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Chapter 3: General practice viability

Government contribution to care


Government spend on general practice is markedly less than in other parts of the health sector (Figure 32). Despite general practice being the most highly accessed part of the health system, funding per person is far greater in public hospitals ($3484) than in general practice ($443.80).11

Figure 32. General practice funding as a proportion of overall health funding

General practice funding as a proportion of overall health funding

Measure: Health expenditure, current prices, by area of expenditure and source of funds, 2021–22 ($ million).

Source: Australian Government, Australian Institute of Health and Welfare, Health expenditure Australia 2021–22. Available at www.aihw.gov.au/reports/health-welfare-expenditure/health-expenditure-australia-2021-22/contents/main-visualisations/expenditure-table

General practice is far more cost-effective than hospital care. The average cost to the Government for a patient to visit the emergency department is $692. If that patient is then admitted to hospital, this cost rises to $1296. In comparison, it costs the Government only $82.90 to support a patient to spend 20–40 minutes with their GP for appropriate preventive care, early diagnosis, and early treatment for health conditions.11

In 2022–23, there were 2.85 million presentations to emergency departments that could have been potentially avoided by a visit to a general practice.11


Effective comprehensive care provided in the practice setting can reduce the need for more expensive care provided in hospitals or by other specialists, if appropriately supported by government. 

Between 2020–21 and 2022–23, Australian Government expenditure per person on GPs dropped dramatically from $466 to $420. This is the lowest per person expenditure on GPs since 2015–16 and reflects the significant decrease in spending on general practice since the height of the COVID-19 pandemic (Figure 33). In the same three-year period, real expenditure on GPs has plummeted by $905.6 million, a decrease of 7.6% (Figure 34).11

Figure 33. Australian Government spending on general practice per person, 2015–16 to 2022–23

Australian Government spending on general practice per person, 2015–16 to 2022–23

Measure: General practice total expenditure on GPs per person.
Data source: Australian Government, Productivity Commission. Report on government services 2024, 10. Primary and community health.
Available at www.pc.gov.au/ongoing/report-on-government-services/2024/health/primary-and-community-health
 

Figure 34. Australian Government spending on general practice ($ million), 2015–16 to 2022–23

Australian Government spending on general practice, 2015–16 to 2022–23

Measure: General practice total expenditure on general practice, 2015–16 to 2022–23 in millions of dollars.
Data source: Australian Government, Productivity Commission. Report on government services 2024, 10. Primary and community health.
Available at www.pc.gov.au/ongoing/report-on-government-services/2024/health/primary-and-community-health 
 

Medicare funding for longer GP consultations is not proportionally equivalent to shorter consultations. Generally, the rebate that patients receive per minute decreases for patients seeking longer consultations, which are usually for complex or multifaceted health needs (Figure 35).12 In this way, the current funding system for general practice devalues appointments for more complex care.

Figure 35. MBS patient rebate per minute for standard GP consultation items

Australian Government spending on general practice, 2015–16 to 2022–23

Measure: Value of the MBS patient rebate for standard GP consultation items, per minute of care.
Source: MBS Online, available at www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/Home 
 

GP INSIGHTS
‘I am most concerned about patients being able to afford the different services that keep them healthy. Many of these are competing for the dollars that patients have including healthy food, health insurance, gap payments for doctors and allied health. There is often the need to decide between these things, worsening people’s overall health.’
‘Complex patient health issues such as chronic disease, mental health, menopause issues - these take time to deal with, and GPs are not remunerated well time wise. I have a lot of long consults and see fewer patients per day than my colleagues. However, I feel I must spend adequate time with each patient to provide quality care, otherwise I am not doing my job properly. There is pressure on me to push through more patients per day to keep practice revenue ticking over, and to earn an income similar to my peers, to make the pressures and responsibilities of being a doctor financially worthwhile. But I am not prepared to lower the standard of care to patients, and thus face some difficult professional decisions.’
‘Mental health, this is still underfunded and often many patients experiencing mental health issues are unable to afford help. They often turn to their GP to help, however, many GPs don't have the capacity to help given the perverse nature of Medicare which incentivises poor medical care. Management of chronic diseases – again having the time to manage these patients. When you look at potentially preventable hospitalisations the majority are patients with chronic disease complications that can be managed in general practice.’