General practice, allied health and other primary care services is an Australia's health topic

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Primary care is the first contact a person has with the health system. It is often synonymous with general practice, however the sector covers a range of public, private and non-government health services and health service providers. These include nursing, midwifery, pharmacy, dentistry, Aboriginal health services and allied health. Primary care may be delivered in a range of settings, including aged care, disability care and the community.

This article presents primary care service use, experience of care, expenditure, information gaps and emerging developments. It focuses on Medicare-subsidised general practitioner (GP), allied health, nursing, midwifery and Aboriginal Health Worker services. While these data are comprehensive and provide useful insights, outside of these sources data on primary health services are limited. For more information, see Data and information gaps and the future of primary health care.

For related primary care information, see Oral and dental health, Indigenous Health and wellbeing, Pathology, imaging and other diagnostic services, Health expenditure and Health workforce.

What is the difference between primary health care and primary care?

The World Health Organization defines primary health care as ‘a whole-of-society approach to health that aims at ensuring the highest possible level of health and well-being and their equitable distribution by focusing on people’s needs and as early as possible along the continuum from health promotion and disease prevention to treatment, rehabilitation and palliative care, and as close as feasible to people’s everyday environment’ (WHO and UNICEF 2018).

Primary care describes the first point of contact an individual has with the health system (Department of Health 2021), and is a subset of primary health care. It relates to the treatment of non-admitted patients in the community.

This page focuses on primary care data and includes some information relating to the more holistic concept of primary health care, such as patient experience.

Primary care service use

In 2020–21, there were around 256 million Medicare-subsidised primary care services in Australia, including, but not limited to, GP attendances (171 million), allied health attendances (27 million) and services provided by nurses, midwives and Aboriginal health workers (4.3 million) (AIHW 2021b).

General practice

A GP is often the first point of contact in the health system.

In 2020–21, 85% of Australians received at least one Medicare-subsidised GP service, a decrease from 2019–20 (87%) (AIHW 2021b).

Across Australia in 2020–21:

  • Females (88%) were more likely to see a GP than males (81%) and received more Medicare-subsidised GP services per person (7.6, compared with 5.7 for males).
  • The number of GP Medicare-subsidised services per person increased with age and was highest for those aged 80 and over (17.8 services per person).
  • A lower proportion of those living in metropolitan Primary Health Network (PHN) areas had a Medicare-subsidised GP attendance (84%), compared with regional PHN areas (87%) (AIHW 2021b).

Of the 171 million GP attendances in 2020–21:

  • The most common type of attendance was a Level B consultation (a consultation that lasts less than 20 minutes) (108 million).
  • A total of 58,000 were Medicare-subsided telehealth services (video conference consultations) (AIHW 2021b).

Allied health

The allied health sector represents a range of services provided by health practitioners who are generally university qualified and with specialised expertise in preventing, diagnosing and treating a range of conditions and illnesses. Allied health professions include psychologists, optometrists and physiotherapists.

In 2020–21, 39% of Australians received at least one Medicare-subsidised allied health service. This was an increase from 2019–20 (36%) (AIHW 2021b).

Across Australia in 2020–21:

  • Females (44%) were more likely to see an allied health professional than males (33%), and received more Medicare-subsidised services per person (1.3, compared with 0.8 for males).
  • The number of allied health Medicare-subsidised services per person increased with age, and was highest for those aged 80 and over (2.5 services per person).
  • The number of allied health Medicare-subsidised services provided per person was similar in metropolitan and regional PHN areas (at around one service per person) (AIHW 2021b).

Of the 27 million Medicare-subsidised allied health services provided:

  • The most common type of service was optometry (10.4 million).
  • Psychology accounted for more than 6.5 million services, while Podiatry and Physiotherapy both had more than 3 million services each (AIHW 2021b).

Nursing, midwifery and Aboriginal health workers

This section includes information on Medicare-subsidised services provided in non-admitted patient settings by:

  • nurse practitioners, registered nurses with experience in a clinical specialty
  • midwives, registered health professionals who care for women's health and wellbeing during pregnancy and childbirth
  • practice nurses/Aboriginal health workers, registered or enrolled nurses, Aboriginal and Torres Strait Islander health practitioners, or Aboriginal health workers employed in general practice.

In 2020–21, 8.3% of Australians received at least one Medicare-subsidised nursing, midwifery or practice nurse/Aboriginal health worker service. This was an increase from 2019–20 (7.8%) (AIHW 2021b).

Across Australia in 2020–21:

  • Nurse practitioners provided almost 750,000 services subsidised by Medicare, up from around 660,000 services in 2019–20. This represents 2.9 services per 100 people in 2020–21, up from 2.6 in 2019–20.
  • There were over 170,000 midwifery services subsidised by Medicare, a 43% increase from 2019–20 (over 120,000).
  • There were 3.4 million practice nurse/Aboriginal health worker Medicare-subsidised services provided, up from 3.1 million services in 2019–20. This represents 13 services per 100 people in 2020–21, up from 12 in 2019–20 (AIHW 2021b).

COVID-19 and primary care service use

Primary care has played a central role in the health care response to COVID-19, and the pandemic has changed the way primary care services are delivered. In 2020–21:

  • The proportion of people who reported that they delayed or did not use a GP service or an after-hours GP service when needed due to COVID-19 was 9.8% and 7.3%, respectively (ABS 2021).

  • Females were more likely to delay or not use GP services when needed due to COVID-19 than males (13% and 7%, respectively). This was the same for after- hours GP services (8.5% and 5.4%, respectively) (ABS 2021).
  • Following the introduction of telehealth Medicare-subsidised items in March 2020 in response to the pandemic, more than one-third (36%) of GP services were delivered via telephone or video-conference in April 2020, up from 8.0% in March 2020 (AIHW 2020).

As at 22 March 2022, 63% of COVID-19 vaccine doses in Australia were administered in primary care settings (Department of Health 2022).

Barriers to GP service use, and experience of care

For Australian health users, cost and waiting times are often a reason for delaying or not using a GP service.

In 2020–21:

  • A total of 2.4% of people who needed to see a GP delayed or did not see a GP due to cost. This was a decrease from 2019–20 (3.7%).
  • 3.1% of people with a long-term health condition who needed to see a GP delayed or did not see a GP due to cost. This was higher than for those without a long-term health condition (1.3%).
  • 16.6% of people felt they waited longer than acceptable for a GP appointment (ABS 2021).

Expenditure on primary care services

In 2019–20, approximately one-third of all health spending in Australia was for primary care ($66.9 billion) (AIHW 2021a). Of this:

  • $13.3 billion was for unreferred medical services (mainly general practice).
  • $12.9 billion was for subsidised pharmaceuticals.
  • $11.9 billion was for other medications.

In 2020–21, $17 billion were paid in Medicare benefits for primary care services, inclusive of GP, allied health and other primary care attendances (AIHW 2021b). The majority of this expenditure was for GP attendances ($8.8 billion, or 51%), followed by diagnostic imaging ($4.2 billion, or 24%), specialist attendances ($2.3 billion, or 14%) and allied health ($1.8 billion, or 10%).

Data and information gaps and the future of primary health care

Although primary health care is an important component of Australia’s health care system, the availability of primary health care data remains limited.

This page focuses on Medicare-subsidised primary care services and the ABS Patient Experience Survey as data sources with national coverage. However, it is not a complete nor comprehensive source of primary care or primary health care information in Australia. For example, information from private health insurance sources, state and territory funded community health data Aboriginal health services are out of scope for this page. This information may be integrated in future years, as data development work conducted by the AIHW provides a robust platform for further insights into primary health care information in Australia.

Notably, the AIHW is leading the development of a Primary Health Care Information System, and the creation of a National Primary Health Care Data Collection (Data Collection) to improve primary health care data and address information gaps. The Data Collection will aim to fill data and information gaps relating to primary care and be an accessible and value-added source of information.

The AIHW also releases information from the newly established national Practice Incentives Program Eligible Data Set, bringing together data provided by Primary Health Networks from general practices across 10 Quality Improvement Measures.

Ongoing work to improve primary health care data including establishing linked primary health care, hospitals, disability and aged care sector data, will enhance the evidence base for policy, planning and research underpinning the critical role of primary care in a sustainable, effective and coordinated Australian health system.

Where do I go for more information?

For more information on primary health care, see:

Visit Primary health care for more on this topic.

References

ABS (Australian Bureau of Statistics) (2021) Patient experiences in Australia: summary of findings, 2020–21, ABS website, accessed 2 February 2022.

AHPA (Allied Health Professions Australia) (2020). What is allied health? AHPA website, accessed 28 January 2022.

AIHW (Australian Institute of Health and Welfare) (2021a). Health Expenditure Australia 2019-20. AIHW website, accessed 5 February 2022.

AIHW (2021b). Medicare-subsidised GP, allied health and specialist health care across local areas: 2019–20 to 2020–21. AIHW website, accessed 2 February 2022.

AIHW (2020). Impacts of COVID-19 on Medicare Benefits Scheme and Pharmaceutical Benefits Scheme service use. AIHW website, accessed 11 February 2022.

Department of Health (2022). COVID-19 vaccination – vaccination data. Department of Health website, accessed 22 March 2022.

Department of Health (2021). Primary care. Department of Health website, accessed 28 January 2022.

World Health Organization & United Nations Children's Fund (‎UNICEF)‎ (‎2018)‎. A vision for primary health care in the 21st century: towards universal health coverage and the Sustainable Development Goals. World Health Organization website, accessed 21 January 2022.