RACGP: Cleanbill Data Reveals Rising Costs in General Practice Care

Royal Australian College of GPs

New data from Cleanbill highlights the cost pressures on general practice which are forcing up out-of-pocket costs for patients, says the Royal Australian College of GPs (RACGP).

The independent Cleanbill 2024 Blue Report released today shows average out-of-pocket costs have increased in every state and territory to over $40. And the number of practices bulk billing all patients also continued to decline – 514 clinics which bulk billed all patients at the start of 2023 had stopped by November.

RACGP President Dr Nicole Higgins said it's further evidence of the need to do more to ensure everyone can access affordable care.

"This report shows we need to do more to address the rising costs for care in Australia – patient financial issues was also one of the top concerns GPs reported in our 2023 Health of the Nation," she said.

"While the government's tripling of bulk billing incentives has helped more GPs bulk bill specific groups, including children, pensioners, and healthcare card holders, more needs to be done to ensure care is affordable for the rest of the population.

"This situation is a direct result of the 10-year freeze on patient Medicare rebates. This ripped funding from general practice, so now even though more people access general practice than any other health service, it gets just 6.5% of the total government spend on healthcare. Practices are also facing the same inflationary pressures as other businesses.

"On top of all that, in many states practices are having to raise patient out-of-pocket fees to cover the costs of an extra state payroll tax on independent practitioners. While practices have always paid payroll tax on their employees, it never applied to GPs because they work under independent agreements, but this changed after a new interpretation of payroll tax law.

"So far Queensland is the only state which has issued a new Revenue Ruling stating patients' fees paid directly to a GP won't be subject to payroll tax, and we're continuing to call for other states and territories to do the same. We're also calling for no retrospective tax collection because this will force practices to close – at least 184 practices closed last year, we can't afford to lose any more.

"It's absolutely vital that everyone can afford general practice care – it helps people live healthier lives and reduces pressure on our hospitals. It's also our most cost-effective health service, with a 20-minute GP consult costing around $40, whereas a visit to hospital costs over $600, and much more if a patient is admitted.

"The government knows action is needed and they've committed to rebuilding Medicare and general practice. While there's no quick fix, we do need to keep up the momentum to secure the financial sustainability of general practice, enable bulk billing for those who need it, and ensure GP care is affordable for everyone."

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