The GP crisis Down Under: Why three new bulk billing clinics could be a game changer for seniors

Canberra has the dubious honour of having Australia's lowest bulk billing rates—and for the territory's older residents, this healthcare postcode lottery has real consequences.

Now, the federal government's plan for three new bulk billing clinics might finally offer some relief, but questions remain about whether $10.5 million in seed funding will be enough to fix the problem.

The ACT's healthcare reality check

The numbers paint a stark picture. While New South Wales enjoys bulk billing rates of 82 per cent, the ACT languishes at just 53 per cent—making it the worst-performing jurisdiction in the country.

For context, South West Sydney boasts an 'always bulk billed' rate of 81 per cent, almost quadruple the ACT's rate of 23 per cent.

What does this mean for your wallet? Nationally, the average out-of-pocket cost for a non-bulk billed GP visit is $43, but this can range from $16 to $99 depending on where you live. For seniors on fixed incomes, these costs can quickly add up, especially when managing chronic conditions that require regular monitoring.

How the seed funding model works

The $10.5 million represents a new approach to healthcare funding—offering one-off 'seed funding' to establish clinics rather than ongoing operational support. This differs from traditional Medicare funding, where the government pays rebates for each service provided.

Expressions of interest are being sought until October 8, with preference given to clinics spread across different geographic regions of the ACT.

The funding can go to either existing clinics wanting to expand bulk billing services or entirely new practices.

Why seniors are feeling the pinch

Australia's bulk billing rate fell from 88.8 per cent to 77.3 per cent between 2021-24, while patient out-of-pocket costs more than doubled from $780 million to $1.66 billion nationally.

Perhaps most concerningly, 8.8 per cent of Australians delayed or deferred GP care due to cost in 2023-24—a significant increase that particularly affects health outcomes for older adults.

There is some good news for seniors nationally. Bulk billing rates for older Australians with concession cards have increased to over 87 per cent following the government's decision to triple bulk billing incentives in November 2023. However, this national improvement hasn't translated to the ACT's unique situation.

What experts are saying

Dr Kerrie Aust from the Australian Medical Association ACT remains cautiously optimistic but realistic about the challenges ahead. She points to a fundamental tension in modern healthcare: the push for bulk billing versus the desire for comprehensive, relationship-based care.

'Someone might come in with a cold and people might see that as easy medicine, but those are opportunities to check, 'How is the family going? What's happening with the child's eczema?'' she said. This 'slow medicine' approach—crucial for managing the complex health needs of older adults—can be harder to sustain under volume-driven bulk billing models.

Meanwhile, community advocates suggest the funding may not be sufficient. Recent research indicates the tripled bulk billing incentives may still be insufficient to reduce out-of-pocket costs, particularly in metropolitan areas where bonus payments are lowest.

The road to 90 per cent bulk billing

This ACT initiative sits within a broader government ambition to achieve 90 per cent bulk billing nationally by 2030. Government modelling suggests current reforms could increase GP bulk billing rates by around 10.5 per cent by 2028-29, potentially delivering 18 million additional bulk billed services per year.

Looking beyond bulk billing rates

The initiative also connects to other healthcare developments, including the upcoming Medicare urgent care clinic in Woden and existing nurse-led walk-in centres across the territory. These services aim to provide alternatives to emergency departments for non-urgent care.

However, as Dr Aust noted, there's a risk of healthcare fragmentation when the focus becomes purely about numbers rather than quality of care. For seniors managing multiple health conditions, having a regular GP who understands their complete health picture remains crucial.

What you can do while waiting

While the new clinics are being established, there are steps Canberra seniors can take:

• Ask your current GP about bulk billing options or payment plans
  
• Check if you're eligible for any concession cards that improve bulk billing access
  
• Consider the new Medicare urgent care clinic in Woden for non-urgent issues
  
• Use existing ACT walk-in centres for minor health concerns
  
• Plan ahead for routine appointments to avoid emergency department visits