The federal government announced in its 2016 budget that the freeze on the indexation of the Medicare rebate paid to doctors would be extended until at least 2020, saving $925 million.

However Dr Manderson, of Worrigee Street Medical Centre in Nowra, said general practices had been absorbing the cost of the indexation freeze since it was introduced in 2014, and something had to give.

‘’GPs have been absorbing the increase in costs of delivering quality services by finding efficiencies for years,’’ she said. ‘’In doing that we have been accepting less than half what it costs to deliver that service.

‘’However we cannot continue to absorb the rising costs so we can either choose to provide lower quality services – like in the bulk billing clinics – or we charge more from the people who can better afford it.

‘’That’s the only way we can cover the cost of treatment for vulnerable patients who would otherwise not be able to afford to go to the doctor.’’

Throsby MP Stephen Jones said if people had to pay more, they would put off going to their doctors and wouldn’t get the medical attention they needed.

‘’Primary care is probably the most cost effective part of the health system, if instead of going to see their GP people present at the emergency ward it’s going to cost the health system as much as 10 times more. It’s just false economy,’’ he said.

However Federal Health Minister Sussan Ley said the Coalition was undertaking ‘’landmark reforms’’ to build a healthier Medicare. ‘’We’re also increasing Medicare investment to $26 billion per year by 2020-21 to help achieve this.’’