The financial crisis threatening Australian general practice

“I was frantic. I was so busy that I felt unsafe.” Imaan Joshi was a final year general practice registrar in Sydney in 2013. She worked at a clinic that bulk billed—meaning it charged patients the same amount as the government Medicare rebate for the service they received, so patients get the consultation free.

That same year, the federal government had implemented a freeze on the Medicare rebate. Instead of the rebate increasing each year in line with wages and consumer price indices, the centre-left Labor government announced it would temporarily pause the annual increase to save money.1 The move was criticised by organisations such as the Australian Medical Association,2 which pointed out that the rebate already lagged the true cost of providing those medical services. Yet the freeze remained in place until 2020, under a conservative Liberal government that initially condemned its introduction.

It means that Australia’s primary care clinics saw their income decline, year on year, for a decade and despite the freeze lifting are yet to catch up on the years lost.

“The Medicare freeze ripped the heart out of general practice in Australia. It took AU$4bn that should have been invested in general practice out of the system. It said that GPs aren’t valued, they’re not worth it,” says Royal Australian College of General Practitioners (RACGP) president Nicole Higgins, a GP in Mackay, Queensland.