Minister for Health and Aged Care - press conference - 12 May 2024

Read the transcript of Minister Butler's press conference in Adelaide on strengthening Medicare; more Urgent Care Clinics; hospital funding; mental health; elective surgery waitlists.

The Hon Mark Butler MP
Minister for Health and Aged Care

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ANDREW COHEN, CEO FORHEALTH: My name is Andrew Cohen. I'm the CEO of ForHealth. I'm standing today with Wendy Saunders from Adelaide PHN. We've got Dr Simounds our clinical lead here at the Western Urgent Care Clinic and Anita Tabb our triage nurse at the clinic. We warmly welcome Mark Butler, the Minister for Health and Aged Care and the local member here in Hindmarsh, who I hope has called his mother this morning. Before I begin, I want to just first acknowledge the traditional owners of this land, the Kaurna people, and pay my respects to elder's past, present and emerging. I also want to acknowledge the nurses here at this clinic and nationally, all the nurses around Australia and around our clinics, because it's also International Nurses Day today, a day where we can reflect on the incredible impact that nurses bring to our healthcare system every day, both in terms of their clinical excellence, and the humanity they bring to our sector.

ForHealth is the second largest general practice provider in Australia. We serve more than 7 million patient visits every year. Our mission is accessible health. We focus on lower socio economic and more health vulnerable areas. The backbone of our business is Medicare. It's the foundation of our business. It's a system that makes me very proud to be Australian. I believe that it's our country's greatest social program. This year is the 40th anniversary of Medicare. I want to start by acknowledging and thanking the Albanese Government for a record level of investment in Medicare in the previous budget, which is the largest since the inception of the program, that included the tripling of the bulk billing incentive, and the establishment of 58 Urgent Care Clinics. And know that Mark's going to talk about even further investment in Medicare and that program today. At clinics like this, in communities like these, we see the impact of that investment first-hand, at the coalface. It has been significant. For this clinic, we'd seen bulk billing rates really decline over a period of two years but since the bulk billing incentive has been tripled, we've actually seen that turnaround for the first time. So, at this clinic, bulk billing consults has risen from under 80 per cent to now well over 85 per cent. Importantly, it’s 100 per cent for pensioners, for kids and for low-income households. That makes a huge difference.

This is also a Medicare Urgent Care Clinic. We are on track to see about 10,000 patients in the first year of operation. That's 30 to 50 patients a day that come here in here, about 60 per cent of those say that they would otherwise have gone to an ED, which means this clinic alone is really helping to divert about 6,000 patients a year away from hospitals. When a patient comes in here, on average, they will commence care from arrival in under 20 minutes. Patients scores for this clinic are about 4.78 out of 5 stars, which is a very, very high level in the context of healthcare. Patients love the service. The community loves this service, and we love providing this service. But beyond the numbers, there are people, there are kids, there are grandparents, there are mums and dads. One of the patients that the Minister is going to meet today, Jim, is a recent patient in our clinic. Jim had a had a head injury that required stitches after a really bad fall. His wife, Jenny had looked around for the wait times at the QEH and the Royal Adelaide Hospital - and the wait times were very, very high. So, she brought Jim in here. He received stitches, antibiotics vaccinations, and Jim was back at home within an hour of coming here, which is really incredible service. Jenny is actually an ex-nurse for South Australian Health, she understands the system and knows what a good service looks like. She actually wrote us a five-star review that said, “Excellent service, could not fault it. This model of care is a great addition to the healthcare system.” That story is only one of 10,000 stories that we will see in a year and that number keeps growing every day. For that, I want to thank the Minister and the Albanese Government for this investment back into patient access and into the green and gold backbone of our system, Medicare. I want to thank Adelaide PHN for their partnership in working with us every day to maintain this service and for helping us establish this service. I also want to thank our doctors and nurses that ultimately are the heroes of these clinic. I'll now handover to Minister Mark Butler.
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Thank you Andrew and Happy Mother's Day to the mothers of Australia and Happy International Nurses Day to the nurses of Australia. Anita, who is working today. She's a mother and a nurse. I hope she gets some time off towards the end of the day.

This is a terrific opportunity for us to make another announcement about our plans for a stronger Medicare and cheaper medicines. As the Treasurer Jim Chalmers has said this Budget on Tuesday night will have at its primary focus the fight against inflation, delivering cost of living relief without adding to inflationary pressures. The centrepiece of which will be a cut a tax cut for every single taxpayer in Australia, as well as other targeted cost of living relief. We will also continue our key strategic focus on a stronger Medicare and cheaper medicines. As Andrew said, we've had three priorities in that area. The first is to strengthen Medicare, to make it fit for purpose for the 2020s and beyond, but also to start lifting those bulk billing rates that were in freefall when we came to government. The second is cheaper medicines. We've really had significant success in driving down the cost of medicines for all Australians. And thirdly, is building this network of 58 Urgent Care Clinics. This is a new model of care for Australia, very common in most countries to which we usually compare ourselves - but 58 Urgent Care Clinics that were delivered in 2023, as we had promised at the election. They are now delivering tens and tens of thousands of services to people when and where they need it in their community. Importantly, free of charge. All fully bulk billed and taking real pressure off our crowded hospital emergency departments. Since these centres started to open in the middle of last year, there have been almost 400,000 bulk build services delivered to Australian patients. Around one in three of those services have been delivered to kids under the age of 15 kids who get sporting injuries or have an urgent need to have a look at a respiratory illness. Parents are able to come here, as Andrew said, be seen very quickly, completely free of charge and get very, very high-quality care from the doctors and the nurses like Trevor and Anita. You see that right around the country. It's in addition to the 950,000 additional free visits to the doctor that have happened since the 1st of November as a result of our tripling of the bulk billing incentive. Driving down the cost of healthcare for hundreds of thousands of Australians at a time of real household budgetary pressure.

I'm delighted to announce today that we will expand this urgent care network by 29 additional Urgent Care Clinics. Medicare Urgent Care Clinics delivering the same terrific level of service you see here in the western suburbs of Adelaide at the clinic here in Royal Park. The 29 additional Urgent Care Clinics will cost $227 million, which will be announced by the Treasurer in the Budget on Tuesday night, and it is a terrific investment in better healthcare for Australians and a stronger Medicare. Happy to take questions.
JOURNALIST: How are negotiations going with the states on the public hospital funding agreement?
BUTLER: At the National Cabinet meeting in December, we made a very significant offer, through that National Cabinet meeting for a landmark hospital funding agreement, not just for the next five years to the end of this decade, but into the middle part of the next decade as well. Lifting the contribution from the Commonwealth to hospital operating costs from something less than 40 per cent, which is where it sits right now, to 42 and a half per cent by the end of the decade, and 45 per cent by 2035. This is a landmark shift in the Commonwealth's contribution to the operating costs of our hospitals, but it will also be a genuine reform agreement. There's a real appetite among all states and territories as well as the Commonwealth to make sure this isn't just a funding agreement, but it also looks at the way in which we can deliver better healthcare to Australians, to look at some of these interfaces between primary care and hospital care, like urgent care clinics. Some of the interfaces between hospitals, aged care facilities, and disability facilities. Those negotiations are proceeding really well. We had a health ministers meeting only a couple of weeks ago, where we received a very comprehensive update from our lead officials who are working very, very hard at landing this agreement by the 30th of June, which was the timeline that was sent to us by our bosses, the Prime Minister, the premiers, and chief ministers. I'm still very confident we'll meet those timelines.
JOURNALIST: Where will these Urgent Care Clinics be located?
BUTLER: Those locations will be announced over the coming couple of weeks. We announced our intention to expand the urgent care clinic network at that same National Cabinet meeting in December, as well as a range of other investments to strengthen Medicare, particularly in the area of older patients trying to avoid them having to come to hospital at all, and if they are in hospital being able to be discharged when clinically appropriate. We made that announcement, A$1.2 billion commitment made by the Prime Minister. Since then, we've been talking to state and territory governments about the best locations for an expansion of the network. Their views on this are really important because one of the critical objectives of this program is to take pressure of busy hospital emergency departments. We rely on them really to let us know what those key hospital emergency departments are that we should be trying to relieve pressure from through other urgent care centres. We'll be making those announcements over the coming couple of weeks, but we've been consulting very, very closely with state and federal governments over the last few months.
JOURNALIST: Do you have a timeframe as to when it could be announced?
BUTLER: I’ll be doing that over the next couple of weeks.  
JOURNALIST: And when will these new clinics open?
BUTLER: I'm really hopeful that we can get them open pretty quickly. I would like to see them open over the course of this year. That's not entirely within my control, because we're working with states and territories, working with Primary Health Networks, like the Adelaide PHN, who've been playing a really important role to tender, to put out a competitive tender for the services. I think we demonstrated building this network from nothing to 58, we did that in a very short period of time. I promise that there will be at least 50 clinics operating by the end of 2023 and we were able to do that. This is something we want to see happen sooner rather than later. And as soon as we get the announcement out over on Tuesday night, and then with locations over the next couple of weeks, we'll be working very hard to get them open as soon as possible.
JOURNALIST: Do you praise this drug that you know, has helped you?
NGUYEN: Yeah, absolutely. Yeah, it has. It's an additional layer of therapy and treatment that's going to put me in good stead for the future.
JOURNALIST: You accused the Coalition of lazy policy when it pledged to reinstate subsidies for the 10 mental health sessions you cut in 2020. At the time, you said more was needed to help people with chronic mental health conditions. So why is it taking so long?
BUTLER: Since the release of the evaluation of the program you're talking about, which is the Better Access program that provides Medicare payments for visits to a clinical or registered psychologist, if you're referred there by your GP. Since the release of that evaluation, I've been working very hard with a group from the sector, representing consumers, their families, obviously clinicians and other experts. That work has finished. I've chaired a number of meetings with that group to find a good response to that evaluation. The evaluation showed that this is a very complex program. Where it is working, it is working well, but there are significant parts of the community that don't get the support that they need through this program. Geographically, it's not being equitably distributed. For poor communities, given the very large gap fees, they're not getting the services they need. This has been a complex piece of work we've had to undertake with this group. That work is finished, and you'll see our response to that very soon in the very near future.
JOURNALIST: The Royal Australian College of GPs said the announcement today is a misguided investment, saying you should be investing more in general practice care. They say these clinics are likely to redirect the workforce capacity away from regular clinics. What's your response?
BUTLER: I respectfully disagree with the College. It’s never really been very clear why they are opposed to this important program that is delivering terrific care to people, often when they can't get access to their usual GP. As I said, one in three of these services are being delivered on the weekend across the country, many others delivered after hours, when people usually can't get into their GP. We're also really clear that this clinic, and others like it around the country, are not there to replace the usual work of a GP - the usual relationship you'll have with your GP. This is for urgent care that can't wait, that needs to be delivered very quickly, often to children. I don't see this in any way compromising the importance of the relationship that patients have with their usual GP. Indeed, with our investments from last year, we're trying to strengthen that relationship, working with the College, the AMA, and others as well. We're trying to make sure that general practice is able to deliver this sort of wraparound multidisciplinary care that people with complex chronic disease need. There are very substantial investments from last year's budget that we're continuing to rollout to do that. I have to respectfully disagree with the College about their views on this program and think the results are there for everyone to see. They are delivering terrific care, free of charge, taking pressure off hospitals, and we want to see more of it not less.
JOURNALIST:  In Victoria, the government has lowered its target of elective surgeries from a promised 240,000 to 200,000. Does it concern you how long Victorians are waiting for electric surgery?
BUTLER: It's not just an issue in Victoria, it's an issue across Australia. It's an issue, frankly, right across the world. There is a whole lot of pent-up demand from the pandemic, that health systems right around the world are still having to work through. The Victorian Government is not immune from that, indeed, given the degree to which Victoria was hit so hard by COVID, they have more pent-up pressure than some other parts of the country. I've only read the reports in the newspaper this morning. I'm not aware of the detail behind the reports. We see as the Commonwealth, our job has been to provide as much possible support to states as they operate their hospital systems as possible, which is why we made the announcement in December of substantial additional funding will be at least at least an additional $13 billion over the course of the next five years. A lot of that is front loaded so we deliberately tried to give a particularly big boost to funding in the first year of the next five-year agreement because we know there is this pent-up demand. We know states want to clear those elective surgery lists as quickly as they can.
JOURNALIST: What's the Federal Government doing to make sure Australians aren't lingering on elective surgery waitlists?
BUTLER: As I said, I know states are working as hard as they can to deal with that pent up demand that came through the COVID pandemic. This is common right across the world. A lot of them are also dealing with workforce supply challenges. A lot of doctors and nurses at the end of the pandemic, who were approaching retirement age, they were exhausted, and, in some cases, they were quite traumatized by what they went through in the pandemic. They took early retirement. So, there's really a twin challenge here that hospital systems right across the world are facing, they've got more demand and they've got real challenges with workforce supply. We're doing everything we can to support our state and territory colleagues to try and make it easier for them to access workforce from overseas where they need but also, as I said, to give that funding certainty over the coming five years, particularly with a big boost in that first year. Thanks everyone.

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