RACGP President questions Government bulk-billing rates

Doug Hendrie

13/05/2019 3:18:31 PM

Dr Harry Nespolon said the actual figures are ‘potentially embarrassing’ for the Federal Government.

Harry Nespolon
Dr Harry Nespolon publicly questioned the widely touted 86% national bulk-billing rate.

RACGP President Dr Harry Nespolon has publicly questioned the widely touted 86% bulk-billing rate, suggesting the real figures are ‘potentially embarrassing’ for the Government.
Dr Nespolon’s comments came in a wide-ranging interview on Sky News. They were made in response to a question from host Chris Kenny over whether the message that people cannot afford to see a doctor is misleading given bulk-billing rates are at record highs and the Medicare freeze has ended.
Dr Nespolon pointed to a 2018 Australian Institute of Health and Welfare (AIHW) report that found one million Australians could not afford to see their doctor.
‘When we talk bulk-billing rates, we’re talking services, not about the number of people who have been charged,’ he said.
‘The Government never releases those figures, I presume because they’re potentially embarrassing. Our guess is it’s probably one third to one quarter of the population paying to see their GPs at the moment.
‘[The messages] are not misleading at all. It’s the way you present your statistics.
‘We do know that out-of-pocket expenses are increasing every year and will continue to increase every year. The Medicare freeze has stopped, but that’s in 2019, and from 2013 to 2018 it took about a billion dollars out of general practice and we haven’t seen a red razoo of that back.’
Later in the interview, Dr Nespolon pointed out that by 2023 general practice would be around $2.45 billion short of where funding would have been had the Medicare freeze not been put in place.
Dr Nespolon also dubbed the election campaign – from both major parties – as ‘very quiet’ for primary care funding.
‘Lots of money has been thrown at the usual suspects, which are hospitals, and pathology got some more money,’ he said.
‘The really big issue as far as we’re concerned is that the part of the healthcare sector that sees most Australians … 90% of Australians each year, which is primary care, your local GP. It seems that both parties … have been very quiet about it during the election campaign.’ 
Dr Nespolon appeared alongside former Howard Government health adviser Terry Barnes, who in response claimed that the lifting of the Medicare freeze is positive for primary care.
‘As far as general practice goes, basically the Government ended the Medicare rebate freeze in the budget and that’s Labor party policy, anyway. So general practice is being loved by both sides of politics,’ Mr Barnes said. 
Mr Kenny suggested the ‘incredibly high salaries’ of doctors might be linked to waste in the healthcare sector.
In response, Dr Nespolon said that specialist fees are expensive and patients often talk about the cost.
‘In terms of general practice, we are the most efficient, cheapest part of the healthcare system, the part that sees most people,’ he said.
‘Like most countries on Earth, [we should be] trying to improve primary care because we know in the long run that the tertiary and secondary [healthcare] sectors are going to become completely unaffordable and inaccessible for most people.’
Dr Nespolon also said the RACGP has been pushing ‘very hard’ for more services for mental health care and for better ways of delivering comprehensive care to very unwell patients.

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Arshad Merchant   14/05/2019 6:17:48 AM

It is cheap on Medicare to ask doctor to do home visit than calling a taxi or nursing home visit than getting a transport... numbers don’t match... RACGP should publish their fair baseline rates rather asking for rebates increase, let public and politicians to sort their own mess

Anthony Hancock   14/05/2019 8:46:21 AM

They are aware that this position trying to maximise bulk billing rates is in direct opposition to the white paper released which seeks to overturn the drive to bulk bill in favour of good clinical care?

Anthony McCarthy   14/05/2019 8:59:02 AM

The proposition people cannot find a bulk billing doctor if that is what they want is ridiculous. Hospital A&E departments are also well funded and available.
Even more ridiculous is the proposition everyone cannot afford to pay a reasonable fee.
The RACGP has driven practice costs up with various interventions, and now wants no one to pay.
General Practice is becoming an unattractive place to be.

Ravi Bundellu   14/05/2019 12:07:54 PM

Australia is fortunate to have Medicare which pays for majority of costs for most of the population
Medicare Bill amounts to Billions of dollars
With increasing advances in research,technologies many new procedures,tests,medications are coming on line on regular basis
Just think about the new cancer and Cystic Fibrosis medications which are now available at dirt cheap cost to patients
It is a hard balancing act
GP rebates need change but it all has to balance up

Dr Pradeep Jayasuriya   14/05/2019 1:38:43 PM

Well done Dr Nespolon - at last a medical leader will to tackle the political use of bulk billing 'rates' .

Dr Philip Ian Dawson   14/05/2019 2:16:26 PM

Firstly, stop calling General Practice "primary care", it is not it is more than "first point of contact care" under the American system. They also have (some) family physicians in USA, whereas other places based on the English system use Family Physician or General Practitioner to describe what we do.
Secondly, if the estimate is 1/3 of patients pay something to see the GP, and its nearer to 100% who pay to see a Specialist outside a public hospital, what's going on here? Does the Federal Government want us to end up with health care based on the US model, rather than the Canadian or NZ systems which are much closer to what we have here? If the quoted medicare statistics are "cherry picked" what about other statistics related to the percentage of the population using emergency departments as their "primary care"?