Doctors say they have increased their average fee for a standard consultation from $64 to just under $75 in 12 months as they face pressure from rising costs, adding to the challenge facing Health Minister Mark Butler as he tries to resuscitate Medicare.
In the same year the Albanese government pledged to overhaul the health system and started rolling out changes to make it easier to see a doctor, the proportion of GPs who said they bulk billed all their patients was halved from 24 to 12 per cent.
GPs are charging an average of $10 more for a standard appointment than they were last year.
The snapshot from the Royal Australian College of General Practitioners’ yearly survey of doctors maps an accelerated deterioration in the affordability of primary care despite Labor’s focus on reform.
The annual report has criticised the “ongoing dysfunction in the health system” and cited a significant jump in both patients’ financial issues and GP workloads and stress since last year.
“The proportion of GPs who bulk bill most of their patients decreased significantly in the last year. This is reflective of anecdotal reports from GPs about the increasing cost of providing healthcare services in general practice and further compounds patient access issues,” the report said.
The data was collected before the government’s $3.5 billion budget promise for Medicare came into effect this month.
But it suggests the cash incentives for doctors who bulk bill vulnerable patients – which amounts to an extra $14 for GPs in cities and $27 in the most remote parts of the country – will not be enough to turn around rising fees for millions of Australians.
“[The federal budget] commitments go some way to improving access to primary healthcare and reducing out-of-pocket costs for patients … But without continued and sustained policy reform, the steady erosion of optimism across the profession will continue,” the report said
The report surveyed 2048 practising GPs representative of age and location, with a confidence level of 95 per cent.
It found GPs have been charging an average of $74.66 for a 20-minute appointment in 2023, which included the roughly $40 Medicare rebate. This was $10.64 more than the average fee in 2022, which was $64.02.
The proportion of GPs who indicated they charged more than $85 for a standard consultation also doubled, from 21 per cent last year to 41 per cent this year.
“In the space of just one year, the proportion of GPs bulk-billing all of their patients halved from 24 per cent in 2022 to just 12 per cent in 2023,” the report said.
“In addition, the proportion of GPs who bulk-bill most of their patients decreased significantly and the proportion who bulk bill a minority of patients increased significantly in the last year.”
While there were still higher rates of bulk billing in more disadvantaged areas, the decline in bulk billing was evident across all levels of socio-economic status. Meanwhile, appointments were becoming increasingly complex as more people had mental health issues, chronic illness or multiple conditions.
“A strong GP workforce is essential for the health of our nation, but it is under pressure. Sourcing and retaining GPs remains the issue that most practice owners rank as their biggest challenge,” said college president Nicole Higgins.
Just under four in 10 practising GPs said they would recommend their profession to their junior colleagues, while almost three in 10 intended to retire in the next five years. More than six in 10 were considering reducing their practising time.
Almost half of GPs were also unhappy with their pay, which trends lower than other medical specialists. “The consequences of this are now evident, with increased costs to patients and challenges meeting workforce targets,” the report said.
Health Minister Mark Butler blamed the former Coalition government’s “cuts, neglect and deliberate misleading” for why it was so hard to see a bulk-billing doctor.
“After a decade of cuts it’s going to take sustained investment to strengthen Medicare, and that is what the Albanese government is delivering,” he said.
“We’ve delivered the largest increase to Medicare payments since Paul Keating was prime minister [and] a larger increase in one year than the former government delivered over seven years. This is in sharp contrast to Peter Dutton’s stint as health minister.”
Shadow health spokeswoman Anne Ruston pointed to the latest Medicare data from the September quarter, which showed the overall GP bulk-billing rate dropped a further 3.7 percentage points in the last three months, to 76.5 per cent. This came on top of an 8 percentage point drop over the 2022-23 financial year.
“Bulk-billing rates have plummeted to the lowest levels in well over a decade as the costs of healthcare continue to rise, and Australians have no confidence that these alarming trends will be turned around,” Ruston said.
“There is a serious crisis emerging under this government in primary care, and the Albanese government must take urgent action to address it.”
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