PATIENTS could be slugged $5 every time they visit their GP under a radical plan being recommended by Prime Minister Tony Abbott's razor gang.

It will signal the end of "free'' visits to doctors and aims to reduce the number of unnecessary trips to GPs.

The co-payment plan was first introduced by the Hawke government in the 1990s but dumped amid a storm of controversy and claims it undermined the universality of Medicare.

Under the new proposals, pensioners and concession card holders would be exempt and families allowed up to 12 bulk billed visits before they must start paying.

HAVE YOUR SAY: What do you think about the prospect of a $5 fee to see a GP?

A Commission of Audit established by Mr Abbott to better target government services explicitly lists co-payments as an option for consideration.

It suggests the use of co-payments and "user-charging or incentive payments''.

Asked directly if he would consider ending bulk billing by introducing a $5 co-payment for bulk billed GP consultations, the Prime Minister refused to rule the option out.

"I am not going to start flagging what may or may not be in the Budget," Mr Abbott told the Sunday Telegraph.

"Other than to say we do need a massive fiscal repair job.

"And we are up to it. But the fiscal repair job starts with the sensible savings we took to the last election.''

The push to consider a new out-of-pocket fee for bulk billed visits follows the Abbott government's pre-Christmas approval of the biggest increases to private health insurance rebates in nearly a decade.

The Australian Centre for Health Research has urged the Abbott government to consider a co-payment which would save the budget $750 million over four years.

A research paper prepared by Mr Abbott's former health adviser Terry Barnes argues that a co-payment could significantly reduce the number of GP visits.

"This would ensure services were targeted to those who needed to visit a GP the most," Mr Barnes said.

"My view is that if the Commission of Audit recommends it the government should bite the bullet.

"This is very affordable to most Australian households, even the less well off. We're talking about the cost of a burger and fries."

The co-payment proposal for GP visits would mirror co-payment charges already imposed on prescription medicines for pensioners and concession card holders under the Pharmaceutical Benefits Scheme.

The proposal comes amid warnings that "six-minute medicine" is driving GPs at big clinics to encourage patients to book multiple visits to resolve complaints while families with sick children cannot get an appointment.

Health Minister Peter Dutton said he wanted to ensure sick people could see a GP when they needed to.

"We will consider any Commission of Audit recommendations when we receive them in January,'' Mr Dutton said.

"My priority is to make sure that we have access to GPs for our most sick."

Australian Medical Association president Steve Hambleton said patients would be less likely to go to a doctor if it was more expensive. "What you don't want people to do is not go to the doctor when they need to," Dr Hambleton said.

Busy working mum Jeanette Kassably believes she's paying enough already in health costs without an additional payment for visiting the GP.

Ms Kassably, 43, from Georges Hall in Sydney's southwest has three school-age daughters, so visits to the family doctor in Bass Hill are fairly regular.

"If they introduce payments for GP visits it's going to affect us quite severely because we already pay for dental and other extras," she said.

"We will avoid going to the doctor as often as we do now. Now, it's a phone call, you see the doctor, and you don't pay anything."

THE ABC OF THE MBS MADE SIMPLE:

Medicare Benefits Schedule for in-rooms consultation

Level A $16.60 to $28.45

Level B $36.30 to $48.05

Level C $70.30 to $82.32

(20 to 40 minutes)

Level D $103.50 (longer than 40 minutes $115.45; between 11pm and 7am , $127 to $150)

Originally published as Abbott wants $5 fee to see GP