General practitioners will now have more incentive to offer millions of Australians free consultations with the federal government's bulk billing sweetener but Canberra patients may not see much of an increase in fee-free appointments, according to those in the industry.
Under the changes, incentives for general practitioners to bulk bill pensioners, concession cardholders and children under 16 will be tripled from Wednesday as part of the $3.5 billion package, announced in May's federal budget.
Federal Health Minister Mark Butler has touted this as the largest investment in bulk billing over the course of Medicare's history, saying the government has received positive feedback from GPs across the country, who were now looking at bringing back bulk billing.
But GP clinics in the ACT that spoke with The Canberra Times said they had no plans to make changes to the way they operate.
The ACT has the lowest bulk-billing rate of any Australian state or territory, with data from online healthcare directory Cleanbill putting it at 5.5 per cent, compared to the national average of 35.1 percent.
East Canberra General Practice principal Clara Tuck Meng Soo said her clinic changed its bulk billing policy a few years ago to meet costs, with the centre now officially only bulk billing veteran gold card holders and then offering the free visits to certain patients at the doctors' discretion.
She said the new government incentives would not be enough for the clinic to reverse those changes.
In cities, GPs will see their incentives grow from $6.85 to $20.65 for a standard consultation.
But Dr Tuck Meng Soo said patients with concession cards were currently charged $75 per consultation at her clinic while full paying patients paid $100, meaning that expanding bulk billing would lead to significant losses.
"We're probably going to continue doing what we do now ... there'll be certain number of patients that all of us see who don't currently meet the practice criteria for billing but will we still continue bulk billing them because we're aware of their personal circumstances," she said.
"With those patients, the fact that we're getting this increased incentive from the federal government ... makes it easier for us to continue bulk billing them."
Campbell Medical Practice manager Madeleine McKillop said her clinic operated under a private billing model and while some bulk billing was offered at the discretion of doctors, the new government incentives wouldn't change the centre's model.
"In terms of the cost of living and the cost of expenses, today it's just not feasible to run a general practice or a small general practice, like ours, on a bulk billing model," she said.
Ms McKillop said more support for smaller GPs was needed.
Further complicating the situation in Canberra, is the ACT government's decision to impose a payroll tax on general medical practices paying more than $2 million a year in wages, says Australian Medical Association's ACT branch president Walter Abhayaratna.
Dr Abhayaratna told The Canberra Times that initially local GPs were optimistic they would be able to bulk bill concession card holders but that optimism quickly eroded with the announcement of payroll tax.
"According to the surveys that we've conducted, GPs are going to be affected by that," he said.
"[The government was] told from the very beginning that this would cause GP practices to recoup those costs, which they can ill afford to when they're on such a marginal surplus.
"That's what the practice owners are telling us, is that they are going to have to increase the cost of the care to patients."
Asked about the payroll tax, Finance Minister Katy Gallagher said it was a matter between the ACT government and GPs. Senator Gallagher said the mutli-billion dollar federal government incentive would make it more viable for GPs to bulk bill in the ACT.
However, Shadow Health Minister Anne Ruston cast doubt over the change, stating there was no guarantee the incentive would translate to more patients being bulk billed.
"There is no doubt that urgent action is needed. Bulk billing rates have dropped every single month under the Albanese Labor Government, plummeting to the lowest levels since 2013," she said.
"This concerning trend has continued even following the Government's announcement on tripling the bulk billing incentive, showing they have failed to restore confidence in the system."
