Minister for Health and Aged Care - press conference - 28 June 2023

Read the transcript of Minister Butler's press conference in Morayfield on Morayfield Health Hub; Medicare Urgent Care Clinics; hospital pressures; Caboolture Hospital; health workforce challenges.

The Hon Mark Butler MP
Minister for Health and Aged Care

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DR EVAN JONES, MORAYFIELD HEALTH HUB: I'd like to start off today, first by acknowledging the traditional owners of the land on which we meet here today and pay respects to their leaders past, present and emerging. I'd like to thank very much both Minister Butler and Minister Fentiman and also honoured guests Ali King and Mark Ryan and all the members of the PHN for coming out today. Welcome to Morayfield Health Hub and to our Minor Accident and Illness Centre. This is a 38-bed facility and has been operational under Commonwealth funding since April. We've delivered over 8,500 services during that time. And we're very enthusiastic about this as a high-quality model that provides sustainable and lasting answers about being able to reduce hospital ramping and decreasing emergency departments. We believe that because it's based on an evidence-based model that comes out of New Zealand's where they've been able to do that, and where they fit some of the lowest admission rates to emergency departments in the developed world. This a high quality, multidisciplinary model which is about how we design and target care in a patient-centred way, and which, in fact, delivers that service within this multidisciplinary based centre. We have doctors, specialists, we have nurse practitioners, we have nurses, and we have reception staff and this is about upskilling everyone so that we can cope with the workforce crisis in this country. So once again, thank you very much for coming here today.


MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Thanks Evan, it's great to be here with the still relatively new Queensland Health Minister Sharon Fentiman, and with Mark and Ali as well, to see the results of being able to reopen this real innovative centre here in Morayfield. Evan really has pioneered the practice of urgent care here in Australia, we've learned a lot from him. It's been a terrific pleasure to be able to reinvest $3.75 million from the Commonwealth for this centre to be able to reopen, it's now been open about three months. But also to learn from this practice here and try to mainstream this model of urgent care right through the country. In addition to this centre, we’ll be opening over the course of the next several months 11 Medicare Urgent Care Clinics here in Queensland, part of 58 clinics that will open across the country that will be able to provide bulk billed walk-in service to people who experience non-life threatening emergencies, many of whom would otherwise be going to our overcrowded emergency departments.


Here already in just three months that Evan has been able to reopen this centre he’s treated, or he and his staff have treated, more than 8,000 people. Their average waiting time is 11 minutes, compared to the hours that category four and category five patients across Australia might be waiting in our major hospital emergency departments. Their survey work indicates that over 60 per cent of those patients who come to this centre say they would otherwise have gone to an emergency department, most likely the emergency department at the Caboolture Hospital. This really is achieving the key objectives that we talked about at the last election campaign. We heard time and time again, across the country, it had never been harder to see a doctor, a GP, than it is right now - and never more expensive. What that meant is that when your child fell off the skateboard and busted their wrist or broke their arm, had one of those non-life threatening emergencies, the only option open to the family was to take their kid to the local hospital. That meant potentially waiting six or eight hours on average to have your kid looked after - placing even more pressure on hospital emergency departments, which after all, were built for those once-in-a-lifetime emergencies like heart attacks like strokes, major car accidents, and the like. So being able to see this reopen is not just a great thing for this part of Brisbane North. It's also a terrific signal to the rest of the country that this is a model that will work. It means that people can get the care they need when and where they need it - those non-life-threatening emergencies - free of charge, seven days a week, extended hours. But also taking pressure off the hospital system which in Queensland, Sharon Fentiman has responsibility for, and we know right across the country - indeed right across the world – we are seeing unprecedented pressures after three years of a once in a century pandemic. So, thank you Evan for the work you’ve done, we've been delighted to be able to provide the funding we promised at the last election, working with Ali and Mark, who told us what a life-changer a game-changer it really was for their local communities. It's a delight to see thousands and thousands of patients here are able to get high quality care, free of charge very quickly, instead of having to wait hours at the local hospital emergency department. I’ll hand over to the Queensland Health Minister.


QUEENSLAND MINISTER FOR HEALTH, SHANNON FENTIMAN: Thank you so much, Mark. It’s fantastic to have the Federal Health Minister here in Queensland investing in the primary care that Queenslanders need. As you've heard from Evan and our federal Health Minister, these kinds of clinics where Queenslanders can get the very best care, close to home, without presenting to an emergency department is exactly what we need to take the pressures off our hospital emergencies. That's why the federal government is investing in these Urgent Care Clinics. I really look forward to Mark coming back very soon to announce locations and opening those clinics. And of course, it works hand in hand with our satellite hospitals, one here in Caboolture that will be open within months, that really has taken the learnings from Evan and this clinic with its minor illness and minor accident clinics, as well as specialist outpatient services. And of course, we've got a satellite hospital on Bribie Island opening early next year. So we know that Queenslanders need to be able to see their GP and, as Mark has said, know when there is a sprain or a break we need to be able to make sure that Queenslanders can get the very best care without having to wait hours at an emergency. I am really thrilled to be able to see firsthand the work of Evan and his team. And I really want to thank him and the team here for the wonderful work that they do. We know that investing in primary care is critical. It is fantastic to finally have a federal government that is investing in Medicare - the biggest investment in Medicare's history - to make sure that more pensioners, more children, can access primary health care, because that is the way we're going to take pressures off our hospital system.


JOURNALIST: Minister, Labor allocated $135 million initially to the Medicare Urgent Care Clinics, I think that's enough $358.5m, at last check. What is the amount that will be spent, I guess, on the Urgent Care Clinics now?


BUTLER: The amount is set out in the May Budget, the $135 million was always the base figure that we knew would be would be adjusted once we'd have the opportunity to get into government and work with state governments about the model of care. But there was extraordinary interest by all state governments, Labor and Liberal alike, because they understood - as we've seen in this particular centre - that a properly functioning Urgent Care Clinic will not only deliver care that people need, when and where they need it, but will take pressure off hospital emergency departments. We’ve worked very, very carefully with those state governments to make sure we've got the scope of services right, that we've got the operational protocols right between the urgent care service, local hospitals and local ambulance services. And we’ve heard some great experience from Evan Jones about how they interact with the Queensland ambulance service in this part of Brisbane. We always knew that we would have to expand the funding and that funding was delivered in the May budget.


JOURNALIST: The fact that this is reopening, is that an admission that it was a wrong decision to close?


BUTLER: I think what's been clear is that the Commonwealth has stepped up, under our government, stepped up to the plate recognising this type of primary care service. Certainly, an enhanced service, it's something additional to what you would usually get in a standard general practice, is something the Commonwealth should take responsibility for. That's been Labor's view. That's why we went to the last election, the only major party who went to the last election, with a commitment not only to refund this clinic, but as I've said, to open 58 Urgent Care Clinics across the country. I really want to make sure that we've got these services operating in a variety of different ways in a variety of different parts of the country, some in the big cities, some regional communities, and we evaluate them properly. One of the things Evan Jones has said, on a number of times I've met with him, is that in countries like New Zealand, this is a very developed model of care: something between a standard general practice and a full fully-equipped hospital emergency department. It has a College which makes sure that people are properly trained for this type of model. And as Evan said, I think, it means that the New Zealand across the ditch has the lowest per capita presentation rates to hospital emergency departments that you can find anywhere in the OECD. So we're committed to this model of care. We think it's right for patients, like to take pressure off hospital emergency departments, and the scope of services that we've funded out of our commitment at the last election, properly evaluated, will really I think set the case for seeing this as part of the health system here in Australia in the long term?


JOURNALIST: What was the impact on the hospitals when they stayed close?


BUTLER: It's the inverse of what we've talked about over the last three months. Over the last three months, as Evan has said more than 8,000 patients have come to this service, more than 60 per cent of them have said that if they weren't able to get access to a service like this, they would otherwise have gone to a hospital emergency department, most probably the Caboolture ED. So that, over just three months, is several thousand presentations to the hospital emergency department of Caboolture that aren't taking place. Great for the hospital, great for the hospital staff having that relieve the pressure. But also, it means the patient is getting a much better service here. They're only waiting maybe 5 or 10 minutes to get seen instead of the hours that unavoidably across the country not just here in Queensland, but across the country, people are waiting and EDs right now


JOURNALIST: Minister, on 60-day scripts Labor Members, including Helen Polley and Dr Mike Freelander, have called for all options to be on the table in terms of helping community pharmacies. What is your response to that? And will you consider negotiating further?


BUTLER: We’ve had a number of discussions with players in the pharmacy sector including with the Guild over the last couple of weeks. I've said that we intend to invest every single dollar the Commonwealth saves from this measure back into community pharmacy, and more. We will be reinvesting a few hundred million dollars on top of that $1.2 billion back into community pharmacy, to enhance the services that they provide to aged care facilities. But I make no apology for our commitment to deliver cheaper medicines. The Pharmaceutical Benefits Advisory Committee provided this advice to the former government five years ago that common medicines that people are on for year after year after year, potentially the rest of their lifetime, they should be able to receive in larger quantities. That's what happens in almost every other country to which we would usually compare ourselves, often for 90 or even 100-day supply, not just 60 days. So yes, we have to make sure that particularly pharmacies in rural communities are supported through this process. Some of those smaller pharmacies that don't have the sort of retail throughput you see in the major cities, aren't selling as much perfume or other health care products. You know, we do want to make sure and we're committed to making sure that those rural pharmacies, in particular, are supported. But this is a good productivity measure for the health system, this is a good measure for patients who, every single month, are going back year after year, decade after decade to get the same medicine they’ve been on, for all that period of time.


JOURNALIST: Should rural pharmacies have been consulted prior to the announcement?


BUTLER: As I think is on the public record, this was probably the Budget measure, of the many hundreds of Budget measures that we engaged – I’m not talking about the health portfolio alone, but the government - engaged with stakeholders at the earliest opportunity. I first had a discussion with the Guild President about this back in March, so many weeks before the Budget. The Guild is the representative for pharmacy business owners in rural communities as they are metropolitan communities. We always knew there would be a differential impact on rural pharmacies, which is why, from the get go, we said that we would double the Regional Pharmacy Maintenance Allowance. This is funding that a rural pharmacy receives just for being open, so it's essentially cash that taxpayers pay to keep those pharmacies open. We said we'd double that allowance and we're looking at other ways in which we can make sure that rural pharmacies are supported through this process. This is going to be terrific for patients, 6 million patients will get cheaper medicines through this. Which is why every single patient group, from the Breast Cancer Network to the Heart Foundation, to Asthma Australia, Diabetes Australia, and so many more besides, as well as doctor groups, have welcomed this measure and said it is overdue. It was recommended to the former government five years ago and their decision not to proceed with that has meant that in the intervening five years, those millions of patients have paid hundreds and hundreds of millions of dollars in payments that they didn't need to pay. I mean it's an incredible waste of energy and resources, at a time where the health care system needs these productivity enhancements and at a time of really serious cost of living pressure for those patients.


JOURNALIST: This hub, I guess, had to close in late 2021 because of funding and negotiations with the Health Hub and the state and federal government led to not a lot. Why didn't the state government pitch in the money sooner and this clinic wouldn't have had to close?


MINISTER FENTIMAN: You've heard from the Minister, this federal Labor Government is absolutely committed and is doing everything they can to reinvest in Medicare and primary health and we welcome that. Our commitment has been to get our satellite hospitals up and running. And we've learned a lot from Evan and his team. So I'm really pleased that we're able to get this hub up and running with assistance from our federal government. I'm so pleased that there has been that huge investment in Medicare and bulk billing. And I think once our satellite hospitals come on board, there really will be an opportunity to take that pressure off emergency and make sure Queenslanders are getting that health care close to home.


JOURNALIST: There were some of those serious cases or failings of the Caboolture Hospital during the time that this was closed. Do you attribute that closure to putting, you know, undue pressure on the ED?


FENTIMAN: Certainly when any clinics, primary care clinics or a shortage of GPs, it does put pressure on our emergency departments. Of course, you know, there are reviews happening now at Caboolture Hospital about those matters. But we do know that investing in primary care, access to GPs, urgent care clinics like this, take the pressure off. And I'm so pleased to see this facility for the first time. I've heard about it from our local Members for some time, and I'm really pleased to see we've taken some learnings from this model to put into our satellite hospitals.


JOURNALIST: Have you met with any family members yet?


FENTIMAN: My office has been in contact with family members and we'll be meeting them shortly and I can let you know that the review into the emergency department will commence from the 3rd of July.


JOURNALIST: Is it quick enough, given that one of these cases relate back to 2022? I mean, how are we only doing it now?


FENTIMAN: It's come to my attention now. And I thought it was very important to work with the HHS to make sure that there were some independent experts looking at how the emergency department deals with children and babies. And as I said, it's heartbreaking for any parent to have to present an emergency and feel like they're not being heard. My other message to patients is if they are unhappy with their service, they can make a complaint. It is very difficult for a hospital or for clinicians to respond, if people don't make complaints. I know it can be a really stressful, dramatic time. But there are also a number of people that can help. Our Office of the Health Ombudsman is there if people do want to get some advice about making a complaint.


JOURNALIST: Minister, do you still have confidence in your Director General?


FENTIMAN: I have confidence with the Director General. As I said, so far, the Department has been responsive to my priorities as a new Minister, in terms of tackling ambulance ramping and crashes on our school system. We have a $764 million plan in our Budget to tackle ambulance ramping, to try and prevent people having to come to the emergency department, in the first place, to expand clinical care, to make sure that we've got more allied health specialist staff rostered on the weekend so that people can get back home sooner. They have been responsive to respond to my priorities around emergency department pressures, and women's health and mental health. And so I have confidence in them.


JOURNALIST: He's tried to distance himself from the submission - considering this man is paid half a million dollars a year, doesn’t the buck stop with him?


FENTIMAN: Obviously, it's up to Cabinet and Government about policy decisions. And I've made it clear that we don't support that submission.


JOURNALIST: But even though you support the submission, that submission was still made public.


FENTIMAN: And the Director General has made a statement on that.


JOURNALIST: During the time, the initial investigation into baby Jarrod, there was concerns about staffing at Caboolture Hospital. Do you know if that hospital is fully staffed now?


FENTIMAN: Yes, I'm assured by the chair of Metro North that there have been more staff going into the emergency department. As we've heard, there is a global workforce shortage of health workers. But I am assured that Caboolture ED is well staffed. I have been there with our local members recently to see firsthand.


JOURNALIST: That family also mentioned that the board of the hospital wasn't told about their case until seven months after it happened. Is that a breakdown in communication?


FENTIMAN: Clearly, I think it is. But it is really important now that the board are engaged the hospital and has recently met with the family. And I’ve let the grandfather know that I'm very happy to sit down with him soon.


JOURNALIST: We just heard that staffing is an issue. Have you had problems staffing the centre?


DR JONES: Absolutely, we're in a workforce crisis. We desperately need to be training more domestic students. And so we're playing our role here. We have a number of nurses here. We're a GP training practice. We're actually training urgent care physicians from the New Zealand College of Urgent Care. And so we really think that everyone has to work together, so government and private industry have to work together to try and solve these workforce issues. We can't continue to steal doctors and other staff from countries that can ill afford to lose them. And so, my own view is that we need to be - Australian train more and more of our own health workers within this country. We have recently, Caboolture is one of the areas that has a very low tertiary degree. Something like 12 per cent of people in this area have tertiary degrees. And so we've engaged with the local high schools, and we have high school groups coming through here, so that people can see a vision for themselves in terms of the health sector. So it's about everyone working together to try and overcome this health workforce issue. It's a worldwide issue, and we absolutely need to be doing everything possible to solve it.


JOURNALIST: What was your, or did you get any feedback when the centre closed, what kind of impact it had on the local hospitals?


DR JONES: Spontaneously the 12,000 local residents formed a group here to advocate for the reintroduction of this service. We were really sad to have to close the service when funding ran out, and it was really heartening to see the local response from local residents who saw the value of the service and advocated to the local politicians and other people this the service needed to reopen.


JOURNALIST: Being in the medical space, though, did you hear feedback on what it was like in hospital, given that it was closed?


DR JONES: Well, the problem that we have in many regions, particularly these regional areas, is that we never have enough staff. And so there's an enormous pressure on local hospitals, and in local general practice as well. And as you know, we've got a general practitioner workforce crisis. Only about 15 per cent of medical graduates currently are going into general practice for a variety of reasons. And we need to we need to turn that round. And, you know, we thank the current state and federal government, because at last, we've got people who are listening to this and can work with us about trying to solve some of these issues.

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