Minister for Health and Aged Care - press conference - 14 June 2024

Read the transcript from Minister Butler's press conference on funding for Aboriginal Community Controlled Health Organisations, chiropractors manipulating infant spines, Government’s neglect of the healthcare system, hospital funding negotiations.

The Hon Mark Butler MP
Minister for Health and Aged Care

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ABORIGINAL HEALTH COUNCIL OF SOUTH AUSTRALIA CEO, TANYA MCGREGOR: Good morning, Tanya McGregor, CEO of the Aboriginal Health Council. It gives me great pleasure to welcome you here today in the council's office, and also welcome you and acknowledge that you stand to meet on Kaurna Land. Today we have the great pleasure of hosting Minister Butler and Minister Burney for today's very important announcement to our sector. So, without further ado, I'll hand over to Minister Butler.
 
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Thanks Tanya for having us here. Can I acknowledge we're coming together on the lands of the Kaurna people and pay my respects to their elders past present and emerging and say how terrific it is to have my friend and colleague Linda Burney here from Sydney, such a great national leader. Speaking of great national leaders, Dawn Casey as well, who is the acting CEO of the National Aboriginal Community Controlled Health Organisation and such an important partner to the Commonwealth Government in our mission to deliver better Indigenous health outcomes and close the yawning gap in health and life expectancy between Indigenous and non-Indigenous Australians.
 
No one contributes more to the cause of Closing the Gap than Aboriginal Community Controlled Health Organisations. They've been supporting Indigenous Australians health for more than five decades. More than half of Aboriginal and Torres Strait Islander Australians use their local Aboriginal medical service and the further you get out from the city, the higher that percentage increases. Really importantly, those organisations and there are about 120 of them we're talking about today, employ about half of their staff who are Aboriginal and Torres Strait Islanders themselves. It's a terrific employment opportunity here in the cities, but importantly, out in rural, regional, and particularly remote Australia as well. Those organisations received a number of different funding sources, but a core funding source is the Indigenous Australian Health Program, which has been operating for many years. It's an important partnership between Dawn's organisation, the national organisation representing this sector, and the Commonwealth Government, and it has been for some time. But we know that it hasn't been working as well as it should. I get around to Aboriginal medical services, I'm sure Minister Burney has this experience herself, and we constantly find that although the AMS is doing terrific work, they haven't had their funding increased to reflect their increase in patient numbers. Aboriginal and Torres Strait Islanders are going to their local Aboriginal medical service because they know they get terrific healthcare there. They also know that the healthcare is culturally safe, it's likely to be delivered by Aboriginal and Torres Strait Islander health workers themselves, that's why they're growing but their funding has not been growing at the same time.
 
Today, I'm delighted to announce that the Commonwealth and NACCHO have agreed a very important new funding arrangement for the next four years. It delivers two things, firstly, this funding arrangement of $2.7 billion over four years, will deliver funding certainty for these 120 incredibly important health organisations around Australia. What we'll also do is to deliver an increase in their funding that reflects their patient activity, and they haven't had that for years. As I've gone around, I was at a Awabakal in Hunter Valley earlier this week, and they were saying they were doing terrific work and as a result, Aboriginal people in the Hunter region were flocking to their services and they hadn't received an increase in funding to reflect that growth in their patient activity. With the announcement today, they will receive that increase in funding to reflect their patient activity and be able to continue the terrific work that they do right across the country from here in central Adelaide right into the most remote parts of Australia. I'm delighted that we've been able to achieve this agreement with the national organisation representing this sector, particularly through their acting CEO, Dr Dawn Casey.
 
Can I also make another plug that's really important for this sector and that is our Government's determination to drive up the rates of bulk billing. This is a sector that has very high levels of pensioners and concession cardholders, and lots of kids under the age of 16 receiving very important primary care services and child and maternal health services. The tripling of the bulk billing incentive in last year's Budget is a huge funding boost opportunity to Aboriginal medical services. Partnered with the increase in funding through the announcement today, in partnership with NACCHO, we are delivering very substantial support to this incredibly important part of Australia's health sector. With those words I’ll hand over to Minister Burney.
 
MINISTER FOR INDIGENOUS AUSTRALIANS, LINDA BURNEY: Thank you, Minister Butler, and thank you, Tanya, and Dawn, and all of you for being here this morning. What this announcement does is it provides certainty, and it reflects what NACCHO’s actually do, the number of people they actually see. The most important thing about NACCHO’s is that they are safe places for Aboriginal and Torres Strait Islander people. You have people that come to NACCHOs for many, many reasons, and I've had the great fortune of actually going to a NACCHO myself and my children. But I also see some of the incredible work that that you all do, especially work with young mums. Closing the Gap doesn't start when someone is born, Closing the Gap starts before a person is born. All that prenatal care, the wonderful work that happens in terms of oral health, and birthing on country is something that is happening across the health space as well. We know Aboriginal and Torres Strait Islander people, when they come to a NACCHO, will come back, will finish their treatment will not leave in the middle of it and get sicker. We know that our people are the sickest people in this country, and if it weren't for NACCHOs, as the Minister said 120 across the country, then I can't imagine where we'd be. Just yesterday, there was a reported case of leprosy in the Northern Territory, and that was detected through a NACCHO. These spaces are incredibly safe important providers of not only immediate healthcare, but increasingly important, preventative healthcare. I want to congratulate the Minister, I want to congratulate NACCHO and everyone that's been involved in finally providing certainty this to this sector, which is absolutely deserving.
 
NATIONAL ABORIGINAL COMMUNITY CONTROLLED HEALTH ORGANISATION ACTING CEO, DR DAWN CASEY: Thank you, Ministers, Burney and Butler. It's been just a great partnership working together with the Federal Government and Minister Butler in the reforms that he's doing across health, which has had a major impact and flows onto Aboriginal Community Control. I think also AHCSA the affiliate here in South Australia, who'd been known for years to do outstanding training for Aboriginal health workers, and we were here not long ago, with the graduation of several health workers that came as a result of the Government's agreeing to fund 500 traineeships. So the other great thing about Community Control health services is we grow our own, so we have Aboriginal health practitioners, who in most states and territories now do a whole range of things. Really delivered during COVID, we had no deaths in the first 18 months, and it was our sector, who called on the Government to recognise that we needed to do something. The partnership is fantastic, we're coming back now that we've had an economist and others working on what is the true formula because we know that there's a $4 billion shortfall between funding that goes to individual Aboriginal and Torres Strait Islander people and that goes to other Australians. I have to say the Government is making good headway in a range of programs and catching that up. Thank you both for your Government's contribution, thank you.
 
JOURNALIST: We've heard from two Aboriginal health organisations that they've had to temporarily cease services due to a Telstra outage. How concerned are you by that?
 
BUTLER: Minister Burney and I had a discussion with the organisation here about that only in the last several minutes, so one of us is going to take that issue up with the Minister for Communications to see whether there's a way forward on it.
 
JOURNALIST: We’ve also seen new guidelines that permit chiropractors to manipulate baby spines and reviews are found that manipulating them doesn’t really help a range of conditions. So, does regulation need to change on that front?
 
BUTLER: I was quite shocked by the reports that were in the papers yesterday. Just for a bit of context, as a result of a review, about five years ago, the Chiropractor Board suspended or stopped the practice of manipulation, including spinal manipulation of infants under the age of two. The review found there was no evidence to support that that was a safe or efficacious practice. That review itself was reviewed only in the last couple of years, and the same conclusion was reached. I was quite shocked that the Board would overturn that pause, or that suspension of that type of practice, which has now been in place for five years. I’ve demanded an urgent explanation from the board, and after this press conference, I’m heading to have a meeting with my state and territory health minister colleagues about that. We had a brief discussion about this issue last night, they all share my sense of deep concern about the decision taken by the board. We'll be having a more formal discussion about that over the course of the next few hours.
 
JOURNALIST: There has been an open letter written to the Federal Government and the state and territory health ministers talking about the health system being under pressure. Are you concerned that it is under pressure considering we’re now in winter?
 
BUTLER: There's no question health systems across the country are under pressure indeed, across the world, they're under pressure. It’s because of a range of different dynamics, some of them demographic, we're getting older, we're getting sicker. This is a particularly pressured time of the year, we've got flu and COVID, rising at the same time, which is placing particular pressure not just on hospitals, but on primary care systems as well. We know we're still living with the legacy of COVID. People weren't getting the care that they needed during those emergency years of the pandemic because of obvious restrictions put in place to control COVID. Health systems across the world, health systems across Australia, are dealing with real pressure and all of my state and territory colleagues are doing terrific work to try to manage that.
 
I just want to remind people, in December the Prime Minister and the premiers, so our bosses if you like, reached an historic agreement, to lift the Commonwealth contribution to hospital funding to 45% over the next 10 years - to 42.5% by the end of this decade. That will unleash at least an additional $13 billion from the Commonwealth into state and territory hospital systems. But we've also done a range of other things in primary care that they've been calling for, a number of them are mentioned in the open letter.

I ask my state and territory colleagues and other members of the community to compare the pair. My state colleagues have asked us to pay attention to bulk billing. We tripled the bulk billing incentive last year with the biggest investment in bulk billing in the history of Medicare. Peter Dutton tried to abolish bulk billing all together and make everyone pay every time they went to the doctor. We've been asked to increase hospital funding. I said we've committed at least an additional $13 billion, Peter Dutton tried to cut $50 billion from healthcare. They've asked us to improve aged care services. Aged care is the biggest area of investment across Government that we have made in the two years we've been in Government . Under the former Government, which cut billions from aged care, and had a Royal Commission which described the aged care system under their watch with a single word ‘neglect’. Again, I ask our colleagues to  just compare the pair. We are working very hard to rebuild a health system that was scarred by 10 years of cuts and neglect.

Now, there's always more that we can do. As I said, we’re meeting for the next several hours with my state and territory colleagues, we have a very constructive relationship. But ultimately, the conclusion of a hospital funding agreement is part of a bigger deal, a bigger set of negotiations that was decided by the premiers and the Prime Minister in December. It covers disabilities in particular. We will work according to those directions that we've been given by our bosses.
 
JOURNALIST: Why have you paused health funding talks with the states and when will they resume?
 
BUTLER: I'm not going to repeat all the detail I gave him a very long-winded answer for which I apologise. But can I just remind people that the hospital funding negotiations were agreed to be part of a broader set of negotiations, which importantly included changes to the NDIS, which are currently before the Parliament, and rule changes that would follow those legislative changes, and the development of a system of foundational supports for people, particularly kids under the age of nine, mostly, with developmental delays and adults with severe and persistent mental illness, a system of foundational supports for them for those people who are falling outside of the NDIS system. It was agreed that all of those negotiations would proceed in tandem. Now, for one reason or another, the hospital funding negotiations have moved more quickly than the disability negotiations. Correspondence between the premiers, particularly Premier Malinauskas who chairs the council of state and territory leaders, correspondence between Premier Malinauskas and the Prime Minister over the last several weeks have reaffirmed that we want those negotiations to proceed in tandem. We've been directed to pause hospital funding negotiations, they will resume as soon as we get a direction, in my case from the Prime Minister, that disability negotiations have caught up with the hospital deal and then we'll be more than happy to resume those negotiations. I'm just as keen as my state and territory colleagues are to reach a new hospital funding deal that will not just mean more money, it will mean important reform that delivers better care, not just within hospital walls, but outside of them, as well. I just say again, hospital funding negotiations are not an island, they're part of a broader set of negotiations that was agreed at the National Cabinet would operate in tandem.
 
JOURNALIST: So what more do you need from the states regarding the disability reform negotiations before restarting those health funding talks?
 
BUTLER: I think everyone would agree that they're considerably behind the hospital negotiations. We've got to get legislation through the Parliament, dealing with the NDIS Act that will allow rule changes to proceed to reflect the direction we've articulated, we want to follow in the NDIS over coming years. Those rule changes need to be negotiated with states, with the sector, and people living with disability most importantly. As I said, states and territories and the Commonwealth are working very hard on building a system of foundational support, and that work is hard work and it is running behind the speed with which we were effectively progressing at health negotiations. It's really a question of how quickly disabilities can catch up. Once we think that they're both operating in tandem, which was the agreement between jurisdictions, the Prime Minister will give me a direction and the Secretary of the Department of Health the direction to resume negotiations. I hope it's sooner rather than later.
 
JOURNALIST: How long do you think it'll take for the talks to catch up to the health funding talks?
 
BUTLER: I'm not part of the disability negotiations, Minister Burney’s not a part of them. They are a separate piece of work, the Prime Minister and premiers will determine the degree to which the negotiations are all operating in the way in which they indicated they wanted them to operate back in December.
 
JOURNALIST: Just one more, is a hospital spending cap of 13.5% next year still the latest offer?
 
BUTLER: Yes, as I understand that's still a position on the table but there are still negotiations to proceed. Thanks everyone.

 

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