Minister for Health and Aged Care - press conference - 1 November 2023

Read the transcript for Minister Butler's press conference in Adelaide on the largest investment in bulk billing in the 40-year history of Medicare.

The Hon Mark Butler MP
Minister for Health and Aged Care

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MEMBER FOR BOOTHBY, LOUISE MILLER-FROST: It's great to be here at Castle Medical Centre in Edwardstown with the Minister and also Dr Stephanie. Having worked in the health sector for so long, I really understand how important general practice is, as the key to the health sector. They do the early intervention, the early diagnosis, management of conditions. And of course, being able to afford to come to your GP on a regular basis is a really important part of managing your own health conditions in the community, and of course, of relieving the pressure on the hospital system. So I'm very excited about this announcement today. And I'll hand over to the Minister.
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Thank you, Louise, and thank you, Doctor Ng for hosting us here today. This is truly an historic day for Medicare. We went to the last election promising to strengthen Medicare, and today we're delivering on that promise. From today, almost $6 billion of new investments in the Medicare system take effect. And the centrepiece of that is a tripling of the bulk billing incentive that will be paid to general practices like this one, if they continue to bulk bill their pensioners, concession card holders, and children under the age of 16, who come through their doors. Doctor Ng tells me that about 80% of their patients fall into those categories.
The tripling of the bulk billing incentive for a general practice in the cities will mean about a 34% increase in their income for every standard consult that they do, for a bulk billed patient. That is a huge injection of confidence and funding into a sector that, frankly, has been under enormous pressure for a decade. A decade of cuts and neglect, particularly six years of a Medicare rebate freeze that was initiated by Peter Dutton when he was the Health Minister on top of the legacy of COVID and then the global cost of living shock that we're all living through right now, has really placed general practice under enormous pressure. This “game changer” - to use the words of the College of General Practice - is going to make a very real difference to the viability of general practice, and really importantly, as well make it much easier for more than 11 million Australians to get to see their doctor, free of charge.
So I want to thank Dr Ng and her colleagues here at the Castle Medical Centre and general practitioners right across the country, for sticking it through, frankly, a decade of real pressure, cuts, neglect, Medicare rebate freezes. We said at last election that we had no higher priority than rebuilding general practice, because as Louise said, it is utterly the backbone of a well-functioning healthcare system. And today we're delivering on that promise.
DOCTOR STEPHANIE NG, CASTLE MEDICAL CENTRE: I am Dr Stephanie Ng, and I'm thankful for the Labor government, for pushing for the tripling of the bulk billing incentive today. At least that will allow practices like ours to continue to bulk bill our vulnerable patients.
BUTLER: Thank you, doctor. Questions?
JOURNALIST: Are you concerned at all about the AMA again today recommending that doctors raise their fees for a third time this year.
BUTLER: Doctors groups like the AMA will continue to provide that sort of advice. Our responsibility is to sustain a well-functioning Medicare system. Doctors groups, particularly the College of General Practice, made a request to the government to triple the bulk billing incentive many, many months ago. We went through a process and we delivered that request in the May budget. The College said that that was a game changer for general practice.
And as I said, a standard 15 to 20 minute consult for a patient covered by the bulk billing incentive, which is 80% of the patients coming through the door here, will go up in the cities by 34%. That is a huge increase in the income of general practices that choose to continue to bulk bill. In the regions that's even higher. For a standard town like Cessnock in the Hunter Valley, or Whyalla here in South Australia, their increase for a standard 15 to 20 minute consult will go up by 50%. This is a very significant injection of funding and confidence into the general practice sector and it's written and it delivers on a promise that we made the last election.
JOURNALIST: Minister you've been unwilling to say how many Australians will actually get access to bulk billing through this proposal. While 11 million Australians are eligible, it doesn't mean that all will get bulk billing appointments. Can you give us some more concrete figure?
BUTLER: The word is incentive: it's an incentive to general practice, and general practice will make their own decisions about whether they take the extra funding which is available to them. But the condition for taking that extra funding is that they bulk bill those patients, those more than 11 million patients. Now, the College of General Practice representing general practitioners asked for this, and we delivered it. When we delivered it, they said it would be a game changer on bulk billing. And I and many of my colleagues have heard from individual general practices, that if they had moved away from bulk billing, because of all of those pressures I've talked about, they were intending to return to bulk billing. And for those that were feeling a need to reconsider their ongoing bulk billing practices, they've reaffirmed their commitment to do it in the long term. So I'm very confident, having worked closely with general practice on this measure, that this will make a real difference to more than 11 million Australians out there and to general practice, who I’m confident now recognise that they have a government in Canberra that is in their corner.
JOURNALIST: Do you expect these measures to incentivise borrowing for vulnerable Australians and will also prompt GPs to offer bulk billing to the Australians not in that category?
BUTLER: I think what we've found, first of all, there's no question it's a huge incentive for general practice to continue bulk billing 11 million pensioners, concession card holders, and children under 16. So that millions of mums and dads out there can have confidence that when their kid gets sick, they can go to a doctor and not have to pay a significant fee. So that's important for those 11 million Australians. But what I also know, talking to general practices over the last year or year and a half, is that many of them have tried to continue bulk billing those vulnerable cohorts, those lower income cohorts, and effectively had to jack up their gap fees for everyone else to be able to sustain the financial viability of their practice. So this will relieve pressure, right across the business, for those individual general practices.
JOURNALIST: How many GPs do you think will ensure more patients are bulk billed?
BUTLER: I can't put a number on it, because it's an incentive that's offered to general practitioners. All I can say is refer to my earlier comments that the sector itself asked for this measure from the government. We worked it through, and we decided it was going to make a real difference and delivered it in the Budget that we delivered in May. Already, we're hearing from general practices, it's already making a difference. And we know that from today, we're very, very confident that general practice will reaffirm its commitment to bulk billing those vulnerable cohorts.
JOURNALIST: What are bulk billing rates at moment? And is there a figure you expect them to rise to?
BUTLER: Bulk billing rates differ vastly across the country, in some areas, like Western Sydney, they're well in excess of 90%, you can move to other parts of the country - like Tasmania, the ACT, the Hunter Valley and Central Coast in New South Wales - and they're more like 50%. So they vary greatly across the country. Broadly, as a national average, taking into account that wide variation, they’re in the low 80 percents, and there's been a significant drop over the last few years because of those pressures that I've talked about. So this incentive, as I said, has always been particularly targeted. Since it's been in place for many years, always particularly targeted at bulk billing, children, pensioners, and concession card holders. And I'm confident this will make a huge difference to bulk billing practices.
JOURNALIST: I might just quickly go back to the doctor, if we can. Are you happy to talk us through I suppose, you know, touching on the rising operational costs. Can you speak to that for sort of this practice what that's meant for you?
DR NG: So for extended consultation, just like Mr Butler said, so a standard consultation is a consultation less than 20 minutes in the practice room. So that will attract about $41.20. And that $41.20 will go not just to the doctors, it also includes the wages for the front desk staff, the nurses, the rent, the utilities, and all the consumables involved in running the practice. For example, mask glove, everything, and also like computers, printers, papers, pen or even a subscription to the software of running the computer. And also insurance and tax. So that's not a lot considering that's just for the $41.20.
JOURNALIST: Have you seen I guess a decrease in people, in foot traffic coming in with the cost of living at the moment, people just not being able to afford an everyday doctor's appointment?
DR NG: Because we are a new practice and we are a bulk billing practice. So we have seen a lot of patients that couldn't afford to see other doctors in other mixed billing practices. So our appointment was full from day one. But we struggled to keep up, you know, with the patients, and with inflation and all that. In past year, we are really struggling to make the practice viable.
JOURNALIST: You mentioned a whole heap of those costs that are hitting you as a sort of business.
DR NG: It’s always the cost, because with all the Medicare rebate, people will think that that is the doctors’ fees. But that's actually the cost - that's actually the fees for us to keep the practice running.
JOURANLIST: And how significantly have some of those costs increase for you? Yeah, you've listed a whole range of them, just how much of some of those jumped?
DR NG: In the past few years, because of the inflation and also on the wages increases, so it has increased significantly: over 30%.


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