General practitioners will be incentivised to bulk bill more of their patients through a tripling of the fee they receive for bulk billing, at a cost to the budget of $3.5bn over five years.
This and other spending on health and aged care appears squarely aimed at improving access to primary health care, and taking pressure off more expensive hospitals and residential aged care.
The bulk-billing incentive, targeted at children, pensioners and other commonwealth concession card holders, is likely to be welcomed by GPs and patients alike as it should help arrest the slide in the number of GPs who treat their patients for the amount they get back from Medicare without any out-of-pocket costs.
In 2022-23 only 64% of patients were fully bulk-billed compared to 67% a year earlier.
GPs have warned that the freeze on indexing of Medicare rebates, in place since 2014, had put their practices under enormous pressure, making it increasingly difficult for them to make a living and and bulk-bill patients.
The Australian Medical Association had been lobbying for a lift in Medicare rebates but the tripling of the bulk-billing incentive, which the health minister, Mark Butler, described as “the largest in Medicare’s 40-year history”, will likely go part of the way to improving access for those least able to pay for doctor visits.
The AMA president, Steve Robson, said: “All in all, we are very happy.”
The government said the measure would have immediate benefits for more than 11 million people, with flow-on benefits for all Australians.
The incentives will cover many common GP consultations, including telehealth and videoconference, Butler said.
The government has also allocated $98.2m for new Medicare rebates for patients who require consultations of longer than 60 minutes. This would support doctors to provide high-quality care to people with chronic or complex needs, the government said.
There was also $445.1m so GP clinics could employ people in allied health care, $951.2m for digital health and $29.8m as an initial investment to reduce fraud, after an investigation found a concerning level of misclaims by doctors.
The budget also provides an additional $358.5m for eight more Medicare urgent care clinics, taking the total to 58 around the country. The government said these would free up overstretched GPs, take pressure off hospitals and improve access to affordable care.
Urgent care clinics are generally located near hospitals and aim to provide patients with alternatives to visiting the emergency ward after hours.
As previously announced, the government is also aiming to drive down the cost of medicines by allowing patients to buy two months’ supply of 320 common medications at once and at the same price as they previously paid for one. Medicines on the PBS are generally capped at $30 and $7.30 for concession card holders.
This will halve patients’ visits to the GP and pharmacist – saving patients an estimated $1.6bn ($180 a year each) and free up millions of GP appointments, Butler said.
The budget also expands public dental service, providing 360,000 adults on lower incomes with continued access to public dental services worth $219.4m.
Pharmacists may lose foot traffic under the new prescription arrangements but they will be front and centre of new rules designed to curb vaping.
The budget allocates $247.4m towards a new anti-smoking and anti-vaping campaign along with more information and support to help people quit.
The government is also proposing stronger regulation and enforcement of e-cigarettes, including new controls on their importation, contents and packaging, with pharmacists to dispense vapes under prescription in the future.
It has also allocated $502.2m for stronger preventive health, including a new national lung cancer screening program targeting those most at risk which is predicted to prevent more than 4,000 deaths in Australia.
As previously announced, the government will give aged care workers a 15% pay rise, as recommended by the Fair Work Commission, costing $11.3bn.
“Aged care workers have been undervalued and underpaid for too long – we are supporting a wage increase for them because it’s the right thing to do,” Butler said.
However, the government is booking some savings in the aged care portfolio to the tune of $2.2bn, by temporarily reducing its assumptions of how many people will need residential aged care.
The residential aged care provision ratio is being cut from 78.0 places to 60.1 places per 1,000 people aged over 70 years.
“The reduction in the ratio reflects the increasing preference of older Australians to remain in their homes, and will save $2.2bn over three years from 2024–25,” the budget papers say. The savings will be redirected to the government’s commitments in the health and aged care portfolio.
The budget provides 9,500 additional home care packages, to be released in 2023-24.
The fight against Covid-19 continues to cost the budget, with more than $2bn over the next two years allocated for continuing vaccination programs, free pathology services, and responses to outbreaks in aged care homes.
The government has allocated $91m towards setting up a Centre for Disease Control to meet the challenges of future pandemics.
