Minister for Health and Aged Care, press conference - 4 November 2024

MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: When the Albanese Government came to power a little more than two years ago, Medicare was in deep trouble. Bulk billing was in free fall, doctors were hard to come by, and the rising cost of medicines meant that as many as a million Australians every year were going without scripts being filled, scripts for medicines that their doctors had said were important for their health. That is why, in the lead up to that election, we made such a clear commitment that we would have no higher priority as a government than strengthening Medicare and making medicines cheaper.
 
I'm very pleased to report that as a result of our record investments in Medicare, we are starting to turn the corner. We've got more doctors, we've got more bulk billing, and we're opening more Medicare Urgent Care Clinics. On doctors, I'm very pleased to report that in the past two years, we've seen the biggest increase in doctor numbers in this country for a decade. I'm particularly pleased to report that the number of junior doctors who are electing to take up general practice training is increasing by more than 25 per cent.
 
On bulk billing, it's now 12 months since our record investment to triple the bulk billing incentive. The College of GPs and so many other general practices around the country made the point at the time that if there was not the investment that we made in the 2023 Budget, bulk billing would continue to slide. I'm very pleased to report that 12 months on from that investment, bulk billing has stopped sliding. In every single jurisdiction across the country we are recording increases in bulk billing rates for visits to the GP. In just 12 months, there have been more than 5.4 million additional free visits to the GP as a result of our record investments.
 
I am also pleased to report there are now 75 Medicare Urgent Care Clinics open. We will have 87 open by the end of calendar year 2024. Already, those clinics that started opening last year have seen more than 850,000 patients, every single one of whom has been fully bulk billed. A third of patients have been kids under 15. They are not only delivering care when and where people need it in their community, they are also taking pressure off overcrowded hospital emergency departments.
 
Now, we know it is still tough to find a doctor, still tough to find a bulk billing doctor in parts of the country, but we are starting to turn the corner. The changes and the investments we have made are starting to make a meaningful difference. We know there's more to do and we're committed to doing more in Medicare, because for Labor is no more important social program in this country. At a time where we have started to turn the corner, that we've started to see more doctors, more bulk billing, we're opening more Medicare Urgent Care Clinics; the last thing Australia needs is for Medicare to be put back in the hands of Peter Dutton. A man that the doctors of Australia voted as the worst health minister in the history of Medicare. A man who tried to abolish bulk billing altogether, tried to cut $50 billion from our hard-working public hospitals, and tried to jack up the price of medicines, not make them cheaper, but make them more expensive by as much as $5 a script. Happy to take questions.
 
JOURNALIST: Obviously you've been spending this whole term putting so much money into Medicare, but the improvements are only up 1.7 per cent. I mean, how much does that indicate how much more funding would be needed to get this back up to an even higher level, closer to 100?
 
BUTLER: As I said in my introductory remarks, and as the College of General Practice made clear, the overriding priority at that time was to stop the slide. Bulk billing was in “free fall,” to use the words of the President of the College of General Practitioners at that time. It was in free fall and without that record investment the rate was going to continue to slide. The most important thing that we were able to do as a result of that investment was to stop the slide, and we have done that. I'm also pleased that we've seen increases in bulk billing in every single jurisdiction, including an increase of almost 6 per cent in Tasmania, which had very low rates of bulk billing. Of course, there is more to do. I'd like to see bulk billing rates continue to increase but just in 12 months as a result of the investments, even if you assumed that bulk billing wasn't continuing to slide, we've delivered 5.4 million additional free visits to the GP. That is making a real difference. That is, as I said, in addition to the 850,000 patients who gone through our new Medicare Urgent Care Clinics also full bulk billed.
 
JOURNALIST: Have you seen an increase in the number of doctors or GP surgeries offering bulk billing, or is that the ones that already were bulk billing more patients?
 
BUTLER: We're seeing a whole range of things. We're seeing doctors who had stopped bulk billing saying that they'd reverted to bulk billing again. We've seen doctors who said at the time that they were considering having to shift away from bulk billing, reaffirmed their existing practice of bulk billing, stopping that slide, as I said. In the Health of the Nation Report that the College of GPs publishes every year, that report was published only a few weeks ago, they said more doctors were doing more bulk billing. It's having an effect across the system. I'm really pleased that of the 5.4 million additional free visits, more than 40 per cent of those additional visits were in rural and regional Australia. Of course, the biggest increase to the bulk billing incentive was outside of our major cities. Take a town like Dubbo, for example, our changes meant that a standard GP consult was increased by 50 per cent, the doctor's income was increased by 50 per cent for every standard GP consult that they bulk bill. That's a very big increase to the income of bulk billing GPs in a town like Dubbo, and that's why the bulk billing increase has happened across the country but has been particularly pronounced in rural and regional Australia.
 
JOURNALIST: That report you mentioned from the RACGP also called for the rebate to be lifted. Is that something that the government is considering?
 
BUTLER: There's more to do, and I've said from the time we were elected that turning around a decade of cuts and neglect was not going to happen in one or two or even three budgets it was going to take long, hard work. I'm determined that we do more to strengthen Medicare, that we do more to deliver cheaper medicines. But I would make the point, though, also that our two budgets have delivered the two biggest increases across the board to the Medicare rebate in 30 years. Over and above the bulk billing incentive changes, we have increased the Medicare rebate in just two budgets by more than the former government did in nine long years.
 
JOURNALIST: As encouraging as these figures it is still between $60 and $95 bucks to see the doctor here. I know you like to jump ugly on Peter Dutton record as health minister, but in hindsight, would have been an idea to embrace that small co-pay. I think in the end, it was they dropped it from $7 to $5 a visit in your first 12 for free. Would you be playing catch up now if we brought in a small co-payment over a decade ago?
 
BUTLER: The Liberal Party has never liked bulk billing. John Howard called bulk billing an absolute rort. Peter Dutton said when he came to the job as health minister, there were too many free Medicare services. That's never been Labor's view. For Labor, bulk billing is the heart of Medicare, and that has been the case for the 40 years since Bob Hawke and Neil Blewett introduced it back in 1984. You are right to say that the ACT is an outlier. If you look at the state by state breakdowns in bulk billing for general practice visits, the ACT is still down at close to 50 per cent of GP visits are bulk billed, compared to a national figure of more than 75 per cent. In New South Wales, it's over 80 per cent in parts of Western Sydney, it's well over 95 epr cent. There's no question, you refer to the Canberra experience, that the ACT is still something of an outlier around bulk billing rates for general practice consults. Of course, I would like to see that increase, as I would right across the country. But you won't see the Labor Party going at any policy that seeks to abolish bulk billing. That was the policy of Peter Dutton, and of course, I'm concerned, if he got his hands back on Medicare, he'd do it again.
 
JOURNALIST: On HECS, the proposal announced yesterday is a one-off wipe of 20 per cent of student debt. If you're a medical student, for example, starting medicine in 2026 how is that going to help you? Is it going to reduce your fees?
 
BUTLER: What you'll see over a series of announcements we've raised in relation to student debt, not just University debt, student debt, broadly, is a real intent on the part of our government to ease the financial pressure on young Australians. Student debt is higher than it's ever been, whether you're an older Australian who got the benefit of free university, or an Australian of my generation that did have some HECS. But it was nothing compared to the sorts of debts that young Australians now undertaking, TAFE or university education are saddled with. They're saddled with these record levels of debt at a time of real financial pressure on them, whether it's rental costs or having to save up for a house deposit. We make no apology for doing everything we can to ease the financial pressure on 3 million Australians saddled with record levels of debt.

Now, as Jason Clare has said, he's got a very substantial report in front of him, the Universities Accord Report that makes a series of recommendations about structural change to university fees. He hopes to be able to have something to say about that more general position towards the end of this year. You cannot overstate the importance of the changes we have already brought in for young Australian saddled with record levels of debt. We have legislation before the Parliament right now that we would like to see pass as quickly as possible that wipes off $3 billion of student debt. Because of the impact through indexation of the peak in inflation, that saves an average Australian with student debt about $1,000 off their off their debt. The changes we've announced over the last couple of days, both the thresholds for starting repayment and cutting 20 per cents off existing debt saves them thousands of dollars more again.

This is about investing in the future of the country. The investment that young Australians make for their own education is not just a personal investment, it's a national investment as well. We’re all deeply concerned at the financial pressure young Australians are facing right now, with that perfect storm of record levels of student debt, rental costs, the cost of living pressure that, frankly, all Australians are facing. We make no apology for doing everything we can to relieve that financial pressure. I just don't understand why there's been such a violent objection to it from the Opposition.
 
JOURNALIST: The Prime Minister was asked on radio this morning and said that if the government was re-elected, this will be the first bit of legislation they will introduce. Now he's also said he wants to see it happen before June 1st. Now that's a pretty short window, particularly if you go to a very late May election. Does this mean that potentially the legislation could be introduced and retroactively moved to June 1st? Or does that get a bit of a clue about the timing of the election?

BUTLER: You can all read tea leaves about election timing. I'm sure that will happen for the coming joyous weeks and months as we lead into the next election. I'm not going to add to it. I think the Prime Minister's statement this morning simply reflects the priority that we give to relieving financial pressure on young Australians.
 
JOURNALIST: There is fresh polling out today in which voters have labelled Anthony Albanese, “weak and useless.” Is he?
 
BUTLER: You know I don't comment on polling. Just like speculation about election timing, there is going to be an almost unimaginable number of different polls put out by private polling companies, by media organisations like yours, and it's not our practice to comment on them.
 
JOURNALIST: Just back to the HECs. Are you suggesting Jason Clare might be doing something more structural on student fees, to take the election rather than sort of one-off measures?
 
BUTLER: He's made clear that he would like to be able to say something towards the end of the year about some of the recommendations around the structure of university fees, which was obviously changed significantly by the former government and was the subject of significant examination by the Universities Accord.
 
JOURNALIST: On the private health check, obviously only part of it was released because of commercial in confidence, but what was released had a lot of questions about viability of some sectors, particularly obstetrics and mental health, and also a lot of questions about volatility of the private health sector as a whole. What's the Government's next move here?
 
BUTLER: I want to thank the sector, insurers, hospital operators, and other stakeholders as well for the way in which they cooperated in this health check. I think it's been an important process, and I hope gives interested members of our community a more dispassionate sense of what is happening in the private hospitals sector. Clearly, there are a number of pressures. Cost inflation across the hospital sector is reducing their earnings and their profitability, and that's a relatively structural change that has happened over the last couple of years. But there are more targeted things happening in the hospital sector, as you say, in mental health, in obstetrics, in some parts of regional communities that need some attention as well. I've asked the Secretary of the Department to keep the Chief Executive Officers Forum, which brings those different stakeholders together to start looking at any short term options that we could consider to assist the sector through these viability challenges and medium to long term reform options as well. I don't have a view about what that might look like into the future. I just want to encourage all different parts of this sector, which sometimes have competing interests, to continue the very cooperative way in which they undertook the process over the last few months.
 
JOURNALIST: Last week you were talking about the COVID Inquiry findings, and you said that the pathway back to trust for the Australian population is quite a long one. At the same time, the authors of the report said that the next pandemic could be six to 12 months away. Obviously, you hope not, but it could be. The same report said Australians would be unlikely to accept the same measures they did last time in the current state of things. Does that concern you? And are you thinking about ways to speed up that return of trust in the Australian health system?
 
BUTLER: I also said at the time that the process of rebuilding trust had to start with the announcement of that inquiry report, with things like the establishment of the Centre for Disease Control, and I think with an honest conversation, which I think was really pleasing in the in the days following the release of that report. As much as people don't want to go back and don't want to think about what was such a painful period for our community, I thought there was a really constructive community debate about some of the things that that happened and some of the things that we could do better. I just wanted to be honest, and I think the inquiry authors accept too that this is not something that we can rebuild overnight. It's going to take determined effort on the part of all governments and a range of stakeholders as well. I know our Government is determined to do our part.
 
JOURNALIST: Could it be generational - we just wait until everybody who experienced COVID is either dead or too old to remember?
 
BUTLER: That's a very grim perspective, so unlike you Phil to take. I'm certainly more optimistic than that. Thanks everyone.