The Rural Doctors Association of Australia (RDAA) said the Federal Government’s announced investment in Medicare and GP training will assist more Riverland patients to access affordable care.

RDAA president Raymond Lewandowski said any investment in health was welcome, especially investment in primary care, and he hoped to see an increase in the number of rural patients able to be bulk billed after November.

“All rural doctors want to provide affordable health care to our patients” Dr Lewandowski said.

“Unfortunately, the reality of providing the complex care needed to patients in rural and remote communities, who simply do not have easy or affordable access to other health care professionals, means that rural GPs have to provide advanced and complex care that is outside the scope of most urban GP practices.

“Longer consultations and increased services (such as surgical and mental health care) adds significant cost to the running of a rural GP practice. These practices are more often than not small, family-owned businesses, that already bulk bill as many disadvantaged patients as they possibly can.

“The expansion of the bulk bulling incentive to include all patients, not just children under 16 and concession card holders, means that for some practices bulk billing will be able to be extended to more patients in need.

“It will be particularly helpful for doctors who already bulk bill patients who do not qualify for the incentive but are struggling to afford appointments, with the gap being subsidised by the GP practice. Additional funding for these patients will be extremely welcome for the doctors who otherwise provide this care at a reduced rate.’

Dr Lewandowski said “the tiering of the incentive for rural and remote settings has also gone a long way in helping to address the additional costs of providing health care in the bush. This key principle built into the bulk billing incentive was due to RDAA’s advocacy, and it has already enabled many rural and remote practices to provide some bulk billed services, but to go to full bulk billing would require further consideration by individual practices”.

“The additional 12.5 per cent incentive for practices that only bulk bill will likely be out of the reach of many rural practices. The cost of providing the advanced level of care needed within rural communities, the shortage of health professionals, and the smaller patient cohorts are limiting factors that result in most rural practices having to mixed bill in order to survive,” he said.

“We are having active discussions with Rural Doctors Association members across a range of rural and remote medical practices to better understand how this incentive could be applied, and in what settings it may or may not be financially beneficial.

“For practices that do bulk bill or have a significantly high rate of bulk billing, these changes will present welcome additional investment into the primary care services they provide. Aboriginal Medical Services in particular will benefit due to the exclusive bulk billing model they have adopted, and that is a much-needed uplift in funding support.”

Dr Lewandowski said “there have been many reviews and reform recommendations that are sitting with the Federal Department of Health to put forward to Government”.

“To really address the issues plaguing our health system, particularly in rural and remote areas, practices need to have other models of funding available to them – not just fee-for-service,” he said.

“The changes to bulk billing are a continuation of the same funding framework that we know is no longer fit for purpose. We worry that the current suite of reform recommendations already on the table will be overshadowed by the bulk billing changes and will result in a missed opportunity for longer lasting and more-effective reform.

“With the Coalition matching the Medicare announcement, the new policy will come into effect in November regardless of which party wins government at the next election.

“We will continue to work with all parties to advocate for election promises,”

“RDAA’s election priorities include initiatives like increased rural training places.

“We look forward to seeing more policies aimed at improving health outcomes for rural patients over the coming months in the leadup to the federal election.” 

This article appeared in the Murray Pioneer, 19 March 2025.