Bulk-billing rates remain low as GPs spend longer with patients, survey finds


Tue 7 Oct 2025
ABC News

GP Owen Harris says he chooses to bulk-bill a small number of his patients at a cost to him and his practice.   

In short
GPs are managing conditions typically handled by specialists due to high costs and only 12 per cent can afford to bulk-bill all patients, according to an industry survey.

The Royal Australian College of GPs report shows patients need longer appointments for mental health, but doctors say they are stuck in a "six-minute medicine" model.

What's next?
Some GPs are worried things will only get worse after November 1 when the government's election package for bulk-billing comes into effect.


Melbourne GP Owen Harris would love to bulk-bill more of his patients.

He specialises in helping patients with complex mental health needs, drug and alcohol issues and gender affirming care.

"None of these things are quick and simple,"  he said.
Although he works in a private billing practice, Dr Harris chooses to bulk-bill a small number of his patients at a cost to him and the practice.

"It's just not in line with my values to force them to pay or ask them to come back or go somewhere else … but it does mean I lose out," he said.

Dr Harris said the system of time-based care, where GP visits were classified based on the length of appointment, encouraged doctors to practice what had become known as "six-minute medicine".


Owen Harris is a GP in the inner-Melbourne suburb of Brunswick.

He said the longer appointments many of his patients needed did not attract Medicare rebates proportionate to the time he spent with them, and he could earn significantly more if he squeezed in lots of shorter appointments back-to-back.

"[But] there is simply no way to sustain empathy, compassion and concentration seeing that many patients in a day," he said.

"Burnout or more superficial care is almost guaranteed."

GPs taking on role of specialists
The Royal Australian College of GPs (RACGP) released its annual survey of members and GPs in training on Tuesday, and like Dr Harris, many of the thousands of doctors surveyed said they were spending longer with patients, particularly for mental health.

The college has urged the federal government to increase Medicare rebates for longer consultations by 40 per cent.

As it stands, the rebate a patient receives per minute generally decreases the longer the appointment is.

"We are living in an ageing society with more chronic health conditions and more complex healthcare needs, which means patients require more time with GPs,"  president Michael Wright said.

Royal Australian College of General Practitioners president Michael Wright says patients require more time with GPs.

GP survey at a glance
The average fee for a six–20-minute standard consultation has increased from just over $78 to $82 (which means the average gap fee is around $39)
28 per cent of people say they are waiting longer for a GP appointment than they felt acceptable
8.8 per cent of Australians delayed care due to cost in 2024, compared to 7 per cent in 2023
As the cost of seeing a GP continues to increase, half of practising GPs said they now charged $90 or more for a six-to-20-minute consultation, which left patients $47 out of pocket after the Medicare rebate.

Only 12 per cent said they were able to bulk-bill all patients compared to 13 per cent last year.

Most GPs said they were also regularly managing conditions typically treated by specialists, such as psychologists or psychiatrists.

Even in metropolitan Melbourne where he practised, Dr Harris said it could be near impossible to find a private psychiatrist to refer his patients to, so he had to do his best to provide that level of care.

Dr Harris said knowing you could not get someone into a specialist or a public hospital mental health unit could be a lot of pressure.

"Particularly for junior doctors, that can be pretty scary," he said.


Doctors' biggest challenge is the rising number of complex presentations, particularly with mental health, according to the survey. (ABC News: Kate Nickels)

The report said funding for GP care had remained stagnant for the past decade and in 2023-24 the government spent $452 on GP care per person compared to $3,649 on public hospital care per person.

Will the bulk-billing changes help?
The RACGP report comes just weeks before new bulk-billing changes promised at the last election come into effect.

From November 1 the government will allow GPs to receive a bulk-billing incentive for any patient. Currently they are only eligible for the incentive if they bulk-bill a patient who is under 16 or a concession card holder.

There will also be an additional 12.5 per cent incentive payment, split between the GP and practice, when all GPs at the same clinic bulk-bill all patients.

Health Minister Mark Butler said these incentives meant nine out of 10 GP visits would be bulk-billed by 2030.

The doctor who does bulk billing  is living in the same cost of living crisis as the rest of us.

Highest electricity prices in the world.

Highest rents and property prices.

Highest insurance. Highest rates and government taxes, levies, fees and registration.

This also corresponds with our politicians having the highest salaries in the world.

It’s not easy for anyone in Australia.

I think our politicians need to be paid the same as a  bulk billing Gp and not be entitled to any thing more than the salary.