Minister Butler press conference at Flinders Medical Centre - 31 October 2022

Read the transcript of Minister Butler's doorstop on Flinders Medical Centre upgrade; SA Aboriginal Arts and Cultural Centre; IUD’s; women’s health; SA Cabinet documents.

The Hon Mark Butler MP
Minister for Health and Aged Care

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PREMIER OF SOUTH AUSTRALIA, PETER MALINAUSKAS: Thanks for joining us here at the Flinders Medical Centre. I'm absolutely wrapped to be here this afternoon with Mark Butler, Federal Minister for Health in the Albanese Labor Government and the state Health Minister, Chris Picton.  

I'm also here with three local MPs from the State Government, and also local Federal MP, Louise Miller-Frost. And from the state party we have Sarah, Erin and Catherine, who all represent areas around the Flinders Medical Centre, and know all too well just how necessary a major upgrade of the FMC is.  

In the Federal election campaign, I was absolutely wrapped that Anthony Albanese heard our calls for more investment in state government health infrastructure and heard our call, in particular, regarding the Flinders Medical Centre.  

In the South Australian Health Network, we have committed major upgrades to all of our existing facilities that require it but the FMC is the big hospital that is long overdue for a major capital investment. To have a partner in the new Federal Government is something that we are very grateful for indeed. 

The $200 million commitment from the Federal Government, in combination with the $200 million commitment from the State Government means this $400 million facility of investment at the FMC will be the biggest change that we've seen at this site since the hospital was first built. The Flinders Medical Centre serves a massive and also growing population in and around the southern suburbs of Adelaide. So ,this investment is overdue and it's something we're very excited to now get on and deliver, having received the initial contribution in the Federal Budget handed down just last week. 

 This is the Federal Labor Government honouring its commitment, in conjunction with the State Government honouring its commitment to now put us in a position to see to the major redevelopment of the Flinders Medical Centre - the biggest in 50 years.  

It starts with our investment down the road at the Repat. And similarly, an investment here that will see new scanning facilities come online and be operational by the middle of next year, ahead of major site words commencing in 2025, to have the whole project complete by 2028.  

This is serious, long-term thinking for a serious, major investment in our second biggest hospital in the state to make sure that we have the ability to service an ageing and growing population in around the southern suburbs of Adelaide, but also regional communities in this part of our state.  

I really do want to thank Federal Labor for partnering with us in this project. I think it's fair to say that the investment from Federal Government in the past when it comes to major capital programs isn't usual. So this is a particularly big investment from the Federal Government to the Flinders Medical Centre right here in South Australia and something that I think you'll be very, very grateful for.  

It did come without a lot of advocacies from Louise, Erin, Sarah and Catherine. But having now achieved that advocacy in delivering a policy outcome we're very excited about getting on with the job of executing this rebuild to make sure we've got a better facility to serve the community into the long-term. 


MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Thank you, Premier. It's a great pleasure to be here with the Premier and so many colleagues, particularly Louise Miller-Frost who's been a strong advocate of the need for an upgrade for the Flinders Medical Centre and of the Federal Government partnering with that. 

It's great to be back here, my first visit here was when my baby sister was born, followed up shortly by a spectacular skateboarding incident that led me to be brought to the emergency department when the Flinders Medical Centre was still a very, very new hospital. But it's not now. It delivers extraordinary services to the people, particularly of southern Adelaide but it does need an upgrade. 

We went to the election with a very clear commitment to the Australian people in strengthening Medicare and the primary focus of that commitment, of course, is strengthening primary care - in particular general practice. But we also know that there is a dire need to see the Federal Government partner with state governments on particularly critical projects to improve the acute care sector. And that's why after really strong advocacy from the Premier right to Anthony Albanese, then the Opposition Leader, we saw the merit in committing to this project as the biggest hospital capital project we committed to anywhere in the country during the last election campaign. And last week, I was delighted to be able to deliver on that promise with $200 million being committed in the Budget to this project.  

It's not the only project that we’re committed to in South Australia. Last week's Budget also saw our delivery of our commitment of $77 million to deliver a Comprehensive Cancer Centre here in South Australia rounding out the network around the country, following Comprehensive Cancer Centres that have been operating for some years now in Melbourne and Sydney. 

The Bragg centre will be a terrific project as Minister Picton knows particularly, rounding out the service there on top of the first proton therapy unit in the southern hemisphere. So we were delighted to be able to deliver on that promise as well.  

And as a further indication of our commitment to take pressure off this hospital, this critically important hospital for the southern suburbs, we also delivered funding for our 50 Urgent Care Centre’s across the country, one of which will be delivered in the precinct of the Flinders Medical Centre giving people out in the community an alternative when they have some of those minor emergencies like their child falling off a skateboard because he's negotiated far too steep a hill instead of being brought to the emergency department here at FMC, being able to access urgent care services in the community will not only make it much easier for families to see a doctor when and where they need it, but also taking pressure off the emergency departments like that here at Flinders Medical Centre. 

It's an absolute delight to be able to partner in a really visionary project that the Government and bureaucrats have put together here at FMC. It's a very wide ranging, covers most of the aspects of the hospital service as I've gone through the detail of it with Minister Picton, also provides additional capacity down at the Repat, particularly for older Australians in this part of Adelaide, which I'm particularly passionate about.  

We're really looking forward to seeing this project start and over the next few years, really improve the offering of this critical hospital service for the southern suburbs of Adelaide has been delivering now for pretty much five decades. 


MINISTER FOR HEALTH AND WELLBEING, CHRIS PICTON: We know how important Flinders Medical Centre is to the health system but as we've progressively been upgrading hospitals right across the state, you can see how old Flinders Medical Centre is looking in comparison to the rest of the health network. In addition to that, it's significantly under pressure in terms of its resources that it does need more space to enable more patient care.  

That's why we've worked on this plan, since coming to government, working with the new Albanese Government, in that fantastic partnership to address a number of challenges. Challenges in terms of the infrastructure that the site has, but also challenges in terms of the capacity that our health services need. Because we know one of the huge problems that our health services face is not enough beds that leads to the access block that leads to ramping that leads to an ambulance response times being an issue. If we can create more capacity that ultimately means that we can get to those patients who need that care in a much timelier way.  

So here at Flinders Medical Centre, which is obviously a hospital that was opened about 50 years ago, there's a lot of complex work that needs to happen to be able to upgrade the infrastructure and expand the infrastructure in terms of being able to care for more people. Part of that is we are moving some of the services here to the Repat that will enable more capacity to be opened up here that work as part of this project has already started. We'll be moving 24 beds from Flinders Medical Centre to the Repat redeveloping disused wards at the Repat to enable that to happen. That will give us more additional space here at Flinders as the first step.  

In addition to that, one of the first steps will be happening is where we are at the moment, the imaging department, where we'll be adding a new CT scanner, a new MRI scanner, that will enable better throughput through the hospital and less delays for people getting that care that they need and ultimately, more action to address that access block in the system. That is a critical component.  

In addition, one of the early works that will be happening over the next couple of years is a significant upgrade to Margaret Tobin centre, which is the mental health inpatient beds here at Flinders Medical Centre, we know that mental health beds are a key contributor to access point as well and having additional mental health beds will significantly aid in that.  

But then the larger, biggest part of that work is going to be a significant expansion to Flinders, which is going to have to be sequenced in a way that keeps the hospital running over time, that will lead up to open in 2028 and will involve overall - 136 extra beds here at Flinders, 160 across the two sites, upgrades to intensive care, upgrades to operating theatres, upgrades to imaging. A comprehensive upgrade to a whole range of performance services, more single beds services, which provides obviously a higher level of infection control, which has clearly been one of the things that's been born out of COVID. But in addition to that, more, both inpatient overnight beds, but also same day beds, which are a key contributor to help in accessing the system as well. 

JOURNALIST: Can I ask you about the cultural centre? So just in terms of that review, I mean, what are you expecting it to throw up? Because you've committed to it staying in the location? What could this change? 


PREMIER MALINAUSKAS: Firstly, what we need is a clear line of sight and certainty around what will be delivered curatorially at the Aboriginal Arts and Cultural Centre. We know that there are multiple elements that contribute to an international benchmark facility realising our ambitions. 

The first of course, is the actual building itself it’s design, the architecture of it. But then there's also what goes into the building. And then secondary, we know that there needs to be greater clarity and certainty around what that offering will be. We see the responsibility of this expert panel, to engage with the art sector more broadly, in conjunction with the Indigenous community, working to make sure the government is in receipt of all the best available evidence and advice to ensure that we're making the right decisions to build an internationally renowned facility.  

There is a movement, internationally, that demonstrates growing interest in indigenous cultures. And here in Australia, we have the longest living one anywhere on the planet, anywhere in human history. That is worthy of celebration and recognition. We don't, as I said this morning, my government doesn't want to build another Aboriginal Arts and Culture Centre - we know Perth is building one, we know the ACT and the NT are building one - we don't want to build another one, we want to build the one, the one that internationally receives awards and acclaim and attracts people from all over the globe to celebrate our indigenous culture, which is why we want to get this right, we only get one shot at this.  

This is genuinely a one in 100-year proposition, we're going to do the work to make sure we get it right. And that this expenditure of taxpayers' dollars, ends up being a proud legacy, not just for indigenous culture, but for everybody in the state. 


JOURNALIST: How much longer will it take? 


PREMIER MALINAUSKAS: This is going to be a short, sharp exercise not too dissimilar to what we did with the Women’s and Children's Hospital. We came to government -  


JOURNALIST: Except the Women’s and Children’s hospital has taken a lot longer than expected. 


PREMIER MALINAUSKAS: The Women’s and Children's Hospital was a short and sharp review that has delivered us an outcome that guarantees a long-term policy solution. We see this as being a similar exercise. We will have this review completed by April next year, and then get on with the job of executing on the back of it. We don't think this is a case of throwing the baby out with the bathwater we actually think the proposition is a good one and worthy of support. It's just about making sure that we do it right and the investment delivers the long-term outcome that we're all hoping for. 


JOURNALIST: How much longer will it take to build the centre though, do you have a ballpark? 


PREMIER MALINAUSKAS: No we don't anticipate there being delays in that regard. At the moment there is no specific timeline apart from loose timelines. But I've been rather deliberate about my language here because I don't think there is any interest in turning a project of this significance and this importance, culturally and economically, into a partisan issue. In Opposition, we supported the project from the Marshall Government. We're sticking with the program. And we hope that we get the now Opposition’s support for making sure that it's a truly world class facility. 


JOURNALIST: I think originally it was 2025 sometime in that? 


PREMIER MALINAUSKAS: Again, if I comment on the 2025 timeline, which was questionable, then I start to descend into being critical of the former government when that's not our aspiration. Our aspiration is to make sure that this project continues to enjoy the bipartisan support that we provided when we were in opposition. I certainly hope that the now opposition can do the same. 


JOURNALIST: And will it definitely cost more than $250 million? 


PREMIER MALINAUSKAS: We know that the design as it currently stands is set to cost $250 million, which is $50 million over and above the budget that has been allocated for. I think, we've got to think about this project in the context of a one in 100-year opportunity and wanting to do it right and do it right the first time around. We don't get another shot at something like this.  

So we are turning our mind to what is the advice that we can get our hands on to ensure that we deliver a project and a program of international world class significance. The tests that I've put to the review team, and I've always thought that should be applied to whatever goes on this parcel of land is this - it has to be good enough for someone to get on the plane, to come to South Australia to visit and see this institution. And then when they go home, they tell everybody, they've got to see it. We want to drive international and national visitation to celebrate indigenous culture at this facility. And there's no point in spending $200 or $250 million on a project that doesn't do that. We've got to make sure it's elite, let's get the advice, and then we'll make a decision. 


JOURNALIST: Can you give us a ballpark of how much it's going to cost?  


PREMIER MALINAUSKAS: Let's wait and see what the advice is that comes back from the review panel, and then the Government will have to make decisions accordingly. 


JOURNALIST: I know there's a story that Triple J Hack has done today, which I think you're familiar with, so they've done this crowdsource investigations of hundreds of women, and one of the biggest issues is that with IUDs, people are having a lot of pain. Is that good enough that people are complaining of unbearable pain? 


MINISTER BUTLER: First of all, I’ve read the report and it was a distressing report to read. Obviously, a lot of women who were interviewed in that report are going through a lot of pain, a lot of distress and trauma, accessing that particular type of contraception.  

Can I say broadly that I've asked Ged Kearney, the Assistant Minister for Health to look at a broad remit in women's health. Over the next few days, I think we'll be in a position to announce our commitments around the areas of endometriosis and pelvic pain, which touches on some of the stories that were reported by the ABC today.  

But more broadly, I've asked Ged to do work looking at essentially the equality of access to services that women have, including the effectiveness of good quality, affordable reproductive health services. It's very clear to me, for example, that there is something lagging in this country around the effectiveness of access to long lasting contraceptives or LARCs where Australia substantially lags the rest of the developed world in terms of uptake of a LARC rather than the contraceptive pill. The former government increased the rebate for IUDs, about four years ago, in the hope that that would increase uptake but clearly there is still something not working quite right in the system.  

Ged will be announcing over coming days a range of different pieces of work that we're doing in this area. I want to have a very broad look at women's equality in access to health, going back right to women's participation in clinical trials, to their participation in the trial around medical devices. We hear too many stories of a gender bias that early in the health services process, which means that medical devices don't quite fit women, often. The clinical trials mean that the dose types and things like that are biased towards men rather than women. We want to have a very broad look at those sorts of things.  

But there will be a particular focus on the effectiveness of our reproductive health services, including contraception. There is a Senate Inquiry that's been kicked off over the last couple of weeks, which will be looking at these sorts of matters as well. I think the Hack story, the ABC story really has highlighted how personal this can be and that sort of level of pain and distress that that these issues in the health system can lead to for individuals. I know Ged is particularly committed to making sure this is an important part of the work in the health portfolio and the Albanese Government.  


JOURNALIST: One of the biggest issues people raised was pain relief, and how it's really expensive to get good pain relief for that. So can you be specific about what your Government will do to help so many women that are having these issues? 


MINISTER BUTLER: I'll be asking Ged to have a look particularly at these stories. A lot of those stories were quite new to me, I have to say, in terms of the experience that mainly young women were talking about, through the stories. And I'll be talking to Ged to make sure that as she starts to set this work in place that those issues are picked up. 


JOURNALIST: Would you consider offering cheaper, really effective pain relief, as clearly Panadol is not working? 


MINISTER BUTLER: I don't want to jump to a conclusion about what we might do. Suffice it to say, though, that these were very distressing stories and I know Ged is particularly focused on making sure we do better in this area. 


JOURNALIST: The training of doctors in this story, but also, we hear from doctors all the time that it is hard to get training in this area, to do it themselves. Is that something you're considering as well having a better rollout of training doctors in IUD insertion? 


MINISTER BUTLER: I think right through the spectrum of reproductive health services, including the possibility of termination services, I think there is a question around the breadth of the uptake of training opportunities in primary care. That's one of the things I know that the Senate Inquiry that was initiated only very recently will be looking at. Something I know Ged Kearney will be looking at as well.   


JOURNALIST: And IUDs are far more effective than the pill but obviously these barriers like doctors training and pain relief are barriers to it. So I guess, can you just give us an answer about what your Government will do sort of concisely about making these contraceptions more available and accessible? 


MINISTER BUTLER: I don't want to jump to a conclusion. What I've said is that even though the rebate was increased, for example, four years ago, a decision we supported, a decision the former government put in place four years ago to try to increase the uptake of IUDs, clearly, still, there are substantial issues. There are substantial barriers. There's no obvious reason to me why Australia should lag so significantly behind the rest of the developed world in and the uptake of long-acting contraceptives, including IUDs. So this is something we are going to look at, we're not going to jump immediately to a conclusion about what might transform this area. But it's very much a focus of Ged Kearney's work as we've really asked her to focus particularly on women's health. 

JOURNALIST: So the Auditor-General, as I'm sure you're aware, has been given access to previously over 100 Cabinet documents. In this case he’s just asking for seven. Why wouldn’t you give them to him? 


PREMIER MALINAUSKAS: Cabinet documents are always produced subject to Cabinet-in-Confidence. It’s an essential principle to the Westminster system and our arrangements of government, not just here in South Australia, but throughout the Commonwealth. And it's something that we place a high degree of value on.  


JOURNALIST: So why have you rejected?  


PREMIER MALINAUSKAS: Because the only people that are entitled to Cabinet documents, are members of Cabinet. That's a principle that we believe in, we think is worthy of preservation. 


JOURNALIST: These documents, though, obviously, to do with sports grounds and community infrastructure and programs, people might think that perhaps there's something to hide, is that the case?  


PREMIER MALINAUSKAS: No. Not at all, in fact, every single cent of expenditure that comes from taxpayers' funds to deliver on our election commitments to which we are wholeheartedly committed is fully transparent and fully available for everybody to see, including the Auditor-General themselves. The only thing that's not publicly available is Cabinet documents, and that's an established principle that has always been upheld.  

My Government's policy is the same as the former government's policy, the release of Cabinet documents can only occur with Cabinet approval. And we have determined that honouring the principles of Cabinet- in-Confidences is a central tenet of the functioning of Westminster Government, we intend to uphold that.  


JOURNALIST: But that’s more than what the Auditor-General wants to be able to do their job? 

PREMIER MALINAUSKAS: The Auditor-General has a very important function to make sure that the expenditure of taxpayers' dollars is done consistently with government policy. And that includes government policy that pertains to the release of Cabinet documents. So what we're doing is utterly appropriate. But again, the threshold issue here is, of course, we are committed to delivering on each and every one of our election commitments. And we made clear and genuine and often very specific commitments to communities throughout the state. And we are absolutely determined to make sure we deliver upon those.  

JOURNALIST: Are you concerned that your Government’s handling of the local sport and community infrastructure programs that that has been referred to integrity agencies. Is that a concern?  


PREMIER MALINAUSKAS: I was not aware of that being the case at all.  


JOURNALIST: That's my understanding from my colleague that it's been handed over to integrity agencies for investigation. 


PREMIER MALINAUSKAS: What I would say is the expenditure of taxpayers' dollars on all of our election commitments is utterly transparent. And we put it into the state Budget, which we handed down within weeks of forming government, because we're absolutely determined to deliver on our election communities. 


JOURNALIST: I guess, you know, transparency, though, and then not handing over those documents from Cabinet, do you see that?  


PREMIER MALINAUSKAS: I understand that members of the media would always love to be in the Cabinet room when the Cabinet deliberations are made but that's not the way government works. 


JOURNALIST: It’s not the media, it’s the Auditor-General though? 


PREMIER MALINAUSKAS: The way Cabinet works is they are in-confidence deliberations. And there's a very good reason for that. Cabinet is important for where members of the government, at the executive level should be able to debate freely, and frankly, all the considerations that underpin thoughtful judgments about executing government policy. And we've got very clear commitments that we've made to people of our state, and we intend to honour them, and deliver upon them. In fact, that's exactly what we're discussing here today. 


JOURNALIST: And I know you have touched on it, but just in terms of giving reassurances to the South Australian public. I mean, there's people in certain areas who didn't get local sports grants, and others who did, when the Auditor-General can’t get access -  


PREMIER MALINAUSKAS: These aren't grants. These are delivering upon very clear election commitments. And, you know, when one contemplates this they have to think about the counterfactual as well. When the Opposition is out there questioning Labor's commitment to delivering election commitments, are they seriously suggesting that we should be breaking our promises? I don't think so.  

Where we've made commitments to the people of our state we intend to deliver upon them. We made those commitments in good faith to the people of South Australia. They elected the Government, and it's now our job to deliver on those commitments. Whether it be the biggest upgrade to the Flinders Medical Centre, in the history of the hospital, or whether it be a commitment to a local sporting community, about the installation of new female change rooms, while they might be different in their size and their scale to the people they affect that have the capacity to be equally as important and that's why we take each and every one of our commitments seriously regardless of the size.  



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