Assistant Minister McBride – press conference in Lismore –16 May 2023

Read the transcript of Assistant Minster McBride's press conference in Lismore about Strengthening Medicare, cheaper medicines, Medicare Urgent Care Clinics, and the Lismore floods.

The Hon Emma McBride MP
Assistant Minister for Mental Health and Suicide Prevention
Assistant Minister Rural and Regional Health

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EMMA MCBRIDE, ASSISTANT MINISTER I'm so pleased to be back in Lismore today at the GP Super Clinic. Our Government has made the biggest investment in bulk billing in the history of Medicare. We've invested $3.5 billion to triple the bulk billing incentive so that practices like this GP Super Clinic here can continue to bulk bill patients. We know the further you live outside of a big city the worse health outcomes are likely to be. We also know the pressures that communities like Lismore have faced to natural disasters, especially the floods last March, we're determined to make sure that wherever you live, and whatever your bank balance, that you can afford quality care, close to home when you need it. This will also help reduce pressure on our overstretched hospital emergency departments, which are just clogged up with people who could have seen a GP, if they could afford to see one close to home.

I'm so pleased in a community like Lismore to be standing outside of GP Super Clinic, a former Labor government initiative, that has seen people in this community, all being bulk billed, that's children under 16, older people, everyone who walks in through the doors of this GP Super Clinic is bulk billed. That's what we want to see in places like Lismore, and right around Australia.

JOURNALIST What about the other GPs is that just because there are incentives are they definitely going to take this up, if they've already got wait lists out the door?

EMMA MCBRIDE, ASSISTANT MINISTER So I was at the Rural Health Conference in Tasmania over the weekend, and I spoke to RT, the incoming president of the Rural Doctors Association of Australia, and what he said to me was that some practices had been forced to stop bulk billing, because they didn't think it was viable, then couldn't afford to, and some practices were at that point where they thought they may not be able to continue bulk billing. And he was very confident that this tripling of the bulk billing incentive with a $3.5 billion investment, would mean the practices that had reluctantly had to stop bulk billing, or were thinking that they couldn't continue bulk billing would be able to continue to do so.

JOURNALIST And so this GP has taken that up already? They've implemented this bulk billing?

EMMA MCBRIDE, ASSISTANT MINISTER This practice, this GP Super Clinic in Lismore, was an initiative under the former Labor Government, and they have always bulk billed their patients. And what that means is, they'll be able to continue to provide affordable quality care for people in Lismore and the surrounding there's six GPs practicing here, and we know what that has meant to local people, especially through the natural disasters that your community has been impacted by.

JOURNALIST And obviously, you know, alleviating pressure from the hospitals so people can actually come in?

EMMA MCBRIDE, ASSISTANT MINISTER This investment will mean that our already overstretched emergency departments, particularly in regional and remote communities, that have been under increasing pressure through the COVID 19 pandemic, we've seen more patients turn up to the emergency department because they've avoided or delayed seeing their GP because they couldn't afford it. So, this is good for people’s care, it's good for general practice, and it's good for our healthcare system.

JOURNALIST And what's the average cost for the patient at the moment and what will that come down to?

EMMA MCBRIDE, ASSISTANT MINISTER So, this does vary widely across Australia. In some communities, people are paying, $100 or more out of pocket. But general practices are private businesses, and that's a decision of the practice what they charge in a co-payment. So, what this is intended to do is give them every support and incentive to bulk bill so that they will bulk bill especially children under 16, age pensioners, and people with health care concession cards. And what we believe it will also do is provide a flow on benefit to others. Practices that are effectively cost subsidising their bulk billing by charging higher co-payments will be able to reduce those co-payments so that everyone will benefit. So, we know that there's about 11 million Australians who are either under 16, age pensioners or hold health care cards, they will see the immediate benefit, and we believe there will be a flow and benefit to all Australians.

JOURNALIST And Medicare rebates?

EMMA MCBRIDE, ASSISTANT MINISTER So, what we will see now in a place like this, for a standard level B consult, the combination of the rebate plus tripling the bulk billing incentive will mean that it'll be the government investing around $60 to $70 in a bulk build session for someone, and having spoken to the doctors in this practice, they said it will make an enormous difference to their practice. This practice does bulk bill and they intend to continue to bulk bill, but it will really boost the viability of their practice and the work that they can do in their community.

JOURNALIST Just on pharmacy, we've spoken to a number of local pharmacies here in Lismore and they're really concerned about the changes to PBS, and that they might have to change their hours and potentially have to put off staff because of the change in dispensing.

EMMA MCBRIDE, ASSISTANT MINISTER I'm a pharmacist myself, and I've worked in community pharmacy, and we want to see thriving community pharmacies, in every city and town across Australia. We know there's around 6,000 community pharmacies right around Australia, providing quality care. Pharmacists are the most accessible health care professionals, and we want to boost and strengthen community pharmacy. So, what we've seen in the Budget is now for the first time, community pharmacies will have access to the National Immunisation Program. So, all children over five will be able to access the National Immunisation program, what we want to see is all health care professionals work to the top of their skills and training, because we know that that's how Australians will get the best care. So, we've announced a national scope of practice review, which will look at, whether it's social workers, or physiotherapist, or pharmacists, and what they can contribute to the top of their skills and training in collaborative team based care so that Australians get the best care that they deserve.

JOURNALIST So, they're worried that they're going to have to cut off stuff, because they're essentially losing half their revenues through the dispensing fees. Is that something that government is worried about, or is looking into?

EMMA MCBRIDE, ASSISTANT MINISTER What our Government's intention is to make health care more affordable, we know that health care is one of the biggest pressures in the household budget. So, this measure will mean that almost 6 million Australians will be able to halve the cost of their medicines. We are determined to work very closely with community pharmacies to make sure that they are strong, that they are robust and everything that's come out of this will be reinvested directly into community pharmacy to make sure that we've got vibrant, sustainable community pharmacies right around Australia.

JOURNALIST You don't worry that's going to lead to shortages with different medicines? That was another concern that some of the pharmacies have said.

EMMA MCBRIDE, ASSISTANT MINISTER All sectors were hit by supply chain problems through the global pandemic and the health care sector was no exception to that. So, what we've done is, as of the first of July, every medicine manufacturer will have to keep six months of that medicine on shore in Australia, to make sure that we've got robust supply chains, from manufacturers, to wholesalers, to pharmacists, so that every Australian can get the medicine they need when they need it.

JOURNALIST And when will this roll out? When will this start being implemented?

EMMA MCBRIDE, ASSISTANT MINISTER So, the first of the 60 day dispensing will start on the first of September for the first 100 medications. And that'll be in consultation with someone's general practitioner, who decided it's clinically safe and appropriate for someone to have two months’ supply of medication for a stable, well managed condition. So, the first of this change will start on first of September for people around Australia.

JOURNALIST Our federal member Kevin Hogan last year called for the Medicare subsidised psychology sessions to be doubled after they were halved, the Opposition has now come out and said that they would do that as part of their Budget reply is that something you guys are looking into potentially putting that back up to 20 from 10?

EMMA MCBRIDE, ASSISTANT MINISTER So, what we saw, and there was a report, the Better Access Evaluation, and this is a report commissioned by the former government. And what that report showed was, that while some Australians would access Better Access the government subsidised psychology sessions, many couldn't and with the increasing sessions, we saw fewer Australians, particularly in communities like here in Lismore, or places outside of major centres be able to access care. Our focus is on equity and access so that every Australian whatever their postcode, or whatever their bank balance can access care.

So, we had a forum at the end of January where we brought together psychiatrists, psychologists, people with lived and living experience, service providers, to talk about Better Access and how we might be able to make it more equitable and more affordable. And we'll continue those conversations with the sector but in the Budget, we've seen over $500 million invested in mental health. We're trying to build the pipeline of psychologists by increasing psychologist in training, provisional psychologists, and psychologist supervision because we know that one of the biggest barriers to people being able to access psychology is a psychology workforce, and that is worse the further you are outside of the major city.

MONIKA WHEELER, HEALTHY NORTH COAST I'm really pleased to be here today to support the Government's Budget announcements, which really have a strong focus in primary health care, and as the local Primary Health Network, we look forward to commissioning a range of different initiatives and in primary health care as a result of this Budget. As a practical example, in Lismore, which one of the urgent care centre sites, we will be commissioning in the coming months, a new urgent care centre for Lismore, which will provide increased access to same day primary health care services for people in this region, there is also a site that has been announced for Coffs Harbour as well, and we look forward to setting that up too. And that will be available to anyone in the region, don't have to be an ongoing patient, you can be a new patient to access the service. There will be after our services included as part of all of the urgent care clinics. We're also really looking forward to supporting multidisciplinary teams in general practice. So that means that more nurses and allied health professionals in the coming year will be able to work with general practice as a result of these Budget announcements. And that's terrific because that means that there'll be comprehensive care providers in every general practice. So, we're really looking forward to supporting our role as the Primary Health Network with a really exciting investment into primary health care.

In relation to bulk billing, we've actually seen a 14% drop in bulk billing in our region over the last two and a half years. So, we do hope that as a result of the announcements in the last week, that that will start to increase again.

JOURNALIST Are you hearing that from GPs that you're talking to, that they're likely to either start bulk billing again or mix their rates in their own clinics?

MONIKA WHEELER, HEALTHY NORTH COAST Well, what I would say is that in the last six months, what we have heard from general practices is that they're really doing a tough and they've had to make decisions, to keep their businesses afloat and to change their bulk billing policies. So, what we hope as a result of this announcement is that those general practices that have changed their policies in the last six months or a year, that they'll actually make that decision to switch back to making sure that bulk billing is available, particularly for people who are older, children, and people living with chronic illnesses as well.

JOURNALIST Just on the Urgent Care Clinic, will that be a new sight? Do you just want to tell us a little more about that?

MONIKA WHEELER, HEALTHY NORTH COAST So, the Urgent Care Centres, as part of the government policy must be housed in an existing general practice. That's part of reinvesting back into existing general practices across the country. So, in our local region, what we've done is we've conducted an expression of interest process, with local general practices here in Lismore, and will very soon work through a procurement process to actually contract the general practice to house that Urgent Care Centre.

JOURNALIST And can you just explain a bit about what that is? What those centres will be?

MONIKA WHEELER, HEALTHY NORTH COAST So Urgent Care Centres have been established, because what happens in a lot of different areas, particularly rural areas is when general practices are not open people will use the emergency departments as almost like a quasi-general practice, because they might not be able to see their general practice in the time that they'd like to see they or they need care in an out of hours period. What urgent care centres do is provide options for people for visiting a general practice when they have that urgent need. So, it's a non-life threatening need. But it is something that they need addressed within a 24 or 48 hour period. And so urgent care centres provide that stop gap between the emergency department and your ongoing general practice that might be booked up for the next week or the next two weeks. And then if you have a general practice that's not able to see you straightaway, an urgent care centre might be that excellent next step solution.

JOURNALIST And aside from obviously the medical rebate, what are the issues of doctors facing regionally that need to be addressed?

MONIKA WHEELER, HEALTHY NORTH COAST Well look in this particular area in Lismore, obviously, we're still recovering from the floods of last year and so we've been working very closely with the support of the Australian Government to help practices get back on their feet. We've had a range of different workforce, wellbeing and locum initiatives that we've rolled out across the region, particularly in Lismore. There was a $5 million announcements that we're currently processing for infrastructure recovery, which is also a fantastic initiative that is currently being implemented for just Lismore primary health care services, so not just general practices, but also pharmacists, allied health professionals and medical specialist services outside the hospital. But we've also seen quite a lot of strain in our community in relation to mental health. So, we've had a very big focus on getting mental health services up and going particularly in the Northern Rivers, post the flooding that we've experienced. So, there's a range of different additional psychological support services now available for people in the Northern Rivers as a result of the floods and their recovery.

JOURNALIST And these incentives will help improve and assist the running of bulk billing?

MONIKA WHEELER, HEALTHY NORTH COAST Of course, the more people can make their health care needs outside of a hospital system, the more that they're going to be supported in that community primary health care environment. There's quite a different experience that people have when they access primary health care, because it is an opportunity to have a longer conversation and to address some of those more ongoing health care needs when you're in a primary health care situation. Emergency departments are not in a position to talk about potentially screening that you might need to get done, or different blood tests, or overall health check. These are the types of conversations that you have in the general practice, and they're not the types of conversations that you should be having in an emergency department because it really is for those life threatening urgent care needs is why you go to the emergency department. So very much it's really important that people are seeing people in primary health care, using primary health care services where they can, so we can just ease that strain on the emergency departments.

KEN STOCKLEY, LISMORE GP SUPER CLINIC Today's not just about the Lismore GP Super Clinic. It's about the community and what we've done, and what we haven't done as a community, and how Lismore has survived the last few years. It's not just our country, it's not just our state, it's Lismore itself as well. And the community spirit that our clinic has is reflected and reflects what Lismore is and we're very fortunate to be part of that city. So, in that respect, we're very pleased for you to be here to chat with us, take the time to see what we do.

There's a couple of people that I normally don't get the opportunity to thank or to stand out, but we have amongst today a group of people that over the last three years have done some truly wonderful things for this community. One in particular, John. John sat during the COVID pandemic, and triaged every single patient that came in to protect those that were in the clinic from those that were coming to the clinic. I would sit down with John and say, 'John, you're the oldest man in the clinic, you're the oldest person here and you're the most vulnerable person on that basis, you shouldn't be doing this.' John's answer was, 'I should because I’m dispensable. The others aren’t. Now that community.

We have Tracy and we have Debbie, they themselves have opened this clinic for anyone and everyone when the need arose. So, during the floods they were there and helped, and didn't ask for anything. They didn't ask the people that opened the clinic to for anything. We had people, dozens deep at the door in the first week of the floods, asking to see the doctor. They had on the clothes that they had on during the flood, they had a plastic bag in their pocket, which had their life possessions in it, they had no ID, they had no medical records. These ladies and the staff went to all the means to make sure that they were looked after. That's what community is all about and we're lucky to have them.

The big gentleman with the beard Steve he's one of the pharmacists here. Steve, flew two helicopter loads of drugs, and medicines on his own behest into Lismore during the flood. Because there we're no pharmacist in downtown Lismore, there were no drugs available. Steve didn't do it to make money. He gave those drugs to the patients that needed it, to the doctors, he worked with the doctors, he worked with his fellow pharmacists, and that's why he has the respect today.

We have here today from the PHN Luke and Rowena, yes Monika, and they have been a pillar of strength to us, in helping us and helping the community to do what they have to do. So, we are very lucky to have all of these people around us today. A couple of my staff phoned me when they knew you were coming, and they said, 'we're a little bit nervous about a federal minister coming to visit,' and they thought that was a bit of rarefied air. And I said to them, 'by the time I've finished speaking, the minister will understand that she's actually in rarefied air because of what these people do for the community.' So welcome. But before I say that I'd have to congratulate you.

What the Government announced in the Medicare increase is exception, it is going to bring bulk billing back, it is going to encourage those that have recently changed maybe to private billing, to go back to bulk billing, and I really think it's a step in the right direction. And you deserve kudos, and you deserve laurels. But we don't want you to sit on laurels. That was this year. Next year, you have to relook at it again. And you have to continue to improve Medicare, not the money side of it, but the services that we provide as medical practitioners and owners of medical clinics. The money helps to do that. The first thing anyone talks about when they talk about Medicare today is money. It should be the last thing that we talked about. The first thing we should be talking about is the services that we provide, and that's what the conversation has to get back to.



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