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Bulk billing is dying, says Bateman

by Jared Reed  

GPs have taken an effective 2% pay cut because of lower than average Medicare rebates, and this sounds the death knell for bulk billing, says Primary Healthcare boss Dr Ed Bateman.  

Speaking today at Primary’s annual general meeting, Dr Bateman told shareholders that cuts in the 2009 Federal budget for primary health sector items had lead to an increasing rate of co-payments.  

“These co-payments are needed by GPs due to insufficient government funding for general practice. In particular, the current bulk billing rebates received for normal GP consultations are approximately half the average privately billed fee,” he said.  

Patient attendances in recent months have been “flat” as result, said Dr Bateman. However, Primary has recorded a near doubling of its operating earnings this year, but only because of adjustments it has made to “claw back” revenue from government funding cuts.  

A third of Primary’s 45 medical centres have introduced co-payments, said Dr Bateman, and the company will increase private patient pathology charges to reduce the negative effect of a reduction in pathology bulk billing. Four new medical centres are expected to open in 2010.  

The company says the integration of Symbion medical centres it bought last year has progressed well this year, and it plans to open four more large scale medical centres next year.  

Primary owns HCN, the developers of practice software Medical Director, and the e-health division increased its underlying margins by a strong 5% in the past financial year, said Dr Bateman.      


27 November 2009
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Latest Comments

  • We stopped bulk billing ALL of our patients(except nursing homes) about 8 years ago. As a result, we fairly quickly lost about 15% of our patients; the 15% who caused us the most problems. They went to the surrounding bulk billing clinics who, because they then had our problem patients to deal with, lost people who were happy to pay for good private care. Within a year we had made up that 15% and more.

    We charge the AMA rate and everyone gets 15 minutes per consult unless they request more.

    Interestingly, a joint injection is $45.00, a fee no-one has complained of despite the loss of a subsidy from "that nasty penny pinching government". How many of you are now providing this skilled service for free?

    We do, of course, make allowances for pensioners, retirees, large families, frequent attenders with chronic illnesses and those on hard times with discounted rates. These vary from 10% for retirees, 20% for well off pensioners right down to "rebate + $10.00" or, at times, "rebate only". What is so good here is that it is we who decide what we will be paid, not some Canberra based anti-doctor mob of politicians and public servants.

    We run on time and there are never any grizzles.

    I know that the prospect is scary for some but the concept is worthy of consideration. We most certainly are not going back.

    Posted by Private GP - Perth 27/11/2009 3:04:27 PM

  • Bulk billing is dying? I think it will be dead by the end of next year. The new Medical Practitioner, Nurses and Health Professional Support Staff Awards 2010 that come into effect on 1.1.10 are already forcing practices to close or reduce their weekend services. The new punishing penalty rates and allowances are forcing smaller practices to either increase their fees or merge into larger practices in order to comply with new Federal Employment Laws. Under the new laws it is becoming impossible for a solo practice to survive on bulk billing. All practices will need to budget conservatively a 10% to 15% increase in wages which represents 60% (the largest) of a practices overheads. Also they will need to consider taking on additional staff due to the new 38 hour work rule which prohibits employers making employees work regularly over 38 hours in a 4 week cycle. If you ignore it be prepared to pay a $33,000 fine for breaching the new National Employment Standards.

    David Dahm CEO BA(Acc.) FCPA,FTIA, FFin,FAAPM,FGLG, AGPAL Surveyor

    Advisers to the 2008 BRW Fast 100 Medical Practice

    Health & Life Pty Ltd - National

    Accountants and Practice Management Consultants

    Posted by David Dahm 27/11/2009 3:07:37 PM

  • Agree with you Private GP Perth. For all successful independent practices Bulk-billing died some time ago (and may it RIP).

    Posted by dr kos1nsk1 27/11/2009 3:51:58 PM

  • I really wish that the government would allow a doctor to bulk bill a patient and take a booking fee or co payment of $5 or $10 etc so it is not too painful to the patients pocket.What possible problem could occur if this was done –many specialists and para medical fields are allowed to do this .

    Posted by annoyed 27/11/2009 8:52:45 PM

  • Well i just dont make much money, it's either eat or go see the doctor. some people have it hard and bulk billing needs to be available. im a contractor and i dont get paid ontime all the time. so if i dont have the money i dont get/deserve medical treatment?

    im not a problem patient, it just seems the government is just wanting to wipe its hand clean and not care about the health of the average australian. i do need to see a doctor atm but have to wait over 2 weeks cause he is booked up. but its not as if anyone wants to help the good of the human race these days.... geez i thought you became a doctor to help people, not for your own greed.

    look at the population growth of QLD in the last ten years and how many new hospitals.

    Posted by annoyedTOO 2/12/2009 5:16:49 PM

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