GP plan to combat ‘completely unsustainable’ NSW hospital costs

The RACGP has urged the New South Wales Government to rein in spiralling public hospital costs by investing in ‘the most efficient and effective part of the health system’ – general practice.  

In a pre-Budget submission to the Government, RACGP NSW&ACT outlined a range of initiatives centred around ‘well-connected general practice’ to support long-term patient health through primary care. 

RACGP NSW&ACT Chair Dr Rebekah Hoffman told newsGP a strong investment in preventive health measures through general practice would secure gains extending beyond political cycles.

‘General practice funding isn’t just a Commonwealth issue – it’s also a state and territory issue, and we are trying to give them actional solutions to try to work in this space,’ she said.

The submission comes as a Bureau of Health Information report on the final quarter of 2025 shows NSW public hospitals are facing increased pressure, with record numbers of emergency department attendances, admissions and ambulance callouts. 

Dr Hoffman said the increased demand comes alongside a ‘completely unsustainable’ surge in NSW hospital spending. 

‘Over the last 10 years, the cost of the NSW public hospital system has increased by more than 60%,’ she said. 

‘That’s completely unsustainable. It’s a symptom of a sick healthcare system that’s struggling under the burdens of an ageing population, an epidemic of chronic disease, and a growing need for mental health care. 

‘The best way to reduce New South Wales hospitals’ spiralling costs is by investing in preventive care that keeps people healthy and out of hospital.’ 

The RACGP submission calls for a $51.8 million package to enable general practices to allow practices to employ more allied health professionals, nurses, mental health workers and care coordinators to better support patients with chronic and complex conditions. 

‘Modelling consistently shows multidisciplinary teams in general practice reduce preventable hospitalisations, improve chronic disease control, and reduce long-term health spending,’ Dr Hoffman said. 

Further bolstering general practice is a $30.5 million annual investment to fund general practices to provide same-day and next-day to meet after-hours demand. 

Also, a $150,000-per-practice after-hours care trial to support more practices to provide care on evenings, weekends, and public holidays. 

Dr Hoffman said expanding after-hours general practice ‘is one of the most effective ways to ensure patients get the right care, in the right place, at the right time’, and it could also help families who struggle to access care for children without taking time off work. 

‘I completely understand that need, but also as a practice owner, I know the reason I’m not open late is because of wages, because Medicare doesn’t cover that cost of wages, so if there was that funding available to be open, my staff would work it, just they need to be able to pay them,’ she said. 

‘Because we operate on such thin margins, this investment really would mean that we can improve the access at these times, and that would be a gamechanger.’

To address youth health, the RACGP recommends an investment of $12 million per year to establish a GP in Schools pilot across 20 NSW high schools to provide GP sessions, mental health triage, and preventive care – with potential to expand to 50 schools for $18.5 million per year. 

‘The evidence shows GP in Schools programs lead to improved mental health outcomes, reduced crisis presentations, faster access to care, and improved attendance by providing early-intervention healthcare for children and young people,’ Dr Hoffman said.

As annual investment of $147.5–166.5 million would also help tackle declining vaccination coverage, including a focus on: 

• an expansion of needle-free influenza vaccination from 2–5-year-olds to all school-aged children 

• free and equitable access to meningococcal B immunisation 

• respiratory syncytial virus vaccination for all aged care residents and people aged 75 and over. 
   

‘Every winter, our hospitals fill with patients who need care due to infections that could be prevented through vaccination,’ Dr Hoffman said. 

‘Making getting a vaccine as seamless as possible will mean less sickness, fewer deaths, and less strain on our hospital system.’ 

An annual investment of $11.5–14.5 million was also suggested to establish roles in all Local Health Districts for: 

• GP Liaison Officers, to smooth a patient’s journey into and out of the hospital system, improve communication, reduce unnecessary referrals, and support safe and timely hospital discharge 

• GPs with specific interests who apply their expertise in key medical specialties to improve access to the care communities need. 
   

Dr Hoffman said the solution lies in the State Government working with GPs. 

‘NSW Health Department data shows every $1 spent on high-connectivity general practice returns $1.60 in health system benefits. That’s not just better workforce productivity, but also fewer preventable hospitalisations and emergency department presentations. 

‘Well-connected general practice is essential for an effective and efficient hospital system.’ 

The NSW Budget is expected to be delivered in June.
 
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