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More than half (53%) of Australians cite cost concerns for GP medical appointments and are going less often, given the realities of the decline of bulk billing practices.

New research from the bi-annual Australian Healthcare Index report conducted by Healthengine and the Australian Patients Association finds a declining trend in Australia’s healthcare rating over four reports down from 7.8 to 7.1/10  since March 2021, and revealed the top three challenges for Australian healthcare:

  • GP, nurse and healthcare worker shortages (47%)
  • Emergency Department wait times (42%)
  • Increasing out-of-pocket costs to see a GP (33%)

Over the past year, Australia’s GP Net Promoter Score has dropped 16%, with this result tied to how costs and wait times are affecting patients. Cost concerns are prevalent for one in four (26%) survey respondents, with 88% of those now paying more. Of the 88% paying more, 19% pay up to $10 more, 24% pay $11-20 more and 45% pay $20+ more for a visit. Already, 10% of respondents have changed their GP/clinic due to increasing costs.

CEO and founder of Healthengine and GP, Dr Marcus Tan said, “The June 2022 Australian Healthcare Index report brought attention to patients’ struggle to access and afford essential healthcare, and whilst the latest report echos this, new concerns are raised as people said they go less often to the GP due to cost concerns. Skipping primary care isn’t a choice people should have to make, but it’s the current reality with the decline of bulk billing and rising cost of living.”

“With GPs also being the conduit to other care including referrals to specialists, mental health treatment plans and medication scripts, the impact of skipping the GP compounds. These findings illustrate just some of the challenges facing Australian healthcare. We must listen to patients and take onboard their experiences to help ensure a more sustainable healthcare system.”

The research also showed that Australians are going without other vital healthcare services, such as filling necessary medication scripts (22%), mental health support (19%), and even some (17%) turning to ‘Dr Google’ as the first stop for health advice.

Australian Patients Association’s CEO Stephen Mason says, “The new Australian Healthcare Index report paints a bleak outlook on Australia’s healthcare from the perspectives and experiences of 11,405 patients. Patients are experiencing long wait times across critical elective surgeries, emergency departments and mental healthcare as well as cost concerns tied to prescription medicines, private health insurance, and dental care and the decline of bulk-bill GP practices.”

CEO of the Australian Psychological Society, Dr Zena Burgess, said more needs to be done to support those who live with mental health conditions.

“While the COVID-19 pandemic concerns decline in Australia and around the world, the need for mental health and wellness support continues. Figures from the Australian Healthcare Index June report in comparison to now find that access to mental health support services has stabilised versus progressed. In a country like Australia, we must lift this standard so we can better support those in need.”

In terms of telehealth to support patients, 57% of people have had an appointment in the past 6 months and 77% were satisfied with the experience noting convenience as a top factor. Top usage of telehealth included 40%  for GP consults, 21% for repeat scripts, 10% for specialist consults and 6% for mental health consults. 84% of people said they prefer telephone vs video consults.

About The Australian Healthcare Index

  • The Australian Healthcare Index provides a pulse check on healthcare in Australia from patients’ perspectives and experiences. It’s produced by Healthengine and the Australian Patients Association, with Painted Dog Research. More than 11,000 adults across Australia participated in the supporting survey and provided personal points of view and experiences across the public and private healthcare ecosystem.
  • Survey questions and a breakdown of responses covered in the November 2022 report are available for viewing on the Australian Healthcare Index interactive Additional demographic breakdowns are available across the state, age, gender and metro/regional. Access to the survey findings is available at
  • Join the upcoming Australian Healthcare Index webinar hosted by Healthengine and the Australian Patients Association on Thursday, 1 December 2022, for a discussion on the report and survey findings. Register today here.  A recording of the session will be provided to everyone who registers.



Key findings related to cost:

Prescription medication: Over 1 in 5 patients (22%) have gone without necessary prescription medication due to the price. 30% of survey respondents disagreed with the position that prescription medication is affordable, an increase of 6% since the June report.

Dentist: 45% of survey respondents do not have a regular dentist/clinic. Those without a regular dentist/clinic, often refrain from check-ups due to not wanting to pay out-of-pocket costs (24%), whilst 21% will only go if they have tooth pain. 12% said they never go to the dentist.

Private health insurance: 30% of survey respondents chose Private Health Insurance (PHI)costs as one of their top 3 challenges facing Australian healthcare.

Pharmacists: Due to increasing GP costs, 11% of people say they check with a pharmacist first before booking a GP appointment. Pharmacists are the first go to for 11% of people before they book a GP appointment due to an increase in GP consult costs. In addition, 32% of respondents look to their pharmacist for medication advice, 29% for vaccinations and 19% for healthcare advice.

Key findings related to access:

Elective surgery: 12% of survey respondents were waiting to have elective surgery across public (75%) and private (25%) hospitals.

  • 43% of crucial Category 1 surgeries have been delayed beyond the stipulated time of within 30 days (2% increase from the June report – 41%). 57% of Category 2 surgeries have been delayed beyond the stipulated time of within 90 days (4% decrease from the June report – 61%). 39% of Category 3 patients also face wait times beyond recommended treatment times.

Emergency Department (ED): 42% of people identified ED wait times as one of the top 3 challenges for Australian healthcare. 21% named ambulance services, including ambulance wait times and ramping.

GP: In the past 6 months, 40% of survey respondents said they’ve experienced a longer wait time to see their GP for a general consult, from the time of booking to appointment. Looking at go to’s for health advice, for those aged 18-34, GPs are the first go to for 46%, while 23% head to Google first and 14% ask a friend or family member. For those aged 65+, GPs are the first go to for 72%, while only 9% head to Google and only 4% ask a friend or family member.

Mental health: Access to mental healthcare was identified as a top challenge for Australian healthcare, with 29% of people choosing it as one of their top 3.

  • 64% of people chose mental health as the top health condition needing better access to support services. 
  • Over 1 in 4 Australians (27% of all survey respondents) sought mental health support in the past 6 months, and of that group 81% received care, but 19% are still waiting.
  • 23% of survey respondents said their mental health has declined in the past 6 months, consistent with the June report (24%), but only 31% identified COVID-19 as a contributing factor (down 9% from the last report). This shows that while the COVID-19 pandemic concerns decline in Australia and around the world, the need for mental health and wellness support continues.

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