A $7.9 billion push to expand bulk billing for general practitioners in Australia has yet to reverse a stubborn decline in patient access to Medicare-subsidised care, according to the Department of Health, Disability and Ageing’s 2025-26 annual report. While the share of bulk-billed GP visits rose to 80.9%—above its 78.5% target—the proportion of Australians seeing a GP without referral fell slightly to 83.6%, missing the government’s 85% goal. The department’s annual report, which spans over 400 pages, highlights that while bulk billing incentives have driven progress, broader access challenges persist.
Pharmacies now handle minor care
The report confirms the program’s incentives, which took effect in November 2025, have boosted bulk billing rates. More than 3,800 general practices registered for the Bulk Billing Practice Incentive Program by June 2026, but overall Medicare Benefits Scheme (MBS) access shrank from 88.0% to 87.8% of the population. The department attributes the drop to patients shifting care to pharmacies, including work absence certificates and expanded prescribing trials, and ongoing cost-of-living pressures. These pharmacy-based services now cover a broader range of minor ailments and administrative tasks, reducing reliance on GP consultations for non-complex issues. The shift aligns with state-based trials allowing pharmacists to prescribe certain medications, further diverting demand away from GP services.
Out-of-pocket costs remain a barrier despite the MBS covering 74.1% of total fees charged in 2025-26, with $35 billion paid in benefits. The report highlights that 20% of patients still face upfront expenses, though the decline in MBS access was slower than the 0.6 percentage point drop seen the year before. The persistence of out-of-pocket costs reflects both the structure of the MBS, where patients often pay gap fees, and the broader economic context, where discretionary healthcare spending remains constrained for many households.
GP shortages persist in remote areas
Workforce targets show uneven progress. While 20 of 21 workforce goals were met, including for nurses, midwives, and allied health, the number of GPs in very remote areas (MM7) fell short by eight, missing a target of 1,327. Metropolitan areas (MM1) overperformed with 28,430 GPs, 378 more than planned, while regional centres (MM2) also exceeded expectations by 314 GPs. Rural towns (MM3 and MM4) maintained the highest GP density, at 128.8 and 128.2 per 100,000 people, respectively, reflecting sustained investment in regional training pipelines.
Training programs are expanding, with 3,549 registrars in active training, 238 more than anticipated, and a 6% increase in GP trainees from 2024-25. The department notes this marks the largest intake of commencing registrars on record, driven by reforms to the Australian General Practice Training (AGPT) program, new GP Training Incentive Payments for registrars, and 160 additional Commonwealth-supported medical places introduced this year.
These measures, alongside updates to the Bonded Medical Program and expanded Workforce Incentive Program streams, aim to address long-standing shortages. Very remote areas (MM7) saw trainees exceed targets by 20%, while remote communities (MM6) underperformed by less than 1%, with 106 registrars against an expected 106.9. The department will prioritise metropolitan GP training pipelines, where full-time equivalent GPs per 100,000 people fell just 0.5 short of the target (111.4 vs. 111.9).
Urgent care clinics cut ED overload
Urgent care clinics (UCCs) have grown to 137 facilities since their launch in June 2023, recording over 3.3 million presentations. In 2025-26, 462,584 visits would have otherwise led to emergency department trips or ambulance calls. The department used this year as a baseline and anticipates higher diversion rates in 2026-27 as the full network becomes operational, particularly in high-demand areas. An independent evaluation found the cost per presentation dropped from $216 to $206, and UCCs reduced ED visits by roughly 10%, though effectiveness varied by location and measurement method.
The report also flags declining immunisation rates. Coverage for children fully vaccinated by age 5 slipped to 92.92%, below the 95% target, while First Nations children aged 12-15 months saw only a 0.1 percentage point gain to 89.71%. HPV vaccination rates for 15-year-olds fell for the second year, hitting 79.55% for females and 76.52% for males, both under the 90% benchmark. The department attributes these trends to post-COVID behavioural changes, including vaccine hesitancy, logistical barriers to accessing immunisation services, and broader social determinants of health affecting uptake among vulnerable populations.
Pharmacy costs also shifted in 2026, with the maximum PBS co-payment for general patients cut from $31.60 to $25, though the concessional rate remains frozen at $7.70 until January 2030. The department met its 85% target for listing new medicines within six months of PBAC approval, a consistent achievement across prior years. This efficiency in medicine approvals reflects streamlined processes between the Pharmaceutical Benefits Advisory Committee (PBAC) and pharmaceutical sponsors, ensuring timely access to newly recommended treatments.
