Health Minster Mark Butler has admitted making change within general practice is a difficult task, as greater focus has turned to his government’s promise to see nine out of 10 GP visits be bulk billed by 2030.
He told ABC’s 7.30 this week “this is a hard sector to make change in”.
The comment followed the release of documents in which the Department of Health, Disability and Ageing’s secretary Blair Comley highlighted that some patients will still face out-of-pocket costs. It comes three months out from the incentives for clinics to do so coming into place.
The document stated: “The department estimates that 23% of clinics are unlikely to join the program based on financial incentives.”
The policy, announced ahead of the election earlier this year, estimated that by implementing incentives for clinics to bulk bill 100% of their appointments, the number of fully bulk billed practices in Australia would be boosted to around 4,800 nationally – triple the current number.
The Bulk Billing Practice Incentive Program will come into effect on November 1.
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Participating practices will receive an additional 12.5% incentive payment on every $1 of MBS benefit earned from eligible services, split between the GP and the practice.
Participating practices must bulk bill every eligible service for every patient to receive the incentive payment, which will be in addition to MBS benefits paid.
In response to the detail that almost one quarter of clinics will be unlikely to take up the incentive, Minster Butler told the ABC’s 7.30 that this was in line with what had been promised.
“I said that about three-quarters of general practices we were confident would go to full bulk billing because it would be in their financial interests as well as in the interests of their patients,” he said.
“The other quarter, we think, will probably continue to mix bill, so they’ll bulk bill their pensioners, the kids who come through their door.
“On average, a practice that doesn’t fully bulk bill is still bulk billing about 70% of their consults.
“Three-quarters at 100%, a quarter at about 70% gets us to 90% over the course of the coming years.”
How the 12.5% payment will be split is still being worked out.
Minster Butler told 7.30 the government was working through that question with the sector.
“I’ve had meetings myself, certainly my department is consulting with individual GPs and their representatives, but also with practice and practice representatives as well. We’ll make a call on that.
“Some are saying that the practice should get the whole lot. Someone’s saying that the doctors should get the whole lot. Some are saying that it should be divided evenly.”
Meanwhile, Healthcare directory Cleanbill has suggested – based on its own calculations – that as of November, it would make financial sense for an additional 43 of WA’s 612 GP clinics to move to fully bulk billing patients under the new program.
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That would double the amount of fully bulk billing clinics in WA.
RACGP WA Chair Dr Ramya Raman said after chronic underfunding and the Medicare rebate freeze there was much to do to improve the public health system.
She added that GPs and the government wanted the same things.
“We are wanting the same outcomes, in terms of having more affordable care from GPs.”
Dr Raman once again highlighted what she said was a need for higher rebates on longer consultations.
“We want the higher rebates for longer consultations, for Level C and D, for that 40% increase in the longer consultations, that would make a tremendous difference and then impact for the patients as well.
“We know that, the number of chronic conditions that have been managed, the longitudinal care, the continuity of care, all of these make a tremendous difference.”
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