Minister for Health and Aged Care – interview on ABC News Breakfast – 5 June 2023

Read the transcript of Mark Butler's interview with Madeleine Morris about Cancer Council data on smoking and vaping, taking action on smoking and vaping, opioids, hospitals, bulk billing

The Hon Mark Butler MP
Minister for Health and Aged Care

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MADELEINE MORRIS, HOST: The number of young Australians who smoke has increased for the first time in 25 years. New data from the Cancer Council comes at the same time as the government looks at tougher action on smoking and the rising use of vapes and e-cigarettes. 

Federal Health Minister, Mark Butler, joins us now from Adelaide to go through the findings. Great to have you on the program this morning, Minister. I read this and I nearly fell off my chair. I mean, all of the hard work that happened in Australia to get people off cigarettes and here we go, the first rise in teen smoking in 25 years. 

MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: And tragically, it's no surprise, given all that we understand about the phenomenon of vaping over the last few years and the degree to which vaping has become a gateway into smoking, even though it was sold to us – sold to governments and communities around the world – as a therapeutic product to get people off smoking. This data is truly shocking Madeleine. We know that at the beginning of the pandemic in 2020, only about 2% of high school students were vaping. That has skyrocketed to about 15% now, from about one in 50 to about one in six, or one in seven high school students are vaping, and the smoking rates have followed a similar trajectory, from about 2%. We got that smoking rate down to next to nothing and it's skyrocketed over the last several years to 13% again. The only cohort in the community where smoking rates are actually increasing. 

MORRIS: So, you've announced a big crackdown on vaping, designed to make recreational vaping illegal. It's a little bit complicated getting that through. Where are we at with that? 

BUTLER: I'm meeting again with state and territory Health Ministers this month. We're putting together a comprehensive framework at a Commonwealth level, working with the Australian Border Force, which will obviously play an incredibly important role to stop these things coming into the country in the first place. But then we need to work with states and territories to police the sale of these products on the ground. You know, in our cities, often down the road from our schools where these shops cynically set up their operation because they know that school students are their market. This is a product that was sold to us to help long-term smokers get off the habit. But we know it's actually being marketed to our kids with fancy sort of pictures on the front, often unicorns and pink ponies and the like, bubblegum flavour. This is cynically a strategy by the tobacco industry to create a new generation of nicotine addicts. And this latest data that the Cancer Council of Victoria has published based on Roy Morgan Research, unfortunately shows that the strategy is working. 

MORRIS: Are you going to have to amp up an education campaign as well, really targeted at that cohort, those younger people? 

BUTLER: Absolutely. And Jason Clare, the Federal Education Minister and I have already been in touch with our state colleagues, including state Education Ministers, because they're getting feedback from school communities that vaping is now the number one behavioural issue that they're dealing with. And I'm not just talking about high schools. This is happening in primary schools as well. So, in the Budget a few weeks ago we had substantial extra funding in for information and communications campaigns. Some of them will be of the sort that we've seen for decades to encourage people to kick the habit. But a lot of that money will go into communications and information campaigns targeted at our kids in particular, as well as additional money for Quitline type support services to help people quit the habit. Because we now have millions more Australians, many of them young, either addicted to nicotine through vapes or starting to take up cigarettes as well. 

MORRIS: Can I just ask you about something else that we're reporting in the news this morning, Minister? And that is a warning from the owners of 17 private pharmacies and clinics that distribute opioids. So, you've changed the funding for that so that methadone and buprenorphine are now on the PBS. But these private clinics are warning saying that they're going to have to close, because that change in costing means that it's no longer going to be viable. You're intending for this to be a good outcome, but are you now concerned about that? If these private clinics close, that is a lifeline in some cases for people who have opioid addiction.  

BUTLER: You’re right. First of all, it is important to say that this is a really important thing for public health. People who are struggling with opioid addiction to date have had to shell out $150 a week to get their treatment, sometimes from private clinics of the type you're talking about or from pharmacies. That is a huge impost for people who are dealing with very substantial health issues, many of whom are on income support. Putting these medicines on the PBS, I think, is long overdue. So instead of $150 a week, people will be paying PBS prices. Obviously, PBS medicines usually go through approved locations, which is PBS approved pharmacies. I am concerned, though, that particularly in New South Wales and Queensland, there are some clinics who've been providing this medicine – this treatment – to this population, again, on a private billing basis, so people are paying substantial funds to that. I'm working with the Queensland and New South Wales Governments on a transition package that will ensure that these clinics have a glide path that ensures, as far as possible, they are able to remain open. I make no apology for putting this medicine on the PBS, but I am very keen to make sure that these clinics, which offer a range of really important services beyond the supply of medicines, are able to keep operating and continue to provide those services. 

MORRIS: Just on another matter before I let you go. Queensland Children's Hospital and Prince Charles Hospital reported today that both have seen a spike in all categories of kids presenting to them, up to 30% in some cases in the first part of the year. That's being attributed to a lack of bulk billing for kids. The changes that you've brought in to increase incentives for bulk billing, do you need to make that happen faster? It's not due to happen until November.  

BUTLER: That is a pretty standard timeframe for making very big changes to the MBS and getting systems in place and getting doctors used to the new arrangements, really, in a matter of some months. What is coming out of Queensland today by way of report is the story that state Health Ministers and clinicians have been telling me for months, even before the last election, that the decline in bulk billing, the real pressure on primary care practice and general practice is showing up at the front door of hospital emergency departments, including for conditions – or importantly for conditions – that could quite adequately be cared for out in the community. That's why we had such a strong focus on bulk billing in the last Budget. That's why we're funding 58 Urgent Care Clinics – bulk billed and open seven days a week for extended hours, as well. And they're rolling out over the coming weeks and months.  

MORRIS: Okay, Mark Butler, thanks very much for your time this morning. 

BUTLER: Thanks, Madeleine. 

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