Minister for Health and Aged Care – interview on ABC Darwin – 19 September 2023

Read the transcript of Minister Butler's interview with Jo Laverty about CareFlight, hospital pressures, Medicare Urgent Care Clinics, recruiting doctors.

The Hon Mark Butler MP
Minister for Health and Aged Care

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HOST, JO LAVERTY: Mark Butler is the Federal Minister for Health and joins you now. Good morning, Minister.  


LAVERTY: You are in Darwin at the moment, welcome. You're here to re-announce funding for CareFlight’s second chopper. So where will it be based?  

BUTLER: It will be based at the Darwin airport, which is where I'm driving to right now. It entered service last month, so it's already been serving the needs of Territorians in the Top End. We also funded the purchase of an additional jet which is in the process of being modified for the medical needs of CareFlight and is expected to enter service in early 2024. Before there was a second helicopter, of course, the only helicopter that CareFlight had, had to spend some time every year on maintenance and that was as much as 110 days a year or about 30 per cent of the time. So, during all of that period there was no helicopter support for the people of the Territory. Having that second helicopter is not only really important just to give back up when there's more than one single emergency they need to respond to, but it also means there's 365 days per year coverage for Territorians in the Top End.  

LAVERTY: You've just heard about some of the struggles with health care here in the Territory, which I'm sure you're familiar with, Minister, about the remoteness and access to medical treatment and facilities. What plans do the Federal Government have to improve access and care for our remote communities?  

BUTLER: This is obviously the first measure that we're up here to talk about today. Mick Frewen, who runs CareFlight, was I think first down in Canberra four years ago arguing for the second helicopter. It's been something that our Territory Labor team has strongly supported. It's a bipartisan position, I'm happy to say so. It is really important for us in Canberra as the Federal Government to recognise that access to high-quality world-class health care is a cherished part of Australia's Medicare system and it needs to be available no matter where you live, whether you live in the inner suburbs of Sydney and Melbourne or whether you live in remote Northern Territory. So, making sure we close that tyranny of distance is a constant challenge for the Federal Government, but also obviously something we need to work closely in partnership with the Northern Territory Government, with the Aboriginal community controlled sector that services the needs of so many of those communities. That's something I'm up here to talk about over the next couple of days as well.  

LAVERTY: I see. When you say bipartisan support, how does the Federal Opposition support remote health in the Northern Territory?  

BUTLER: I was talking particularly about CareFlight, the additional helicopter and the additional jet. Obviously, we have a range of other measures we announced at the last election, which were particularly Labor measures that the Labor team up here in the Territory argued for very strongly. For example, additional dialysis services that we're in the process of working through right now, 500 additional Aboriginal health workers and Aboriginal health practitioners, which is a real shortage in remote communities in the Territory, but also across the Top End in Western Australia and the Queensland Top End as well, as a range of infrastructure projects here in Darwin. There's a substantial one for Danila Dilba and also a number down in the centre, we had I think a really strong focus on remote communities health.  

Health systems right across the world are really struggling after three and a half years of the pandemic and the Darwin community, frankly communities right across Australia, are no different. Health Ministers, I meet with them every few weeks, including your Chief Minister, who's also your Health Minister – Health Ministers are grappling with the legacy of COVID, which is a lot of deferred care that people weren't getting and that they should have been getting but they just weren't able to during the COVID period. But also a real workforce squeeze that's impacting, frankly, every country on the planet.  

LAVERTY: Are those 500 Aboriginal health care workers tagged just for the Northern Territory?  

BUTLER: No, but a very substantial number will be here because they're really targeted at more remote communities, but they'll also be in the top end of WA, in Queensland and some other parts of the country as well but this is obviously such a big focus for the Federal Government.  

LAVERTY: On ABC Radio Darwin, you're hearing from Mark Butler who is the Federal Minister for Health. Our hospital has had several issues with technology, staffing and bed blocks and it's all led to seven code yellows in six months. In fact, one those code yellows was around the Osprey crash and people who were in there for cancer treatment were moved away from the hospital. They were taken over to different accommodation. Is the Federal Government considering further funding for our hospitals, given it wants to use the Territory as a hub for defence?  

BUTLER: That's something we're always open to talking to state and territory governments about. We obviously want to make sure that the hospital capacity of a particular jurisdiction is able to deal with some of those surges that particularly Darwin has to manage, since it's had the AUSMAT team and the Trauma Response Centre here after the Bali bombings. In terms of the pressure on the hospital more broadly, we're very concerned at how hospitals are managing demand right across the country.

I've read about the pressure here at the Royal Darwin. It's no different to a lot of pressures right across the country, not just in regional cities like Darwin, but also in our major cities, which is why we'll also be announcing over the next little while the opening of the Urgent Care Clinic at Palmerston and also one down in Alice. These are rolling out across the country over the course of this year and they're intended to deal with the fact that at the Royal Darwin, as I understand it, more than half of the presentations to the hospital every year don't need to be in a hospital. They could quite adequately be cared for in a more appropriate setting in the community. The problem is that setting just often doesn't exist. The Urgent Care Clinics that will be open in Palmerston in the next couple of weeks on the 1st of October. It will be open seven days a week, extended hours and importantly bulk billed. It will be equipped and staffed to deal with those non-life threatening emergencies: they definitely need care quickly, but they don't need to be cared for in a fully-equipped hospital. That's a really important way of taking some pressure, some significant pressure off our hospital systems right across the country, including here at the RDH.  

LAVERTY: Well, a huge number of beds are taken up by people who shouldn't be there, but they're there long term with things like dementia or severe disabilities that have just been acquired. So having specialised places for those people to go to would make a big difference as well, you would think? 

BUTLER: Yeah, spot on. I mean the pressures are really at the front door, which is people coming into the emergency department who could be quite adequately cared for at an Urgent Care Clinic – and frankly better for them as well. I mean, if your kid falls off the skateboard instead of spending 6 or 8 hours at an emergency department, much better to go into a walk-in clinic, fully bulk billed and probably given the experience we're seeing in other Urgent Care Clinics, you'll be seen very, very quickly and very adequately.  

But there's also a challenge that you point out of longer stay patients with significant disabilities or older, frail patients not being able to find an adequate care option out in the community. That's something that all Health Ministers are working on very hard right now. We've been directed to by National Cabinet, so by the First Ministers. Natasha Fyles, of course, sits in both forums. She has that great opportunity to see both debates but that's a harder piece of reform work. It's something we've been directed to do by National Cabinet. As you say, people with quite significant dementia needs, quite significant medical needs, longer stay older patients and people on the NDIS – the National Disability Insurance Scheme – who really should be able to find some accommodation options through that scheme, instead of having to spend sometimes literally months and months in a hospital bed.  

LAVERTY: I have to make a quick correction by the way, it wasn't a code yellow after that Osprey crash, it was a code brown, and then it was only a week or so later, there was another incident where a truck involved in defence forces rolled over and they thought they might have to go to another code brown, but it was able to be managed. Just to clarify that. I did get a text message for you, Minister, which says: there is a strong Labor interconnection with CareFlight, why do they charge cattle stations to retrieve and charge nothing to communities? The Northern Territory Government contract is for retrieval regardless, isn't it?  

BUTLER: I can't answer that question. It's a contract with the Northern Territory Government, so I'm not across the details of the contract between CareFlight and another level of government. I mean our contribution really to these operations has been the purchase price for the second helicopter and the second plane.  

LAVERTY: Well, perhaps you can keep that in your back pocket for a little small talk when you go to the big launch today, Minister.  

BUTLER: *laughs* thanks.  

LAVERTY: You're welcome. In the latest quarterly report, Commissioner Vicki Telfer says the Territory's health services went from 7,955 full time equivalent health workers. That's June 2022 to just 7,373 in March this year. So that's a pretty big drop in a fairly short amount of time. The Northern Territory Government has had several recruitment campaigns, but we're still struggling – as is much of the world, as you've pointed out, Minister. In terms of getting more doctors up here to the Territory, are there plans to reduce HECS fees for doctors who decide to work up here, specifically in the Northern Territory?  

BUTLER: We've already, only in the last several months, introduced different HECS arrangements for doctors who are willing to go and work in more regional and remote areas. Those are in the process of being rolled out, but we passed the legislation earlier this year to do that. Really, you've put your finger on probably the most challenging issue in the health system, and that is getting enough workers. I mean, frankly, it's an issue down in Melbourne where they're really struggling to clear their elective surgery backlog, not because they don't have the surgeons or the operating theatres, they just don't have the theatre nurses.

There's such a crunch on nursing supply right across the world and obviously the further you get away from the big cities, the more challenging that issue becomes. I'm really, really keen to talk to people over the couple of days I'm here in the Territory about some other ideas we might have to attract more workers, nurses, doctors, allied health workers, Aboriginal health workers to the Territory because with all of the best intention to fund services, and there's lots of good intention both in the Northern Territory Government and in our Federal Government, if there aren't the workers on the ground, it won't really deliver much improvement to people's lives. That's probably the top of the list of concerns that health ministers are working through. We're only just about to receive a report about how we're performing on international recruitment. I think for too long we've thought “well, Australia is such a terrific place, we can just assume people want to flock here to work from overseas” but the global market for doctors and nurses has become very, very competitive. National Cabinet commissioned a review of all of those settings, how we are performing in the global marketplace, if you like, for overseas doctors and nurses, which are an important part of our health system, and that will be delivered to the National Cabinet over the next several weeks when it next meets. 

LAVERTY: One of the barriers is you have a health professional, a nurse or a registered GP or whatever the case may be, and they may have done their training and qualifications in a place like the Philippines, for example, and are exceptional at what they do. But then they come to Australia and they have to retrain in certain areas. Will you make it easier for people to come to Australia from other nations if they already have those qualifications?  

BUTLER: That's a very big part of the review that was commissioned by a very esteemed public health bureaucrat. One of the things she is looking at is the way in which we recognise overseas qualifications for doctors, particularly GPs, which is the area I'm most worried about in terms of shortages, and also nurses as well. Obviously clinical safety, patient safety is the most important issue for us, we've got to make sure that people working in Australia do have the right qualifications. But there is a clear view, I think understandably, that some people with outstanding training and experience from overseas are expected to jump through far too many hoops. They spend a long period of time, often frankly working in our major cities, driving Ubers or working at cafes because it takes so long to get them registered and approved to get onto the floor and deliver the health care that they've been trained to do. 

LAVERTY: Yeah, it's very good to speak with you. Enjoy our lovely weather that we put on for you today.  

BUTLER: It’s not bad weather up here! 

LAVERTY: It's pretty nice, right? Thank you very much for your time. 

BUTLER: Good to talk to you. Bye. 

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