The Australian Federal Budget 2024-25 has missed the opportunity to build on the previous budget to significantly strengthen the healthcare system and make it more affordable for patients. While the budget includes several worthwhile initiatives, it lacks fundamental changes to reform the system for general practices in the long term.

Below are the key impacts of the budget on the primary care industry

Medicare

• MyMedicare: $16m has been allocated over four years to implement system changes to MyMedicare

• Practice Incentive Program (PIP) Quality Improvement incentive payment: $57.4m in funding over two years to extend the payments until 30 June 2025.

• Medicare claim period: reduction from two years to twelve months.

• Urgent Care Clinics: An additional 29 clinics are to be added, taking the total number to 87. These walk-in clinics are fully bulk-billed and designed to take the load off of hospital emergency departments.

While the funding of MyMedicare and PIP will be welcomed by the industry, the addition of 29 urgent care clinics is seen by some as diverting services that existing GP clinics could provide if they received the funding.

Mental Health

• Wrap-around mental health care: $71.7m in funding will be provided over four years for wrap-around care for people with complex needs. This will enable practices to commission services such as mental health nurses, counsellors, social workers, and peer workers to provide care between GP and specialist appointments.

• Removal of MBS item 2712 from 1 November 2025: GPs are advised to use standard consultation items, including level E, instead.

• 61 Medicare Mental Health Centres: $29.9m over four years allocated towards centres that will provide free access to a psychologist and psychiatrist. They will be walk-in and free, no referral needed.

• National low-intensity digital mental health service: $558.5 million over eight years to establish a service that will be free of charge and will not require a referral.

• Child and youth mental health services: $29.7m over three-years to improve mental health services for children and youth.

Funding for wrap-around mental health care is seen as an important step in developing mental health services at the primary care level. However, the addition of no-referral-needed mental health care concerns some in the industry, as it is seen as taking GPs out of the loop of their patients’ health care needs.

Women’s Health

• Long-acting reversible contraception training: $5.2 million over three years to support placements of health practitioners to undertake training.

• Menopause care: $1.2 million over two years to support training of health practitioners to better treat, care for, and manage women’s health during menopause.

• Gynaecological specialists: $49.1 million funding for two MBS items for specialist gynaecological care. The Medicare payment for a minimum 45-minute initial gynaecological consult will increase to $168.60, and the payment for a minimum 45-minute subsequent gynaecological consult will increase to $84.35. These increases take effect on 1 July 2025.

These initiatives are seen by the industry as very positive improvements to women’s health, especially in providing more contraception alternatives to people in rural and remote areas.

Chronic Care

• Chronic care: $2.6 million will be provided to support patient care improvement and GP services, health professional education, condition awareness, and digital resources for childhood dementia, juvenile arthritis, stroke, rare diseases and epilepsy.

• Parkinson’s disease: $0.8 million over two years to deliver a General Practitioner Education Program.

These are seen by the industry as positive steps to increase awareness and support for chronic conditions.

Vaccinations

• COVID-19 vaccine program: $490m will be provided over four years to continue to fund the program.

• Shingrix® vaccine: $57.7m will be provided over four-years to expand eligibility for the shingles vaccine, Shingrix®.

• Pharmacists’ vaccinations: $0.9m over two years to expand the locations where pharmacists can provide vaccines, including residential aged care homes and residential disability services.

Expanding the eligibility for Shingrix® and the continuation of the COVID-19 vaccination program are seen as positive steps by the industry. GPs and pharmacists are likely to have differing views in relation to the expansion of vaccinations pharmacists can perform.

Cancer

• Bowel Cancer: $38.8m over four years to continue the National Bowel Cancer Screening Program. Including lowering the screening age to 45 for the free bowel cancer screening kits.

This is a positive step, supported by the RACGP Guidelines for preventive activities in general practice.

Pharmaceutical Benefits Scheme (PBS) Medicines

• Freeze on PBS prescriptions: The budget includes a one-year freeze on the maximum co-payment for a PBS prescription for anyone with a Medicare card and a five-year freeze for pensioners and other Commonwealth concession cardholders.

• PBS listings: $3.4 billion will be provided over the next five-years in new and amended PBS listings.

This is a positive move for patients, especially considering ‘cost-of-living’ pressures.

Taxation changes

• Instant asset write-off: The $20k instant asset write-off for small businesses has been extended to 30 June 2025.

• Changes to tax rates: The increase of the Medicare levy threshold and the changes to tax rates and income thresholds.

• HELP indexation: The changes made to how HELP debts are indexed is expected to result in a reduction of $3b of student debt.

The extension of the instant asset write-off is positive for small businesses. Changes to tax rates are expected to result in all individual taxpayers paying less tax than they otherwise would have. The changes to HELP indexation will benefit many students and professionals but is particularly important to health professionals as they tend to have significant levels of HELP debt.

Conclusion

While there are some positive announcements in the budget regarding MyMedicare, the Practice Incentive Program, Mental Health and Women’s Health which will have the most impact on GPs, there is no significant reform to Medicare of the primary health system overall.

Although the indexation of MBS rebates is expected to deliver an additional $900m in benefits for FY 2024-25 (which is certainly much more pleasing than the years of Medicare freeze that practices have endured in the past), it does not fully compensate for the neglect of the system during those times. The tripling of the bulk-billing incentive from November 2023 has positively impacted bulk-billing practices, but this is not felt across all practices. It is hoped that the ongoing review of the Medicare system brings about real change that provides better outcomes for patients and practitioners.

For specialist advice for your medical practice or financial affairs, contact the team at Findex.

The views and opinions expressed in this article are those of the author/s and do not necessarily reflect the thought or position of Findex.