Press conference at Chemist Hill, Adelaide

MINISTER FOR HEALTH AND AGED CARE MARK BUTLER: Thanks for coming out. And thanks, Luke, for hosting us at this terrific Chemist King, which is a really important part of these parts of the western suburbs, not only providing medicines and a whole lot of other health products and retail products, but also providing really important health care services, which is something we're here to talk about today.
 
Although the weather out there is utterly beautiful, it is important to say that flu season already is upon us. Already, we have about 40% more cases than we had at the same time last year. So it's important to start talking about the importance of flu vaccination. And today I can confirm that flu vaccine is available right across the country. It's important also, particularly after four years of a COVID pandemic where there wasn't as much attention on flu, to remind Australians that flu can be a very serious disease, particularly for older Australians over the age of 65 for other Australian adults who might have compromised immunity. And importantly, for very young Australians - so under five year olds - flu can be a very serious and, tragically, sometimes fatal disease. Indeed, of all of the flu deaths recorded last year, one in four of them were Australian kids. So, it's important for parents to bear that in mind when considering whether or not to get their under five year olds vaccinated for flu.
 
Our Government is utterly committed to cheaper medicines and an important part of our cheaper medicines, medicines policy, is ensuring that free vaccinations or immunisations, are as widely available, as is possible. And pharmacy plays a really important role in this. Pharmacy proved its worth over the course of the COVID pandemic: 12 million COVID vaccinations were delivered in pharmacy, paid for by the Australian taxpayer. Pharmacy was perhaps the most widely accessible health service right through the COVID pandemic. They didn't close their doors. People right across the country knew that they could go to their pharmacy, get some advice, get some products, and also get their COVID vaccinations.
 
And based on that just terrific contribution that community pharmacy made to our country through the pandemic, we took the decision from the 1st of January this year, that community pharmacists would be able to deliver all of the vaccinations that are freely available under the National Immunisation Program to any Australian aged over five years old. We still want under five-year-olds to be going to their doctor or to their to their local Child Nurse because there's the ability to pick up a range of other things there. But for over five-year-olds, all of the National Immunisation Program vaccines are now freely available at your local community pharmacy. And importantly, taxpayers are paying community pharmacists exactly the same fee a GP gets to deliver that vital health service. So I encourage Australians right now, particularly over 65s, pregnant women, parents of kids who might be immunocompromised, if they're over the age of five, think now about this great opportunity to get your flu vaccine from your local community pharmacy. Perhaps at the same time you might consider getting your updated COVID booster, which should be something people are thinking about as well.
 
Today, though, I also want to make an additional announcement to that program. And that is that we are now going to pay community pharmacies to be able to visit aged care facilities and disability homes to also deliver National Immunisation Program vaccines. Importantly, that will include flu vaccinations. I've just been talking to Luke and Nick about local aged care facilities, who are crying out for their local pharmacy with whom they have a very close relationship, to be able to come and deliver the flu vaccine to aged care residents. And up until this announcement today, they've not been able to do that under the free-of-charge arrangements under the National Immunisation Program. We've decided to provide funding to community pharmacies to go out visit aged care facilities, use that strong relationship they already have with the provider and with local residents and deliver the flu vaccine to give that protection to vulnerable aged care residents. And I want to thank community pharmacy for stepping up, not just through the COVID pandemic but in the time since then, to deliver this wide range of health care services that, increasingly, people are coming to their local community pharmacy with whom they have a really strong relationship and talking to them about all of the other services that community pharmacies are very well qualified to deliver. Happy to take questions.
 
JOURNALIST: How does this work with the aged care sector? Is it an institution reaching out to the local pharmacy? Or did the pharmacist reverse engineer that?
 
BUTLER: It's a very close two way dialogue. And Luke may talk about his local experience here. But as you can imagine, aged care facilities provide a whole lot of medicines to their residents. Most residents are on several medicines or even more. And so there's a very close relationship between a particular aged care facility and their local community pharmacy, with a whole lot of traffic going there almost every single day. And that's why facilities have been calling out to their local pharmacy, at a time when it is difficult to get access to a local GP. They're calling out to their pharmacy: “can you come and deliver the flu vaccination to the aged care residents you know so well. I mean, you're providing their medicines, and you have this very close relationship and understanding of them.” And up until now, they haven't been able to be paid to do that. So we're doing that, just to continue expanding the role of community pharmacies, well qualified healthcare professionals, but really importantly, giving that convenience, those cheaper medicines and vaccines to aged care residents and that convenience for aged care providers, who want to make sure that their residents are vaccinated as we head into flu season.
 
JOURNALIST: How many Australians benefit from this in the age?
 
BUTLER: There are about 200,000 Australians in an aged care facility at any one time. They're all over 65, pretty much, and so they're all eligible for the free flu vaccination under the National Immunisation Program. Now, not every single facility might access this, but we expect hundreds and hundreds of facilities will. Already I think we've got almost 4,000 pharmacies signed up to this program, using the access to the National Immunisation program, they're keen to do it. Local aged care facilities, even before we made this announcement, had been ringing into their local pharmacy, you know, concerned that they wanted to make sure that their residents were vaccinated in time for flu season to commence. But they were having difficulty getting hold of their local GP.
 
JOURNALIST: This is a new program, how have people in aged care homes been able to receive the flu vaccine in the past?
 
BUTLER: This program has always been available for GPs. So they can get free flu vaccination through their GPs. That's been the case for many years. As I said, from the 1st of January, pharmacists were able to provide free flu vaccinations, but only in the pharmacy itself. So today, I'm making the announcement that we’ll allow pharmacists to go out into aged care facilities and disability homes, as well, and to provide those flu vaccinations free of charge to the aged care residents or the disability home residents. And pharmacists will be paid the same fee that GPs have always got. Now, a whole lot of people want to get their vaccinations at their local pharmacy. And if they're over 65, up until this year, they've had to pay a fee. Or they could get it free of charge at GPs, but they'd have to pay a fee if they wanted to go to their local friendly community pharmacy and get their flu vax, because maybe it was more convenient, or they had a good relationship with their local pharmacist. As I said, providing that free of charge option to people in the community, or to residents in an aged care facility, is just another part of our commitment to cheaper medicines.
 
JOURNALIST: And what will this cost taxpayers this program?
 
BUTLER: It depends really on take up. I mean, we want all over 65s to get a flu vaccination. So from our point of view, whether it's at a GP or local pharmacy is neither here, nor there. We just want them to get access to it. But we want to give them as many options as possible. So if they want to go to their local pharmacy, and increasingly, that's what people want because it's convenient and they have that relationship, then they shouldn't be disadvantaged financially by those old arrangements that only allowed GPs to provide fact vaccinations under those free of charge NIP arrangements.
 
JOURNALIST: You mentioned the 40% increase in cases. Why do you think that is?
 
BUTLER: The flu season jumps around a lot, it's fair to say. I mean, sometimes it starts earlier, it can go up and then drop away and then go up again. So we don't know really what the trajectory of flu cases is going to look like. We, as the government, have the responsibility to remind Australians that the best protection against severe disease or hospitalisation or even worse, is a vaccine. I mean, last year the flu vaccine reduced the risk of hospitalisation by more than two-thirds. This is a highly effective vaccine. And so for those Australians over the age of 65, if you're an adult with compromised immunity, or if you're a parent of a child under the age of five and over six months, or a pregnant woman, you are strongly recommended to get the flu vaccination. It is a very effective prediction against severe disease.
 
JOURNALIST: Do you think people have just become complacent because of the pandemic?
 
BUTLER: What we have seen is a drop off in vaccination rates since the pandemic. The drop off in flu vaccination rates last year for over 65s was relatively small. But you know, it was a drop off, nonetheless. So I do encourage people over the age of 65 to very strongly consider getting a flu vaccination this year, along with your COVID booster if you're due one. But there was a much more pronounced drop off in vaccination rates for little ones aged between six months and five years. And we've seen a drop off in childhood vaccination rates really across the board, not just for flu and but for a range of other conditions. And this is a global phenomenon that the World Health Organization has pointed to. So we're considering ways in which we can continue to promote to parents of young ones the benefits of vaccination, we've got some campaigns that have been rolling out across social media platforms that parents would typically access to just remind Australian parents of the benefits of vaccination. And we do that in relation to flu vaccination as well.
 
JOURNALIST: Nick, what does this program mean to too many pharmacists going out into the community now and being able to offer another service like this?
 
NICK PANAYIARIS, BRANCH PRESIDENT OF THE PHARMACY GUILD IN SOUTH AUSTRALIA: It's a really, really important extension to the program and it just closes the loop, in terms of what pharmacists are already doing in terms of helping increase those vaccination rates. And make sure that, especially in those aged care facilities, which are our most vulnerable, basically, at the end of the day, that they are protected against the flu for another season. And it is quite frustrating that we've been able to go into those facilities and vaccinate for COVID, but we haven't been able to vaccinate for flu at the same time. And you can vaccinate at the same time for the flu. So we absolutely welcome the announcement by the Minister and the Government to extend the program to make sure that we can vaccinate for flu at the same time.
 
JOURNALIST: Will it make a big difference in terms of try alleviating the stress to some patients coming into the pharmacy to get a jab, they can quite comfortably stay in their own rooms to get it done.
 
PANAYIARIS: It's just not feasible to bring out, you know, aged care residents out of the homes, basically, to get vaccinated. But there has been circumstances where, you know, and again, Luke's got an example from last year, where an aged care facility actually paid the pharmacist to go and vaccinate, because they were just desperate to get someone to vaccinate. So this announcement will just make it a lot easier from that point of view. We've been getting a lot of calls lately, and we've been working with the Government to make sure we can get this extension to the program. Because aged care facilities and especially with disability sector, as well, have been crying out at the moment. They just can't get anyone to actually undertake the, you know, the vaccinations process, basically, from that point of view. As of next week, I'm sure community pharmacy will be ringing up those aged care facilities and just letting them know the good news.
 
JOURNALIST: What's your message to parents that this winter flu season, we've heard obviously 40% increase in cases so far.
 
PANAYIARIS: The announcement that community pharmacy can actually vaccinate under the NIP now for a whole series of vaccines, it's just the conversations we have basically at a community pharmacy level to actually ask - whether it's the mum, the child or whatever, or the family - are your vaccinations up to date? And if they're not, we have those conversations and then use that opportunity to say, “well, look, it is a very bad flu season already, it's come early, the best protection you can have is to make sure you're vaccinated”. So the convenience of obviously, one: the interaction we have with patients on a regular basis to have that conversation and just remind them how important it is to get vaccinated.
 
JOURNALIST: Nick was explaining a bit of a scenario where you were getting phone calls to say that we need you to come in. Can you just elaborate on how that played out?
 
LUKE MICHAEL, PHARMACIST: I'll give you a bit of background. So community pharmacies work with aged care facilities, so we have a relationship with them. So the facilities that we service at this pharmacy, we go there every day, we work with the GPs, we work with staff there, and we work with the residents. So we have an ongoing working relationship with them. And a lot of those facilities, we actually have provided COVID vaccines for the facility, for the residents and some of the staff there as well. So it's been difficult to explain to them why we can do a COVID vaccine with them, but we can't do a flu vaccine. So a couple of examples: last year, like Nick said, we had a facility that the GP was unable to provide the vaccines for the facility. They paid us to come out and do it. That's the point they were at, that they funded it themselves. They saw the value in doing it, but they couldn't access it. And that was the only way they could do it. A couple of weeks ago, I had a facility email me and say: “the GPs, again, we work with, we know them, they were unable to do it”. And they asked us “can you come in and do the vaccines for us? You've run a successful COVID vaccine clinic, we work with you, you know, our residents.” It'll be easy for us to do it. And I have to say “no”. And I had no other suggestion for them. They contacted their Primary Health Network, and they were told late May was when they'd be able to come and do it. So on Monday, I can email them and say that we can come and do that for you now.
 
JOURNALIST: How much of a relief is that now, as someone who's you know, in the game to provide healthcare that, you know - how hard is it to tell an organisation “no, we can't actually do this, our hands are tied”. And now the pathway has been cleared.
 
MICHAEL: It's great. And it's a logical step that we've gone from being able to vaccinate, to the COVID vaccines, to be able to get subsidised vaccines for all the vaccinations, to be able to service those that are most vulnerable, that probably need it the most. So it's been really good.
 
JOURNALIST: Minister, pathology services are calling for a $630 million boost in the Budget, saying they're under immense financial strain. And if they don't get these cash injection services could close or they could be forced to start charging for blood tests. Will they get any money in the Budget? And what do you think of this claim that there's a risk Australians will have to fork out their own blood tests?
 
BUTLER: For the Labor Party, bulk billing is the beating heart of Medicare. We have no higher priority in health policy than try to protect bulk billing services for Medicare. That's why we put in place the biggest investment ever in bulk billing in last year's Budget: a $3.5 billion dollar investment to lift bulk billing rates for GP attendances. We're also obviously committed to bulk billing in other services, including pathology services that you refer to. I mean, already around 99.7% of Medicare pathology services are bulk billed. And we’re determined to do everything that we can to protect that rate, to continue the availability of bulk billing pathology services for Australians. Now, I can't indicate what we are or not going to do in the Budget. We're taking this submission very seriously. We'll have more to say about it, in due course.
 
JOURNALIST: But you're sympathetic to the claim that they are under financial pressure. It sounds like you're looking favourably on this?
 
BUTLER: What I am committed to doing is to make sure that bulk billing is as widely available for Australian patients as possible. That's why it was the number one agenda for us in health policy when we came to government and was the biggest investment in last year's Budget. Now we know that bulk billing is not just a challenge for GP consultations, there are challenges right across the system, after 10 years of cuts and neglect that were kicked off by Peter Dutton when he froze the Medicare rebate. I'm alive to the pathology campaign from the big pathology providers and we're taking it as part of the Budget process.
 
JOURNALIST: Just on another topic, just away from health, can you confirm if the eSafety Commissioner has fined X – formerly known as Twitter – for not taking down posts?
 
BUTLER: Can I say this: our Government is utterly committed to making sure that social media is a safe place for Australians. And we support the work of the eSafety Commissioner. Australia has one of the world's leading eSafety regimes: laws that were put in place with our support by the former government, but have been continued by our government with increased funding. And we absolutely support the work of the eSafety Commissioner.
 
JOURNALIST: I have a couple of questions about the two stabbing attacks that happened in Sydney. Obviously, mental health has been discussed at length since then. Is the federal government putting enough money towards mental health or should there be more?
 
BUTLER: First of all, can I say that it's been a just a dreadful week for the people of Sydney and the people more broadly in Australia. And all of our hearts still go out to the people of Sydney broadly, and particularly to those who lost loved ones in the dreadful attack a week ago in Bondi Junction. We also know that the events later on in the week in Western Sydney have been a cause of great distress as well to that community. In terms of the the event in Bondi Junction, there will be a Coronial Inquiry undertaken by the New South Wales Government. So I don't want to talk about the events in that event, in particular. But there has obviously been a discussion over the last several days about mental health support services for those who had the most acute, usually lifelong conditions: psychotic disorders which might include a condition like schizophrenia. And I think that that is a debate we need to have in Australia. You know, there's been a lot of debate over the last couple of years about the adequacy of psychological support services for people with more mild to moderate illnesses, like depression and anxiety. And that's an important debate, as well. But this is quite a different challenge that the community has. All of the health ministers met over the last couple of days in Brisbane on Thursday night and on Friday, and we were able to have an initial discussion about some of these issues. For the last couple of years, there has been an analysis that has been underway of what is called the unmet need for people with very severe chronic mental illness, including those psychotic disorders that we're talking about. Already, that analysis has been delivered here in South Australia, it showed there was quite a significant gap. And over the coming weeks and couple of months, I expect the unmet needs analyses will be delivered for all of the other jurisdictions in Australia. And that's going to be a really important base for us to do the work in the area of foundational supports, for example. A lot of a lot of people with those very severe, lifelong mental health conditions like psychotic disorders, if they're not on the NDIS, they are falling between the gaps. And that really was the purpose of the agreement that National Cabinet came to in December to build that system of foundational supports for people falling outside of the NDIS. And this is one of those very big groups. So there has been some work underway. But I think the events of the last week and the community debate that has enlivened, I think, have meant that Health Ministers are looking at that very closely.
 
JOURNALIST: Have you had any briefings about mental health services or resources since the attacks?
 
BUTLER: As I said, we had quite a fulsome discussion about these issues at the Health Ministers Meeting that was underway on Thursday night and Friday, so the last 48 hours or so. These services are largely delivered by state governments at that severe chronic end. And so we were able to have a good discussion about that. There will be, I think, important lessons from the Coronial Inquiry the New South Wales Government has obviously initiated in response to the tragic attacks in Bondi and the tragic killings there. So there will be important lessons, including about how jurisdictions communicate when people shift from one state to another. So yes, there have been those initial discussions. But as I said, this has been an area where there's been work underway for some time. It's complex work, how these services interact with the National Disability Insurance Scheme, which was designed to cover people with severe and chronic mental illness. So many people with those levels of illness are currently covered by the NDIS. But it's clear that many are not. And that really was the work that the Premiers, the Chief Ministers and the Prime Minister at National Cabinet directed relevant Ministers - Disability Ministers and Health Ministers – to undertake as we build that system of foundational supports.
 
JOURNALIST: Just shifting back to the eSafety Commissioner if that's okay. Sorry to chop and change. Will the Federal Government consider banning X from Australia if they're not going to police themselves properly?
 
BUTLER: I've heard suggestions that Elon Musk is saying he's going to fight the fine that the eSafety Commissioner has said would be levied against X, because of the way in which they've refused to take down graphic videos around last week's attacks. And can I say this: Australia is not going to be bullied by Elon Musk, or any other tech billionaire, in our commitment to making sure that social media is a safe space. So if he wants to fight that fine in court, well, we're up for that fight. Because we are determined to do the important work of keeping social media safe. And I say that's not just the job of Government or the eSafety Commissioner, though, as well. I call out to Australians, as you're looking at your social media platforms, don't share this graphic content. Don't forward it. This graphic content should not be on our social media. It is not a safe message, particularly for young people who are accessing social media. So this is a shared job all of us have. The eSafety Commissioner is taking a leading role. This is one of, I think, the world's leading regimes. We have been trying to make social media a safe space. But we're not going to be bullied out of this job by any billionaire, whether it's Elon Musk, or any of the others.
 
JOURNALIST: How does the federal government try and rein this in, then?
 
BUTLER: Through the important work of the eSafety Commissioner. As I say, I think this is recognised as one of the best programs in the world. We have strong laws, we have a strong eSafety Commissioner, supported by her staff, and when she puts in place a fine - which she won't do lightly - because a platform like X refuses to take down a graphic video, we will back her to the hilt. And we're not going to be bullied by Elon Musk into backing down on the enforcement of these laws that have strong bipartisan support. Thanks, everyone.