The government has vowed that nine out of ten GP visits will be bulk-billed by 2030, but GPs are warning not all practices will take up the offer as longer consults would not see the same level of benefit as shorter ones.
On Sunday Labor launched a major election policy incentivising GP clinics to bulk bill every patient.
In 2023, the Albanese government tripled the bulk-billing incentive for pensioners, concession card holders and families with children, but recent data showed bulk-billing rates were sliding for patients who do not qualify for concessions.
Labor said it would expand the bulk-billing incentive to all Australian Medicare cardholders from 1 November if elected and give clinics who bulk billed every patient an additional loading payment of 12.5% on their rebates.
The Coalition quickly pledged to match the $8.5bn plan “dollar for dollar”.
Under Labor’s promised boost, the bulk-billing incentive, which would apply on standard and longer consultations as well as mental health plans, would be scaled according to how far a general practice is from a major city, with larger payments as communities get more remote.
A GP that currently receives $42.85 from the government for a standard consultation would, under the plan, receive 62% more, getting $69.56 if they were a bulk-billing practice in the cities and metro areas.
In a small rural town it would almost double to $84.86.
However, the Royal Australian College of General Practitioners (RACGP) – the peak body for GPs – warned the government’s proposal may not be adopted by all practices.
RACGP’s president, Dr Michael Wright, told Guardian Australia the injection of funding was “well overdue” but said it may take time for GPs to assess whether the “really big change” will suit their practice.
“Extending those bulk-billing incentives to everyone doesn’t necessarily mean everyone gets bulk billed because, if the patient rebates are still too low to cover the cost [of running a practice, GPs are] not going to be able to take part in this program,” Wright said.
He added that there was concern among GPs that the plan would create “unreasonable pressure to see people too quickly”.
While the government’s proposal gives the biggest incentives for shorter consultations, the college has advocated for increasing the rebate for longer consultations in order to prioritise the care of people with chronic health conditions.
Under Labor’s proposed plan, the payment to GPs for longer appointments is lower.
According the government’s modelling, rebates to bulk-billing GPs for longer consultations of 20 to 40 minutes would increase in cities by 38% – from $82.90 to $114.61 – and by over 50% outside metropolitan areas.
Consultations between 40 and 60 minutes – currently attracting a rebate of $122.15 – would rise 30% in cities to $158.77 and over 40% in rural locations to over $170.
“We just have to make sure that this isn’t going to make it harder for people to get more time with their GP.”
The health minister, Mark Butler, on Monday said the government’s modelling had “very clearly” shown the majority of practices would benefit by offering extended bulk billing and the estimate of nine out of 10 visits being bulk-billed by 2030 was “conservative”.
Butler told ABC News Breakfast: “Our modelling suggests that almost 5,000 general practices will be better off if they move to 100% bulk billing in their practice based on the funding we announced yesterday.”
The Australian College of Rural and Remote Medicine (ACRRM) said the announced expansion of GP training, including the expansion of rural generalist (RG) training places and the move to increase bulk-billing incentives, had the potential to significantly improve healthcare access.
ACRRM’s president, Dr Rod Martin, said: “Under this initiative, a standard bulk-billed consultation at a regional or rural practice will almost double, reducing cost barriers and ensuring more affordable access for patients in rural, remote, and First Nations communities.”
Dr Elizabeth Deveny, the head of the Consumers Health Forum of Australia, agreed doubling the bulk-billing Medicare rate for standard consultations was an important way to tackle limited access to bulk-billing for patients in rural and remote Australia.
“What we have been consistently hearing from consumers for some time now is that they struggle to find providers that will bulk bill them, and they simply cannot afford to see a doctor,” Deveny said.
“This investment, if taken up by GPs, will significantly reduce out-of-pocket costs when consumers see a GP.”
