Media event date: 
3 November 2019
Date published: 
4 November 2019
Media type: 
Transcript
Audience: 
General public

FRAN KELLY:

Greg Hunt, welcome to Insiders.

GREG HUNT:

Good morning Fran.

FRAN KELLY:

Minister, will the Government stop neglecting older Australians right now? And announce more funding for these home care packages right now?

GREG HUNT:

We've taken immediate action. Indeed, straight after the Royal Commission briefing and the report being released, I went into the Council of Australian Government's Health Minister's meeting.

For the first time ever in Australian history, one of the elements of the Royal Commission was put into practice. The agreement was put in place to make the safe and quality use of medicine as national health priority.

This comes from one of the three priorities that the Commission identified.

FRAN KELLY:

I'm going to come to that now, but I want to talk about the home care waiting lists.

Because they are shocking. 120,000 people waiting to get home care so that they don't have to go into a home.

16,000 people last year died while they were on that waiting list. That is shameful.

Why didn't the Government have some announcement of some more money ready to roll out right now? Because this is not a surprise.

GREG HUNT:

We will be responding to the Commission.

FRAN KELLY:

Will be? Why not now?

GREG HUNT:

Well firstly Fran, because we only received the report at the same time as the public. A briefing an hour before.

FRAN KELLY:

Yes, but minister, we all knew this problem. It's not an unknown problem?

GREG HUNT:

With great respect, we are responding to what is the most profound and serious review of age care in Australia, in the Commission's words, in four decades.

We called this because we recognised that there were deep and serious challenges.

The Commission went further than we expected in the sense that it identified a nationwide challenge over multiple decades.

It identified both a cultural and a governmental challenge, and so, we are responding, and there will be additional home care packages.

There has already been, and I do think that it is very important to say this, a doubling of home care packages, including a 25% increase in the last year. So we've gone from 60,000 to 125,000.

FRAN KELLY:

That's true but it’s a drop in the ocean. People are waiting on this, on average, these are the top people needing top level care, 22 months on average.

So whatever you're putting in clearly isn't enough.

Your own department told the Royal Commission that it would cost $2.5 billion a year to get rid of the waiting list. Like I say, this is not news to the Government.

When the Government does announce the funding package in MYEFO, will it be at least $2.5 billion?

GREG HUNT:

It will be a significant package.

FRAN KELLY:

That high?

GREG HUNT:

I won't pre-empt it. We will now consider and respond to the findings and the priorities of the Royal Commission, and we will do that.

The Prime Minister said that, because we believe in this. And I think it's very important.

FRAN KELLY:

But how quickly? The Government has been doing things, but the point is.

GREG HUNT:

The first response was within hours.

FRAN KELLY:

We haven't got it.

GREG HUNT:

No, with great respect, the thing that we were able to do immediately, as we got the priorities, was to go into the Council of Australian Government's Health Ministers meeting and do what no government has ever done, and take the issue of chemical restraints.

To make the question of the safe use of medicines, a national priority. Real-time response. Now we are working, as we have, the 900 pages of the Commission's powerful and important, and I think, ground-breaking report, which deals with a culture within Australia, and we will be responding to that in the coming weeks.

And I think that that is an extremely important message. Acceptance, acknowledgement, but for all of us, the message of this is that as a country, we have a challenge.

FRAN KELLY:

Sure.

GREG HUNT:

And it calls that out. And I thank them and I honour them for that.

FRAN KELLY:

It does call that out. But I don't think that governments should slide away from the fact that they're directly responsible for policy responses.

And I think it was surprising that the Government didn't have something ready to go?

GREG HUNT:

Well, given that we are responding to the report, we responded, and here, I respectfully disagree with you, in real-time, with one of the elements.

We were able to do that.

FRAN KELLY:

Let's talk about that.

GREG HUNT:

The other elements, as we had the issues, we also signalled that we would be accepting and responding to the findings and the priorities of the Commission. And that's the right thing to do.

FRAN KELLY:

In six or seven weeks?

GREG HUNT:

No, I said within a matter of the coming weeks.

FRAN KELLY:

OK. The chemical restraints, the Commissioner says this needs immediate action to reduce the usage of it.

In the words of the Commissioner, ‘They render people drowsy, unresponsive and remove their ability to interact with other people.’

In other words, they sedate and stupefy residents. The Government has new regulations, they’ve gone some way to addressing it. 

But will this Government now toughen the regulations to force a reduced use of these psychotropic drugs for management purposes, or do we have to wait for Christmas for that too?

GREG HUNT:

We will be taking stronger action on those things.

FRAN KELLY:

What will we be doing?

GREG HUNT:

With great respect, let me finish the sentence. We will be taking stronger action, firstly within hours of the report, we had the change in the status of medicines.

Secondly, we are now working to make sure that we have the right response.

But thirdly - we have already taken very significant action in terms of much tougher standards on chemical restraint and on physical restraint.

FRAN KELLY:

With respect, though, talking about chemical restraint, the changes you've made, as I'm told, do nothing to actually reduce the use of it.

And it's pretty clear what is needed to affect that immediately.

GREG HUNT:

Well I.

FRAN KELLY:

If I can just say. No clear or informed consent before the drugs are administered, should be put in place.

There is no insistence at the moment on a behavioural plan before the drugs are handed out and no register of how often they're used and why.

And it's broadly agreed that those three changes, which the Government could add to the regulation right now, would reduce the use of these drugs?

GREG HUNT:

Let me talk about action. And also the great national challenge here. In terms of action, we will be dealing with chemical restraints.

A. We've taken steps already.

B. In the immediate response to the Royal Commission, we acted within hours.

And C. We'll take the further steps that the Commission talks about. So we will be dealing with chemical restraints as one of the three priorities that they've identified for a response right now.

FRAN KELLY:

Do you think informed consent should be a part of that and a behavioural plan should be part of that?

GREG HUNT:

Our approach is to look at the elements outlined in the Royal Commission and to adopt them, and we think that that is an important and necessary step.

The understanding a d the role of families, the ability to make sure that we have checks and balance, are critical.

And this is the bigger picture. Why did we call this Commission? Because we had deep concerns about not just.

FRAN KELLY:

And because Four Corners was about to launch a report that was going to reveal the degree of the cruel and harmful behaviour within.

GREG HUNT:

This is a much bigger issue, with respect.

And I say that because what we've done, on our watch, our time, and I do take that as a deep personal, profound responsibility, that if you're in these role, you have you to say - what are we going to change in our time?

We called the Commission because we wanted a once-in-a generation line in the sand where we said, ‘What are the challenges?’

What the Commission found, which went beyond anything that I had expected, was a national cultural issue.

That's confronting for all of us, and indeed, one of the headings in the Commission is, ‘Confronting’. And we have to deal with that as a country.

But as a Government, we have to take primary responsibility. It's been multiple governments over decades.

The country, as a whole, and indeed, one of the saddest finings was the number of people who have had no visitors.

So on all of these things, what's the big change here?

The big change is to deal with what the Commission refers to as an ageist society, and respect. And respect is both government and communal.

And this is the moment, this is the line in the sand, together, where we change the way that Australians deal with ageing in what is, by definition, an ageing society.

FRAN KELLY:

Alright, we wait for the Government's response.

GREG HUNT:

It will make us a better country and a better society as a result of the Commission.

FRAN KELLY:

Let's talk mental health.

The Productivity Commission this week found as many as one million Australians are going untreated, slipping through the cracks of the mental health system.

Many of them either too sick to be treated at the GP but not sick enough to be admitted to acute care in hospital.

This is a well-known and dangerous gap in care for people with mental health as you know. What are you going to do about it?

GREG HUNT:

We're establishing a series of adult mental health centres around the country.

FRAN KELLY:

How many of them?

GREG HUNT:

We are starting with eight and we're building 100 over the course of the next decade.

FRAN KELLY:

So that's a firm commitment? The Government will build 100 of these centres?

GREG HUNT:

I said that that is our objective and we're starting already. We have allocated over $60 million to that.

Similarly, we have the eating disorder treatment centres, residential treatment centres being established for the first time in every state and territory. These are transformative.

But the big picture here is, again, on Thursday and Friday, for the first time, we were able to secure the support of the states and territories for a single integrated national mental health system, and that is an historic breakthrough, and it's a land mark moment.

The other thing which, as a country, we have to do, is not just to provide the services, but we have to do that. But to give people that sense that to seek help is OK.

That's one of the largest barriers is, in some cases services, but above all else, the cultural moment of whether it's a farmer, whether it's a young person, whether it's an older person, crossing the line to seek that help, self-stigma is identified as a great challenge.

And we're saying to people - reach out. Seek that help, and if you do that, then there are services that can assist and support.

FRAN KELLY:

It is an important message, but the next bit is crucial, that when they do it, there are the services, and you talked about the structural reform that you and the states agreed on, the unified mental health system.

What does that actually mean? Because the Productivity Commission's preferred option in its report is regional commissioning authorities.

It says that federal and state funds should pool their money and these independent regional authorities should use the money to commission a range of services, basically, for people in the regions. Is that the model you support?

GREG HUNT:

Well, actually, that's one of 88 recommendations.

FRAN KELLY:

It says it is the Commissions preferred option.

GREG HUNT:

There are two options there and they said that they'll come back.

FRAN KELLY:

It does say that it is the preferred option. I’ve got it here.

GREG HUNT:

The big point here that the commission wants is a unified system. And you asked "What does that mean?"

It means, prevention, treatment and recovery. The prevention where the Commonwealth takes the lead. The treatment where, in the early stage, again, it's the Commonwealth that takes the lead.

But then, as we build what is called by some, and I think appropriately, as the missing middle, this notion of matching what we do with headspace for young people with the adult service, and then in the hospitals, to have the capacity for people to have acute treatment, but then to be given support after they leave hospital.

And that's been, in my judgement, and in the Commission's judgement, a gap.

FRAN KELLY:

So this is going to take more money, isn't it?

GREG HUNT:

Look, there are always more investments and resources.

We recently allocated over $700 million for the largest youth mental health and suicide prevention.

FRAN KELLY:

Over how many years is that?

GREG HUNT:

That's over the course of the budget period. But that's the largest package in Australian history on this front.

FRAN KELLY:

The Alan Fels Mental Health Commission, when it talked about it, this was five years ago now talked about it needing an injection of at least $1 billion over five years.

There will have to be extra money. Presumably, you won't take it away from the hospital beds?

GREG HUNT:

In every budget, we've added more since that time, so I think that’s important to understand.

Examples are, recently $375 million for youth mental health, specifically through the work of Headspace.

So a $700 million package. $375 million just for headspace, but the big point here is building for younger people, people of middle age, people of older age, the support services.

But within that million that hadn't sought treatment, the biggest barrier is actually self-stigma.

The difference is that stigma is, where if I have a problem and you're not judging me.

Self-stigma is if I have a problem, I'm reluctant to go and get that help. And we know from evidence and research, that that is still a huge issue in Australia.

So if we can break that down, if we speak the language of common humanity, if we give people that sense of confidence, then they can access the services.

At the same time, better work on prevention, work with the states on the support for people as they seek the treatment.

But then the recovery pathways, Beyond Blue's program of tracing people and working with them in the way back is recovery after release from hospital, that gives them support, and is, perhaps, the single most powerful suicide prevention tool that this nation has ever had.

FRAN KELLY:

We do need to make sure that the services are there when they do get through the stigma, no doubt. On private health funds, they're under pressure.

Premiums are about to rise again. They have to get your approval first that's the law.

If they come asking for a rise of more than 3%, will you sign off?

GREG HUNT:

Well, we are being very tough with them.

We've just produced the lowest change in 17 years, two years ago, and the lowest change in 18 years last year.

FRAN KELLY:

But they're coming back again and it's still more than twice of inflation. Will you sign off on something more than 3%?

GREG HUNT:

Let's put it this way. We have reduced by 40% what the private health insurance premiums were under Labor. Now I'm pushing to go even further.

And most significantly, we're doing this without what Labor was proposing, which was to rip away the private health insurance rebate from tens of thousands of Australians.

FRAN KELLY:

Let's not worry about what Labor was saying. You're in power now. People are falling off at a great rate. Young people pulling out of private health insurance.

One health expert I’ve read described the industry as being in a death spiral.

GREG HUNT:

That was someone who wanted to abolish private health. Mark Latham identified that person and said that person wanted to destroy the Australian private health system.

FRAN KELLY:

Steven Duckett is a very well respected health expert.

GREG HUNT:

I would urge you to go to Mark Latham's book on that.

FRAN KELLY:

Is it time to set up a Productivity Commission review into the private health system?

GREG HUNT:

No, we're actually getting on and doing it. We've already delivered the largest reform in over a decade in private health, which included better access to mental health, better access for young people.

Better access for rural and remote, and a dramatic simplification. What that did was lead to the lowest change in 18 years.

But now we're going further and looking, in particular, at perverse incentives which have been in the system for decades, such as preventing people getting full treatment for mental health conditions, not just in the hospital, but through hospital in the home.

And that, again, gives people better coverage, better chance of recovery, and that great human outcome of knowing that they can be cared for at home, which brings us back to exactly the sorts of things that we want to do in transforming aged-care.

FRAN KELLY:

And more funding. Minister, thank you very much for joining us on Insiders.

GREG HUNT:

Thanks Fran.

Ministers: