An adult without concessions would not be able to find a bulk billing GP in 10% of electorates, according to a new report.
The online healthcare directory Cleanbill on Sunday released an electorate breakdown of its third annual Blue Report based on a survey of 6,925 general practices carried out during October 2024.
The Blue Report, published in January, found that for new adult patients without a concession card, four out of five GPs will charge a gap fee.
Cleanbill collects its information, according to its founder, James Gillespie, by compiling a list of general practices nationally, which they call to ensure they are an operating GP clinic, ask if they bulk bill adult patients and, if not, what out-of-pocket fees they charge.
Data managers then check that information against what is stated on clinics’ websites and repeat calls until they can ensure consistent information.
When it comes to what is happening across the 151 commonwealth electoral divisions, Cleanbill was unable to find any available bulk billing clinics for adult patients in 15 electorates, compared with four in its first report in 2023.
Those 15 electorates were Bass (Tasmania), Boothby (South Australia), Braddon (Tasmania), Brisbane (Queensland), Clark (Tasmania), Fairfax (Queensland), Franklin (Tasmania), Jagajaga (Victoria), Kingston (SA), Lyne (New South Wales), Lyons (Tasmania), Mayo (SA), Newcastle (NSW), Shortland (NSW) and Swan (Western Australia).
The report found there were still 12 electorates with bulk billing rates exceeding 50%, of which nine were located in western Sydney.
While some electorates have gained bulk billing clinics since 2023, Cleanbill found the majority (86.7%) had fewer with an average drop of 13.7% in the two-year period.
The electorate of Burt in WA experienced the greatest decrease in bulk billing rates from 61% in 2022-23, dropping to 6.5% in 2024-25, followed by Gorton in Victoria, dropping from 64% to 15% in the same period.
Gilmore in NSW experienced the largest increase in bulk billing clinics, from 10.9% in 2022-23 to 23.5% in 2024-25, followed by Cowper (NSW), which rose from 2.6% to 13.5%, in the same period.
Cleanbill found the electorate of Chifley in NSW had the greatest decrease in average out-of-pocket costs, from $50.25 in 2022-23 to $22.92 in 2024-25, followed by Parramatta in NSW, from $56.85 to $35.70 in the same period.
Meanwhile, Watson (NSW) experienced the largest increase in average out-of-pocket costs, going from $24.54 in 2022-23 to $36.52 in 2024-25, followed by Wide Bay in Queensland, rising from $39.67 to $49.71 in the same period.
Dr Christopher Harrison from the Menzies Centre for Health Policy and Economics at the University of Sydney said Cleanbill’s results were based on patients not covered by the incentives the government introduced in 2023, which increased the amount that GPs receive when they bulk bill children and concession card holders.
“This likely explains why the government can point to a well-documented increase in bulk billing rates overall, while at the same time Cleanbill finds that it has become increasingly difficult for an adult who does not have a concession card to find a GP practice that will bulk bill them,” Harrison said. “These two results are not contradictory.”
There are likely to be existing patients already on a practice’s books who are and will continue to be bulk billed, as well as cases where a patient with financial difficulties could be bulk billed based on GP discretion, he pointed out.
“These data do highlight a growing issue within our healthcare system,” Harrison said. “A sustainable way to incentivise GPs to bulk bill this patient group needs to be found.”
The health minister, Mark Butler, said: “Official data shows our record investment to strengthen Medicare has stopped the freefall in bulk billing that was created under the Coalition Government.
“After we tripled the bulk billing incentive for GPs, bulk billing has started rising again in every state and territory – delivering an additional 5.8m free visits to the GP in just 13 months.”
Nationally, 77.2% of all GP visits were bulk billed in November 2024, he said, an increase of 1.6% from October, before the investment took effect.
The president of the Australian Medical Association, Dr Danielle McMullen, said the Cleanbill report provided a “limited” snapshot of GP billing practice.
“The Productivity Commission’s authoritative report on government services tells a much clearer story – commonwealth spending per person on general practice has declined since 2018/19, and more patients are delaying GP visits due to cost.”
The president of the peak body for general practitioners, Dr Michael Wright, said: “All Australians need affordable access to a GP who knows them. With a federal election fast approaching, we should be seeing bold commitments from all political parties to achieve this.”
