The Nowra GP has slammed a national commission of audit recommendation that would see people forced to make a $15 co-payment to visit a doctor and access Medicare services.

Co-payments of up to $6 to visit the doctor had previously been flagged by the federal government as one way to tackle rising health spending, and this new recommendation takes it further.

‘‘Regardless of the dollar amount, there’s always a nervousness among a percentage of patients for whom any cost can be a deterrent to seek primary health care,’’ Dr McCartney said.

‘‘The problem is that primary health care is probably the most cost-effective health care. If a person presents at an emergency department for instance, there’s more tests that need to be done, more staff involved.

‘‘So our frustration as GPs is that the federal government is focusing on the wrong end of the health system.’’

Under the recommendation, people who usually get bulk-billed would be charged $15 per visit, with the charges dropping to $7.50 after 15 services a year.

Pensioners and concession card holders would be charged $5 for the first 15 visits, and then $2.50 thereafter.

‘‘Some people simply don’t have an extra $15 or $5 in their wallet, and if they do they might need to spend it on something else,’’ Dr McCartney said.

‘‘Single mums for instance put themselves last and might spend that money on nappies. Pensioners with chronic disease might be worried about their budget.

‘‘So the most needy of our patients might delay going to the doctor and that’s when something minor may turn into something serious, which means we’re treating people later, which will ultimately cost more.’’

In this way, Dr McCartney said, a co-payment would be a barrier to people seeking ‘‘preventative health care’’, which would come at a cost to the health system.

‘‘There’s so much that can be done in primary health care to keep people out of hospital,’’ she said. ‘‘Acting upon this recommendation would be a backward step for the government.’’