Clinics Withdraw Bulk Billing For New Patients As Australians Pay More To See A GP

Following the recent revelation that bulk billing rates for doctors’ appointments continued to decline last year, a report has now found Australians to be paying an average of $43.38 out of pocket to see a GP – with New South Wales residents paying $44.05.

The figure for 2024-25, arrived at by aggregating data from 7,000 clinics nationwide, represents a 4.1 percent increase on that for the year prior. Concerningly, the proportion of clinics offering bulk billing to new patients has declined by almost fifteen percentage points over two years, now recorded at 20.7 percent.

34.5 percent of clinics in New South Wales were found to be offering bulk billing to new patients, by far the highest rate of any state or major territory. In second place was Victoria at 19.1 percent, whilst only 3.3 percent of clinics were offering bulk billing in the Australian Capital Territory and none in Tasmania.

For new patients attending clinics that are not offering bulk billing, out-of-pocket payments are nearly seven percent higher nationwide than they were at the start of 2023. Costs increased by 4.3 percent in New South Wales, the second lowest figure yet more than double Victoria’s two percent increase.

Report paints “concerning picture”

Healthcare directory Cleanbill, which publishes the annual report, said that it painted a “concerning picture” for healthcare accessibility in Australia.

“While the decline in bulk billing has slowed, rates have continued to slide, with almost 80% of available Australian GP clinics no longer offering bulk billing to adult patients,” the report stated, noting that remaining bulk billing clinics are “largely concentrated” in New South Wales, with Western Australia for instance now having one clinic offering bulk billing per 46,639 adult residents.

“For those adults who cannot access bulk billing, average out-of-pocket costs are also climbing at an accelerating rate. In Tasmania, where there are no longer any clinics available to bulk bill them as new patients, adults are spending over $54 on average for a doctor’s visit, $7 more than 2 years ago.”

“In these circumstances, it’s easy to see why over 1.5 million Australians didn’t go to see a GP in 2023-24 because of concerns surrounding cost; up 25% from 2022-23.”

“This should not be happening.”

GPs urge more investment

The Royal Australian College of General Practitioners (RACGP) said the report “highlights the need for an urgent injection of funding in Medicare to support more bulk billing and reduce out-of-pocket costs”.

The professional association noted that while Medicare data shows 77.6 percent of GP consults are bulk billed, “the percentage of practices bulk billing new adult patients without concession cards continued to fall”.

“However, this decline slowed after the Government tripled bulk billing incentives, showing the value of this investment.”

RACGP President Dr Michael Wright emphasised the benefits of increased investment, saying that clinics had long been neglected.

“With proper investment in Medicare we can increase bulk billing, and reduce out-of-pocket costs for people who aren’t being bulk billed. Both of these things are crucial,” Dr Wright said.

“GP clinics are under pressure after decades of underinvestment and the Medicare freeze.. Today’s patient rebates don’t come close to the cost of care, so people are paying more out-of-pocket, and it’s harder for GPs to bulk bill. On top of this, practices have been hit by inflation like everyone. 

Bulk billing battle as election approaches

Bulk billing has already figured as a major issue in the upcoming federal election to be held this year, with Dr Wright urging all political parties to make bold commitments to ensure all Australians have “affordable access to a GP who knows them.”

The office of shadow health minister Anne Ruston said the downward trend identified by Cleanbill “adds to data from the Department of Health, which shows that the overall GP bulk billing rate, including concessional patients, has decreased by 11% under the Albanese Government.”

It referenced pledges from the Coalition to invest in women’s and mental health, as well as to invest in training for GPs.

However, health minister Mark Butler noted that overall bulk billing rates were up late last year over a year prior. The official figure of 77.6 percent based on data from between July and September 2024 is 1.1 percent higher than it was a year before.

“Every state and territory now has more bulk billing, with the largest rise in some states which have historically struggled with lower rates of bulk billing,” Butler stated.

“The number of Australians visiting their GP has also increased in the past 12 months, with a 1.2 percentage point increase in the number of GP visits overall.”

Greens health spokesperson Jordon Steele-John said that the party was “committed to getting back to going to the GP for Free, including increasing the bulk-billing incentive and establishing 1000 Free Local Healthcare centres across Australia.”