You’re not imagining it – funding for GP services as a proportion of total health spend has taken a nosedive.
The proportion of total health funding which goes toward Australian primary care services shrunk from 8.0% in 2003 to just 5.5% in 2023, lending weight to the idea that general practice has been deprioritised.
A new paper co-authored by RACGP president Professor Michael Wright and published in the Medical Journal of Australia examined two decades’ worth of expenditure trends across the primary care sector.
It found that while the share of spending allocated to all primary care declined slightly over the timeframe, the subset of that funding which specifically goes to primary care services – i.e. bulk billing incentives and GP consult rebates – fell far more sharply.
“We talk about strengthening Medicare, and ostensibly there’s a lot of rhetoric about that,” lead author Dr Rafal Chomik, a researcher with UNSW’s International Centre for Future Health Systems, told The Medical Republic.
“When you look at the data, of course, everything is increasing in dollar terms – but the focus on primary care is declining, and it has been declining faster than expected.
“There was a worry that might be the case, because hospitals are quite often the flashy things that you see that are more visible for ribbon cutting … but you see less of the day-to-day primary care work publicly.”
In 2002, around 36% of all health spending went to primary healthcare more broadly; this includes the money going to GPs, bulk billing incentives, and Medicare, as well as PHNs, community health programs, and public health.
Eight percentage points of that 36% represented funding going to primary care services; i.e. the money for GPs, bulk billing incentives, and Medicare, not including all the rest.
By the 2022-23 financial year, the proportion of total health spending going to primary healthcare more broadly had gone down to 33% and the component representing primary care services was 5.5%.
Related
“As a proportion of [primary healthcare spending more broadly], [funding for primary care services] also declined from 22% to 17% of expenditure, suggesting that even within the primary health care budget, GP-type services are being de-emphasised,” the researchers wrote in the Medical Journal of Australia.
This does not mean that less money is being invested into primary care now compared to 2002, but it does mean that the growth in funding for primary care is slower than that for other parts of the health system.
Dr Chomik said he had personally found it interesting that the distributional impact of primary care funding had become weaker over the two-decade period.
“In 2013-14, the poorest areas got 50% more of the [complex care] funding than the richest areas, but by 2023-24 that narrowed to 35% more in the poorest area than the richest area,” he said.
“That’s kind of saying, okay, yes [the funding for complex care] is generally more progressive, but that progressivity has weakened over time, and I explain that in access terms.
“We know that health hasn’t improved in those poorest areas relative to the richest areas from other research … so instead my explanation is that it must be related to access.
“Because of the barriers that happened when bulk billing was partly abandoned, you had access issues and therefore people went to their GPs less, and that came through the Medicare numbers and the spending that happens in those areas.”
International comparisons, the researchers wrote, suggest that Australia is lagging behind the OECD average in terms of primary care funding.
Medical Journal of Australia 2026, online 2 June
