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‘We’re going to intervene in the market’: Health Minister
Mark Butler has confirmed the Federal Government will step in if too few general practices sign up to incoming bulk-billing reforms.
Minister Mark Butler speaking in Federal Parliament on Wednesday, when he defended the Government’s Medicare investment. (Image: Mick Tsikas/AAP)
Health and Ageing Minister Mark Butler says he is prepared to ramp up Federal Government intervention if bulk-billing rates do not increase as its modelling predicts.
Ahead of Saturday’s launch of the Bulk Billing Practice Incentive Program (BBPIP), Minister Butler said he is ‘not just going to sit by and let some markets really prohibit members in their community from being able to access bulk-billed visits’.
‘I’ve been really clear with doctors’ groups, some of which have been a little sceptical about this in the lead-up, that they should not underestimate our determination to achieve this,’ he told the ABC on Wednesday.
‘In Canberra, for example, which you probably know is a pretty stubborn market to get bulk billing in.
‘We’re going to intervene in the market.
‘We’re going to fund new practices that come into the ACT, set up here on the basis of being fully bulk billing.’
The ACT has historically had one of the lowest bulk-billing rates in the country, with financial pressures impacting its few fully bulk-billing clinics.
Last month, an expression of interest process opened for a $24.3 million intervention package to start three new bulk-billed general practices in the ACT.
Minister Butler indicated that approach could be replicated elsewhere in a bid to boost accessibility to bulk-billing clinics.
‘We think the settings we have right now are going to do it, but if there are particular markets in the country like Canberra where we’re just not getting that increase that we need to see, then we’ll look at taking action,’ he said.
In a later interview with ABC Adelaide, the Minister said ‘there’s only a few areas like that in Australia’.
‘Newcastle and the Hunter Valley are a concern for me. [In] Newcastle, the bulk-billing rate is much, much lower than it is in Western Sydney,’ he said.
He acknowledged an ‘element of stick’ as well as carrot in the approach to ensuring take-up of the expanded bulk-billing incentive.
In the same interview, he also rejected claims that the policy promotes short appointments by offering the same incentive, regardless of consultation length.
‘I know there’s this thing going around that this is going to create six-minute medicine, that is a red herring,’ he said.
‘We’ve based all of our calculations on exactly what GPs are doing right now.
‘There’s no need for them to change their practice and to rush patients through in order to get an advantage from this funding.
‘The funding will advantage them if they just keep doing what they’re doing now.’
The flagship Government policy was also raised in Federal Parliament’s Question Time on Wednesday.
‘Already, a thousand clinics have told us they’re charging gap fees this week and they’ll move to full bulk-billing next week – and that’s on top of the 1600 clinics that are already fully bulk-billing,’ Minister Butler said.
In its modelling of likely uptake of the policy, the Department of Health, Disability and Ageing (DoHDA) said it anticipates 1603 clinics will sign up in 2025–26, growing to 3206 by the end of 2026–27, and 4573 a year on from that.
Ultimately it predicts 4814 of a total 6633 clinics (73%) will enrol, with a target of 87.8% bulk-billed GP services by 2028–29.
newsGP has contacted DoHDA to clarify whether the sign-up numbers discussed this week are based on expressions of interest received alone, as well as to request confirmation of the exact number of current fully bulk-billed clinics.
Figures for the latter have varied from 800 to 1600.
DoHDA did not respond in time for publication.
RACGP President Dr Michael Wright said the changes coming into effect on 1 November represent the largest boost to Medicare funding in years and that the ‘additional investment is welcome’.
He said the college is supporting members to understand the new incentives, so they can make an informed decision about whether the program is right for their clinics and patients.
‘We share the Government’s commitment to ensuring all Australians can access affordable general practice care when they need it,’ he said.
‘We know the new incentives will increase support for many GPs and their patients, particularly for practices universally bulk-billing and those in regional and rural Australia where the incentives are greatest.
‘But as the Department of Health’s modelling shows they won’t work for all practices.’
Dr Wright said that the extended Medicare freeze and ‘years of chronic underfunding’ has made many GPs ‘nervous about switching back to a system that once again makes them 100% reliant on government funding decisions’.
‘For these GPs, this decision is fundamentally a trust issue, not just a financial one,’ he said.
The RACGP President also pointed out that while the current Government has shown its commitment to Medicare, ‘there is no guarantee a future government will do the same’.
‘GPs need long-term certainty for their practices and for their patients,’ he said.
‘Practices and GPs across Australia will do what is in best long-term interests of their patients, their practices, and the communities they serve. That won’t change on 1 November.
‘Nobody wins if practices are forced to close their doors for good because practice running costs can’t be covered.
‘We ask all patients, and the Government, to respect the billing practice of their GP, and to speak to practice team staff members with respect and courtesy – they’re only doing their job.’
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