Minister for Health and Aged Care - press conference - 22 May 2024

Read the transcript of Minister Butler and Senator Watt's press conference on new Medicare Urgent Care Clinic for the Gold Coast; banning pharmacy compounding of replica weight loss medicines; ICC independence; taking pressure off hospitals.

The Hon Mark Butler MP
Minister for Health and Aged Care

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SENATOR FOR QUEENSLAND, SENATOR MURRAY WATT: Thanks everyone for coming along today to the beautiful warm Gold Coast. As our South Australian friend Mark Butler has been recognising, you can always rely on Queensland to turn on a beautiful day. I'm very pleased that you've been able to join us here outside Gold Coast University Hospital for a really important announcement that Mark will make shortly about increasing health services here on the Gold Coast. Last week in the federal Budget, you will have seen that the number one issue that the Albanese Government dealt with through the federal Budget was continuing to provide more cost-of-living relief for Queenslanders and for all Australians. We did that, of course, through our tax cuts, which will come into force on the 1st of July. And every single Queenslander, every single Gold Coast resident, who is a taxpayer now will get a tax cut under that proposal from us. And of course, we also provided energy rebates, in addition to those that the Queensland Government is providing. But we also understand that we need to take cost of living relief and provide that to Queenslanders in every way we possibly can. And that includes through their health costs. We've taken a lot of action, led by Mark as the Health Minister, to deliver cheaper medicines, reduce the costs that people are facing when they go to GPs. And again, Mark has got a very important announcement for us today. So why don't I hand over to him to do that. And thanks again, Mark for coming here to the Gold Coast.

MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: It's an absolute pleasure. Thank you, Murray. It's great to be here with my friend and colleague to talk about some really important initiatives in last week's Budget to continue strengthening Medicare. And to do so in a way that helps with cost-of-living pressures that are on every Australian household right now. 

We came to government promising to strengthen Medicare after a decade of cuts and neglect and also to deliver cheaper medicines. And our three-point plan to do that was to lift bulk billing through tripling the bulk billing incentive, which we did in last year's Budget. Already that's delivered, just since November, almost a million additional free visits to the doctor across the country. We also promised to deliver cheaper medicines. We've done that right across the country. In the last week's Budget, we announced that for pensioners and concession cardholders, medicine prices would be frozen for up to five years - another really important measure to help with cost-of-living pressure. But the third point in our strengthening Medicare plan was to deliver a network of Medicare Urgent Care Clinics. We opened 58 of them over the course of last year, including one here in Gold Coast. And they are designed on a seven day a week basis, to provide people with easy access to urgent care in the community, when and where they need it. One in three of the visits have been children under the age of 15. They fall off their skateboard, they get injured in Saturday afternoon sport. Instead of spending hours waiting in a hospital emergency department for that urgent care, they're able to walk into one of these clinics, be seen by highly qualified doctors and nurses who often have experience in emergency medicine and receive quick, high-quality care, completely free of charge. And already, in just a matter of months, 400,000 patients have gone through these 58 Medicare Urgent Care Clinics. 

In last week's Budget, we announced that we'd expand this network by an additional 29 clinics. And I'm delighted to announce that there will be a second clinic opened here in the Gold Coast, in the Southport region, to continue to provide that terrific urgent care option for families here in the Gold Coast, seven days a week, extended hours, fully bulk billed. But importantly, to take some pressure off busy emergency departments across the country. And there is no busier emergency department than here at Gold Coast, which is why we've taken the decision very quickly to open a second Medicare Urgent Care Clinic here. This is going to make a real difference to access to healthcare here in Gold Coast. But it's also going to take some much-needed pressure off this busy hospital emergency department. 

Happy to take questions. 

JOURNALIST: How much is this going to cost and when will it be open?

BUTLER: We're hoping to have this open by the end of the year. We promised at the last election to open 58 of them in the course of 2023 and we delivered on that promise. 58 Medicare Urgent Care Clinics open by the end of last year, already delivering 400,000 completely free of charge visits, through those clinics. So we want to see them open as quickly as possible. Now we have a process to go through: a competitive process to make sure we get the best value for money and the best option for people in this part of the Gold Coast. But I want to see these open by the end of the year. People out there need this option, they're finding it hard to get into their GP, emergency departments right across the country, frankly, right across the world, are experiencing unprecedented pressure after three or four years of this global pandemic. So we’ve got to do everything we can to relieve that pressure, to give people options to receive care out in the community when they can, rather than having to come to hospital Eds.

JOURNALIST: How many patients are expected to see annually or monthly or weekly. Do we have any sort of idea of how much pressure that's going to take off emergency departments and local GPs?

BUTLER: What we do know is that these clinics are seeing something in the order of 40 or 50 patients a day. They're open seven days a week, as I said. The vast bulk of people who are going through these clinics around the country are saying that if this clinic was not available to them, they would have to go to the hospital. And so it is taking some pressure off the hospital emergency departments. We know that. Importantly, as well, it means that families are able to get access to the urgent care that they need, close to them in the community, relatively quickly, and completely free of charge. We know, for example, if your kid falls off the skateboard on the weekend and breaks their arm, instead of spending hours waiting in an emergency department, it is a much better option to go in, on a walk-in basis, to one of these Medicare Urgent Care Clinics and receive high quality care relatively quickly and completely free of charge. The feedback from parents, for example, has been really positive about the impact of these clinics.

JOURNALIST: What processes do you go through to decide where these clinics are?

BUTLER: These are arm's length from government. They're not conducted by me or by us. They're conducted by the Primary Health Network, in this case, here in the Gold Coast, which has a terrific relationship with the primary care providers, particularly general practices, in this region. So they conduct that process. It's a competitive process to make sure that taxpayers get the best possible result. And the PHN here will be doing that, again.

JOURNALIST: How much money is set aside for this clinic, specifically on the Gold Coast?

BUTLER: I'm not in a position to say that because, in part, that depends on the activity that comes through. We provide these clinics with some block funding grants to help their operating costs, we provide the clinics with some equipment grants, if they need to buy some additional equipment. You know, we want to make sure that people have access to free diagnostics, so free imaging, free pathology, as well, if not on site, but very close to that site. And as well as that, obviously, they're able to bill Medicare for the activity that's going through it. So we’re absolutely determined to make sure this model works. It's a relatively new model for Australia, quite common in countries we usually compare ourselves to. But we want to make sure we get the finances right; we're evaluating the program as it goes through. But already, I'm really confident it's making a great difference to the delivery of health care in the community, at a time of real pressure. 

JOURNALIST: Have you been following the ramping issue? And do you have any thoughts on it? I know it is a state issue, but have you been following the commentary on it? 

BUTLER: I have. Obviously, this is, as you all know, the busiest emergency department in the country. It's got some quite unique characteristics, given it is close to the border, so there is some cross border traffic, that also uses this very high-quality hospital and the terrific doctors and nurses that work within it. This is something that we talk about as a group of health ministers very regularly. We meet probably more regularly than any other group of ministers in the country, because there's real pressure on our health care system. And we have a population that's aging, a population that has more chronic disease or mental illness than it might have had 10 or 20 years ago. And as I said, we have the pressures of the pandemic. This is being experienced right across the world: people are presenting to hospitals, sicker than they otherwise would have been, because they weren't getting the care for non-COVID conditions through the course of the pandemic, that otherwise they would have got. So health systems right across the world are really struggling to get through the legacy of COVID, the scarring of the health care system that really comes from that long pandemic. And on top of that, we know that this is a really fast-growing community. So just keeping up with the population growth here is something I know the state government is very strongly focused on. We announced in December last year, at a National Cabinet meeting, that we would put substantial additional funds into the hospital operating costs of state governments. We're in the process of negotiating a new hospital funding agreement right now, not just with Queensland, but with all states and territories. Those negotiations are going really well and they will result in an additional at least $13 billion from the Commonwealth into state hospital operations.

JOURNALIST: Just on the Ozempic-like compound regulations. What are some of the government's concerns and how do you plan on regulating?

BUTLER: The overriding objective of medicines regulation is safety and effectiveness. Millions of medicines are taken every single day in Australia and Australian patients take those medicines with a level of confidence that we know what's in them, and we know the conditions under which they were manufactured. And the problem with these new, large-scale manufacturing operations of replica Ozempic or replica Mounjaro is that we don't know either of those things. We don't know what's in them, we don't know the conditions under which they're manufactured. I've been taking advice now for the last several months from all of the key experts and regulators, and everyone - except the pharmacy business owners who are conducting this business - the doctors’ groups, the pharmacy groups, the Pharmacy Board and Medical Board, consumer groups like Diabetes Australia and the Eating Disorders Alliance, they all say this is an unacceptable risk to public safety and it should be shut down. This is not just an Australian issue. In America, the equivalent regulator over there, the FDA - the Food and Drugs Administration – has also warned about the significant public safety risk posed by the compounding of these so-called replica drugs.

JOURNALIST: Why won't that loophole be closed until October?

BUTLER: After taking advice and considering this for some time, I've decided on a four-month transition period because I know there are thousands of patients who have been lured into this market. I want to give them time to go and consult with their doctor and make sure that there are alternative, proper treatment arrangements put in place. But I want to be really clear, this is an unacceptable safety risk. This is an abuse of the compounding exception that's always existed in our medicine system to allow doctors and pharmacists to make a one-off decision to provide a particular patient with a compounded medicine or ointment that’s not commercially available. And what we've seen over the last several months is that exception, essentially, exploited by some businesses who have set up large-scale manufacturing operations, where there's no line-of-sight on safety, at all. And that's a public safety risk that simply can't continue.

JOURNALIST: Will legislation have to change and how do you plan on regulating it? 

BUTLER: No, I can make the decision on the advice of the Therapeutic Goods Administration to remove these particular medicines from the compounding exemption. These are powerful new drugs that have a significant impact on the body and it's simply not acceptable to have them compounded in a way that essentially gets all around the safety regulations that we've long had in this country. So I can take the decision to remove those medicines from the compounding exemption. And I've taken that decision to apply from the 1st of October. 

JOURNALIST: The Chief Prosecutor of the International Criminal Court says he's seeking arrest warrants for Israeli and Hamas leaders. US President Joe Biden says seeking the arrest warrants for Israeli leaders is outrageous. Do you agree?

BUTLER: The Australian Government has had a longstanding position that the ICC is an important part of the international apparatus, and we don't interfere with decisions that are taken by them. They will go their usual process. What I have said over the course of this morning is we reject any idea, though, that there is some equivalence between Hamas and Israel. Hamas is a proscribed terrorist organisation that precipitated this devastating conflict with some of the most vile and heinous acts of terrorism on October 7. They still won't release hostages held in Gaza, some of them very young children and elderly Israelis. So we reject any idea of equivalence between Hamas and Israel. But we've got a longstanding position as a country not to seek to interfere with independent decisions taken by the ICC.

JOURNALIST: Just back to Ozempic compounds. Do you know how many Aussies have been affected?

BUTLER: Part of our challenge here is this is all off radar. There's no reporting through the Medicare system or PBS system of patients who are lured into this market taking these products. We know that it's certainly in the thousands, potentially in some tens of thousands of people. And I want to make sure that they have the opportunity to go and see their doctor and find an alternative treatment. I'm particularly concerned to make sure that people with diabetes are able to access the legitimate medicines, Ozempic and Mounjaro, because in Australia those are approved right now for diabetes, not for weight loss. We've seen right around the world, over the last 24 months or so, demand for these products skyrocket as people start using them for weight loss. And that's caused a global shortage as the companies have been unable to, essentially, open new factories to make more of this product to deal with that explosion in demand. So this has been a challenge for the country, as it is for countries right across the world, to deal with these shortages. We've been talking to doctors and doctors’ groups, for some time now, about the need to prioritise people with diabetes for these drugs which are in short supply right across the globe. 

JOURNALIST: How good is this for the Gold Coast?

GOLD COAST PHN, LISA BEECHAM: It's really exciting news that's been announced today to be able to have another Medicare Urgent Care Clinic on the Gold Coast, will really assist to take the pressure off the busy emergency department. We have such high demand for our Gold Coast ED department. And it's just really important that we can do anything to take the pressure off right now. 

JOURNALIST: If I’m not mistaken, there's one in Oxenford?

BEECHAM: Correct, we've had one at Oxenford since late last year and we've been seeing a really appropriate range of patients through there, and patients that would have otherwise come into and come to Gold Cast ED.

JOURNALIST: So do you think this will take pressure off the hospital?

BEECHAM: Absolutely. So we really want people to think about seeing their usual GP for usual care and usual chronic care. And if they can get into their GP, see their GP. If there's an urgent problem and you couldn't access your GP or if it's after hours or your GP’s off sick, we really recommend the Medicare Urgent Care Clinics. They're free, they're open from 8am to 10pm, seven days a week, even on holidays, it's free. There's access to things like splints and plasters and stitches. You know, if there's anything that you think is not an emergency, then definitely think about going to the Medicare Urgent Care Clinic

JOURNALIST: Are you able to give a short list of some of the conditions people might be able to present with?

BEECHAM: Anything that's urgent and needs to be seen that day, that isn't an emergency, is an ideal candidate for the Medicare Urgent Care Clinics. So things like: rashes, babies with colds and flus, babies with gastro, adults with colds and flus, adults with gastro, rashes, sprains, fractures, minor lacerations that need suturing or gluing, anyone that needs prescriptions after hours and its urgent, like for a chest infection. Those sorts of things are really appropriate. Gold Coast PHN’s got an excellent website that helps step you through what a Medicare Urgent Care Clinic looks like, and what conditions are really useful for going to those clinics. 

JOURNALIST: We know it's going to be in Southport, but whereabouts?

BEECHAM: The most important thing with these clinics is to make sure that they're accessible for the majority of our population. And we know that our northern corridor saw a huge population explosion, in the last few years. So that's why the first clinic was placed at Oxenford. Southport is also an area of need, with a high population there. And there’ll be a needs assessment undertaken, there'll be clinics canvassed and they'll be assessed for the suitability for the Urgent Care Clinic, and a Medicare Urgent Care Clinic will be chosen.

JOURNALIST: Do you have any sites in mind? 

BEECHAM: Certainly there were people that applied in the last iteration of the process, and some of those clinics came from Southport. And so they will be canvassed again to see if they're interested. But at this stage, there's no specific site selected yet.

JOURNALIST: What else can be done to address ramping and bed block?

BEECHAM: I think we all need to take our part in it. You know, sometimes people don't know when to go to ED or when to see their GP. So if in doubt, during hours, you could always call your GP and chat to your GP’s receptionist or nurse. You could call 13 HEALTH, that's another option. I know when I was a new mum and my kid had a rash from head to toe, I was really worried about my child. And you know, I've got all the medical education on board to be able to appropriately deal with that. But for new mums, I really feel for them. I find it really hard sometimes trying to help them navigate that process. But certainly, they can talk to their GP during hours, they can ring 13 HEALTH and they can have a look at the PHN website about the Medicare Urgent Care Clinic.

JOURNALIST: Is access to aged care on the Gold Coast an issue that's contributing to bed block and ramping?

BEECHAM: I think that we should all do everything we can to make sure we stay healthy. One of the most preventable admissions to hospital is influenza. We know that each year, elderly people are at risk of going to hospital, children under five are at risk of going to hospital. Flu vaccine is free now in Queensland for everyone, so there's no excuse. For everyone over the age of six months, go get a flu shot. You may just help with the ramping issue; we may be able to keep some people out a hospital. Make sure your child is up to date with all the vaccine preventable immunisations. Make sure you see GP for your chronic disease catch up. We know during the pandemic it was hard for our old patients to come in for their chronic disease, they were frightened about catching COVID. We've now got to catch up all the diabetic care, all the heart failure care, all the renal care, and make sure that everyone's on a correct action plan for when they have exacerbations like asthma flare ups or COPD flare ups. And so they know how to manage their care and not necessarily go to ED, unless they need to.

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