Minister for Health and Aged Care - press conference - 23 May 2024

MEMBER FOR MAKIN, TONY ZAPPIA MP:  Good morning, we're here at the Modbury Hospital, which since 1973, has been providing essential health services to people in the northeast. I'm here with State and Federal Health Ministers, Chris Picton, and Mark Butler, and with Dr Sally Johns. Now, the reality is we know that health is a priority for people right around across the country, but we also know that our health services are indeed under pressure, and we're all very acutely aware of that. The State and Federal Labor Governments, over recent times have been investing huge amounts of money into providing additional services. Services that will meet the needs of the people here in the northeast. I'm pleased to see that both the state and federal ministers are here today to talk about some of those additional services, and with that, I'll hand over to Mark Butler.
 
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER:  Thank you, Tony. It's such a pleasure to be here with my longtime friend and colleague, Tony Zappia, who's been a real advocate for better healthcare services in the northeastern suburbs of Adelaide, and a big supporter of Modbury Hospital here, where we're at today as well. It’s great to be here with Chris Picton and Dr Johns who will answer all of the technical questions about what we're talking about today. As Tony said, we came to government a couple of years ago, with a very clear agenda to strengthen Medicare and to make medicines cheaper. This followed 10 years of cuts and neglect to Medicare that had put general practice, in particular, in its most parlous position for 40 years. That wasn't just an issue for general practice, state health ministers, state premiers like Chris Picton and Peter Malinauskas, were telling us that they were starting to see the results of that disinvestment in general practice show up at their emergency departments because people simply weren't able to get the care they need when and where they need it in the community.

We've had a three point plan to strengthen Medicare, the first was to turn around the sharp slide in bulk billing that we inherited when we came to government. The centrepiece of that agenda was the tripling of the bulk billing incentive in last year's Budget, a $3.5 billion dollar investment to turn that bulk billing rate around. Five months on, I'm pleased to say that we are seeing increases in bulk billing across the country, including an increase in bulk billing of almost 4 per cent here in South Australia. That’s in just five months, the second-best result of all states in the federation. Here in Makin, we've seen more than 10,000 additional free visits to the doctor in just five months, obviously good for people's health, but also particularly good for the cost-of-living pressure that households here in Adelaide and across the country are facing.
 
On bulk billing, can I congratulate Minister Picton and the Treasurer Stephen Mullighan, for the really constructive and mature way in which they've engaged with the College of General Practice and the AMA to bring to a resolution this uncertainty over payroll tax that flowed from a court decision in New South Wales. The announcement yesterday, between the Treasurer, Minister Picton, and the College of General Practice, not only will give certainty to general practitioners, which I know was such a clear objective of Chris Picton in particular, but also will help drive bulk billing as well given the design of the arrangements that Chris and the Treasurer announced yesterday. I really want to congratulate them for that and look forward to other states making similar resolutions over the coming period of time.
 
We've also been very focused on cheaper medicines. Australians have already saved literally hundreds of millions of dollars at the pharmacy because of a range of measures that we've taken over the past two years to make medicines cheaper. In last week's Budget, we announced even further measures, we will freeze the price of medicines for up to five years for pensioners and concession card holders. That will have a huge benefit for the cost of living for those households and we are also freezing the price of medicines for general patients next year as well.
 
The third element of our strengthening Medicare agenda is a network of Urgent Care Clinics. I'm really pleased to announce today that last week's Budget will fund a sixth Urgent Care Clinic here in South Australia, which will be placed in the area around the Modbury Hospital designed to take pressure off the busy emergency department and service the communities in the northeastern suburbs of Adelaide. That announcement is part of a $56 million package from last week's Budget to strengthen Medicare here in South Australia. It is a package that flows from the National Cabinet meeting in December, where the Prime Minister put money on the table for short-term investments, quick investments to strengthen Medicare while Chris Picton and I, and Chris's colleagues from other states and territories continue to negotiate a new hospital funding agreement for the next five years, those negotiations are still underway.
 
I'm delighted that the projects that Chris and his department put forward to the Commonwealth for funding through that program, were incredibly innovative projects, particularly focused at better care for older Australians here in South Australia. To prevent them from having to go to hospital in the first place if they don't really need to, and can be adequately cared for in other settings like aged care facilities, and if they do have to come to hospital, that they're able to move through the hospital system as quickly as possible, obviously, in an appropriate clinical way, but as quickly as possible to other care settings to free up those hospital beds for other South Australians. I've been saying this around the country, some of the programs that Minister Picton and his department and clinicians, like Sally who have been leading here in South Australia, are among the best I've seen anywhere in the country. They're innovative, they're working, and I'm delighted that through this $56 million package, we've been able to provide investment from the Commonwealth to help support not just Chris, obviously, but clinicians like Sally, and the department here, continuing that terrific work. I might hand over to Chris Picton and then happy to take questions.
 
 
SOUTH AUSTRALIA MINISTER FOR HEALTH AND WELLBEING, CHRIS PICTON MP: Thank you very much Mark. It's great to be here at Modbury Hospital today to outline how this funding is going to make a difference for our hospitals and our healthcare here in South Australia. I want to thank Mark and his team for their co-operation, working with South Australia, and addressing some of these fundamental challenges that we face across our broader healthcare system. Obviously, not just what we control as a state government and how that interacts with primary care and aged care, which are predominantly responsibilities of the Federal Government as well. While we've put more and more money into our public hospitals, from the state perspective, hiring additional doctors and nurses, it’s that interaction with primary care and GPs, and also aged care, that does put pressure on our public hospitals as well that we need to address.
 
So in particular, I have been having discussions with Mark for well over a year in terms of the issues that we face in terms of aged care in our hospitals. As of this morning, we have 190 patients who are currently in SA Health, in our hospitals and in other beds that we have across the system, who are waiting for aged care places. That's the equivalent number of patients of this entire Modbury hospital behind us, who need to be in aged care who are waiting for aged care but can't get into aged care. So, that's a big change. If we can address that blockage of people leaving our hospital system to get into aged care, then that helps up free up capacity. It not only helps those people who will get better support and ongoing care in aged care rather than being stuck in a hospital bed but frees up the next bed for somebody who's coming from the emergency department, frees up the next emergency department bay for someone from the waiting room for the ambulance ramp as well. That's critically important to make sure that we get flow happening through the system.

Our aged care providers are under the pump, they are, you know, obviously, wanting to make sure that they don't get into trouble in terms of taking people who are complex and difficult without the support that they need in place. At the moment they don't feel like they have that support. We're addressing a real decade of missed opportunity addressing that. Just before Mark left office in 2013, he was Aged Care Minister putting extra money into dementia care to help address this problem, that was then cut as soon as the Abbott Government took office. What we're now having to do is turn that around, providing additional support for aged care so that they can help take these aged care patients and then free up the hospitals.

The biggest component of the funding that is being announced today, is going into a geriatric flying squad. This will be doctors, nurses and staff from SA Health going out to aged care providers to help them with the transition of people from hospital into aged care, particularly those people with complex needs to make sure that their better supported and aged care providers are more willing to accept them and get them out of hospital. In addition, making sure that they're less likely to come back to hospitals afterwards and bounce back into hospital, which is not only bad for the broader healthcare system, but it's actually a poor outcome for those people themselves to be in and out of hospital all the time. There's been some models of this tried interstate, but I think we will be rolling this out on a comprehensive statewide basis for the first time around the country. We're confident that this is what's needed to help address those 190 people who do need to be somewhere else and free up those beds for other people who need that care. In addition, we welcome all the other components of this funding and the additional support that's going in from the Commonwealth Government into dementia care, into aged care supports into the Urgent Medicare Centre as well. That will help in this catchment here at Modbury Hospital, which we know is an ageing population, which we know has difficulties for people being able to access GPs. Thank you, Mark, we look forward to co-operating with you. To answer all the technical details of how this will work, I'll pass over to Dr Sally.
 
NORTHERN ADELAIDE LOCAL HEALTH NETWORK HEAD OF GERIATRIC UNIT, DR SALLY JOHNS: Thank you, my name is Sally Johns. I'm a geriatrician and the Medical Head of Unit for the Northern Adelaide Geriatric Service, which is based here at Modbury and also supports the Lyell McEwin Hospital. I'd like to thank the Ministers not only for this announcement, but also for their significant investment that it is. It is a welcome announcement and investment in the care of older people and in supporting our public hospital system more broadly.
 
As a clinician, I know firsthand that when particularly our older people are acutely unwell, they come to our hospital and they need to have their acute care needs met. But once they've received their initial treatment, and as they begin to recover, the hospital may not be the best place for them to continue to be receiving their care. Particularly for our older patients with dementia, to be able to have their care delivered within a familiar environment, and with their familiar residential aged care facility staff supporting them can make a huge difference both to them and to their families. This is a very welcomed announcement and investment to allow for this new initiative for us to partner with the aged care sector, and to work alongside the residential aged care facility staff to support the transition of older people from our acute hospitals, back into their usual place of residence, and to ensure that their care can be met with the best possible care delivered in the right place, thank you.
 
JOURNALIST: Dr Johns, when it comes to older South Australians that you're treating in Adelaide, north and northeast, are you seeing more complex patients at the moment relative to even pre-COVID and sort of four or five years back?
 
DR JOHNS: I think we certainly have an ageing population and with ageing comes increasing complexity and increasing health needs. That is reflected in what we are seeing in our hospitals, but also in what our colleagues who are working in residential aged care are also working with. So yes, I think there is an increase in the in the challenges in delivering care, and we need to be ready to meet those challenges.
 
JOURNALIST: Does that increasing complexity also create problems outside of a hospital setting, say in an aged care setting, trying to handle those complex patients that might be trying to move back out of the hospital?
 
DR JOHNS: No doubt that work in aged care is a very complex space, and particularly some of these patients have highly specialised needs. They need the support of the specialist teams from the hospital to be able to support their care, which is what this funding and what this initiative will be able to provide.
 
JOURNALIST: Of the 190 that was mentioned before, how many do you think would be able to be moved out of the hospital system under this new plan, the flying squad?
 
DR JOHNS: We certainly take a very patient centred approach which focuses on the individual patient, what their care needs are, and what needs to be done in order to meet those care needs. There would be a significant proportion of those patients who could have their care needs met within an aged care facility provided that the right supports are provided to come alongside those residential aged care facilities.
 
JOURNALIST: All the 190 wouldn't necessarily be able to be moved out?
 
DR JOHNS: I think the complex needs of the individual patient needs to be considered on an individual basis, and for many of those patients their care needs could be delivered elsewhere.
 
BUTLER: Can I say in response to both of your questions, in addition to the funding the state governments for this flying geriatrics squad, there is also a program that we are funding in this package for higher level dementia needs - level six and level seven dementia needs  patients who are probably not able to be cared for in a standard aged care facility in spite of the fact that we've substantially lifted the staffing capability of aged care with our investments over the last two years. There's a couple of different approaches here to being able to see people leave hospital and get care out in a community that is appropriate to their needs.
 
JOURNALIST: You flagged the payroll tax issue that was dealt with yesterday. Are you satisfied that's getting the balance right in a South Australian context?
 
BUTLER: I think the evidence of that is the fact that the Treasurer, Minister Picton, and the President of the College of General Practitioners were able to announce this together. What I had been saying is I recognise that payroll tax was a state responsibility, but obviously, as a government that was putting very substantial investment into general practice, in part, after calls to do so from state governments, I was hopeful that state treasurers and health ministers would sit down with doctor representatives, particularly the College of General Practice and work through this difficult issue in a constructive and mature way. I think the evidence is there to see from yesterday's announcement that that is exactly what the Treasurer here in South Australia and Minister Picton did with the College and I think it's a terrific outcome.
 
JOURNALIST: When are the other locations of the new Urgent Care Clinics funded in the Budget going to be announced?
 
BUTLER: Over coming weeks. These are locations that we've talked through with state governments. Frankly, some state governments, as they thought through what their per capita allocation of the funding the Prime Minister announced in December was clear to them. Some states have decided that they would like to withdraw some of the efforts they're making in primary care and have the Commonwealth pick that up. Some other states have a particular focus on trying to clear their hospitals of the long stay older patients that Minister Picton and Dr. Sally have talked about. This is not a particularly South Australian issue, this is something that we're seeing right across the hospital systems nationally. Those announcements will be made over the coming weeks. Every state receives a per capita allocation that reflects their population share, relative to the money that was announced by the Prime Minister. There's a slight difference between states about their sort of emphasis. I think it's been really clear here in South Australia that the State Government, the clinicians, the Department, and particularly Chris Picton have been very focused on trying to find innovative ways to clear the beds of people who have been in hospital and now clinically able to be discharged and just need an appropriate level of care support out in the community.
 
JOURNALIST: Can I ask you about COVID, earlier this week, the Queensland Chief Health Officer said the new highly transmissible FLiRT variant had arrived in Australia. With this in mind, given the rate of other respiratory illnesses in the community at the moment, how worried are you about FLiRTS arrival in Australia?
 
BUTLER: What we are starting to see, Chris might want to talk about the South Australian situation, but what we are starting to see over the last few weeks across the country is COVID cases starting to rise. This is a little bit more difficult to measure than maybe it was 12-24 months ago, because testing is not as common but using some other metrics like cases in aged care settings, which are much more rigorously tested, and hospitalisations for COVID, we are starting to see numbers climb across the country, after the long summer wave had started to taper off over the course of March and April. We're focused on that, particularly coming at the beginning of winter, and being a little bit more contemporaneous with the rise in flu cases than we've seen over the past couple of years. I think it is a reminder, first of all, for healthcare and aged care settings to be very focused on this. But for the community, if you haven't had a COVID booster, if you haven't had your flu shot yet, now's the time to consider getting that. We're very focused on it. I'll be having a briefing with the Chief Medical Officer in the next few hours to get an update about where those issues are up to in aged care settings in particular, which obviously house our most vulnerable people.
As to the nature of this variant, I'll be getting some more advice later today, but the advice I've got is this is of a type with the Omicron. Some variants that we've seen now for a couple of years they’re certainly a little bit more infectious or transmissible than the earlier COVID variants, but not as severe as a variant like Delta was in 2021, for example. So there's a new name, and a new sub variant but it is as I'm advised over time with the Omicron sub variant we've been dealing with now for a while,
 
JOURNALIST: You’ve mentioned keeping up to date with vaccination, but is there any other community messaging you want to get out there at this point in time as this highly transmissible variant comes into the country?
 
BUTLER: Vaccination is obviously your best protection against severe disease, particularly if you're older, particularly if you have a compromised immunity. If people are sick we encourage them, I'm sure all health authorities, encourage people to stay at home and not put others at risk, particularly stay away from vulnerable settings for hospitals and aged care facilities. I think Australians have come to understand very well, the idea of COVID safe behaviour. We're getting into that winter season, again, we're starting to see COVID cases rise again, as they have been doing now for a while, every four to six months. It's just a reminder, again, as we particularly get into a season where there will be more flu, there is a little bit more RSV, that the coincidence of these three respiratory illnesses do pose some particular challenges to healthcare systems, to aged care. It's just a reminder for people to update your booster if you haven't, and to be COVID safe, if you're sick, make sure you isolate yourself.
 
JOURNALIST: How's the South Australian health system coping with this increase in respiratory cases we're seeing at the moment?
 
PICTON: I was just speaking to the Chief Executive about this this morning, our hospitals are very busy, but it's not entirely driven just by respiratory issues. We are seeing ageing of the population, that's the predominant issue that leads to increases in terms of the pressure on our hospital system, not just here in South Australia, but across the country. But we're obviously very mindful in terms of respiratory illness, and if there's an affect there. People who get sick and need hospital care, but one of the other affects is in terms of impacts upon our staff as well, and staff absences that we need to be mindful of as well. As Mark said, we're obviously going through a COVID wave at the moment, but we've been through a COVID wave every few months, for the past few years. So we know what the impacts that that has are, and it's a timely reminder for the community to make sure you're up to date with the vaccinations for COVID and the flu. But also, those key public health messages that we've been talking about for years haven't gone away, and to make sure if you are sick, please stay away from vulnerable people, vulnerable settings, particularly aged care and hospitals. You might be not too bad, your friends might be not too bad, but somebody else might get a lot sicker from COVID or the flu than you would, and you're going to look out for them to.
 
JOURNALIST: Following up on that, and given what the Federal Minister has said to you, are you concerned that there's a level of complacency that's kicking in at the moment with regards to those basics that we followed through the particularly the peak of the pandemic when it comes to hygiene and staying away if you are unwell?
 
PICTON: I think it's a balance. I don't think anyone's advocating that we go back to 2020 type policies or practices. I think it's a sensible approach if you are sick, to stay away from people, particularly if they're vulnerable. That's a consideration that we should all have for people in our community, and that's what we'd encourage people to do.
 
JOURNALIST:  How are these geriatric flying squads going to work and when can they get up and going?
 
PICTON: We'll be working to get these up and running as soon as possible. Dr Johns, her team and all of our other local health networks, will be working very busily, now that we've got this announcement from the Commonwealth Government to get these up and running. This is going to be working in partnership with aged care, and we've been doing this on a number of fronts. Mark referred to earlier what we've put in place already, where we are in reaching into aged care with our virtual emergency department through the virtual care service. That has actually led to a reduction in terms of the number of ambulances that have been going from aged care homes to our hospitals. We think this will be an extra step forward of actually having that flying squad being delivered. We hope to see staff coming on board over coming months.
 
JOURNALIST: Chris on radio this morning, women were waiting, I think, up to a month for their results of mammogram testing. Are you aware of the delay at the moment?
 
PICTON: We have seen a big uplift in terms of the demand for people coming through BreastScreen. We are putting in place additional staff to manage that, particularly radiologists, who are the doctors who analyse the results. We're putting in place an additional six of those doctors to make sure that we can meet that demand. We're doing that training and onboarding as soon as possible, because we know that it's important to make sure that we get timely results.
 
JOURNALIST: Have there been issues from recruitment? Is that what's contributed to this or how this has built up?
 
PICTON: I think what we've seen is a really big uplift in the past few months. So compared to where we were a few years ago, pre-COVID levels even, before we saw that big dip through COVID, we’re about a quarter higher in terms of the number of women we're seeing. That's great and it is fantastic that women are coming forward. I think it's a combination of things, I think the Commonwealth Government have helped us do some advertising campaigns, which have helped that as well. We need to now put those additional radiologists in place. We have recruited those six. They’re doing the training and onboarding at the moment. That will help to bring those turnaround times for the analysis down.
 
JOURNALIST: But when will they be ready to go? How long is this training?
 
PICTON: I understand that first couple will be completing their training within I think weeks or next month or so, and then the other four will take a couple more months as well.