Minister for Health and Aged Care – interview on Sky News Afternoon Agenda – 1 November 2023

Read the transcript of Minister Butler's interview with Kieran Gilbert about the largest investment in bulk billing in the 40-year history of Medicare.

The Hon Mark Butler MP
Minister for Health and Aged Care

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KIERAN GILBERT, HOST: Now we're going to have a third go at this third time lucky, let's hope, with Health Minister Mark Butler. Can you hear me there?
GILBERT: Oh, great. Well, three times on the day of tripling bulk billing, so quite appropriate on that. But the question I wanted to ask you to kick off with: it's focusing on 11 million Australians, but will it ease the cost pressures across the board for people going to their GPs?
BUTLER: It will, this cohort has always been the target of bulk billing incentives, that is: kids under the age of 16, aged pensioners, disability pensioners and concession card holders. It's about 11 million Australians, but it's much more than that in terms of the throughput of an average general practice. The practice I was at a couple of hours ago, for example, 80 per cent of their patients will be covered by this bulk billing incentive. Obviously older Australians, people on disability pensions are more likely to be attending their general practice, as are children. This is a huge boost in funding for general practice that frankly has been under enormous pressure for about a decade now. It's also going to make it much easier for those 11 million Australians, many of them low-income Australians, to see a doctor completely free of charge.
GILBERT: You’ve suggested that some GPs will return to the practice of bulk billing, now, with this initiative and with this greater incentive. Have you got a sense of how many GPs we're talking about in that category?
BUTLER: We've been receiving messages from general practices right across the country that they're intending to return to bulk billing. Many of them had moved away from bulk billing only in the last couple of years, because of that build-up of pressure: the freeze in the Medicare rebate that Peter Dutton started, then COVID, and then obviously the cost of living shock that swept the globe over the last 12 or 18 months.
So those GPs didn't do that willingly. They want to be able to bulk bill their pensioners, their kids, their concession card holders. We're hearing from them right across the country: those that have moved away intend to return to bulk billing, because this is a very big income boost for general practices that do bulk bill their patients. For many others, they've been saying they're under real pressure to move away from bulk billing and this initiative from the government, strengthening Medicare, as we promised to do at the last election, means that they can confidently tell their patients they'll be bulk billing well into the future.
GILBERT: I know practices have been told to make sure that their software systems are up to date, to ensure the collaboration with the Health Department is as smooth as possible. Are you expecting teething problems or will these bulk billing increases be seen immediately?
BUTLER: We've been looking at this closely. Obviously, we announced it in the May Budget. November the 1st is the usual date for the introduction of big changes to the Medicare Benefits Schedule. So, there's been substantial time for us to make sure that these software arrangements - the Services Australia arrangements that operate the Medicare system - are all in place. And I'm assured that, from today, doctors will be able to do this very straightforwardly.
GILBERT: Now the AMA has also recommended today the third increase in GP fees, their schedule of GPs and doctors fees. Is it reasonable what they're suggesting?
BUTLER: They will make the recommendations that their members want them to. I mean our job really is to put in place a sustainable, affordable, fair Medicare system that's been a great Labor program or Labor mission for many decades. We came to office recognising that particularly general practice was under enormous pressure, probably the most parlous state that it's been in, in the 40-year history of Medicare. That's not only important for general practice, in and of itself but we know when general practice is suffering, you see that reverberate right through the health system, meaning that many more people are attending emergency departments because they see that as their only option.
We made no apology for putting general practice right at the top of the list of our priorities in health policy. We delivered on that promise in the May Budget: a huge increase in income. So just recognise this, Kieran, for a general practice in the cities, the income they receive for bulk billing these patients for standard consults - you know, a 15 to 20 minute consult - their income goes up today by 34 per cent. In the regions, that's even more. So a place like Dubbo, or Cessnock in the Hunter Valley, Whyalla in South Australia, their income goes up by 50 per cent - by half - for bulk billing those patients. And those patients might make up as much as 80 per cent or more of the throughput in their practice. This is an enormous injection, not just of funding, but I hope also of confidence at a time when general practice has felt under pressure, frankly, unloved by governments in Canberra. I hope now they recognise that they have got a government in Canberra that is very much in their corner.
GILBERT: Yeah, as you said, you've had this as your number one priority since coming into office. There's also parallel to this, what is known as the scope of practice review. I think in simple terms it's basically to look at the options for nurses and pharmacists, what more they can do in the primary health care system. But I guess inherent in what you're saying about the GPs place in all of this, Australians want to have access to their GPs first and foremost.
BUTLER: Absolutely, general practice is really the cornerstone of our healthcare system and you see that right around the world. That idea of a family doctor or a general practitioner, as we call them here in Australia, are absolutely central to a well-functioning health care system. They also know that the patient profile of today is very different to what it was in the 1980s when Medicare was developed. People with complex chronic disease, which is very common today, need a team of people working to them, not just a doctor. The doctor will be the leader of the team, but good practice nurses, maybe diabetes educators if they are one of the millions of Australians with type two diabetes, different allied health professionals as well. And we know that pharmacists can deliver more primary care services than they're currently allowed to do. I've said at a time when countries around the world, including ours, are really struggling with the supply of workforce in health, but demand continues to go up, it doesn't make sense not to have everyone utilising the full range of their skills and their training and their experience. That's what this review to unleash the potential of all of our health workers is aimed at doing.
GILBERT: Well, a significant day in health. We appreciate your time, Minister. Thanks so much.


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