Minister for Health and Aged Care - press conference - 10 May 2024

Read Minister Butler and Assistant Minister Kearney's press conference on historic Medicare changes for women battling endometriosis; more doctors in Adelaide.

The Hon Mark Butler MP
Minister for Health and Aged Care

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MEMBER FOR BOOTHBY, LOUISE MILLER-FROST MP: I'm Louise Miller-Frost, I'm the Member for Boothby. Welcome to Boothby and welcome to Thrive General Practice. This is one of the endometriosis clinics that the Albanese Labor Government has funded all around Australia and I have to say, I get such positive feedback about this. Women who approach me and say, “I have had endometriosis undiagnosed for years and years and years, and now I finally got into a general practice that is specialised in endometriosis and my life has changed.” That's a really fantastically rewarding thing to hear. Congratulations to Thrive General Practice for the work that they're doing in that area, not only with women here, but also across general practice to help have that network.
We are here for exciting announcements today, I'm thrilled to have the Minister for Health Mark Butler, Assistant Minister for Health Ged Kearney and my friend, Catherine Hutchesson, the Member for Waite who of course, is chairing the endometriosis inquiry in State Parliament. I will hand over to Minister Butler for the exciting announcements.
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Thanks Louise, thank you Alecia for hosting us here at Thrive in beautiful Glenelg South on this beautiful Adelaide autumn day. I think it's fair to say that there has been a huge structural failing in our health system to support the many hundreds of thousands of women dealing with complex gynaecological conditions like undiagnosed endometriosis, pelvic pain and PCOS. For too many years now, too many Australian women have had to suffer in silence, and Medicare just hasn't given them the support that they need and the support that they deserve. For example, if I go and see a cardiologist or gastroenterologist, Medicare will give me twice the funding that a woman will receive to go and see their gynaecologist and what that has meant is that too many women feel they have to suffer in silence, because they can't find a long consult or don't have the ability to afford it. Too many women feel that they can only have a short consult but that simply doesn't even scratch the surface of a complex condition that they're experiencing. Or too many women have to pay out-of-pocket expenses that are just too high, out-of-pocket expenses that for example, I would not have to pay to visit a cardiologist or a gastroenterologist. I think women have been saying particularly over the last several years, enough is enough, we want some equity, we want some support from our Medicare system.
There is no single decision that Government can take to correct this historical inequity, frankly, this historical discrimination. Bit by bit as a Government under the leadership of Ged Kearney, particularly as the Assistant Minister for Health, here with responsibility for women's health, we've been trying to make things better. The first decision we took was to open 22 of these endometriosis and pelvic pain clinics, including the terrific clinic here in Glenelg in Louise's electorate, of Boothby that I hear is already making such a difference for so many Australian women.
We know we need to do better in terms of systemic change. A good national endometriosis management plan, good clinical guidelines, because we know as much as there might be these terrific clinics in parts of Australia, the first port of call for so many Australian women and teenage girls will be their GP. We want their GPs to understand as much as possible about these complex conditions. There have been for too long, too many stories of young girls and Australian women being given short shrift and being told it's just period pain or being put straight on to the pill and a whole range of other frankly, unsatisfactory responses. We, as a Government, are determined to help terrific leaders like Alecia and so many others across the health system, develop those guidelines make sure that all health professionals in the system are alive to these issues and are able to respond in a meaningful, sensitive proper way to women and young teenage girls coming to see them.
Today, I want to announce that we're going to deal with this Medicare inequity.  We are doubling the fee for a long consult with a gynaecologist. This builds on a decision we took in last year's Budget to fund long consults for general practitioners generally. This will be of benefit to women seeing their GP with these complex conditions, as they think about where they might be referred. It also is providing a really important opportunity for long detailed consultations with their GP for women fleeing family violence. This was a big call from that sector for women with complex mental health conditions, and men for that matter, as well. Today, I am announcing that we will double the Medicare rebate for a long consultation with a gynaecologist for a range of complex gynaecological conditions most obviously endometriosis, but also chronic pelvic pain and PCOS as well, polycystic ovary syndrome. This is long overdue. I've seen one campaign set up say it's “About Bloody Time”, that this inequity be dealt with, and that the extraordinary skills and training that gynaecologist equivalent to cardiologists, gastroenterologists, rheumatologist, and all of the other specialties be remunerated by Medicare in a way that is appropriate to the complexity of these conditions. That will flow on as a significant cost benefit to the many, many thousands of Australian women who will benefit so much from a good detailed, long consultation with their gynaecologist. We’re delighted to make that announcement today.
ASSISTANT MINISTER FOR HEALTH AND AGED CARE, GED KEARNEY: Thanks Mark. Ged Kearney, the Assistant Minister for Health and Aged Care. It is such a delight to be back here at Thrive Family Clinic, which I know runs a wonderful service for the women of Adelaide who have long been suffering. We know around one in nine women will have endometriosis, and it takes on average seven years and longer, we know some women have waited many, many years to be diagnosed. We're hoping to bring that figure right down through wonderful initiatives like this. I'm so proud to be part of a Labor Government that listens to women, that understands what women are telling them, and then has the capacity to act and make a real difference. I congratulate Mark. I congratulate Louise who has been an amazing advocate for the women of Adelaide. This is a great announcement today that will make a huge difference to the lives of so many women, thank you.
THRIVE FAMILY PRACTICE, DOCTOR ALECIA MACROW: Thank you, my name is Alecia, I'm a GP and I'm the Director and Owner of this practice. We are a practice that's been around for about three years, and we have set up from a very values base, we are here to work collaboratively with our patients and to look first at the underlying issues and then look at management from a very zoomed out point of view. Not just looking at what might be happening in small places but also thinking about food, and movement, and social connection, and so forth.
We were honoured to be recognised here as Adelaide’s only endometriosis clinic. We've really taken it as an opportunity to practice the sort of medicine that we think should be practiced everywhere, which is gently, and taking time, listening, and thinking about all of the connections with things, as well as working collaboratively with all sorts of different practitioners including gynaecology, physiotherapy, psychology, dietitian, and exercise physiology. We've really made a wonderful difference to so many of the women that we've seen. I was just saying earlier, we see women and they come in and they're up here and they've seen so many different people and they’ve spent thousands of dollars and they’ve had often many surgeries already, and they’re not finding answers and it really takes primary care, I think, to stop and look at the big picture before explaining and helping these women to understand what’s happening, and then finding them a pathway forward. We’re very pleased to hear about increased access to gynaecology, which has been very well needed, and it’s a team approach is needed. You can’t fix something very complex with something very small, we’re very appreciative of that. Thank you so much for your interest in our clinic, and looking forward to talking more about pelvic pain and endometriosis in the time to come.
CHAIR OF THE PELVIC PAIN FOUNDATION, DIRECTOR OF THE AUSTRALIAN COALITION FOR ENDOMETRIOSIS, GYNAECOLOGIST, DR SUSAN EVANS: Hi, my name is Susan Evans, I'm a gynaecologist, Chair of the Pelvic Pain Foundation and I'm a Director of the Australian Coalition for Endometriosis. Today is a big day for so many women, girls, and assigned female at birth Australians with pelvic pain. It’s easy to forget that actually, it takes two sides of the consultation desk to make change. Before today, people who worked in this area of pelvic pain were asked to upskill to more complex and stressful work at a lower income. It doesn't work. We don't have a strong enough health practitioner workforce in Australia to care for the large number of people affected by endometriosis and pelvic pain, and today is a wonderfully welcome help in building support for those practitioners that really do want to do a fantastic job, take the time, do pain education, get great outcomes for their people that have been severely compromised in their financial returns they had for doing that wonderful work. I'd like to thank Minister Kearney, Minister Butler, the lovely Alecia Macrow who is spectacular, and of course Louise Miller-Frost for this big first step forward to building Australia's health practitioner workforce.

KIM, PATIENT: My name is Kim. I've had symptoms for about 15 years and endometriosis, diagnosed when I was about 13. I've been coming to the Thrive clinic for six months now, I found this space to be just a nurturing and fantastic help for me to continue my journey with Endo.  I'm thankfully doing quite well at the moment and had some support from extra services here that I've discovered including the pelvic physio as well, and help from Alecia, thank you.
JOURNALIST: Why is this not starting until July 2025 rather than July 1 this year?
BUTLER: These substantial changes to the Medicare Benefit Schedule, take some time to put in place. We'll take the time to make sure the regulations are updated, the practices are notified about the software changes and so on and so forth. We also want to align this change with the development of the Endometriosis Management Plan I referenced earlier and we think this timing is about right.
JOURNALIST: When it comes to longer consults, as well, what does that mean in terms of start? Is there enough people already working in this field to cover those longer consults and more people to join the workforce?
DR EVANS: I think that gynaecologists would love to do a better job in this space. They need some upskilling, but it doesn't take long. The Pelvic Pain Foundation of Australia provides an annual health practitioner seminar to work on that upskilling and we support all the practitioners who are keen to work in this. We are coming from a relatively low base, but gynaecologists don't take much to upskill them to all the things that are required, it can be done, this will be an incentive to assist that process.
JOURNALIST: Have the community practices been built around the individual needs?
DR MACROW: Yeah, if I could just add to that if that's okay. I think extra time is an investment, longer time spent with a specialist whether that's a specialist GP, or specialist gynaecologist, where people feel heard and understood, they understand the options that are available to them, probably need less care in the long term. They're not bouncing to ED, they're not bouncing between specialists, they're not having a lot of tests, and hopefully not having a lot of surgery. Surgery may be a very important part of endometriosis management but it's by no means the only part. Some time to talk as well as, intervention is very, very. That's the thread that I see. I see women every day and they come in and they tell me that they're not being listened to enough because there's time constraints and there's financial constraints, and so I think there is such an investment in stopping and listening.
JOURNALIST: How many more women do you expect to come forward and seek treatment given that this might eliminate some of the financial barriers?
DR MACROW: I think there's financial barriers. As Kim said, when she came to us she was feeling mentally, emotionally and financially exhausted. I think encrypted sort of decreasing the out of pocket cost to these women, and having them know that they feel safe enough to come and be heard, not just five minutes of their story but more of their story, is going to encourage women to come forward because I think there's a lot of women who are just suffering quietly because they've given up or they're exhausted or they're burnt out from the way that their journey is looking at the moment.
JOURNALIST: These 430,000 new services, can you go into more detail on what they are and where they will be?
BUTLER: This is a $49 million commitment that will be contained in the Budget and we expect that there will be about 430,000 services covered by these new funding arrangements. Some of them will be the initial long consults, some of them will be the review session that has also been doubled, in terms of the Medicare fee that will be attracted to that. We think that's a very significant addition to the long consultation that Alecia just talked about.
JOURNALIST: Why won’t you fund a clinical trial of the drug DFMO to help children suffering from neuroblastoma? For only $15 million children's lives could be saved?
BUTLER: We'll be looking at all of those applications as they’re put forward. These decisions broadly are made by expert review panels, and I'll be happy to have a look at that submission.
JOURNALIST: Does that seem like a reasonable ask though, in the scheme of dollars in the Budget, seems like a small ask?
BUTLER: We've made a very, very substantial investment that I announced last week into research, particularly into clinical trials. There are grant rounds for clinical trials that are funded by Government, they're overseen by a panel of experts who review the submissions to that and that says it should be. These decisions shouldn't be made by politicians. They should be peer-reviewed and made by scientists with expertise in that area. But I'm certainly happy to look at that story and see how we go forward.
JOURNALIST: Over to Port Lincoln this morning, the announcement in regard to the Single Employer Model, being trialled how much of a difference do you think that's going to make to attracting and retaining regional GPs?
BUTLER: This is a relatively new solution to a long-standing problem. One of the challenges we have for GPs in training - they've done their medical school, they're doing their postgraduate training - is that over the course of their training, they will jump from employer to employer. Unlike a non-GP specialist who will generally do their postgraduate training in a hospital, and have a single employer for that entire period. Those GPs in training don't get continuity of service, they don't get access to paid-parental leave and other things like that that come from having several years of service. The solution we've found is to have GPs in training employed by one single employer, which will be the State Government. Now we've trialled this in two pilot sites, one of which was here in South Australia. They've been tremendously effective in attracting new medical graduates who want to become GPs but aren't willing to make those sorts of industrial sacrifices.
I'm delighted today that there's been such an enthusiastic response by the Malinauskas Government, to our offer through the last two Budgets to expand that from two sites to 20 sites across Australia. I'm confident that will make a real difference. This year, for example, we've seen a significant increase in the number of young doctors taking up GP training either as general GP trainees or as rural generalist trainees. They are green shoots of recovery, to a very significant challenge I've talked about on a number of occasions, which is our GP pipeline just not being sufficient to replace the existing workforce. There's no single solution to this, but this is a significant opportunity for young medical graduates, young doctors who want to become GPs and want to work in rural Australia, to do that, knowing that they'll be able to enjoy the sorts of benefits their hospital equivalents do. Often these GPs in training will be in their late 20s, early 30s, they'll be of childbearing age, access to things like paid parental leave, is a really significant incentive to continue what they want to do, which is to become GPs.
JOURNALIST: What about expanding the university places? The State Government has mentioned that's not within their control. Is that something you're looking at?
BUTLER: You're right, that is a Commonwealth decision. It's a conversation I have with my State Health Minister colleagues from time to time. This is an issue that was dealt with in the Universities Accord that Education Minister Jason Clare has released relatively recently. Those are conversations that we'll continue to have not just within the Commonwealth, but also with Ministers like Chris Picton.

This morning I've announced an additional 40 medical student places in Darwin. Darwin becomes the last jurisdiction to get its own medical school. That's a significant addition to that part of regional Australia. We added 80 medical school places in far north Queensland from Mackay up through Townsville and Cairns over the last couple of years as well. We have made some additions to medical school places, particularly in regional Australia, because we know from evidence that if you train in regional Australia, you are more likely to start a career and stay there build a life, build a family there as well.
JOURNALIST: Are there more on the way to South Australia though?
BUTLER: We've made no decision about additional Commonwealth supported places for medical schools at this stage.
JOURNALIST: Minister, do you agree with the Resource Minister’s position on gas?
BUTLER: The Resource Minister is responsible for releasing a paper that is the Government's position on gas. It's important to say the key policy lodestar for our Government in energy, and manufacturing, and transport is our commitment to net zero emissions by 2050, and also our commitment to having strong five-yearly emissions reduction targets in accordance with our obligations under UN treaties, but in accordance with long standing Labor policy. In contrast, we saw a wasted decade of 22 energy policies, which all failed to stick and lead to a massive dearth of the sort of investment we need to renew our energy infrastructure. I know there's been a bit of attention to this paper over the course of the last 24 hours, but I do remind people that the key element of our energy, our transport, our manufacturing policy, when it comes to emissions is our net zero emissions commitment and the gas paper along with everything else must be seen in that context.
JOURNALIST: Climate groups are arguing the strategy can create more emissions rather than less, do you disagree?
BUTLER: For the first time, because of decisions taken by our Government, gas projects, gas-fired generators - there are a number of my electorate, the neighbouring electorate, Hindmarsh - those big producers of gas are covered for the first time by the safeguards mechanism, which requires them as a matter of law to be reducing their emissions along with every other large emitter in the Australian economy. We are deadly serious about our commitment to net zero emissions by 2050. We are deadly serious about the five-yearly reductions that we've committed to. We're deadly serious about our target of 82 per cent renewable energy in the Australian energy system by 2030. We've doubled the number of renewable energy projects being approved since we came to Government. All of this signals the very clear direction that Australia under our Government is taking, and that is to invest in clean energy, which overwhelmingly will be renewable energy. By contrast, all that Peter Dutton has is some sort of plan to build a whole host of nuclear power stations up and down the Australian coastline that will deliver the most expensive form of electricity known to humanity.
JOURNALIST: Minister, there's been some criticism from within the Labor caucus about this policy, and some have said that they've been blindsided by it. Has there been a failure in process carrying the backbench with you and developing the strategy?
BUTLER: A whole number of members of our party are deeply passionate about this area. Their communities are passionate about this area and have been so deeply frustrated by a lack of action on climate and energy policy for 10 long years. Many of our caucus members, many members of the community expressed that frustration constantly as this debate and this policy development process continues to unfold and frankly play catch up on 10 years of inaction. I don't think that's a problem at all. I think that's a reflection of a healthy caucus that is deeply passionate about the transition in Australia that is underway to a clean energy economy.
JOURNALIST: The Government has won its immigration case, is it a relief that more detainees won't be released onto our streets?
BUTLER: We argued that case very strongly. We're of course pleased to hear that the High Court decision released this morning has endorsed the position put before the court by the Commonwealth. I haven't had the chance to read the decision, obviously, it's only come down in the last very little while, but obviously we're pleased that the court accepted the Commonwealth's arguments that there is an obligation on detainees to cooperate with Commonwealth authorities.
JOURNALIST: Just tracking back to the Port Lincoln announcements this morning. A bit of a two pronged question. Will this announcement helped to attract more homegrown GPs, already growing up in the regions to stay in in their regions? What about the overseas recruits? Where does this leave overseas recruitment? I know that's been a big factor in trying to get doctors out to the regions.
BUTLER: We've seen through the examples of the Single Employer Model that we've rolled out so far, a mix of young junior doctors from the local area itself taking up this opportunity but really pleasingly we've seen doctors move to these areas. Down in Tasmania, where the whole of rural Tasmania is covered by this model, and it has been for the last 12 or 18 months, we've seen people not just go from Hobart, for example, but moved from other parts of Australia to take up the opportunity to train as a rural generalist. To have that employment certainty for the period of their training. I'm very confident that will be the case here in South Australia as well.
As to the challenges we have in in getting international medical graduates, whether they're doctors, or nurses, or other health professionals into Australia onto the floor, using their skills and their training quickly enough, the National Cabinet commissioned a review by Robyn Kruk, a very esteemed Australian public servant, that's been delivered to Australian Health Ministers. We're working through those recommendations one-by-one and really trying to streamline the process for international medical graduates, and other nursing graduates to come to Australia if that's their wish. Particularly to fill some of the gaps in workforce that we have, especially in rural and regional Australia, and to be able to do that as quickly as possible. I don't want to see those graduates whether they come from the NHS in England, or India or wherever, get to Sydney or Melbourne and spend frankly, months and months and months sitting in an apartment working as a barista or driving cars because of our bureaucratic systems being too sclerotic to get them onto the floor delivering vital health care services as soon as possible.
JOURNALIST: Ged, you’ve been critical of the Government's future gas strategy, and you've said that the strategy sees a role for gas beyond 2050, and you said that we shouldn't rely on it, any more longer than necessary. When do you think we need to stop extracting and producing gas?
KEARNEY: What my message clearly was, that as Mark said, we've had 10 years, over a decade of inaction on climate change. We’ve had a policy disaster. We finally have a Government that is spearheading the production of renewable energy because we know we need to get to net zero by 2050. We know that we on our road, on the right path to having 82 per cent renewables by 2030. My constituency and many of the others around me, and other members, Louise, your constituency, I'm sure is very passionate about that progress. The very strong message that my constituency wants me to be talking about, is the fact that this is a Government that is 100 per cent committed to making Australia a renewable energy superpower. That means a reduction in reliance on fossil fuels, and that means, I say that the future, which this Government is committed to, the future is renewables and over time, we will become less reliant on fossil fuels.
JOURNALIST: From what you're hearing from your constituents, when do you think that we should stop relying on gas?
KEARNEY: I'm no expert in that transition. I've worked with wonderful people in the party like Mark, who was previously the Shadow Minister for Climate Change. I will leave that up to the experts. But the very clear message is, and I know that we can't turn gas off tomorrow, so much of our industry relies on it, but the fact is that the future is renewables. We are committed to that and a less reliance on fossil fuels over time is essential. We had Minister Bowen in Victoria just this morning, for example, announcing a fantastic investment starting the tender process for the capacity investment scheme, which will see in Victoria alone, around 700,000 houses being powered by renewable energy. That is the sort of commitment that my constituency wants to see from the Government and that is the commitment that we are delivering.
JOURNALIST: Do you support what the strategy has laid out? Do you support the planning and the development of the strategy?
KEARNEY: I support us moving as fast as we possibly can to a renewable future, and I support the Albanese Labor Government’s trajectory towards that.
JOURNALIST: Were you aware that this policy was coming? Or were you blindsided as others say they were?
KEARNEY: There has been discussion about this policy over some time. The Minister has engaged the caucus. In hindsight, there might have been a little more discussion about when the paper was going to be announced. I'm sure there will be some reflection on that in the caucus. But as Minister Butler says, we are a robust caucus, we have these discussions, and that is one of the wonderful things about the Labor Party is that we feel we can have these discussions. But overall, my message to my constituency is that the Labor Party is 100 per cent committed to renewables future.
JOURNALIST: Is your position on this policy, somewhat influenced by the strength of the Greens vote in your electorate?
KEARNEY: My position on the need for us to be a renewable superpower is driven by my personal belief, and certainly that of my constituency who let me know loud and clear that that is the direction they want this country to go, thank you.


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