Australia's GP funding debate has entered a new phase. The Royal Australian College of General Practitioners and more than 20 peak health and patient organisations delivered an open letter to Parliament House in Canberra on March 3, demanding that the federal government increase Medicare rebates for longer GP consultations. The signatories include Palliative Care Australia, Parkinson's Australia, Sexual and Reproductive Health Australia, and Dementia Australia — a coalition that makes the fiscal argument for reform difficult to dismiss as narrow professional self-interest.
The core complaint is structural. Under the current Medicare system, the per-minute value of patient rebates decreases the more time a patient spends with their GP. In plain terms, for many people with serious conditions, the sicker they are, the more they pay out of pocket. This is not a peripheral inconvenience. GP consultations now average nearly 20 minutes, a reflection of the increasingly complex needs patients are bringing to their family doctors. A rebate architecture built for shorter, episodic interactions has not kept pace with a population that carries higher rates of chronic disease, mental illness, and multi-condition comorbidities.
The specific ask from the RACGP is a 40% increase to Medicare rebates for Level C and Level D consultations — the longer appointment categories. The College is also proposing a 25% increase to Medicare rebates for GP mental health items, with a Level C consultation rising from $82.90 to $116.06 and a Level D increasing from $122.15 to $171.01. RACGP President Dr Michael Wright has framed the case in system-wide terms. He argues that properly funding longer consultations is vital for patients with chronic disease, mental health concerns, and complex health needs, and points to flow-on effects including improved diagnosis times, more affordable care, and reduced pressure on hospitals.
The Australian Medical Association is pushing a parallel but differently structured proposal. The AMA has proposed a reformed seven-tier rebate structure with time brackets ranging from under five minutes to 60 minutes or more, with proposed rebates running from $19.60 at the lowest level to $260.80 for consultations of an hour or longer. The AMA argues that the existing Medicare structure does not reflect modern health issues, and that as consultations grow longer, inadequate rebates are forcing more GPs to pass costs onto patients through higher out-of-pocket charges.
The consequences of inaction, the AMA warns, are two-fold: patients with chronic conditions, mental health concerns, and complex care requirements will continue to be underserviced, relying on the hospital system as their conditions worsen; and Australia will fail to attract sufficient doctors to general practice, deepening the current workforce shortage. These are not abstract risks. Between 2013 and 2020, Medicare's payment for many GP services did not rise with inflation, adding financial pressure that many clinics say contributed to lower bulk-billing rates and higher out-of-pocket costs for patients.
Proponents of the government's recent investment package will fairly point out that significant reform has already been delivered. The government committed a record $7.9 billion to expand bulk billing, described as the largest single investment in Medicare since its creation more than 40 years ago. The November 2025 package tripled the bulk-billing incentive and added a 12.5% Medicare rebate top-up for clinics that fully bulk bill. The government's stated ambition is for nine out of ten GP visits to be bulk billed by 2030. From that perspective, the political and fiscal case for layering another significant structural reform on top of that outlay is one the government will want to test carefully against forward estimates.
There is also the question of whether higher rebates alone will solve access problems in areas where workforce shortages are the binding constraint. Critics argue that current health policies still assume a metro-style business model that is difficult to apply when practices cannot simply turn over more patients and when workforce shortages are the real limiter. Better rebates help sustainable practices; they do not conjure GPs in communities that have none.
What the data actually tells us, though, is that the current rebate structure creates a genuine disincentive for the kind of care that prevents expensive downstream hospitalisations. The AMA has explicitly warned that patients with chronic conditions, mental health concerns, and complex care requirements will continue to be underserviced if reform stalls, resulting in higher costs as they rely on the hospital system once their conditions worsen. Preventing a single avoidable hospitalisation almost certainly offsets the rebate uplift for many extended consultations. That is a fiscally conservative argument for reform, not just a progressive one.
The evidence points toward a middle path: structural reform to the rebate tiers is overdue and defensible on both equity and efficiency grounds, but it is most effective when paired with workforce policy and targeted at the patients and regions where the access gap is greatest. Government investment into bulk-billed care has increased, but a targeted reform to rebates for longer consultations could bridge the gap created by the rise in complex cases. The open letter now sitting before parliamentarians deserves a substantive, evidence-based response — not a political calculation about the election cycle.