Your ref: A1307290
28 May 2026
PRIVATE AND CONFIDENTIAL
Mr Peter Rundle MLA
Chair
Community Development and Justice Standing Committee
Legislative Assembly of Western Australia
Parliament House
4 Harvest Terrace
West Perth WA 6005
By email: cdjscsubmissions@parliament.wa.gov.au
Dear Chair
SUBMISSION TO THE INQUIRY INTO GUARDIANSHIP AND ADMINISTRATION IN WESTERN AUSTRALIA
The Australian Medical Association (WA) [AMA (WA)] welcomes the opportunity to contribute to the Community Development and Justice Standing Committee (Standing Committee) inquiry into the guardianship and administration system in Western Australia.
We focus this submission on Term of Reference 7 — the role and conduct of the State Administrative Tribunal (SAT) — and, in particular, on a discrete but important issue: the ongoing lack of reimbursement for medical practitioners who prepare medical reports required for proceedings under the Guardianship and Administration Act 1990 (WA) (the Act).
1. The role and conduct of the SAT
SAT decision-making in this jurisdiction depends on timely, high-quality medical evidence. However, the current system relies heavily on unfunded and uncompensated clinical labour, often provided by non-salaried treating General Practitioners (GPs) and other non-GP specialists working outside the public sector, to perform an essential statutory function for vulnerable Western Australians.
In collecting evidence about a person’s capacity, the SAT exercises statutory powers and depends on the cooperation of medical practitioners to provide reports without which it cannot carry out its role.
However, although section 16(2) of the Act provides that SAT may approve payment to defray costs and expenses incurred by a person who, at SAT’s instigation, gives evidence or information,
SAT has advised that it is unable to approve such payments because Parliament has not appropriated funding for that purpose. The result is that the SAT’s core processes systematically externalise costs onto medical practitioners and their practices. The system’s current design creates an unfair and unsustainable burden on clinicians.
As noted above, many GPs and non-GP specialists are not salaried employees. They are typically contractors or sole traders, and these reports are often completed in their personal time or during practice hours, reducing their capacity to treat patients. Without reimbursement, these non-salaried medical practitioners and their practices bear the full cost, unlike salaried medical practitioners who predominantly work in the public sector.
Moreover, there is presently no Medicare item available specifically for the preparation of SAT medical reports, and there is no indication this will change in the foreseeable future.
In addition, medical practitioners often require the assistance of practice staff to complete medical reports, representing a further financial imposition. Medical practitioners providing services in residential aged care facilities and rural and regional areas are more likely to be required to complete SAT medical reports and are disproportionately out-of-pocket. They typically face higher travel costs, limited administrative support, and reduced access to Medicare rebates.
Against the backdrop of broader cost-of-living pressures and increasing demand on primary care, continued reliance on medical practitioners and their practices to absorb the costs of this unpaid work is becoming increasingly unsustainable. Medical practitioners are compelled to subsidise the costs of this key aspect of the guardianship and administration process when it should rightfully be funded by the State.
2. The burden on medical practitioners is real, growing and inequitable
Demand for SAT-instigated medical reports is likely to increase as Western Australia’s population ages and the prevalence of dementia, cognitive impairment, neurological conditions and mental ill-health continues to rise.
As outlined in the SAT’s 2024-2025 Annual Report, the number of applications under the Act has increased by 16% from 6,061 in 2023-24 to 7,026 in 2024-25. Of these, the number of applications the SAT received for the appointment of new guardians and/or administrators increased by 18% from 2,860 in 2023-24 to 3,379 in 2024-25.
These figures demonstrate that the demand for medical evidence supporting SAT proceedings is not isolated or occasional, but systemic and growing.
The AMA (WA) understands that GPs may spend approximately 30 to 46 minutes preparing a SAT medical report, depending on the complexity of the matter. While unaware of the number of medical reports required by the SAT from medical practitioners last financial year, it would be fair to assume a close correlation with the increasing number of applications the SAT received for the appointment of new guardians and/or administrators in 2024-25.
The Public Advocate, in her appearance before the Standing Committee on 25 June 2025, also referred to growing concerns regarding vexatious applications for guardianship and administration. Such applications may generate additional requests for medical evidence and further increase pressure on already stretched clinicians and practices.
3. System administration and filing practices can compound the burden (eCourts / lodgement)
This submission is not confined to the issue of a lack of reimbursement for report preparation for the SAT. The AMA (WA) has previously raised an instance with Government where interruptions or constraints in SAT lodgement processes through the eCourts portal have shifted further costs onto a practitioner. Of particular concern, the AMA (WA) was informed of an instance where a medical practitioner, in February 2026, was reportedly instructed by SAT staff to hand-deliver a report when online lodgement through the eCourts portal was unavailable, and use alternative electronic channels was not permitted. The AMA (WA) considers this especially unreasonable for rural and regional practitioners and an avoidable diversion of limited clinical resources.
While the AMA (WA) understands practitioners may lodge reports by post or by facsimile, these channels are not always feasible in contemporary clinical practice. In particular, standard postal delivery cannot guarantee receipt within the timeframes required for SAT matters, and the use of express post introduces an additional cost overhead for practices — again with no reimbursement mechanism. In addition, many medical practices no longer maintain facsimile capability as healthcare providers continue transitioning away from legacy technologies toward secure digital communication systems.
The AMA (WA) understands that email was removed as an accepted method of filing effective 1 July 2023. The AMA (WA)’s concerns were reinforced by remarks from the Chief Justice of Western Australia, Hon Peter Quinlan, reported in The West Australian on 5 February 2026, regarding significant and ongoing disruptions associated with outdated court information technology infrastructure.
4. Law Reform Commission and Government acknowledgement
In its Final Report for Project 114 on the Act, the Commission stated that “the lack of remuneration for medical and other experts who spend time completing and giving evidence in proceedings under the Act should be addressed”.
The Commission in reaching this view received representations not only from the AMA (WA) but also from the Commission’s Medical Expert Reference Group which “highlighted that General Practitioners are central to a person’s care; and alongside this, they are time poor and not paid, reimbursed or able to bulk bill for reports provided for the purposes of assessing a person’s decision-making capacity under the Act”.
The Chief Medical Officer also told the Commission that the lack of remuneration for medical professionals becomes a “serious matter” because it may result in assessments being conducted under time pressure and in less-than-optimal environments.
However, the Commission ultimately did not make a formal recommendation on this issue, noting that reimbursement arrangements would not ordinarily be addressed in legislation and may intersect with Commonwealth Medicare settings.
The AMA (WA) notes and appreciates advice from the Attorney General, Hon Dr Tony Buti MLA, in May 2026, that he is giving careful consideration to reimbursement under section 16 of the Act and that the Department of Justice has been instructed to investigate the matter.
The AMA (WA) strongly agrees with the Commission’s conclusion that this issue requires resolution. The AMA (WA) respectfully submits that the Standing Committee is well placed to recommend a practical Western Australian solution that does not depend on Commonwealth
involvement — namely, a State-funded reimbursement mechanism for SAT-requested medical reports.
5. Recommendations sought
If the issue remains unresolved before the Standing Committee reports on 27 May 2027, the AMA (WA) respectfully submits that the Standing Committee should expressly recommend the Western Australian Government establish and fund a formal reimbursement framework for medical practitioners who prepare reports requested or required by SAT under the Act, including by:
- (1) making a recurrent budget appropriation sufficient to enable SAT to approve and pay such reimbursements, retrospectively and prospectively, consistent with section 16(2) of the Act; and
- (2) establishing a clear, transparent administrative mechanism, including an agreed fee schedule subject to annual indexation, and straightforward claiming processes, developed in consultation with relevant stakeholders such as the AMA (WA).
In addition, the AMA (WA) respectfully requests that the Standing Committee recommend the establishment of sustainable contingency electronic lodgement processes in the event of eCourts portal and other outages.
6. Conclusion
For medical practitioners, reimbursement is not a financial windfall — it is a system safeguard that supports the integrity, sustainability and accessibility of the guardianship and administration framework:
- It supports timeliness and quality of medical evidence for capacity determinations.
- It discourages rushed completion or avoidance of report requests from the SAT due to uncompensated workload (a risk flagged with the Commission).
- It is especially important for aged care and regional/rural communities where the burden is concentrated.
The AMA (WA) would welcome the opportunity to provide further information or appear before the Standing Committee should the Standing Committee deem it necessary.
Yours sincerely
redacted: s47F - Personal privacy
Dr Kyle Hoath
AMA (WA) President