Is bulk billing on the NSW Central Coast so low that it requires a $25.3 million investment?
The federal government has directed $25.3 million to boost bulk billing in a region which has fairly average bulk billing rates already. It’s unclear why.
One of the few surprises to come out of Tuesday night’s budget was an announcement that the Department of Health, Disability and Ageing would be setting up six new, fully bulk billing clinics in the Newcastle, Central Coast, Lake Macquarie and Lower Hunter regions of New South Wales.
The six new clinics will be competing directly with existing practices in these areas.
“The plans to intervene in Hunter-New England with bulk billing clinics – look, we’re really concerned about that and the impact that’s going to have on distorting the market,” RACGP president Dr Michael Wright told The Medical Republic.
“We’ve said before that if you want to increase the availability of bulk billed services, the way to do that is to increase Medicare rebates.”
At this stage, it’s unclear how funding will be distributed to these new clinics.
If the past is anything to go by, though, it will likely be a grant distributed to the local Primary Healthcare Network, which will then commission private companies to spend the money.
The Newcastle, Central Coast, Lake Macquarie and Lower Hunter areas are all part of the Hunter New England and Central Coast PHN.
With the potential exception of Lower Hunter, all those districts are located on the coast rather than the vast inland area covered by the PHN.
According to the budget documents, the six new clinics will deliver 155,000 bulk billed GP services each year.
“The bulk billing rate in this part of the country is significantly lower than the national average,” the health papers read.
This is technically accurate. According to the most recent Medicare dataset, the national GP non-referred bulk billing rate for Australia in the July to December period of the 2025-26 financial year was 78.8%.
For the Hunter New England and Central Coast PHN, the average GP bulk billing rate was 74.9%.
But to say that this region has an aberrantly low bulk billing rate would be inaccurate.
Far from having the lowest bulk billing rate in Australia, the Hunter New England and Central Coast PHN don’t even have the lowest bulk billing rate in NSW.
That title goes to Northern Sydney, with a rate of 71.1%.
One may argue that the Hunter New England and Central Coast area covers a population with higher levels of socio-economic disadvantage than Northern Sydney.
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But there are still areas with far lower average GP bulk billing rates.
North Brisbane, North Perth and Canberra all have GP bulk billing rates lower than 70%, while the bulk billing rates for Tasmania and Adelaide also both come in at around 75%.
The idea the coastal NSW areas could be considered rural areas of workforce shortage is also iffy.
“I would hate to think that the government would think that they’re supplying services into rural areas [with this], because funding bulk billing clinics in coastal areas where you’ve got high population densities and it’s all serviced by highways and freeways – that’s not rural,” ACRRM president Dr Rod Martin told TMR.
The next question one might ask, however cynically, is how these regions voted in the most recent federal election.
Newcastle is considered a very safe Labor seat, while the Central Coast seat of Robertson is a marginal seat which most recently went to Labor. Hunter, which is also considered a swing seat, also went to Labor in 2025.
The more regional, inland parts of the Hunter New England and Central Coast PHN are nearly all Nationals seats.
