(SA) Exempt Payroll Tax for All GPs
Author: Oliver Grindlay, Noah Tolmie, Gus McLaughlin, Charlie Byrne, Scout Salathiel, Charlotte McHarg, Daniel Kim, Sara Washer & Genevieve Gill | Publish date: 28/10/2026
P: In SA, non-bulk-billing clinics have to pay payroll tax.
S: The SA Treasurer should amend Schedule 2 clause 17B of the Payroll Tax Act 2009 (SA) to exempt payroll tax for all general practitioners (GPs).
E: Royal Australian College of General Practitioners (2023): ‘We are continuing to call for an exemption for payroll tax for all general practices … to ensure people can continue to access high-quality GP care’.
Problem Identification:
Schedule 2, clause 17B of the Payroll Tax Act 2009 (SA) outlines that general practitioners’ bulk-billed services are exempt from payroll tax. However, GPs’ non-bulk-billed services are not included in this exemption.
According to the Royal Australian College of General Practitioners (RACGP), this means that ‘rising tax pressures, particularly payroll tax, are undermining the sustainability of general practice’. Dr Siân Goodson, RACGP Chair, explained that non-bulk-billed fees would have to rise to cover the tax and therefore ‘it is patients who will bear the brunt’. The RACGP further outlined that this ‘tax burden … will ultimately increase pressure on hospitals and emergency departments’.
Context:
Bulk-billed services refer to medical services that patients ‘don’t have to pay for’ because Medicare covers them. Conversely, non-bulk-billing (or private billing) refers to a service where ‘the patient is billed an out-of-pocket fee determined by the practice’.
According to the Australian General Practice Alliance (AGPA), payroll tax is a tax paid by a clinic on its total ‘wages and salaries’. RevenueSA (n.d.-b) outlined that when a clinic reaches a threshold of $1.5 million in total wages, they pay 0-4.95% additional tax, and 4.95% for wages that exceed $1.7 million.
When RevenueSA (2023) issued a revenue ruling, they clarified that general practices may be liable for payroll tax on wages paid to GPs. Subsequently, as of July 2024, the SA Government introduced an exemption from payroll tax for bulk-billed services.
Arguments:
The RACGP emphasised that payroll tax ‘means patient access to affordable … care will be compromised.’ Associate Professor Peter Subramaniam, president of the Australian Medical Association SA (AMA SA), stated that the ‘majority of practices operate on narrow margins, and … cannot afford this additional tax burden, which is why they have to pass on the cost to patients.’ Dr Siân Goodson noted that some GPs now charge administration fees of ‘$5-$10 in mixed billing or private billing practices’ to cover additional costs ‘including payroll tax’. The Australian General Practitioners Network highlighted that the payroll tax [leads] to ‘more people avoiding GP visits due to higher costs’. Associate Professor Subramaniam stated that payroll tax meant ‘general practices were being hit with rising costs … [which] could result in barriers to primary health care.’ He further highlighted, ‘this isn’t just a tax on doctors - it’s a tax on access to healthcare.’
Subramaniam stated, ‘when patients can’t afford to see their GP … that puts pressure on overcrowded emergency departments, adding to the stress and costs on the system.’ The SA Health Performance Council, an independent health advisory board, reported that from 2024-2025, 2,346 hospitalisations per 100,000 would ‘have been avoided or reduced by appropriate and early health interventions’. In an ABC article, Dr Daniel Byrne, owner of a private general surgery practice in SA, stated, ‘I treated two patients …, both of whom would end up in the hospital under this new system if they can't afford to see me.’ The RACGP stated the payroll tax affects ‘the sustainability of the health system, as it is likely to increase demand and place additional strain on hospitals and emergency departments.’
According to The Law Society of South Australia, the existing payroll tax exemption ‘is intended to provide … an additional incentive for GPs to bulk-bill patients.’ However, the RACGP stated ‘payroll tax on the earnings of GPs raises the cost of running a practice, making it more difficult for GPs to bulk bill.’
Advice/Solution Identification:
The RACGP, AMA SA, and AGPA have called for an exemption from payroll tax for all GPs. Associate Professor Subramaniam stated that ‘a complete exemption in SA would be a step … towards improving access to primary care for people in the community’.
Precedent:
There is domestic precedent for exempting payroll tax for all GPs. In QLD, all GP services became exempt from payroll tax in 2024.
Public Support of the Solution:
(This list reflects publicly stated positions and should not necessarily be taken as endorsement of this specific brief.)
News Coverage:
ABC News - “More SA general practices charging extra administration fees to cover payroll tax”. This article stated that an increasing number of private medical practices are incurring additional administration fees due to changes in payroll tax, and that this is leaving patients with a financial burden. By: Malcolm Sutton | 2 April 2026 - Read the article here.
William Buck - “Unresolved payroll tax issues and implications for practice owners”. This article discussed the legislation of payroll tax and medical practices for each state in Australia and what the implications of the legislation are for practice owners and employers. By William Buck | 15 August 2025 - Read the article here.
ABC News - “GPs call for stop to payroll tax, warning vulnerable patients will be worse off”. This article detailed the SA Government’s reimposition of a “longstanding tax obligation” under SA payroll legislation after 15 years of GP clinics not including GP wages in the calculation of payable payroll taxes, and how this would impose a financial burden on patients and hospitals. By: Josephine Lim | 18 March 2024 - Read the article here.
ABC News - “Queensland medical bodies warn of escalating costs to visit GPs due to payroll tax clash”. This article reported that Queensland’s peak medical bodies warn that a clarifying ruling on payroll tax liabilities for general practices could force clinics to reduce bulk billing and raise out-of-pocket patient fees by up to $15 per visit. By: Rachel Riqa | 1 February 2023 - Read the article here.
Where to go to learn more:
(2023) RACGP: Queensland payroll tax move another nail in the coffin for general practice care | RACGP - This media release outlined the impact payroll tax decisions have had on general practices and the consequences of required changes by practices on patients. It recommended an exemption from payroll tax for all general practices so that patients continue to get sufficient care. Read the media release here.
(2026) Blue Report | Cleanbill - This report outlined the bulk billing and out-of-pocket cost trends observed from contacting GP clinics across Australia. Read the full report here.
(2024) 2024-25 State Budget Wrap | The Law Society of South Australia - This article explained what the payroll tax exemption is and its incentivisation for GP clinics. Read the full article here.
(2025) Payroll tax for medical practices: a state-by-state analysis | William Buck - This article outlined how QLD’s state revenue payroll tax policy differs significantly from other states. Read the full article here.
(n.d.-b) Rates and Thresholds | RevenueSA - This article outlined how the payroll tax rate is calculated. Read the full article here.
Payroll Tax Act 2009 (SA) - Read the full Act here.
Human Perspective:
David is a 72-year-old retiree living in a South Australian suburb who regularly visits a GP to manage several ongoing health concerns. As the out-of-pocket cost of appointments increased, David became more conscious of whether he could afford each visit. These fee increases made him reconsider booking appointments for symptoms that initially did not feel urgent. When he developed persistent shortness of breath, David waited to see whether it would improve rather than paying for another consultation. Subsequently, late one night, David’s symptoms rapidly worsened, and he had to call an ambulance. The ED doctor later mentioned that the symptoms he suffered could have been prevented had he not avoided visiting the GP.
To protect the anonymity of those involved, this is a fictionalised account drawn from an amalgamation of real-life stories, experiences and testimonials gathered during the research process for this brief. Any resemblance to actual individuals is purely coincidental.
Conflict of interest/acknowledgment statement:
N/A.
Support
If your organisation would like to add your support to this paper or suggest amendments, please email hello@foregood.org.au.
Disclaimers
Please review all FORE disclaimers here.
Reference list:
Australian General Practice Alliance. (n.d.). General practice and payroll tax. https://australiangpalliance.com.au/issues-and-polices/general-practice-and-payroll-tax/
Australian General Practice Network. (n.d.). South Australia's payroll tax on general practitioners: A critical threat to healthcare access and affordability [Press release].
https://www.agpn.org.au/press-release-payroll-tax-sa
Australian Medical Association. (2025, August 14). South Australians pay more to see their GP because of payroll tax [Media release]. https://australianmedicalassociation.com.au/sa/articles/media-release-south-australians-pay-more-see-their-gp-because-payroll-tax
Buck, W. (2025, August 15). Payroll tax for medical practices: A state-by-state analysis. William Buck. https://williambuck.com/news/business/health/payroll-tax-for-medical-practices-a-state-by-state-analysis/
Crouch, B. (2024, August 23). GP patients facing higher bills to cover a state tax being ‘double tapped’. The Advertiser. https://www.adelaidenow.com.au/news/south-australia/gp-patients-facing-higher-bills-to-cover-a-state-tax-being-double-tapped/news-story/cedec5ec18d391c7e522f87602489954
HealthStaff Recruitment. (n.d.). What is the difference between bulk billing, private billing and mixed billing? https://www.healthstaffrecruitment.com.au/news/what-is-the-difference-between-bulk-billing-private-billing-mixed-billing/
Lim, J. (2024, March 18). GPs call for stop to payroll tax, warning vulnerable patients will be worse off. ABC News. https://www.abc.net.au/news/2024-03-18/sa-gp-payroll-tax-cost-patients/103599482
Payroll Tax Act 2009 (SA). https://www.legislation.sa.gov.au/_legislation-documents/lz/c/a/payroll-tax-act-2009/current/2009.22.auth.pdf
RevenueSA. (n.d.-a). Payroll tax and the medical industry. https://revenuesa.sa.gov.au/payrolltax/payroll-tax-and-the-medical-industry
RevenueSA. (n.d.-b). Rates and thresholds. https://revenuesa.sa.gov.au/payrolltax/rates-and-thresholds
RevenueSA. (2023, November 22). Revenue ruling PTA041. https://www.revenuesa.sa.gov.au/resources/publications/revenue-rulings/revenue-rulings/pta041/pta041
Riga, R. (2023, February 1) Queensland medical bodies warn of escalating costs to visit GPs due to payroll tax clash. ABC News. https://www.abc.net.au/news/2023-02-01/qld-gp-payroll-tax-changes-will-cost-patients/101911278
Royal Australian College of General Practitioners. (2023, January). RACGP: Queensland payroll tax move another nail in the coffin for general practice care [Media release]. https://www.racgp.org.au/gp-news/media-releases/2023-media-releases/january-2023/racgp-queensland-payroll-tax-move-another-nail-in
Royal Australian College of General Practitioners. (2025, September). Payroll tax for specialist general practitioners [Position statement]. https://www.racgp.org.au/FSDEDEV/media/documents/Position%20statements/Position-statement-Payroll-tax-for-specialist-general-practitioners.pdf
Royal Australian College of General Practitioners. (2026, May). RACGP warns tax burden is undermining the viability of general practice in Victoria [Media release]. https://www.racgp.org.au/gp-news/media-releases/2026-media-releases/may-2026/racgp-warns-tax-burden-is-undermining-the-viabilit
SA Health Performance Council. (2026). Monitoring the performance of South Australia's health system: 2022 to 2026. https://www.sahealth.sa.gov.au/wps/wcm/connect/505664ab-6136-4e37-8a4f-a0aa98f3d021/Attachment+1+-+HPC+four-yearly+report+to+Minister+2026.pdf?MOD=AJPERES&CACHEID=ROOTWORKSPACE-505664ab-6136-4e37-8a4f-a0aa98f3d021-q1BFCig
Services Australia. (n.d.). Bulk billing. https://www.servicesaustralia.gov.au/bulk-billing?context=60092
Sutton, M. (2026, April 2). More SA general practices charging extra administration fees to cover payroll tax. ABC News. https://www.abc.net.au/news/2026-04-02/sa-general-practices-charging-extra-admin-fees-payroll-tax/106522256
The Law Society of South Australia. (2024, June 7). 2024-25 State Budget Wrap. https://www.lawsocietysa.asn.au/site/site/news-media-and-advocacy/media-releases/2024-25-state-budget-wrap.aspx
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