MEMBER FOR BOOTHBY, LOUISE MILLER-FROST: Thank you so much for coming down. I always love doing press conferences here at the Marion Domain Medical Centre, where we of course have our Urgent Care Clinic. This is such an exciting place. We've had over 16,000 people coming through, fully bulk billed, getting their urgent care, and staying out of emergency departments because they didn't need to be there. They needed urgent care, they were too sick to wait for their own GP, but not bad enough to go to an emergency department, and that's what the Urgent Care Clinic is about, and it has been such a success.
Having worked in the health sector for so long, I love a good health announcement, and we've had so many over the last three years. We had the tripling of the bulk billing incentive, which has resulted in a 4.2 per cent increase in bulk billing right here in Boothby. We had cheaper medicines. We had the rebuild of the Flinders Medical Centre, which has already started. It has resulted in 52 extra beds already open, between Flinders Medical Centre and the Repat Health Precinct, including the geriatric evaluation and management unit at the Repat and the Margaret Tobin Mental Health Centre, which is being expanded as we speak. It's a real honour to welcome Minister Mark Butler here, following yet another fantastic announcement. Thank you, Mark.
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Thanks so much, Louise. Thank you to Dr Carolyn and Dr Max for joining us today and for the work they do, particularly rolling out this exciting, relatively new model of care for Australia, the Medicare Urgent Care Clinic network, which we kicked off in 2023. Our approach to strengthening Medicare has been pretty simple. It's about more doctors, more bulk billing and more Urgent Care Clinics, and we've been delivering on all three of those points right through this term of government.
On Sunday, we announced the latest and biggest chapter of our strengthening Medicare investments. As Louise said, in 2023, in response to a very clear view from doctors that bulk billing was in free fall, we tripled the bulk billing incentives that GPs receive when they bulk bill pensioners, concession card holders and kids under the age of 16. That has worked as we intended. Bulk billing for those Australians now sits comfortably above 90 per cent. More than 9 in 10 visits for those Australians to the doctor are bulk billed. What it has meant in South Australia is a 4.2 per cent increase in bulk billing. The second biggest increase of all states, and last year alone, about half a million additional bulk build or free visits to the doctor that otherwise would have seen people having to dip into their pocket and pay a gap fee.
We have also been busy trying to make sure that there are more junior doctors in general practice training. This year, there are more junior doctors training as GPs than there has been at any time in our history. We know we need to do more, which is why Sunday's announcement included such a significant investment in expanding the medical workforce, expanding the number of nurses and midwives able to do postgraduate training as nurse practitioners and endorsed night midwives, and particularly trying to channel those extra doctors and nurses into primary care, because we know that is the backbone of a well-functioning healthcare system.
Then there is our network of Medicare Urgent Care Clinics. We promised 50 at the last election and we have delivered 87. They are working fabulously well, delivering high quality urgent care through doctors like Dr Max here, taking pressure off emergency departments like the Flinders Medical Centre, and seeing about 1.2 million Australians fully bulk billed.
Sunday's announcement was about turning around bulk billing for the rest of Australia, for middle Australia, those Australians who don't have access to a concession card but are seeing their bulk billing rates slide. These aren't wealthy Australians. The concession card kicks out at about $40,000 for a single person, which is substantially below the minimum wage, and $70,000 for a household. The bulk billing rates for those Australians is now at about 60 per cent and it's dropping.
We are determined to turn that around, because for Labor, bulk billing is the beating heart of Medicare. It always was. We know it has been hard fought. The AMA fought it when Bob Hawke introduced Medicare 41 years ago. John Howard called bulk billing “an absolute rort”. And of course, Peter Dutton, when he was Health Minister, tried to abolish bulk billing altogether, because he said, in his words, there were “too many free Medicare services”. Peter Dutton tried to impose a tax on every patient, every time they went to their GP, but we stopped him doing that. Instead, Peter Dutton froze Medicare funding for six long years, which took about $8.3 billion out of the Medicare system, according to the AMA.
The investment we announced on Sunday effectively puts in what Peter Dutton ripped out of general practice. We're confident it will turn bulk billing around for middle Australia. We're confident that, in time, we will get back to 9 in 10 visits to the doctor being free. That will deliver about 18 million additional free visits to the GP every single year. It is a very substantial investment.
On Sunday, within minutes of our announcement, Peter Dutton practically tore a hamstring finding a microphone to match our commitment, which was pretty surprising, given the decades long opposition to bulk billing that the Liberal Party and Peter Dutton in particular has had, and the strong philosophical view they have that Medicare should be a safety net scheme with a strong focus on ‘user pays’. That's why, of course, Peter Dutton tried to introduce a GP tax.
Anne Ruston let the cat out of the bag yesterday, showing that the Coalition’s announcement on Sunday had all the sincerity of a fake tan. Anne Ruston, yesterday, said that the Coalition has "never supported the idea that the only card you should take to the doctor is your Medicare card”. Well that is what bulk bulling is, the idea that you only need to take your Medicare card, and can leave your credit card at home. All you need is your Medicare card. If you don't support that idea, you don't support bulk billing. That has been the view of Anne Ruston for years. It has been the view of Peter Dutton that users of Medicare should pay.
Australians have a very clear choice at this election. Why would you trust Peter Dutton, who created the mess we currently have around bulk billing, to fix it? He has always opposed bulk billing as a concept and Anne Ruston, only in the last 24 hours, has reiterated that opposition, and their philosophical commitment to ‘user pays’ in Medicare.
I will now hand to Dr Carolyn and then I will take questions.
DR CAROLYN ROESLER: Thank you. I echo the sentiment of all GPs, and especially within the ForHealth organisation, that we are very grateful and welcome these reforms to Medicare. As you've heard, it will strengthen and really promote that general practice is a great career to choose. We also know what every GP wants is that Australians can start to get back on top of their health.
Nothing is more demoralising and depressing to see across my work in general practice, and I bulk bill by the way, but in urgent care especially, where we're seeing young people present with very significant illness. We're seeing people with chronic illness who have not been able to avail a GP appointment. We know this is also what they're seeing in the emergency departments with the overcapacity. These patients are really having to make a choice and getting their health checks is something they just cannot afford. For people to not be able to get their screening and preventative healthcare and a face-to-face with doctors, we know is having a really significant and a detrimental effect, especially on the middle class. We know, especially in areas of mental health, it's absolutely critical that there is an affordable system whereby patients can come and see a GP, and it doesn't have to be a financial burden. I think we all, in our bulk billing clinics especially, are really, really positive that this can bring about a change. I think that for patients with chronic health issues, who are opting to not get their medications filled, to not come and get blood tests, this gives GPs a choice now, and it opens up ways that they can see these patients, and see them more frequently. To have a diabetic attend your clinic eight times a year achieves far better outcomes than someone coming in twice a year, and that GP having to load these consoles. For continuity of care, to get back to the very core of primary care, is giving the middle class and all Australians an opportunity to enjoy good health, which should be something that we don't have to make a decision about.
DR MAX ADAMS: I am a doctor at the Marion Urgent Care Clinic and I’m definitely not alone when I say this is going to help millions of Australians. It's going to help people see the doctor, affordably and locally. It will be without the barriers that, as Carolyn described, has meant in the last 10 years, people have often presented late to get their health care, or have received care in a more expensive environment, such as emergency department, which could have been avoided if people were able to afford to see their GP.
I'm so excited that not only is money going into general practices that are in existence today, and Urgent Care Clinics, but also in developing and encouraging future trainee doctors to start general practice. We have been seeing a huge drop in general practice trainee positions being filled in recent decades, but in the last few year things have really turned around. I think that is because of the investment that Labor has made, and the signalling they have made to say to young doctors, medical students and junior doctors in the hospital, that general practice is a viable career path, it's something we should be proud of, and is the backbone of the healthcare system.
I commend Labor on the way in which they are putting this money into primary care. Not just that the money is going in, but also the combination of things that they are putting it into. It's exciting too, in my opinion, that nurse practitioners are going to get additional support to train and prepare for primary care positions.
Thank you very much.
JOURNALIST: Minister, the ABC has spoken to a South Australian GP who says that with these changes, doctors will still be out of pocket, with the proposed rebate. So do you concede that there is a shortfall there?
BUTLER: We have modelled this really carefully and our modelling indicates that the majority of general practices across the country, including here in South Australia, will be better off if they take up our offer to bulk bill all their patients.
Not only, for the first time, would they get the tripled bulk billing incentive for non-concession card holders, so for all of their patients. But on top of that, they will get, for the first time, a 12.5 per cent loading on their rebates, if they bulk bill all of their patients that come through their door.
Our modelling is very clear. We have a good line of sight of general practice income, practice by practice, and we are able to model which practices will be better off and which won't. We are confident that for the majority of practices across the country, it is in their financial interest to take up this offer and become fully bulk billing practices. For the rest, they will continue to maybe to charge gaps to some patients coming through, on higher incomes. That's why our modelling indicates we'll get to about 9 in 10 free visits to the doctor. People on very high incomes may still be charged a gap, but I am really clear that this is in the interest of general practice.
I do want to say though, that in some of the commentary since Sunday, some doctors have said they would prefer if we just gave this money through an increase to the rebate, with no strings attached. I understand why some doctors or practice owners might want that, but I couldn't in good conscience do that without guaranteeing a good patient outcome on bulk billing. As I said earlier, bulk billing, for Labor, is the core mission of Medicare. The idea that everyone should access the best quality health care available in this country, which is the best quality health care available on the planet, no matter what their income, no matter what their means, no matter whether they have a credit card or not. This is contrary to what Anne Ruston says, but we make no apology for attaching strings to this additional money. We want a good outcome for patients on affordability and bulk billing.
JOURNALIST: Minister, health insurance premiums are set to rise by 3.73 per cent. How can you justify the highest jump in seven years?
BUTLER: This has been something I've thought about and worked on for some months with the insurers. You can see from media reports, a number of insurers were seeking premium increases of about 6 per cent. I went back to insurance companies over the summer, three times, to require them to sharpen their pencils and bring their claims down. I sought advice from the Department of Health and Aged Care, and also the Australian Prudential Regulation Authority, which has responsibility for ensuring that our private insurance system and our private hospital sector are both viable.
We came to a very clear view that this was the right balance. I have been determined to squeeze out of the insurers the best outcome, in patients’ interests. I need to maintain a viable private hospital sector, but my overarching objective has been to get the best possible deal for patients, and I’m confident we've done that.
Over three years, the private health insurance increases over our term of government have averaged 3.2 per cent. Over the nine years of the former government, they averaged 4.2 per cent. The highest increase over the last 20 years was Peter Dutton's increase when he was Health Minister, which was a whopping 6.2 per cent that he courageously rolled out on Christmas Eve in 2014.
At the same time, Peter Dutton also cut the private health insurance rebate for 2 million Australians, leaving them further out of pocket. I re-introduced indexation of that rebate for millions of Australians.
Of course, this will be an imposed on all households at a tough time. I understand that, but I've squeezed the best possible deal out of private health insurers that I thought was consistent with a viable private hospital sector.
JOURNALIST: What impact it would have now if Australians decide they can't afford private insurance?
BUTLER: I encourage all Australians with insurance right now, or who are thinking of taking out private health insurance, to shop around. The 3.73 per cent increase is a weighted average across the industry, but if you go to our website, health.gov.au, you will see the 29 different insurance funds are all proposing quite different increases.
We have a very reliable website, privatehealth.gov.au, which is moderated by the Private Health Insurance Ombudsman. They are a very independent, reputable office holder. That website gives all Australians access to every bit of information that they need to make the best decision for them. Such as, prices, what is on offer, what is covered, and the extent to which benefits get paid. I encourage all Australians to shop around, as this is a competitive marketplace. Some insurers are proposing increases above 3.7 per cent, and some are considerably below 3.7 percent. Every Australian, if they're thinking about maintaining insurance, should be confident that they are getting the best possible deal in the market.
JOURNALIST: Can this rise be justified when insurers’ low payments to hospitals are driving closures of maternity units around the country?
BUTLER: I am really concerned. First of all, this is an increase set against what is happening with payouts. Payouts are for hospital activity over the last year have increased by about 7.5 per cent. That increase reflects activities are returning to hospitals after COVID. Health inflation, which measures the costs in the health sector, rather than broader economy, is running at about 4 per cent, which is above what I have approved as an insurance premium rise.
But you're right, there is a broader challenge out there in the private hospital and private health insurance sector, particularly in two sectors. I am most worried about mental health, particularly psychiatric hospitals, and maternity services. I was down in Tasmania yesterday announcing Commonwealth support for the Tasmanian Government and Calvary Hospital, to expand their birthing unit capacity, to pick up the slack after Healthscope suddenly announced they would be pulling their maternity services out of Hobart, and also Darwin. We're doing what we can to ensure that families have choice, particularly to ensure families who've paid hard earned cash for private health insurance coverage, only to have that ripped away from them through a very sudden decision by Healthscope, can continue to exercise choice.
JOURNALIST: What would a re-elected Labor Government do to reduce specialist fees?
BUTLER: We will have more to say about that over the near future. My major focus around affordability has been on general practice and on medicines. We have saved Australians around $1.2 billion through cheaper medicines policies, some of which were really hard fought. They were opposed by some of the lobbies involved in pharmacy, they were opposed by Peter Dutton, who voted against these measures. But I was determined to push through measures that not only cut the cost of medicines, which is good for the hip pocket, but also got better health outcomes, and made sure people could get their scripts filled.
We have been focused on cheaper medicines and the affordability of going to the GP. But I have said very clearly, including to the AMA, growing out-of-pocket costs for visits to non-GP specialists is increasingly becoming a ‘BBQ stopper’ in Australia. They are growing very fast. Bulk billing rates for visits to non-GP specialists is way lower than for GPs.
A re-elected Albanese Government would start to develop measures, in consultation with patient groups and doctor groups, that start to deal with the affordability question for people going to non-GP specialists. It is becoming a growing impost on people's access to healthcare.
JOURNALIST: What is your message to people who have had a rate cut and felt a bit of relief and now this, and just maybe feel like these ongoing cost of living pressures never end?
BUTLER: My message would be, we hear you. We know that households are continuing to experience significant cost of living pressures. I would also reassure them we have worked hard over the last few months to squeeze out of private health insurers the best possible deal, which I think is consistent with viability of the private hospital and private health insurance sectors. They want these sectors to survive, obviously and thrive. They provide about two-thirds of all elective surgeries in this country. It is important that we have a viable sector, but I've worked really hard to make sure that they get the best possible deal through this premium round. It's a deal that's below health inflation, which is the cost based that insurers and hospitals work on. But we are doing everything we can to deal with cost of living pressures that households are experiencing, whether that's the energy bill relief we have provided, tax cuts that flowed over the past 12 months to every single tax payer, not just to some, and what we've done in areas like health and child care as well.
JOURNALIST: I think we've all had an experience where a private health cover hasn't covered something you might have expected that it would. Have health insurers indicated they're willing to do anything to make products better value for money?
BUTLER: There are really two things I would say in response to that. The first is to reiterate what I said earlier, that people should avail themselves of this independent information on privatehealth.gov.au and compare what is out there in the market, because there are lots of different private health insurance products, that all offer different types of cover and prices.
This is an issue, for example, in maternity services. Only gold insurance products are required to offer maternity, which I think is constraining the choice that families have or want to have around these things. I have put a range of ideas before the CEOs forum that I created, which includes CEOs of the major insures, the major hospitals, patient groups, and clinicians represented by the AMA. They would include, for example, a requirement that all levels of insurance, not just gold level, would have to offer maternity services. I think that would be an important change to offer more choice to families. That's just one example of a series of ideas that we have put to the sector about reform and a sector that affect really requires it.
Thanks everyone.