Press conference with Minister Butler, Melbourne – 12 November 2025

BASEM ABDO, MEMBER FOR CALWELL: Welcome to Craigieburn and welcome to Calwell. In particular, I want to welcome Minister Mark Butler for joining us here today to talk about how we're delivering bulk billing to all Australians.
 
When I was elected 6 months ago, fewer than 40 per cent of local GP clinics fully bulk billed. Within just 6 months, that number has almost doubled to over 75 per cent. It's testament to this government's record investments in Medicare and is a game changer for communities such as mine with the single largest investment ever in Medicare history. In particular it’s changing local health outcomes for patients and in particular for their families.

I'm delighted to be joined by the Minister here today, and I'll hand over to the Minister. Thank you.
 
MARK BUTLER, MINISTER FOR HEALTH AND AGEING, MINISTER FOR DISABILITY AND THE NDIS: Thank you. I'm so happy to be here with Basem. He is a terrific local member. Working with him in the short 6 months since he was elected shows to me just how utterly connected to his beautiful community in Melbourne he is. And I know how hard he campaigned on our Strengthening Medicare policies, particularly our record investment in bulk billing, and he's already indicated what a difference it is making to his communities.
 
I'm really delighted to be here at the Craigieburn Medical and Dental Centre here. This is one of the well over 1,000 GP clinics around the country that since 1 November have gone from charging a gap fee to some of their patients to bulk billing everyone that comes through their doors for GP consults. Because of our record investment, it's obviously good for their patients, but our investment shows that it's good for the practice and it's good for the individual doctors themselves. We want to see by the end of this decade a bulk billing rate for all Australians around 90 per cent. We know that's where we are for pensioners and concession cardholders as a result of the investment we’ve put in place in 2023 to triple the incentive that GPs get for bulk billing those Australians. But we want to extend that bulk billing to all Australians, which is why we invested more than $8 billion from 1 November to pay doctors more for bulk billing those Australians and to pay practices an incentive if they bulk bill 100 per cent of their patients. And that's what this practice is doing.
 
Dr Bashir has joined us today. I'm really delighted to hand over to her to indicate what this means for her practice as a GP and for her patients, then I'm happy to take questions. Thank you, Doctor.
 
SUMBAL BASHIR, GP: Thank you. My name is Dr Sumbal Bashir. I have been working and living in this community for a few years. I believe it's a very good initiative to improve access to healthcare. We have been seeing patients, like – they have better access to health care without any financial strain, and I think it will certainly improve long-term health outcome. We have more opportunity and time to participate in preventive health care because otherwise, it would come at the end of list because people will discuss obviously urgent issues first because of financial strain. But I think now we can spend more time. Especially living in this multicultural area, it's very good opportunity to engage in continuity of care and prevent health outcome and chronic disease burden on health system as well. I feel very comfortable, and it's a good opportunity to engage in ongoing health improvements. That's all.
 
BUTLER: Thanks, Doctor.
 
BASHIR: Thank you.
 
JOURNALIST: What evidence do you have that this is enabling doctors to spend more time with patients when it's necessary?
 
BUTLER: Obviously, these are relatively early days. The investment only took effect a couple of weeks ago, but as I said already, hundreds and hundreds of clinics have moved to bulk bill all of their patients. We modelled this on existing practice, so we modelled the investment on exactly the practice that doctors were already undertaking. However many consults they were doing an hour, we put that in – we calibrated that investment to make sure that three-quarters of practices would be better off if they move to a 100 per cent model.
 
What doctors like Dr Bashir have said to me this investment means is that patients don't feel a financial barrier to coming to see them. They come when they need to come rather than when they feel they can afford to come, and they can come back for repeat consultations without worrying about the gap fee that they might be charged for that. It's really making sure that doctors and patients are able to deliver the healthcare and receive the health care when they need it rather than when they can afford it.
 
JOURNALIST: I've got a couple of questions on another matter if that's okay to go to them. Former Family Court Chief Justice Diana Bryant said on Monday that it may be better for parliaments to step in now and regulate the field of paediatric gender medicine rather than rely on whatever disputes become before judges. And she made reference to a case that I think she was involved with, which was a landmark case for puberty blockers, and said that the evidence that she'd heard back in 2013 that blockers were fully reversible and without side effects – and that was evidence given by so-called paediatric gender medicine experts – was misleading and overconfident.
 
I know the government's currently undergoing a review of puberty blockers. Is it not incumbent, given the international evidence and given views of people like by Diana Bryant, for you to step in now and pause the use of puberty blockers in children in Australia?
 
BUTLER: Puberty blockers are pretty much exclusively prescribed by clinicians employed by state governments in state government services. A decision about a pause on puberty blockers, such as was initiated by the Queensland Government, is ultimately a matter for state governments.
 
What I think the role for the Commonwealth here is to ensure that all clinicians and all members of the community have access to the best possible clinical advice about the use of so-called gender affirming care for teenagers and young people generally, but the use of puberty blockers in particular. And that's why I asked the National Health and Medical Research Council to conduct this review. It is the body in Australia that has decades of experience to do this, has a statutory charter to do it in a sober, evidence-based way. When I asked them to do it at the beginning of this year, they confirmed to me their view that this was a highly contested and still evolving area of clinical practice. You see that in the debates that are happening right around the world about this. I'm convinced this is the right process. We want the experts with a statutory charter to provide the best possible clinical guidance to clinicians, to parents and to judges, frankly, if they have matters come before them about what should happen to precious teenagers and young people.
 
JOURNALIST: When are you expecting to have that guidance?
 
BUTLER: The guidelines generally will take a little while to develop, but I ask that the advice about the use of puberty blockers be expedited and that is due to be delivered in the middle of next year, within the next 6 to 9 months.
 
JOURNALIST: I guess there are children now where these decisions are being made. There are many experts around the world who argue that harm has been done to children as a result of that. Does that weigh on your mind?
 
BUTLER: This does weigh on my mind heavily because we're dealing with people who are at a very vulnerable, formative stage of their lives in their physical development and their emotional development, frankly. There are arguments on both sides of this debate, if I can characterise this debate as having 2 sides, who are very alive to the harm being done to young people in this area, including, frankly, in some of the nature of the public commentary and the public debate. That's why I think the right thing to do is to bring this back to science and to ensure that the best qualified experts, overseen by the body that has had a statutory charter to develop clinical guidelines in this country for decades, resolves this debate and delivers compelling definitive advice to all practitioners, all families and frankly all judges about this.
 
JOURNALIST: Puberty in Australia is no different to puberty around the world. Is it good enough that we're waiting 6 to 9 months when other comparable jurisdictions like, for example, the UK have decided that it's too dangerous for children to be prescribed puberty blockers?
 
BUTLER: A range of countries to which we often look for, not for advice particularly but to compare what we're doing, are taking different approaches here. It is true that the UK has taken a different course since their review conducted last year. Some other countries have changed practice but many others haven't as well. It is important that we look overseas for evidence, and to the extent there is some research, some peer-reviewed research there, that's obviously something that the National Health and Medical Research Council will be doing as they develop these guidelines and their early advice about the use of puberty blockers.
 
JOURNALIST: Just on a slightly different issue, it was revealed yesterday through FOI documents that Sex Discrimination Commissioner Anna Cody investigated whether anything could be done to block the reappointment of Reem Al-Salam as the United Nations Special Rapporteur on Violence Against Women and Girls. Are you at all concerned that our sex discrimination commissioner is stepping in a manner like that?
 
BUTLER: I read those reports. I don't have anything to say about that. That's not a matter within my portfolio. That's a matter for the Attorney-General.
 
JOURNALIST: Are you concerned that we've got a sex discrimination commissioner who says that she doesn't understand the term biological women?
 
BUTLER: All I've seen is a couple of media reports about that. I don't have enough information to make a comment about that.
 
JOURNALIST: Shouldn't a sex discrimination minister be able to define the term woman and know who she is responsible for?
 
BUTLER: I can only say this so many ways. I have read a couple of media reports about this. I do not have enough information about what the commissioner may or may not have said to provide a comment on a matter, particularly one that's outside my portfolio.
 
JOURNALIST: Great. Just a couple of questions from me, please. I know you're a proud South Australian, but isn't it time to bite the bullet, to see that SAHMRI should never have had the contract with proton therapy in the first place, write off the costs, and move forward with another proposal in another state?
 
BUTLER: As I think you know, Jen, we're working with South Australia to see whether there is an alternative pathway to deliver this important national capability for the country. Obviously, the contract that was entered into some years ago by the then South Australian and Commonwealth governments is not able to be delivered because, frankly, the company that they entered that contract into is simply incapable of delivering that capability. There's a lot of sunk capital, including human capital in South Australia, that means that if there were a South Australian solution, that might be able to be delivered more quickly than any other jurisdiction that would be essentially starting from scratch. That's why I've thought it important to see whether South Australia has an alternative model. We're working closely with them. We're getting close to the point of seeing whether that is possible and then going to other jurisdictions to see whether they have some alternative models that they want to put on the table as well.
 
JOURNALIST: Minister, the technology has changed  significantly. You don’t need the bunker that’s in the Bragg Centre. The machine much smaller can be equipped in any major hospital. I know that there is a proposal that the Peter MacCallum Centre in Melbourne has put to your office. Will you accept that offer or are you even considering it?
 
BUTLER: As I said at some point we will at some point soon, frankly, we will go to other jurisdictions. And I'm aware of, in broad terms, of the Peter MacCallum proposal. I'm also aware of changes in technology that are happening in this area. All of that information is being pulled together to ensure that we take a new path forward that delivers this capability, particularly for children.
 
JOURNALIST: Doctors have had enough. They’re saying they’ve had enough. It needs to happen. Is it time, Minister, to move away from South Australia and look to Melbourne to house this unit? It could be up and running by next year.
 
BUTLER: That's not a decision I'm making today, particularly given the experience we've had with previous governments making decisions about this matter. This is a capability we don't currently have in this country, so I don't want to get it wrong a second time. I want to make sure that we deliver the best capability in the quickest possible way for Australia's children, and for the clinicians who desperately want this armoury in their toolbox. At the moment we're still having to send kids overseas. We've streamlined the program that allows children to be able to go overseas supported by the Commonwealth taxpayer to receive that treatment there, but I want to deliver this capability as soon as possible. It's a matter of enormous frustration and regret that we've had this experience in South Australia, but we can't change that fact. We've now got to find something in the future.
 
I hear the frustration of clinicians very loudly. I hear the frustration of families as well. I just want to make sure we get this right this time.
 
JOURNALIST: Are you considering it? Are you considering the Peter MacCallum?
 
BUTLER: Of course we're considering this. We're just making sure we go through the proper process, given the very, very significant amounts of money that will be involved in any of these proposals. And making sure that –
 
JOURNALIST: [Inaudible]… now to send the families overseas? That’s already been spent?
 
BUTLER: Yeah. Making sure that we are able to unwind the situation in South Australia and make the right decision this time.
 
JOURNALIST: Thanks Minister.
 
BUTLER: Thanks very much.