Breast imaging providers warn of potential service collapse without urgent Medicare reform

Private providers and specialists are calling on urgent government intervention as they struggle to stay afloat with Medicare rebates falling short for breast cancer diagnostics.

Queensland X Ray will no longer provide breast mammography, imaging or biopsy services to Cairns patients, halving the number of screening services available and causing delays that could place some patients at risk. Surgeon Dr Aemelia Melloy specialises in breast surgery and is concerned that the inevitable delays caused by the lack of screening options will place her patients at significant risk. Picture: Brendan Radke

Breast cancer diagnostic services in Australia are at risk of a potential collapse due to unsustainable Medicare rebates, which are failing to cover the rising costs of care for both patients and providers.

Specialists, women’s imaging providers, and the peak body for radiology, Australian Diagnostic Imaging Association, have united to highlight the growing financial strain on both the industry and patients, due to rising out-of-pocket costs.

Highlighting the emerging concerns is Cairns-based breast surgery specialist Aemelia Melloy.

Dr Melloy said if the federal government cannot increase rebates, a publicly funded diagnostic service is necessary to guarantee women have access to essential imaging services. Picture: Supplied.

According to her, changes to the rebate for diagnostic breast imaging require urgent federal government action, as the public health system is “excessively reliant” on private providers for these services.

“The main issue is the public health system relies so heavily on private providers for breast imaging,” she said.

“There is no guarantee the service will even keep running if it isn’t profitable for companies to provide it.”

Dr Melloy said this was where Medicare rebates need to be “lifted” to help offset some of the cost to provide sustainable diagnostic imaging.

“It’s a public health right to be able to access imaging,” she said.

Queensland X Ray medical imaging services located within the Cairns Private Hospital building at 144 Lake Street, Cairns City. Picture: Brendan Radke

Cairns residents were forced to wait up to four months after Queensland X-Ray, one of only two private providers in Far North Queensland, temporarily stopped diagnostic mammography services in Cairns in November 2024.

This left only one private provider, I-MED Radiology, offering the service, covering women’s diagnostic imaging from Cairns to the Cape.

For years, Queensland X-Ray rotated experienced women’s imaging radiologists from Brisbane to Cairns every second week before the temporary suspension.

Following the Cairns Post’s Critical Condition campaign, which called on state and federal governments to restore the service, Queensland X-ray announced the appointment of a Cairns-based women’s imaging radiologist starting in early March.

Surgeon Dr Aemelia Melloy said the public health system in this case is overly dependent on private providers for breast imaging services. Picture: Brendan Radke

To highlight factors contributing to a potential system collapse, Dr Melloy said the “minimal” Medicare rebates were unsustainable for private providers, adding, “it’s such a small rebate, it barely keeps the lights on”.

“Everything is costing more — the cost of living, running a business — but the rebates remain insufficient,” she said.

“Radiology providers and doctors still have all the running costs of a business.”

With rebates often falling short of covering basic expenses, these costs are frequently passed on to patients.

Private providers told the Cairns Post on average a Medicare rebate for a 45-minute diagnostic breast mammogram ranges from $80 to $120, while patients are often charged more than $500.

“These small rebates have to cover the radiographer, the radiologist’s review, and the report,” Dr Melloy said.

It also needs to cover essential business costs like administration and daily operations.

Despite charging out-of-pocket fees, many radiology providers are struggling to stay afloat.

“With the current system in breast imaging, there’s just no money to keep a business going,” Dr Melloy added.

Private providers have stated the current funding is insufficient to cover cost of radiographers, much less the basic expenses needed to keep their operations running. Picture: iStock.

For Dr Melloy, the issue is clear: women who can afford imaging are seen sooner, while those who can’t face long waits due to high costs, creating inequitable access to care.

“If a woman can’t afford the out-of-pocket expenses for breast imaging, her GP can refer her to the public hospital, and we arrange imaging at no cost,” she said.

“However, there will be delays as the referral must first be received by the hospital, triaged, and imaging arranged.”

Regardless of how the booking is made, all imaging appointments are still handled by private providers like Queensland X-Ray or I-MED Radiology.

CEO Queensland X-Ray, Dr Robert Clarke. Picture: Supplied.

Queensland X-Ray chief executive Rob Clarke said the number of radiologists with expertise in women’s imaging was small and this was adding to the difficulty in keeping a sustainable service.

“We are struggling to keep providing these services statewide,” he said.

“Our existing pool of women’s imaging specialists feel the current workload is not sustainable.

“As a statewide service, women’s imaging is offered in Townsville, Mackay, Toowoomba, Brisbane, and the Gold Coast, all of which face shortages of radiologists with expertise in women’s imaging.”

The I-MED Radiology Network building at 121 Sheridan Street. Picture: Brendan Radke

While reinstating the service at Queensland X-Ray was a “positive” outcome for the region, Dr Melloy said it was still a “temporary” measure.

“If for any reason another radiologist has to stop, we will be back in the same boat,” she said.

“So in terms of equitable early access to imaging, if you can afford to pay then you get your scans earlier.”

Originally published as Breast imaging providers warn of potential service collapse without urgent Medicare reform