Bulk-bill GP clinics in NSW fall from half to one-third as workers miss out on healthcare ‘cornerstone’

The battle to find an affordable GP is now harder than ever for working adults in NSW. Here’s why.

The battle to find an affordable GP is now harder than ever for working adults in NSW with just one in three clinics taking on new bulk-billed patients.

A new study by healthcare directory service Cleanbill has found 34.5 per cent of GP clinics in NSW bulk-bill, a dramatic fall from the 49 per cent who reported they would bulk-bill all new patients two years ago.

The 2025 Blue Report surveyed more than 6,900 GPs nationwide on their availability to take on new clients and bulk-bill all eligible non-concession adults, as well as taking an estimate of their average out-of-pocket charge for a standard consultation.

It found just 20.7 per cent of GPs nationally provide universal bulk-billing, and Cleanbill couldn’t find a single GP clinic in Tasmania that met the criteria.

NSW had by far the highest rate of bulk billing of any jurisdiction but among the highest out-of-pocket costs, rising from an average of $41.06 in 2023 to $44.05 in 2025.

Bulk billing rate 2023-2025 for all jurisdictions, based on number of GP clinics who will bulk-bill all new non-concession patients. Picture: Cleanbill

While there are “positive takeaways” from the NSW figures in comparison to the nationwide picture, Cleanbill founder James Gillespie said, “it’s important to put them into context”.

“Bulk billing and access to affordable and available GPs ... is the absolute cornerstone of our healthcare system,” he said.

Average out of pocket costs from 2023-2025 for all jurisdictions, based on price quoted. Picture: Cleanbill

“You should be able to go and see a GP, regardless of your economic circumstances, and get the same level of care.

“These statistics indicate that that’s less and less likely to happen.”

Australian Patients Association CEO Lisa Robins said the decline is “deeply troubling”.

“Working Australians grappling with the cost of living ... often feel excluded from bulk billing services, which they perceive as being reserved for concession card holders, leaving them feeling overlooked and unsupported by the healthcare system,” she said.

Lisa Robins, CEO of the Australian Patients Association. Picture: Supplied

Dr Michael Bonning is a former medical officer in the Royal Australian Navy who is now a reservist and civilian GP, pictured at home in Elizabeth Bay. Picture: Toby Zerna

Australian Medical Association NSW councillor and inner west GP Dr Michael Bonning said the report’s findings reflect long-term “under-indexation” of the Medicare rebate.

In 2013 the Gillard Labor government temporarily froze indexation on the rebate, which continued for several years under Coalition governments and never readjusted to compensate.

“When you combine that under-indexation with significant inflationary pressures, you get to a breaking point where general practices need to bulk-bill fewer patients or increase the average out-of-pocket fee to … keep the place running and retain good staff,” Dr Bonning said.

Royal Australian College of General Practitioners (RACGP) president Dr Michael Wright said the study shows it is “crucial” that the federal government invests more into Medicare, with patients missing out on “billions of dollars” in rebates.

“If they don’t have access to high quality GP care, they’re more likely to end up in emergency departments or hospitals,” he said.

“That’s not good for their health, and it’s not good for taxpayers who end up ultimately paying for the system.”

RACGP President Michael Wright.

A recent NSW Bureau of Health Information survey of emergency department patients found 28 per cent believed a GP or another health professional could’ve treated them, at least to some extent.

Dr Bonning said in addition to increasing the Medicare rebate itself, governments should incentivise bulk-billing by increasing funding for practice nurses, and raising total spending on general practice from 6.5 to 10 per cent of the health budget.

When contacted by The Daily Telegraph, federal Health Minister Mark Butler did not address specific interventions raised by GPs, and disputed the Cleanbill study’s findings.

Department of Health data shows over 77 per cent of GP visits – including concessions – were being bulk-billed as of November 2024.

“After we tripled the bulk billing incentive for GPs, bulk billing has started rising again in every state and territory – delivering an additional 5.8 million free visits to the GP in just 13 months,” the Minister said.

“We know there’s more to do to keep strengthening Medicare after a decade of cuts and neglect from the Liberals, and we are committed to doing it.”

Do you have a story for The Daily Telegraph? Message 0481 056 618 or email [e-mail]

Originally published as Bulk-bill GP clinics in NSW fall from half to one-third as workers miss out on healthcare ‘cornerstone’