Introduced in the 2024/25 NSW Budget, the program protects bulk-billing for people needing a GP and reduces the strain on our emergency departments. It is the first time the NSW Government has made a direct intervention to protect bulk-billing rates.

The package provides a new, ongoing payroll rebate to clinics for contractor GPs that meet the bulk-billing thresholds of 80% of services in metropolitan Sydney, and 70% in the rest of NSW.

Clinics will also benefit from the waiving of $104m of historical payroll tax liabilities, which began accruing for contractor GPs under the previous government.

There are more than 2,300 GP clinics across NSW. The NSW Government’s Bulk-Billing Support initiative will protect the bulk-billing rates at GP clinics for families across the state, saving households money and reducing the strain on emergency departments.

NSW Health estimates that a 1 per cent decrease in bulk-billing equates to around 3,000 additional emergency presentations.

For large clinic networks like ForHealth, with 37 clinics across NSW, the Bulk-Billing Support Initiative will enable them to continue to serve their communities and keep bulk-billing rates high. ForHealth bulk-bills roughly 5 million patient visits each year around Australia, 2.5 million of which are in NSW. They are the largest bulk-biller in the country.

GP clinics in metropolitan Sydney must bulk-bill at least 80% of their patient services to be eligible for the ongoing payroll tax rebates. For GP clinics outside of metropolitan Sydney, a lower bulk-billing rate threshold of 70% applies to ensure broader access to the initiative.

Since the announcement in June, Revenue NSW, the AMA and RACGP were engaged in a specially formed working group to develop a practice note to assist clinics, their accountants and legal advisors.

Following these discussions, Revenue NSW released a comprehensive list of LGAs and suburbs in NSW where the 80% threshold is applied, as well as the Commissioner’s Practice Note and a flow-chart to assist clinics.

Previously, the AMA’s Dr Michael Bonning said of the Bulk-Billing Support Initiative that: “Legislating ‘no retrospectivity’ will provide certainty for practices and will minimise the risk of more closures of general practices in NSW.”

With this Initiative, the Minns Labor Government is keeping GP clinics open and appointments bulk-billed for families and households amid the cost-of-living crisis, while also reducing the strain on emergency departments.

Quotes attributable to Minister for Health Ryan Park:

“We know that the federal Coalition’s freeze on Medicare rebates as well as the NSW Liberals and Nationals’ inaction on GP payroll tax had severe consequences for the access of GPs in NSW."

“With GPs becoming more difficult to access, people are either putting off seeing a doctor and allowing their conditions to deteriorate, or they are presenting to hospitals with non-urgent conditions."

“The lack of GP access is having severe impacts on our emergency departments."

“The Bulk-Billing Support Initiative will stem declining bulk-billing rates, and foster greater access to GPs, and in turn, relieve pressure on our busy hospitals.”

Quotes attributable to Minister for Finance Courtney Houssos:

"The Bulk-Billing Support Initiative comes after extensive consultation and cooperation with the peak-bodies to deliver a solution that alleviated financial stress for GP clinics and delivered real cost-of-living relief for families."

“This is the first-time the NSW Government is making a strategic investment to support bulk-billing rates and protect family budgets.”

Quotes attributable to CEO of ForHealth Andrew Cohen:

“At ForHealth we understand how important access is in healthcare, and especially in the current economic context. We are proud to be one of the largest bulk-billing general practice providers in NSW with roughly 2.5 million bulk-billed patient visits each year."

“This initiative from the NSW Government will help protect bulk billing accessibility at clinics like ours, throughout outer metropolitan and regional NSW. In many of these practices we are expecting the level of bulk-billing to increase as a result."

“The removal of any retrospective payroll tax liability for all medical centres is a weight off the shoulders of the industry as clinics will no longer be at risk of closure due to large historic tax bills.”