Bulk-billing’s ground zero: Shell-shocked GPs lament demise of primary care

A Canberra GP clinic’s decision to end bulk-billing for defence force veterans is being held up as the latest shock threatening to undermine primary health care across the country.

Mar 02, 2023, updated Mar 02, 2023
(Photo: AAP)

(Photo: AAP)

The blunt warning from Queensland leaders of the Royal Australian College of GPs (RACGP) comes as an auditor-general’s report reveals public hospitals and emergency departments in Queensland are buckling under demand pressure and workforce shortages.

GPs have repeatedly stated that much of the demand stems from weakened primary health care services, where ageing patients and those with long-term chronic conditions are falling back on the public health system because the local doctor is either absent, difficult to access or unaffordable.

Those assessments align with some of the auditor-general’s findings, which list serious shortcomings in meeting demand, including:

The number of patients waiting longer than clinically recommended for a specialist doctor has increased by 80 per cent to about 104,000 patients.

Between July 1, 2017 and July 1 last year, the total number of patients waiting longer than recommended to see a specialist increased by 177 per cent.

State-wide ambulance ramping targets, where paramedics have to wait with patients in hospital parking bays until an emergency room becomes available, have not been met in the past eight years.

Opposition Leader David Crisafulli has seized on the findings as the result of the Palaszczuk Labor Government’s failings.

But RACGP president and Mackay based GP, Dr Nicole Higgins, said these instances would continue to worsen if primary health care, funded by the Commonwealth, was not fully revived.

She said in the current climate, she understood why the YourGP practice made the tough call to cut bulk-billing of defence force veteran patients.

“YourGP would not have made this decision unless it was absolutely necessary. Due to long-term, chronic underfunding of general practice, their hands are tied,” she said.

“The owners of the clinic have to find ways of keeping their heads above water or they will have to shut up shop, a scenario in which no one wins, particularly regular patients who have been frequenting this practice for many years.”

Higgins said it was a sign of “things to come” if the federal government failed to boost investment in general practice care so that practices would not be forced to hike fees or close.

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“The key to relieving pressure on our entire health system is giving general practice care a shot in the arm,” she said.

GP and former army major, Dr Kerry Summerscales, has indicated to an industry media outlet that her practice, whose patients were 90 per cent veterans, was resisting taking similar action to the Canberra clinic, but that holding out was “coming at a cost”.

Summerscales, also based in Mackay, said long discussions on the future of how they will manage their billings in the future to stay financially viable were continuing.

“It is a personal decision of mine, and the practice has been gracious enough to absorb the cost of that,” she said.

“From a practice point of view, it’s not feasible and it’s not viable. The administrative burden associated with DVA (Department of Veterans Affairs), combined with the complexities of care, often mean veteran consults are longer consults.

“We want to provide the best possible care for our veterans, but longer consults are not remunerated appropriately, thus there is pressure to push patients through quickly, or charge a higher gap – which one cannot do when charging to DVA.”



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