A Senate inquiry is looking into rural healthcare. The biggest problem it should tackle is "GP deserts" - communities in the bottom 5 per cent of the country for GP services per person.

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People living in GP deserts get about 40 per cent less care than the national average, despite being sicker and dying younger.

But as every Canberran knows, it's not just a problem for the bush. The ACT has the lowest bulk-billing rate in the country, fewer GPs per person than some remote communities, and several Canberra suburbs are GP deserts.

Back in 2010, the territory government was forced to set up nurse-led clinics. Last year, the federal government stepped in with a bespoke $24 million package to establish new bulk-billing clinics.

The ACT's experience reflects what the data show nationally. The way the federal government pays GP clinics simply doesn't work in GP deserts, even after a multibillion-dollar boost.

The bulk-billing incentive, which clinics get when they don't charge a patient, was tripled in 2023, then expanded to all patients in 2025. Annual spending on the incentive has surged to about $2.8 billion a year, or almost a third of total Medicare spending on general practice.

The subsidy helped lift bulk-billing across most of the country, but it's poorly targeted and arbitrary.

The incentive rises with remoteness. A clinic in a regional centre gets one rate. A clinic in a small town gets more. Those jumps have no relationship to local rates of bulk-billing, patient fees, or whether there are enough GPs.

Some regional centres sit in the top quarter of the country for GP services per person. Some are in the bottom 5 per cent. The subsidy treats them the same.

It's like........

© Canberra Times