Public spending on general medicine is increasing



Despite increased funding, general medical expenses remain a fraction of the amount received by public hospitals.

GP funding has increased since the start of the pandemic, but pressure on GPs and patient costs remains. (Image: Getty Images)

Spending on general practice increased by $635.6 million over the past fiscal year, according to the Productivity Commission’s latest report on government services.

The analysis, which was released on Tuesday, details the government’s biggest apparent investment in GPs since 2012-13 and represents an annual increase of 6% on the previous year.

The increase is likely to reflect significant changes in general medicine since the start of the pandemic, including the widespread implementation of telehealth and the deployment of the vaccine.

In contrast, in 2018-2019, the amount of public spending on general practitioners increased by $23.1 million, or 0.23% of the previous total.

Overall reported spending on general medicine reached $11.23 billion in 2020-21, up from $10.57 billion the previous year, with the amount spent per person also rising significantly to $437 – up more 5% from 2019-20 levels.

Spending details are not detailed in the report, but much of the difference is likely attributable to GP’s role in rolling out the vaccine.

According to the latest statistics, general practitioners delivered 24,510,119 doses of vaccines, almost half of the amount delivered across the country.

The amount spent on general practice, however, remains a fraction of the total annual investment in the public hospital system according to data from the Productivity Commission.

Public hospital spending figures are older, with 2019-20 being the last year for which details are included in the report. They show a year-over-year increase of $2.685 billion, with the total reaching $76.7 billion, more than seven times the amount spent on general medicine in the same 12 months.

Another striking statistic from the report suggests that the number of “potentially preventable GP-type presentations” to hospital emergency departments has reached record levels.

There were 328,724 more presentations of this nature recorded in 2020-2021 compared to the previous year, reaching a total of 3.16 million. This represents an increase of 11.57% from 2019-20, and more than 250,000 more than the previous high level.

The “potentially preventable” category is defined as presentations that did not arrive by ambulance or police, with a semi-urgent or elective triage category, and where the patient was not admitted to hospital or referred to another hospital and did not Do not die.

RACGP President Dr Karen Price told Nine Newspapers the rise is due to underfunded general practice funding relative to other health services.

“If you don’t fund primary care properly, it goes somewhere else – and it costs everyone a lot more,” she said.

A report commissioned by the RACGP and published in 2020 found that unnecessary hospital visits cost around $540 per presentation (in 2017-2018 figures).

More than a third of urgent GP appointments (33.9%) saw a waiting time of more than 24 hours in 2020-21, the highest proportion in recent years. There was also a lower proportion of urgent appointments seen within four hours.

However, the number of people who saw a GP in the past 12 months and waited longer than they thought was acceptable fell from 18.7% in 2019-20 to 16.6% in 2020- 2021 – possibly a reflection of the wider availability of telehealth, although no further analysis is given in the report.

Demand for GP services was also higher than ever, with an average of seven ‘GP type services per person’. However, patients are now paying more in fees than at any other time covered by the report, at an average of $41 per visit – despite telehealth’s universal bundled billing.

Outside major cities, the figures describe the strain on the rural GP workforce, with 363 full-time equivalent GPs serving remote and very remote parts of Australia out of a total full-time workforce of 29,419.

This figure has stagnated and even decreased in recent years, despite concerns about labor shortages outside major cities.

The report suggests that general practice is gradually reaching a better gender balance, although there is still a long way to go. It records 59.5% of general practitioners in full-time equivalent as being men, a proportion that has been falling in recent years.

And despite the pressures on general practice, another figure shows the esteem in which the profession is still held by people across the country.

Unpublished data from the Australian Bureau of Patient Experience survey shows 95% of patients say their GP ‘always or often showed respect’ – a higher figure than any of the eight previous years indicated in the report.

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