NSW budget 2024: Bulk billing incentives for GP clinics

Doctors will bulk bill more patients across the state after the Minns government waived looming unpaid GP payroll taxes and introduced tax incentives for clinics with high bulk-billing rates.

Doctors will bulk bill more patients across the state after the Minns government waived looming unpaid GP payroll taxes and introduced tax incentives for clinics with high bulk-billing rates.

The $189 bulk billing package will write off years on unpaid payroll tax on GPs who contract rooms in clinics without being classified as an employee.

Revenue NSW had been seeking outstanding payroll tax from GP clinic after a landmark case in 2021 found GPs on independent contacts owed the state millions. The cost of waiving the outstanding tax to the NSW budget, handed down today, is $104 million.

Medical peak bodies had warned the government for five years, a failure to waive the tax could see GP clinics forced to charge patients an extra $20 per appointment or close their doors. NSW Health estimated that as little as a one per cent decrease in bulk-billing rates equates to more than 3000 additional patients in emergency hospital departments.

As a result Health Minister Ryan Park and Finance Minister Courtney Houssos engaged with doctors groups in meetings over the last year in the attempt to find a palatable outcome that would not push more patients into hospitals.

The Minns government legislated a 12-month pause on payroll tax audits, penalties and interests in September last year after intense lobbying from the medical groups.

All unpaid payroll taxes incurred up to September 4 this year will be waived.

Incentives revealed in the NSW budget will see more doctors bulk billing patients. Picture: Jason Edwards

In addition to the waiver, $77 million in rebates will be available to GP clinics that meet bulk-billing thresholds. Clinics in Sydney will need to bulk bill more than 80 per cent of their patients to be eligible with regional clinics having to bulk bill more than 70 per cent. Around $8 million will be spent on implementation costs.

NSW is the only state to legislate the full retrospective GP payroll tax waiver. Both Queensland and Victoria introduced unlegislated amnesty and exemptions earlier this year.

Finance Minister Courtney Houssos said the initiative would support families struggling with cost of living pressures.

“This is an important cost of living measure to support bulk billing for families right across NSW,” she said.

“It is largely a federal responsibility to support bulk billing, but we understand the importance of primary health care.”

Treasurer Daniel Mookhey addresses the media after delivering this year’s NSW budget. Picture: Newswire / Gaye Gerard

Treasurer Daniel Mookhey said the state government was intervening for the first time to ensure bulk billing rates either “stay the same or get better”.

Australian Medical Association president Dr Michael Bonning said the NSW government had picked up the slack from years of underfunding from the Federal government.

“Legislating ‘no retrospectivity’ will provide certainty for practices and will minimise the risk of more closures of general practices in NSW,” he said.

“Unfortunately, general practice continues to struggle with decades of underfunding from the previous Commonwealth government.”

Royal Australian College of GPs NSW chair Dr Rebekah Hoffman also welcomed the move.

“(GPs) can continue to operate and keep their doors open for patients, without fear of being hit with a huge tax bill that will shut them down,” she said.