More Australians are being priced out of regular medical care, as the number of healthcare clinics offering bulk billing services continues to decline.

Key points:

· Just 10 per cent of WA GP clinics offer bulk billing for patients, a report says

· Some people are foregoing medical appointments due to out-of-pocket costs

· Doctors say many clinics can't afford to provide bulk billing

Perth resident Justine Ioppolo made about a dozen visits to her doctor in 2023.

On top of her regular check-ups, Ms Ioppolo was in the process of getting an ADHD diagnosis.

The 29-year-old soon discovered she had hit her Medicare safety net, leaving her more than $2,000 out of pocket in the first half of last year.

Ms Ioppolo said bulk billing was never an option.

"It's quite shocking," she said.

"Not only is it hard enough to get an appointment … sometimes the price makes you not want to go. But why are we putting a price on our health?"

"We're not all well and this age bracket is when women are having children and they're constantly going to GPs, so why wouldn't we have a subsidy?"

NSW has most bulk-billing only clinics 

A survey by healthcare comparison website Cleanbill found nationally just over 24 per cent of the clinics they spoke to in November were offering bulk billing to all customers.

The company says this represents a drop of more than 10 percentage points since April when they last conducted the survey of almost 6,100 clinics.

This figure does not include clinics that bulk bill certain categories of patient, such as children, healthcare card holders or clinics that bulk bill but charge additional fees to become a patient.

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WA has recorded the largest fall in bulk billing rates across Australia, a report has found.(Grace Burmas)

New South Wales had the highest number of bulk billing only clinics at 37 per cent of the 2,098 surveyed.

Tasmania had the least with just 0.9 per cent of the 130 clinics contacted.

Slump in WA bulk billing

Cleanbill owner James Gillespie said Western Australia recorded the largest decrease in bulk billing clinics nationwide, dropping from 26 percentage to 9 per cent.

The firm surveyed 593 clinics in Western Australia.

 

Some patients are thinking twice before booking a doctor's appointment because of out-of-pocket costs.( ABC News: Grace Burmas )

"It's driven in large by 514 clinics nationally switching from being bulk billing clinics, to private billing clinics," Mr Gillespie said.

Recent Australian Bureau of Statistics data shows the number of Australians who delayed seeing a GP because of concerns about costs rose over 2022 and 2023 to more than 1.2 million.

The federal government last year announced it would triple the incentives paid to doctors who bulk bill children under the age of 16, pensioners and Commonwealth concession card holders.

Treasurer Jim Chalmers estimated the change would benefit around 11 million people, including around five million children.

'Bandaid effect'

AMA WA Council of General Practice chair Simon Torvaldsen said the incentives were not enough to significantly raise bulk billing rates.

"I think it's had what you might call a bandaid effect," he said.

"It's only available to children, [pensioners] and concession card holders, there's a bunch of other people who have cost-of-living pressures who aren't benefiting at all from this."

 

Simon Torvaldson says many clinics can't afford to bulk bill patients. ( ABC News: Grace Burmas )

Dr Torvaldsen said his Mount Lawley practice had largely moved away from bulk billing patients, as it was no longer financially viable to do so.

"We're bulk billing probably 2 or 3 per cent more than we were at the same time last year, but if you go back two or three years, we're actually still bulk billing less," he said.

"It's a small business, we have to pay our staff, wages are going up, cost is going up, insurance is going up, and if we're running at a loss we have to close down."

It was also hoped the subsidies would relieve some out-of-pocket expenses for patients not eligible under the scheme.

But Dr Torvaldsen said this had not been the case.

"Any extra income from this bulk billing incentive is already being chewed up," he said.

"It's preventing us from going bankrupt at this point in time but it's not actually changing anything else."

Government defends moves

In a statement, federal Health Minister Mark Butler said the government's investment of $3.5 billion to increase bulk billing incentives for doctors applied to three in every five GP consultations.

His office also questioned the Cleanbill report, saying the latest bulk billing statistics from the September quarter of 2023-24 showed 73.2 per cent of all standard GP consults were bulk billed.

The treasurer acknowledged the difficulty of accessing GP care and pointed to the delivery of 58 urgent care clinics as an interim solution for easing pressure on emergency wards.

 

Treasurer Jim Chalmers said the incentives would benefit millions of patients. (ABC News: Luke Stephenson)

"We've already invested billions of dollars and we'll see the benefits of that in the coming months and years," Mr Chalmers told the media in Brisbane on Monday.