Government spending on general practice surges

Spending on general practice rose by $635.6 million in latest financial year, according to the Productivity Commission’s latest Report on Government Services.
 
The analysis, which was published on Tuesday, details the biggest apparent government investment in GPs since 2012–13 and represents a 6% annual increase on the previous year.
 
The rise is likely to reflect significant shifts in general practice since the onset of the pandemic, including the widespread implementation of telehealth and the vaccine rollout.
 
By contrast, in 2018–19 there was a $23.1 million increase in the amount of government spending on GPs – or 0.23% of the previous total.
 
The overall expenditure reported for general practice reached $11.23 billion in 2020–21 compared to $10.57 billion for the previous year, with the amount spent per person also rising noticeably to $437 – up by more than 5% on 2019–20 levels.
 
The spending details are not broken down in detail in the report, but much of the difference is likely to be attributable to the role of general practice in the vaccine rollout.
 
According to the latest statistics, GPs have delivered 24,510,119 vaccine doses, almost half of the amount delivered across the country.
 
The amount spent on general practice, however, remains a fraction of the total annual investment in the public hospital system according to the Productivity Commission’s data.
 
The figures for public hospital spending are more dated, with 2019–20 the latest year for which details are included in the report. They show an increase of $2.685 billion year-on-year, with the total hitting $76.7 billion, more than seven times the amount spent on general practice during the same 12 months.
 
Another striking statistic in the report suggests the amount of ‘potentially avoidable GP-type presentations’ to hospital emergency departments hit record levels.
 
There were 328,724 more presentations of this nature recorded in 2020–21 than in the previous year, reaching a total of 3.16 million. That is an increase of 11.57% compared to 2019–20, and over 250,000 more than the previous highest level.
 
The ‘potentially avoidable’ category is defined as presentations who did not arrive by ambulance or by police, with a triage category of semi-urgent or non-urgent, and where the patient was not admitted to hospital or referred to a different hospital and did not die.
 
RACGP President Dr Karen Price told Nine Newspapers the rise is due to general practice funding being underpowered relative to other health services.
 
‘If you don’t resource primary care properly, they go somewhere else – and it costs everybody much more money,’ she said.
 
A report commissioned by the RACGP and published in 2020 found unnecessary hospital visits cost around $540 per presentation (in 2017–18 figures).
 
More than a third of urgent GP appointments (33.9%) registered a waiting time of more than 24 hours in 2020–21, the highest proportion in recent years. There was also a lower proportion of urgent appointments being seen within four hours.
 
However, the number of people who saw a GP in the previous 12 months and waited longer than they felt acceptable dropped from 18.7% in 2019–20 to 16.6% in 2020–21 – possibly a reflection of the greater availability of telehealth, although no further analysis is given in the report.
 
There was also more demand for GP services than ever, with an average of seven ‘GP-type services per person’. However, patients are now paying more out-of-pocket expenses than at any other time covered by the report, at an average of $41 per attendance – despite universal telehealth bulk billing.
 
Outside the major cities, the figures outline the stress on the rural general practice workforce, with 363 full-time equivalent GPs servicing the remote and very remote areas of Australia out of a total full-time workforce of 29,419.
 
The figure has stagnated and even decreased in recent years, despite the concern about the workforce shortages outside large urban areas.
 
The report suggests the general practice is gradually reaching greater gender balance, although there is still a long way to go. It records 59.5% of full-time equivalent GPs as male, a proportion that has fallen in recent years.
 
And despite the pressures on general practice, another figure shows the esteem in which the profession is still held by people across the country.
 
Previously unpublished data from the Australian Bureau of Patient Experience Survey shows 95% of patients as saying their GP ‘always or often showed respect’ – a figure higher than for any of the eight previous years shown in the report.
 
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