Key Points
- One in four Victorian clinics bulk bill new patients, one in 10 in WA and less than one in 100 in Tasmania.
- Average out-of-pocket costs for a GP visit are highest in NSW, ACT and Tasmania.
- The rate of bulk billing across Australia dropped by 11.1 per cent between April 2023 and November 2023.
If you've found yourself calling around to find a doctor's clinic that bulk bills, you may not be alone.
A report released on Monday revealed fewer than one in four GP clinics will bulk bill every patient who walks through the door.
After contacting more than 6,800 clinics across Australia, Cleanbill, an online healthcare directory, found the national bulk billing rate for doctors accepting new patients now sits at 24.2 per cent.
Here is what that looks like, state by state.
A decline in bulk billing
By bulk billing, doctors bill Medicare instead of the patient, so there is no out-of-pocket cost for a visit to the doctor.
A total of 514 clinics across Australia that bulk billed all patients at the start of the year had stopped by November 2023.
Findings from Cleanbill's previous report in April 2023 showed that 35 per cent of GP clinics in Australia offered bulk billing to new patients.
That's a drop of more than 11 per cent within the year.
The decrease in bulk billing is even more pronounced in regional areas, where service delivery costs may be higher. Source: Getty / stockstudioX
While the rate of bulk billing in the state was 26.1 per cent in 2023, it is now almost 17 per cent lower, coming in at 9.2 per cent.
It was already hard to find a bulk billing doctor in Tasmania in the first half of the year, but by November, just two of more than 100 clinics in Tasmania bulk billed, of which one of those charged a one-off $167 fee for initial appointments.
The ACT has the second lowest access to bulk billing with 3.8 per cent of clinics providing the service to new patients.
The state you are most likely to be bulk billed in
NSW remains the state where most clinics taking on new patients are bulk billed. However, the number has reduced.
The state went from having a bulk billing rate of 48.6 per cent earlier in the year, to 37.2 per cent towards the end of it.
Increasing out-of-pocket costs
Cleanbill's report also tallied out-of-pocket costs for GP visits.
The average gap fee paid for a visit to the doctor across Australia was $41.68, which is 3.1 per cent higher than earlier in the year.
Those in Tasmania face the biggest cost to see a GP, with the average gap to be paid being $10 more, at $51.67.
Source: SBS News
"The costs of running a practice in those rural areas mean that the fees tend to be higher, and bulk billing rates tend to be lower.
"That's why I think we've observed that in Tasmania and gotten to the point where you only have one clinic that is bulk billing all new patients and still taking on new patients," he said.
Royal Australian College of GPs (RACGP) president Dr Nicole Higgins said the findings of the Cleanbill report were further evidence of the need to do more to ensure everyone could access affordable care.
"It’s absolutely vital that everyone can afford general practice care – it helps people live healthier lives and reduces pressure on our hospitals.
"It’s also our most cost-effective health service, with a 20-minute GP consult costing around $40, whereas a visit to hospital costs over $600, and much more if a patient is admitted," Higgins said.
Source: SBS News
She said that practices in many states are increasing fees to cover the costs of an extra state payroll tax on independent practitioners, that had recently been introduced, amid inflationary pressures.
Opposition health spokesperson Anne Ruston urged Labor to take "urgent action" and said Australians had been "given no confidence that these alarming trends will be turned around."
In a statement to SBS, she warned a visit to the doctor could become even more expensive.
"The cost of seeing a GP could rise to over $100 per consult and Australians are struggling to afford the rising costs of health care," Ruston said.
Fees to visit the doctor in Australia
Rates of doctors who bulk bill have declined in recent years, as the
The government provides a $41.40 rebate for a standard 15-minute GP consult via Medicare. But a GP can charge more than that, which means anything above that amount would be an out-of-pocket expense for the patient.
Incentives have been introduced to try to get more doctors to bulk bill for certain patients, including children. Source: Getty / Halfpoint Images
"As much as we want to charge as little as possible, we do need to keep the lights on," she said.
The federal government tripled the incentive paid to doctors who bulk bill children under 16 years of age and Commonwealth concession card holders as of November, in a bid to improve access to GPs for these groups.
Health Minister Mark Butler said the $3.5 billion incentive package would apply to three in every five GP consultations.
Even though the Cleanbill report covers a time that coincides with the Albanese government's one year in office, Butler told SBS news that the previous administration was to blame for reduced access to bulk billing doctors.
He said "a decade of cuts and neglect" meant it had never been harder to see a bulk billing GP.
Urgent care clinics and hospital emergency departments
The federal government is hoping its newly opened urgent care clinics may provide another healthcare option.
The final two of 58 additional urgent care clinics (UCCs) that it had promised, opened at the end of December.
Butler said these were designed for people to access when they had an urgent, but not life-threatening, need for care.
"The clinics are open extended hours, enabling more patients to be seen after hours and over weekends, for walk-in care that is fully bulk billed.
"Medicare UCCs are making a big difference to the local communities they support and reducing pressure on emergency departments," he said.
Ruston also indicated concern about a "crisis" within the healthcare system.
“There is a serious primary care crisis emerging under Labor, and the Albanese government must take urgent action to address it.
“Addressing this primary care crisis is critically important to reducing avoidable interactions with our hospital systems, which are currently facing enormous pressures."
Gillespie said it was "extremely fair to assume" that reduced access to bulk billed appointments "had put additional pressure on emergency rooms at hospitals around the country.
Australian Bureau of Statistics figures released in November showed the number of people who had doubled from the previous year.
"You have to assume that a large proportion of those 1.2 million people are ultimately ending up in the emergency room," Gillespie said.
"Whether that be because they want to go and see a doctor in a place where they know it's going to be free, or they put off seeing a doctor because of concern surrounding costs until the medical issue that they have becomes an emergency and they have to go to the hospital emergency room anyway."
