Is your electorate impacted by a bulk-billing shift?

Data gathered from across Australia’s 151 Federal electorates has found 15 areas, including all five in Tasmania, have no clinics offering bulk-billed standard consultations for new adult patients without a concession card.
 
The other 10 electorates were Brisbane and Fairfax in Queensland, Boothby, Kingston and Mayo in South Australia, Lyne, Newcastle and Shortland in New South Wales, Jagajaga in Victoria, as well as Swan in Western Australia.
 
That is according to a follow-up analysis from Cleanbill, an online health directory, after its Blue Report last month charted a decline in bulk billing rates.
 
The report also shows out-of-pocket costs climbing for most non-concession card holders across the country ahead of the general election.
 
In its equivalent report two years ago, Cleanbill found only four electorates where no bulk billing options were found for new adult patients.
 
However, RACGP Tasmania Chair Dr Toby Gardner said the report’s focus on the proportion of bulk billed new adult patients presenting to practice is ‘not a good measure’.
 
‘We’ve never really had high levels of bulk billing in Tasmania,’ he told newsGP.  
 
‘We’ve been one of the lowest bulk billing areas in the country, perhaps after the ACT, for a number of years.
 
‘And most of that is due to lack of workforce.
 
‘We’ve never really had much of a corporate presence in Tassie, we’re essentially just like one big rural area of Australia, so we’re under-doctored and where you see the biggest out-of-pocket expenses.’
 
Dr Gardner also suggested that many patients in the state will have benefited from the tripled Medicare bulk-billing incentive introduced by the Federal Government in November 2023.
 
‘We have seen a big uptick in the number of concession card holders being bulk billed since the tripling of the incentive, and I think we saw the biggest gains in bulk billing for concession card holders after that incentive was announced,’ he said.
 
‘That’s something that we were really proud of in Tasmania.
 
‘We’ve got so many concession card holders in Tassie, I think we have probably the most in the country, because we’ve got the oldest and the most disabled population.’
 
The Cleanbill report also ranked electorates according to the biggest decreases and increases in out-of-pocket fees.
 
The research found ‘significant disparities’ in out-of-pocket fee changes across different electorates, with some falling and others increasing.
 
The largest rise in gap fees was found in the NSW electorate of Watson, with an increase of $11.98 from $24.54 two years previously, to $36.52 in 2024–25.
 
However, that remained lower than the average out-of-pocket fee reported across the country, which stood at $42.37, an increase of $3.14 from two years previously.
 
Cleanbill found the largest decreases in out-of-pocket costs in Chifley and Parramatta in NSW (a fall of $27.33 and $21.15 respectively), which it said was due to the ‘moderating’ impact of clinics in those electorates moving from bulk bulling to private and mixed billing.
 
Overall for patients who are not bulk billed, out-of-pocket costs increased between 2023 and 2025 in 136 electorates – or 90% of the total – according to the survey, which was carried out late last year.
 
But Federal Health and Aged Care Minister Mark Butler has questioned the data, saying the Federal Government published the most transparent data around bulk billing for general practice visits.
 
‘My first answer would be to have a look at the official data around bulk billing rather than the headline-grabbing phone poll by a private company,’ he said.
 
‘And it shows that 77% of all general practice consults are bulk billed. Now that’s not as high as we’d like, we want to do more in bulk billing.’
 
This week, an RACGP delegation including Dr Gardner is in Canberra to advocate to politicians across the political spectrum for measures that would make general practice more viable for GPs, and more affordable for patients.
 
For the RACGP Tasmania Chair, one of the solutions to reducing costs for non-concession card holders is to increase the funding for longer consultations.
 
‘With the level C rebate being so low at the moment, it just doesn’t cover the cost of time for a double appointment for a new patient,’ he said.  
 
‘If we increase that rebate by 40%, which is what we’re asking for in Canberra, that would hopefully increase the rates of bulk billing new patients, as well as having more doctors around.’
 
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