The Sydney suburbs missing out on free GP visits

Fewer than half of children in some of Sydney’s most affluent suburbs are being bulk-billed for GP visits, while adults across NSW are paying more to see the doctor than last year, as the state’s health minister urged the federal government to put Medicare reform at the centre of its election pitch.

Children and older patients across Sydney and NSW are more likely to visit the doctor for free now than a year ago after the Albanese government tripled the incentive paid to GPs who bulk-bill their most vulnerable patients.

A patient is bulk-billed when Medicare rebates cover the full cost of a GP visit. A lower proportion of overall appointments are being fully covered by the government than when federal Labor came to power in May 2022. Patients aged between 16 and 64 are seeing the biggest slide in bulk-billing rates.

In NSW, an analysis of Medicare data shows the government’s strategy of incentivising bulk-billing of children, older people and concession card holders – particularly in regional Australia – has boosted free visits for those communities even as the overall rate has declined.

Regional towns such as Walcha, Tamworth and Griffith saw the biggest rise in bulk-billing of children. North Sydney, Mosman, and the northern beaches also saw higher rates, although bulk-billing in more affluent areas of Sydney remained low, with fewer than half of patients 15 years old and younger in Woollahra and Mosman visiting the doctor for free.

A vast majority of appointments in Sydney’s west were bulk-billed, but working adults in suburbs including Liverpool, Burwood, Parramatta and Bankstown were less likely to be bulk-billed than they were 12 months ago.

Royal Australian College of General Practitioners president Dr Michael Wright said bulk-billing rates varied across Sydney, but access to free GP visits shouldn’t depend on your postcode. Credit: Dion Georgopoulos

Federal Health Minister Mark Butler said the government’s $3.5 billion investment had arrested the “freefall in bulk-billing”, and flagged future investments in Medicare ahead of the federal election.

NSW Health Minister Ryan Park, who has repeatedly attributed unprecedented demand and strain on the state’s public hospitals to the collapse of primary care, said he was encouraged by the Albanese government’s plans to “put Medicare at the centre of the federal election campaign”.

“I am very concerned that the decline of bulk-billing is forcing people into impossible choices of either treating the ED like a GP clinic, or forgoing care, having their condition deteriorate and ending up in hospital,” Park said.

A separate analysis by Cleanbill, a website that polls GP clinics on gap fees and bulk-billing, found only one-third of clinics in NSW would bulk-bill a new adult patient.

The survey of more than 6000 GP clinics across Australia found non-bulk-billed patients were paying $43 out-of-pocket on average for a standard consult, $2 more than last year.

Royal Australian College of General Practitioners president Michael Wright said increasing Medicare rebates across the board would help boost bulk-billing rates and reduce rising out-of-pocket costs for all patients.

“We need to make sure that all Australians have affordable access to a GP – and that it doesn’t depend on your postcode,” Wright said.

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