Minister for Health and Aged Care – interview on ABC Radio South East SA – 26 September 2023

Read the transcript of Minister Butler's interview with Rebekah Lowe about a new Medicare Urgent Care Clinic in Mount Gambier, one of four new Clinics opening in South Australia.

The Hon Mark Butler MP
Minister for Health and Aged Care

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REBEKAH LOWE, HOST: Well over 40 per cent of presentations to South Australian hospitals are for non-urgent or semi-urgent care. In an effort to divert this, Mount Gambier will have a new Medicare Urgent Care Clinic set up and expected to be running from October this year. To tell us more, we're joined by the Federal Minister for Health and Aged Care, Mark Butler. Good morning, Minister. Thanks for your time.


LOWE: So why has the location been chosen in Mount Gambier of the Mount Gambier Family Health Centre?

BUTLER: That was done through a competitive process, the Mount Gambier Family Health Centre. I'll come to why we decided to put one in Mount Gambier, first of all. When we promised this in the election campaign, I had a look at all of the emergency department wait time data.

We've got hundreds of public hospitals obviously across the country. You talked about around 40 per cent of all hospital emergency department presentations being what doctors and nurses call non-urgent or semi-urgent. That figure is actually quite a bit higher in Mount Gambier: it's more than 50 per cent of presentations to the Mount Gambier Hospital ED are officially classified as semi-urgent or non-urgent.

Now, obviously people need care, but they don't necessarily need hospital care. Think about your kid falling off a skateboard and really hurting their arms significantly. Obviously, you don't want to wait eight or ten days, which is sometimes what it takes to get in to see a GP now but you equally don't need a fully equipped hospital.

This is really a gap that we've identified in the Australian health care system. In many countries overseas there is this urgent care level service that sits somewhere between a standard general practice and a fully equipped hospital. It's there for people who have those non-life threatening emergencies that need urgent attention, but not the sort of range of equipment and staff you see in a hospital. That's why we promised that we would open, if elected, we'd open 50 of these clinics this year. And today's announcement is the South Australian part of that, including one in Mount Gambier, which I'm really delighted about.

LOWE: So you're saying people can go there for breaks, minor injuries? Does the Family Health Centre already have something like an X-ray machine for breaks?

BUTLER: All of these will be required to make sure there are imaging facilities available to them. Obviously, X-ray is very critical. Some of them will be on site around the country, some will be just down the road. We're working this out as we open these clinics. But importantly, the clinics across the country, including in Mount Gambier, will be open seven days a week, extended hours. In Mount Gambier, 8am until 10pm, seven days a week and really importantly, fully bulk billed. So all you'll need is your Medicare card and you'll be seen quickly.

We know that when you take your kid who's fallen off a skateboard to a hospital emergency department, you're often there for six or eight hours before you are seen, because the hospital obviously prioritises heart attacks or very serious car accidents that come through their doors. Here, you'll be able to get care when you need it, where you need it in the community, completely free of charge. Not only good for the patients, obviously, but also taking pressure off our hospital emergency departments, which are pretty strained right across the country, indeed, right across the world. Hospital systems are very stressed after three and a half years of COVID.

LOWE: So, Minister, 8am till 10pm, seven days a week, how will staffing be secured for this?

BUTLER: This is really where the Commonwealth funding comes in. There will be funding provided to these clinics to make sure they have the expert staff on hand, that they have the appropriate equipment. And of course, in addition to that, they'll be able to bill Medicare. I mean, a number of providers had tried to do this just using the standard Medicare system, and it didn't work because of the extended hours you need, because of the extra equipment you need and the extra staff. We've kicked in with a new program which supplements that funding. It provides these services with additional funding so they can provide that broader range of services across seven days a week and not charge anyone a gap fee so everyone will be bulk billed provided you've got your Medicare card.

LOWE: Minister it's hard enough at the moment to get a GP appointment. Will the Mount Gambier Family Health Centre, will that still be a GP clinic as well as an Urgent Care Clinic?

BUTLER: That's right. What we've done is: we've run a competitive process across the country, and we've essentially gone out and said to existing general practices 'do you want to take your practice to the next level?' Obviously, continue seeing all of your patients in the usual way who might come in to see you quite regularly, particularly if they've got ongoing chronic disease like diabetes or all the rest, but in addition to that, have a special new part of your practice that caters for walk in patients.

You don't have to be a patient on the books of Mount Gambier Family Health to be able to go in and see this Urgent Care Clinic. Anyone in the area will be able to walk in to this clinic without an appointment and ask to see a doctor or a nurse urgently. That's the really important thing about it. It's walk in and completely free of charge. But of course, Mount Gambier Family Health will continue to operate their usual practice. This will be on top of it, with additional funding from the Commonwealth Government.

LOWE: Minister Butler, it's expected that these will open from October. Are we ready? Do we have the staff? Do we have the machines, the equipment everything that's necessary to open this in October here in Mount Gambier?

BUTLER: I think the Mount Gambier clinic is due to open in the first week of November. The Primary Health Networks which coordinate general practice and other primary care in regions, in this case the Country Health Primary Health Network for South Australia, ran the competitive process, made sure that the practice – in Mount Gambier's case, Mount Gambier Family Health – was able to satisfy the conditions which we've negotiated with all of the state governments and I'm confident that they'll be ready to be up and running in the first week of November.

LOWE: Is this model sustainable? $135 million for the new 50 urgent care clinics across the country? It works out to about $2.7 million per clinic by the time you factor in wages, utilities, medical supplies. Is that enough to keep this going? How and how quickly will this sort of take effect, this funding?

BUTLER: The $135 million was the baseline funding that we committed at the election. At the Budget in May, after negotiations with the state governments about exactly what range of services this would cover, what hours of the day and seven days a week and so on, we provided about an additional $350 million to this program. We're very confident after having worked with state governments and worked with the sector that we've got the funding right. But there's substantial additional funding on top of that $135 million which will be provided to these clinics.

LOWE: So, what will be the cost of running something like this?

BUTLER: They're not exactly all the same. Some of the clinics in the country will be a little bit smaller than clinics in the centre of the big cities, for example. At the end of the day, it's not a standard Medicare billing that allows you to operate an Urgent Care Clinic seven days a week, so we have had to provide additional funding.

What we do know is that that's going to be substantially cheaper than people presenting at a hospital and will take pressure off hospitals now that are really struggling with the level of demand in the community. Diverting all of that activity away from hospital emergency departments is going to be good for the hospital system, but it also means that people will get care much more quickly, in a much more accommodating environment, than having to front up with your sick kid who's fallen off a skateboard to a crowded emergency department.

LOWE: Speaking of the crowds that you can see at GP clinics as well, we keep hearing about GP pressure. What is the Federal Government doing to ease this? I know yesterday there was announcements about making it easier to recruit overseas doctors?

BUTLER: That's right. There really have been some pretty silly bureaucratic hurdles in place to recruit overseas doctors where we need them and we have always in our health care system had to recruit some doctors and nurses from overseas to meet our demand here in Australia, particularly in country areas, frankly. We've been trying to make that easier for practices to be able to do that, get rid of some of the hurdles.

The Urgent Care Clinic program is only part of a $6 billion investment in the May Budget to strengthen Medicare and particularly turn around the fortunes of general practice that I've been pretty clear I'm very worried about. After almost a decade of the Medicare rebate being frozen under the last government, general practice was in a very parlous state. In May, the Budget included a $6 billion investment, the centrepiece of which was tripling the bulk billing incentive, so a big increase to the income of doctors who bulk bill their pensioners, their concession card holders, their kids under the age of 16. We also put in place the biggest increase to the Medicare rebate in more than 30 years, across the board. So, since Paul Keating was Prime Minister.

We recognise that strengthening Medicare is important for its own sake. You know, it's the backbone of our healthcare system. But if Medicare is faltering, the pressure all ends up at our hospitals and we need our hospitals to be operating for those once-in-a-lifetime emergencies that they were built for – heart attacks, strokes, serious car accidents and things like that – and have really good systems of primary care in the community which people can get, when and where they need it.

LOWE: Minister Butler, thank you very much for your time on the program this morning.

BUTLER: Thanks, Becc.


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