Report pinpoints electorates most likely to bulk bill

Electorates in western Sydney have more bulk-billing clinics than almost any other part of Australia, according to analysis by the online directory Cleanbill.
 
Research published this week found nine of the 10 electorates with Australia’s highest proportion of bulk-billing practices are in Sydney – mostly in the city’s west – with the electorate of Calwell in north-western Melbourne the only one outside of the NSW capital.   
 
The electorate with the highest ratio of bulk-billed clinics is McMahon at 97.3%, extending down to Greenway at 81.6% in 10th position. Both are suburban areas to the west of Sydney’s CBD.
 
Western Sydney has had high bulk billing rates historically, with the recent tripled bulk-billing incentives reinforcing that.
 
The Cleanbill analysis is based on its January ‘Blue Report’ – the accuracy of which is disputed by the Federal Government – which reported an ‘unprecedented surge’ in bulk-billing clinics across the country.
 
It indicates that 147 of 150 electorates saw some increase, while 42 electorates reportedly had more than half of general practices fully bulk bill compared to 12 last year.
 
The report also suggests the increases are not evenly distributed across the country, with every one of the 18 electorates where it found 70% of existing clinics fully bulk bill located either in NSW or Victoria.
 
Out-of-pocket costs are highest in Tasmania and the ACT, according to the Cleanbill data, which indicated an average of $59.91 and $57.56 in those areas respectively – figures that do not take into account consultations that are bulk billed.
 
The Government’s own data suggests the average out-of-pocket cost when including both bulk-billed and privately billed consults stood at $11.02 in the January–March quarter, down from $11.11 a year previously.
 
For RACGP Vice President Dr Ramya Raman, the findings of the Cleanbill report are ‘no surprise’, but do little to address her concerns about practice sustainability.
 
‘One of the points as a practising GP that I do want to say is it’s very clear that the Medicare rebates have not kept pace with the inflation,’ she told newsGP.  
 
‘Especially when we talk about the operational costs of running a practice, the margins are so fine.

‘It’s absolutely driving out-of-pocket costs and creating barriers to access in itself.’
 
She believes the emphasis on the bulk-billing model has contributed to the collapse of practices such as in Kalbarri, which was widely reported earlier this month, and she again called for an independent pricing authority to oversee MBS fees.
 
‘It would be very helpful because it would provide the trust and certainty that we need when we’re making financial decisions, including billing policies,’ Dr Raman said.
 
In response to the Cleanbill report, Federal Health and Ageing Minister Mark Butler said more than 3800 practices are now fully bulk billing, including over 1450 that were previously mixed billing practices.
 
‘Specific data contained in the Cleanbill analysis cannot be relied upon and should not be reported as accurate,’ Minister Butler told newsGP.  
 
‘We are thrilled that since the Government’s landmark investment more Australians are accessing bulk-billing doctors.’
 
The Government did not provide any further data on the bulk-billing rates by electorate.
 
Cleanbill’s January Blue Report was researched from 1 November to mid-December last year, with its founder James Gillespie telling newsGP that there have since been ad hoc updates ‘to reflect clinic closures, openings, and data update requests from individual clinics’.
 
In April, Cleanbill reported that uptake of the expanded bulk-billing incentives introduced last November is growing significantly faster in rural and remote areas, with the number of fully bulk-billing clinics rising by around 20 percentage points nationally.
 
That increase was notably higher in small rural towns based in Modified Monash Model 5 areas, where the proportion of fully bulk-billing clinics went from around 21% in January 2025 to 57.8% 12 months later.
 
At the same time, Cleanbill suggested the number of clinics in metropolitan areas increased by 16.8 percentage points.
 
The Federal Government has a target of increasing the overall bulk billing rates to 90% by 2030, with the most recent data showing the overall level for the January–March quarter standing at 81.9%.
 
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