Federal government announces bulk billing splurge, but will it be enough?

Doctors groups welcome the multibillion-dollar investment into Medicare but would like to see more investment into more complex general practitioner consults.

A massive $8.5 billion is to be invested into Medicare — regardless of who is elected into government this year.

The Minister for Health Mark Butler made the announcement, calling it “the single largest investment into Medicare since its creation 40 years ago”. The majority of the money is to enable bulk-billing for a GP appointment available to most Australians — promising to deliver 18 million bulk-billed GP visits each year and save patients hundreds of dollars each year in out-of-pocket costs. Patient savings are projected to be $859 million a year by 2030.

Opposition leader Peter Dutton has pledged to match the promise if the Coalition wins this year’s election.

Labor has also promised to deliver more doctors and nurses into Medicare with 400 nursing scholarships and “the largest GP program in Australian history” by funding the training of 2000 GPs each year by 2028.

The Royal Australian College of General Practitioners (RACGP) has welcomed the commitment that would see thousands of GPs trained annually.

RACGP President Dr Michael Wright says the scale of this investment shows the government understands the critical need to fund a sustainable general practice workforce.  

“We welcome the government’s workforce initiatives to build Australia’s specialist GP workforce into the future,” he said. 

“The GP attraction initiative will match the wages, and parental and study leave entitlements of GP trainees to those of hospital-based doctors. This will remove one of the most significant barriers to junior doctors choosing a career in general practice.  

Dr Wright also said that the proposal is asking GPs to make major changes to their operating models.

“This will require careful consideration to ensure patient care is sustainable and funding is targeted at those who need it most,” he said.

“GPs will need government support to understand and adjust to the proposed new funding model, if they choose to do so,” Dr Wright said.

“Extending bulk-billing incentives to everyone won’t necessarily mean everyone gets bulk-billed, because patient rebates are still too low to cover the cost of care,” he said. 

“Ultimately, we need to make sure GPs are enabled to deliver high quality care that is sustainable and doesn’t put unreasonable pressure on practitioners to see people quickly or make it harder for people to get more time with their GP,” Dr Wright said. 

The General Practice Registrars Australia (GPRA) called the announcement “historic” and a “real game changer,” its President Dr Chris Dickie said.

“The commitment to improve pay and leave entitlements for GP trainees — a reform GPRA and our members have been actively advocating for over many years — is a fantastic step forward in attracting doctors into general practice and increasing access for patients,” Dr Dickie said.

“Addressing the drop in pay, the lack of study leave, and the absence of parental leave — as proposed through these initiatives — is exactly what our members have been calling for,” he said.

“The announcement today means that GP registrars entering training in their early years will now have access to parental leave, study leave, and a base wage incentive, ensuring parity in employment conditions with hospital-based specialty registrars” Dr Dickie said.

The Australian Medical Association said it had campaigned for years for extra funding for the primary care system and welcomed the commitment.

AMA President Dr Danielle McMullen said general practitioners are the cornerstone of Australia’s health care system and equitable access to affordable GP care is essential.

More funding needed for complex care

Dr McMullen said more work was still needed to address issues relating to the growing complexity of general practice care.

“This funding package will help address affordability issues for many vulnerable and disadvantaged Australians who do not currently qualify for bulk-billing incentives. But greater support for patients with more complex needs can’t afford to be ignored,” she said.

“We need a rethink of Medicare rebates to ensure today’s patients who have increasingly complex needs get the care they require. Today’s patients have more chronic disease, more mental illness, and our population is ageing,” Dr McMullen said.

“Australians need more time with their GP, but the structure of Medicare encourages shorter consultations, meaning many patients face out-of-pocket costs,” she said.

“While bulk-billing incentives will now be available for all patients, it is important for the public to understand that general practices will still need to set their fees based on an assessment of the costs they face in running a modern medical practice,” Dr McMullen said.

The RACGP echoes the AMA’s stance on fees and bulk-billing, especially for more complex patient cases.

“More targeted funding to support people with chronic and complex conditions is still the most cost-effective way to improve Australia’s health care system,” Dr Wright said.

The RACGP calls for a 25% increase to patient rebates for mental health consults and a 40% increase to patient rebates for longer consults.

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