Health Minister questioned about bulk-billing rhetoric at GP25

The RACGP President has kicked off GP25 by grilling the Health Minister on his flagship bulk-billing incentives policy – a move met with spontaneous applause from hundreds of GPs in the audience.
 
On Friday morning in Brisbane, on Turrbal and Jagera Country, the RACGP’s premiere general practice conference officially opened.
 
More than 1300 local and international delegates gathered at the Brisbane Convention and Exhibition Centre, alongside college staff and sponsors, to connect and learn.
 
Day one of the event saw RACGP President Dr Michael Wright and Federal Health and Ageing Minister Mark Butler sit down for a Q&A – the ‘honest and frank’ discussion held amid the Minister’s continuous promotion of his controversial bulk-billing incentives policy.
 
Dr Wright asked the Minister a long list of tough questions, including calling out his rhetoric around GP remuneration and market intervention, public claims which have led to widespread anger from many of the nation’s GPs.
 
‘The college … wanted additional funding to be put into general practice, into rebates or changes to time-tier consults that we continue to work on, but without a particular obligation around bulk billing,’ Minister Butler answered.
 
‘I didn’t think that was a decision that our Government could make given our long-standing commitment to bulk billing, which I know has been controversial over many years in the sector, but which we’ve been pretty upfront about.’
 
Minister Butler acknowledged there are elements of the funding package where the RACGP and Government have a ‘respectful disagreement’, in particular around controversial threats of market intervention.
 
He also said the sector is not a single market across the country, but rather ‘a collection of quite different markets that behave in quite different ways’ which do not reflect an objective analysis.
 
Acknowledging that some practices have switched billing models since the 1 November changes kicked in, Dr Wright then asked the Minister’s advice for those that are not going to benefit financially from shifting to new models.
 
‘We’ve never tried to pretend that every practice would shift,’ Minister Butler responded.
 
‘We’ve been very frank about … when we think the bulk-billing rate will get to our target of 90% … we’ve said by the end of the decade.
 
‘I know the college is providing advice to members about how you manage those conversations, and I’ve got no sense that that’s not working.’
 
One of the biggest challenges, Dr Wright said, is that many practices feel threatened about their business models.
 
‘That is not the intent,’ Minister Butler responded.
 
‘My focus is on ensuring two things: to ensure patients have affordable, accessible support from primary care through GP-led teams. Connected to that inextricably is support for a thriving general practice sector.’
 
Dr Wright closed the Q&A to acknowledge the additional Government funding and the focus on general practice.
 
‘We do recognise that it’s happened and we do want to keep working together,’ he said.


RACGP President Dr Michael Wright opening GP25 in Brisbane. (Image: Jake Pinskier)

GP25 kicked off on Friday morning with a smoking ceremony delivered by Tribal Experience and a Welcome to Country from local Elders, before RACGP Queensland Chair Dr Cath Hester officially opened the conference.
 
‘I would like to welcome and to thank our many dedicated and hard-working GPs here,’ she said. ‘It’s a very special privilege to host the RACGP’s flagship event in Brisbane this year.’
 
‘No matter what activities you choose this weekend, I hope that you come away buoyed by shared experience, by connection, that you feel supported, validated and recognised for the incredible and irreplaceable work that you do as GPs to care for your communities every day.’
 
Dr Wright then gave his opening address, acknowledging special guest presenters, including Chief Medical Officer Professor Michael Kidd, renowned journalist Leigh Sales, Aboriginal and Torres Strait Islander health leader Professor James Ward, Queensland Health Minister Timothy Nicholls, and Human Rights Commissioner, Lorraine Finlay.
 
He then delved into the college’s commitment to supporting a strong and sustainable general practice, particularly in light of recent funding changes and uncertainty among members.
 
‘The theme of the conference is around our future, stronger together – and that has never been more apparent to me,’ he said.
 
‘As seen in the last couple of weeks, the power of our united membership, and to fight for the needs of our patients and for the future of our profession to ensure general practice is at the heart of our health system, has been abundantly clear.’  
 
Dr Wright said the college is committed to championing investment and systems to GPs to focus on providing care to all communities across Australia.
 
‘Unless the value of general practice is understood by funders, policymakers and the wider community, we put all our work at risk,’ he said.
 
‘Let us reaffirm our mission: that the best investment in the health of this nation is a trusted GP who knows the patient, in a practice team that works.
 
‘Let your voice be heard as we shape the general practice of the future.’
 
Minister Butler then took to the stage to deliver his keynote address, noting it has been ‘a big year’ for the college and for the government and health sector.
 
‘As I became Health Minister, my number one priority was rebuilding general practice for two reasons, because I know you all certainly know that a vibrant, strong general practice sector is the backbone of a well-functioning healthcare system, but also that I had the view that general practice was arguably in its most parlous state,’ he said.
 
Referencing key finding from the RACGP’s Health of the Nation report, Minister Butler spoke about accessible and affordable general practice care, the associated barriers and the policies to repair, including strengthening Medicare, 60-day dispensing and the rollout of urgent care clinics – a model the college remains cautious of.
 
Highlighting ‘a stronger Medicare’, Minister Butler backed an RACGP priority of boosting Australia’s healthcare workforce, praising the college’s GP training program.
 
‘In particular, we need more GPs,’ he said.
 
‘When [Labor] came to government, the number of junior doctors choosing general practice as their preferred career was going down. And I’m so pleased that the work we’ve been able to do with the college taking over GP training again, has seen that start to turn around.
 
‘Last year was a record number of GPs in training, this year is another record, and next year we’ll break that record again.’
 
Finishing with eyes on the future of healthcare, Minister Butler said shifting the lens from ‘episodic’ patient care to holistic care is a priority.
 
‘I am certainly very clear that the long-term challenge for this sector is to reshape Medicare around the patient profile of today,’ he said.
 
‘Today is about complex wraparound care, with GPs leading teams of health professionals on the foundation of a strong relationship between you, your practice, and patients.’
 
The Health Minister finished with an acknowledgement that while the Government and the college ‘don’t always agree on all elements of health policy’, they work respectfully with each other.
 
‘I certainly respect the leadership role of the college,’ he said.
 
‘Our work together has made a difference … and we are starting to see the green shoots of that recovery.’
 
GP25 also included the RACGP’s 68th Annual General Meeting, held on Thursday, and continues until 16 November.
 
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