Opposition calls out ‘bullying’ of GPs over bulk billing

Questions have been raised over the tactics used by some MPs to ‘pressure’ GPs into taking up universal bulk billing with the topic coming under the spotlight at a parliamentary hearing.
 
GPs have expressed ongoing frustration that despite the program being optional, governments have weighed in on their practice choices and have tried to influence change.
 
Several practices have also faced growing financial strain, including a remote West Australian clinic which this month announced its closure due to the cost of operating a fully bulk-billed remote GP clinic exceeding the funding to support it.
 
At a recent Senate Estimates hearing, the Opposition called out some Labor MPs for ‘bullying GPs’ to take up universal bulk billing despite the Federal Government’s own data showing not all practices would benefit from switching billing models.
 
Shadow Health Minister Anne Ruston asked whether the Government could confirm ‘that over 30% of GP practices in Australia would be financially worse off if they shifted to a full bulk-billing model?’
 
Daniel McCabe, from the Department of Health, Disability and Ageing (DoHDA), responded that ‘when we modelled this, there were practices that were charging higher out-of-pocket costs that wouldn’t be financially better off – there was a smaller percentage’.
 
Another DoHDA representative, Jo Da Rocha, added ‘there were 6600 PIP practices that were modelled and of that, 4800 were considered over the lifetime likely to sign up because it would be better off for them’.
 
Senator Ruston brought attention to media reports of Labor MPs writing to local GP clinics ‘querying them about why they aren’t bulk billing’ – a move she described as ‘bullying GPs’.
 
She also questioned why MPs would be ‘putting pressure on a practice by expressing great disappointment that they’re not bulk billing, when the department’s own figures suggest that 30% of practices would be worse off if they went to a full bulk-billing model’.
 
‘We’ve actually seen letters that have been sent. I’ve got one here from the Member from Bendigo, Ms Chesters expressing her disappointment that the particular clinic wasn’t bulk billing,’ Senator Ruston said.
 
‘You’ve got your MPs out there making these comments, trying to bully, as I say, their local GPs.’
 
Federal Finance Minister Katy Gallagher responded that these letters were ‘MPs doing their job’ and she refuted the suggestion that this was ‘bullying’.
 
‘MPs engaging with local businesses and talking about what the Government is doing to support their work and engaging in a conversation with them is the MPs doing their job,’ she said.
 
While Minister Gallagher herself had not written to GPs, she said she had been closely watching the clinics signing up, and visiting a number of them to show appreciation.
 
‘MPs writing and actively engaging on this is a good thing,’ she said.
 
‘I would say every single Labor MP and senator has been out talking with general practice about the investments we are making and our attempt to increase bulk-billing rates across the country, because it is one of the major issues facing households.
 
‘They do that in whatever way they choose to, whether it be by letter, whether it be the way I’ve done it here locally, and many other ways that they have engaged. I think that’s entirely appropriate, and I think their constituents expect them to.’
 
RACGP President Dr Michael Wright told newsGP there is a trust issue emerging.
 
‘They’re right to call out the coercive tactics used to push GPs into bulk billing,’ he said.
 
‘The Government’s own numbers show that a third of practices will be worse off if they do this and we’ve seen that despite the increased uptake by practices, this model isn’t sustainable for many.
 
‘Frankly, there is a trust issue here that practices are reluctant to rely on the Government.’
 
Dr Wright added that Medicare rebates are not keeping pace with increasing costs of care, and practices are coming under more pressure.
 
‘It’s no wonder that many are concerned and definitely why we need proper investment in general practice,’ he said.
 
‘If it seems like there’s less funding to support the work that GPs do, it’s because more and more funding is being spent elsewhere in the health system.
 
‘Relatively speaking, the percentage going to general practice has dropped from 8% 20 years ago down to 5.5% in the most recent data.’
 
The data comes from research by Dr Wright, published in the Medical Journal of Australia which explored two decades of Australian primary healthcare expenditure from 2002–03 to 2022–23.
 
The analysis shows a persistent decline in primary healthcare’s share of total health expenditure, a decline in GPs and other direct primary health services’ share and a stagnant share for enhanced primary care services.
 
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