Medicare bulk billing is dying in Tasmania and is unlikely to ever recover, according to a Mowbray GP who says the community must "reluctantly" get used to it.
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Dr Andrew Jackson, of the Northern Suburbs Medical Service, says "abysmal" support from the federal government meant patients searching for GPs who bulk-bill for all their services, would increasingly do so in vain.
One of only two medical practices servicing Launceston northern suburbs, the comments come after news Mowbray Medical is turning away more than 20 patients a day and is no longer able to offer mixed billing, as the result of what it claims has been a "persistent lack of government support".
Bass Liberal MHR Bridget Archer says she is committed to working with GPs in the region, adding she is not satisfied with accepting the situation was final.
A proposed visit by federal Health Minister Greg Hunt is expected to take place within the next two months.
However, Dr Jackson, who is a practice principal and full-time GP at the Mowbray clinic, said history had proven the government's failure on addressing the issue.
"There was no longer any hope that a federal government health minister would ride in on his or her white stallion and save the day for general practice by substantially increasing the dollar value of GP Medicare rebates - history has proven this," he said.
Echoing comments made by Australian Medical Association president Dr Tony Bartone earlier this year, Dr Jackson said Medicare rebates for GP services would be around two-and-a-half times higher than the level if they had been fairly and properly indexed.
Instead of the standard bulk-bill rate being $38, Dr Jackson said it would closer to about $95.
At this level, Dr Jackson suggested most GPs would be prepared to bulk-bill nearly all of their services, or instead charge a relatively small "gap" payment for those who could afford it.
"For GPs who want to practice highly quality medicine, not turn over patients at sausage-machine rates, invest in new medical equipment and training, and be able to retire from practice at a seemly age, the $38 rebate has lost any meaning and cannot be acceptable for anyone who wants to have a long-term career in general practice," he said.
Dr Jackson said his practice used bulk billing heavily in some important areas to support local community health, including the immunisation of more than 1000 patients for influenza.
"We will shortly be running a whooping cough immunisation campaign with bulk billing," he said.
"We bulk-bill diabetes assessments and mental health plans, among others.
"We also bulk-bill our new humanitarian refugees. And at our Newnham nursing home where we provide care for 65 frail elderly residents, we continue to bulk-bill them all."
Ms Archer said she was working to finalise the date of a proposed forum with Mr Hunt and others in the health field, as part of an upcoming visit to Tasmania expected to take place within the next six to eight weeks.
"I am committed to working with the GPs in Northern Tasmania and the [health] minister to constructively work on a range of issues that have been raised with me by medical practices in my community," she said.
"Bulk billing is certainly one of these issues and I am not satisfied with accepting that the current situation is final and I will continue to do what I can to look at creating effective change in this area."
Despite the challenges, Dr Jackson said it wasn't all "doom and gloom" for the area, with the Northern Suburbs Medical Service still accepting new patients - including those impacted by the closure of the Caledonian Medical Centre in April.
Dr Jackson said the closure of Invermay's only health centre and the "scattering" of its doctors elsewhere in Launceston, had been a blow to the northern suburbs.
"But more good news is that my practice advertised locally that Caledonian patients were welcome to attend our practice which they have, our books are not closed, and we are not turning anyone away," he said.
The practice has also been successful in recruiting additional GPs, with recent expansions also helping to take pressures off hospital emergency departments.
"Part of this development is a two-bed infusion bay to enable the giving of treatments that previously meant sending many patients to the hospital including for urgent care," he said.
"Being able to pay doctors well and have great facilities and staff attracts doctors to our practice and can help them stay in the long term - this is a good news story for our northern suburbs."
Jessica Willard
Being a health reporter to me is about more than just reporting the problems. It's about asking why they are happening in the first place and what needs to change to fix it.
Being a health reporter to me is about more than just reporting the problems. It's about asking why they are happening in the first place and what needs to change to fix it.
