This is why maintaining a viable and trusted private system matters nationally.
Another major issue throughout the year has been prostheses reform. APHA has consistently acknowledged there are legitimate opportunities to improve efficiency within the prostheses system, but reform cannot simply become a mechanism for extracting savings from hospitals without considering the broader consequences.

Hospitals are already operating under significant financial pressure. If reforms generate major savings for insurers while hospitals continue absorbing rising costs without adequate compensation, that imbalance worsens and, again, patients ultimately feel the consequences.

We support innovation. We support efficiency. We support transparency and modernisation. But sustainable reform requires sustainable funding, and APHA will continue advocating firmly, but constructively, for that principle.

At its core, healthcare is about people, and perhaps the most positive story in this sector is the extraordinary professionalism and resilience of our workforce.
Even under sustained pressure from workforce shortages, rising demand and ongoing fatigue across the system, clinicians continue delivering exceptional care to Australian patients every single day. That commitment deserves recognition, and it deserves support.

The workforce challenge facing healthcare is not temporary. It is fundamentally demographic. Australia's population is ageing, healthcare demand is growing and competition for skilled healthcare workers is intensifying globally.
Workforce sustainability must therefore become a strategic national priority.
Private hospitals are already investing heavily in workforce development, including graduate programs, clinical education, leadership development, wellbeing initiatives and more flexible workforce models. These investments matter enormously, but the pressures remain severe.

There are shortages across nursing, allied health, specialised clinical roles and support services. Competition for staff remains intense, burnout continues to affect the broader health system and wage pressures continue to rise.

Healthcare workers deserve to be valued appropriately. They deserve fair remuneration, safe workplaces and opportunities for professional development. But hospitals must also be funded in a way that allows those investments to continue because hospitals cannot absorb unlimited workforce cost growth without broader funding reform.

Ultimately, workforce capacity is national health system capacity, and preserving that capacity must be treated as a national priority.

Anyone working in healthcare understands that the public and private systems are deeply interconnected.

When private hospital capacity contracts, pressure flows directly into public hospitals. When private mental health services reduce, public systems absorb additional demand. When elective surgery access deteriorates privately, public waiting lists inevitably grow.

The systems are partners.

That partnership was demonstrated clearly during COVID when private hospitals worked collaboratively with governments to support national capacity. We should not wait for another crisis to rediscover the value of collaboration because Australia's future healthcare challenges are significant.

An ageing population, growing chronic disease prevalence, rising mental health demand, increasing care complexity, workforce constraints, regional access challenges and rapid technological transformation will all place additional pressure on the health system over coming decades.

No single part of the health system can manage these pressures alone. Australia will need a coordinated and strategic approach across both public and private healthcare, and private hospitals will play a central role in that future.

Healthcare demand in Australia is only moving in one direction. Demand will continue increasing significantly over the next two decades, and expectations around access and timeliness will continue growing as well.

Weakening private hospital capacity at precisely the moment demand is accelerating would be strategically short-sighted because Australia needs more healthcare capacity moving forward, not less.

We also need to acknowledge the pace of change occurring across healthcare more broadly.

Digital transformation is accelerating rapidly. Artificial intelligence capability is emerging quickly. Consumer expectations are evolving, while cybersecurity and environmental obligations are becoming increasingly significant.
Hospitals are navigating all of this simultaneously.

These developments create major opportunities to improve patient outcomes, strengthen coordination of care and reduce administrative burden, but they also require substantial investment.

Hospitals are being asked to invest in technology infrastructure, cybersecurity capability, workforce training, clinical governance and major capital redevelopment, all while operating under growing financial pressure.

Hospitals cannot deliver this transformation sustainably if core operating viability continues deteriorating. That is why policy settings matter. Hospitals need confidence and stability to invest in the future, and Australia needs a private hospital sector capable of continuing to innovate.

Despite all of these challenges, there is still reason for optimism because throughout one of the most difficult operating environments in recent history, private hospitals across Australia have continued delivering exceptional care.
Our members have continued investing. They have continued innovating. They have adapted under immense pressure while continuing to care for millions of Australians every year.

That resilience deserves recognition because it reflects the depth of capability, professionalism and commitment that still exists across this sector.

APHA's objective is simple: to help secure a future in which private hospitals remain world-class, patients continue to have genuine choice, workforce capability is strengthened and funding arrangements properly reflect the real cost of care.

That is not an unreasonable ambition. It is a necessary one.

One of the most important achievements over the past year has been ensuring that the voice of private hospitals has remained visible, credible and influential within national policy discussions.

And that has required sustained advocacy, not reactive advocacy, but strategic advocacy.

APHA has worked hard to ensure the challenges facing private hospitals are understood not only within government, but within the broader national conversation.

There is now greater recognition of the financial pressures facing providers, greater recognition of workforce challenges and greater recognition of the consequences for public hospitals if private capacity weakens.

Most importantly, there is growing recognition that reform is necessary.
That progress matters because healthcare reform is often gradual. Meaningful change generally only occurs once there is broad acknowledgment that reform is genuinely needed, and we are increasingly seeing that acknowledgment emerge.

As we look ahead, I remain optimistic about the future of Australia's private hospital sector. Not because the challenges ahead are insignificant, but because this sector has consistently demonstrated resilience, professionalism and an extraordinary ability to adapt.

Private hospitals in Australia have evolved enormously over recent decades. The sector has expanded clinical capability, embraced new technologies, invested heavily in workforce development and continued delivering increasingly complex care to millions of Australians.

That track record matters because it demonstrates something important about this sector: when supported by sensible policy settings and sustainable funding arrangements, private hospitals innovate, invest and deliver.

The national discussion over the past year has rightly focused on sustainability and viability. Those issues are real, and they require urgent attention. But the future of private healthcare in Australia should not be defined solely by financial pressure.

The more important question is what kind of health system Australia wants to build over the next decade.

From APHA's perspective, the answer should be clear.

Australia needs a strong mixed health system in which public and private providers work alongside one another — not in competition, but in partnership. The country needs sustainable hospitals capable of investing in workforce, infrastructure and innovation. Patients need insurance products that are transparent, reliable and genuinely focused on access to care. And governments need policy settings that recognise the private sector as an essential part of national health system capacity.

There is also enormous opportunity emerging across healthcare. Advances in digital capability, artificial intelligence, data integration and new models of care have the potential to improve patient outcomes significantly over the coming years, and Australia's private hospitals are well placed to contribute to that transformation.

But innovation requires confidence, stability and long-term investment.
That is why the conversations taking place at this Congress matter so much. The discussions over the next few days are not simply about current operating pressures. They are about shaping the future direction of healthcare in Australia and ensuring the system remains capable of meeting growing demand in the decades ahead.

APHA will continue engaging constructively with governments, insurers and stakeholders across the system to advocate for reforms that strengthen long-term sustainability. Our role is not simply to raise concerns. It is to contribute seriously and responsibly to practical solutions.

Throughout all of these discussions, it is important not to lose sight of the people at the centre of the system.

Every day, across metropolitan, regional and rural Australia, private hospitals continue delivering extraordinary care under increasingly complex conditions. Clinicians, nurses, administrators, support staff and hospital leaders are managing immense pressure while continuing to provide patients with high-quality treatment, compassion and reassurance during some of the most difficult moments in their lives.

That contribution deserves recognition.

On behalf of APHA, I want to sincerely thank every person in this room and every member organisation represented here today for the work you continue to do.

I also want to thank our partners, sponsors and stakeholders for their ongoing engagement with the sector and for contributing to the important conversations that will take place throughout this Congress.

While the challenges facing private healthcare are significant, I remain confident that Australia can continue building one of the strongest mixed healthcare systems in the world, provided we approach the future with realism, collaboration and a willingness to make thoughtful long-term decisions.
Every person in this room understands what is at stake, but we also understand the strength of this sector.

Across Australia, private hospitals continue caring for millions of people with professionalism, compassion and extraordinary skill. That work matters deeply.
Thank you for everything you continue to do for patients, communities and the broader health system.

I hope you enjoy the Congress, and I look forward to the discussions ahead.

Thank you.

-ENDS-

Previous Speeches:
3/4/2025 Hospital Viability & the Political Landscape