Minister for Health and Aged Care - press conference - 27 June 2023

Read the transcript of Minister Butler's press conference in Wyong on Voice to Parliament; health policy; Aboriginal and Torres Strait Islander health; Closing the Gap.

The Hon Mark Butler MP
Minister for Health and Aged Care

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MEMBER FOR ROBERTSON, DR GORDON REID: Good morning, everyone. Thank you so much for coming out today. I'd firstly like to start by acknowledging the traditional owners of the land upon which we meet and pay my respects to all Elders past, all Elders present and all Elders emerging and recognise that the land upon which we learn or the land, the land upon which we love and the land upon which we heal, always was and always will be Aboriginal land. It's exciting that at the end of this year, after October, the Australian people will have a chance to have their say in a referendum to not only recognise Aboriginal and Torres Strait Islander peoples as the first peoples of this country, but also constitutionally enshrine a Voice to Parliament so that we can listen and we can hear from Aboriginal communities about the laws and the issues that will affect our people. I, too, want to thank Belinda and the team here at Yerin for showing us around their tremendous and their terrific facility here at Mardi. They do such fantastic work with Aboriginal communities here, the over 17,000 people who identify as Aboriginal and Torres Strait Islander here on the Central Coast. The work they do is absolutely phenomenal in not just providing that frontline medical care, but also providing that preventative health that social, emotional and spiritual wellbeing and support to make sure that people are cared for in a holistic manner. And finally, I want to thank the Health Minister, Minister Mark Butler, for making the journey to the Central Coast. Mark knows the importance of health services here on the Central Coast and to our Aboriginal Medical Service, here at Yerin Eleanor Duncan. And with that, I'll pass over to the Health Minister Mark Butler.


MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Thanks very much, Gordon and I particularly want to thank Belinda and her team for showing us around this terrific Aboriginal Medical Service here in Wyong, the Yerin Eleanor Duncan service. I also want to acknowledge the traditional owners of these lands and echo the acknowledgement that Gordon gave to those Elders. Gordon is playing such an amazingly terrific role as a Member of our caucus, particularly as a strong advocate for better healthcare policy across the nation, but most particularly here on the Central Coast. This is a region that has real challenges with the availability and the delivery of healthcare services. Gordon has been advising me and the government, more broadly, on ways in which we can alleviate those challenges by, for example, allowing the entire region to recruit overseas trained doctors, a really important change that we made very soon after coming into government, a change that was strongly advocated by Gordon. But also, policies that were the centrepiece of our Budget in May to lift bulk billing rates, because we know unfortunately, that the Central Coast and the Hunter Valley, for that matter, have some of the lowest bulk billing rates in the country. So tripling the bulk billing incentive, lifting the Medicare rebate by the highest amount in more than 30 years, all of these things are going to improve the availability and the affordability of healthcare services on the Central Coast, and have been deeply informed by the advocacy of Gordon, who obviously is an emergency physician who's worked at the two major hospitals in the Coast and has such experience there.


Now, I want to talk a little bit about the referendum later this year. The Australian people will, as Gordon said, get the chance to vote to change our constitution to recognise the place of First Nations people in our country. More than 30 years since the High Court first swept aside the legal fiction that this was somehow vacant land when Europeans arrived more than 200 years ago, recognition is long overdue in the country's founding document. But they'll also get the chance to vote to give shape to that recognition through a Voice to Parliament, to listen to allow the Parliament and members of the executive like me, as the Health Minister to listen to the voices of First Nations people about issues that particularly impact them. I can't think of an area of policy where listening to those voices will be more important than in health.

For far too many years, the Australian Parliament, Health Ministers of both political persuasions, and the community more broadly, have been confronted with frankly appalling statistics about the health gap between Indigenous and non-Indigenous Australians. Indigenous Australians are seven times more likely to die of kidney failure than non-Indigenous Australians. The suicide rate among young First Nations people is twice that of young non-Indigenous people. And while we were able to get the rate of cancer deaths down over the past decade by 10 pe cent across the country - a terrific achievement - cancer deaths rose by 12 per cent for Indigenous Australians. These are broad health challenges that unarguably are impacting Indigenous Australians very differently. But there are also health challenges that impact Indigenous Australians that are largely unknown to the rest of the population. Take rheumatic heart disease, for example, a condition that was largely eradicated in developed countries more than 50 years ago. Doctors working in our major cities will likely never see a case of rheumatic heart disease in their entire career. But in remote Aboriginal communities, you find some of the highest rates of rheumatic heart disease in the world, a debilitating condition usually contracted in childhood that can either cause death, or the very least, lifetime cardiovascular disease. This is a condition of grinding poverty. And you see those rates in remote Aboriginal communities, some of the highest in the world even outstripping areas like Sub-Saharan Africa, the poorest region on the planet. We've known all of this for so long now, none of this is news. And with the best of intentions, substantial investment, terrific work by organisations like the AMS here at Yerin, still, we are not seeing the gap close at all.

We have to be honest and say that the current approach just isn't working and in those small areas where it is working, it's just not working fast enough. I know as Health Minister, our government knows, I think First Nations Australians know and so many more broadly in the community know, that a new approach is needed. And it's needed more in health policy than any other area of policy that I can think about. That new approach can be delivered by a constitutionally enshrined Voice to the Parliament, and to the Health Minister of the day so that we can start to close those gaps. We can give Aboriginal and Torres Strait Islander people of our country longer, healthier and happier lives. Happy to take questions.


JOURNALIST: You've had a really informative tour hear at Yerin now and hearing a lot of the aspirations what they do here, but also what they're aspiring to do. How would the Voice facilitate that?


BUTLER: Yerin does amazingly terrific work. As Belinda was saying to us earlier, their instinct is to work in a transdisciplinary or multidisciplinary way rather than in the sorts of silos that tends to characterise governments of countries like Australia. Our challenge is to intervene earlier, our challenge is to prevent some of those health conditions I talked about that afflict Indigenous Australians at such higher rates from emerging in the first place. And that means listening to First Nations people about ideas of prevention and early intervention that will be engaged by their communities. We know that ideas that will work in communities like the communities of Indigenous Australians, are developed by those communities themselves. That's why Parliaments and Health Ministers like me, should be listening to those voices. We also know that the solutions to so many of the challenges I just talked about are not particularly health solutions. They also touch on housing availability, on poverty, on the availability of good job opportunities and learning opportunities to keep young Indigenous Australians engaged and positive and happy about their circumstances. So just getting health advice, or just getting housing advice won't allow us to get to the root of these problems. And that's really what the Voice will allow the Parliament and the executive government to do: they'll be able to think about these issues in a much broader holistic way that mean we can get to the root of the problems before they emerge.


JOURNALIST: Specifically, what are some of the key messages that you've taken away just from your time here?


BUTLER: There are some specific issues that that Yerin very rightly took the opportunity to raise with me about how some of the programs have been delivered by the Commonwealth Government as well as the New South Wales government, just to make their lives easier so that they can do the work that I know they can do so well, if government makes their lives easier. I think that the broader message that we were hearing about the importance of transdisciplinary care, of not just working in silos, which too often governments do, was a very strong message from the team that we that we met with today and why they told us does such strong supporters of this constitutional change to recognise the First Nations people in this country, but to give shape to that recognition through a Voice that allows the Australian Parliament, the Australian Government to listen to the views of Aboriginal and Torres Strait Islander people.


JOURNALIST: You mentioned you are doing an audit of the Closing the Gap. I suppose some of the issues that were raised today about either being penalised for doing well or, you know, having KPIs put upon services here when they know they can perform better, will that form part of that audit as well?


BUTLER: It will, it's exactly the sorts of issue that we committed to as governments. I mean the former government signed that document, the Closing the Gap Implementation Plan, and a very clear commitment within that Plan was to ensure, as far as possible, that services for Indigenous Australians were delivered by Indigenous Australians. We've just seen a fantastic Aboriginal Community Controlled Health Organisation here that can deliver so many of these services. So that audit will allow us, as a government, to step through all of the services and where there's an appropriate transition that can take place between a non-Indigenous service organisation to an Indigenous service organisation, we’ve committed, the former government committed, to doing that and I intend to carry through on it.


JOURNALIST: What about the PHN, it’s been described as an unnecessary layer, will you give some consideration to maybe reviewing that and the role of the PHN?


BUTLER: The Primary Health Networks are an important part of our healthcare system, they do allow a degree of planning and commissioning to take place across a region and they have a very important role to play. We're committed to keeping the PHN network in place, 31 PHNs, across the country. But of course, there's always room for improvement and the delivery of those services and the sorts of services that PHNs have the responsibility to commission or to deliver in the first place. I think that's really the message we got today.


REID: Can I just say, I'm not going to talk as an MP for a second, I just want to talk as a doctor. One of the most powerful things that people can do, whether it's in the clinical setting or in the community setting, is listening. We know and I know, working in the emergency department, that more often than not, you can find out what's wrong with the patient and develop a preliminary diagnosis or provisional diagnosis through the patient history alone. This centre here is full of health professionals. I know there'll be people watching on and listening on today where they will know that the patient history is the most important part of the clinical encounter, more so than any physical examination or investigation, CT scan, blood test or the like. So, at that point, you can begin treatment and begin to treat that diagnosis and ultimately save a life. And that really is the power of listening and that's what the Voice is all about: making sure we're listening to community about the issues and the laws that will affect them and provide better outcomes. Thank you.

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