Date published: 
3 July 2018
Media type: 
Transcript
Audience: 
General public

MICHAEL MCLAREN:

The new financial year has brought a whole raft of changes, as we said yesterday, but many are on the health front. For example what’s described as a life changing breast cancer medication that’s called Ribociclib or Kisqali has been listed on the Pharmaceutical Benefit Scheme, the PBS.

Now, treatments that use to cost sufferers more than $5000 a month – it’s a lot of money isn’t it – will now cost them less than 500 and around 3000 patients will benefit. And at the same time, a new Medicare item is being created for the 26,000 men who’ll need an MRI prostate cancer scan.

Now this year more than 17,000 Australian men will be diagnosed with prostate cancer and the disease will claim around 3500 lives. These are all numbers and statistics but behind them there are real human beings, aren’t there? And the creation of this new item, the $400 rebate, means prostate MRI scans will be brought within reach really for the first time for some 20,000 men who need them, but simply up until now can’t afford them.

Now also taking effect - as I said there’s a lot of changes coming here - also taking effect is a new program providing free whooping cough vaccines for pregnant women, while every 12-month-old baby in the country will be offered a free Meningococcal vaccine. We complain and whinge about government a lot, I think a lot of it’s fair enough, but this is really where taxpayers dollars, when channelled through government, can really make a difference in people’s lives.

Of course the Minister responsible is Greg Hunt, the Federal Health Minister. He’s on the line. Good morning, Greg.

GREG HUNT:

Good morning Michael.

MICHAEL MCLAREN:

Thanks for your time. Before we get to that, I mean, we’ve obviously had quite a few health stories in the news in the last couple of day, which you’re aware of.

There was a warning just yesterday in fact from the Royal Australian College of General Practitioners about pharmacy-run health checks. Now, the RACGP say that these present long-term health dangers and the chemists are motivated by money. Some people more cynical than myself might say, well, you know, a few doctors might be motivated by the coin too, but do you share the concerns of the RACGP?

GREG HUNT:

Look, I think the important thing is that the doctor is always the primary source of care and something that we would encourage. There’s an important partnership and this is what I’d urge pharmacists and GPs to do and I’ve seen very, very good cooperation on the ground between pharmacies and GPs. So pharmacists can sometimes provide an early warning.

There are programs which the government subsidises and supports for things such as dose administration or Webster packs, diabetes checks and pain meds checks. So these are important, but always the primary start for anybody is their GP, that’s the cornerstone. But work as part of what I call a primary team and I've seen fantastic partnerships between doctors and pharmacists and at their best they operate in a local community as a community pharmacist and community GPs.

MICHAEL MCLAREN:

It really should be symbiotic shouldn't it between the two. There's a story today as well about Professor Brendan Murphy. I know you know Professor Murphy, he’s the chief medical officer of your own government and he suggested a scheme - and we're here talking about medicines and costs and what-not in the medical field - he suggested a scheme under which GPs could perhaps suggest several specialists for patients who’d then be able to compare the fees before the GP makes a final referral. Now, I mean government’s all about trying to save a few dollars. I mean is that something you'd consider?

GREG HUNT:

We are open to different ways of increasing transparency or understanding what your costs might be. For most people, 85.8 per cent of the time when they go to the doctor, they have no costs at all. That's the bulk billing level. That's the highest ever on record, so that's very important for cost of living.

MICHAEL MCLAREN:

Just before you move on, sorry. Just on that, on bulk billing and the record numbers and what have you, is that actually good for society that when people go to the doctor the vast majority never pay a cent?

GREG HUNT:

Look, I think a high bulk billing rate is important because for many people it means that they can just go to the doctor without having to worry or defer. So I think that's a very important step and...

MICHAEL MCLAREN:

Why don't we apply the same principle then to say child care, which has been in the news? I mean why doesn't everyone just get a bit of free child care?

GREG HUNT:

Well we do what we think is the right balance. So there are circumstances where child care is subsidised significantly, but what we’ve done is – and I’m focusing on health – ensure that the vast majority of people pay nothing when they go to the doctor.

Where there are out-of-pockets potentially on the horizon for operations or procedures that are being referred by a GP, then what we're seeing now is very good cooperation from the medical profession to say, look, we're willing to put in place fee transparency, so it's not a surprise, and you can have a choice. And the fact that the GPs and the surgeons are all willing to do this, I think, is a real tribute to the work of Professor Murphy, who's the chief medical officer, but also all of the different players. So I think that there'll be a very important step forward on this front shortly.

MICHAEL MCLAREN:

I think there's some merit behind this, yeah. Just one more though on that bulk billing rate before we move on. You sure it doesn't create doctor botherers in that, you know, hey there’s nothing to pay I may as well go and get that sniffily nose checked out by Dr Bloggs. I mean someone picks up the bill and we talk about it being free. You know you've got the portfolio. It ain’t free. We spend $414.5 billion in health every year, a lot of it’s Medicare related, it ain’t free. Someone’s picking up the tab.

GREG HUNT:

Yeah, that’s actually over the whole four years of the budget…

MICHAEL MCLAREN:

The four years. Still.

GREG HUNT:

It’s about almost $100 billion this year and it increases over the course of the four years. But that’s absolutely right. My view is this, that providing, ensuring that people can see their GP without having to worry means that they see- they get the help that they need at the earliest possible time. And there are always one or two individuals, but that’s up to the GPs to say – look, with respect, we might take a break before we next catch up. But for the most part, I think, the patients do the right thing and the GPs do the right thing. And the fact that five out of six visits to the doctor, more than five out of six visits to the doctor, are completely free, I think is a strength of the Australian model.

MICHAEL MCLAREN:

You haven’t convinced me. I just don’t understand that- you know say you’ve got a couple earning 351-point-whatever-thousand a year, they’re not getting any Child Care Rebate anymore because hey, they can pay for it themselves. Good luck to them. But if- that same couple can go and get bulk billed doctors’ visits. Anyway, I don’t get it but anyway.

GREG HUNT:

What you find actually is that, on average, and it’s not a perfect relationship, but on average there tend to be higher bulk billing rates in areas that are less able to pay and slightly lower bulk billing rates in areas that are more able to pay ...

MICHAEL MCLAREN:

Yeah, I’m sure that’s right. I’m sure that’s right

MICHAEL MCLAREN:

Alright. Now, we want to talk about these very significant announcements that kicked in as of the start of the financial year. As I said, the spend over four years, as you’ve pointed out, in health - $414.5 billion. It’s a lot of money. It’s a heck of a lot of money. But you know, you’ve got to carve this up and you’ve got to spend it the way you think is best. I mean, this might be a stupid question, Greg, but how do you as the Health Minister and the department, how do you actually decide, in this case, what to subsidise, what medicines should be on the PBS, what treatments and what ones miss out? How do you come up with that?

GREG HUNT:

So, there’s a committee of independent medical experts and that’s called the Pharmaceutical Benefits Advisory Committee. They assess the new medicines that are brought forward by the proponents. And so it goes firstly through the Therapeutic Goods Administration if the medicine’s safe, and then secondly through the committee of experts to say – is it effective? And the great thing is we’ve guaranteed – and it’s something that the government has done – that if the experts recommend it, we will list it.

And it’s really an interesting study in what a strong economy brings because our predecessors actually started to defer the listing of medicines because, according to their own budget papers in 2011, there were, due to fiscal circumstances, they were deferring the listing of medicines. There was a massive, massive outcry in a senate inquiry at the time and what we’ve been able to do is when you’ve got a strong economy, that means you can list everything and we’ve guaranteed, so long as we’re in government, we’ll do it. The medical experts bring forward something such as Kisqali, which is a breast cancer drug. For over 3000 women a year, this will be literally life-changing. It will extend their lives. It will improve their lives.

MICHAEL MCLAREN:

Because it used to- this Kisqali or Ribociclib as it’s otherwise known, I mean, this used to cost up to $70,000 a year, didn’t it?

GREG HUNT:

Correct.

MICHAEL MCLAREN:

And now you’ve brought in the change on the PBS, what’s it now?

GREG HUNT:

It’ll either be $39.50 per script, or for concessional patients, $6.40 per script, and that just makes a dramatic change [indistinct].

MICHAEL MCLAREN:

Life-changing. Literally life-changing.

GREG HUNT:

There are very few people who can afford $70,000 a year.

MICHAEL MCLAREN:

No. No one can afford that. No one can afford that.

GREG HUNT:

You’d have to mortgage the house. You’d have to- if you’re in a position to even do that. So this just makes that medicine available to every single Australian women that needs it. And so we’re helping out with breast cancer, which of course is such a tragic condition. We have the best survival rates in the world, at over 90 per cent for five years, but we just want to keep driving that forwards and forwards and improving it.

MICHAEL MCLAREN:

Good, happy. Just before you go, this is important too for the men, the Medicare item that you’ve created for the 26,000 men who are going to need an MRI prostate cancer scan, isn’t it?

GREG HUNT:

Yep. I think virtually everybody will know somebody who’s had breast cancer and equally they’ll know somebody who’s had prostate cancer. So the MRI will now be available under Medicare. That will save thousands and thousands of men hundreds of dollars for the MRI. What it does is it gives you a better quality test and you should get it as early- whenever your GP recommends it.

They’ll do a preliminary test and if they think that you need it, then people will be able to, again, exactly as we discussed, go to the doctor without having to think about the cost and get their test and the MRI will let them know if they do or they don’t have prostate cancer. The thing is, with prostate cancer you can get incredibly good outcomes if it’s detected early.

MICHAEL MCLAREN:

If- yep. You’ve got to get in early.

GREG HUNT:

But, you know, it does take…

MICHAEL MCLAREN:

Quite right.

GREG HUNT:

… three-and-a-half-thousand men every year, but if you get in early, that’s the best chance of beating it.

MICHAEL MCLAREN:

Yep. That’s correct. No, well done, good. Greg, I think that’s going to make a change to a lot of people’s lives and a change for the better. We’ll continue the to and fro on the bulk billing at another time. I thank you for your time.

GREG HUNT:

Thanks, Mike.

MICHAEL MCLAREN:

That’s the Health Minister there, Greg Hunt.

Ministers: