Minister for Health and Aged Care - press conference - 3 October 2024

Read the transcript of Minister Butler's press conference on Para Hills Medicare Urgent Care Clinic.

The Hon Mark Butler MP
Minister for Health and Aged Care

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MEMBER FOR MAKIN, TONY ZAPPIA MP: Good morning, everybody. It's good to be here at the McIntyre Medical Clinic with the Federal Health Minister Mark Butler, acting State Health Minister Stephen Mullighan, and with a bunch of my colleagues from the northeast here in the electorate of Makin. I'll start with Michael Brown, Member for Florey, Blair Boyer, the Member for Wright, Olivia Savvas, the Member for Newland and Rhiannon Pearce, the Member for King. And with a whole bunch of the crew here at the McIntyre Medical Clinic. Can I say it is terrific to see so many of the staff here for this announcement.
 
Today we're here because we know that when it comes to health and the provision of health services, it matters to the people we represent here in the northeast. Particularly when people need urgent medical care, they want to know that they can get that urgent medical care in a timely way and somewhere close to where they live. It's one of the issues that we've been trying to address for some time. Because when Labor came to office in 2022 we know that the health system was under immense stress. But we're slowly chipping away and working at that to ensure that people do get the health care that they need. And Minister Mark Butler, who will speak to you in just a moment, I believe, has very methodically and progressively committed to making our health system, the health system people expect from a place like Australia, the health system that each and every one of us here today would like to know is available to our own community and the Urgent Medicare Clinics that have been committed to by the Albanese Labor Government are delivering on our commitment to ensure people in the north and northeast of Adelaide get the health services they need.
 
Finally, can I say this, I know for a fact, and we get it in my office on a regular basis that people are going to the Modbury Hospital and to the Lyell McEwin hospital for urgent care, when in reality, they could be getting that care at a medical clinic just like this one. That's exactly what this is about today, and I'll hand over to Minister Mark Butler to just provide some more details.
 
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Thank you so much, Tony. We're also joined here by Dana Wortley, the member for Torrens. It's a great turnout because this is a really important initiative in the northeastern suburbs. I want to thank the McIntyre Medical Centre for hosting us here today and agreeing to put in a submission to take their practice to the next level and become part of the growing network across the country now of 76 Medicare Urgent Care Clinics, moving up to about 87 by the end of this calendar year.
 
As Tony said, when we came to government a couple of years ago, our health system was under real pressure. We've got a lot to be proud of our health system here in Australia. Only in the last couple of weeks, the Commonwealth Fund that undertakes some very highly regarded international research, ranked Australia's healthcare system as number one in the world. Importantly, number one for health equity and Medicare is right at the core of that, but also number one for healthcare outcomes. That's something that should be celebrated, something we should be proud of, particularly in the year of the 40th anniversary of Medicare. But we do know it's a healthcare system that is under real, real pressure after a decade of cuts and neglect to Medicare, particularly the six-year freeze in the Medicare rebate that Peter Dutton started when he was the Health Minister. We also know that as a population, we're getting older and we're getting sicker. There's more chronic, complex chronic disease, but also more mental illness in the community that's putting pressure on primary care as well as the hospital systems. And then on top of that, we've got the long legacy of COVID, something that has left very deep scars on our healthcare system.

As we were coming to government, what we were dealing with was a system of bulk billing in general practice that was in freefall. No surprise, really, given the six-year freeze on the income of general practitioners through the Medicare rebate. We had a situation where one million Australians, according to the Bureau of Statistics, were going without a medicine that their doctor had prescribed as important for their health. They were going to the pharmacies and simply unable to afford that medicine. We were also finding that hospitals, increasingly as Tony said, were being overwhelmed with semi-urgent and non-urgent presentations to their emergency departments, because people had no choice. Because when their kid fell off the skateboard or got injured in Saturday morning footy, there was no general practice to go to, to get into quickly, so they were spending hours and hours waiting in already very crowded emergency departments. That's why we had no more important policy promise to the Australian people than a promise to strengthen Medicare, to return bulk billing to the beating heart of Medicare. Since we tripled our investment in bulk billing in November last year, we've seen more than 4 million additional bulk billed visits to the general practice starting to turn around a bulk billing rate that was in free fall when we came to government. We've also delivered hundreds and hundreds of millions of dollars in savings to patients at the pharmacy through our cheaper medicines policies.
 
What we're here today to celebrate in the northeast of Adelaide is our Urgent Care Clinic program. As many would know, this is a very common model of care in pretty much every country to which we compare ourselves. Across the ditch in New Zealand, it's been around for about 20 years, taking pressure of hospital emergency departments, but also giving patients an option to get that urgent care in their own community quickly, and in Australia on a fully bulk billed basis. We took a promise for the last election to establish 50 by the end of 2023 and we established 58. Already, since June last year, almost 800,000 Australians have been seen at one of our Medicare Urgent Care Clinics. As much as 70 per cent of those patients say that if the Urgent Care Clinic wasn't available to them, they would go to the local hospital emergency department. We're already seeing a moderation in category four and category five presentations to hospitals like Modbury up the road and Lyell McEwin out to the north. I'm delighted that the state government has been such a strong supporter here in South Australia of our Urgent Care Clinic program. It's a really important complement to their Priority Care Clinic program. The sixth clinic in South Australia, this one at Para Hills Medicare Urgent Care, will not only take pressure off those two important local hospitals, Modbury and Lyell McEwin, but it will also provide mums and dads with an urgent care option for their kid. When they get sick overnight or they get injured in Saturday morning sport, to be able to be seen in their local community pretty quickly by expert doctors and nurses who have often got a background in emergency medicine and importantly, fully bulk billed, completely free of charge. All you need to bring to one of these clinics is your Medicare card. You can leave your credit card home if you like. Thank you to the South Australian Government for supporting this sixth clinic as part of our strengthening Medicare investment for 2024. Thank you to McIntyre Medical Centre for stepping up and putting yourself forward to take your practice to the next level. Thank you to Adelaide PHN, the Primary Health Network, for overseeing this tender process. And most importantly, thank you to the doctors and the nurses and the staff who are working at this clinic, because I know it's going to make a great difference to people in this part of Adelaide.
 
SOUTH AUSTRALIAN ACTING HEALTH AND WELLBEING MINISTER, STEPHEN MULLIGHAN: Thanks very much, Mark, and we thank the Commonwealth Government for, once again, working so quickly to roll out more health infrastructure across our nation, but particularly here in South Australia. It is remarkable to think that in just over two years, this is now the sixth Urgent Care Clinic that we're seeing opened up here in South Australia, and we've seen more 50,000 walk ins through these Urgent Care Clinic, people being able to be treated rather than have to go to our emergency departments. That is providing real relief to the pressure on our emergency departments. A really great example of the State Labor Government working closely with the Federal Labor Government to invest very quickly and substantially in our health system that benefits South Australians. As the Federal Minister said, this is located pretty much right in the middle of the Lyell McEwin Hospital and the Modbury Hospital. South Australia is investing directly in our health system. We are adding by the end of this year, we would have added 300 extra beds to our health system across greater metropolitan Adelaide. We are recruiting more doctors, we are recruiting more nurses. We have recruited more paramedics and ambulance officers and got more ambulances out on the road. And today's announcement shows that when you've got two governments working closely together, investing in their respective areas of responsibility, you really can expand the availability of these medical services to  local communities. I'm going to throw down to the Clinical Director here of the medical clinic, Dr Bill Monkhouse, who can talk us through what it will mean for patients and they can turn up without needing an appointment, without needing to bring their credit card, as the Minister says, in order to get urgent medical treatment, Doctor.
 
 
PARTNERED HEALTH CLINICAL DIRECTOR, DR WILLIAM MONKHOUSE: Thank you. First off, I'd just like to thank the federal government, current federal government, for actually breaking the mould and doing something. There is a massive problem with patient visits to emergency rooms, I’m from an emergency room background, and somebody has that last put their hand up, stepped up to the plate and done something about it. I applaud  that and thank you very much for it. We're all about patient journey, we're all about trying to improve that patient journey. We're trying to improve that for the mum and dads with the kids with the cuts, the fractures, the grazers, whatever it is, the febrile illness. We're about them to be seen in a timely manner and by appropriate people in somewhere that's close to their home. We are definitely about taking away that eight hour wait time that we currently got in emergency rooms for those problems. It's a work in progress, and we hope to be seeing 50 patients a day as soon as possible, and I'm sure we'll probably pull it off. Do you have any questions?

JOURNALIST: There’s been over 50,000 visits across the other five Urgent Care Clinics in Adelaide. So, your 50 a day that you're hoping to see, does that fit as more or less compared to the others?

DR MONKHOUSE: We would like them all to see 50 a day, absolutely.  If you examine the numbers that the whole concept was based on that was probably the plan from day one, 50 patients a day for each of them. Some would do more, some would do less. It doesn't matter. They're doing something.

JOURNALIST: We see from the start here, 30 per cent of presentations to the Lyle McEwen and Modbury Hospital could have come here instead. Do you think that's accurate?

DR MONKHOUSE: My emergency room experience tells me that that number is probably higher. The number of patients that turn up at EDs all across Australia, it is not a solely South Australian problem, would run well into 40 per cent. Those people can come here.

JOURNALIST: For people who are unsure what they should be coming here for. What are those types of conditions?

DR MONKHOUSE: So walk out the front of our building and you will see a list there of things. That's part of a work in progress. I'm not so happy that we set limitations on what comes. I think the question is, do you need to go to an ED do you need to call an ambulance? Do you need to go and see urgent care centre? That's going to evolve. So, we'd like to see most people who say: I'm injured, I'm sore, my child's sick, I need to go to urgent care centre, they'll see me as soon as possible, they're going to bulk bill me, they're going to supply me with what I need, case closed. People need to learn again. Once upon a time, you would have gone through general practice with that problem. General practice has shifted to chronic care because of our ageing population, so we become the new general practice, urgent care. It's that normal range of daily problems that we see in families,  in groups of people, that's the things we do. I don't think we should have a list. I think if you think you're sick, you do see a doctor, you come to urgent care.

JOURNALIST: And if it's life threatening, go to ED?

DR MONKHOUSE: People who have difficulty determining what's life threatening and what's not. So, you know, absolutely, if you’re critically ill and you need an ambulance, call the ambulance, let them sort it. But if you are sick, or you are hurt and you consider it urgent, you come here.

JOURNALIST: And Dr on staffing is it already to go?

DR MONKHOUSE: Yeah, more than ready to go. We've had an existing staff base with our Priority Care Centre, and that's worked really well. So we just had to add to our roster, with some more receptionists and a couple more nurses and a few more doctors. We've been running, taking patients for the last week.

MINISTER BUTLER: Can I just add to what Dr Bill said that we worked very closely as we're rolling out the first of these Urgent Care Clinics to have clear protocols between the clinics themselves, local ambulance services and hospitals. They need to work very much hand in gloves so that people are clear where a patient should be. And every now and then, a patient will present to one of these Urgent Care Clinics, and it becomes apparent to the triage nurse that the person should be at an emergency department. And equally, what we're finding is emergency departments increasingly are aware of local UCCs, and so are referring people back there. Ambulance staff are obviously a critical part of that system, and I've been very closely involved in the development of those protocols as well. In my sense, it is still fairly early days, as Dr Bill says, but 12 to 15 months in these systems are working very well around the country.

JOURNALIST: Just before we do move on, where do we go from here? Do you commit to opening more or is it about diverting attention to these Urgent Care Clinics that are already open?

BUTLER: As I said, we opened 58 last year, and the Budget this year, we agreed to open another 29. We'll have all of those open by the end of this year, so we'll have a network of 87. As to what happens in the future, from a Labor Government perspective, remains to be seen. Obviously, there's a lot of demand out in the community now for these because people are seeing them, whether it's clinicians or patients, are seeing them work so well. What is clear, though, is this is not an investment that is supported by the Opposition. Angus Taylor, as the Shadow Treasurer, has made very clear, as has the Shadow Finance Minister that this is part of the investment that they do not support, and you could expect would be cut in the event that a Dutton government is elected at the next election, along with a range of other investments we've made that they've said very openly, very transparently, they do not support and intend to reverse cheaper medicines investments and things like that as well.

JOURNALIST: So you won't commit to more yet, but you're not ruling it out?

BUTLER: I wouldn't rule out something that's been this successful. But obviously we're working in the budget process that came from the May Budget this year.

JOURNALIST: On shrinkflation, what is the government's crackdown going to look like?

BUTLER: Australians are sick of being taken for a ride by the two big supermarket operators every time they do their weekly shop. We're determined to give Australian shoppers a fair deal and protect them from the dodgy discounts that we've seen revealed by the ACCC, that tough cop on the beat over the last couple of weeks. Also, this morning, we've seen that we need more transparent and genuine pricing arrangements, particularly through unit pricing in. That's something the ACCC has called out. So, we're determined to strengthen unit pricing protections for Australians and protect them from this shrinkflation, where supermarkets and products are misleadingly presented as a particular price - in spite of the fact that they've been shrunk in size.

JOURNALIST: Is this a problem at the supermarket level, or the supplier end, or both?

BUTLER: We’re going to have a look at the scope of this code, the unit pricing code, but the very clear advice from the ACCC is that we need a stronger code. We need unit pricing that is implemented by supermarkets, that is more visible, more legible. It's not in small font. It's not deliberately put in place in a way that people can't read it easily. The ACCC tells us that 90 per cent of shoppers use the idea of unit pricing, because it's simple to understand. You can work out how much, how many mls, how many grams of a particular product you're getting for $3, or $4 or $5 and supermarkets are clearly seeking to minimise the impact of something that is an important protection for shoppers. So more visible pricing, making sure that they're not mixing up the different units in a way that is designed, frankly, to confuse shoppers. We're all about protecting shoppers, and it's quite clear now that shoppers, for too long in Australia have been taken for a ride by the big supermarkets.

JOURNALIST: How big will the penalties be for supermarkets that are caught breaching?

BUTLER: We're going to undertake a consultation process on this code, ACCC only yesterday was provided with $30 million in extra funds from the government to crack down on anti-competitive conduct that is driving up the supermarkets profits, but it's driving up prices for Australians in their weekly shop. We are determined to do everything we can to protect Australia's shoppers at the moment, because they are being taken for a ride by our big supermarkets.

JOURNALIST: And if the code is expanded, who else could it cover?

BUTLER: That's one of the issues that we'll be working through in the consultation process. Obviously, the big supermarkets are the main target here. They are primarily responsible for what is happening as people go about their weekly shop. But we'll have a look at the scope and see whether there are other retailers as well who should be within the scope.

JOURNALIST: Talk us through one of your own experiences of going for a shop and finding yourself the victim of shrinkflation?

BUTLER: I do the shop for my house every single week, but I do it with a two and a half year old in the trolley, which is an additional distraction to understanding unit price. It Lots of people are doing the shopping with kids and running around, and they're rushed because they want to finish the shop as quickly as possible, and they want a system of pricing that is easy to understand that is legible and is transparent, and they're not getting that from Australia's big supermarkets right now.

JOURNALIST: Are we talking, you know, getting a bag of chips and feeling like there's half of a bag of air in there that sort of thing?

BUTLER: We’re determined to make sure that if you want to buy a bag of chips, I don't encourage you doing that regularly as Health Minister, but let's talk about milk. If you're going for milk with different bottle sizes, you don't just compare a small bottle to a large bottle on price, because obviously there's a different amount there. You want to use unit pricing so you can be very sure that at a time of massive cost of living pressure on Australia's households, shoppers were able to get the best bargain they can.

JOURNALIST: Minister just on a separate issue, you've been very tough on tobacco and vapes. There's been a major turf war going on, very concerning numbers across Victoria and now in South Australia. Does this suggest that the Border Force isn't doing enough about illegal tobacco?

BUTLER: I might make a couple of remarks from a national perspective, and then the Treasurer will want to say something. I'm sure we're determined to crack down on illicit tobacco and vapes coming into the country illegally. This is a huge public health problem. I can say, as the Health Minister, vaping is a massive public health menace for young Australians, and we know now that it is a product deliberately targeted, recruiting a new generation to nicotine addiction. The investment we made into Border Force and the import regulation I put in place on the 1st of January was determined to choke off supply from overseas of this product targeted at our kids. Already we've seized at the border well more than 5 million vapes taken out of the hands of kids, and we're now in the process of shutting down the vape stores and starting to regulate what tobacconists and convenience stores are selling as well.

Illicit tobacco is also a really serious challenge. Frankly, it's harder to detect at the border than vapes, which have a whole lot of metal in them. But again, we have provided almost $190 million of additional resources to Border Force to start to step up their activity in cracking down on illicit tobacco coming in as well. This is primarily a threat to the health of Australians, particularly young Australians. It's also a threat to the integrity of our taxation system because illicit tobacco is designed to get around the taxation of tobacco products. But really concerningly, it's also a really lucrative source of revenue for some very bad people, for organised crime gangs, who are using the money they get from vapes, they get from illicit tobacco, to fund their other criminal activities like drug trafficking and sex trafficking. That's why health ministers around the country, including Chris Picton here, who's been a really terrific supporter of this he has such a long history in tobacco control, going back many years, we've worked really closely with police ministers, with the heads of health departments and police commissioners as well, because we understand, although this is primarily a health challenge to be enforced by health authorities, it also creeps into organised crime. And so, there is a need when there's intelligence about the involvement of organised crime, for police to get involved and work as well. We've developed a very clear protocol between policing and health authorities right around the country to ensure that everyone is doing their job when needed. Now, primarily that's a health job, but from time to time, we do need the support of policing authorities, because it's clear that the sort of activity we've seen for too long in Victoria, dozens of tobacconists and convenience stores firebombed in the gang war that's been underway in Victoria now for quite a long time may be creeping into Adelaide as well, but I'll ask The Treasurer to say some more.

MULLIGHAN: Thanks, Minister. In addition to the Federal Minister's comments this is something we take extremely seriously in South Australia. And just as the Federal Government has significantly increased resourcing to Border Force, we have done the same with state government agencies, creating dedicated new units, both within health, but also within consumer affairs, to hunt out those illegal retail shops that are selling illegal tobacco and also vape products, and work with South Australian police to crack down on this criminal behaviour. And as we are now seeing, this is activity which is not being taken just at the backyard level. It is now increasingly being undertaken across the country by organised crime. The message to people engaged in this activity is that they will be found and they will be subject to the full force of the law. We will not tolerate this behaviour in our community, not just because of the health impacts that they threaten our community with but because of the overall impact it has on our community when we see incidents like we've seen in the last 24 hours.

JOURNALIST: Treasurer, the pro-Palestinian rally that's planned for this Sunday, will it go ahead?

MULLIGHAN: That will be up to the organisers. I think the clear message from the community, from the government and from political leaders here in South Australia is that it should not go ahead. It is, of course, a long-established privilege of our democracy that people can peacefully assemble. They can peacefully protest. But I think we all agree it is in very poor taste to be organising a protest on the very day one year on where there were terrorist attacks on another democracy, in our in our global community, on Israel. So, it is not for politicians to be determining on a case-by-case basis, who should be allowed to protest over what issue. We have long had established legislation now that in our democracy, here in South Australia, people should have the right to peacefully assemble and to peacefully protest, and we maintain that commitment. It's an important tenet of our democracy, but the last thing we want to see is that privilege abused and for people to organise protests and demonstrations which can only be taken to the rest of the community to be inflammatory and unnecessary. So, all the focus now is on the organisers of this protest. They should do the right thing. They should defer the protest to another date when it's not going to be so inflammatory on the remainder of the South Australian community.

JOURNALIST: But why would the Parliament approve a protest like that on the year anniversary of the invasion?

MULLIGHAN: It's not up for politicians, whether it's collectively as the parliament or for individual decision makers to be picking and choosing which cause we think deserves to have the right for a demonstration or a protest that is not now. It has worked for decades here in South Australia. We passed laws approximately 50 years ago in the wake of the Vietnam moratorium demonstrations to enshrine the right for South Australians to peacefully assemble and to peacefully protest. But there is also an expectation on people who are undertaking those demonstrations that they should do it in concert with good taste and overall expectations of the community. I think this is an occasion where the organisers would be doing themselves a good service, and importantly, the rest of the community by doing the right thing and putting this protest off to another day is unnecessarily inflammatory. It is very hurtful to a significant section of our community. And the right thing for these organisers to do would be to defer this protest.

JOURNALIST: Is there any part of parliament that does have the power to get involved and stop it from going ahead?

MULLIGHAN: Of course, under those protest laws, which have long been established here in South Australia. Of course, the parliament has to approve the use of any part of the parliamentary precinct, including for demonstrations. But it is very risky situation to find the parliament or for decision makers within our parliamentary process to be picking and choosing who gets to protest and over what cause. This is a long established right that we've had in our legislation, that people are entitled to peacefully assemble and peacefully protest, but with that comes a responsibility of doing it in a way which doesn't inflame already heightened tensions more broadly in the community, or seek to cause distress or upset or hurt among sections of the community. I think a lot of people who have been focused on this to date are concerned that holding this protest on this date will be unreasonably hurtful and impactful on sections of the community who don't deserve to suffer further distress. So, the attention should now go back to these protest organisers to do the right thing and to defer to protest.

JOURNALIST: In Sydney the Hezbollah flag was raised during protests there? Would you have any words for people who are considering doing that here?

MULLIGHAN: I think fortunately, we've got a long history in South Australia of much better behaviour when it comes to protests than what we've seen in other parts of the country. Only a couple of weeks ago, I went over as the Minister for Defence and Space Industries to the land forces conference, where I saw some of the most disgraceful and outrageous behaviour by some of the protesters over there. The last thing we want to see is that sort of criminal behaviour start infiltrating our demonstrations and protests, which have always been peacefully and lawfully held. The Police Commissioner has made it clear he will be applying the law, and he and his officers will be making sure that any protests on any date will be conducted peacefully and in accordance with the law, and that if there's any demonstration that involves criminal activity or breaching the peace, his officers will respond accordingly.

JOURNALIST: So what would it take for the government to intervene?

MULLIGHAN: What we won't stand for is demonstrations which are undertaken contrary to the law, which beach the legislation which has long been in place here in South Australia, where people are breaking the law, being unreasonably disruptive, they're causing criminal damage, or that there are elements of racial vilification. That is what the Police Commissioner has made clear he and his staff will be looking for when they work through with protest organisers, any protest which is organised here in South Australia. But our message to these protest organisers is that they should do the right thing and find another date. This is not a date that is appropriate to be organising this particular protest. Thanks everyone.

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