Minister for Health and Aged Care – interview on ABC Regional SA Drive – 28 September 2023

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

The Hon Mark Butler MP
Minister for Health and Aged Care

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EMMA PEDLER, HOST: Many of you know how hard it is to get in to see your local doctor. You're probably like: 'yep, Emma, we know, we're sick of talking about it, why hasn't anything changed?'

Well, tomorrow it's going to be discussed, this time in Whyalla, as Federal Health Minister Mark Butler joins forces with Senator Karen Grogan for a regional health forum. And Federal Health Minister Mark Butler joins us now. Good afternoon.


PEDLER: I'm good. You've had quite the extended stay in South Australia?

BUTLER: Yeah, I've been at home for several days in a row, which is very, very rare. We had the Cabinet meeting on Monday, which usually happens in Canberra, so that was good. I didn't have to get on a plane on Sunday night and fly to Canberra. We had the cabinet meeting here and I've been here all week, which is a long time since I was in my home town for an entire week. So, I'm feeling blessed, but I'm heading up to Whyalla and Port Augusta in the morning.

PEDLER: Yeah so, what's on the agenda for both Whyalla and Port Augusta?

BUTLER: I'm seeing a couple of health providers in particular, but I'm also meeting with the Northern Eyre Peninsula Health Alliance, which is a very active alliance of health providers obviously in that region. I’m having a particular meeting with them and then after that having a more open regional health forum in Whyalla. Then travelling to Port Augusta and speaking to a couple of healthcare providers there. It’s an opportunity to talk about our agenda in regional health. But as you said in your intro, Emma, some of the frustrations people are having at not being able to get in to see a doctor. This is something we're experiencing right across the country, in the big cities as well, but it's obviously a more acute problem in regional Australia. I mean, I said in the lead into the election, people were telling me it's never been harder to see a doctor than it is right now and it's never been more expensive after a decade of cuts to Medicare. And then on top of that, the impact of a three and a half year, once-in-a-century pandemic. The healthcare system really is struggling right across the country, frankly, right across the world. I was only just meeting with health ministers from the G20 – so the biggest 20 economies – everyone's health system after these last three and a half years is under enormous stress.

PEDLER: We heard at the start of the week how you're opening this, you know, patient drop-in centre really to take pressure off the emergency department in Mount Gambier and the work's getting underway to put that into what is already an existing surgery. If that proves to take that pressure off and to get better health care for that region, is that something that then we may see pop up at other bigger centres around Australia?

BUTLER: That's certainly what I'd like to see. We went to the election promising 50 of these Urgent Care Clinics. And just for your listeners benefit, this is quite a new model for Australia. But many of our friends – for example, over the ditch in New Zealand – they've had this model for many years. It's something in between what you'd understand as a typical general practice on the one hand and a fully equipped hospital on the other. So, it's really where, think about your kid falling off a skateboard and busting their arm, you can't necessarily get in to see your usual GP immediately – and that's become even worse over the last few years – but you don't really need to go to a hospital, you just need to be able to walk into a clinic that's open seven days a week that is fully bulk billed and know that you'll be able to get care of a quality for a non-life-threatening emergency from well-trained doctors and nurses.

That's what we're rolling out: 58 Urgent Care Clinics will be opening over the course of this year, including five here in South Australia. And then what we'll do is evaluate them and just make sure that we very clearly understand what works. What we want to do is give people the opportunity to receive the care they need when they need it in the community. But we also want to take pressure off our hospital systems because we know that about half of all of the millions of presentations to emergency departments that happen every year in Australia, about half of them are classified by the doctors and nurses as non-urgent or semi-urgent. What that means is many of them could be quite adequately cared for in a more community setting rather than a fully equipped hospital.

PEDLER: We know that a lot of our regional hospitals now are staffed by locums instead of local GPs as well, and we know that state budgets are having to pay for these locum doctors and in a large number of cases as well a huge amount of FIFO nursing or medical professional staff into country hospital centres. How is that budget going to work in a long-term scenario when it doesn't work for a private business?

BUTLER: I think as a long-term scenario there are real problems with this system, and I know the South Australian Health Minister, Chris Picton has been very vocal about this, but we as a group of health ministers representing all of the jurisdictions we meet very regularly, much more regularly than any other ministers’ group – the transport ministers or the education ministers. We're meeting very regularly, which probably your listeners would expect given we're coming out of a pandemic. One of the things, particularly the state health ministers, including Chris Picton, have been very vocal about is just the way in which their budgets are getting very seriously impacted by this locum market that charges quite high fees for people to move in and do some locum work, but also the concern is you just don't get the continuity of care that you get from people who are working on a more ongoing basis in a particular community. So, because of a lot of that advocacy from Chris Picton and his state colleagues, there's a big review underway at the moment by the health ministers group of locum arrangements, that's only really partway through, but we do really want to have a good look at the way in which that is distorting health budgets in regions and also just the continuity of care that I think regional communities rightly expect.

PEDLER: And the concern I guess as well, that if a budget can run into the red for so long, what's the long-term future of that, of having to replace like big equipment and rebuild centres when the money is instead going towards staffing? So, I know that that's something for the future. These kinds of issues are obviously going to be brought up in both your meeting with the Northern Eyre Peninsula Health Alliance and probably at the forum as well. With the forum, can anyone attend that or was it an RSVP situation?

BUTLER: I haven't actually arranged it myself. I think we've done it in partnership with some of the local health providers, so I'm sorry, I can't answer that particularly. It will be at the Westlands Hotel in Whyalla tomorrow morning. It's really an opportunity to have a good talk with particularly local health providers and patient representatives, health consumer representatives about what we can do to alleviate some of these workforce shortages. This is really the number one issue facing our healthcare system.

Again, I say that we're not unique around the world. All of the world health authorities report a global workforce shortage for nurses and for doctors and for a range of other allied health providers. Since we've been in government, we've had two budgets, and both of them have contained substantial measures to start to try and make it more attractive to work in regional Australia as a doctor or as a nurse. For example, if you're a doctor or a nurse working in regional Australia now, you may be able to have, depending on how long you work in those areas, you may be able to have your entire university debt wiped – even if you're in a relatively large regional centre like Whyalla, Mount Gambier or Port Augusta. That's legislation we passed over the last several months. There's a range of other incentives really trying to make it attractive for doctors and nurses to get out and work in regional Australia, but that's not going to happen overnight. We just we can't unfortunately flick a switch, but we're working very hard on making it much more attractive for people to do that work.

PEDLER: I've brought this up already today, but it's very difficult to get someone to work in the country as a full time GP based in that centre when they can be based in Adelaide and fly in and get paid twice as much?

BUTLER: And maybe only work three days a week. That's really what that locums review is doing because it's really aggravating a workforce shortage we already had because increasingly we've got some health professionals choosing not to work full time because they can earn the same salary working only a few days a week. This is a very, very serious challenge that we have, which is why we've got that locum review underway.

PEDLER: And why wouldn't you if it was legal to do so?

BUTLER: Of course, you can't blame people for taking up that opportunity if it's there but it's really having a very serious impact on state health budgets. It is also important to have continuity of care. What regional communities want as much as city communities is doctors who understand their community and doctors who know their patients rather than coming in for only very short periods of time.

PEDLER: All the best at the forum tomorrow. You're at Westlands and doing some other meetings while you're around. Safe travels.

BUTLER: That's right. Can I just say. I’ve just been informed by my office, 9.30 to 10.30 is the Regional Health Forum at the Westlands. It's open to the public and there's no RSVP required.

PEDLER: Excellent. Anyone in Whyalla, if you've got any concerns or anything to add to the discussion, solutions would be great. If you've got a solution, get along from 9.30 to 10.30.

BULTER: We’re all ears for solutions.

PEDLER: That's it. Wouldn't that be wonderful? Mark Butler, Federal Health Minister, thank you for your time.

BUTLER: Thanks, Emma.

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