Minister for Health and Aged Care's press conference on 4 September 2024

MEMBER FOR ASTON, MARY DOYLE MP: It's great that we're all here in Bayswater with this exciting announcement for our community. We've got an Urgent Care Clinic, and it's a wonderful thing too. I'm so excited to be here with Minister Butler, and I'd like to invite Minister Butler to say a few Words.
 
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Thanks, Mary, and thank you, Todd, for having us here at this clinic, which is a general practice just next door, which has expanded into what is now going to be part of the Medicare Urgent Care Clinic network. It's terrific to be here with Mary Doyle. When Mary became the first candidate in 100 years to take a seat from the Opposition, I remember campaigning with her, and one of the things she was most passionate about, as someone with lived experience of serious health issues, was joining a team that was focused on strengthening Medicare.
 
That's been such a focus of our work over the last two years: to turn around a decade of cuts and neglect. And whether it's tripling the bulk billing incentive, which has delivered more than 3 million additional free visits to the doctor just since November, or this Urgent Care Clinic network, or cheaper medicines, which is saving people hundreds of millions of dollars at the pharmacy, we know that these strengthening Medicare initiatives are making a real difference to millions of people. But we also know it's still tough out there, and it's really tough to find a doctor when you need it, either for yourself or for your kid. We know that it's tough affording the medicines that your doctor has said are important for your health, and that's why we're determined to do more. Earlier this week, I announced an additional hundred medicines to be added to the 60-day prescriptions list. That means that you can go to your doctor for a range of common medicines, if you're on them on an ongoing basis, and receive a script for 60 days’ supply, rather than just 30. What that means, for example, this week for the hundreds and hundreds of thousands of Australians dealing with asthma you can now get two inhalers for the price of one. I was speaking earlier this week to a family, a mum who has two kids, all three of them suffer from asthma, all three of them need preventative inhalers, which cost $30 each, that's a $90 medicines bill every single month. This decision, if the doctor chooses to provide a 60-day script, halves that cost at a time of serious cost of living pressures for Australia. We are determined to do more for cost of living and also to provide better healthcare.
 
I'm really delighted today to announce that we are adding seven Urgent Care Clinics to the Commonwealth's network of Medicare Urgent Care Clinics, and that includes this one here at Bayswater, known as the Maroondah Urgent Care Clinic, as well as Glen Waverley, also in eastern Melbourne, and five more around Victoria. Urgent care is a terrific new model of care. It's effectively something between a standard general practice and a hospital emergency department that's open seven days a week, importantly, is fully bulk billed and allows you to go and get high quality urgent care when and where you need it. I was talking to Tanya here, who brought her kid here who was suffering, it turned out, from croup. She knew if she wasn't able to get the care she got here at this clinic, she would have had to wait for hours and hours at the local hospital emergency department: Maroondah ED. She was seen, she got an appointment within an hour and a quarter, and within two hours of first known and she had to go to the clinic her child was back in bed. She was confident she knew how to care for him and was able to avoid having to go to the ED and wait for hours and hours and hours. There are hundreds of thousands of those stories already in the short time that this network has been operating.
 
Around across the country, one in three patients are kids under the age of 15. Here, I'm told as many as 38 per cent of the patients going through this clinic have been under the age of 15, which is the highest number I've heard of all of the Urgent Care Clinics operating around the country. This means they're not spending hours at the emergency department, and it is for care that needs to be delivered urgently. They're injured on the sporting field, they fall off a skateboard and break their arm, or they have a significant illness that their parent needs seen immediately. The only alternative really, now, is to go to an already crowded hospital emergency department. I'm delighted that this is added to the network, and I might ask Todd to see if he wants to say a few words about his experience expanding his general practice. I want to thank you for taking the decision to lift your general practice up to a new level. Obviously next door, you’re continuing to provide the great services that have traditionally been provided in an Australian general practice, but also offering this quite new model of care for Australian patients in this part of Melbourne.
 
GP AND CEO, MAROONDAH MEDICARE URGENT CARE CLINIC, TODD CAMERON: Thank you, Mark, thank you, Mary. It's a real privilege to be able to serve the community in this manner. Being a general practitioner myself for 30 years now, I've seen changes in general practice over time, and certainly a lot less treatment room-based care is delivered at the moment in general practice. What we have in the Urgent Care Clinic, and the guaranteed funding makes a huge difference to the continuity of that care. What we have here is a model where we have one admin, one nurse, one GP on all the time. We typically seen three to four patients per hour. Over the course of the week we run 14 hours a day, seven days a week, means we're usually seeing somewhere between 250 and 300 patients per week. We've seen 24,000 patients since we started in January of 2023. At this point in time, we're running at about 14,000 patients per year. A lot of that work is in the after hours period, so 43 per cent of all of our consults occur outside of normal hours. We find that we get referrals from the Maroondah ED, which we collaborate and work really closely with, as well as Ambulance Victoria. Local GPs also send a lot of patients here because they're just not really necessarily geared for jumping in and doing urgent work in the treatment room.
 
Yesterday, in the afternoon, we had eight patients in the row that were requiring sutures, you can't imagine that really happening in this area in general practice. This is a really cool place for GPs to step into. All of the GPs that work here are vocationally-registered GPs, the same qualification standards you'd expect in any general practice in Australia. For them, that gets a work that's a bit different it's more like an emergency department in the lower acuity. It's a great opportunity for both the GPs to do work that they love and is meaningful work, and the community to get the benefit from that. I'm really grateful for the opportunity to continue to provide that care.
 
BUTLER: Thank you. One of those eight sutures was the result of a hedge trimmer. A reminder to everyone out there to use your hedge trimmers in the way that the safety instructions reflect - and that includes me - happy to take questions.
 
JOURNALIST: Labor MPs are calling for Medicare rebates for dental work as well. Is that on the agenda for this term of Government?
 
BUTLER: Look, my focus in this term of government is to strengthen the fundamentals of Medicare. I've been really clear that the most important focus of government is on general practice. When we came to government, general practice was in the most parlous state it had been for the 40-year history of Medicare, and we know that it is the backbone of a properly functioning healthcare system. That's why I make no apology for the focus on lifting bulk billing in general practice, on developing this network of Urgent Care Clinics, and also dealing with the cost of living pressures in access to medicines. I know that many of my colleagues are ambitious for Medicare to do more. We're very proud in Labor of our role in creating and defending and strengthening Medicare. I know my colleagues would like to do see it, do more, but right now, my focus is, as I said, on strengthening the fundamentals of Medicare, which have been under real pressure after 10 years of cuts and neglect.
 
JOURNALIST: Is there a time frame for Medicare dental rebates, though? Because you've previously said Labor's committed to providing this. So is there a time frame, or are you sort of just letting it further down the road?
 
BUTLER: Look, there's no there's no work on that in this term of Government. We have a Medicare scheme for children in Family Tax Benefits families who are able to access $1,100 of dental services every two years. I'd like to see that taken up more than it is. I think only about 40 per cent of eligible kids are using that service. I'd like to focus on lifting that number, because we know good oral health in childhood and adolescence sets you up really well for the rest of your life. Right now, we are working with state governments on developing a new oral health plan, and that's about practical change that we can make that will make a real difference. I know that there is ambition for Medicare in the medium to long term, but right now, we're focused on the fundamentals of Medicare, as it was envisioned by Hawke 40 years ago and Whitlam 50 years ago, and that particularly is about general practice.
 
JOURNALIST: You called for review into the private hospital sector. The investigation is done. You going to release the findings of that review. And also, what can the Government do to stop a private hospital as closing down?
 
BUTLER: To your first point, you're right: I asked the secretary of my department to undertake what I described really as a health check for the private hospital sector. This is a really important part of our healthcare system. For example, it does about two thirds of elective surgery or non-urgent surgery in the healthcare system. It's predominantly commercial actors, some of them for profit, some of them not-for-profit. It's funded by private health insurance. This is a private system that involves or requires the big commercial operators, private health insurance companies, and the private hospital operators, to work together in a way that serves the interests of patients as well as their own commercial interests, whether they're for profit or not for profit. I know that is under pressure right now, and I wanted my department to undertake a more objective, neutral, if you like, check of the health of the private hospital system. That work has finished, the analysis hasn't been provided to me yet. In terms of what might be released publicly, I was very grateful that the vast bulk of the players in the system, whether they were insurance funders, effectively or private hospital operators, provided a lot of pretty commercial-in-confidence, sensitive information to our department to be able to get a really good sense of what's really happening out there in the sector. Obviously, they don't want that released, so the full report will not be released. That would breach faith, really, with those companies and organisations who participated in this in good faith. But I've asked my department to look at preparing a version of this report that is able to be released publicly so the community understands what's going on, without breaching faith with the undertakings we gave to keep that commercial information in-confidence.
 
JOURNALIST: On the second point, Minister, so what can, what can your government do in this term to stop private hospitals from closing down?
 
BUTLER: The first thing I want to say is that there's no silver bullet from Canberra or funding solution from taxpayers to deal with what are essentially private pressures in this system. We want to look at what we can do, but I've been really clear with insurers and with private hospital operators that there's no simple fix from Canberra or no bailout from taxpayers that are going to deal with pressures in the private hospital system. These operators, many of them very large, need to work together in a way that serves the national interest as well as their own commercial interests. But I am also keen to have a look at the analysis when it's provided to me, it hasn't been yet, and work with private hospital operators and private health insurers to work through ideas or ways in which the federal government can assist with some of those pressures. But I do want to be clear, there's no bailout, there's no silver bullet that will come from Canberra to deal with some of these pressures. The sector itself is going to have to provide that leadership. If there's way in which we as a government can provide support, and I know state governments as well be interested to know what they can do, then obviously we're up for that. Because the private part of our healthcare system is fundamentally important to the broad operation of Medicare.
 
JOURNALIST: Are you saying that the federal government won't tip in any money?
 
BUTLER: I didn't say that. I said, I haven't seen the analysis. But I do want to send a clear message to the private operators, whether they're for-profit commercial operators or the not-for-profit insurers and operators. There is no simple fix that can come from Canberra for pressures that are very diverse and varied. Some of them are general cost pressures in the healthcare system that flow from wages and energy bills and such like. But some of the pressures are about the way in which the healthcare system operates now, there's more out of hospital care, there's more day surgery rather than overnight stays. Some of the regional pressures we see really flow from workforce supply in areas like mental health, obstetrics and the like. There is no one answer to a sector that's facing a whole myriad of diverse challenges.
 
JOURNALIST: How concerned are you about escalating tensions between insurers and the private hospitals?
 
BUTLER: This has always been a sector where these operators, many of them quite big, pretty influential, powerful operators, play it hard and they negotiate hard. And that's really quite not particularly surprising given the nature of these commercial relationships. We've seen a few over the last six to 12 months get pretty tense, but all of them ultimately have resolved in a deal that serves the interest, both of the operator and the funder, and most importantly, the patients. It just goes again to reinforce the fact that the nature of this system, which was contemplated very deliberately by Bob Hawke and others in developing Medicare, is a fundamentally important part of our healthcare system that requires these operators to work together in the interest not just to their own organisations, but the interests of patients.
 
JOURNALIST: Herald Sun is reporting as well today that a man died from cardiac arrest because paramedics closest to him was stuck at Maroondah hospital because ED staff there told them that they had to wait there. How concerning is that to you?
 
BUTLER: I've only read the story in the Herald Sun. I don't have any more information than I've read in the media. I'm reluctant to talk about the detail of cases. I mean, obviously a person has died, and that is that is a tragedy for the family and the loved ones concerned. The broader story goes to pressure, I think, on our hospital system. I've said earlier this morning that hospital emergency departments really end up being the lightning rod for failings right through the healthcare system. People aren't able to get the care they need out in the community. Too many end up at the hospital emergency department because that's their only option. And that really is why we're setting up these Medicare Urgent Care Clinics. Really to try and take pressure - not for cardiac arrests, obviously - but for some of those more semi-urgent or non-urgent cases that make up about 40 per cent of all emergency department presentations in Victoria. How can we divert more of them to clinics like this, so that EDs and ambulance systems can operate on those once in a lifetime emergencies, like cardiac arrests, like strokes, like serious car accidents and the like that do require a fully equipped hospital emergency department.
 
JOURNALIST: How concerning is it to you, though, that hospital EDs are saying, you know, they're too busy, that paramedics are forced to wait with them because they can't take care of these patients and offload them, and then other people who need urgent paramedic health, you know, dying because they can't get this help that's stuck at the hospital. Like, what does this say to you about the pressures on EDs?
 
BUTLER: Obviously, it's deeply concerning. This is a pressure that's been faced by hospital systems right across the country, actually, right across the world, particularly in the wake of COVID. I mean, our system is still under real strain. There are challenges getting the workers we need into our hospital systems. People are sicker than they were before COVID because they weren't getting the care and the checks that they needed during periods where there were lockdowns and the diversion of resources into dealing with the pandemic. Still, hospital systems are dealing with that legacy. And as I said, we need to do everything we can to relieve as much pressure from hospitals as possible. Make sure that care that could be delivered elsewhere, in clinics like this, in aged care facilities, in a range of other settings outside of hospitals are diverted as much as possible, so hospitals can focus on their core work, which is those once in a lifetime emergencies that absolutely need a fully equipped hospital emergency department. I'm deeply concerned about this case and about all of the other cases I see right around the country where hospitals are just under really serious strain. It's probably the number one topic of discussion that I have with my state health minister colleagues. It's why we're so focused on this program, on making sure we can get a new hospitals agreement in place as quickly as possible, to provide more Commonwealth funding to state hospitals, to support the terrific work doctors and nurses and other health workers do in hospitals like Maroondah right across the country.
 
JOURNALIST: Have you spoken to the Victorian Health Minister about this particular incident?
 
BUTLER: No, I haven't this morning, and look, ultimately, this particular incident is a matter for the Victorian Government and for the Victorian health system. The Commonwealth has no role in overseeing or being involved in any way in the operation of hospital systems in any state or territory. Our job is to provide funding for states to operate their hospitals, and as I said in December, we put more than $13 billion additional dollars on the table to provide that extra support to our terrific public hospitals around the country. But our other role is to try and build programs like this to take that pressure off hospital emergency departments.
 
JOURNALIST: I mean, Victoria's health hospital system is clearly sort of in dire straits at the moment. I mean reports today that Victorian Health Minister applied for a $400 million bailout so that hospitals could pay their staff. Have there been conversations between the Victorian Government and Commonwealth about extra funding so that hospitals can make sure that their bills are paid and that their staff are paid?
 
BUTLER: Again, I've read I've read those stories, I don't have any more information than anyone else does who's read those stories, I think, in The Age this morning. Yes, funding is a very common topic of discussion between state health ministers and me, and frankly, state premiers and the Prime Minister as well. That's why we've put that additional money on the table. That agreement, if we're able to reach, it, will take effect from the first of July next year. But in the interim, we've delivered $1.2 billion of additional funds to state hospital systems, or state health systems to try to relieve that pressure on hospitals, not just in Victoria, but right across the country, are dealing with these issues. Some of that funding goes to Urgent Care Clinics like this one, some of it more than $150 million that we've committed to Victoria will also try to make sure that older patients are able to be seen either outside the hospital system in the first place, or if they have to go to hospital or able to be discharged as quickly as they possibly can, again, relieving that pressure on the hospital system. We've got a longer-term funding fix on the table. But in the interim, we haven't wasted time. We've decided to put more money through a $1.2 billion commitment the Prime Minister made at National Cabinet in December, and this is really part of rolling out some of that funding.
 
JOURNALIST: How much of that funding is going towards the Victorian Government and Victorian hospitals?
 
BUTLER: I can't remember the exact dollar figure, but it's a proportional share. It's basically determined on a population share basis. Around a quarter of that money, some of that will be Urgent Care Clinics, and the rest, a little more than $150 million will be on initiatives to better support older patients around their journey through the hospital system. But those priorities were determined by state Governments effectively. We made the funding available, we then asked all state and territory governments to put proposals to us about the best way in which that funding would be deployed in their jurisdiction. The Victorian Government focused particularly on these Urgent Care Clinics, but there's also a range of programs that will be funded for older patients, either preventing them being having to be admitted to hospital in the first place, or, as I said, if they are admitted to hospital, trying to make sure that as soon as they're clinically able to be released or discharged from hospital, there is somewhere for them to go.
 
JOURNALIST: Have you seen these sort of urgent bailouts in other states, or is Victoria really like the only one that's they gave the Treasurer basically like a day's notice to get this money to the hospitals. Have you seen these cases in other states?
 
BUTLER: Around the country, hospital systems are under real pressure, and health ministers at a state and territory level, are constantly in negotiation with their Treasurers about ensuring that their hospitals have sufficient funding. As I said, I only read the story in the media about the $422 million I think it was that the Victorian health system requested from Treasury. I have no more information than that. I'm pretty reluctant to talk in detail about it. But it just goes to my earlier comments to say that hospital systems are under real pressure, and that partly reflects the demographics of our community, and older community that's getting sicker as well. It partly reflects the legacy of COVID, that's probably felt more sharply here in Victoria, that that felt the brunt of COVID more than other parts of the country. But it also reflects failings in the rest of the health and aged care system after a decade of cuts and neglect, and we're very focused on turning that round as a Commonwealth Labor Government.
 
JOURNALIST: What role would the state governments play in relieving tensions between insurers and private hospitals?
 
BUTLER: Look I think primarily this is a Commonwealth responsibility. We regulate and oversee the operation of the private health insurance sector, which is the funder of private hospitals. At different state and territory level though, there is obviously a relationship between the public hospital system and different private hospitals. There is sometimes some sharing of the elective surgery load and other things like that. I know my state and territory health ministers are interested in the outcome of or the results of this health check. They're very focused on making sure that the public hospital sector remains viable, remains strong. Because to the degree there are closures, particularly in some sensitive parts of a sector like mental health or obstetrics, that ends up having to be picked up by the public hospital system, which - I think we've been talking about over the last 10 or 15 minutes - is already under very serious pressure. They're not principal players in this, but they're obviously impacted by any disruptions to private hospital services. This has been a subject of a number of discussions, not just between me and my health minister colleagues at state and territory level, but also I know between chief executives, and I imagine that will continue to be the case. Thanks everyone.