Jordon Steele-John (WA, Australian Greens) Share this | Hansard source

I want to talk about the government's bulk-billing changes that came into effect over the weekend. Back in February, the health minister told Australians the new incentive would mean that some 4,800 clinics would be fully bulk-billing and that more people would not pay out-of-pocket costs. Are we expecting huge changes to the availability of bulk-billing now that the new incentive has been launched? It looks like probably not.

Under the new scheme, GPs and their practices can choose to be fully bulk-billing in order to get an incentive payment, but many GP practices have stated they won't be able to sign up. Pre 1 November, out of roughly 6,500 GP clinics nationwide, about 1,600 were fully bulk-billing clinics. According to the government's own data, released on Monday, just 622 of Australia's 4,720 metropolitan practices planned to change from mixed billing to bulk-billing once the changes are in place. This means that only 13 per cent of metro GP clinics will offer fully bulk-billed services to their patients as a result of this change. So for anyone in a metro area heading in to see their GP for an appointment any time soon, odds are you will still pay out of pocket. The government has said that this plan will fix the system. But, in reality, in its current form, it is barely making a dent. For most people, especially in our suburbs and in our cities, this means still paying some $80 or more to see a GP.

People are putting off care, waiting until they are sicker or ending up in hospital because they can't afford basic check-ups. The expanded incentives scale down for metro areas, meaning that the majority of Australians—those living in cities and large towns—may not see much of a difference at all for quite some time.

Let's be clear. The overwhelming majority of doctors want to bulk-bill. They want to care for people without worrying about costs, but they can't keep their doors open on rebates that don't even cover basic costs. The RACGP has been sounding the alarm for months. GPs are spending longer with patients, dealing with more complex conditions and health issues, but Medicare rebates haven't kept up. The expanded incentives don't go far enough to change that. The incentive offered for longer consults is simply not enough to make them viable. The Greens have been calling for higher rebates on longer appointments so that people managing complex and ongoing health issues can access bulk-billed care.

I want to live in a country where no-one ever hesitates to go to the doctor because they're worried about money and where doctors are able to bulk-bill everyone. But the reality is that a lot of GPs and medical admin staff have probably been having some really tough conversations with their patients since 1 November, trying to explain complex billing systems and the intricacies of Medicare bulk-billing in the hope that their patients will understand that their inability to make the switch is not so much a choice but, genuinely, the only way that some clinics can stay afloat.

We need a funding model that actually reflects the costs and complexities of care in 2025, and we need to make sure GP clinics around the country can afford to bulk-bill every patient. The Greens have been saying this for years: health care is a human right, not a privilege. I am glad the government agrees in principle that all should be able to see a GP without cost, but this plan doesn't deliver it. It is time for Labor to get on with real reform.