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Thursday, July 25, 2024

$189m injection for new bulk billing initiative

The NSW Government says an injection of around $189 million as part of a new bulk billing initiative will ensure the cost of seeing a GP remains accessible for people across NSW.

The Bulk-Billing Support Initiative will legislate to provide:

  • a new ongoing payroll tax rebate for contractor GPs at clinics that meet bulk-billing thresholds
  • a waiver for past unpaid payroll tax liability for contractor GP wages to 4 September 2024.

The Government says the initiative will protect bulk billing rates by reducing financial pressures on GP practices so they don’t pass on additional costs to patients and will save clinics from closure.

It’s hoped it will also reduce the strain on the state’s busy hospital emergency departments. NSW Health estimates that a 1% decrease in bulk-billing equates to around 3000 additional emergency presentations.

Once enacted, the NSW Government will give an ongoing payroll tax rebate for contractor GP wages to be provided to clinics with bulk-billing rates above 80% in metropolitan Sydney, and above 70% in the rest of the state.

A recent survey revealed that:

  • 72% are quite concerned or extremely concerned about the cost of healthcare;
  • 48% of adults are cutting back on healthcare appointments due to affordability;
  • 37% of parents are cutting back on appointments for their children due to affordability.

For the last five years, medical peak bodies have been warning that failure to address the issue could see GPs charge patients as much as an additional $20 per appointment.

The Government says the initiative resolves uncertainty around the applicability of payroll tax on contractor GPs, which first arose in 2018 under the previous state government.

To relieve pressure on GPs, in September 2023, the NSW Government legislated a 12-month pause on payroll tax audits for GP practices and tax penalties and interest accrued on outstanding debts.

Since the pause was enacted, the Government has worked with Royal Australian College of General Practitioners (RACGP) and Australian Medical Association (AMA) to develop the support initiative.

NSW will be the first state to legislate a full retrospective waiver for past unpaid payroll tax liabilities for contractor GP wages.

“AMA NSW welcomes the decision by the NSW Minns Government to legislate to guarantee no retrospective payroll tax liability for general practice. The Minns Government will be the first state to offer this guarantee in legislation,” said the AMA’s Dr Michael Bonning.

“Minister Park and Minister Houssos have been responsive to the concerns of general practice from the moment they took their portfolios. Minister Park has shown his commitment to the important role of general practice in the NSW Health system.

“Legislating ‘no retrospectivity’ will provide certainty for practices and will minimise the risk of more closures of general practices in NSW.

“Unfortunately, general practice continues to struggle with decades of underfunding from the previous Commonwealth Government.”

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