Minister for Health and Aged Care – transcript – ABC 7.30 – 2 May 2023

Read the transcript of Minister Butler's interview with David Speers on vaping and Medicare.

The Hon Mark Butler MP
Minister for Health and Aged Care

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DAVID SPEERS, HOST:  Welcome to the program. 


SPEERS: Vaping is so prolific right now. Realistically, what is it going to take to stop young people getting their hands on vapes?

BUTLER: Concerted comprehensive action by all levels of government. What I tried to do today was to set out that sense of determination but also urgency that all Health Ministers have. This is a public health menace, particularly impacting younger Australians. It is a deliberate strategy, I think, of Big Tobacco to create a new generation of nicotine addicts, and we simply can't stand by and let that happen. 

SPEERS: So will you have to beef up border checks?  

BUTLER: We’ll have to beef up border checks, and we're committed to doing that so that the only way companies will be able to import vapes is to demonstrate that they will be for sale through a pharmacy on prescription by a health professional, and that they comply with new standards - no more bubblegum flavours, no more pink unicorns on the wrapping, it will be pharmaceutical with plain flavours and not disposable. 

SPEERS: And on that are you expecting police then to be checking people who are vaping to see if they have a prescription?  

BUTLER: We're not going after people who vape, this is something very much focused on vendors. This is the convenience stores, these are the vape stores that too often, frankly, are setting up shop down the road from schools because they know that it's their market. This is very much focused on vendors to stop them doing what I think the community accepts is the wrong thing.  

SPEERS: You're going to allow all GPs to prescribe nicotine vapes, but there are currently no nicotine vaping products that are approved by the Therapeutic Goods Administration. The Royal Australian College of GPs told us they prefer to have an approved product to prescribe. So, what are you expecting doctors to do here, prescribe unapproved products?  

BUTLER: There will be products that are assessed against standards put in place by the TGA. And at the end of the day, a sponsor needs to submit a product for approval...

SPEERS: Have any companies done that? 

BUTLER: I'm not aware of them doing that.

SPEERS: Are you inviting the tobacco companies to seek an approval for these nicotine products from the TGA? 

BUTLER: I think that's a long, laborious process, and at the end of the day, I'm not going to wait for sponsors to do that. If there are products in the marketplace that comply with the standards I've just set out: they need to be free of chemicals, and the TGA list is particularly dangerous, they need to be at particular nicotine levels, as well as all of the other things I set out around the flavouring and presentation. If they are compliant with those standards, and can be prescribed by doctors as a smoking cessation device or to help people with nicotine addiction, that is something that will be able to be imported and sold through pharmacies only.  

SPEERS: Okay. You’ve also announced a further tax hike on cigarettes today as well to raise more than $3 billion over the next few years. What impact will that have on smoking rates? Or is this more a revenue raiser?  

BUTLER: This is principally a health measure, we know from the last time we were in government doing this that price signal in tobacco is an important addition to a panoply of measures designed to drive down tobacco. And the problem with excise over the last couple of years is that it actually started to lag inflation. So relative to other products in the market, it was becoming cheaper to smoke cigarettes. And we think particularly at a time when we want to redouble our efforts to drive down tobacco rates, and also combat, frankly, the risk that people will transition from vapes on to cigarettes, putting that price signal back in the market is important.  

SPEERS: But is there an inconsistency or will there be an inconsistency? I mean, why should it be legal to buy nicotine cigarettes without a prescription but under your plan you would need a prescription to buy nicotine vapes?  

BUTLER: I think if 100 years ago, governments knew what they know now about smoking - that it’s killed millions and millions of people across the world, they might not have let smoking take hold in the community...

SPEERS: But you’re in government now...

BUTLER: For decades we've been trying to combat tobacco and drive down those smoking rates. Vaping is still an emerging technology, and I think what governments at all levels now recognise is that we've got the chance to nip this in the bud. It is going to be difficult because it really has flourished over the last two or three years. But it is different in nature to cigarettes...

SPEERS: Why, just explain that to us, because under what you're suggesting here, you need a prescription for nicotine vapes, no prescription for cigarettes. Why?  

BUTLER: Because cigarettes have very deep roots in the community, they have been around for decades, they are terrible for your health, they remain a major killer of Australians and people across the world. But I think tobacco control experts recognise that they do have deep roots in the community. And it requires quite a different, more sophisticated suite of measures to drive down tobacco use...

SPEERS: Because there'd be too much of a black market for cigarettes, is that the problem?  

BUTLER: But also because there are deeply ingrained habits that some people have had for many decades...

SPEERS: So because so many people are hooked, you can't really move to a prescription? 

BUTLER: And because this is a product with very deep roots in our community that goes back well before any of our lifetimes. So, it has been a long, hard effort to drive down tobacco use and in the space of a few decades we've got that down from 30 or 40% of adults smoking, to just 10%. We're determined to get that number down even further, while at the same time making sure that there's not a new generation of nicotine addicts created through vaping.  

SPEERS: Let's go to the alarming fall in bulk billing rates as you call them today, will next week's Budget include measures to make seeing a doctor more affordable?  

BUTLER: I'm not going to reveal measures in the Budget. We've already revealed some of the strengthening Medicare measures through the National Cabinet meeting the Prime Minister had with Premiers last Friday. They are strong reform signals about creating a Medicare system that's fit for the 21st century. But we also recognise there are financial pressures, particularly on general practice. And we are going to have more to say about strengthening Medicare next Tuesday night.  

SPEERS: Well, you said that the GP system is in its worst shape in 40 years, and you are concerned about the number of, well, the falling number of medical graduates who are choosing general practice? Is the Medicare rebate paid to GPs right now adequate? 

BUTLER: David, you only have to wait to Tuesday night, we know that there is financial pressure on general practice, particularly because of six years of a freeze on the Medicare rebate, under the former government. So that’s been front of mind. It's obviously something that doctors' groups and others have been talking to us about...

SPEERS: Pretty strong argument...

BUTLER: You are going to have to wait until Tuesday night to see the full range of measures that we put in response to the Strengthening Medicare Taskforce. 

SPEERS: Okay, just finally, the South Australian Premier told this program last night that the $2.2 billion you've announced will make a difference. This is what you've announced so far. But he said the truth is, we're going to need a lot more to address the cratering of primary health and access to GPs, are you prepared to spend a lot more than that $2.2 billion?  

BUTLER: He's right. It's not enough in and of itself. It's an important start because it signals we're not just going to put more money into the existing system, which is not really serving the needs of patients today. So, there will be more in the Budget next week. But I also have said this won't be fixed in one Budget. This is a long-term effort to get Medicare back into the shape we've always wanted it to be in. And it's not quick to turn around the number of medical graduates who are choosing general practice as a career, we have to turn that around, but that won't happen in one Budget either. 

SPEERS: Mark Butler, thank you.  

BUTLER: Thanks David.  

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