Minister Butler doorstop in Kincumber - 2 March 2023

Read the transcript of Minister Butler's doorstop on NSW Medicare Urgent Care Clinics Expressions of Interest, general practice, 'my health' app, digital health systems, TGA cough syrup recall, mental health and Distribution Priority Areas.

The Hon Mark Butler MP
Minister for Health and Aged Care

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General public


DR GORDON REID, MEMBER FOR ROBERSTON: Well good morning everyone, Dr Gordon Reid here, Federal Member for Robertson and I want to thank you all for coming out on this sunny, sunny day in Kincumber. I firstly want to thank Dr Ian Charlton here at Kincumber Family Doctors for having us today. I want to thank the Health Minister Mark Butler, Assistant Minister Emma McBride and Shadow Minister for New South Wales Health Ryan Park for coming along today for this important announcement. 

We know that health care access here on the Central Coast over the last decade has become increasingly more difficult. I know as a currently practicing doctor in the emergency department at Wyong Hospital, the real on the ground stories of this, we have people coming through the emergency department on a daily basis, those triage category four and fives, who are too sick to go to the general practitioner, but not sick enough to go to the emergency department. So that's the bulk that we see in the emergency department, and they're also having difficulty accessing their doctor, whether it's having to schedule to be sick, because they can't get in, or whether they can't afford to see their doctor, that's one of the reasons that they present to the emergency department. So, we know here on the Central Coast that access to health care is vital. It's something that we need to strengthen and it's something that we need to build on. And with that, I'll hand over to Minister Butler for an important announcement here for the Central Coast. 

MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Thanks very much, Gordon. It's terrific to have Gordon Reid as a member of our caucus, he provides an extraordinary perspective as an emergency physician in a time of real crisis in the health system. There's no higher priority for the Albanese Labor Government in health and making it easier to see a doctor because we know after nine years of cuts and neglect to Medicare, it's never been harder to see a doctor than it is right now across Australia. And it's never been more expensive, the average gap fee for the first time in the history of Medicare is now higher than the Medicare rebate itself. And that's why strengthening Medicare is right at the core of this Labor Government’s health policy agenda.  

I'm very pleased to announce today that we're opening Expressions of Interest for 14 Urgent Care Centres. This is part of our commitment at the last election to deliver 50 Urgent Care Centres across Australia. The 14 centres will be located right up and down New South Wales, from as far south as Albury up to Lismore in the north. And I'm delighted to announce that two of those centres will be here on the central coast in the Gosford Hospital part of the catchment, and also around the Wyong Hospital as well. As Dr Reid said, these centres are about making it easier to see a doctor when you have one of those non-life-threatening emergencies that doesn't require you to go to the emergency department, and that could be quite adequately cared for in the community. Right now, we know that about half of all emergency department presentations around the country - so that's about 4 million out of 8 million every single year are classified as non-urgent or semi-urgent. So, when your kid falls off the skateboard and busts their arm, or you get a deep cut, or something in your eye, you do need care very urgently, but you don't necessarily need to go to a fully equipped emergency department. Our policy of building Urgent Care Centres around the country will take that pressure off the emergency departments that Dr Reid’s talked about, but importantly also make it easier for people to see a doctor when and where they need it out in their own community.  

The 14 Expressions of Interest will be asking existing general practices like Dr Charlton’s here: if you want to take your practice to the next level, the Albanese Labor Government will back you in doing that, there will be good levels of funding to make sure these Urgent Care Centres are viable. Importantly, they will be open from 8am to 10pm, seven days a week, they'll be available to walk in patients, not just patients who happen to be on that practice's books, and they will be completely free of charge - they will be fully bulk billed. We're confident that will make it easier to see a doctor than it is right now, particularly for those non-life-threatening emergencies. And importantly, take that pressure off the emergency departments that are currently under extraordinary pressure right across Australia. So, I want to thank Dr Reid and I want to thank Emma McBride for their advocacy about the challenges in seeing a GP here on the Central Coast. It's been really tough, we know that the former Morrison Government ripped away the ability of practices in this part of New South Wales to recruit overseas trained doctors and that had an awful impact on this region. That's why we were very proud to reinstate that ability for practices on the Central Coast and other parts of New South Wales, including parts of the Hunter Valley, because that just made a bad situation worse. We're committed to making sure that people on the Central Coast have the best access, affordable access to good general practice. Happy to hand over to Emma.  

ASSISTANT MINISTER FOR RURAL AND REGIONAL HEALTH, EMMA MCBRIDE: Thanks very much, Minister Butler, I am so proud to be here today as part of an Albanese Labor Government, joined with my colleague, Dr Reid, and thank you to Dr Charlton for hosting us here today, and the Shadow Minister, Ryan Park for joining us. Health care is what matters, especially in regional parts of Australia. We know the further you live outside of a big city, the worse your health outcomes are likely to be, and a big part of that is being able to access primary care. As a pharmacist that worked at Wyong Hospital for nearly 10 years, so, people that had ended up in hospital that would have avoided it, if they had have been able to see a GP close to home, and affordably. We know that these Expressions of Interest and these Urgent Care Clinics will make a really big difference to local people. With rising cost of living pressures, this is as much about family budgets as it is about health care. We want to make sure that everyone, wherever they live, whether it's on the Central Coast of New South Wales, or across Australia, can get that timely affordable health care. So, by having the right health care in the right place at the right time, and that's what these Urgent Care Clinics will do. And I'm so pleased that Minister Butler has chosen the Central Coast of New South Wales, with my colleague, Dr Gordon Reid to be able to make this announcement about opening the Expression of Interest process for 14 Urgent Care Clinics across New South Wales. Existing practices will be invited to put in an Expression of Interest, and it’ll mean that local people will be able to walk in without an appointment, free of charge and get the health care they need close to home. So, thank you very much, Minister Butler for making the announcement here in our communities on the Central Coast today. I'll hand over now to Ryan. 

NEW SOUTH WALES SHADOW MINISTER FOR HEALTH, RYAN PARK: Thank you, today's a great day, coming off the back of some very concerning emergency department figures released yesterday highlighting that 67,000 people walked into an emergency department and walked out again over the last quarter without being treated. I was asked yesterday: how do we address some of those issues? And what I said was very clear: we have a strong partnership with the Commonwealth and today's announcement here on the Central Coast by Minister Butler highlights that we have a government in Canberra who understands the challenges in delivering health care, particularly in regional and rural areas. This is a government that's hit the ground running after close to a decade of underinvestment and ripping apart Medicare. We now see a government in Canberra who understand the importance of delivering first class quality, affordable, accessible primary care and the role that it plays in taking pressure off our busy emergency departments. The reality is the state can't do it on its own and the Commonwealth play a really important role in making sure primary care is affordable and accessible. Having these clinics that are free of charge, not needing an appointment will go a long way in taking pressure off our busy emergency departments. I want to thank the Minister, I want to say how proud we would be to be able to work with him and his team if elected in the next few weeks. This is something that will require a lot of concentration and then a lot of effort because our emergency departments working the way they are is simply not sustainable. And I'm very, very proud and delighted that the Commonwealth through Minister Butler has recognised that and put forward a plan that will take pressure off our very, very busy emergency departments. Thank you. 

JOURNALIST: Minister Butler, we’ll just start with these, so it closes on the 12th of April – the Expressions of Interest - is that enough time? 

BUTLER: We've worked very closely with state governments and also with Primary Health Networks, which are the bodies that represent general practice in particular regions on the process that we should follow and we're very confident that this about six-week Expression of Interest process will be more than adequate. You know, we've been very clear and open with general practices across Australia that this was coming, we've got an extraordinary level of interest already from practices to participate in this program. In some jurisdictions, frankly, we’ve had a shorter Expression of Interest process than what we're proposing for New South Wales. So, I’m very confident this will elicit a high degree of applications.  

JOURNALIST: When will the first clinic in New South Wales be operational? Can you give us a month? 

BUTLER: That will depend to a degree on the Expressions of Interest. But we're committed to having these centres across Australia operating this year. 

JOURNALIST: By the end of the year? 

BUTLER: Yep, this year. 

JOURNALIST: And every single one operational? 

BUTLER: That's right.  

JOURNALIST: Okay. And why have you added Campbelltown as an additional location for the Urgent Care Clinic? 

BUTLER: As I said, there was a high degree of discussion between all state governments and the Commonwealth about locations of these centres, we're particularly keen to make sure that we're targeting the hospital catchment areas in most need. We've also worked very closely to develop clear operational protocols between hospital systems and the centres, and between ambulance services and the centres. So, that's been a really important process. And I think we've got agreement between all governments and Commonwealth, now, on those matters. It became clear, though, as we discussed these issues, that there was a gap in South Western Sydney, and so, as a result of that, we've agreed with the New South Wales Government to add an additional centre to the 13 that we promised at last year's election and have that located around the Campbelltown area. 

JOURNALIST: How do you intend to fill these clinics with doctors, with the shortage? 

BUTLER: That will be a matter for practices that are applying for this, but my feedback, and I think the feedback of state governments and the Primary Health Networks has been there's a high degree of excitement about this work, I've talked to doctors who are very keen to work in this type of practice. Some of them have emergency department experience, some of them are general practitioners who are wanting to take their work to that next level, I'm very confident this will be staffed properly. Now, that doesn't mean that we don't have a GP workforce challenge across the country, and particularly here on the Central Coast, as I talked about the impact of the former government's decision to rip away the ability to recruit overseas trained doctors here has had a real impact. But we're committed to making sure we have the right models of care in place across the country. 

JOURNALIST: If we're sitting inside Dr Charlton’s clinic here as well, would this be an adequate size clinic to turn into an Urgent Care Clinic?  

BUTLER: That’s a matter to flesh out through the Expression of Interest process. I don't even know whether Dr Charlton has an interest in this, I'll leave that to the proper processes. But you know, what is clear is we will expect the practices to have the right equipment, or access very closely to the right equipment, the right diagnostics and things like that. But clearly, Dr Charlton and his colleagues have been practising this type of medicine in this community for some time.   

JOURNALIST: And given that the Expressions of Interest are just opening, how can you assure that all of them are going to be operational and set up in less than 12 months? It seems like a very short amount of time to get it off the ground when Expressions of Interest are just opening?

BUTLER: Yeah, well that will be a condition of the Expression of Interest. I think I've been clear about this since before the election when I announced this policy, first of all, that we that we wanted these up and running in 2023. Ryan Park has talked about the pressure that New South Wales emergency departments are under we can’t sort of prevaricate around this. We've been talking about this for a long time now, practices across Australia have tried to make this sort of model of care work. It's a very common model of care in most countries to which we usually compare ourselves. But the Medicare funding system doesn't quite support that mode in the way in which we'd like it to operate: seven days a week on a bulk billing basis. So, I think people are ready to go, they're keen, they understand what this model of care would look like, they just need a Commonwealth Government to back them on it, and now they have one. 

JOURNALIST: With the suburbs that are listed, is it strict on the boundaries of those suburbs and townships as well, or is there a bit of wiggle room on the outside, too? 

BUTLER: When the Expressions of Interest are published, and they'll be operated by the Primary Health Networks here in New South Wales, the boundaries of the catchment will be quite clear. Those boundaries essentially are designed around hospital areas. So our key objective here rather than obviously, giving people access to affordable care when and where they need it, is to take pressure off particular hospitals that we know are under pressure, so Gosford and Wyong are two of those hospital catchment areas that we've identified across New South Wales, so there will be a boundary, but it's a relatively generous boundary. It's not, you know, within a kilometre of the hospital, it's a relatively generous boundary that, I think, will mean that there's a good number of practices who can consider whether or not this is the right thing for them. 

JOURNALIST: So we just had a local doctor call us today off the back of this announcement saying it's all good and well, but they still feel like their model isn't really viable with the amount of money and support they're given, and they asked us to ask you on their behalf when you'll pay them a reasonable amount to keep their businesses operational, essentially? 

BUTLER: We’re committed to funding this properly. You know, we're committed to making sure that this model works, and that's a process that will become clearer through the Expression of Interest process. As to funding general practice more broadly, which I think is the basis of your question, as I’ve said, we've got no higher priority than strengthening Medicare, we're the only party who took to the last election a commitment to increase investment in Medicare. And as my colleagues know, we've been working very hard with doctors' groups, nursing groups, patient groups, importantly, and others, to work out how best to use that investment, and that will be made clear in the May Budget. 

JOURNALIST: And so how are you going to make sure that these clinics are going to be viable and actually achieve what you're setting out to do? 

BUTLER: We’ve worked very hard with, as I’ve said, Primary Health Networks and state governments on being clear about the model of care, about the scope of practice that will govern the work that these Urgent Care Centres do. And we're committed to making sure they're funded properly. And we'll do that. 

JOURNALIST: This is just on the new ‘my health’ app, is that the answer? Is the current clunky system in place where it was where was found that not enough information was being shared between patients and doctors? 

BUTLER: This in and of itself is not going to solve the real problems, I think, that operate in digital health here in Australia, this was a central message from the Medicare Taskforce that we need to do better on digital health. And the first thing we need to do is improve the functionality of My Health Record, it is still a relatively old PDF format system that needs to be upgraded. That's the clear recommendation from the Strengthening Medicare Taskforce. But in addition to that, we need better connections between the My Health Record, which is really the mothership of our digital health system, a patient-controlled health record, we need better connections between that and the hospital system and specialists and pathology. Frankly, far too few health practitioners upload their information to a patient's My Health Record. GPs are basically terrific at doing it, specialists are not so good, pathology services are not so good. So, there's a lot of work for us to do in this area. Today, the Digital Health Agency, or maybe yesterday I think it was, it was in the last 24 hours, they’ve conducted a launch of a new app, and that is going to be, you know, a substantial step. But it's not going to fix things overnight. I understand that there's a lot of work for us to do in this area. 

JOURNALIST: The TGA has made a significant recall on dozens of cough syrups and lozenges, does the Federal Government have any role in ensuring this message about the recall is getting out to consumers given that risk? 

BUTLER: Yeah, this is obviously a substantial step that the TGA has taken to recall a whole range of brands of cough syrup, essentially dry cough syrups. They don't do that lightly. They only do that where there's an identified threat to patient safety. And so, I do encourage everyone out there to talk to your pharmacist if you're buying a cough syrup, particularly for a dry cough. And if you have cough syrups in your cupboard, and you're unsure about whether your cough syrup is covered by the recall, then either look it up on the TGA website or speak to your pharmacist as well. 

JOURNALIST: And just finally, since scrapping the extra 10 mental health sessions you've repeatedly said you would have more to say on helping people with complex conditions. So, when can we expect an announcement on that? 

BUTLER: Emma McBride, who is the Assistant Minister for Mental Health and I have had now a number of deep discussions with the mental health sector. There's no, frankly, easy answer to this, the mental health sector is experiencing its own workforce challenges that you see across the economy, but you particularly see, in mental health. We’re committed to providing better care for those who have more complex needs around their mental health. Frankly, the Better Access system is not well designed to do that, we know we might have to think either of changes to the Better Access system, or to new models of care. But as we've talked to the sector, they're really keen to work with the new Albanese Labor Government on making sure we can do that.   

JOURNALIST: Since changing the DPA status in the Central Coast last year, how many GPs have actually been brought here? 

BUTLER: We don't have data on that yet. This is something that Gordon Reid and Emma McBride pushed really hard for, as did a number of MPs up in the Hunter Valley because it had really punched a hole in the guts of general practice in these regions in New South Wales. I mean, the former government essentially pretended that recruiting a GP in a community like this or in parts of the Hunter Valley was this same as recruiting a GP in Rose Bay in Sydney. And it's just not that simple. So, we reversed that, obviously it is going to take some time for that to work through the system, because the COVID pandemic, the closing of Australian borders, had a real impact on our ability to recruit workers from overseas, including nurses and doctors. So, we haven't got the data yet. We're committed to making sure that our change makes real difference in the Central Coast, and as soon as we have some of that data, we'll share it with you. 


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