It’s the precise scenario the clinic fears could happen again with the introduction of the $7 co-payment on GP visits, pathology and X-rays, as announced in the budget this week.

Elmwood practice manager Craig Ford said if patients put off treatment and only sought help when a problem got more severe, it could would cost them — and the health system as a whole — much more down the track.

Elmwood was the region’s first exclusively bulk-billing clinic and opened in 2007, and among the new patients were older people who live in the city’s rural surrounds.

“We had lots of comments from these people who hadn’t been to a doctor in years because of the expense, but now they could see a doctor about all their issues and it wasn’t going to hit their hip pocket,” Mr Ford said.

“People will put off the little issues, that may be little to them but may actually be much more.”

Concession card holders and patients under 16 will only be charged for the first 10 visits, and then receive the current rebates.

Five dollars of that payment will go to creating a medical research fund, while $2 will go back to the doctor.

On top of the co-payment, the budget also provides that private-paying patients will get $5 less from their Medicare rebate; indexation of Medicare Benefits Schedule fees will be frozen for two years from July this year; and indexation of income thresholds for the Medicare Levy Surcharge and Private Health Insurance Rebate will be frozen for three years from July next year.

Victorian Nationals Senator Bridget McKenzie said asking patients to contribute to the cost of their healthcare would stop the over-charging and over-servicing that currently occurs.

Mr Ford said in his experience, over-servicing rarely happened: “I don’t think people go to the GP for fun or just to fill in time.”

Chairwoman of the Border Medical Association Tracey Merriman agreed the government did need to address the high costs of healthcare.

She doubted freezing indexation would help in the long term and feared doctors and specialists would be forced to raise their fees as the other costs of running a business continued to rise.

“I know as a specialist, I’m aware we’re treating patients who are the most vulnerable, but when we have to pay $20,000 to $30,000 in medical defence insurance, that has to be met before we can start paying our bills or anything else,” she said.

Dr Merriman said fixing the system may well require more contributions from the public, but questioned how the multibillion-dollar medical fund would help.

“It’s hard to see how that will sustain Medicare at the moment,” she said.

“The $2 is a very small increase per patient.”