Press conference with Minister Butler, Melbourne – 20 November 2025

MARK BUTLER, MINISTER FOR HEALTH AND AGEING, MINISTER FOR DISABILITY AND THE NDIS:  Thanks everyone for coming along. I've got a couple of things I want to announce today. I'm going to deal with Medicare Mental Health Check In first. I'm here with the Assistant Minister for Mental Health and Suicide Prevention, Emma McBride, and also Chris Blake from St. Vincent's Health, who is going to talk about this really exciting program that will roll out from 1 January. I've also got some exciting news about the operations of cohealth here in Melbourne, and so I'm joined by the Member from Melbourne, Sarah Witty, and Jo Briskey, the Member for Maribyrnong. Once we've dealt with some opening remarks around Medicare Mental Health Check In, I'll say a couple of things about cohealth and Sarah and Jo might add a couple of remarks as well, and we're happy to take questions.
 
We've been focused as a Government on strengthening Medicare in all of its relevant respects. More bulk billing, more Urgent Care Clinics, more doctors and nurses to ensure we have the health workforce we need and cheaper medicines as well. But one of the other focus areas of our Government over the last three years is making sure the mental health services that people need are available to them in an affordable way. When I formed, together with Emma, the Mental Health Reform Advisory Committee, their overarching message to Emma and to me and to the Government was that we needed a stepped model of care, a series of services that met the different needs that people had in terms of their mental health. That can be relatively low-intensity support through to formal psychological therapy delivered by qualified usually clinical psychologists through to more complicated services including in an acute care setting. It was very clear that in some of that stepped system, there were very significant gaps here in Australia. Again, an overarching message from this committee was that we didn't have enough low-intensity supports for people who needed relatively immediate but low-intensity support for milder to moderate mental health symptoms often in the form of anxiety and depression.
 
What that meant was it was a gap in and of itself that should be filled. It also meant that those Australians were being referred instead to more formal psychological therapy through the Better Access Medicare Scheme, going to face-to-face usually CBT services from a qualified clinical psychologist and aggravating some of the weight lists and shortages that we have in that area as well. Developing a low-intensity service would, in and of itself, have the benefit of filling that gap but also relieve pressure on the formal psychological therapy system that we have funded by Medicare.
 
In the 2024 Budget, we set aside some hundreds of millions of dollars to fill that gap, and for the first time, to put in place this universal free-of-charge Medicare-funded mental health support service. After undertaking a rigorous competitive tender process that was the subject of many, many applications from different organisations across the country, the decision was taken to choose St Vincent's Health as the provider of that service for the Government. St Vincent's will be known to all Australians as a terrific health service that has served the interests of Australians for decades and decades right across the country. But it more recently also has a terrific track record in digital health and digital mental health in particular, which is why I'm so excited that the tender process came up with this decision.
 
I'm going to ask Chris Blake after Emma to make some remarks about how this service is going to be stepped up. But the important thing for me as Minister is that it will be universal. It will be free of charge. It won't require a referral from a doctor. It will be available seven days a week and for extended hours and fill that really important gap. So if you are feeling stressed, feeling anxious, have had a life event that has put really serious pressure on you that you don’t feel that you can get through it yourself, or with the support of family and friends, you know that there is this service available to you, either to help you step through a self-care model or also perhaps provide you with some low-intensity cognitive behavioural therapy online through qualified practitioners. This is a terrific addition to what is already a world-leading mental health support system that we have here in Australia. Again, all part of our commitment to a stronger Medicare.
 
I'll ask Emma to say a few words and then hand over to Chris Blake, the head of St Vincent's Health to talk about how they will deliver this service for the Government and for the Australian community.
 
EMMA MCBRIDE, ASSISTANT MINISTER FOR MENTAL HEALTH AND SUICIDE PREVENTION: Thanks very much, Minister Butler, and I want to acknowledge your leadership in this, creating a new front door for mental health support and care for all Australians. When we came to Government, people were seeking more support. They needed it sooner, and it needed to be affordable. With the work of experts and listening to the advice of lived experience and working with clinicians and innovators, we now will have from 1 January, Medicare Mental Health Check In, a free service for Australians aged over 16 to be able to get that earlier support. As Minister Butler has said, we all experience periods of distress in our life, the loss of a loved one, feeling pressured by overwhelming work demands, bereavement, relationship breakdown. Medicare Mental Health Check In will provide that support to Australians sooner and for free. As Minister Butler has said, it will be introduced in a staged way because we're balancing timeliness with clinical safety and making sure that as it's introduced in three phases. We are working alongside lived experience to co-design this service to make sure that it meets the needs of all Australians.
 
From 1 January, the digital service will be online. From the end of March, the low-intensity CBT. And from the end of May, the full service will be available. We anticipate, given the need across Australia, that about 150,000 Australians will benefit from Medicare Mental Health Check In each year. This is part of our broader reforms to create a system of mental health support and care in Australia under Medicare. The new low-intensity services will complement the roll out of 91 Medicare Mental Health Centres across Australia, offering free walk-in support and care for Australians, wraparound support that they need within their communities, complemented by links to digital psychologists and psychiatrists. We are also expanding our services for young Australians, knowing that the distress amongst young Australians have doubled since headspace was first introduced. We are expanding the headspace network to 203 centres right across the country, more outreach to remote and more regional communities in Australia. We are also introducing headspace Plus, 30 of them across Australia, uplifting the clinical capacity of headspaces to meet the more complex needs of young Australians today. And for the first time, introducing 20 new youth specialist care services to be able to respond to the very complex needs of young Australians in primary care outside of hospitals.
 
As a former mental health clinician myself that worked for many years in in-patient services, I saw distress escalate to crisis simply because there wasn't enough support in the community. We are now creating a new front door to mental health support and care for all Australians under Medicare that people trust, for free, and closer to home.
 
Thank you. I'll now hand over to Chris.
 
CHRIS BLAKE, ST VINCENT'S HEALTH AUSTRALIA: Thank you. It’s fair to say that this is a game-changing initiative on behalf of the Government, and St Vincent’s is proud to be partnering with the Government to deliver the service.
 
The service is all about catching people when they need it, where they need it, early on in their mental health issues In January, the first tools and helpful facilities will be available via a website. In March, that will move to Telehealth SMS a suite of extended digital tools, including trained mental health practitioners that people will have access to through that front door. And then by the middle of the year, we will have a full suite of tools that are available, including the digital self -guided tools that the Minister has already mentioned.
 
We really see this as taking pressure off the mental health system. We know that 50 per cent of people, even in the last year, have had some form of mental health issue. This is about catching those people early, when they need it to take pressure off the acute services, which we will always need, but also to provide services to those people when and where they need it. It's also a game changer for regional and remote Australia, who often have very limited access to these types of tools.
 
At St Vincent's we're very proud to be partnering with the Government in what is essentially an absolutely game-changing mental health initiative. It is, essentially, the future of health care. Thank you.
 
BUTLER: I might just deal with cohealth first, and then take questions. Cohealth is a very well-known community health service here in Victoria, in what is quite a unique Victorian mob that traces its history right back to the Whitlam initiative for community health centres. Most other states dropped that model of care after the dismissal of the Whitlam Government, but Victorians, to their credit, have kept this model and delivered a really terrific range of community health services over the last 50 years right across Victoria.
 
Cohealth has served the communities around Collingwood, Fitzroy and Kensington for many years and, as Victorians know, they did an announcement some weeks ago that they would cease their general practice services just before Christmas this year. This came as a shock to the Commonwealth Government, which obviously funds much of its general practices through the Medicare system. It certainly came as an enormous shock to the communities that cohealth has served for many, many decades.
 
Sarah Witty the Member for Melbourne, and Jo Briskey the Member for Maribyrnong who are with me today, whose communities have been served by cohealth were similarly shocked by this and have been engaging with their communities, including through very well attended community meetings, to try and find a response and a different way to a closure of this critical service just before Christmas.
 
I've been calling on cohealth to pause that decision, which I'm glad to say the board decided to do over the last couple of days, to the end of February. Today I've announced that the Commonwealth will provide $1.5 million to be able to extend that pause to the end of July to give us time, along with the Victorian Government, to review the cohealth service, particularly the primary care services involved with cohealth, and to chart a way forward to ensure, as far as possible those services are able to continue beyond the 31 July.
 
I want to thank the Victorian Government for their cooperation here. The review will be conducted jointly with them given the level of support that the Victorian Government has always given to cohealth and to other community health services here in Victoria. I want to thank Sarah and Jo for their relentless advocacy in Canberra and beyond for a solution to be found to this quite shocking announcement that was made a few weeks ago. I'll ask them to say a few words and then we're happy to take questions about that decision or the investment in Medicare Mental Health Check In.
 
JO BRISKEY, FEDERAL MEMBER FOR MARIBYRNONG: I stand here on behalf of my beautiful community in Kensington who were deeply distressed at cohealth’s shock announcement that they would be closing their GP services just before Christmas.
 
I've been working really closely with that community, because it is a health service that our community owns. As the Minister said, it's been a service that has delivered the primary health care for that community for decades now, and to be a part of a Government that is going to step in and help find a pathway forward is something I'm incredibly proud of.
 
I stand here today as a representative of this community who fought hard. They were not going to let this service close on their watch, and I just want to congratulate the community for standing strong and working with me as their representative in the Federal Government to secure a pathway forward. This is our Labor Government recognising the importance, and it's the reflection of our value of Medicare and funding primary health care through GP services for our community.
 
Thank you very much, Mr Butler and the Victorian State Government. We are going to see a really strong outcome for our community I'm sure, because that's what our community deserves.
 
SARAH WITTY, MEMBER FOR MELBOURNE:  I too, like my community, was very distressed when I heard about the potential closure of cohealth and, straight away, I got on board with my colleague Jo Briskey and we went marching to Minister Butler's office and made sure that he heard the voice of our community.
 
We stood strong with our community and made sure that we've got the right outcomes to be able to move forward, able to support the most vulnerable people in our community. I'm so proud to be part of a Government that is leaving no one behind, making sure that every vulnerable person has access to GP services, both in my community and in Jo's community as well. Thank you, Minister.
 
JOURNALIST: What are cohealth telling you they need in order to stay open? And was this a case of State Government under funding?
 
BUTLER: Cohealth put a proposal to us after we had pressed them for some time to pause their decision and to allow us time, along with the Victorian Government, to find a better path forward than closure.
 
They put a proposal to us about what funding would be required for them to pause in the middle of next year, which would be 3 July. That funding - $1.5 million - has been granted by the Commonwealth on the condition that there be a joint review involving the Victorian Government about the model of care that cohealth operates there.
 
I want to make the point that, through our strong Medicare policies we have very significantly increased the Medicare income of cohealth through our bulk billing reforms. This is a population that, from 2023, benefited from the tripling of bulk billing incentive from that budget two years ago and, from this month, extended bulk billing support to every single one of the patients that come through the doors of those cohealth general practice clinics.
 
Other commentators, like Stephen Duckett for example, made the point that other community health services in Victoria are not reporting the same financial predicament that cohealth has reported, so we want to really have the opportunity to review their model of care, their billing practices, and see if there is a sustainable model going forward, like there is obviously with other community health centres in Victoria, to ensure that they can continue to provide general practice services to their community long into the future.
 
JOURNALIST: You've come through with Federal funding. Is the State Government likely to need to stump up as well?
 
BUTLER: The Victorian Government has agreed to be a part of this review, and that review will explore not just Commonwealth funding, but I'm sure may explore some of the issues that have been ventilated here in Melbourne around infrastructure funding for community health centres as well. We don't have a view about that yet.
 
We want to allow an independent review of cohealth to explore those issues in a sober, evidence-based way that allows the community to have input rather than being shocked by a decision to close their service with very short notice.
 
JOURNALIST: If the patients who are concerned about the future of their healthcare, are you just kicking the can down the road? Is there a chance that this service could be closed regardless?
 
BUTLER: What we’re doing is we’re listening to the community. The community wanted time to consider a viable path for this service that served the communities that Jo and Sarah were talking about for decades. We want to see it continue to serve those communities for decades to come. As I said, they have received record amounts of Medicare billing over the last couple of years. We’ve delivered the three biggest increases to the Medicare rebate in 30 years – the biggest, the second biggest and the third biggest. And on top of that, the frankly extraordinary bulk billing funding that we’ve put in place to triple the bulk billing incentive and, for the first time, extend that bulk billing support to every patient, not just patients with a concession card. There’s every reason to think that cohealth general practices should be in a much healthier position right now than they were two or three years ago. Certainly last time I visited a cohealth service in Collingwood, they were reporting the extraordinary benefit of the tripling of the bulk billing incentive in 2023.
 
We think there is a path forward. You see that with other community health services. They’re not reporting the same financial predicament that cohealth is, so I feel very confident that we can find a path forward for this service.
 
JOURNALIST: Could that path forward look quite different in terms of its service offering?
 
BUTLER: I don’t want to pre-empt the review. What I've said, and certainly what Sarah and Jo have said, is they want a chance to look at this in a sober, evidence-based way rather than dealing with the crisis, essentially, that was precipitated by a board decision to close a decades-long service with only a few weeks' notice. I know that's been an extraordinary source of distress for staff at cohealth as well, but also, as Sarah and Jo have said, for their communities.
 
JOURNALIST: Just on the mental health announcement, often one of the biggest barriers to people accessing the help they need is knowing what's available to them. What will you be doing to make sure that people know that this service is available?
 
BUTLER: I'll ask Chris to supplement that as the organisation that's been awarded the contract. But we want to do everything we can to give people information about the options that they have, and we'll be saying more about that over the coming period. But what we've tried to do as we've rolled out new services is to make sure people are aware of them and also to attach them to the most trusted government program brand in the country, and that is Medicare. What Medicare says to people is that there is strong clinical practice and there is strong affordability. And that's why we want to make sure that people recognise that this is a government funded service that they can trust and know that they can access for free. I'm not sure that Chris wants to add anything about awareness raising?
 
BLAKE: I would just add that clearly we'll be using all of the Medicare channels as the primary source of getting information out. But we'll also be working with government to work out where do people who need help get their information, particularly young people. That work is about to commence. We will be getting the information out before 1 January, and then we'll be continuing that information constantly as the service gets stepped up.
 
JOURNALIST: I've got questions on another matter, Emma. Just on the mental health service, when you say trained professionals, who are you- like what kind of- psychologists, counsellors, who will be those professionals?
 
BLAKE: I’m happy to talk to that. We're working with a university provider to build the skills to supplement the training and the volume of trained practitioners that are available at the moment. That's why is being stepped up, because that's taken some time to get that training in place and to get the volume of new people, new highly trained people into the system to augment what will be a digital service, to give them access to those trained professionals. Clearly, this isn't a crisis service. There are many other high needs services that are already available. It's actually about taking the pressure off those services so that those services are available to the people who need them as well. These two skills will work hand in hand so that there's a seamless flow through the system of catching people earlier, giving them the help that they need through trained mental health practitioners, and if they need crisis help, then referring through to that crisis help. All of that will come online over the first half of next year.
 
JOURNALIST: So how many professionals do you have in the pipeline versus how many you’ll need for this service?
 
BLAKE: We're still working through the numbers for that. We're modelling that out and that will all be released before January.
 
JOURNALIST: Can we go to another, is that okay? New Zealand announced yesterday that they are going to follow the UK, Finland, Norway and Sweden in restricting access to puberty blockers for young people. I guess, what's your response to that? And gender clinicians have assured the public for years that puberty blockers are safe and reversible. Are you confident that that's the case?
 
BUTLER: To your first question, Rachel, I've seen the headlines of the New Zealand decision. I haven't had an opportunity yet to read those reports in detail. I understand the New Zealand Government has taken the decision largely to reflect the approach in the UK and  in Queensland, although, that was the subject of legal challenge. Effectively the grandparent, if you like, existing patients not to allow new patients of a certain age to be prescribed puberty blockers. As you know, we've taken an approach as the Commonwealth Government to initiate a review by the NHMRC, the National Health and Medical Research Council, of guidelines for the prescribed- for gender-affirming care generally, but to ask them to expedite a review about the prescription of puberty blockers for children and teenagers. That will be delivered in the middle of next year. As I said to you a while ago when we talked about this, the decision about prescribing puberty blockers is one that State Government agencies are responsible for. All of these services are State Government services. All of the clinicians undertaking this work are State Government employees. All of the prescriptions are off-label. They are not PBS prescriptions. They are prescriptions made off-label by clinicians employed by State Governments, ultimately state governments have to decide whether or not these prescriptions are delivered by their services. Our responsibility as the Commonwealth is to ensure that the State Governments and parents and the community have the best possible clinical advice from the preeminent authority in this area, which is the National Health and Medical Research Council.
 
JOURNALIST: Just returning to that initial question, do you believe that puberty blockers are safe and reversible, as the Federal Health Minister, and in a country where they are being prescribed in Australian hospitals to children at the moment?
 
BUTLER: As you know, over the summer I asked the National Health and Medical Research Council for some initial advice about that, and asked them to consider undertaking this review of clinical guidelines. They described this area to me, if I remember the words right, as contested and evolving. I think out of fairness, the preeminent authority in the area of clinical practice and clinical guidelines, that’s pretty compelling. They say this is a contested area, and it’s evolving. It’s still a relatively new model of care anywhere around the world. And as you know, Rachel, it is highly contested by clinicians and by people more broadly in the community. That’s why I thought it was so important, particularly in a contested space, that we ask the pre-eminent authority to issue guidelines which are hopefully, once they’re issued, regarded by everyone, including state governments as deeply compelling, whatever they end up deciding. But ultimately, that’s a matter that’s still underway. I have great respect for the work of the National Health and Medical Research Council. I don’t intend to pre-empt it. I intend to wait for it.
 
JOURNALIST: Just on the National Health and Medical Research Council, I understand the make-up of the committee to develop Australia's new national guidelines on youth gender dysphoria was announced a couple of days ago. One of the members of that panel is Kenneth Pang, who is a leading proponent of the gender-affirming care model. And I understand he was one of four authors of the Royal Children's Hospital's previous national guidelines for gender dysphoria. Given he's now being asked to help draft the new ones, is that a conflict of interest given he's sort of marking his own homework a bit?
 
BUTLER: The first point I make is that the NHMRC puts together this work under a statutory charter independent from any minister and I respect their role in doing that. I know that the NHMRC is approaching this very sensitive, important piece of work carefully to ensure that all voices are heard, including parents who have obviously a significant stake in this as well. I have complete confidence in the NHMRC to ensure that these committees are representative, that they accommodate all views in, again, what I have had described to me as a contested and evolving area of clinical practice.
 
JOURNALIST: And just finally from me, I understand in January, immediately after your Labor counterpart in the UK, Wes Hosking[sic], made a change regarding gender dysphoria in his country, you asked health bureaucrats- sorry, it was December, I beg your pardon, for a briefing on the weight of evidence in support of a pause or ban in the Australian context. Can you, I guess, tell us exactly WHAT your thinking was in asking for that and was it because you were concerned about this area of medicine?
 
BUTLER: Sorry, Wes Streeting? Yes.

BUTLER: You know, obviously, this is an area that has been evolving in a number of different countries. You've mentioned some of them, Rachel. The UK was probably the highest profile review, the Cass Review, and then decisions taken by the Health Secretary, Wes Streeting, were widely reported with the subject of significant debate here in Australia as well as other countries. Yes, that did capture my attention and I spent quite a bit of time sort of reading and thinking about what a proper Australian response to that should be. And as I said to you in a response to an earlier question today, then asked the NHMRC as well as the department to give me options about what the Commonwealth could do to help settle a position that was less contested than perhaps the position we have right now. That's why we landed on the NHMRC position, and this was the right decision by the Commonwealth to pull together the evidence and deliver what is the sort of pre-eminent piece of clinical guidelines work.
 
JOURNALIST: And ultimately their final report's not due to be handed down I don't think until 2028. Are you comfortable with that timeline?
 
BUTLER: This is work that they've been conducting for decades. They don't do it with haste, they do it carefully, and  that is reflected in the level of respect and confidence that people have in their guidelines. But I did say to the council that I thought that was a long time period to wait, particularly around the issue of prescription of puberty blockers, which is the more contested area in this space. And that's why we agreed upon an expedited piece of advice that's due in the middle of 2026 on that issue in particular.
 
Thanks everyone.
 
JOURNALIST: Sorry just one more question. On hospital funding, the Prime Minister yesterday told states that if they don't engage constructively on hospital funding negotiations, he will roll them onto another interim one year funding arrangement. Do you think that threats are the best way to secure a deal?
 
BUTLER: That was simply a statement of reality. I mean, time- the runway to get this agreement is getting shorter and shorter. That's not anyone's fault particularly, that's just around the affliction of time. South Australia goes into caretaker  on 21 February. And unlike school funding arrangements, for example, health funding arrangements need to be agreed by every single jurisdiction. After February, we start to have the clock tick on whether or not we can actually implement a new hospital funding deal in time for 1 July. I think all jurisdictions understand that if we're not able to do this by February at the latest, then it's going to be very difficult to secure a long-term agreement before the 30 June given all of the technicalities that are associated with that, a series of cabinet decisions.
 
He was just stating the obvious, I think, and I think all jurisdictions recognise that. We've had a lot of constructive negotiation over the last several weeks, including a full-day negotiation last Friday. States are represented by and large there by heads of premiers, departments, or heads of treasury. At a very senior level. They've agreed to come back together in the next couple of weeks.
 
Of course, there will be a lot of colour and movement at a political level. There always is around hospital funding. It's a very big part of our budget, a very big part of- and an even bigger part of state government budgets as well. The sort of political commentary around this from states over the last couple of days doesn't surprise me. I've been in the health portfolio long enough to know that is one of the truisms of Australian politics.
 
But beneath all of that, there is a lot of constructive negotiation going on, not just about hospital funding, but about disability reform which is inextricably linked to this negotiation.
 
JOURNALIST: And what happens if the deal can't be reached between state and the federal governments?
 
BUTLER: We default to other arrangements, frankly. Either we agree a one year rollover or we default to other arrangements about the degree of financial support from the Commonwealth to states. States understand all of this. Obviously, as I said, it's not just a hospital funding issue. There are disability reform issues that are under negotiation at the same time that we've made clear are inextricably linked. This is a complex negotiation at a time of significant pressure on all of our health and aged care and disability systems.
 
JOURNALIST: Just one last question on another matter. The Climate Change Minister Chris Bowen has conceded that Adelaide is not going to host the COP meeting but he will take on the COP presidency. Is this a good outcome for Australia and why?
 
BUTLER: This is an evolving story  over the last couple of hours. I don't want to comment on the run. As you know, this has been a matter under pretty strong negotiations between Australia and Turkiye. We want the best outcome for Australia and our region and for climate negotiations at the global level generally, and that's been our load staff through this negotiation. But I don't have an up-to-date position on what's happened over the last couple of hours. I’ll let Minister Bowen and others talk about that.