With NSW hospital spending surging by more than 60% since 2014, the Royal Australian College of GPs (RACGP) has called on the State Government to work with GPs to bring costs under control in its 2026–27 NSW pre-budget submission.
RACGP NSW&ACT Chair Dr Rebekah Hoffman said “completely unsustainable” hospital costs show change is needed.
“Over the last 10 years, the cost of the NSW public hospital system has increased by more than 60%,” she said.
“That’s completely unsustainable. It’s a symptom of a sick healthcare system that’s struggling under the burdens of an ageing population, an epidemic of chronic disease, and a growing need for mental health care.”
The policy initiatives outlined in the RACGP pre-Budget submission closely align with the NSW Government’s own vision for the state’s health system outlined in the Future Health: Guiding the next decade of care in NSW 2022-2032 Strategy.
“The best way to reduce New South Wales hospitals’ spiralling costs is by investing in preventive care that keeps people healthy and out of hospital,” Dr Hoffman said.
“General practice is the most efficient and effective part of the health system to invest in. NSW health department data shows every $1 spent on high-connectivity general practice returns $1.60 in health system benefits. That’s not just better workforce productivity, but also fewer preventable hospitalisations and emergency department presentations.
“Where someone needs hospital care, it’s better for both the system and the patient that they have a smooth and efficient journey from referral to discharge to care provided in the community by their usual GP. Well-connected general practice is essential for an effective and efficient hospital system.
“For the next NSW Budget, we’re calling on the Government to back initiatives aligned with its own 2022–32 health strategy, and which are informed by the work of the NSW special commission into healthcare.
“There has never been a more important time for New South Wales to invest in primary care.”
Key funding recommendations
Invest in GPs with Specific Interests and GP Liaison Officers
Hospitals face long wait times, high volumes of referrals, and rising demand for specialist care. The RACGP is calling for an annual investment of $11.5–14.5 million to establish the following positions in all Local Health Districts:
- GP Liaison Officers (GPLOs), who smooth a patient’s journey into and out of the hospital system, improving communication, reducing unnecessary referrals, and supporting safe and timely hospital discharge
- GPs with Specific Interests (GPwSIs), who apply their expertise in key medical specialties to improve access to the care communities need, such as dermatology, developmental disability, and psychological medicine.
“Patients continue to experience long waits in our hospitals, and fragmented communication between GPs and hospitals is leading to inefficiencies, delayed diagnoses, unnecessary referrals, and repeated investigations,” Dr Hoffman said.
“Funding GP Liaison Officers will improve referral quality, reduce outpatient demand, and support safe and timely hospital discharge. Funding patients to access the care they need from GPs with Specific Interests in each health district would unlock access to care, while reducing demand on our hospitals.”
Introduce a GPs in Schools Program
Youth mental health needs in NSW are rising, with increasing numbers of young people presenting to emergency departments for issues that could easily be managed earlier in community care.
The RACGP is calling for $12 million per year to establish a GP in Schools pilot in 20 NSW high schools to provide GP sessions, mental health triage, and preventative care, with expansion to 50 schools for $18.5 million per year.
“The evidence shows GP in Schools programs lead to improved mental health outcomes, reduced crisis presentations, faster access to care, and improved attendance by providing early-intervention healthcare for children and young people,” Dr Hoffman said.
Expand access to vaccination against influenza, meningococcal B, RSV, and pertussis
Without a targeted investment in vaccination, NSW will experience more preventable deaths, avoidable hospitalisations, and pressure on emergency services, especially in rural and regional communities. The RACGP is calling for an annual investment of $147.5–166.5 million to fund:
- an expansion of needle-free influenza vaccination from 2–5-year-olds to all school-aged children
- free and equitable access to meningococcal B immunisation
- RSV vaccination for all aged care residents and people aged 75 and over.
“Every winter, our hospitals fill with patients who need care due to infections that could be prevented through vaccination,” Dr Hoffman said. “Making getting a vaccine as seamless as possible will mean less sickness, fewer deaths, and less strain on our hospital system.”
Support general practice after-hours care
The RACGP is calling for a $30.5 million annual investment to fund general practices to provide same-day and next-day to meet after-hours demand and a trial of $150,000-per-practice after-hours care trial so more practices can provide care on evenings, weekends, and public holidays.
“Expanding after-hours general practice is one of the most effective ways to ensure patients get the right care, in the right place, at the times patients need it – whether it’s for something urgent or routine,” Dr Hoffman said.
Invest in multidisciplinary team models within general practice
Chronic disease continues to be the most significant driver of demand on the NSW hospital system. The RACGP is calling for a $51.8 million package to enable general practices to employ more allied health professionals, nurses, mental health workers, and care coordinators to better support patients with chronic and complex conditions.
“Almost half of our adult population live with at least one chronic condition and need support from a range of health professionals,” Dr Hoffman said. “Modelling consistently shows multidisciplinary teams in general practice reduce preventable hospitalisations, improve chronic disease control, and reduce long-term health spending.”
~ENDS
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