As more GP clinics abandon or significantly reduce bulk billing, parents and carers say it is becoming harder to find a clinic that routinely bulk bills children.
In response to Guardian Australia’s series on the bulk billing crisis, more than 300 people shared their stories of how healthcare costs are adding pressure to family budgets on top of the rising costs of living.
One woman in her 30s living in Melbourne with two children under three said: “The bottom line is if you have money and can afford private doctors, your child can get assisted in time.”
Her six-month-old recently developed an infection in his finger and the pharmacist told her he needed to see a GP and get antibiotics as soon as possible.
“I tried our bulk-billed doctor but they had no spots available at all, and they said that the nurse couldn’t help, he had to be seen by a GP. So I went to my private GP and they had an immediate appointment but I had to pay $80. I was able to manage it but for those parents who can’t afford it, their child waits and faces all the risks of complications that an infection can bring to a little baby.”
Mother-of-two Amanda Paiva said she was “very lucky” her two GPs still offered bulk billing, but the rising cost of medication and the stretched-out wait times for appointments was taking a financial toll.
Over the past three months, she has had to take her son to the GP every week with a recurring ear infection. Living off the single income of her partner, Paiva said they wouldn’t be able to afford the GP if bulk billing disappeared.
“I’m an asthmatic so … I’m meant to take preventer every day and I don’t because the cost to get them filled is too much that we can’t afford,” she said. “I only take them sparingly as I need if I get bad.”
Terese Edwards, the chief executive of the National Council for Single Mothers and their Children, said single mothers in particular regularly neglected their own medical needs so they could afford to pay for their children’s appointments, medication and treatment.
She said that when the $550 coronavirus supplement became available, many single mothers used it to finally access therapy, go to the dentist and get their eyesight and hearing tested.
“Single mothers are already forgoing their own medical treatment,” Edwards said. “People attended to their own medical appointments when there was those extra funds.”
Another reader said their family GP in Sydney now only bulk billed children under five and that out-of-pocket costs meant she and her husband “have thought twice about seeing the GP for ourselves”.
A reader from regional Victoria said in order to find a GP that bulk billed both parents and their child, his family had to drive a 140km round trip. “I lived in the UK for a number of years and the system there is far superior … We have ‘universal healthcare’ [in Australia] in name only,” he said.
Prof Julie Leask, a social scientist and vaccine expert, said she was concerned that as bulk billing became harder for families to access, vaccination rates would fall.
“The international evidence is clear and consistent: reducing out-of-pocket costs for vaccinating a child increases immunisation rates.”
Leask said this would more often affect poorer families. “So there’s a risk we could see greater inequities in vaccination coverage for children.”
GPs say Medicare rebates are not enough to make bulk billing sustainable, given the rising costs of managing a practice as well as implementing Covid-19 measures and vaccinations.
Dr Bruce Willett, vice president of the Royal Australian College of GPs, said GPs often chose to bulk bill certain patient groups.
“For example, the vast bulk of GPs opt to bulk bill children, pensioners and healthcare concession card holders,” he said.
“I’m not personally aware of any patients delaying childhood vaccinations due to cost, but it is possible because cost of living pressures are biting for many families. Parents and carers are having to make difficult decisions when it comes to making ends meet and paying for groceries, fuel, medicines, health appointments and more.
“This only reinforces the importance of boosting investment in general-practice care so that no patients are left behind.”
The federal health minister, Mark Butler, has acknowledged the bulk-billing crisis, and appointed experts to the Strengthening Medicare Taskforce to examine how basic healthcare can be made more affordable to those most in need.
