After months of hype and misleading PR, the Bulk Billing Practice Incentive Program and expanded triple bulk billing incentives are officially here.

At a launch-day-eve press conference, Health Minister Mark Butler told reporters that come Monday, 1000 mixed or privately billing practices would be making the switch to universal bulk billing.

“Already, we’ve been told that there are 1,000 practices who, this week, are charging gap fees and next week will be moving to a full bulk billing model,” Health Minister Butler said. “That number is growing every single day.”

While attendees at the Senate Community Affairs Legislation Committee meeting in October were told by the Department of Health, Disability and Ageing that 800 to 850 clinics were already universally bulk billing, Minister Butler has revised the numbers up.

“Now, at the moment, there’s about 1,500 thousand practices in the country who are fully bulk billing, they bulk bill all of their patients all of the time,” he said on Friday.

Two days prior, Minister Butler told ABC journalist Patricia Karvelas that doctors should not underestimate the government’s determination, promising to “intervene” in stubborn markets like Canberra.

“I’ve been really clear with doctors’ groups, some of which have been a little sceptical about this in the lead-up, that they should not underestimate our determination to achieve this,” Minister Butler said.

“We’re going to intervene in the market. We’re going to fund new practices that come into the ACT, set up here on the basis of being fully bulk billing. I’m not just going to sit by and let some markets really prohibit members in their community from being able to access bulk billed visits,” he said.

However, despite the rhetoric, doctors continue to be sceptical.

In a Healthed survey last fortnight, only 12% of GPs agreed that the government’s messaging to the public around bulk billing incentives was accurate.

Speaking on the Australian Doctors Federation’s Lets Talk Medicine podcast just ahead of the launch, former RACGP President, GP and researcher Professor Karen Price was doubtful that many clinics would make the switch to universal bulk billing.

“I’m not optimistic at all that it’s going to be taken up. I think because there’s been a loss of trust from the profession to the government, people are wise to be cautious, given what’s happened over the last decade in my experience, of denigrating general practice,” Professor Price said.

“We’ve got this tension that the politicians face with the populist position and ribbon cutting announcements and that doesn’t sit well with having a long and complicated conversation about complexity in the health system, with health system literacy, with financial literacy.” – Professor Karen Price

“I think it has some use for those doctors who are already bulk billing in low socioeconomic areas. But it’s still a volume-based activity. It’s still related to high volume throughput. We still haven’t addressed mental health. In fact, we’ve gone backwards. We haven’t addressed complexity and multi-morbidity. We haven’t addressed aged care. We haven’t addressed after-hours. And all it is, as I see it, is a quick fix for the pollies. And we’re still kicking the can down the road in what could be a genuine reform,” she added.

Also speaking on the podcast, Australian Doctors Federation Chair Dr Aniello Iannuzzi said that even GPs who might benefit in the short term feel the risks are too great to make the change.

“It’s really unchartered waters, and I know a lot of GPs I talk to are very scared, and they’re not going to jump into this, due to fear more than anything else, even though the numbers in some areas may be tantalising. There are too many risks, there is too much chance of a new government altering items numbers further, or the bulk billing incentive may alter further, and once you’re signed up, it’s going to be very hard to untangle yourself,” Dr Iannuzzi said.