I'll get at Welcome to another installing the You project. It's the seventh of January, as I sit here in the bloody office here in the thriving metropolis of Melbourne, just slowly stepping back into the studio and slowly regaining a little bit of momentum, coming out of the hammock and the jacuzzi and having grown up conversations in twenty
twenty five with grown ups. Now. A grown up that I talk to every two weeks, sometimes once a week, but typically every two weeks is David James, Kevin Patrick, Brian Gillespie, his son James, who's better looking and smarter, not quite as access not quite as accessible. He's joined me today, not filling in for his old man, but just here in his own rights, have a really interesting chat about something that is relevant for all ozsies. Get I mate, how are you not bad?
Craig. It's going to be on with you again.
Do you like that intro? Yeah?
No, it's the run. I would say.
If you're struggling to get out of the havoc and jacuzzi in Melbourne coming out of the holidays, you got to move up to the Sunshine Coast. Craig, you never have to get out of the havoc and jacuzy up here.
Yeah, I know your old man's always telling me a version of that. I don't, I don't know. I mean, look, we're all very parochial. We all love well, we don't all love where we live. But I do love the Sunshine State. But as someone who has had I would say about sixteen or seventeen skin cancers cut off, I probably shouldn't. I probably shouldn't relocate it.
Looks it really is a bit of a double edged sword up here. You've got to be careful with that. But yeah, if you're if you're, if you are looking to get more cut out Craig, and this is the place to be.
But yeah, look I'll take that under advisement. I'll probably take a hard pass at this point in time. But if I review that, I'll get back to you. Thanks for your terrible advice. All right, now, let's just quickly let's dive in. So rather than me give a bio or me try to talk about clean Bill or the Blue Report, just tell my audience as quick or as slowly as you want, mate, who you are, what you're doing,
and what's coming out next week as well. We're recording next week, but by the time this goes live, it'll be out.
Yes, yes, So.
I might give a little bit of a longer version of events, if that's all right, Gray, Yeah, sure, and take everyone back to the start. So I grew up in Queensland and I was studying commerce law at university at the University of Queensland back in twenty sixteen. And while I was studying there, I was working as a teacher ade at a primary school and one Monday I came into the staff room and the pe teacher was laid out on the floor stretching. She'd injured herself over
the weekend. She injured her back, but more than being concerned about the injury itself, she was concerned about getting someone to take a look at it. She was new to the areas, she didn't have a regular GP and as a working professional, she didn't have time during the day to find every single GP clinic around her and then call them all during business hours to see if they would take her on as a new patient and whether or not they would bill.
Her and Craig. I was kind of shocked by that.
It seemed insane to me that one of the most important relationships that people have in their lives, the relationship that they have with their local doctor, could be suck. In the nineteen sixties, you know, where people were still looking things up in the Yellow Pages and making calls during business hours.
Just about everything else is online.
I couldn't imagine that that was the one thing that had held off and was still not online. So I went home and I did a bit of research, and I found that that actually was the case. People still the most efficient way to find a doctor was to just look up in the Yellow Pages and give them all a call.
And that seemed saying to me.
So I used the ample Utia holidays that I had at the time and started calling up doctors myself and building lists of all of the doctors in a given area and getting their pricing and availability information, and then I put it all up on a directory called Mind the Gap, and the directory is completely free, and the idea behind it was that people could go on anytime the day or night, see every single GP clinic or dental clinic or specialist around them, and then filter them
by the price of their basic services. And it worked pretty well for a time. But it was very small scale because it was just me doing it. I didn't have any money or anything, and yeah, I didn't have. It was just whatever I was able to get done in my unique holidays. And so when I finished Union,
it kind of slowed down a little bit. But then I went to work as a grad in my first year out of UNI, and in this role, I I met up with with a bloke named Joel who taught me a little bit about programming and a little bit about how to use Excel a little bit more efficiently, and a light bulb kind of went off in my mind, and so I used the COVID lockdown to teach myself a little bit of programming, and I put together a new website called clean Build that used the best of the.
Programming that I'd learned as well.
As my full time salary to pay teams of callers to do the calling that I was doing previously by myself. And at the start of twenty twenty three, I released clean Belle's first ever Blue.
Report, which was.
A report into the statistics we put together by listing every single GP clinic we could find across all of Australias capital cities and the whole of the Northern territory of the Act and Pasmania. So it was a huge undertaking, but we were the first to go out and do this comprehensive calling and it forms the basis of the listings on the website. And so when we put this report out, we called it the Blue Report and just
released it. And the idea behind it, really, Craig, was just to try to get people get awareness out there of the website, of help people find the website and find the free resource that it provided. But it created something of a storm. There was a lot of interest because, as you would know, bolk billing rates have been going down. A lot of people have seen that in their communities.
They weren't necessarily seeing it in the statistics that were being published by the government, and our report was the first one that really captured what it was like to try to find a bulk billing clinic.
In your community that and so we kept doing that.
Each year we've gone out, we've called towards the end of each year, we've called every single GP clinic we're able to find across the country, and then in January of the following year released the Blue Report that reports on what's happened in the previous year to both bolk billing rates and out of pocket costs if you're looking at every single GP clinic across the country. And that's
what this year's Blue Report does. It's our third annual Blue Report, and it reports on what's happened since since the start of twenty twenty three to both billing and out of pocket costs across the country.
A couple of things. I want to know why the Blue Report? What does that mean? Where did that name come from?
Oh, you're gonna laughs. It's because Kleingvill's logo is blue. Okay, that's the teeth as it goes.
Unfortunately, that's that's the reason, Vie.
That's all right. But it's like I always wonder about, you know, the etymology of words or terms. I'm like, what's the origin story for that word or for that term, or even for that phrase. So that's cool. Also, I want to know before we jump into the numbers and the stats and we see what's actually happened happening across the medical landscape. Yeah, I want to know, like, why does a young dude spend his wage paying people to create this thing? And I'm pretty sure that you're not trying to get.
Rich doing this, because you could get rich much easier, and you could, you could, you could invest your In fact, this would make you about the worst business man ever.
But yeah, So what what was the like just from that curiosity of the lady in the staff room when you were doing that work in the school and seeing that to this thing that you have now created, which is you know, expanding and growing and getting a footprint and recognition and all kinds of attention. What what was the motivator for you? Like? Why did you want to invest so much of your life and your own money to do it?
Well?
Yeah, I mean, you're absolutely right. It's not been a particularly fruit investment so far. Over the course of the first eighteen months of Cleanville, it cost me a fair amount of money. It's now bringing in enough money that it can pay for itself. Although I still am working a different job full time. I no longer have to pay my salary to keep it running, which is good. But I mean when it first started out, when it was just mind the gap it was and it was
just me doing the calling. It was just something to do over the Holimads. It was something that I wanted to investigate and see what was happening in I'd always grown up assuming that that Australia had this really robust universal healthcare system, and the purpose of a universal healthcare system and a robust one was to ensure that anyone who got sick at any time would be able to go and see a doctor, regardless of their economic circumstances.
And the more I dug into it when I was working online the Gap, the more I realized that it was firstly a lot more complex than that, and secondly becoming increasingly rare that people, regardless of their economic circumstances would be able to access that primary care that they needed. And so Mind the Gap kind of then more from being just an interest thing to almost feeling as though
a mission that had to be completed myself. I felt like I was in a position now where I understood quite clearly what was happening in our broader medicare system and in the accessibility of primary care, and I wanted to ensure that there was a tool that people could use to find doctors and see how much it would cost to go and visit them. And that carried over
into clean build as well. And I mean it might sound, I guess trite, but it was really a feeling that if there is an opportunity here for me to make a differences improve people's access here, and I instead decide to stand by and do nothing to ensure that people have that access, then you know, I'm kind of accepting the fact that there's nothing that can be done.
Yeah. I remember, if I remember correctly, that is when you first launched in twenty twenty three, or you did your first Blue report, and my correct was twenty twenty.
Three, twenty three.
Good, yep. That you know, reaching out to all of these, you know, first time, reaching out to all of these medical centers and clinics and providers and trying to get information about pricing, you weren't exactly warmly received by everybody. Do I recall that correctly.
Yeah, So it's I think we did receive a bit of a warmer reception in twenty twenty three than I was receiving in twenty seventeen. When I first started doing it with mine in the gap, Like in twenty seventeen, it was really unheard of thing to call up a clinic and ask what their price was, and I had all number of clinics.
Refusing to provide a quote.
You had, you know, twenty twenty five percent of clinics refusing to provide a quote because they just it was a foreign thing.
But we kept doing it, and.
The blue reports that we've done in twenty twenty three and in twenty twenty four now have completely changed the
national narrative around disclosure of pricing. Now it's an expectation that when people call up at GP clinic they will be able to get that information, to the point that when we're collecting data for GP clinics now we have fewer than one percent not providing a quote, and an increasing number of GP clinics each year are putting their pricing up on their website, so you don't even necessarily.
Have to call them anymore. You can just go on that website.
Now it's still a small percentage, unfortunately, but it is a growing percentage. And so that's been I think a really really good byproduct of the advocacy work that we've done in this area.
Yeah, yeah, well that is great, And I mean, think about any other product or service where I'm selling you something but I'm not going to tell you how much it is what it's a ridiculous notion. Yeah I want to buy that lounge, Sure, how much is it? I can't tell you. Or I want to go and train with a personal trainer. Sure, I'll train you three days a week. Okay, how much is a per session? Can't tell you, Craig.
It's the way I think of it as almost even more of an imperative than those examples, whilst they're good examples. The way I explained it when I first started out was that imagine if you're running law on fuel in a neighborhood that you don't know, and instead of there being an app that shows you all of the petrol stations around you and how much they cost, there's no app. There's nothing that you can see. None of the petrol stations even have that big sign out front that says
how much it costs. You just have to drive up to the pump, fill up your car, and then go in and pay whatever they tell you the cost is for filling up your tank. That's the situation that you were in with GPS, and are still in with some specialists across the country, where you need this service. You need what they're providing. If you run out of petrol, you're not going very far. If you're not able to take care of your health, you're not probably going very
far either. You need the service that they're providing, and there is no transparency whatsoever around costs. It would be an utterly foreign concept for that to occur with petrol, yet it's something that people have accepted for a long time.
With medicine in.
Australia, is there a particular area of specialty in the medical space that is particularly elusive and or evasive when it comes to clarity around pricing. Well, so, we've we've.
Had a lot of success with GPS and with improving the likelihood that.
The GP clinic will tell people what they're pricing is ahead of time. We've also seen that flow through to some special so we have listed dermatologists on the website, and most dermatology clinics quite forthcoming in the pricing information that they had. We've not branched out too much into
other specialties yet. I know from experience when I was doing the calls for mind the Gap back in twenty seventeen, we had even greater difficulty in getting pricing information from all specialists, whether they be dermatologists, nts, psychiatrists, anything like that we were having trouble. So it will be interesting, I think, to see as we expand out into other specialties, which we intend to do in the early months of next year, whether that culture has also changed.
Yeah, yeah, all right, Well, without further ado, let's jump in and give us kind of the the highlight reel or the snapshot of what the new report is going to tell us in terms of your key findings.
Of course, so it's worth remembering when you look at the report. But what we're looking at here is the bold billing rate as defined by our report. So we define it a little bit differently to the government, and the way we define it is the percentage of available clinics, so clinics that are taking on new patients that will both build a regular adult for a standard consultation.
Now that it sounds.
Very specific when you lay it out like that grade, but that's actually how the vast majority of adults interact with their GP is they'll go in for a standard consultation. And we only want to measure the available clinics because if you're someone new to an area, who are the vast majority of people who are using clean to find GPS. It's unhelpful to know that there are five GP clinics around you that will both bill you if none of them are able to take you ont.
Of the patient.
So there's not really there's no list of every GP clinic in Australia. In fact, it's very difficult to even
tell how many GP clinics there are in Australia. So when klean bill goes out, we're just looking to find every single one that we can, so I guess we're assembling the comprehensive lists in that regard, and that means that we found in twenty twenty three we found just over six thousand, three hundred clinics in six eight hundred, and this year over six thousand, nine hundred, So we are improving as the years to go by, and I would estimate that this is probably between ninety five and
ninety nine percent of the GP clinics across Australia. We've called a price Information and what we found is that over the course of the last two years, the BOLD building rate across Australia has fallen from thirty five point seven percent to twenty point seven percent.
Wow.
What that means is that the percentage of clinics that will both bill a new adult patient has fallen from over a third of clinics, it's now around a fifth of clinics right now.
It's gone from literally gone from one in three to one in five. I mean that is that and that is in two years?
Yeah?
Yeah? And why? I mean, sorry to interrupt, but no, why is that?
Like?
Why do you what's your theory?
Well, I've got to be a little bit careful about how I talk about this, Craig, because my other job, by full time job, is working for the government, so I'm not actually allowed to comment on government policy, right, But I would say, more broadly, think about the last two years, Craig, and the economic circumstances that we've all faced. It's been I don't think it's too much to say
it's been a cost of living crisis. We've all faced the crunch of inflation, and small businesses are heavily impacted by that, and most GP clinics, even today when there are these large practice owners around, most GP clinics are still small businesses and so when their costs go up, they unfortunately a lot of them, have to make the choice between continuing to both bill only certain groups and charging out a pocket cost for their regular adult patients,
or some of them have to look at cutting costs elsewhere or potentially shutting down if they're not able to continue to bold fill their clientele or make ends meet in other ways. So I think that's why we're seeing the bolk billing rate ball and fall so rapidly over the last two years. Is just we've faced very difficult economic circumstances over the last few years, and we're seeing these play out with GP clinics, which are mostly small businesses.
Yeah, right, right, okay, all right, So number one is bolt billing rates is on the slide one third down to one fifth. Yep, all right.
Next, well, what's really interesting is, well, Craig, is how these bulk billing rates stack up within the states and territories. Because the national bolt building rate is overwhelmingly being held up by New South Wales at this stage, right Musicwealth has a thirty four point five percent vault billing rate. Over half the volt billing clinics nationally are located in New South Wales. Wow, Yeah, which means that all of
the other states have far lower bolt billing rates. In fact, Victoria and Queensland are the only two other states now that have a vault billing rate above ten percent.
Wow wow, that's amazing. I mean, so so all of the states other than Queensland and Victoria are below ten.
Percent, below ten percent. Yeah, Tasmania is currently at zero percent.
Wow wow wow. Okay, yeap.
What's really interesting as well is when you break this down by numbers. So Western Australia has six hundred and sixty one clinics that we were able to find. Thirty seven of those we have listed as bold billing, which is a six point two percent bolt billing rate. But if you break that down by population, that means that there's now one bold billing clinic in Western Australia for every forty six thousand, six hundred and thirty nine adults.
Yeah yeah, yeah. And as you were saying before, like not all of these bulk billing clinics are open to new patients, is that right?
So the way that we measure them when we're talking about these percentages, all of these are open to new patients, right right, right. In actuality, the bulk billing rate may in fact be a little bit higher than this places than what we're reporting. But those clinics are not taking on new patients. It's not super helpful if you're a new patient looking for a clinic around there.
Yeah, of course, of course, of course. And so I mean, what's the bottom line for the bottom line is just that the bottom line is higher for patients and for the general public.
Right, Yeah, And we see this playing out in the average out of pocket costs. So some time ago, the out of pocket cost, the average amount that you're paying started started increasing to the point that it now exceeds the Medicare rebate in and of itself. So the Medicare rebate is forty two dollars and eighty five cents for standard consultation, and the average out of pocket cost that you're paying is forty three dollars and thirty eight cents.
So you're paying double the Medicare rebate for a standard consultation and you're getting less than half of that out from Medicare when you're when you're going to see the GP.
And do you think, James, I mean, if you have any data on this, but you're I mean, you're in and around it. Do you feel like you know, people are not going to the doctor who perhaps should be going to the doctor purely just because they can't afford it, and they've got to choose between buying food for the kids or going to see about that pain they've got in their bloody left ear.
This is a really, really good question, Craig. And thankfully, whilst Klingber isn't able to collect statistics on this, the Australian Bureau of Statistics does publish statistics on this. So each year in November they publish the percentage of Australians over the age of fifteen who haven't gone to see a GP because of concerns surrounding costs in the previous year.
So literally just what you've just asked, they published. And what's interesting is that in twenty twenty one, twenty two, which is the first, which is the which we're released in November of twenty twenty two, and so we're incorporated into our twenty twenty three Blue Reports, the percentage of Australians over the age of fifteen who hadn't gone to see a GP because of concerns and cost was three
point five percent. Now that's about six hundred thousand Australians that percentage now two years later is eight point eight percent, which is over one point five million Australians. So you've seen just a truly enormous increase in just the last two years. And the number of Australians who aren't going to see the doctor because of costs.
Hang on, let me just so, one point five million people who need to go the doctor have not gone to the doctor purely, not because they don't want to go, or not because they don't need to go, but because they can't afford it. That's that's scary, isn't it? It is?
And it has brought implications for the healthcare system that we're living in because for how much longer can you consider that you have a universal healthcare system If you have over one one and a half million Australians not
going to see the doctor because of costs. If the entire purpose of a universal healthcare system is to ensure that people can see a doctor regardless of their economic circumstances, that would seem to be a fairly indicted, a fairly clear indictment on that system when that many Australians can't go to see a doctor because of costs.
So I mean with this report, which is enlightening and kind of shocking to be honest, What are the underlying aims? You know, what are the drivers? What do you want to happen? I'm sure there's not a thing, there's many things, but what would you like to see happening? Mate?
Well, there are really two goals that we have in
releasing a report like this. The first is the same goal that I've had for every piece of media that I've released, every report I've released for the media since the Mind the Gap days, and that is to provide to peace people an idea of the coverage that clean bill has and the fact that clean bill exists out there as a free website that they can use to go and find GPS around them, because whilst these statistics may look dire, it is still possible in most areas
to find either a bowl filling or a low out of pocket cost GP. And having a service like clean bill, a free service like clean built that shows people where these GP clinics are, lets them filter them by their pricing and then see exactly how much it'll cost to go on them. They have to pick up a phone is critically important to ensuring that people are able to find the doctors who they can afford and who are
available to see them. So that's one of the reasons that we release the report is just to create awareness of the service that clean Bill provides. But the second reason that has become a lot clearer since releasing these reports under the banner of clean Built, just because of how comprehensive the statistics have become, is that Kleanbal's the
only one doing this. We're the only ones even trying to find every single GP clinics across the country, and we're certainly the only ones reporting on availability rates, on foulfilling rate on a clinic by clinic basis, which is
how people interact with their GP clinics. The way that we publish this data reflects how people interact with GPS around them, and so when we're publishing these reports, what we're hoping to do is provide decision makers both at the federal and state level with the best information possible to inform the policy decisions that they're making. So we're not partisan about this, We're not advocating for one side or the other. What we're saying is this is the
state of healthcare in Australia. We've arrived at this state and arrived at this description of this state by going through the process that everyday Australians have to go through every single time they're looking for a new GP, and
this is what it looks like for them. And so decision makers can then take this information that we provided and it can assist them what we hope it can assist them in designing policies that will ensure that Australians are more able to find those faulk building all well out of cost options around them.
Yeah, that's for a noble intention. I'm just having a look everyone at the Clean Build site. It's just clean build dot com dot au. Super super clean and sharp, no pun intended, but very nice sight mate, very just very clean and clear and almost dare I say clinical,
but not in a boring way. Everyone. So if you want to have a look at what James is talking about, and you want to do a little bit of a search yourself and whether not you're a potential patient or even if you are a provider like a doctor or a dermatologist or dentist blah blah blah, think am I right in saying that? Yeah?
Absolutely, Craig and Also, all of the reports that we release are on the website food, So if you want to see, you know, what's happening with dermatologists on a national level, we release the report into them in October of last year, and you can go on the website and see that report in full too.
Yeah, yeah, yeah, amazing, amazing. What else do you want to share with a smike before you go anything we need to know or consider or you want us to have a look into.
Uh, well, look, I mean I think you've been incredibly comprehensive creage in everything that you've covered off on here today. I would say as well that the website is completely free to use when you're when you're going out and doing those searches, so there's there's no fee attached as a membership or anything like that. So yeah, it's really just to reiterate that that's the services out there and one that people can use completely free of charts.
But James is starting a cult, but that's a separate thing.
So.
Night Craig, let's not get into that.
While yeah, just google clean build cult. You're so he's not I'm being silly. I mean, do you know what's funny for me? Sitting here. Okay, interview over officially, But what's funny sitting here for me, mate, is I know you probably hate this, but you're so much like your dad and just the way that you talk and the way that you phrase things, and yeah, I don't know if you like that or hate that, but he's a pretty bloody good communicator. So it's not the worst trait,
you know. Just before we go one, thank you so much, mate, Just dear people, So, is that the only place you want to kind of send people clean build dot com dot au. Do you want to steer them towards any social media or anything? Oh?
Yeah, I mean actually that's thank you for bringing that up, Craig. I'm only just getting used to that now because we've only just started up some social media recently. So if you search at clean bill oz, we're on everything except
for Twitter x or whatever it's called now. We're on TikTok, We're on YouTube, on Instagram and basically what I've been doing with those with the videos that we've been putting up there is just really short, one minute long videos that explain some element of the healthcare system, because at the moment, Australia has one of the most complex healthcare systems on Earth, and a lot of the stuff that you and I have spoken about here today, Craig, a
lot of the terms that we're using, things like folk filling, things like out of pocket cost, may be quite new to a lot of people, so that we have some socials and it's really just videos explaining out what those terms mean, why we're in the state that we're in when it comes to bolth filling, what the government statistics mean and why they're different to clean Bill statistics, and also just explainers of the reports that we release as well.
So we'll be doing an in depth explainer of the Blue Report, going into a little bit more detail than you and I have today, Craig, and things like that. So if people are interested in learning a little bit more about clean Bill's background and also seeing a little bit more about the healthcare system and the reports we release, it's at clean bill oz on just about every social media you can find.
And when you say os is a US.
Or a US, it occurred to me, as I said at Craig, that was slightly as well. Yeah, Cleanville a US.
James Gillespie from Clean Bill, you're a gun mate, we'll chat next year, I'm sure, and we'll say goodbye off in a moment, but for now, thanks for being on the You project mate, Thanks very much, Craig