Bulk-billing rates in freefall: RACGP

General practice care urgently requires greater investment so that no patients are left behind, according to the Royal Australian College of General Practitioners (RACGP).

It comes following reports of new data from hundreds of Australia’s largest medical centres, casting further doubt on the optimistic bulk-billing figures frequently trumpeted by the previous federal government.

When the Primary Care Business Council, a group representing the seven biggest operators of 500 GP clinics, compiled statistics analysing all cases of a GP consult lasting 20 minutes or less (the most common type of GP visit) and calculated the percentage of those consults that were bulk-billed they found the rate has fallen to an average of 61% across the 12 clinics. This is a 12% decline from just two years ago and one of the operators has a rate of just 36%.

RACGP President Adj. Professor Karen Price said this was further evidence that general practice care needed greater support.

“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.”

The RACGP President said that Australia was slowly waking up to the true state of bulk-billing.

“More evidence is emerging that bulk-billing rates are not what they seem,” she said.

“In fact, bulk-billing rates are in freefall and without urgent action some patients will be left behind. Some may remember the previous government pointing to a national bulk-billing rate of more than 88% but this doesn’t tell you the full story. Health Minister Mark Butler is right to say that previous governments have ‘sugar coated’ the state of primary health care.

“It is 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 proportion of patients who had all GP care bulk-billed was just 67.6% nationally in 2020 and 2021 and as the Primary Care Business Council found, some of their operators have rates well below that.

“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.

“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 nationwide. Urgent action is needed, and that includes greater investment in general practice care.”

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