Chronic disease care gaps widen as GP costs rise

Chronic disease now costs Australia’s health system $98 billion a year, while more people are delaying or skipping GP visits because of cost.

Australian Institute of Health and Welfare figures show three in five Australians live with at least one chronic condition, and two in five live with two or more. Overweight and obesity have overtaken tobacco as the leading drivers of disease burden.

The share of people who needed a GP but delayed or skipped a visit because of cost has nearly doubled in a decade, rising from 4.1% to 7.7%. Among people with chronic conditions, 9.2% went without care because of cost, compared with 5.5% of people without chronic conditions.

Almost two-thirds of chronic disease spending is consumed by hospitals rather than community care that could prevent admissions.

Nurses push for funding access

Australian College of Nursing chief executive officer Adjunct Professor Kathryn Zeitz said the current funding model was locking nurses out of primary care. “The sickest Australians are the ones being priced out of primary care, which ends up shifting the cost onto our expensive hospital system,” Zeitz said.

Zeitz said nurse practitioners and nurse-led clinics provide chronic disease care including monitoring, prescribing, wound care, health checks and prevention, but face funding barriers in a system focused on GPs.

“General practitioners are core to primary health care – but we need to reorient the system to recognise that not every primary health care encounter requires a medical practitioner, and reduce pressure on hospitals,” Zeitz said.

The college is calling for funding reform under the National Health Reform Agreement 2026-2031, which commits governments to strengthen primary care from 1st July 2026.

Its proposals include extending the Baseline Practice Payment and the Workforce Incentive Payment to nurse-led services accredited under the ACSQHC National Safety and Quality Primary and Community Healthcare Standards, removing MyMedicare barriers for independent nurse practitioner-led and registered nurse-led clinics, extending the MBS 75% rebate rule to nurse practitioners, and counting nursing activity and outcomes in the new National Primary Health Care Data Collection.

The college is also calling for scholarships for 2,500 nurses a year with Commonwealth Supported Place eligibility to scale designated registered nurse prescribing, along with a funding mechanism and pathology-testing access via a Nurse Payment Administrator.

“Failing to do so means that people simply go without, or end up in an emergency department, with one in five ED patients there because a GP wasn’t available in time,” Zeitz said.