Australia’s bulk billing figures were back in the spotlight this week…
The true state of bulk billing in Australia could be worse than expected with the latest investigation by industry groups revealing that the former government’s much touted figures of more than 88% had little basis in reality for GPs or patients.
Statistics from the Primary Care Business Council, a group representing the seven biggest operators of 500 GP clinics, showed that over the last two years, the percentage of bulk billed consults had declined by 12% to an average of 61% across the clinics surveyed, with one general practice recording a rate of just 36%.
Speaking with ABC Adelaide’s David Bevan and Stacey Lee on August 15th, the new Federal Health Minister, Mark Butler, said that it was clear that bulk billing rates were going in the wrong direction, and that seeing a doctor was becoming increasingly expensive for patients.
“The official data tells us that if you are paying a gap, say the gap has gone up considerably over the last nine years, particularly because there was a freeze on Medicare rebates put in place by the last government for six years,” Mr Butler said.
“Right now, the official data tells us if you’re paying a gap fee for a standard consult, it’s now more than the Medicare rebate itself for the first time in Medicare’s history.”
Mr Butler said that even though bulk-billing figures had been sugar-coated by the previous government, the system would not be axed under Labor.
“Not on my watch. Bulk billing is a very important element of Medicare now. You know, there have always been people who pay a gap, who can afford to pay a gap.”
“But when you’re talking about the gaps potentially being levied on people, on low incomes, particularly people on fixed incomes like pensioners or young children, particularly young children, and concession card families, then we’ve seriously got a problem.
“I think that’s why so many GP organisations are drawing attention to this.”
RACGP President Adj. Professor Karen Price said this was further evidence that general practice care urgently requires greater investment so that no patients are left behind.
“Unless greater investment is made in general practice care, more and more practices will have little choice but to pass the cost on to patients,” she said.
“This can result in patients delaying or avoiding consultations with their GP and having a health condition worsen to the extent that they end up in a hospital bed. When this is replicated in communities across Australia, particularly in rural and remote areas, the health of the nation suffers.”
Professor Price said that it was vital to distinguish between the proportion of GP services that are bulk billed, and the proportion of patients who had all their GP consults bulk billed.
“The figures are skewed because there are some patients with multiple, complex issues who see their GP again and again for different types of health problems and this inflates the proportion of GP services that are bulk billed. In addition, practices are required to bulk bill COVID-19 vaccination services and for much of 2020 some patients, including children and concession card holders, were bulk billed for every single telehealth consult.”
The proportion of patients who had all GP care bulk billed was just 67.6% nationally in 2020 and 2021.
“In reality, many people are finding it more and more difficult to find a bulk-billing GP and this will have significant consequences for the health and wellbeing of many patients nation-wide. Urgent action is needed, and that includes greater investment in general practice care.”
“Six years of a freeze in Medicare rebates is effectively a wage freeze for the nation’s general practitioners for six long years,” Mr Butler said.
“Rebuilding general practice is my top priority, not only for its own sake, but also because we know that patients can’t get the care they need out in the community in general practice, they end up at crowded emergency departments, putting even more pressure on our hospital system.”
Speaking with Lachlan Kennedy from Ten News First on August 16th, Mr Butler pointed out that the new government will make a ‘substantial commitment’ to fixing the system, through the implementation of the $750 million Strengthening Medicare Fund.
The Strengthening Medicare Taskforce began work in July 2022 to provide concrete recommendations to the Australian Government by the end of 2022.
“I’m meeting now on a monthly basis for the rest of the year with doctors and nursing groups and patient groups to work out the best way to invest that money,” Mr Butler said.
“We’re also rolling out 50 urgent care clinics that will give people a bulk billed opportunity to attend and get care for those minor emergencies that at the moment people are taking to hospital emergency departments, which are already heaving with unprecedented pressure.
The Australian Government will consider the recommendations from the taskforce and deliver the highest priority improvements to Medicare through the $750 million Strengthening Medicare Fund.
“So, we’ve got a range of investments we committed to in the election campaign,” Mr Butler said. “But this is not going to be a quick thing to turn around after nine years of neglect and cuts.”