Assistant Minister for Health and Aged Care, press conference - 18 October 2023

Read the transcript of Assistant Minister Kearney's press conference on the Weston Creek Medicare Urgent Care Clinic.

The Hon Ged Kearney MP
Assistant Minister for Health and Aged Care

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SENATOR THE HON KATY GALLAGHER, MINISTER FOR FINANCE: Thanks, everyone for coming out. And you can see I'm joined here by my fantastic federal colleagues, Ged Kearney, Andrew Leigh, Alicia Payne, Dave Smith and of course the ACT's Chief Minister to make this really important announcement today which is about the Medicare Urgent Care Centres here in Canberra and how they are going to operate. Remember in the election, we made a commitment to have an urgent care centre in Canberra. We've been working over the past 18 months with the ACT Government to talk about the implementation of that commitment and we're very pleased to announce today that the urgent care centres will be operating through the nurse-led walk in centres across Canberra — as you know, there's five of those. They've been operating for some time, they offer a fantastic service to the ACT community, they're much-loved community health facilities, very well utilised, and act as a complement to the hospital system here, through the emergency department. So we're really pleased that we've been able to reach this agreement. I should have said I'm here as Mark Butler as well, who's been unfortunately has to do some other parliamentary duties today. But Mark has been working so closely with Rachel Stephen Smith, and the ACT Health Directorate around the best way to implement our commitment which is really to invest in primary care, to make sure that we can take pressure off hospital emergency departments, to make sure that people have access to bulk-billed health services here in the ACT and across the country. We're really pleased we've got with these clinics up and running, with the extra investment in them, we'll have 30 Medicare Urgent Care Centres operating across the country. We've got a commitment to 58 and they will be rolled out through the rest of the year. But these have been, even when we've seen them operating in other parts of the country, so well utilised already. We can see they're being utilised by people under the age of 15, which is a no brainer, really, because it's always your kids that get sick out of hours. They're being used on the weekends, they've been used in evenings and they've been able to take those presentations away from the emergency department, which is the work we've been doing with the states and territories. After a decade of neglect into primary care, it really is a genuine partnership about how we make sure the states and territories have the help they need on the hospital front and that the federal government is investing in the primary health sector to make sure that the primary health system, GPs, these type nurse led clinics and other supports can actually take the pressure off and, importantly, provide Australians with bulk billed access to health care services. So we're really pleased to get to this point today. I know Canberrans love the nurse led walk in centres, they're a credit to the nurses that run them, that operate them, that they've been able to be so successful. I remember at the time they were quite controversial when we bought them in. But through the work and the professionalism of the nurses that have staffed them, they are a highly trusted, well utilised part of our community health system now. Canberrans love them. I use them all the time. I'm sure you've all used them as well. And it's fantastic that we've got this partnership $7.1 million where we can provide that extra investment so that extra services can be provided through the clinics. And I'll hand over to the Chief Minister who can talk about that now.

CHIEF MINISTER ANDREW BARR: Thank you. Thank you very much, Katy. Thank you Ged, Alicia, Andrew and David for being here and the team at the Weston Creek Walk In Centre for hosting us this morning. This is an exciting announcement and we're really pleased to be able to partner with the Commonwealth to deliver a significant improvement in primary health care in the ACT. We see the strength of that partnership in this announcement, the capacity to be flexible to look to roll out a great Commonwealth initiative right across the ACT in partnership with an existing, proven and really popular primary health care delivery mechanism. Now, we're very keen to continue to work with the Commonwealth to strengthen Medicare to increase access to after hours of primary health care to support more bulk billing in our city. More services closer to where people live. And that's exactly what we're achieving with this announcement today and the Commonwealth's investment building on ACT government investment over many, many years. And as Katy has touched upon, she has been involved in this process. She has worked very hard for us both as a Health Minister and now in federal parliament to strengthen primary health care in the ACT. And this was a further example of that commitment. I thank each of our local federal members for their advocacy in working with us to ensure that we have a network of urgent care walk in centres right across the ACT, so in each federal electorate, in each territory electorate, close to community. That's what this announcement is about. It serves, we see a significant purpose in diverting many, many patients away from emergency departments. We're of course investing in improving our emergency departments in the territory with a new build underway now at the Canberra Hospital and the new Northside Hospital planned as well. So it's a comprehensive response to our growing communities health care needs, primary health care, and investments in hospitals. And that's what we're about as a government. And on behalf of Minister Rachel Stephen Smith, who is on some well deserved leave at the moment, we thank the Commonwealth for working with us to make this a reality. And now handing over to Ged Kearney for a few words.

THE HON GED KEARNEY, ASSISTANT MINISTER FOR HEALTH AND AGED CARE: I'm so thrilled that we're able to contribute and build on the great work that's been done here in the territory. A great initiative for the people of Canberra that was started by the wonderful Katy Gallagher when she was Chief Minister here. The beauty of the urgent care clinics is that they are innovative and we are trialing different models of care right around the country. Models of care that respond to the community's needs. And here in the ACT that is building on the infrastructure that's been well established and well loved by the Canberrans. As an ex nurse myself, I'm very proud that the nurse led clinics have been so embraced by Canberrans. I just saw some statistics today that said there's been over 51,000 presentations in the first six months of this year to the walk in clinics. And that is wonderful and 94% of those people who are treated here are [inaudible]  treatment and only a small percentage have to be referred on. So it just goes to show how effective these clinics are and how urgent care clinics and the model that we're establishing federally are flexible and innovative and meet the needs of local communities. So I congratulate everyone involved and particularly the people who are working here. This extra investment will mean more nurse practitioners more advanced practice nurses and I believe specialist physiotherapists for the people of Canberra and that's a good thing. So thanks, everyone.

JOURNALIST: Minister, a lot has been made over the past 18 months about the timing for the announcement of the ACT urgent care clinics. Is this later than you would have liked?

GALLAGHER: We made a commitment during the election to get them up as soon as we could. So obviously it's a big program, 58 clinics working with each state and territory and talking with them around the models and that's taken some time in the ACT to work through. I'm just really pleased that we've reached agreement and this extra investment can flow and we can build upon the really successful model here. So I mean, I think you'll see it as a sign of the work that Mark does, like Mark works in partnership with state and territory health ministers. You know, the ACT government was clear that their view was that they believe that, you know, building on the successful walk in centre model was the best outcome for this city. I mean, they're known, they're open the extended hours, they're open on weekends. Canberrans loved them. It made a lot of sense to work with them about how we implement that and what the model might look like. So you know, we've been looking at how we roll these out across the country. It takes a little time, they're new models of care. But I'm really pleased that we've reached agreement and you know, Canberrans will be the beneficiary of that with those extra nurses and physio and diagnostic services coming in.

JOURNALIST: Why won't these expansion of services in these clinics undermine the viability of general practice which is already struggling?

GALLAGHER: Well, look, I think that was some arguments put at the time we started the first walk in centre, way back when at Canberra hospital. And I think you've seen that the demand for health care, the pressure that GPs are under, there is a good ecosystem of community health facilities here in the ACT, they work alongside each other. There's more work than each facility can do, really, there's you know, when you look at the waits to get into GPS, there's a you know, I think it's about a 30 minute wait here at the walk in centres but they're very, very well utilised. So I think it's more about making sure Canberrans have access to health care rather than taking work off others.

JOURNAIST: The walk in centres have been around for a while but the ED numbers are still bad for the ACT. Have they made the impact that we all thought they would?

GALLAGHER: Well, I think again, at the time, when they were established it was to provide access to health care and to take pressure off emergency departments. And you'll see from the statistics in the Health Performance Report, there's a very a reasonably low rate of referral from the walk in centres to the emergency department. So that says to me, that they are meeting a need in the community and that they are not, you know, that they are able to meet those low urgent, low acuity issues and have a small number of people that go to the emergency department. But in a town like the ACT where you have two busy emergency departments and a growing city, you are going to see pressure on emergency departments. This isn't peculiar to the ACT, you see it right around the country.

JOURNALIST: Is there a chance that there's going to be undue pressure on these walk in clinics given that you can't really find a GP that bulk bills anymore?

GALLAGHER: Well, bulk billing rates in the ACT have always traditionally been pretty low. We'd like to see that increase and I don't know if the Chief Minister wants to add to this answer. But the walk in centres have been offering free health care for some years now. And we see that operating in partnership and alongside general practice. I mean, it's no secret people like general practice, if they've got a general practitioner, they like that continuity of care that they get from there but for those other times and I mean, I put myself in this category, I'm like every other Canberran, I have a GP but there are many times during the year between myself and my children where we require the walk in centre and that's what they're about. They're about episodic, low acuity presentations that can be dealt with and people can go home have, you know, cared for, they're not about providing, you know, GP type services and having that continuity that you would get with your GP.

BARR: I would just add that we need more health services across the board and so our population continues to grow. Canberra has been the fastest growing city in Australia for the best part of a decade now. So we know we need to continually invest in more health services closer to where people live. So there's expansion of services at our existing walk in centres. We have a program of additional community health centres that were part of our 2020 election commitment that are rolling out across the suburbs in the ACT and we're investing in our hospitals. So it's across the entirety of the health system. I think I'd make a couple of points back to to Ian's earlier question. In 2014, the Abbott Government savaged health funding in Australia and that had consequences across every state and territory health system. And I think people tend to overlook the significance of those 2014 cuts in that infamous Joe Hockey budget. It'a taken years and years and years to recover from that. And we're still not there yet. We finally have a federal government that's prepared to work with the states and territories to invest in primary health care, to strengthen Medicare and to invest in hospitals. Haven't seen that for 10 years. But I don't expect this federal government in its first 18 months in office to be able to fix 10 years of neglect from the Federal Liberals, but they're making a start. Today is another practical example of that collaboration between the Commonwealth and the States and Territories. And I make this simple point as I did yesterday, in relation to the National Skills announcement and that when investment in TAFE, when the two levels of government work together, we can achieve some fantastic things for our community. And for the second day in a row now, in some of the most significant areas of public policy, in education and health, we are making joint announcements, to invest more in health and in skills. That's what we need from the Commonwealth. And that's what we're getting from the Commonwealth. That's what people voted for when they voted to change the government last year.

JOURNALIST: A question for the Chief Minister and the Minister. With the failure of the federal coalition to refer their ACT drug laws bill the Senate inquiry, do you expect that that is that for this intervention attempt in ACT matters. Further to that in the lead up to the next federal election, are you expecting more attempts to intervene in territory matters?

BARR: Yes, I am and the Federal Coalition can't help themselves, but what do we interfere in the democratic rights of the ACT. We've seen this on numerous occasions, and I expect we will continue to see it. It's part of a culture war. It's about, I think they describe it as throwing red meat to their conservative base, but it demonstrates the values of the Liberal Party in particular, that they are prepared to trample on the rights of ACT residents through their democratically elected Parliament. I know a number of Coalition senators have attempted to do this on a variety of issues. So, I expect it to continue. And I certainly hope that the progressive forces in the Senate continue to resist it. It stunned me that the Greens and David Pocock on at least one occasion on other issues, voted to support these sorts of political stunts. I think Canberrans were stunned as well. So, I would hope that what we saw yesterday where an overwhelming majority of senators rejected this hyper-political culture war intervention, that that voting bloc will hold together to resist further attempts that I'm sure are coming.

GALLAGHER: Well, what he said –

JOURNALIST: But is that it in terms of this attempt?

GALLAGHER: Well, I don't know what their tactics are going to be, but I don't think it's any surprise, really. I mean, this is a political party that has chosen the politics of division over everything else. We see it in absolutely everything that comes to the Senate. And if they can pick a fight and, as Andrew said you know, toss out a bit of red meat to have that kind of inflammatory debate, they will do so. They don't care about evidence. They don't care about rational debate. Or considering the fact that territory is very well managed under a democratically elected Parliament, of which they have representatives in that Parliament to continue to try and play these games in the Senate. And we've seen the result of, I guess, their approach to the territory in that they lack any territory representation in the chamber.

JOURNALIST: Shouldn't it be a better look at these laws, though, from a Commonwealth perspective?

GALLAGHER: Well, I mean, we've taken a view that the ACT Assembly is a democratically elected Parliament. It is a mature Parliament. They are accountable to their constituents in the communities. They face election every four years, and it's appropriate that they're allowed to govern with the support of their community or otherwise. I mean, the people of the ACT will have the ultimate say on this. And it's not the role of the Commonwealth Government to interfere, to play games, and to pretend about policy issues for which they have no responsibility for – the Commonwealth Parliament or the Commonwealth Government. And we took that position, and we made it clear when we got rid of the Andrews Bill, which was, you know, I guess the most symbolic and practical hindrance on the ACT assembly to govern in its own right. And we took a view on that, and it's a consistent view that we hold.

JOURNALIST: The ACT's trialling the expansion of duties for pharmacists to ease the burden on GPs. If successful would the ACT Government, this could be very much one for the Chief Minister. If successful, would the government look at allowing pharmacists to prescribe certain medications?

BARR: Well, look, we have an open mind to what the Health Practice referred to as scope of practice reform. The states and territories are working together, sharing information on some of the trials that are being run in different jurisdictions. Go back to point I made earlier. We're going to need more health services and we should be accessing the skills and talents of everyone who works in the healthcare sector. Pharmacists, nurses, doctors. We really want to bring all of that capability to the fore to assist our growing community. So, we have an open mind, certainly not ruling things in or out today. You'd want to look at the evidence on specific trials. But we should go into this with an open mind, and we should go into this with a view of utilising the skills that we have available in our healthcare sector.

JOURNALIST: Doctors are still unhappy about any payroll tax arrangements. Are you going to persist with that?

BARR: Well states and territories are talking around those matters. There's a pretty fundamental principle here that payroll tax applies across all occupations. I note that after the GPs called for a payroll tax exemption, so did the pharmacists and then the dentists came out as well. So, were we to just agree every time someone said, “I don't want to pay tax,” we would have a very long line of people lining up to get a tax exemption. The point I have made repeatedly is the ACT has the highest payroll tax free threshold at $2 million. So, you pay zero payroll tax on the first $2 million of your payroll. And what that means is that most small and medium sized businesses, whether they are in the healthcare sector or otherwise don't pay payroll tax in the ACT. Our payroll tax is particularly focused on large national and multinational corporations who should be paying tax and I think that is a view that is shared broadly across the community.

JOURNALIST: Just with the Weston Creek Centre that we've got here as part of announcement here. There'll be advanced scope physiotherapists for the walk in centre here, as well as a radiographer and sonographer here as well. Why have resources been, I guess, allocated to this specific centre here? And is this centre perhaps an example of one that's sort of leading the way nationally, or at least in the ACT?

GALLAGHER: Well, I might see if Andrew has anything to add to this, but I think the nurse led walk in centres are leading the way, so we're very proud of them here in the ACT and where they can provide additional services. And this is part of the investment is looking at how we can utilise physiotherapists. They're widely utilised in emergency departments around the country because there’s a recognition, particularly on weekends with sporting injuries and such, that that's what's needed to meet the patient demand. And we'll have a look at how it goes. We'll work in partnership with the ACT Government about how the extra investment is working, how that matches up with patient need and continue to work in partnership with them about as the model evolves.

BARR: Just very briefly, it complements existing capability and capacity that we have here at the centre and a skill set that we're endeavouring to develop further. So, it's another practical example of the two governments working together to enhance the health service offering for the community, but also to create centres of excellence, effectively, within our ACT health system.

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