Assistant Minister McBride – radio interview – ABC Illawarra – 15 May 2023

Read the transcript of Assistant Minister McBride's interview with Melinda James about strengthening Medicare, Medicare Urgent Care Clinics and Barstool Brothers.

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

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MELINDA JAMES, HOST: One of the surprises on Budget night was the tripling of the Medicare incentive for GPs when it comes to bulk billing under 16-year-olds and concession card holders. To explain that and more of the Government's health care package, I'm joined now by the Assistant Minister for Health, Emma McBride, who's in Wollongong today. Good morning to you.

EMMA McBRIDE, ASSISTANT MINISTER: Good morning Mel, it's good to be with you.

JAMES: Can you explain to me just how the Medicare incentives will work for GPs? How will it work and what will be the flow on benefits for patients?

McBRIDE: What we've seen after a decade of neglect of general practice is there's simply not enough GPs bulk billing. We've seen sharp drops in bulk billing right around Australia, including practices that had formerly bulk billed children under 16, or age pensioners or concession card holders. Australia's changed a lot since the 80s when Medicare was first started, but Medicare hadn't kept pace.

So, from the first of November, what our Government is doing is tripling the bulk billing incentive for doctors. This is supported by a $3.5 billion investment. What this historic investment will mean is that Australians get the care they deserve. So, GPs will now have a tripling of the incentive to bulk bill patients. This has the potential to benefit 11 million Australians, including 5 million children. And what we know is that this will also cause a flow on benefit, because GPs will have more financial viability, and they will then be able to also reduce the co-payments of other Australians.

JAMES: I think the Minister, Mark Butler, said that if people go to their GPs, and their doctor does not bulk bill their child, their under 16-year-old or them if they're a concession card holder, then people should maybe shop around for a GP who will. So, is that the Government's view, that that should be our expectation when we go to the GP, that we should be bulk billed for an under 16-year-old or a concession card holder?

McBRIDE: Well, I was in Tasmania at the Rural Health Conference on the weekend, and Tasmania has had some of the lowest bulk billing rates across Australia. And talking to GPs, overwhelmingly they believe that this tripling of the bulk billing incentive would mean that they could either return to bulk billing children under 16, or age pensioners, which they'd reluctantly had to stop doing, and also to be able to continue bulk billing for some practices. I heard from a practice that was considering stopping bulk billing in the new financial year, but they believe with this tripling of the incentive that they'll be able to continue to do so. So, what we're hoping to see is a real boost in bulk billing right across Australia, particularly in those communities like much of Tasmania, and particularly regional Tasmania, where we've seen a sharp drop off.

JAMES: GPs say while it's welcome, of course, that after 10 years of the Medicare rebate being frozen, that is simply not enough, and that this means that the cost of providing GP care is still well above what any government is prepared or willing to subsidise. So GPs say, they'll still be going backwards, even with the tripling of this incentive. Do you accept that there are more problems here that won't be solved by this tripling of the incentive?

McBRIDE: Strengthening Medicare is the top priority in health for our Government. Our Government stood up the Strengthening Medicare Taskforce and was going to be backed in by $750 million, and we've far exceeded that. We're working very closely with the Royal Australian College of General Practice, and with the Australian Medical Association. We are determined to turn this around. We've also introduced grants for general practices, so that they can invest in their IT capacity, in their infection prevention and control and equipment. We're working with single employer models so that GPs or doctors in training can move seamlessly from training in our hospital system to working in general practice. We're investing in innovative models of care and multidisciplinary team-based care through the WIP incentive. So there is lots of investment across the whole of general practice to strengthen it. Because we are determined to make sure that wherever you live, whatever your bank balance, you'll be able to access care.

JAMES: Another concern that's been put to us by a local GP who runs a practice as well is that by setting up the system, where you've got the tripling of the incentive for certain patients who are deserving, of course, our children and vulnerable, that means that we're setting up a system whereby those who are ineligible for that tripling of the incentive are subsidising those who are eligible. They'll still be paying full fee. Their concern is that it erodes the principles that underpin Medicare, which is free health care for all. They feel like there'll be some paying for the care of others. Do feel that's the way the system's going with this?

McBRIDE: Medicare was set up and designed 40 years ago to provide universal health care. Before Medicare was introduced, the main reason someone ended up bankrupt was because they couldn't pay their medical bills. It's something that as a Labor Party that set up Medicare and has always supported Medicare, we are determined to strengthen it to make sure that it's more robust. And we are continuing to work with the Royal Australian College of General Practice, with Australian Medical Association and others to do all that we can to properly provide the financial scaffolding that will mean general practitioners who want to provide bulk billed care will be able to do so. And through the tripling of the bulk billing incentive, and the rebate increase, will mean that in the most remote parts of Australia, that the Government is investing nearly $80 in the most common bulk billed session.

JAMES: Can I ask you another question about a Government election promise, which was the setting up of these 50 Urgent Care Clinics across the country? Where are things at with that? And what will they look like? Are we still expecting to see at least 50 of them set up very soon?

McBRIDE: What I'm pleased to be able to say that there’ll now be 58 Medicare Urgent Care Clinics across Australia. We saw in the May Budget an additional investment of $358.5 million towards Urgent Care Clinics. Some Medicare Urgent Care Clinics will be open as soon as July with the rest scheduled to open by the end of the year.

A Medicare Urgent Care Clinic will be a place where you can walk in without an appointment, free of charge, and receive the care that you need. It's care that's more acute than what your general practitioner can provide, but not as urgent as what you would need to present to an emergency department for. So, what it's intended to do is reduce pressure on general practitioners, and also stop people clogging up our emergency departments and putting more strain on our already stretched public health system.

JAMES: And who will run these? We have facility very much like you just described at Bulli which a lot of locals refer to as the Bulli ED, it's not an emergency department, if you have something very serious, you'll be sent to Wollongong quick, smart, but it is for those things, as you said, and you walk in off the street, it sounds very much like that model that's run by this state's health department, and they constantly have trouble getting doctors to staff it. So, I'm just wondering who would run this and who will be employed by these health care centres.

McBRIDE: So, these Urgent Care Clinics will be run by existing general practitioners. In New South Wales, a registration of interest process was opened in April, and through the Primary Health Network, and the Department of Health, those applications are being worked through at the moment. So, it'll be an existing general practice that will run it. And we've been told from those general practices that they're certain that they'll have the staff to be able to run those practices, at those extended hours, providing that type of care. And from what we've seen in other parts of Australia, and other parts of the world, that this is a very successful model of care, to be able to reduce pressure on other general practitioners, and to stop people turning up in emergency departments. So, we're really pleased that with the interest of the states and territories, we've now been able to expand the number of Medicare Urgent Care Clinics, and very pleased to see some of them opening up in July.

JAMES: Do you know if there are any opening up in our region?

McBRIDE: There will be one I understand opening up in Wollongong. And I understand that's on track, as are the other Urgent Care Clinics right around New South Wales and across Australia.

JAMES: I have one final question. I know that you're planning on meeting with a pretty well known local community organization, the Barstool Brothers here in Wollongong. They're doing all sorts of amazing work in mental health. And one of the things they want to do is promote not just the management of hospitality workers' own mental health, but they want to develop a program where hospitality workers can identify signs in others, maybe customers and their colleagues, when they might be struggling with their mental health. I know they're very keen to meet with you. You seem familiar with their work, what do you know of what they do and what kind of support you might be able to give them in the future?

McBRIDE: I was so pleased to be introduced to Barstool Brothers by the local MP in Cunningham Alison Byrnes, who is a big supporter of the work they do. I heard of the work that they were doing through COVID and was really impressed by the benefits local people have seen so far, and their advocacy. So very pleased to be visiting the Barstool Brothers today, might be able to have one of their burgers. What I know is that some of the most effective mental health and suicide prevention programs are local, where local people have seen a need, in this case for hospitality workers and their patrons, and have put forward a local solution to a widespread problem. So very keen for the chance to meet with them again today.

JAMES: It will be very interesting to see what comes out of that conversation. Thank you so much for joining us this morning and taking the time to come in as well.

McBRIDE: It's a pleasure to be here.


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