Government trumpets increase bulk-billing rates

Sabra Lane: The Federal Government's trumpeting new data showing bulk billing rates are up 2.1% from last November when the Government tripled the rate it paid GPs who see patients under the scheme. Bulk billed patients pay no out-of-pocket expenses to see a doctor. The Health Minister's Mark Butler. Mr Butler, thanks for joining AM.

Mark Butler: Thank you.

Sabra Lane: The 2.1% increase is a figure the Government reported in February this year. Is the Government considering additional investments to further increase the bulk billing rate?

Mark Butler: No, we're not right now. We've seen an additional 950,000 free visits to the doctor since these new incentives came in on the 1st of November. So they are working to arrest, first of all, the freefall in bulk billing that we inherited when we came to Government. They're providing, I think, much better remuneration to GPs who are bulk billing, their pensioners, their health care cardholders and children under the age of 16. And we are seeing a pleasing rebound in bulk billing, particularly in some of those areas I was most worried about. So Tasmania is up 5%, which had the lowest rates of bulk billing of any of the major states. And we're seeing big increases in regional Australia as well.

Sabra Lane: Concerns were raised though last week that the benefits of tripling the bulk billing incentive have been eroded because some states have changed the way that they interpret payroll tax, meaning that GPs now are counted as employees rather than contractors, with the states increasing their tax take from those GPs. And the doctors say that's coming from their pockets. Have you got a handle on just how big a problem that is and what are you saying to the states?

Mark Butler: Well I have said to states a number of times publicly that I'm urging them to sit down with doctor representative groups and make sure that these changes in the interpretation of existing payroll tax rules don't impact the GPs in a way that effectively neuters or neutralises the impact of the massive investments we made in last year's budget.

Sabra Lane: Have you got a handle on how big it is, the problem?

Mark Butler: Well it varies from state to state because each state government is taking a slightly different approach to this question and it would be good to have some uniformity across the country. That would give certainty to general practice and I think to patients who have seen over the last several years it's never been harder, never more expensive to see a GP than it has been over the last few years which is why it was our highest priority when we came to government.

Sabra Lane: So you don't know how big a problem it is with the states?

Mark Butler: States are still really negotiating the impact of these things. They're still talking to doctors groups about potential amnesties and which general practices might or might not be subject to these changes. So by and large they haven't yet impacted general practice but understandably general practice is very worried that in the future they might see changes that really do neutralise the impact of the significant investment we made in general practice in last year's budget.

Sabra Lane: You mentioned Tasmania there at the start. I am Hobart based and many people here struggle to see a GP in a timely fashion. We have another example here of Risdenvale Clinic. It closed a week ago because they cannot find GPs and that's affected 1,400 patients. What can the Commonwealth do to ease those problems?

Mark Butler: Well we also have this year seen a really pleasing increase in the number of junior doctors choosing to take on general practice as their vocation. An increase of about 130 additional junior doctors taking up general practice training compared to last year. But this is not going to be a change we see overnight. It has never been harder to see a GP than it is right now.

Sabra Lane: So can you say anything to those people? I mean even your colleague Julie Collins said it was distressing.

Mark Butler: Well and it is distressing. We have seen general practices around the country closed down and particularly in regional areas it has been very hard to attract general practitioners. We have got a range of things underway in those areas, particularly in regional Australia where we rely heavily on overseas trained doctors to make it easier to recruit them from overseas and have them working in regional Australia providing those vital services.

Sabra Lane: Are you going to deliver further assistance in the budget to help smooth that passage? Because those 1400 patients are looking for help now.

Mark Butler: Well you know I am not going to announce any budget initiatives on this program, Sabra, but this is a piece of work that health ministers from a state and territory level and I are working on very, very regularly. We only met again the week before last to talk about the progress of the recommendations we received to make it easier to recruit doctors from overseas. But at the end of the day we also need to recruit more junior doctors into general practice here in Australia and we have seen really over the last several years some of the lowest rates of interest among junior doctors in general practice ever. It used to be the case that about one in two medical graduates chose general practice as their preferred career. That got down to about one in seven. So I am really pleased that this year I hope because of the confidence that they see in general practice more junior doctors are taking up general practice as their preferred career. But that is not going to be seen overnight. It takes some years to train a new general practitioner unfortunately.

Sabra Lane: What about the patients who can't get bulk billing? What's happened to the amount they are charged under the Medicare benefit schedule since November? Are there out of pocket costs going up?

Mark Butler: We had seen out of pocket costs going up very significantly over the last several years. The bulk billing rate that I have talked about today indicates that there still is substantial bulk billing of people who don't qualify for the bulk billing incentives. So those incentives apply to pensioners, to health care card holders, concession card holders and kids under the age of 16.

Sabra Lane: So to the point of that question, sorry.

Mark Butler: Well people who don't qualify for those incentives do still receive bulk billing in some parts of the country. So in Western Sydney there are still significant bulk billing rates. But where you are in Tasmania it is the case that people who don't have that health care card are often not bulk billed.

Sabra Lane: Mr Butler, thanks for talking to AM this morning.

Mark Butler: Thank you Sabra.

Sabra Lane: And Mark Butler is the Federal Health Minister.