GP visits costing Australians more than ever, survey finds

Out of pocket costs to visit general practitioners are higher than ever, a survey from the peak body for GPs has found, along with the first indications in a long time of a boost in GP workforce numbers.

The gap has risen to an average $36.86 for a 20-minute consult in 2024, up from $34.91 last year, according to the Royal Australian College of General Practitioners’ 2024 health of the nation report.

Dr Nicole Higgins, the college’s president, said rising out of pocket costs hit the most vulnerable, such as those living with chronic complex illnesses who required longer consultations, hardest of all.

“The gap is the highest it’s ever been,” she said.

Dr Nicole Higgins says the Medicare rebate covered 85% of GP costs when it launched 40 years ago. Photograph: Jono Searle/AAP

Part of the rise in longer consultations is due to mental health presentations. The report found 71% of GPs reported mental health as one of their top reasons for booking a patient consult, up from 61% when the report started in 2017.

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The college is calling for a 20% increase to all Medicare rebates for 20-minute and longer consults and additional increases for rural and remote communities.

When Medicare was first launched forty years ago, the rebate covered 85% of the cost of someone seeing their GP, Higgins said.

“That has now dropped to 45% because of a 10-year Medicare freeze by successive governments and poor indexation,” she said.

The Royal Australian College of General Practitioners president, Dr Nicole Higgins, tweeted this graph, saying: “That blue wedge is your gap payment.” Photograph: AMA

“The health sector has also been hit by inflation. This is why, despite the tripled bulk billing incentive, patients’ out-of-pocket costs have increased.”

One in four GPs are bulk billing more consults since the government tripled the incentive for bulk billing pensioners, children and healthcare card holders, found the report based on a survey of more than 3,000 college’s members.

The report is based on the college’s survey findings and data collated from multiple sources, including the Australian Bureau of Statistics, Institute of Health and Welfare, Private Health Network and Cleanbill.

Higgins said the report also found “some green shoots” in workforce data, with the college exceeding the targets it set to recruit young doctors to train as general practitioners in rural and urban programs in 2025.

“For the first time in a long time, we’ve got more people wanting to train as GPs,” Higgins said.

Compared to previous years, GPs were happier and more likely to recommend general practice, especially among junior doctors and those working in Aboriginal and Torres Strait Islander medical centres, the survey found.

“The investment in 2023 in the federal budget has actually shown GPs that they’re valued, and that’s really having that flow on effect on [the] workforce,” Higgins said.

The boost in numbers was needed as GPs were getting older, with two out of five indicating they would retire in the next five years, she said.

However, the report also revealed a significant increase in GPs’ concern about their administrative workload – from 60% in 2023 up to 70% in 2024. It was the top reason GPs gave for why they were planning on quitting in the next five years.

The report also called on the government to overhaul the much-maligned My Health Record, after finding nearly one in every three GPs (31%) rarely or never use the electronic medical record. A productivity commission report found it “plagued by incomplete records and poor usability”.

Higgins said $5.4bn in savings – a sum the commission estimated could be generated annually from a more efficient health data system – could be re-invested in reducing out of pocket costs.

Dr Christopher Harrison, from the University of Sydney’s school of public health, said bulk billing was “essential” to ensuring the country’s healthcare system was efficient and accessible, and he urged the government to take more action.

“Bulk billing removes financial barriers that may push patients to delay care or to seek it from an emergency department, which costs the system far more,” he said.

“The increases to the bulk-billing incentive items payments were a step in the right direction. These results support other evidence that they have made a difference.

“However, more needs to be done to incentivise the bulk billing of people of working age who are not covered by the current incentive items.”