Minister for Health and Aged Care – press conference – 5 June 2024

Read the transcript of Minister Butler's press conference in Canberra on bulk billing being on the rise, GP shortages, ADF recruitment and NDIS fraud.

The Hon Mark Butler MP
Minister for Health and Aged Care

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MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: At the election, we promised the Australian people that we would strengthen Medicare. A critical task after a decade of cuts and neglect that begun by Peter Dutton’s horror health Budget delivered 10 years ago, almost to this month. Our plan was focused on 3 core areas: first to boost bulk billing, to deliver cheaper medicines, and rollout of a network of Medicare Urgent Care Clinics. We've been busy over the last 2 years delivering on that promise. I'm pleased to say that the tripling of the bulk billing incentive that was delivered in last year's budget, a $3.5 billion investment from taxpayers, is starting to see bulk billing rise. Over the 7 months since the new incentives took effect, from the 1st of November, we've seen an additional 1.7 million free visits to the doctor. We're seeing bulk billing rates rise in every single jurisdiction in the country – an increase of around 3.4% across the nation and particularly pleasing increases in bulk billing rates in some of the states that had lower rates to begin with. In Tasmania, for example, that had the lowest bulk billing rate of all states, we've seen an increase in bulk billing of more than 8%. Now there is more to do, obviously, and, and we're committed to continuing to implement our plan to strengthen Medicare, but whether it's the 1.7 million additional free visits to the doctor, more than 400,000 bulk billed visits to our 58 Urgent Care Clinics, or the millions of millions of Australians who are benefiting from our cheaper medicine policy, our plan to strengthen Medicare and turn around a decade of cuts and neglect that we saw under the former government is starting to see results. Happy to take questions.
 
JOURNALIST: Both Andrew Giles and Matt Keogh have been caught out saying the wrong information in the last week. Do Ministers know what their policies are and does the Government have a credibility issue?
 
BUTLER: The position of Government policy in both of those areas is crystal clear. In ADF recruitment, we've been clear that we intend to open up recruitment possibilities from our Five Eyes partners: the US, UK, Canada, and New Zealand. We will do that in a staged way so that permanent residents in Australia who have been here for more than one year, who are citizens of New Zealand, and pass a whole range of security checks, obviously, will be able to apply to enter the ADF from the 1st of July this year. The other 3 Five Eyes partners – the US, UK and Canada – those same arrangements will kick in on the 1st of July next year. This is part of our very ambitious plan to lift the size of the ADF by about 30% between now and 2040 – over the next decade and a half. Recruiting to the ADF is obviously hard in a tight labour market, as we're experiencing right now with unemployment with a 3 in front of it, for the last couple of years. We are determined to grow the size of the ADF to deal with the really challenging security situation we have. I don't understand why the Opposition is playing politics with this. Andrew Hastie said that our Five Eyes partners were to use his words a “natural recruiting pool.” That's why we're focused on doing this but we're obviously going do it in a carefully staged way.
 
JOURNALIST: But yesterday Matt Keogh very clearly said in the morning that any resident from any country from the 1st of January next year would be able to apply. That information is now wrong and has been clarified. Do they know their policies? Is there any issue here with the information that is going out?
 
BUTLER: I'm not going to draw a fine-tooth comb over every single sentence uttered by every single minister. The policy is really clear and that's the important thing. We're focused on improving the security and the defence of our nation. Obviously, part of that involves a very big investment in hardware, particularly naval hardware, but also growing the size of our ADF.  We've thought about this carefully. We've taken advice, the policy is very clear. It will be a staged careful expansion of recruitment focused particularly on our likeminded Five Eyes partners.
 
JOURNALIST: There is some media out today, you would be aware, that says GP visits are 3 million fewer this year and bulk billing rates are actually falling. That seems to contradict the data you’ve put out so where is the discrepancy and can explain the differences?
 
BUTLER: I’ve been very upfront with the Australian people from before the election, and certainly since I was appointed Health Minister, that general practice was in a parlous state. Perhaps its most parlous state in the 40-year history of Medicare and really that's probably no surprise given their income was frozen for the large part of the last decade. A Medicare rebate freeze for 6 years that was begun by Peter Dutton in that horrid health budget of 10 years ago. You freeze the general practice income and obviously there is going to be pressure on bulk billing. I've tried to be upfront about that. The figures that were published today take a big part of the period before the new bulk billing incentives took effect. They took effect on the 1st of November. If you look at the results, they've started to see bulk billing rise in every jurisdiction in the country. In the 7 months since, as I said, an additional 1.7 million visits or there abouts – free, bulk billed to the GP in just those 7 months. In April, there were more than 400,000 additional free visits in just one month to the GP. That wouldn't have happened if we had not put in place those bulk billing incentives.
 
Now as for the fewer visits, there are a couple of factors at play. It is hard to find a GP. I've tried to be upfront about that. We have a supply problem with general practice, we need to train more junior doctors into general practice. Not enough of them are choosing that as their preferred career only about one in seven at the moment compared to the historical rate, which was closer to one in 2. I'm really pleased the number of junior doctors taking up GP training this year, is up almost 20 per cent on last year. That's showing the green shoots of recovery of interest in general practice, but I'm not going to pretend it's not still a challenge finding a GP in Australia right now. And a second factor at play is that we did see an artificial inflation in the number of GP visits through COVID. There were lots of short visits, less than 6 minutes to get a COVID vaccination, they were all bulk billed because that was a natural requirement during a pandemic. Obviously, you've seen a drop off in those short bulk billing consultations that were all a one-off, related to COVID.
 
JOURNALIST: As you say that it is hard for people to find a doctor in some areas, what are you doing to make it easier for people to get actually?
 
BUTLER: As I said, we've got a challenge with the number of young doctors taking up general practice. I'm glad that we've seen an increase of almost 20 per cent this year. That's going to take some years to work through the system. It takes 5 or 6 years for a junior doctor to train as a GP, and to get the Fellowship of the general practice college. This can't be turned around overnight. This structural decline that we've seen for years now, it can't be turned around overnight but we are starting to see the green shoots of recovery.
 
We've got particular plans to try and encourage junior doctors, particularly to take up general practice training in rural Australia. That's through a ‘single-employer model’ that deals with some of the real industrial disincentives to take up general practice compared to other specialties, for example, you don't get continuity of service through this because you're changing employer through your 6 years, you don't get paid parental leave, all those sorts of things we've started to deal with through the single-employer model. But as I say, this is going to take some time to train a bunch of new junior doctors.
 
In the meantime, we need to make it easier to be able to recruit overseas trained doctors. That's always been a significant part of the system, whether it was doctors or nurses or other health professionals. We're working through recommendations that were delivered by Robyn Kruk to the National Cabinet, to health ministers, to clear some of the bureaucratic red tape to allow communities to recruit overseas trained health professionals more easily.
 
JOURNALIST: Just on these numbers here, great news in Tasmania but why is it so low here in the ACT?
 
BUTLER: I'm glad to see some recovery in the ACT with an increase of more than 5% in bulk billing rates over the last 7 months since the new incentives took effect. The reality is it's very patchy across the country. There are parts of western and southwestern Sydney where you see bulk billing rates well over 95% for GP visits, whereas in the ACT and then in Tasmania over the last several years, it's been way lower than that. Even on the Central Coast and Hunter Valley, not far from Western Sydney, you've seen bulk billing rates significantly lower than that part of the biggest city in the country. I'm glad that you've seen the best recovery of bulk billing rates in those markets that have the lowest rates to begin with. I'm also really pleased that some of the largest increases in the number of free visits to the doctor are in rural and regional Australia, because that was also an area of particular concern. You're getting an increase and you're getting an increase in the parts of the country I was most worried about
 
JOURNALIST: Twice in the last week the wrong information has been put out. Surely, you're worried that people can't trust what government ministers are saying?
 
BUTLER: It's important that we communicate our policies really clearly and if some miscommunication happens then that is clarified as quickly as possible and that's happened in both those cases.
 
JOURNALIST: Just on the NDIS, criminals are impersonating providers and using money for organised crimes, money's being spent on drugs, holidays, and cars. Is that acceptable?
 
BUTLER: No, it's completely unacceptable. I think the testimony before Senate Estimates will come as a big shock to many Australians. All Australian taxpayers are contributing to this really important scheme. If you remember what it was like for people living with disability, before the NDIS was introduced, this has been a life-changing scheme. But there's clearly too much waste in it. There are too many rorts and as you say, there are far too many dodgy providers. It's really important that this be cleaned up. It's really important that this critical social program be put back on track. That’s why today in the Parliament, we will be debating the legislation that the NDIS Minister Bill Shorten has introduced to start that process. I made the point a couple of times this morning, this is not just the responsibility of the Commonwealth Government, or the Commonwealth Parliament. This was a scheme introduced and supported by all governments, including the states and territories. They need to help us get this thing back on track, start to clear out the dodgy providers, stop waste and stop the rorts and make sure that these precious taxpayer dollars that are being channelled into this life-changing social program, go to things that actually change the lives of people living with disability, not some of the stories we heard last night.
 
JOURNALIST: Bit of left field this one, I’d like to get your reaction to it. In America, the number of people that use marijuana every day has for the first time in 40 years, surpassed the number of people who drink on a daily basis. What's your reaction to that? And do you think Australia is ever going to get down that same path?
 
BUTLER: As you probably know, there are many jurisdictions now in the US that have legalised marijuana and marijuana products. It's a very different system to Australia where that is not the case. There's not a significant debate that I've really noticed here in Australia to follow the American path. Given the degree to which recreational marijuana use on a legal basis is now really common in some very big jurisdictions in the US, perhaps those statistics aren't surprising. But the situation here in Australia is very different. I don't sense any debate to go down that American path here.
 
JOURNALIST: With the NDIS as well, participants of the NDIS are concerned that with this overhaul and the issues in the NDIS, that they're going to be left behind, how are you going to make sure that doesn’t happen?
 
BUTLER: Bill Shorten has been really clear. We've got to undertake this process in co-design with people who are living with disability, with their families, with the NDIS board, led by people with disabilities was really deeply experienced in their sector. Bill Shorten’s exactly the right person to do this. He was one of the architects of the scheme. He knows this sector really well. People living with disability and their families know and trust him. I know they have confidence that he is the right person to do this job. You’re right, it is critically important that this process of getting the scheme back on track, cleaning out the waste, and the rorts and the dodgy providers be done in a careful way, which ensures that we're taking people with disability with us on the journey.
 
JOURNALIST: You’re trying to find $14 billion in savings through the scheme. For people who are on the scheme that hear this they will be rightfully concerned that they're going to lose certain services or, you know, the kind of personalisation that's been at the heart of this scheme. How are you going to make sure that that doesn’t happen?
 
BUTLER: As Minister Shorten has made clear, it's important to point out that although there are savings that are in the Budget here, that those savings are delivered by reducing growth in the scheme. The scheme is still projected to grow at 8% a year, that's very significant growth. It's still a scheme that will grow. It won't grow as fast as it currently is, because the growth, frankly, is very high compared to other social programs. I think Minister Shorten has been very careful to point out there is still growth in the scheme and to reassure Australians living with disability and their families, the scheme is there still to support them. We want it to work in the way it was originally designed to work not to feather the nest of dodgy providers and to support rorts.
 
JOURNALIST: How can you slow growth without stopping people from being on the scheme?
 
BUTLER: It's about growth in the scheme. It's about the very significant inflation you're seeing in this scheme compared to other important programs, whether it's Medicare that I have responsibility, even aged care, where we're dealing with very significant demographic pressures with the ageing of the population. The growth in NDIS is particularly significant. So, reining in that growth, which will still be very significant at 8% per year, is a responsibility we have for taxpayers to ensure that taxpayer’s money is spent wisely. The scheme will still grow. It will still be there to provide some world leading support for people living with disability, but we've got to cut down on the sorts of stories we heard and that alarming testimony in the Senate. Thanks, everyone. 

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