Minister for Health and Aged Care – interview on ABC North West – 29 September 2023

Read the transcript of Minister Butler's interview with Tom Mann about the Whyalla Regional Health Forum, Mount Gambier Urgent Care Clinic, making it easier to see a doctor or nurse in regional and rural Australia and Voice to Parliament.

The Hon Mark Butler MP
Minister for Health and Aged Care

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TOM MANN, HOST: Have you been maybe putting off a health appointment because it might be feeling too hard? Or maybe you're concerned about the plans for the future of health care in regional SA? Whatever your position you may want to take the opportunity today to take part in a regional health forum which is taking place in Whyalla a little bit later this morning, in about two hours time with Federal Health Minister for Aged Care for Health and Aged Care Mark Butler. He is with me now ahead of the forum. Good morning.


MANN: Very well, thank you. Can you tell me about this forum that's being held in Whyalla today?

BUTLER: I'm holding a public forum in Whyalla at the Westlands Hotel at 9.30 to hear from health providers, but importantly as well patients about the challenges that they're experiencing getting good, affordable access to healthcare. Before that, I'm about to sit down with the Northern Eyre Peninsula Health Alliance that have been doing work now for some time. It's a collection of local governments and also health providers in the region; again, just trying to come up with innovative solutions to the challenge of having enough doctors and nurses out in regional Australia. The whole world right now is grappling with a shortage of health workers. It was there before COVID but the pandemic has seriously aggravated what is now a global workforce shortage. We're seeing it in our major cities, but it's much more acute in regional communities. The further you get out from some of the bigger regional towns, it becomes even worse. This is a very serious priority for our government and it's terrific to be up in Whyalla to listen to people on the front line really.

MANN: We have been covering a lot of stories recently about shortages in GPs, various health services, mental health providers, even the suspension of birthing services at the moment in Whyalla. What have been some of the specific concerns you have been hearing ahead of this forum?

BUTLER: Probably the most serious concern among many in the health system across Australia is general practise right now. I said in the lead up to the election last year, that was the area of the health system I was probably most worried about. We had a decade where the Medicare rebate wasn't really increased at all and that placed enormous pressure on general practice. We saw general practices starting to shut in many areas, but also those that remained open started to reduce their level of bulk billing, consults where you don't have to pay a gap fee. That was really the biggest focus of our budget. We invested an additional $6 billion in Medicare and our budget in May, the overwhelming bulk of which goes into general practice because we know that if general practice is failing, people aren't able to get the care they need when and where they need it out in the community. What ends up happening is they end up getting sicker and having to front up to the emergency departments in our hospitals, which places even more pressure on hospital systems that are already pretty stressed.

MANN: Now what do you see the path forward in increasing the number of GPs in regional South Australia? Obviously, some towns have had to take it upon themselves, advertising internationally to try and bring talent in. What can be done to improve those numbers and, you know, give people better access to GPs?

BUTLER: A whole range of things. There's no silver bullet for this, our budget particularly focused on increasing income to general practice particularly if you bulk bill.  For a standard GP consult from the 1st of November, a general practice will earn about 50 per cent more if they bulk bill than they would have before the 1st of November. The biggest investment in bulk billing in the 40-year history of Medicare.

We also need to make it much easier for local communities to recruit doctors from overseas. Overseas doctors and nurses have always been a big part of our health workforce, but we also want to increase the attractiveness of locally trained doctors. Doctors who do their medical school in Australia and then choose to go out and build a career and build a life in regional communities. So, for example, not too long ago we passed legislation through the Parliament that would effectively wipe the university debt, the debt that students owed because of their training, if they go out and practice for a particular period of time in a regional or remote community. We're also lifting the incentives for doctors and nurse practitioners to work out in regional communities. No one of these measures alone is going to change things overnight but we're trying to put in a whole armoury of measures that make it far more attractive for doctors and nurses to build a career and build their lives in regional Australia.

MANN: Now you mentioned presentations to emergency departments. One recent announcement from earlier this week was the was funding for four urgent care clinics with three around the wider Adelaide area and one for Mount Gambier. How were those locations chosen?

BUTLER: With a fifth urgent care clinic to be announced in the next week or two in the outer south of Adelaide as well. We committed to 50 urgent care clinics at the last election. We chose those locations based on emergency department waiting times. We went through all of the published data on, how long people waited in emergency departments, particularly for some of the less urgent presentations. Conditions that could be properly cared for out in the community if there was the proper service out there.

This is quite a new model for Australia. Many other countries around the world to which we usually compare ourselves, have this level of service somewhere between a traditional general practice in Australia on the one hand and a fully equipped hospital on the other. They're open seven days a week. They're well-staffed by people who are able to deal with fractures, for example, or deep cuts that aren't life threatening, but certainly need care urgently. If your kid falls off the skateboard and busts their arm. At the moment, if you can't get into a GP within a few hours, too often people are then forced effectively to go to a hospital emergency department. These new models of care, as I say, seven days a week, extended hours and importantly fully bulk billed so all you need to take is your Medicare card. We will have 58 of those clinics open before the end of this year. Now, that won't provide national coverage. For example, there's not one in the iron triangle. There's a whole lot of other areas of Australia where we haven't been able to put one of these clinics in the first round. What I want to do is see them up and running to demonstrate, first of all, most importantly, the benefits of getting that care available to people when and where they need it, but also the reduced pressure on hospital emergency departments. Some of these clinics have already been opened now for several weeks in other parts of the country and already the data shows that people are going to them who would otherwise be waiting six or eight hours in a hospital emergency department, for example, to have their kids fracture looked after. Instead, they're often in within 15 minutes, 30 minutes, and things are looked after very quickly.

MANN: Federal Minister for Health, Mark Butler is with me ahead of a health forum being held in Whyalla later on this morning at Westlands Hotel at 9:30. Now the ABC recently reported on a range of health organisations throwing their support behind the Voice to Parliament. The referendum is just over two weeks away. What value do you see these health organisations have found in the establishment of a voice to Parliament?

BUTLER: This was a really significant statement. More than 125 national health organisations – really any serious health organisation that your listeners would be familiar with signed their organisation's name to this letter. I think the reason is because health professionals are on the front line of the Closing the Gap initiative. I mean they see every single day the enormous gap in health outcomes and life expectancy between Indigenous Australians and non-Indigenous Australians. I mean, you see it in their life expectancy, which is eight years less than the average Australian. You see it in a whole range of conditions like diabetes, kidney disease. They're twice as likely to die by suicide in their early 20s as non-Indigenous Australians. Health professionals I think, understand the enormity of the gap in outcomes between Indigenous and non-Indigenous Australians, but they also know through their own training that a good doctor always listens carefully to their patient and in doing so you get the best treatment possible, you get the best diagnosis possible. I think the message from them is that a good parliament and a wise government should also be listening to the voice of Aboriginal and Torres Strait Islander people, because with the best of intentions and very substantial investment we just have to be honest that the current approach is simply not working. I mean there's a lot of investment going into closing the gap, but it's not actually resulting in a substantial closing of the gap in any of the key health outcomes that we've been measuring since 2008.

MANN: Now, and on the Voice to Parliament with just two weeks to go recent polling has shown a consistent trend for a no outcome, but also some polling has shown wide disengagement, with up to 30 per cent of Australians may be still undecided or haven't thought about this referendum at all. Does that concern you?

BUTLER: It's still two weeks until polling day, although remote polling is open now and the pre-polls in the major centres open on Monday. It's becoming increasingly common that even with federal elections that many Australians start to make up their mind in the final few days or even the final 24, 48 hours of an election campaign. That's why in all of those campaigns, the political parties keep doing their work to put out their message and their particular platform. I think a referendum campaign is no different. People have busy lives, and these are pretty tough times right across the world with the cost of living shock that countries right across the world are dealing with right now. I understand that people are focused very much on their own lives but as we get closer to polling day, I'm confident Australians will turn their minds to how they're going to vote.

MANN: And finally, Minister, regardless of the outcome, the Government has been accused of causing division for the establishment of this referendum process. There's been a rise in abuse of First Nations people in the discourse and rhetoric in recent months. Do you think there could have been a different path for a similar result that would have caused less pain for those that this voice is purported to help?

BUTLER: First of all, I do acknowledge that there's been a big increase in reports of distress by Aboriginal and Torres Strait Islander people. I know the support hotlines that Lifeline runs for First Nations people has seen a huge increase in their call numbers and an increase in the complexity of those calls as well. You're right, this has been for many First Nations Australians a very difficult process, but it's a process that's been running now for many, years. Tony Abbott started the discussion about constitutional recognition, set up the working groups that worked right through Malcolm Turnbull's prime ministership and led ultimately to the convention at Uluru that resulted in the Statement from the Heart from First Nations leaders. This is something that has been running for many years now and our view as a government was that it was time that the Australian people got a say in the next step forward. We've done years and years of talks and constitutional conventions. It's time now for the Australian people to have their say.

MANN: Minister, thank you very much for your time.

BUTLER: Thanks, Tom.

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