President’s Message: A new chapter

It is a privilege to write to you as the new president of AMA (NSW). 

Having served as vice president over the past two years, I have seen the strength, expertise and commitment of our members across every part of the profession. 

I want to acknowledge and thank our outgoing president, Dr Kathryn Austin, for her outstanding leadership and service to AMA (NSW). Kathryn has led this organisation with integrity, determination and a deep commitment to the medical profession. Her advocacy has strengthened AMA (NSW), and I know many members join me in thanking her for the contribution she has made. 

I also want to acknowledge Fiona Davies for her significant contribution as Chief Executive Officer. Fiona has been the heart and soul of AMA (NSW) for decades and her leadership, judgement and commitment to the medical profession has been deeply valued.  

I also warmly welcome the announcement of Dominique Egan as the next Chief Executive Officer of AMA (NSW). Dominique has been a strong advocate for doctors through her work as Director of Workplace Relations, and I look forward to working closely with her, our Board, Council and vice president Dr Theresa Ly as we enter this next chapter. 

Over the next two years, my focus will be clear: AMA (NSW) will be strong, direct and unapologetic in advocating for doctors and patients. 

For more than 20 years, I have worked as a general surgeon in western Sydney. I have seen firsthand what happens when patients cannot access care early enough. They wait longer to see a GP. They wait longer for public outpatient clinics. They wait longer in emergency departments and longer for surgery. By the time many patients reach specialist care, their condition has become more complex, more costly and harder to treat. 

That is the reality confronting patients and doctors across NSW. 

The Bureau of Health Information figures show the scale of the problem. In the October to December 2025 quarter, NSW emergency departments recorded 820,009 attendances, the highest of any quarter since BHI reporting began in 2010. A record 79,004 patients left emergency departments without, or before completing, treatment, up 15.9 per cent on the same quarter a year earlier. 

These are not just numbers. They represent patients who could not get the care they needed when they needed it. 

The Federal AMA’s 2026 Public Hospital Report Card paints the same picture. In NSW, too many patients are waiting too long in emergency departments, and performance has gone backwards on key measures over recent years. The report shows the proportion of emergency department visits completed within four hours remains well below pre-COVID levels, and NSW continues to face serious pressure across emergency and planned care. 

Governments cannot keep pretending this can be fixed with another announcement, another pilot program or another short-term funding patch. Doctors are tired of being asked to carry system failure on goodwill alone. 

Hospital funding must be transparent, needs-based and sufficient to meet demand. The Commonwealth must also pay its fair share. For years, the AMA has called for public hospital activity to be funded on a genuine 50-50 basis between the Commonwealth and the states and territories. That has not happened.  

We also need to get serious about preventive health. The Special Commission of Inquiry into Healthcare Funding recommended that preventive health should become, and remain, a long-term whole-of-NSW-Government priority. That recommendation must not be allowed to gather dust. It must be built into funding, planning and service delivery. 

If governments want to reduce pressure on hospitals, they need to invest earlier and general practice is central to this. GPs are the front door of the health system, but too often they are expected to manage increasingly complex patients without the funding, time or support required. When general practice is under pressure, patients end up in emergency departments, public hospital clinics and specialist rooms.  

Then, when the costs of that care are higher, doctors are blamed, as we have seen with the Federal Government’s recent attack on specialist fees. 

Excessive fees should be scrutinised. No doctor should be above accountability. But blaming specialist fees will not fix stagnant Medicare rebates, rising practice costs, pressure from private insurers, failures in workforce planning, or a public system that cannot meet demand. 

That is also why the current VMO arbitration matters so much. 

VMOs are a critical part of the NSW health system and public hospitals cannot survive without them. They provide specialist expertise, surgical care, procedural care and continuity for patients who rely on public hospitals. But goodwill cannot be allowed to become the business model for public healthcare. 

This arbitration is about more than one group of doctors. It is about whether NSW can continue to attract and retain the skilled medical workforce needed to deliver safe, timely and high-quality care. If VMO arrangements are allowed to fall behind, the impact will be felt by doctors, hospitals and patients. 

AMA (NSW) has committed significant resources to this fight because the outcome matters for the whole profession. We will continue to keep members informed as this process progresses, and we will continue to stand firm in defence of fair, sustainable and workable arrangements for VMOs. 

And, finally, membership matters. If you are already a member, thank you. Your membership strengthens our advocacy and allows AMA (NSW) to take on the major issues affecting doctors across NSW. 

If you are not yet a member, now is the time to join. The stronger our membership, the stronger our voice.

I am taking on this role because I believe AMA (NSW) has a critical responsibility to be the strongest possible voice for the profession. 

Our members are not asking for special treatment. They are asking for a health system that works, conditions that are fair, and policies that put patients and doctors ahead of political convenience. 

Over the next two years, I look forward to working with vice president Dr Theresa Ly, Dominique Egan, our Board, Council, members and staff to ensure AMA (NSW) remains a strong, effective and fearless advocate for the medical profession. 

There is much work ahead, and we are ready to get on with it.