Only a quarter of GP clinics are now bulk billing, new survey shows

Government rebates are not matching soaring costs for doctors, a new survey says, and patients are paying the price for the yawning gap.

Bulk billing is on the skids in Adelaide as GPs facing rising costs not being matched by rising rebates.

Just over one in four GP clinics now offer bulk billing in regular business hours, a new survey shows, compared to the national average of almost 43 per cent.

The average out of pocket gap in Adelaide is $34.81 for a standard 15 minute consultation but this varies widely across the city.

Greater Fleurieu Medical Clinic closes.

The national survey of 4188 GP clinics by Cleanbill was held between August and December — but more clinics such as the Blair Athol Medical Clinic ceased bulk billing on January 1.

Cleanbill.com.au is a free online healthcare directory allowing patients to find GPs near them and compare them by the price of their basic services.

Its survey covered 291 GP clinics in Adelaide and found just 81 bulk billed.

It also found 27 were not taking any new patients, further reducing access — and adding to strain on hospital EDs.

Cleanbill founder James Gillespie said it appears more clinics are moving to charge a gap.

“Anecdotally, our callers who spoke to the practice managers found many said while they were bulk billing when the survey was taken, they indicated they would likely stop in the coming months,” he said.

The survey found a clinic at Belair charged the highest gap in Adelaide at $54.42 while one at Salisbury had the lowest at $12.75.

Blair Athol Medical Clinic practice owner Dr Kamal Wellalagodage has tried everything from lobbying politicians to a street protest to gain support in an area with economically disadvantaged and culturally diverse patients.

He wants restrictions eased to allow overseas trained doctors easier access to the area.

“We stopped bulk billing on January 1 — we tried hard but the government did not care,” he said. “Many patients cannot afford to pay a gap, it is very difficult.”

Dr Kamal Wellalagodage, with patient, Max Moldovan. Picture Dean Martin

Federal Health Minister Mark Butler has ordered his department to supply him with an accurate picture of the state of bulk billing, saying “primary care is in its worst shape since Medicare began.”

Royal Australian College of General Practitioners SA & NT president Dr Sian Goodson.

“Across the country we hear stories of Australians not being able to get in to see a bulk billing doctor or GPs changing from bulk billing to mixed billing,” Mr Butler said.

“The reality is after nine years of cuts and neglect from the former government it’s never been harder or more expensive for Australians to see a GP.”

State health minister Chris Picton said: “A lot of the demand we are seeing in the hospital system is because people are finding it almost impossible to get in to see a GP when they need to, it’s an absolute crisis.”

Royal Australian College of General Practitioners state president Dr Sian Goodson said practices across Australia are being forced to move from bulk billing because Medicare patient rebates are too low and don’t reflect the cost of providing high-quality care.

“GPs are struggling to make ends meet,” she said. “Medicare rebates weren’t set at an appropriate level from the outset and have never been properly indexed, and the Medicare freeze ripped further funding from GP patients.

“A staggering $2bn has been taken from general practice patients due to the freeze and inadequate indexation.

“We are very concerned about the road Australia is going down. Without proper investment in general practice care, it will get worse.”

Adding to pressure, baby boomer GPs are preparing to retire — some earlier than expected — while young doctors are shunning the GP path to instead opt for other specialties or stay in the public hospital system.