Bulk-billing GP clinics around Australia listed

Access to clinics where all patients are bulk-billed varies wildly, as the government prepares for a new program encouraging GPs to waive patient fees. SEARCH YOUR SUBURB

Janelle Carroll, pictured with her son Jordan, believes everyone should have access to free healthcare. Picture: Jason Edwards

Access to general practices where all patients are bulk-billed fluctuates based on where you live, new analysis shows, and doctors hold concerns incoming reform will only reward those churning through appointments.

An analysis of Healthdirect Australia data found the Northern Territory had the highest rate of bulk-bill only clinics per 100,000 people.

NSW and Victoria came in second and third, while the Australian Capital Territory had the worst rate, followed by Tasmania and WA.

Mixed-billing — where some patients, like kids or seniors, are bulk-billed — is the most common fee structure for Australian clinics, according to Healthdirect.

NSW had 533 universal bulk-billing clinics, Victoria 352, QLD 214,WA 62,SA 51, the NT 46,Tasmania nine and the ACT five.

A new program being introduced in November will see participating practices receive an additional 12.5 per cent incentive payment on Medicare rebates, split between the GP and the clinic.

Participating practices must bulk bill every eligible service for every patient to receive the payment.

Health department modelling estimates about 4800 general practices will be in a better financial position if they adopt full bulk-billing – meaning they will gain more in additional Medicare payments than they would lose in patient fees.

Health Minister Mark Butler said he was “very confident” that a 90 per cent bulk-billing rate by 20230 target will be hit.

Royal Australian College of General Practitioners president Michael Wright said the college expected the incentives would increase bulk-billing rates, and it’s likely some practices would move to a 100 per cent bulk-billing model.

GP attendances without a referral had a bulk-billing rate of 77.4 per cent between July and March, according to health department data, up from 76.7 per cent last year.

NSW had the highest rate (81.9 per cent) and the ACT the lowest (52.8 per cent).

RACGP president and Sydney GP Dr Michael Wright. Picture by Max Mason-Hubers

“While the initiative is likely to support more consults being bulk billed, GPs and practices will only change their billing practices if they are sure it’s in the long-term interests of their patients and their practice’s viability,” Dr Wright said.

“The feedback we’ve received from GPs indicates the structure of the incentives may be a driver to encourage short consultations, yet increasingly, longer consults are what our patients need.

“It is important to both increase bulk-billing rates and reduce costs for patients who aren’t bulk-billed.”

He said general practices needed sufficient support to ensure they remained financially viable and could continue to provide high-quality care to the community.

Geelong GP Bernard Shiu’s two practices are mixed-billing, and offer bulk-billing to some patients like kids and veterans.

He said changes coming in November would mean universally bulk-billing clinics could maintain that model, and some lower-cost mixed billing clinics may make the switch.

GP Bernard Shiu with some flu shots. Picture: Mark Wilson

He said many universal bulk-billing clinics had been moving away from the model because the incentives were “horrible” and the rebates unsustainable.

“The government has finally understood that in the business sense, it doesn’t work,” Dr Shiu said.

Dr Shiu said the bulk-bill only business model relied on high volumes of patients.

But he said he required more time with his and would not be shifting to universal bulk-billing as he would “lose money big time”.

Mr Butler said modelling was based on current appointment times and “not some hypothetical change to the time of consultations becoming shorter”.

Janelle Carroll and her 4yo son Jordan. Picture: Jason Edwards

Belgrave Heights mum Janelle Carroll recently needed to find her four-year-old son a new GP because his was only bulk-billing children at certain times.

But to get an appointment at the necessary time was “impossible” and she faced a gap fee of $45, she said.

Ms Carroll, who also has two teenagers, said free healthcare should be available to everyone.

Healthdirect Australia National Health Services Directory general manager Prashan Malalasekera said the directory included billing options and opening hours.

“Our role is to ensure this information is current and accurate so that consumers can access trusted information about the health services near them,” he said.

Data caveats include that some clinics listed are single GP rooms while others are multi-doctor practices, or they may have changed their billing structure.

Originally published as Bulk-billing GP clinics around Australia listed