Minister for Health and Aged Care - press conference - 4 April 2024

Read Minister Butler's press conference on Medicare Urgent Care Clinics hitting the major milestone of 250,000 visits; Victorian health system; gender inequality in healthcare.

The Hon Mark Butler MP
Minister for Health and Aged Care

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ANDREW COHEN, CEO FORHEALTH: Good morning, everyone. My name is Andrew Cohen. I am the CEO of ForHealth and I'm joined by Dr Max Adams, the clinical lead here at Marion and also Michelle McKay, the CEO of Adelaide PHN. Today we warmly welcome the Honourable Mark Butler, Minister for Health and Aged Care and our favourite local member Louise Miller-Frost. Before I begin, I just want to start by acknowledging the traditional owners of this land, the Kaurna people and pay my respects to elders past, present and emerging.  

This year is the 40th anniversary of Medicare. A system that makes me proud to be an Australian and a system that really underpins our practices at ForHealth which service more than 7 million patients every year. It is arguably the greatest social program our country has. And I want to start by just acknowledging the Albanese Government's record investment in Medicare for its 40th year, the largest since its inception. This includes the tripling of the bulk billing incentive. It also includes the establishment of 58 Medicare Urgent Care Clinic sites, including this one here at Marion. I guess at the coalface in clinics like these, in communities like these, we see the impacts of this investment. To give you an example, here at this clinic we had seen bulk billing decline for two years steadily and since November since the tripling of the bulk billing incentive, this site has seen its percentage of bulk billing consults go up from 69% to 80%, which is a significant change, but also 100% for pensioners, children and low-income households.  

This site is also a state Priority Care Clinic and a Commonwealth Urgent Care Clinic which is an incredibly important service to the community. It sees more than 50 patients a day through those two services, which is about 20,000 patients a year as we move forward. About 80% of those patients were either directly triaged from the ED or state they would have otherwise gone to an ED, and that is a really important service to the hospital. On average they will commence care from coming here in less than 30 minutes and 93% of patients that have come here state that they highly recommend the service, which is an incredible number.  

But beyond the statistics, there's stories of kids coming in here, grandparents coming in here, working mums and dads coming in here. And to give you just a flavour for that, a couple of days ago there was a working dad that came in here. He’d waited at the hospital for six hours - he'd injured his ankle playing basketball, probably did some amazing spin move. But he injured his ankle playing basketball, he came in here, he was at the ED until 4am and was really worried about getting to work the next day. So, he left the ED at 4am after six hours of waiting and looked up this urgent care site, came here first thing in the morning, he was seen in 15 minutes. His ankle was treated, he was given crutches, and he was discharged within 30 minutes. That morning, the ED line was one person shorter. And he got to work on time, most importantly. I think it's stories like these. He left a five star Google review saying that he couldn't recommend the service highly enough, and that it went way beyond his expectations. But this is only one in 20,000 stories for the next year just from this site. And for that patient access and for that investment in this community I want to thank the Albanese Government for really putting patient access back to the forefront of their agenda and putting the green and gold foundation of our healthcare system, Medicare, back to the front of the agenda. I also really want to thank the Adelaide PHN for their incredible partnership in establishing and maintaining this site here. 

MARK BUTLER, MINISTER FOR HEALTH AND AGED CARE: Thanks Andrew, thanks Louise Miller-Frost for welcoming us to your electorate of Boothby and ForHealth for welcoming us to this Urgent Care Clinic. It's still less than two years ago that I promised that an Albanese Labor Government would establish 50 Urgent Care Clinics by the end of 2023. And after the election, we got about putting in place that commitment. Working with state governments to design the locations to have the greatest impact on hospital emergency departments as Andrew has talked about, working with the Primary Health Networks - the PHNs - to conduct competitive processes. There were very significant numbers of general practice clinics that were interested in taking the next step, really lifting the service that their clinic was offering in the urgent care program.  

And we were able to deliver the promise as I said we would by the end of 2023. And from this week already those clinics - there are 58 of them not 50 - they've serviced 250,000 patients just in the last several months. Now they're servicing across the country more than 10,000 patients every single week - well over half a million a year, delivering urgent care for non-life threatening emergencies. Delivering care where people need it, when they need it. But most importantly, as Andrew says, taking that pressure off our hospital emergency departments which right across the country are under very, very serious pressure.  

In those several months where 250,000 patients have been looked after, around a third of them are under the age of 15. So, they are parents who have kids who are sick who need to be seen urgently or who've fallen off the skateboard and broken their arm. They need urgent care, but they don't necessarily need to go to a fully equipped hospital emergency department and thankfully when they do, they're often waiting for 8, 10 or even more hours to get the care that they need. And as Andrew said, the response we're getting from patients is incredibly positive, their waiting times are very short, the quality of care they're receiving from the doctors and nurses at these clinics is very high. And importantly, it's fully bulk billed, so all they need to do is bring their Medicare card, they don't need to pay a gap fee or worry about the possibility of paying a gap fee at all.  

This has been a missing part of the Australian healthcare system now that's been identified by lots of experts, lots of providers and frankly lots of patients as well. Most other countries to which we would usually compare ourselves have something like this system, something in between a standard general practice on the one hand and a fully equipped hospital on the other. And we're determined to build such a model of care here in Australia. We've only got 58 clinics so far across the country. That doesn't provide national coverage even though it is delivering care to hundreds of thousands of patients every single year. We're determined to scale this up, to evaluate how it's working. If there are improvements that we can make, we will make those improvements. There are lots of clinics in communities like Louise’s here in the southern suburbs of Adelaide, in metropolitan communities. But we've also opened clinics in regional communities so we can evaluate how those clinics are helping support those communities and relieve that pressure from our regional hospitals as well. I want to thank Andrew and ForHealth for their work in taking a bet on this and committing to have their organisation play a leading role in the urgent care program right across Australia.  

LOUISE MILLER-FROST, MEMBER FOR BOOTHBY: Thanks. I'm Louise Miller-Frost, I’m the local Federal Member for Boothby. My background is in community health so I worked in divisions of general practices for many years and also running community health services. And I know how important health services - affordable accessible health services – are to our quality of life here in Australia. This is a really fantastic clinic. I get such positive feedback. I believe we've had since it opened in November around 5000 people have come through. That's potentially 5000 people who didn't turn up to the emergency department. So that's faster, affordable care for them. But also, it means that those people who are actually in the emergency department waiting for care can get the care that they need faster. The doctors and nurses there can also focus on those emergencies. 

This is part of a whole suite of health promises that we made when we came into government because we knew that health was something that we really needed to fix. So, a couple of weeks ago, I was down at Flinders Medical Centre where we had the plans for the new tower there, 26 new beds that are going to be fast tracked, opened hopefully mid-May. And that's on top of other beds that have already been opened. That's an important part of addressing health services in South Australia. Along with this, the Urgent Care Clinic, of course the endometriosis clinic down at Glenelg, which is going absolute great guns and taking clients from all over Adelaide. That's a really important service.

And of course, as Andrew mentioned, tripling the bulk billing in Boothby. That meant an extra 4.8% of consults are being bulk billed. And that's a fantastic step forward. We've also got the cheaper medicines, thousands of thousands of thousands of prescriptions where people are getting twice the amount of medicine that they used to get for the same price for the sorts of medicines that they have to have on an ongoing basis. So affordable, accessible medicine is a real keystone to our quality of life here in Australia. And congratulations Minister Butler, this is a really another important step forward. Thank you. 

JOURNALIST: So, there are reports today that Victorian regional hospitals fear they'll be forced to close off slash jobs because the Victorian government has ordered them to find savings. Are you concerned about that? 

BUTLER: Of course I think all Australians are concerned about the pressure our hospital systems are facing right now, and this is a global phenomenon. Hospital systems after a four year long pandemic are under enormous pressure. A whole lot of people weren't able to get the care that they needed during pandemic restrictions. That was particularly the case, frankly, in jurisdictions like Victoria and New South Wales to a degree where there were extensive lock downs. People didn't get their cancer screenings. They weren't able to get to the doctor to receive the care they normally would. And so right through our hospital systems, we’re seeing higher levels of acuity, bigger pressure while at the same time dealing with workforce exhaustion, frankly. So, we're seeing this across the country, and we are working very cooperatively with our state colleagues to try and do what we can as a Commonwealth to help them get through this this post-COVID period. In the National Cabinet meeting in December, the Prime Minister committed to more than $14 billion in additional funds from the Commonwealth to all of the states and territories to help them with the operating costs of their hospitals. And as we've been talking about this morning, our primary job as the Commonwealth is to try and take pressure off the hospital system by rebuilding general practice and developing new innovative models of care like these urgent care clinics.  

JOURNALIST: And are you worried amalgamations of regional health services will reduce the level of care regional Australians will receive? 

BUTLER: I've only seen the press coverage very briefly this morning on the matters you're referring to. Ultimately, the way in which the hospital system in Victoria is managed is a matter for the Victorian Government they have a very different system, for example, to other states and territories that tend to have larger hospital districts than Victoria traditionally has had. That ultimately is a matter for the Victorian Government. Our job as the Commonwealth is to provide as much financial support as we can to the operation of the hospital system. We're doing that and also, as I said, to take pressure off the hospital system through better primary care through Medicare.  

JOURNALIST: You said that the Senate Inquiry into reproductive healthcare access would inform your commitment to making abortion and contraception more available in Australia. The government's response is seven months overdue. When will we see it? 

BUTLER: Ged Kearney, the Assistant Minister for Health is taking a leadership role on this, as she is more broadly in women's health. She's had a Women's Health Advisory Council working with her to deal not just with some of the recommendations for that important Senate report on reproductive health in particular, but more broadly around some of the structural bias and inequalities for women in the healthcare system more broadly. As Louise just mentioned, we’ve funded and opened endometriosis and pelvic pain clinics. That was a pretty clear gap in the system that we've started to address, but there's much more we need to do. We're working through the recommendations from that Senate Inquiry, as Ged I think has said, a number of them involve state responsibilities as well. So, I know she, but I as well, have been talking to our health minister colleagues at state and territory levels about the recommendations that impact their systems, and in due course we're going to have a comprehensive response to that. 

JOURNALIST: So ultimately, as the Health Minister, you make the decisions and put the case to the Treasurer. What's your opinion on it? 

BUTLER: I think the report was a very good one. And I think we're looking at it very constructively. But as I said, it's not just a Commonwealth responsibility, we are also talking to our state and territory colleagues, we're taking this report very seriously. 

JOURNALIST: And health specialists are telling us that there is a gender bias in rebates for medical procedures which is costing women more money. Do you agree there's a problem? 

BUTLER: Even before the election, I said and others in Labor said that we were hearing the reports from women about a really clear structural bias in health care systems. Some of them are potentially about the structure of the Medicare Benefits Schedule, which I know the ABC has been reporting on this morning in a comprehensive report. But we conducted a very broad, detailed survey of Australian women right across the country and asked them about their experiences in health care. And they did report very serious issues about bias in the system. As I said, Ged Kearney as the Assistant Minister for Health has pulled together an advisory council to consider ways in which we could deal with those structural biases. And already we've put our money where our mouth is by investing in new endometriosis and pelvic pain clinics. But I know there is more for us to do, Ged is leading that work, but we're committed to doing more in the coming period of our government. 

JOURNALIST: And would you support a gender focus review for the Medicare Benefits Scheme? 

BUTLER: As I said, we've got structures right now that are looking more broadly at gender bias in the healthcare system that obviously includes the way in which the MBS - the Medicare system - operates. I'll consider the reports that I've been reading over the last 24 hours. But I'm pretty confident that we've set up good structures now, we've surveyed Australian women, we've had a women's health summit that's brought together all of the groups that the ABC reports mentioned this morning, and we've got a good advisory structure I think that's working through these issues in a considered way to provide recommendations to government.  

JOURNALIST: These clinics, fantastic idea, any evidence to suggest they should be opening longer or opening earlier?  

BUTLER: We're working through that with all of the different operators. There are different experiences across the country about when the peak periods for the clinics are, and frankly, when the peak periods for emergency departments with the local hospital are. We've said to them that we want them open seven days a week and on public holidays and that is happening, and we're also talking to them as they scale up and get all of their staff recruited about having the maximum possible span of hours. That's still a work in progress. Some of them are already operating from 8am to 10pm, others are scaling up to those sorts of hours. But we're really committed. The promise I made before the last election, which was here in the electorate of Boothby, was for them to operate seven days a week, to be available to walk in patients, to operate extended hours - so early in the morning and into the evening - and to be fully bulk billed. And we're committed to making sure that promise is delivered. Thanks, everyone. 

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