GPs juggling rising costs and bulk billing
Doctors say the cost of providing healthcare is growing amid a push to get more GPs to offer no-gap care to patients.
Only 12 per cent of general practitioners say they bulk bill all of their patients, and 8.8 per cent of people – the highest on record – delay going to the doctor because of cost, a new survey of GPs has found.
The cost of seeing your doctor has also gone up from an average of $75 to $82 this year, leaving an average gap fee of about $39 to be paid by patients from their own pocket.
Those are key takeaways from the upcoming Health of the Nation report, to be released by the Royal Australian College of General Practitioners next week, and comes ahead of bulk-billing changes due to come into effect on November 1, based on pledges made during the last federal election campaign.
The annual report draws on survey responses from the nation’s GPs and is designed to provide policymakers with insights into the state of general practice and how patients access care.
According to an early release of data from the report, figures from 2023–24 show 8.8 per cent of people reported delaying seeing a GP due to cost. That’s a 25 per cent increase, up from 7 per cent the previous year, and the highest rate on record.
“Everyone should be able to see a GP when they need to,” said RACGP president Michael Wright, as he pointed to multiple factors leading to more expensive care.
“We are treating more complex health conditions and that takes more time,” Dr Wright said.
“The costs of running a practice are increasing – from staffing to electricity and council rates.
“The majority of visits are still delivered without cost to the patient, but there are definitely ongoing cost pressures on general practice.”
The report shows that just 12 per cent of GPs reported bulk billing all of their patients. The percentage of doctors who said they bulk billed most of their patients decreased slightly to 36 per cent, while the percentage of those bulk billing a minority to no patients was about 40 per cent.
“While only 12 per cent of GPs can now afford to bulk bill all patients, most GPs still report bulk billing the majority of their patients,” Dr Wright said.
The report’s release comes ahead of bulk-billing changes that formed the cornerstone of the government’s re-election campaign and led to pledges that, in combination with emergency care clinics, nine out of 10 GP visits would be free for patients by the end of the decade.
From November, GPs and practices will share in added financial incentives if they bulk bill every eligible service and patient. In another change, bulk-billing incentives will no longer be restricted to certain groups, such as children and concession cardholders, and will instead be available to cover any person who has a Medicare card.
The government hopes the changes will encourage more doctors and clinics to offer bulk billing so fewer patients are left to pay out-of-pocket to see the GP.
“While the coming additional government investment in general practice is very welcome, these new incentives are targeted, and we are waiting to see which practices and patients they will work for,” Dr Wright said.
“Extending these bulk-billing incentives to everyone doesn’t necessarily mean everyone’s going to get bulk billed if patient rebates remain too low to cover the cost of care.
“Funding gets results. We need stronger investment in patient rebates to make care affordable for all Australians. We’ve been arguing for a long time that patients increasingly need more mental health support, and they need more support to manage chronic and complex conditions, and that needs longer consults and more Medicare funding to support them.”
Either way, Dr Wright hoped statistics from the RACGP’s report would provide a benchmark to help gauge how the policy worked in practise.
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