Health Minister Jillian Skinner has confirmed no payment would be charged as the government would ‘‘put patients first’’.

Her statement comes as health experts warn the unprecedented cuts will put huge pressure on state hospitals in the short and long term, with more patients forgoing GP visits that could keep them out of hospital, at the same time federal hospital funding is cut.

GP clinics are already counselling worried patients, with patient numbers halving in one large practice in south-west Sydney on Wednesday as people mistakenly tried to avoid the fees.

Mrs Skinner said she had on Wednesday told the federal health minister her concerns about the pressure the cuts would place on hospitals.

‘‘There is no doubt there have been significant cuts ... It is cost-shifting and NSW will have to accommodate a loss of more than $1 billion over the forward estimates for hospital services.’’

The health program director at the Grattan Institute, Stephen Duckett, said the budget contained ‘‘the most parsimonious funding model since the introduction of Medicare’’. He said states like NSW and Victoria would suffer most as they were most efficient and so had less savings to make.

Jeff Richardson, the foundation director of the Centre for Health Economics at Monash University, said co-payments would inefficiently shift the cost of care from cheaper GPs to more expensive hospitals.

‘‘We can expect to see queuing [for hospital treatment] to get worse,’’ he said.

NSW Labor health spokesman Andrew McDonald said hospitals were depending on the federal money to ‘‘keep their heads above water when it comes to waiting lists’’.

‘‘At the moment it takes longer to get a hip replacement in Fairfield than it does in Estonia, and twice what it takes in New Zealand and England,’’ he said. OECD figures show the median wait time for a hip replacement in Estonia is 196 days, compared to 210 in Fairfield. It is 99 days in New Zealand.

‘‘This money is core business for NSW Health  ...  Jillian Skinner has been banging on about increases in operations performed in NSW, but most of that has come from National Partnership Agreement money’’.

Fairfax Media understands that at least some of the money that has been cut comes from a funding pool that was to be used for managing people with chronic conditions to keep them out of hospital.

The practice manager at the All Care Carnes Hill Medical Centre in Horningsea Park, Neeraj Gureja, said patient numbers had dropped by 50 per cent on Wednesday.

‘‘Normal fluctuation is in the range of 10 per cent and my patient numbers have dropped by 50 per cent, and I’m really, really concerned,’’ he said. ‘‘People are so scared. Many have cancelled and many have just not shown up.’’

The busy clinic has 14 doctors and sees between 1500 and 1800 patients a week, all bulk billed.

‘‘The people in this area cannot afford to pay, there is a lot of financial stress on them,’’ he said. ‘‘ People will end up more in hospital.’’

Lyn Morgain, transitional chief executive of Cohealth, said staff were being peppered with questions.

‘‘They are asking will we have to pay this and when do we have to start paying this? And the second question is what will we do if we can’t pay it?’’ she said.

- with Nick Toscano