Early poll results suggest about 30% of GPs plan to abandon bulk-billing soon in response to the extended rebate freeze
Early poll results suggest about 30% of GPs plan to abandon bulk-billing soon in response to the perma-freeze on Medicare patient rebates
But top health bureaucrats say bulk-billing rates won’t necessarily plunge from the current all-time high of 84%, though they have not investigated the likely impact of the budget move to prolong the rebate freeze until 2020, slashing GP incomes.
No modelling was done on the ramifications for doctors or the health system beyond the estimated saving for government of $925 million, Andrew Stuart, a departmental deputy secretary, told a Senate committee.
“Essentially, we believe that it is competition from the increased doctor supply that is driving the bulk-billing rate,” Mr Stuart said under questioning by Greens Leader Richard Di Natale, a former GP.
According to preliminary results from an RACGP survey launched a week ago, 30% of GPs plan to stop bulk-billing entirely because of the extended freeze.
“That’s quite a figure – almost a third of GPs say they will cease bulk-billing,” RACGP president Dr Frank Jones told TMR.
“Some GPs have told us they will have to close their practices. Some have told us they will have to cut back on administrative and staff hours. Others have told us they’ll have to cut back on the medical supplies they stock.
“And many, many, are reconsidering bulk-billing of all or some groups of patients.”
But Mr Stuart told the Senate Community Affairs Committee that GPs needed to stay competitive and they had a range of choices open to them.
“Because we are involved in a competitive environment, where GPs not only have to think about their billing practices in relation to their income, they also need to think about their billing practices in relation to the competition in their region,” he said.
“There are a range of possible GP responses to changes in the rebate. Obviously there is accepting an income reduction. There is doing extra consultations. The average hours worked by GPs have fallen quite a lot in the last 10 or 15 years… ”
Among other factors, younger doctors were working on average fewer hours, and GPs were shifting towards higher priced services, he said.
“If you put all that in the mix, it is very difficult for the department to predict any precise outcomes, but what I am trying to say is, is there actually an access problem in general practice?
“I would say no, there is not. Bulk-billing rates are at an all-time high. GP supply per 10,000 patients is at an all-time high.”
Pushing out the pause in indexation for two more years will shear $50,000 from the annual income of an average full-time GP by 2020, according to modelling by Sydney University’s Family Medicine Research Centre.
