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Newcastle Herald
Newcastle Herald
Damon Cronshaw

Budget incentives won't fix bulk-billing shortage, Newcastle GP says

Dr Fiona Van Leeuwen, chair of the Hunter General Practitioners Association. Picture by Peter Lorimer

A Hunter doctors' group say the federal budget's incentives for GPs won't be enough to resolve the difficulty most people have in finding a doctor in the region who bulk-bills.

Most GPs in the Lower Hunter will get the lowest bulk-billing incentives announced in the budget, government mapping shows.

The map shows Newcastle, most of Lake Macquarie and parts of Maitland will get the lowest incentives because they are considered metropolitan areas.

In a key budget measure, the government tripled the incentives paid to doctors who bulk-bill patients aged under 16, pensioners and Commonwealth concession card holders.

The Albanese government estimated its bulk-billing incentives would benefit about 11 million people, including about five million children.

Health Minister Mark Butler said the incentives would "address the sharp decline in bulk billing over the past few years".

The incentives for GPs in metropolitan areas will rise from $6.60 to $20.65 per consultation.

In other areas of the Hunter, the incentives will rise from $10.65 to $33.35 and $11.35 to $35.40, depending on the level of remoteness.

Dr Fiona Van Leeuwen, chair of the Hunter General Practitioners Association, said the incentives won't be enough to fix the bulk-billing problem.

"The out-of-pocket gap that patients are needing to pay is still so significant that these incentives, as useful as they are, don't necessarily mean things will change," said Dr Van Leeuwen, a Hamilton GP.

The budget also contained minor rises in the Medicare rebate that the government pays GPs for a consultation.

Rebates for a standard consultation will rise from $39.75 to $41.40, but the full cost of a consultation can be more than $80.

As such, the average out-of-pocket cost to see a GP in NSW has been about $41.

Dr Van Leeuwen said the increased bulk-billing incentives and Medicare rebate "won't be equivalent to the full cost of a consultation in Newcastle".

Until this happens, she said GPs are unlikely to "change from private billing to bulk billing".

"Most general practitioners are unable to bulk bill the majority of patient consultations because costs exceed revenue."

However, she said the bulk-billing incentives did highlight a key issue.

"By directing these incentives to low-income earners, the government is flagging that they recognise more vulnerable people are being priced out of medical care.

"Interestingly, most GPs for many years - and still today - have provided cheaper consultations to patients on lower incomes.

"That is the same service being provided for a lower fee. That has nothing to do with the government. GPs just do it because it's the right thing to do.

"Remarkably, many GPs still bulk-bill some of the most disadvantaged patients on compassionate grounds because we know they have no other means of accessing health care."

The GPs wear the cost of this.

"The government should pick up the tab for this, not the GPs," she said.

"All these things risk the viability of general practice and make it an unappealing medical specialty for new graduates. That's partly why there is a shortage of GPs."

Dr Lee Fong, of Hunter Primary Care, said the bulk-billing incentives were "a strong and welcome indication from the Albanese Government about the value of general practice care".

"The provisions being made for vulnerable populations - such as those who can least afford to pay gap fees, those in rural/remote regions and those with complex care needs - are particularly welcome.

"There's still a lot to be done to reform our healthcare system, but this is a good start."

Australian Medical Association [AMA] NSW president Dr Michael Bonning said the "tripling of the bulk billing incentive is something the AMA has called for and welcomes".

Dr Bonning said the incentive provides better financial support "for doctors who choose to bill vulnerable groups".

"The incentive is even more significant in locations outside major metro centres. It is particularly important for rural practices when there aren't many options," he said.

"The Hunter region is one of the electorates where bill billing is very difficult to access and so this is somewhere that these initiatives can make a big difference for patients."

To see more stories and read today's paper download the Newcastle Herald news app here.

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