Radio interview with Minister Butler - 10 February 2025

SALLY SARA, HOST: The federal government at the weekend committed half a billion dollars to improve contraceptive and hormone therapy access for women. But the Coalition wasted no time in matching the promise, as both sides get into campaign mode for the federal election, which of course, is yet to be called. So what are the health policies are on the table? The federal Health Minister, Mark Butler, is my guest. Minister, thanks for coming into the studio.
 
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: My pleasure.
 
SARA: Now let's start with unfinished business. A wide-ranging Senate Inquiry into reproductive health made a series of recommendations around a year and a half ago. The Government still hasn't officially responded. Why not?
 
BUTLER: We'll be tabling our response to that inquiry and also to a more recent Inquiry around menopause health, this week. We wanted to work carefully on a package of measures for a response. And having delivered that yesterday, will now deliver our response at the Senate sometime over the course of the next few days. But I make the point: you can't strengthen Medicare without strengthening women's health. That's really the message of those two very important Senate Inquiries. Women consume about 60% of the nation's health services. And as I made clear yesterday, and as all of your female listeners know very well, women face a whole range of very significant costs, simply because they're women around contraception during menopause and perimenopause. And yesterday's landmark package really reverses the decades of neglect that those two Senate reports really highlighted and delivers Australia's women - finally - more choice, better care and lower costs.
 
SARA: So just to clarify the package of funding yesterday, that's it for the funding you're announcing this week. But the responses to Inquiries and Committees will be later in the week. Is that right?
 
BUTLER: We’ll table a formal written response to those two reports - two really important, thoughtful reports from the Senate - the first on reproductive health and the second on menopause. We'll table those written responses this week. But in terms of measures, there's a very significant package we released yesterday. It will really transform care around menopause and give women a whole range of choices and lower costs for their reproductive health, particularly in contraception.
 
SARA: One of the recommendations was that all public hospitals be equipped to provide surgical pregnancy terminations or timely and affordable pathways to other local providers. Your government has provided funding to the states, but no compulsion for hospitals to provide abortions. Why not?
 
BUTLER: It's not our policy to seek to force state governments to deliver one service or the other in any of the 700 public hospitals. That is a matter for them. We've briefed them on that Senate report. The Assistant Minister for Health, Ged Kearney, and I had a long meeting with state and territory health ministers after the delivery of that report about the evidence that the Senate heard around access to public hospital abortion or termination services. I'm confident all of those state and territory health ministers took that advice seriously, and they'll make their decisions according to their operational needs.
 
SARA: If that's an important issue at the federal level, why not put forward some compulsion or some ties in that funding to make sure that it happens? It's not only, of course, in the city areas, we've seen more reporting on terrible situations in regional Australia as well. You've got the possibility to do that.
 
BUTLER: There is theoretically the possibility, but tying state government hospital funding, which is such a crucial part of our health system, to some sense from Canberra about what the operational arrangements should be in every one of the 700 public hospitals - given that we have no line of sight about the workforce that they employ and a range of other important things like that - it's just not our approach to things. I mean, our approach has been certainly to brief states and territories about this important report, because this is essentially their area of jurisdiction, but also to work on those areas that we have responsibility for. So we've expanded access to medical terminations, to the point now that in the year after we did that, three times as many GPs prescribed MS-2 Step - the medical termination medicine - as had done before, twice as many pharmacies prescribed for the first time as well. So there's been an expansion of that and yesterday's measures to provide more choice and lower costs for contraception is about giving Australia's women, you know, better access to contraception. We have one of the highest abortion rates in the developed world. And, you know, it's pretty clear from that Senate report that one of the drivers of that is poor access to good contraception. So that's what that package was about yesterday.
 
SARA: It's interesting what you're saying, that there's no line of sight for that spending. If the federal government is putting billions of dollars into health, shouldn't there be a mechanism so you do have line of sight that these services, that should be provided, are being provided. Because particularly in the regions, the reporting has shown they are not.
 
BUTLER: We want to see better access to surgical termination services as we've delivered in relation to medical termination services. What I said was, I have no line of sight over where the half a million doctors and nurses and health professionals are employed through the 700 public hospitals and a range of other outpatient facilities where these services can and often are provided as well. I mean, the idea that Canberra starts to make decisions about what services are delivered in each of those public hospitals is not going to end well. It's not the way that we approach our reliable partnership with state and territories. Obviously, we have some broad objectives that we want to seek with public hospitals, particularly about how they interface with the services we have responsibility for. But I'm not about to get into a situation where I seek to direct effectively what services provided in what particular hospital.
 
SARA: So some women will still go without.
 
BUTLER: I know that state and territories have taken this seriously. They listened to the advice. There have been these debates which you'd be aware of, Sally, in particular states, Queensland, New South Wales and some others that have led to changes by those state governments. And that's been a very good thing. Because of course, we want to see Australia's women across cities and the bush have access to as many services as possible, including this.
 
SARA: Minister, we need to look at some other issues this morning on mental health. The Coalition says if it's elected, it will bring back the 20 subsidised psychology sessions that were available during the pandemic. The Government brought that back down to ten. Any chance you're going to revisit that?
 
BUTLER: Let's remember that the increase from 10 - which is what it had been for many years - up to 20, was a Covid measure. It was designed to provide some additional support during lockdown. It was always intended to drop down to 10. That was the decision taken in the final Morrison Government. I don't remember Peter Dutton seeking to argue against that. Maybe he did in Cabinet.
 
SARA: Looking forward, will you up to it 20?
 
BUTLER: The problem with doubling the number of sessions, without doubling the number of psychologists is they created a bottleneck. And a whole lot of people ended up not getting access to any services at all. Bringing that back down to 10 has meant a whole lot more people have got access to important psychological therapy, so I'm not inclined to lift the number back up to 20 without expanding the psychology workforce, which is what we've been focused on over the last couple of Budgets, as well as providing a number of other services that people can access. Medicare Mental Health Centres that we're rolling out around the country. We've got a few dozen open, we've got more ready to open. They’re walk-in, they’re free of charge. And also building a national early intervention service that will take pressure off our psychology therapy.
 
SARA: Minister, in 2024, more than 100 tobacco stores were firebombed in Victoria alone. We spoke last week on the programme to former federal police officer Rohan Pike, who's described the nation's current tobacco tax as fuelling the tobacco wars playing out.
 
ROHAN PIKE (FROM EARLIER): No doubt it's the excise rate that's driving this crime market. The gap between the legal and the illegal price created the market and continues to drive it, and future price rises are really only going to add fuel to that fire.
 
SARA: So from a law and order perspective, it's not working. From a consumption of cigarettes, it's not working. They're still being bought. From a tax take perspective, the tax take is down. It's not working. What are you going to do?
 
BUTLER: Increasing the price of cigarettes right across the world is recognised as one of the most important tobacco control measures. And I remain of the view that is important. I don't agree with that interviewee, that the increase in the excise is what caused the tobacco wars that we're seeing play out now. The vast bulk of those increases happened under the last government during the last decade. What created it was that organised crime decided that illicit tobacco and vapes, for that matter, were a low risk, high reward source of revenue to bankroll their other criminal activities like sex trafficking and drug trafficking. Yes, they were operating on that price differential. They find an opportunity to make revenue to bankroll their criminal activities. The response to that should be a law enforcement response. And that's why we're working on hundreds of operations between state and federal authorities to shut down illicit tobacco, to shut down vapes. Illicit tobacco is hard, it's harder to detect, it's easy to get into the country. But on vaping, we've already seen really important progress a 30 per cent reduction in young people vaping in the last 12 months. A 50 per cent reduction in suspensions from schools for vaping. This is starting to have an important, result in terms of the public health of young people. But there's no question we're not only up against Big Tobacco on this, we're now up against organised crime. State, territory and Commonwealth authorities are going to have to work hard on law enforcement.
 
SARA: Finally, on the Victorian by-elections, Labor holds a narrow lead over the Liberals as counting resumes. In Werribee, it has been a very safe seat for Labor for more than half a century. What went wrong? And is this a sign of things to come federally, in your view?
 
BUTLER: I don't pretend to have a detailed knowledge of Victorian state politics. This is a by-election for a state government that's into its second decade. It's been a tough time in Victoria. As we all know, over the last several years, they had a very tough pandemic. It's not surprising when you look at the sweep of history that a state government in its second decade cops a big hit in a by-election. These are state issues being played out down in Victoria. We've got a federal election coming up in the next few months. At some time, people will vote in that federal election, I'm confident, on federal issues and the very clear choice between the cuts they'll see by Peter Dutton and the sort of measures to strengthen Medicare you saw us release yesterday.
 
SARA: Mark Butler. We'll need to leave it there. Thank you.
 
BUTLER: Thanks, Sally.