Bulk billing dropping

Report says out-of-pocket cost for GP visit is $41.69

Less than a quarter of Australian GPs are offering bulk billing to their adult patients, a new report has revealed.

And in another blow to families battling cost-of-living pressures, the research found that those patients who are not bulk billed have been hit with higher out-of-pocket costs.

The independent report from healthcare directory Cleanbill detailed the pricing structure of consultations from more than 6800 clinics around the country, and showed that only 24.2 per cent offered bulk billing to adults.

The worst hit state was Tasmania, with less than 1 per cent (0.9 per cent) of clinics bulk billing adults. The best rate was NSW, at 37.2 per cent.

The bulk billing rate in Queensland was 17.6 per cent and the average out-of-pocket costs are $41.27.

When aggregated, the report also found Queensland’s bulk billing rate had slumped 9.7 percentage points on its previous report and out-ofpocket fees had increased 2.8 per cent.

The report found the national average out-of-pocket cost was $41.69, was higher than Cleanbill’s 2023 report average of $40.45. The lowest was an average of $38.68 in South Australia; the highest was $51.19 in Tasmania.

Cleanbill founder James Gillespie said the research was conducted after the federal government introduced new bulk billing incentives for Australian general practice in November last year.

He said despite $3.5bn added from November 1, there was an 11.1 per cent drop in clinics bulk billing adults who are not eligible for concession.

“[That equates to] 514 clinics moving away from bulk billing everyone to private billing or only bulk billing certain groups,” he said.

“Making sure people are able to access affordable, accessible care is going to be more cost effective than [having] go to public hospitals.

RACGP president Dr Nicole Higgins said the report provided evidence of the need to do more to ensure affordable care was accessible to all.

“While the government’s tripling of bulk billing incentives has helped more GPs bulk bill specific groups, including children, pensioners, and healthcare card holders, more needs to be done to ensure care is affordable for the rest of the population,” she said.

“This … is a direct result of the 10-year freeze on patient Medicare rebates. This ripped funding from general practice, so now even though more people access general practice than any other health service, it gets just 6.5 per cent of the total government spend on healthcare.

“Practices are facing the same inflationary pressures as other businesses.”

Dr Higgins said it was “vital” that everyone could afford GP care for healthier lives, and to reduce pressure on hospitals.

“It’s also our most cost-effective health service, with a 20-minute GP consult costing around $40, whereas a visit to hospital costs over $600, and much more if a patient is admitted,” she said.

Health Minister Mark Butler’s office questioned the Cleanbill report, pointing to latest bulk billing statistics from the September quarter of 2023-24 showing that 73.2 per cent of all standard GP consults were bulk billed. MBS data said out-of-pocket costs for standard GP consults had reduced by 0.7 per cent in 2023-24 compared to the previous year, from $39.29 to $39.

“Affordable … care is going to be more cost effective than public hospitals

James Gillespie Cleanbill