Minister for Health and Aged Care – interview on ABC Radio Adelaide – 26 September 2023

Read the transcript about Minister Butler's interview with Stacey Lee, Nikolai Beilharz and David Bevan about four new Medicare Urgent Care Clinics opening in South Australia.

The Hon Mark Butler MP
Minister for Health and Aged Care

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STACEY LEE, HOST: Mark Butler is the Federal Health Minister and joins you now. Good morning, Minister.


LEE: The Advertiser's reporting today that four of the Urgent Care Clinics being announced today are in existing facilities. The one at Marion, the one on Old Port Road, the one in Elizabeth and the one in Mount Gambier. What will be different about them?

BUTLER: We made a decision when we created this program that we wouldn't go out and seek to build new clinics and potentially sort of set up operations in competition with the existing general practices, which frankly are already struggling after a decade of cuts to Medicare. What we'd do instead is go out to existing practices and ask them whether they were interested in taking their practice to a new level. So, continuing their existing practice with all of their patients who come to see them regularly, who are on their books but in addition to that, add a new service, an urgent care service, which would be open seven days a week, extended hours, and not just care for the patients on their books, but take walk-in patients from the area who needed urgent, but non-life-threatening care. So, when your kid falls off a skateboard and hurts their arm and you can't wait six or eight days to get into a GP, your usual GP, which as your listeners would know, is often the case at the moment.

So, often they think the only alternative is to walk into an emergency department even though they don't really need fully equipped hospital care. We know that that's almost a half of all of the presentations to emergency departments around the country, including here in South Australia, are what the doctors and nurses classify as non-urgent or semi-urgent. You can't wait six or eight days, but you don't need to go into a fully-equipped hospital. We asked those practices 'if we provide you additional money, would you be willing to expand your service to walk in patients seven days a week, extended hours, and importantly on a fully bulk billed basis?'. No one will be charged a fee for this, all you will need to do is to take in your Medicare card.

NIKOLAI BEILHARZ, HOST: These are going to be swamped, aren't they? Because you've got the combination of 'hey, it's free' and 'hey, you don't even need to make an appointment, you can just rock up'. These are going to be overwhelmed, these centres?

BUTLER: We've got some operating already. They're certainly proving to be popular, but they're not overwhelmed. We worked very carefully with state governments, particularly hospital systems and also with the sector – with the general practice sector – to make sure we've got the operational protocols right. You can't walk into one of these clinics if you've got a run-of-the-mill health issue that you've been meaning to check on for days or weeks even. This will only be available for people who have an urgent need for care, non-life threatening.

BEILHARZ: So if you've got a cold, if you turn up and you say, I've got a pretty bad cold, you'll be turned away?

BUTLER: You'll be asked to see your usual general practice. And that might be that general practice. But this is specifically targeted at people who need urgent care for an urgent, but non-life threatening emergency and people understand what that is.

DAVID BEVAN, HOST: Yeah. The examples that Stacey gave of the one at the Domain, at Marion, another one on Port Road, what extra facilities will be there? Will it be one doctor, one nurse between what, six and 12? What extra resources?

BUTLER: There will obviously be doctor and nurse capacity there, which will be sufficient to make sure that as people are walking in, they're able to be seen relatively quickly.

BEVAN: And what's relatively quickly?

BUTLER: Some of the – it will depend on the time of day and it will depend on the day of the week. But, the clinics that are already operating are seeing people, you know, sometimes 15 minutes, sometimes half an hour, 45 minutes. Compare that to waiting six to eight hours, which is the average wait in an emergency department.

BEVAN: Right. So – and appreciate it depend on the demand and the time of the day – but you should be seen within an hour. That's the expectation?

BUTLER: We are going to collect the data very carefully on these things. We're opening 58. We promised we'd open 50. We're opening 58. That's a very good addition to fill a real gap in our healthcare system, but it's not going to give national coverage. So, we want to make sure that we evaluate these very carefully, because this is quite a new model for Australia. It has operated for many years in New Zealand very successfully and in many countries in the northern hemisphere but we do recognise we're going to have to evaluate this very carefully to make sure we get things right. So, we got the right people going in, we got the right team in place, the right equipment, x ray machines, pathology, all those sorts of things. And we're going to obviously monitor the wait times...

LEE: And the clinics I mentioned, the four that are being announced today were also dental centres. Will the dental facilities still be offered at those centres or is that being removed to make space for the nurses and the doctors and the urgent care?

BUTLER: No, they'll still continue to be offered there. As I'm getting around to these clinics that are being opened, the operators are saying that emergency dental is something that is presenting to these clinics as well. So, again, I hate to pick on kids falling off their skateboards – but your kid falls off a skateboards and knocks a couple of teeth out. Sometimes it is hard to get in to see a private dentist in the same way it is hard to get in to see a private GP. So in some of the clinics, that will be in urgent service available as well.

BEVAN: Minister, we know you've got a press conference to go to. We appreciate your time. If you wanted to stay on, we're more than happy to take your response to Dr Sian Goodson. She joins us now. She's chair of the Royal Australian College of GPs. Good morning, Dr Goodson.


BEVAN: What do you think of this idea?

DR GOODSON: We always welcome any funding towards general practice and funding for patients access to GPs. So, there's lots of positives. But I do have some concerns and some questions still that I'm unsure about. So, it's very difficult often for patients to determine actually what is urgent and what isn’t urgent. And I worry that this is free care, that patients may feel that they can go and get scripts from this doctor if they can't get in with their own doctor that day. And it may be very difficult for patients to determine what's appropriate for these centres and what isn't. So the triage systems and the processes are going to be really, really important. I also worry a bit about workforce because we know we don't have enough GPs in South Australia. The GPs running these Urgent Care Clinics will presumably be coming out of usual general practice to provide this service and that potentially could exacerbate usual primary care. And what actually are the costs per patient for this service and how does that compare to usual general practice?

BEVAN: Okay. Mark Butler is listening. Minister, we appreciate you hanging on. You want to respond to that?

BUTLER: I missed one or two of those points. First of all, I want to thank the College for their engagement on this. I know this is a new model. We've been very careful to make sure that we set these things up, not in competition with general practice. As I think I said earlier, I'm conscious general practice is doing it tough, which as the College knows, is exactly why we put $6 billion of additional funding into Medicare, the overwhelming bulk of which is going into general practice.

We've invested more in this Budget in general practice than any government in living memory has done. But this is an important gap in the system. It's important when we think about the cost of this service that we're not just compare it to the cost of a standard general practice service, but also to the cost of all these people going into hospital emergency departments. Because that's what we know is happening right now. I'm very conscious about the workforce crunch in general practice, I've talked very publicly about my concern that not enough medical graduates are choosing general practice – an historic low number of medical graduates are choosing general practice as their career.

I’m very conscious of what the College says there, but we also know from these clinics that are already operating that there's a high level of interest among doctors and nurses to work in this new model. They see it as exciting. Now, not all of them are doing it full time. Some of them are doing it a couple of days a week and spending the rest of their week doing their usual job. I don't pretend that this is going to fix a whole lot of the other structural challenges in general practice, which I have to say I've had a really good engagement with the College of General Practice on starting to fix.

BEVAN: All right. Well, we'll see how it goes. Mark Butler, thanks for your time.

BUTLER: Thanks very much.


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