Are you a GP owner on the NSW Central Coast? Mark Butler has beef with you.
Local GPs and the national practice owner association say the federal government’s $25 million investment in building new clinics is a tacit admission that bulk billing alone cannot sustain a clinic.
Speaking to Paul Culliver on ABC radio Newcastle on Tuesday, Mr Butler could not rule out that the six new bulk billing clinics that the government had committed to funding would not poach GPs from existing practices.
Mr Butler explicitly called out general practice owners in the region.
“I am calling them out, because every other part of the country is shifting,” he said.
“As I said, the number of bulk billing practices in this region per capita is half the New South Wales average.
“The bulk billing rate is 30% lower than Sydney, than Western Sydney and South Western Sydney.
“Now, you can’t tell me it’s more expensive to run a GP practice in Newcastle or in the Central Coast than it is in Sydney. There is no economic reason.”
In response to a question about whether there was anything to “stop these bulk billing clinics just cannibalising staff from other clinics”, Mr Butler said he couldn’t control the movement of general practice staff.
“If a GP wants to move to a practice like that from another practice because that practice won’t be bulk billing, we can’t stop them, and I don’t particularly want to stop them,” he said.
“But I’m confident there will be a net increase in GPs.
“I suspect these practices, as they’re working to set up, will be looking to recruit GPs from outside the existing general practice community here in the region, and there will be a net addition to the number of GPs.”
Because the Central Coast area is classified as an area of workforce shortage for GPs, practices in those locations can recruit overseas-trained doctors.
Mr Culliver pointed out that GP clinics in the area were already trying to recruit doctors from the UK and asked Mr Butler why he thought the new bulk billing practices would find recruitment any easier.
“Because these new practices will be actively recruiting,” the minister said.
‘And depending on the practice owners who bid for this, some of them are pretty aggressively recruiting in the NHS right now. They’re out there, they’re doing campaigns.
“And so, the existing practice that’s doing pretty well, they’re happy with the existing arrangements, charging gap fees to a number of people, a relatively low bulk billing rate.
“They might not be doing active recruitment right now, whereas these new practices I’m pretty confident will be doing active recruitment.”
Established mixed-billing practices, Mr Butler said, should “re-examine their existing arrangements so that they can keep their patients”.
Newcastle GP Dr Max Mollenkopf, who owns one of the established mixed-billing practices in question, told The Medical Republic that the additional funding going toward creating the six new clinics made it clear that bulk billing alone was not enough to keep practices afloat.
“There’s certainly consumers out there who are struggling with the cost of living, and as a result they are struggling to access care from GPs,” Dr Mollenkopf said.
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“I think that the disappointing part of this is that the government has chosen instead to find select providers and provide significant background funding, which obviously is the cost of actually providing bulk billing around here, and then expecting the rest of us to bulk bill with a completely different funding set.
“I’d be happy tomorrow to bulk bill all my patients if the government actually covered the cost of providing that bulk billing.”
The alternative, he said, would be for the government to funnel funding to patients with lower socio-economic status directly.
Despite his criticism, Dr Mollenkopf will be among those applying for the funding.
“Why would you leave millions of dollars of government funding on the table?” he said.
“But I don’t necessarily think it’s fair to have one group of practices with significant background funding and a second group that are expected to meet that same level on a totally different funding set.”
The peak body for GP practice owners, the Australian General Practice Alliance, was similarly doubtful.
“This is a clear signal that bulk billing is non-feasible,” AGPA chair Dr John Deery said.
“If the federal government is intervening in a private business because they … are fixated on bulk billing going up, to the detriment of the community and the GPs working in it, there is … an inherent assumption that bulk billing is not sustainable.”
The new clinics are expected to open in mid-2027.
