By Callum Ludwig
Health directory Cleanbill released the third annual Blue Report in 2025, scoping out the availability of bulk billing for an adult without concessions in communities across the country.
It is a mixed bag for the federal electorates of the Outer East, with the changes in bulk billing clinics over the last three years varied between Casey, Aston and Deakin.
Since the end of 2022, Cleanbill has called each GP clinic they could across Australia to gather pricing and availability information for bulk billing across the country, checking in with the 6925 clinics yearly to account for any changes. Only 64 clinics nationally either didn’t provide their pricing and availability information or didn’t answer Cleanbill’s multiple attempts to contact their clinic or the report.
Aston’s previously strong availability of bulk-billing has nosedived, having sat at 36 per cent of 25 available clinics in 2022-23 and 32.4 per cent of 37 available clinics in 2023-24, it has now tanked to a concerning 11.1 per cent of 36 available clinics in 2024-25. The average out-of-pocket cost for a consultation has only risen by $2.28 to $36 during this time.
The Royal Australian College of GPs (RACGP) President Dr Michael Wright said all Australians need affordable access to a GP who knows them and with a federal election fast approaching, we should be seeing bold commitments from all political parties to achieve this.
“With proper investment in Medicare we can increase bulk billing, and reduce out-of-pocket costs for people who aren’t being bulk billed, both of these things are crucial,” he said.
“We know funding works, government data and the RACGP’s Health of the Nation report have shown the tripling of incentives has helped GPs bulk bill more children and concession card holders, particularly in rural and remote areas where the incentives are highest,”
“But most Australians aren’t eligible for higher incentives and they’re missing out. A recent report in Nine newspapers found those aged 16 to 64 are paying more out of pocket, and it’s putting many people in a tough spot.”
The electorate of Casey has been one of the biggest improvers in the country in availability, albeit having risen from a low base of 11.8 per cent of the 34 available clinics in 2022-23 to 15 per cent of 40 available clinics in 2024-25. This is however a reduction from 18.4 per cent of 38 available clinics in 2023-24, while the average out-of-pocket cost for a consultation has risen by $6.53 to $41.81 in the last three years.
Deakin’s availability remains largely unchanged, slightly down to 13.9 per cent of the 36 available clinics currently from 14.3 per cent of only 28 clinics in 2022-23. It dipped in between those years to 12.5 per cent of 32 available clinics in 2024-25 before rebounding and the average out-of-pocket cost for a consultation has risen by only $2.46 to $39.33 in the last three years.
Minister for Health and Aged Care Mark Butler was asked for comment on the report in January and said a ring around of general practices by this private company is no substitute for core Medicare data though Medicare data shows that there aren’t as many bulk billed visits as they would like.
“I’ve been very clear we need to do more, and what we have done has made a meaningful difference, but it is still tough for general practices, and importantly, it’s tough for patients to find affordable access to a GP when they need it,” he said.
“The general increases to the Medicare rebate have started to take some of the financial pressure off GPs, not only allowing them to bulk bill, importantly, age pensioners, concession card holders and children under the age of 16, but also to take some of the pressure off out-of-pocket costs for other Australians,”
“Obviously that group of other Australians are a big focus of ours, they were a big focus of our cheaper medicines policies, those Australians who don’t qualify for concession cards.”
The Australian government tripled the incentive for GPs to bulk bill children under 16, pensioners and other concession cardholders from 1 November 2023 and nationally 77.5 per cent of all GP visits were bulk billed in December 2024, an increase of 1.9 percentage points on October 2023 before the incentive took effect. However, the Cleanbill report found the percentage of practices bulk billing new adult patients without concession cards has fallen to 20.7 per cent nationwide.
Australian Medical Association President Dr Danielle McMullen said GPs are facing rising costs pressures to keep their practices going, pay staff, cover rapidly rising rent and insurance, and deliver first-class care to their patients following the release of the Cleanbill report.
“We for many years saw a Medicare freeze, and so that rebate the patients get back for general practice care really has not kept pace with the cost of providing that medical care,” she said on ABC Radio.
Dr McMullen also told media the report did not provide a full picture if bulk billing rates in Australia, saying it measured only how many practices fully bulk bill every single patient that comes through the doctor’s door for every single service.
“The federal government made a significant downpayment of around $6 billion for primary care in the 2023 budget, which has slowed the decline of bulk billing rates,” she said.
“We welcomed this investment and we continue to advocate for further reform and investment to ensure the system continues to support improved access and affordability for patients.”
Cleanbill considered bulk-billing clinics to be:
Clinics with at least one doctor who is taking on new patients and is bulk billing, even if the clinic has other doctors who do not bulk bill.
Clinics that are bulk billing during regular, weekday business hours, but which do not bulk bill outside of these hours
Clinics that bulk bill without charging a one-off, yearly, or monthly fee to access bulk billing.
