Need for bulk-billing docs mightier than AHPRA

4 minute read

A Victorian tribunal hit pause on an AHPRA decision to impose conditions on a GP’s registration due to the dearth of bulk billers in the area.

In what may be a sign of just how rare bulk-billing doctors have become, a GP in regional Victoria has successfully won a stay against AHPRA mandated education and supervision, in part because he regularly bulk bills patients.  

The Bendigo GP was reported to AHPRA for two separate incidents which occurred during consults last year, wherein patients alleged he made homophobic and racist remarks.  

Earlier last month, the Medical Board of Australia opted to impose conditions on the doctor’s registration requiring him to undertake mandatory education, attend mentoring sessions and practise under supervision of another doctor.  

These were to last for a period of 10 months, meaning the regulators wouldn’t decide on dropping or extending the sanctions until January 2025. 

The Bendigo doctor immediately applied for a review of the decision and applied for a stay of conditions on the basis that the financial cost of complying with the Medical Board’s demands would force him to close his practice.  

Supervision alone was projected to set the GP back by at least $364,000, outweighing the doctor’s expected income of around $250,000 per year.  

VCAT senior member Anna Dea, who handled the application for a stay in early April, ultimately agreed that the doctor “would have had to make special (and potentially somewhat impracticable) changes to his practice … [such] that it may be regarded as the equivalent of a suspension”.  

To be clear, the original Medical Board decision has not been overturned, merely paused. 

The next phase of the GP’s regulatory odyssey will be a review hearing with the Board toward the end of this year.  

Ms Dea did not dispute the Medical Board’s decision that the GP’s conduct pointed to the possibility of his having caused harm by insulting patients but concluded that it was in the public interest for him to continue practising.  

“[His] is one of the few remaining bulk-billing practices in the region … [there are] a number of long-term patients who currently depend on [this doctor] for the management of their serious medical conditions,” she wrote.  

“I accepted that evidence showed [the doctor’s] inability to practise (due to the challenge of finding and paying a supervisor as required by the Supervision Condition) may jeopardise the timely and well-informed treatment of those patients for many months and render the practice unviable.”  

Bendigo’s bulk-billing level is indeed one of the lowest in the country; in October 2023, just 67.3% of GP consults in Bendigo were bulk billed. 

At that time, the Australia-wide bulk-billing rate was 75.6% and Tasmania – roundly considered the worst jurisdiction for bulk billing outside of Canberra – had a bulk-billing rate of 66.3%, only marginally lower than Bendigo. 

The town’s fortunes have changed over the last five months, however. 

Since the introduction of the tripled bulk-billing incentive in November 2023, Bendigo’s bulk-billing rate has increased by eight percentage points to 75.3%.  

Last week, Assistant Rural and Regional Health Minister Emma McBride even specifically recognised Bendigo as has having had one of the biggest jumps in bulk billing across the country.  

Meanwhile, the average bulk billing rate across the country has risen to 77.7%. 

The VCAT approval for a stay in the Bendigo GP case was made just a few weeks ago, when the town’s bulk billing rate had already been sitting close to the national rate for some months.  

If Bendigo’s bulk billing situation was dire enough to warrant a stay for a sanctioned doctor, then at least half the country is theoretically in the same boat. 

The Medical Board declined to comment for this story. 

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