‘Market distorting’: Government-backed clinics open in ACT

Two new fully bulk-billing clinics, shored up by millions of dollars of Government funds to attract GPs, are opening in the ACT this week, Health and Ageing Minister Mark Butler confirmed on Monday.
 
Coombs Bulk Billing Practice, run by Ochre Health, opened in Philip on Monday and is due to transfer to the suburb of Molonglo once fit-out works are complete.
 
A clinic run by Next Practice Deakin opens in Tuggeranong in the south of the territory on Tuesday, while a third clinic, operated by Macquarie General Practice, is due to open in the northern suburb of Gungahlin next month.
 
They are the first clinics to go live following a series of controversial market interventions designed to boost bulk-billing rates, with each new general practice backed by the Federal Government’s Bulk Billing GP Attraction Initiative.
 
Contracts for the three new clinics worth $9.8 million will last until 30 June 2028, with tender documentation showing the clinics are expected to open 40 hours a week, and funding is ‘to be used towards recruiting and retaining new workforce to the ACT’.
 
The college has strongly opposed the intervention, which was announced last September, with RACGP NSW&ACT Chair Dr Rebekah Hoffman saying that her concerns remain as strong as ever.
 
‘We know that in the ACT they have one of the lowest number of GPs per capita,’ she told newsGP.
 
‘Where are the GPs that will be staffing these clinics coming from?
 
‘They’ve not been able to adequately describe where this workforce that will be staffing these clinics is going to come from, so I have concerns they’ll just be moving from one clinic to another and not actually seeing an increased number of patients.’
 
Dr Hoffman said she has also heard from RACGP members who are worried about the impact on the viability of their own practices.
 
‘I’ve got concerns about the fact that [the new clinics] will be competing with other small businesses,’ she said.
 
‘Doctors who have been working in the ACT for many, many years might see themselves as no longer viable to work if a practice opens next door with significant additional funding that has meant they can undercut them and see their patients.’
 
Minister Butler said there are now 23 bulk-billing clinics in Canberra, with eight switching from mixed billing since the expansion of the tripled bulk-billing incentive came into effect last November.
 
‘Having three new GP clinics will help make medical care cheaper and more accessible for many Canberrans,’ he said.
 
RACGP President Dr Michael Wright, however, is also highly sceptical.
 
‘We are really deeply concerned about interventions like this that distort the market, when the real problem is the inadequate Medicare rebates to cover the costs of care, particularly as GPs are providing more complex and chronic disease management for an ageing population,’ he told newsGP.

‘Market disruption like this really isn’t in the long-term interests of practices, and for the patients who are going to need long-term care from GPs who know them and their history.’
 
Dr Wright said there needs to be an evaluation of the impact on patients, practices and the community.
 
‘We really need to collaborate, we really need to make sure that sufficient funding is going to support practices to provide the care that our patients need, and this intervention approach has more risks potentially than benefits,’ he said.
 
The ACT is not the only area targeted with a similar approach, with a $25.3 million Federal initiative recently confirmed for six new fully bulk-billing clinics in the Newcastle, Lake Macquarie, Central Coast and Hunter Valley areas of New South Wales due to open by July 2027.
 
Minister Butler has signalled the Government would intervene in the market if bulk-billing rates remained low – although the rate in the Hunter New England and Central Coast PHN area has risen by more percentage points than the national and state average, recent statistics show.
 
Dr Hoffman also has particular concerns about the short-term nature of the funding, noting the ACT contracts end in two years.
 
‘We’re not sure what will happen after that,’ she said.
 
‘If people move to work in these clinics and then there’s no funding – like what happened to the super clinics a generation ago – then we’re actually going to be putting these communities in a worse place than they are in now.’
 
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ACT BBPIP bulk billing Canberra Medicare