Minister for Health and Aged Care – doorstop in Canberra – 2 August 2023

Read the transcript of Minister Butler's doorstop in Canberra about strengthening Medicare, tripling the bulk billing incentives and cheaper medicines.

The Hon Mark Butler MP
Minister for Health and Aged Care

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ASSISTANT MINISTER FOR EMPLOYMENT, COMPETITION, CHARITIES, AND TREASURY, ANDREW LEIGH: Good morning, my name is Andrew Leigh, the Assistant Minister for Competition, Charities and Treasury, and Employment and also the Federal Member for Fenner. I'm delighted to have Mark Butler here in the heart of the Fenner electorate, which is named after the great virologist Frank Fenner. I'd like to thank Dermot, Morgan and the team here at Ochre health, for their generosity in showing us around the centre, and showing us the important work they are doing. Labor has always been committed to a strong universal health care system. We built Medicare, we fought for Medicare, we're continuing to work on strengthening Medicare. And in the last Budget, we tripled the bulk billing incentive. We've also this year delivered cheaper medicines, and we're moving to 60-days prescribing. These reforms are so important for people in Canberra, and across Australia, in dealing with the cost-of-living pressures that many Australians are facing. Health care is not only vital to who we are, as to living well, but it's also a potential source of financial stress. And so the reforms that Labor has put in place are absolutely vital and they've been driven by a great reforming healthcare minister in Mark Butler.
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Thanks so much, Andrew, and thank you to Ochre Health for hosting us here this morning. Ochre is a big player in general practice right around the country, and I'm really delighted to say is also part of the Urgent Care Clinics that we're rolling out - 58 of them across the country to deliver the care that people need when they need it, for these non-life threatening emergencies that happen so often, instead of those people having to go to hospital. These centres will be bulk billed, they'll be available seven days a week for extended hours. I'm delighted that Ochre Health has invested their good brand in our Urgent Care Clinic program.
We're here today with Andrew at the Gungahlin Centre to talk about the impact of our tripling of the bulk billing incentives, along with all of our other strengthening Medicare reforms, are going to have on general practice. I said when we were first elected that the thing I was most concerned about in the health portfolio was the parlous state of general practice after a decade of cuts and neglect. The state premiers raised this at National Cabinet, because they know the fact that people find it harder than ever to see a doctor – and more expensive than ever – means that their emergency departments are overwhelmed with cases that frankly could and should be dealt with in the community if only people were able to see their doctor at an affordable price. We had a great opportunity to talk to the staff and the doctors here at Ochre Health in Gungahlin about the impact that tripling the bulk billing incentive will have on their practice and most importantly on their patients. But also all of the other reforms we announced in the May Budget – part of more than $6 billion invested in new measures in general practice.

I want to say a couple of words, as Andrew said about our commitment to cheaper medicines. We've already delivered three major measures in bringing down the price of medicines for Australian patients, a 25 per cent cut to the safety net, or the maximum amount that pensioners pay for their medicines across the year delivered in July last year. In September, we cut the price of 2,000 brands of medicine, putting $130 million back into the pockets of patients. And on the 1st of July, we delivered the biggest cut to the price of medicines in the 75-year history of the PBS. But we know there is more to do, which is why we are committed to 60-day prescriptions being available for a range of ongoing health conditions – more than 300 medicines that were recommended to our Government by the Pharmaceutical Benefits Advisory Committee: the group of medicines experts that oversee the operation of PBS and have for many years.
I just want to talk about why we're doing that, why it's so important, 30-day scripts make a lot of sense if you're going to your doctor and seeking a single course of medicine for a single episode of illness for example, an infectious disease. They make no sense for people who are on the same medicine, year in year out, decade in decade out, sometimes for the rest of their lives. That is why the experts advised us to allow 60-days prescriptions, which will give 60-days' supply of medicines for the price of a 30-day script. Halving the cost of medicines for six million Australians who are dealing with these ongoing health conditions. It is beyond explanation why Peter Dutton would block the halving of the cost of medicines for six million Australians who are grappling with ongoing health conditions. It is just beyond explanation. Now, I read that they are considering their position today. I urge the Coalition to back patients. I urge the Coalition to support our commitment to cheaper medicines for millions of Australians during a global cost of living shock.
JOURNALIST: Are you concerned that the Coalition will team up with the Greens or crossbench to block this?  
BUTLER: The Greens will make their own position. I'd be amazed if they teamed up with the Liberal Party who will for political reasons, potentially block access to cheaper medicines for six million Australians. The focus, though, has got to be on the alternative Prime Minister. We know his record in health care is not a good one. When he was the Health Minister, not only did he try to abolish bulk billing altogether, he also tried to jack up the price of scripts by $5. His record on cheaper medicines is not a good one. But this is the opportunity for him to stand alongside patients, particularly in this cost-of-living shock that is sweeping the globe, an opportunity to halve the cost of medicines for six million Australians who have to go to the pharmacist year in year out, decade in decade out, for the same medicine for their ongoing health condition.
JOURNALIST: Have you been talking with the Greens and crossbench to sure up their support if the Coalition does move to disallow it?
BUTLER: Of course we've been in ongoing dialogue with the Greens Party and with crossbench senators about the policy rationale for this. Obviously, it is a substantial hip pocket measure for six million Australians, but it's also going to be good for their health. We know from evidence overseas, and all of those comparable countries that allow 60 or even 90-day prescriptions for chronic disease medicines, that it improves medication compliance as well, by as much as 20 per cent. It's good for their hip pocket. It's good for their health, it will free up millions of GP consultations that are currently undertaken just for routine repeat scripts. People will be able to go to their GP less frequently if we're able to pass this measure, as well as saving substantial funds.
JOURNALIST: The Coalition’s public line so far has been that they want you to go back to the negotiating table with community pharmacies. You made that announcement on Friday. Can you confirm that your work there is done and there will be no more concessions to pharmacies, or is that still an ongoing process?
BUTLER: We committed that every single dollar the Commonwealth Government would save through this measure of 60-day prescriptions will be reinvested back into community pharmacy. We've been listening to the voice of pharmacists and to my colleagues, not just from government MPs, but across the crossbench, and the Coalition as well, about what would help support community pharmacy through this change. And after listening to those representations, we made the last announcement about our reinvestment package on Friday at the Pharmaceutical Society Australia conference, and that's a particular focus on support for small rural pharmacies. We've now committed the full $1.2 billion that we are advised we will save through this measure as a Commonwealth Government. I've also said there's additional investment into community pharmacy to support good medication management in aged care facilities – that's over and above the $1.2 billion. And finally, I've said that we've also heard representations from the pharmacy sector, that they're interested in bringing forward negotiations on the next Community Pharmacy Agreement. We're exploring that, and I'll have more to say about that in the near future.
JOURNALIST: Before we get to other questions, are we able to speak to the doctor – what difference will the bulk billing make to practices and doctors?
DERMOT ROCHE, CEO OF OCHRE HEALTH: Firstly, I think the Government's investment into primary care that came out of the last Budget is the first real significant investment for over a decade. The combination of Medicare indexation – the 1st of July, 3.6 per cent – plus the Strengthening Medicare grants that come through in July, plus the tripling of the bulk billing from November, is genuinely a shot in the arm for general practice. It will allow doctors to continue to bulk bill concession card holders, pension card holders, and children. And we've seen in the last couple of years a significant decline in bulk billing rates. This will certainly help stem that flow.
JOURNALIST: Do you think that your doctors here will increase the amount of bulk billing that they do, is it an incentive?
ROCHE: Absolutely it is an incentive, yes. For concession card holders, pension card holders, and children, the increase in the bulk billing incentive will now allow doctors to consider continuing to bulk bill those patients. While in the past, the move to less bulk bulling has been a trend that we've seen over the last couple of years, this will certainly help stop that trend.
JOURNALIST: It's been three months now since your National Press Club address and the vaping ban that the Government announced, when will Australians actually expect to see that situation change because as far as I understand, there's been no movements in the last three months?
BUTLER: We've been working very hard with state and territory governments to make sure that we have our legal arrangements lined up. As I think I said, at that Press Club address, there is complete consensus across jurisdictions that we need to stamp out this public health menace, particularly for our younger Australians. We've been working very hard to make sure that the legal arrangements we might put in place at state, territory and the Commonwealth level align in the best possible way. We've also been working across the Commonwealth, particularly, the health agencies, Border Force, working very closely with Minister O'Neil and her agencies, and education as well, to make sure that we get the legal arrangements as perfectly right as we possibly can. We're working very hard at that, I committed that this was a piece of urgent work for the Commonwealth. State health ministers have said the same, and we'll have more to say about that in the near future.
JOURNALIST: Do you have a timeline? Will it be in place by the end of the year for example?
BUTLER: We'll have more to say about in the very near future.
JOURNALIST: But currently there's no timeline for when people can expect to stop being able to purchase these products at convenience stores and petrol stations?
BUTLER: We're committed to getting this right and committed to making sure that the arrangements across the country are perfectly aligned, so there are no more loopholes for this public health menace. That's been the problem over the last several years, that there have been so many loopholes, that essentially a market has just flourished in those things that are so obviously and cynically marketed to our children.
JOURNALIST: Any indication so far as to how much it will cost, at least, in this preliminary work?
BUTLER: That is also work that that we're doing with the TGA, who will have a particularly important role in enforcing these arrangements, as well as Border Force. I've said previously that through the Budget process, we recognise there would need to be additional resources provided both to the TGA and the Border Force to enforce these arrangements. The Commonwealth is completely committed to making sure those agencies are properly resourced to do their job.
JOURNALIST: Would you bring forward doctors' ability to prescribe vapes, and take out that red tape as an earlier measure to get some of this work started quicker?
BUTLER: That is obviously another measure I've talked about publicly before. If we closed down the informal access to vapes, how are we going to make sure that people who genuinely have therapeutic need for smoking cessation purposes have that access. We're talking to the TGA about that.
JOURNALIST: The RACGP has made changes that allow foreign doctors to achieve their Australian qualifications faster, does more need to be done in the space?
BUTLER: National Cabinet asked Robyn Kruk, a very esteemed public servant, particularly in the health area, to conduct a review of arrangements for overseas trained doctors, nurses and other health professionals. She has already provided an interim report both to health ministers and to the National Cabinet: so, to the Prime Minister, premiers and chief ministers. She'll be providing a final report very soon to make sure that those arrangements are as streamlined as possible, while obviously always placing the safety and the quality of healthcare at the top of our concern. I'm very pleased that the College is looking at their arrangements to make sure that they're streamlined. We've been talking to all of the colleges, including the College of General Practitioners, about the arrangements we have in place. This is a very competitive marketplace globally. Other countries are competing very hard for access to the global talent pool of doctors, nurses and health professionals, which have always been an important part of Australia's health workforce, particularly in rural and regional Australia.

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