Canberra GPs say Albanese and Dutton's Medicare pledge won't get them to bulk-bill

The Albanese government claims its $8.5 billion plan, which the Coalition has matched, will make nine in 10 GP visits free nationally by 2030, with an extra 210,000 consultations a year to be bulk-billed in the ACT and 25 GP practices forecast to be better off if they bulk-bill all patients.

But early results from a survey by ACT independent senator David Pocock have cast doubt on the likelihood of these projections - which are based on Treasury modeling - eventuating in the ACT, which has the lowest bulk-billing rate in the country.

Senator Pocock sent a survey to all 82 general practices in the ACT, with 427 GPs between them, and received initial responses from 44 GPs - representing just over 10 per cent of the profession.

When asked how likely they were "to bulk-bill more consultations and services as a result of the new expansion of the tripled bulk-billing incentive", just two GPs responded "I will bulk-bill all services" - and it is understood they work in practices that already do so.

Both major parties plan to extend the tripled bulk-billing incentive to all patients, give GP practices that bulk-bill all patients a 12.5 per cent loading on top of existing Medicare rebates, and boost training programs.

Local GP Betty Ge said while any extra GP funding was welcome, she did not expect the pre-election pledge to make it financially viable for her to start bulk-billing.

"We welcome this injection of funding into primary care [but] this is probably too little," Dr Ge told The Canberra Times. "We have to pay our bills."

Senator Pocock said while the new incentives "will work for places like Tassie and Western Sydney, they will not move the dial here in the ACT, as they won't address our unique circumstances."

"We have fewer GPs, lower competition and higher costs than many regional areas," he said.

ACT patients are more than twice as likely to be charged a gap fee, which averages $48 in the territory but can be as high as $74 for a standard consultation of between six and 20 minutes, than in the rest of the country. The rebate for this type of visit is $42.85.

Almost half (46 per cent) of GP visits in the territory attracted an out-of-pocket fee in December 2024 compared with under a quarter (23 per cent) nationally.

The vast majority - 82 per cent - of GPs surveyed by Senator Pocock said they would continue to bulk-bill the same amount even if the higher bulk-billing incentive was available to all patients, with 9 per cent saying they "may bulk-bill a little more", 2 per cent saying they would bulk-bill "somewhat more" and 2 per cent saying "substantially more".

The higher bulk-billing incentive, which the government has provided for children and pensioners since November 2023, starts at $21 for a standard consultation in metro areas including Canberra.

When asked "how likely are you to bulk-bill all consultations and services as a result of the new 12.5 per cent practice incentive payment", 91 per cent of GPs surveyed responded "I won't - I just can't bulk-bill/not all of my colleagues will bulk-bill."

The 12.5 per cent loading - which is $5.46 on top of the current rebate for six to 20 minutes - will only be available to practices that bulk-bill all patients. Many GPs are independent contractors and have no say in this.

Just two GPs responded "I will bulk-bill all services", being the ones that already do so.

Three ACT medical practices bulk-bill all patients for GP visits and each relies on grant funding, including for youth and drug and alcohol services, to stay afloat.

Australian Medical Association ACT president Kerrie Aust, who is a Canberra GP, said a focus on standard consultations would only worsen "six-minute medicine", where GPs are incentivised to churn through quick appointments.

Senator Pocock agreed, saying a wider overhaul of Medicare was needed.

The higher bulk-billing incentive, which the government has provided for children and pensioners since November 2023, starts at $21 for a standard consultation in metro areas including Canberra.

Senator Pocock said the ACT should be treated as a regional area by the health department, which would give Canberrans extra Medicare funding.

ACT Chief Minister Andrew Barr and Health Minister Rachel Stephen Smith said the $8.5 billion pre-election pledge would be "a game changer for Canberrans accessing healthcare", while Fenner MP and Assistant Treasury Minister Andrew Leigh said it was "the health reform Canberrans deserve".