Minister for Health and Aged Care - press conference - 20 February 2023

Read the transcript of Minister Butler's press conference in Perth on nurse practitioners; GP shortages; ambulance ramping; nurse negotiations in WA; silica.

The Hon Mark Butler MP
Minister for Health and Aged Care

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MEMBER FOR HASLUCK, TANIA LAWRENCE: Thank you everyone, I’m the Member for Hasluck, and I'm very proud today to welcome Minister Butler, the Minister for Health and Minister Amber-Jade Sanderson, State Minister for Health to the Midland Curtin campus to talk about an incredible, progressive nursing announcement and I hand over to you.

MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Thanks Tania. It's just terrific to be here at Curtin University and to join my ministerial colleague, Amber-Jade Sanderson for the second time in three weeks. Three weeks ago, the Prime Minister and I were here with Amber-Jade, announcing the opening of Expressions Of Interest for the seven Medicare Urgent Care Centres that Labor promised would be delivered here over the course of 2023 at the last election, and we're really excited about that Expression Of Interest process. But today, we've got another really exciting proposal to announce which was the brainchild of the Western Australian Government here, but will be funded out of a fund of $100 million that Prime Minister Albanese put on the table at a recent National Cabinet meeting and that fund is directed at finding innovative ways to deliver better care out in the community - care near where people live when and where they need it, which obviously in and of itself is important, but importantly as well care that will take pressure off hospital emergency departments.

This project today seeks to harness the extraordinary skills and training and experience of specialist nurses, nurses we describe in Australia as nurse practitioners. These are highly qualified nurses who in addition to their standard training, have a degree - often a Graduate Diploma - have also undertaken Master's degree training as specialist nurse practitioners. The arrangements we have in Australia, though, which are a myriad of regulations at state level, at federal level are, frankly, the product of turf wars that have gone on for far too long within the health sector over many decades in Australia means that so many of these highly qualified nurses aren't able to operate to the full extent of their skills and training. Well, this project that has been proposed by the Health Minister in WA, Amber-Jade Sanderson will be funded by the Commonwealth, seeks to show just what a difference nurse practitioners can make, particularly out in the community in primary care settings. Our commitment of more than $11 million will allow at least 20 nurse practitioners to be employed in primary care settings across Western Australia - that might be general practices, Aboriginal Medical Services, community health centres - to use their full range of skills, not to be constrained by limits in the Medicare Benefits Schedule as to what they might do without having a doctor looking over their shoulder, to use their full range of skills and training and demonstrate the difference they can make to the Australian healthcare system. We're really confident that it will make a difference to members of those communities where these services are put in place. But it will also improve our ability to demonstrate what real reform of Medicare can mean. I've said on a number of occasions that at a time when demand for quality health care is soaring, it's really skyrocketing in this country, but workforce is constrained, it just doesn't make sense not to have everyone working to their full scope of practice - that is using all of their skills, all of their training, rather than have that work constrained by outdated regulation and turf wars. So, I really want to thank the Western Australian Government for this really innovative proposal. It's going to make a great difference obviously here in Western Australia, but I think across the country, we're going to learn a lot about the difference that nurse practitioners can make to Australia's health care system.

WA MINISTER FOR HEALTH AND MENTAL HEALTH, AMBER-JADE SANDERSON: Thank you. I want to thank Minister Butler and Tania Lawrence, the Member for Hasluck, for being out here today and supporting this really important trial. Nurse Practitioners are highly skilled health professionals who have taken the time and resources to upskill to a Master's degree level, they can treat and they can diagnose and treat, they can organise and seek pathology, imaging, and they can support patients in a primary care and an acute care setting. They are underutilised, they're underutilised particularly in Western Australia. We know there are at least 60 in WA who are not employed in nurse practitioner roles, but who are working in health care. So, we want to make sure we're removing the barriers for those highly skilled healthcare workers to be able to provide care in our community. This will be through an Expression Of Interest process in conjunction - in partnership - with WA Health and the WA Primary Health Network. And we want to prioritise areas that are currently underserved by general practice and primary care. So, we're looking at areas where GPs have closed their books just due to being completely full, regional and remote areas, areas that have high populations of Aboriginal and First Nations communities who need better access to chronic disease management and primary care. It is a very exciting opportunity for nurse practitioners. And certainly I really appreciate - the state government very much appreciates - the Commonwealth commitment to not only expanding primary care, but a willingness to do things differently to look at who we've got in our sector currently, who's being underutilised, and how we can use them to their best full skill set.

JOURNALIST: Can I just ask you first, Amber-Jade, in terms of, you sort of touched on it there, but where do you see them having the biggest impact, is that where those regional towns where there's just one GP, and you know, they can help alleviate some of that pressure?

SANDERSON: There's a range of areas that they can help. And we're certainly looking at aged care, pharmacies, GP practices, as well as potentially country hospitals. But certainly that primary health care is going to be the priority area. So yep, could be a town where there's just one GP, a single GP, they're under pressure, they can't take leave, for example, they might be a good partnership, placing them in aged care, so they're able to diagnose, treat to prescribe, order imaging or pathology, instead of those aged care patients getting in an ambulance, and ending up in hospital for weeks on end. So, there's a range of settings, we also want to look at how they might work with pharmacists. So, to be able to see people in a pharmacy so that people can come in, make an appointment, and get the prescriptions that they possibly need.

JOURNALIST: How would it work? Say for Joe Blow, calling their GP and trying to book an appointment? How do they know who they're meant to see, the nurse practitioner or the GP? Or how does that work for the person at home?

SANDERSON: Well, depending on the setting, it would be up to that - certainly that clinic - to determine what's the most appropriate pathway for that patient and to discuss it. So, if it's wound management, for example, something a nurse practitioner could do, then they may be referred there to be seen that day, if they prefer to see their GP, they may be waiting some time.

JOURNALIST: And so that will be a free service to see the nurse practitioner?

SANDERSON: Yes. So that would be the intention that this is available to people that will remove those barriers for our community for patients to access primary care.

JOURNALIST: Do we expect to be overwhelmed with expressions of interest?

SANDERSON: Well, we certainly hope that we will fill those expressions of interest – there's around 20 positions - as I say, nurse practitioners have not been valued as much as they should have under the previous Commonwealth Government. But certainly what we're signaling today is that we value you, you bring a lot of experience, and you can assist us in a time where we really do need to increase our workforce significantly, and expand that scope.

JOURNALIST: And we've obviously seen big issues with ambulance ramping here in the in the past few months. Is this going - how far will this go to alleviating that pressure?

SANDERSON: Well, every part of the system is under pressure. What occurs in our emergency departments is a symptom of a broader healthcare system that has been under pressure after two years of a pandemic, and a fatigued workforce. So, what happens in primary care is critical to how our emergency departments are functioning, what the Commonwealth is doing is their funding, they're stepping up, and they're putting their funding in place that we need when we say we've got a solution here, and this will assist.

JOURNALIST: Can I ask you where we're at with the negotiations with the nurses at the moment?

SANDERSON: So, obviously, the ANF, we're still awaiting their counteroffer, which they committed to providing to the state government mid-December last year, that offer hasn't been received, we continue to meet with them in the Industrial Relations Commission. We're still open to good faith negotiations. But we're not going to wait for that offer or for those negotiations, we are starting the implementation of the historic reform of nurse-to-patient ratios. And we've also provided that 3% to 4.5% pay rise for our nursing and midwifery staff and the $3,000 cost of living bonus.

JOURNALIST: So that's going ahead already?

SANDERSON: Well the cost-of-living bonus was set, I think towards the end of January, that arrived in people's bank accounts and the pay rise is being processed, now. So, I think it's any time now. And we are absolutely committed to introducing nurse-to-patient ratios. We're not going to wait for the industrial instrument to be registered. We've given that commitment. And we will absolutely continue with that.

JOURNALIST: So, there is a time limit on the negotiations, really?

SANDERSON: Well, it's up to the ANF, essentially, but what we're saying as a government is we value our nursing and midwifery staff and we don't want protracted negotiations to be impacting them adversely. We value them, we need them and we want to make sure that they get that pay rise that they well deserve.

JOURNALIST: I just want to ask you about something else if that's okay, just in terms of the union's demanding a ban on engineered benchtops, is that something that the government will consider.

BUTLER: I know Tony Burke as the Workplace Relations Minister is meeting with his state and territory colleagues next week. They're responsible for workplace safety that includes regulation of matters like this. This has been an absolute tragedy across the country over the last several years, these imported manufactured silica products have caused enormous damage and death to many, many Australians, and the government's determined to take action to deal with that. I know an import ban is obviously an option that will be considered by ministers when they meet next week, we're determined to do what we can to protect the health of Australians. In the health portfolio, we've asked the Lung Foundation, which has particular expertise, obviously, in lung diseases or dust diseases, to put together an action plan to reflect the government's response that we inherited from a former government earlier last year, and that action plan is out, I think, this week for consultation. If there's more to do, though, then we will do it because we're determined to respond to this really serious health problem.

JOURNALIST: As the Health Minister, though, do you support a ban?

BUTLER: Well, I want to see a good discussion at the meeting next week. I know my colleague, Tony Burke is determined to take action here to protect the health of people at work. You know, people in the 2020s should not be going home with what can be a fatal disease. So, I know he's determined to work with his colleagues to take the necessary action and in their health portfolio, I’m similarly determined.

JOURNALIST: And just in terms of stronger laws as well to protect the more than 600,000 workers that have already been exposed to silica, do we need to do more there as well?

BUTLER: We're working with unions on those issues. I know Tony Burke is, and in the health portfolio, Ged Kearney and I are, as well. I mean, this has moved pretty quickly, this area. It probably should have been dealt with in the mid part of the last decade. And it’s only really in the last year or two there has been determined action by governments to put an action plan in place. So, we're reviewing that action plan and the decisions the former government took, we're in the process of implementing them, obviously. But we also want to know what else we can do to protect vast numbers of Australians who have been potentially exposed to this.

JOURNALIST: So do you see a ban in terms of the action plan - being part of that action plan?

BUTLER: Well, I want to allow that discussion to take place between the relevant ministers and I know Tony Burke will be doing that next week. Thank you. 

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