Medicare changes welcomed but doctors say more still to do

CEO of the Rural Doctors Association of Australia (RDAA) Peta Rutherford, welcomed the changes to bulk billing arrangements announced in the 2023 budget on May 9, saying it would help to rebalance services.

"I'm not saying it's the panacea but it is a step in the right direction," Ms Rutherford said.

"We have seen a move away from GPs bulk billing. The tripling of the bulk-billing incentive payment to GPs will support people to be bulk billed," she said.

READ MORE:

RACGP president Dr Nicole Higgins said the budget was a win for patients.

"Every patient deserves access to high-quality, affordable and accessible general practice care, irrespective of their postcode or income," Dr Higgins said.

"We know the problems impacting our health system can't all be fixed in one go, but tonight's budget includes a groundbreaking investment in the health of all Australians by strengthening general practice care. The government has shown real commitment to strengthening Medicare and rebuilding general practice care for all patients.

"The $5.7 billion funding package triples the bulk-billing incentive, hikes Medicare rebates and boosts the Workforce Incentive Payment. It also includes funds for a new Medicare item for longer consultations lasting more than 60 minutes," Dr Higgins said.

The government has been under pressure to do something about the GP crisis which is seeing less trainee doctors enter the system, increasing gaps between what an appointment actually costs and the government rebate and the disappearance of bulk billing in some areas.

Dr Frank Simonson of Merimbula Medical Centre said he had always bulk billed children so they never missed out.

"The increase in the incentive payment will mean we can bulk bill the most vulnerable patients so they will get timely treatment. There is no change for everyone else," Dr Simonson said.

Ms Rutherford said boosting the Workforce Incentive Payment was a "significant investment supporting the employment of additional staff such as nurses and nurse practitioners as well as allied health service professionals within a practice.

"We talk about a team approach and recognise we have a multidisciplinary approach. It's about seeing the right person. It's a very expensive model when you have a doctor doing wound care, rather than a nurse," Ms Rutherford said.

At a broader level there is a move to attach funding to a patient and practice, which could be used by the GP, nurses or allied health professionals. Ms Rutherford said it was about linking a patient to a GP to access a broader range of services, which would help support the viability of rural practice.

But there remains no movement on the district of priority arrangments which see trainees doctors undertaking so called rural practice in places such as Campbelltown and Dubbo. It has effectively kept trainees closer to larger centres of population, leaving rural areas struggling to find trainees.

In April 2022, Dr Frank Simonson of Merimbula Medical Centre explained why some GPs weren't bulk billing, using the figures for that period.

"For a 15-minute consultation the bulk billing rate is $39.10. If you see four patients an hour, then you will have earned $156.40. My wages bill alone ranges from $95-$135 an hour depending upon the day. Out of what is left, I must pay for the running costs of the business, which includes insurance, rent, supplies and so forth. After all this is paid there is not much left to pay the doctor," Dr Simonson said.

Currently the bulk billing rate is $39.75; it's what the GP gets from the government for bulk billing. If a patient is not bulk billed and pays a private consultation fee to the GP, the patient receives the $39.75 instead.

If the patient is a concession card holder there is about an extra $10 incentive from the government for bulk billing. This figure is dependent on an area's classification.

In the budget of May 9, the government has pledged to triple the incentive. In the Bega Valley that means it comes close to $30. When it is added to the $39.75 bulk billing rebate, the total comes much closer to what doctors are charging for non-bulk billed consultations, averaging between $65-$70.

It could have the effect of reinstating a broader use of bulk billing.

However if you are not a concession card holder the GP will still only get $39.75 if they bulk bill.

The bulk-billing incentive payment will help ensure eligible patients across rural and remote Australia will have greater access to GP services without having to pay an additional out of pocket expense.

The Medicare rebate is increasing too and so from November 1 the rebate given to a patient who is not bulk billed, will increase to $41.40.

Our journalists work hard to provide local, up-to-date news to the community. This is how you can access our trusted content: