"Dr P", an American surgeon, says he was bullied, harassed and discriminated against as he tried to have his skills recognised in Australia. Credit:Brian Cassey The action came as two former chiefs of the ACCC said governments needed to get over their fear of taking on powerful medical lobby groups and investigate the college of surgeons to see if it was restricting the supply of surgeons in Australia. Professor Allan Fels, chairman of the ACCC during the 1990s, when it investigated the college for limiting entry to the profession, said it was time for the regulator to reopen its probe. "Prima facie, the college faces a case to answer," he said, adding that it also had "unacceptable" conflicts of interest. But Professor Fels said governments needed to collaborate with the ACCC, because they had given the watchdog insufficient support in the past.

"Governments have been reluctant to take strong action because of a fear of the surgeons' lobby and because of some ill-advised concerns that the more surgeons, the more operations, and the more costs to government," he said. "It's part of the Harper inspired competition reforms that anti-competitive practices by surgeons be put under the microscope." A spokesperson for the college of surgeons said it had been scrutinised by the ACCC in detail, met all its requirements and that there were no outstanding issues under consideration. She said the college had issued guidance to its members on fees and that patient safety was its only consideration when deciding who practises surgery. "The college meets all the accreditation requirements of specialist colleges set by the Australian Medical Council, including in relation to formal and transparent processes," the spokesperson said. "The college has owned the problems of discrimination, bullying and sexual harassment in the profession and is 100 per cent committed to dealing with them."

But Professor Graeme Samuel, who chaired the ACCC during the 2000s when it monitored the college, said its secrecy and control over selection processes had the power to affect the prices surgeons charge Australian patients. "Control over competition almost invariably results in lowering of quality or higher prices," he said. Professor Samuel said most medical colleges in Australia were "closed shops" and that health ministers needed to "take charge" and open them up to more scrutiny to benefit patients. In the late 1990s, the ACCC investigated allegations the college was illegally restricting entry to the profession, including through its assessments of overseas-trained surgeons. The college avoided legal action by allowing the ACCC to monitor its training and assessment processes until 2009. Professor Samuel said that during this time, state and territory health ministers "told us to back off".