SONYA FELDHOLFF, HOST: South Australia's Mark Butler joins us now. Minister good morning.
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Good morning.
JULES SCHILLER, HOST: What's the biggest mistake, do you think we made during the pandemic?
BUTLER: The key takeaway from this really powerful, measured report is that leaders didn't have the tools in the toolkit that they needed to respond to this extraordinary emergency. The words of the report are “they had to build the plane while they were flying it”. There wasn't a pandemic plan in place. There wasn't a source of independent, expert advice about how to do decision making, particularly after the first few months. That meant our response is as good as it was in relative terms compared to other countries, our response wasn't as good as it could have been, and we've got to be better equipped for the future.
FELDHOLFF: If we were not prepared for this pandemic, where are we placed for what the report says is the almost certainty of more pandemics, possibly every 20 years? Are we less prepared now or less equipped, I should say, to deal with the pandemic that next comes along?
BUTLER: That's a really striking conclusion from this report, Sonya. We're probably in a worse position today than we were in early 2020. Governments have much more debt, so they don't have the economic ability to respond in the way that governments did. Healthcare systems are still deeply scarred. The health workforce was exhausted. Many retired at the end of the emergency phase of COVID. But most importantly, you said this in your introduction, the report says that community trust has been seriously eroded. And that's going to be a hard process to rebuild, the report authors say “that the community is unlikely to respond to some of the directions that were key elements of the pandemic response in the very cooperative way that they did through the pandemic we've just seen”. We've got to rebuild that trust. And central to that task is our announcement to accept the key recommendation of the report and establish an independent, authoritative Centre for disease Control to set about developing those plans to provide much more evidence based advice about decision making.
FELDHOLFF: That seems to get broad support, the centre that you're talking about here and obviously looks at the logistics, but addressing trust is a separate issue, isn't it?
BUTLER: It's not really in my view. First of all, I would say we're the only developed country that doesn't have a CDC like this. It has been a gap in our system for too long. But the key takeaways from the report, I think, are that decision making was not based on solid evidence. We didn't have the data in front of leaders that they should have had. They weren't in a position to balance risks and benefits of a particular decision to consider some of the non-pandemic impacts. And the report talks a lot about the mental health impacts on children and young people, for example. An evidence-based approach to decision making is key to this, and the CDC will deliver that. But also, the report's very critical about the lack of transparency around decision making. The community really did complain about not understanding the rationale for decision A, B, C, or D. Again, a transparent CDC where people can understand the evidence for decisions, I think is key to rebuilding trust.
SCHILLER: When you say did not understand, I mean, obviously people understood that, you know, it was better not to mingle, go into pubs and things like that with a communicable disease. I think what people struggle to understand why someone who tested negative could not go to a parent's funeral, why people who were willing to have tests could not cross a state border in compassionate circumstances. Do you think that we needed more transparency when the public were reading and being confronted by these incredibly distressing situations?
BUTLER: Yeah, that's one of the key takeaways from the report. People didn't understand the basis for particular decisions. There were thousands of them. We deliberately did not go through every single one of the thousands and thousands of decisions. But in a broad thematic sense, people didn't weren't given reasons for a particular decision other than this is the decision of government. That is what has eroded trust and we've got to make sure that is not the approach next time.
FELDHOLFF: Getting back to this trust issue, though, and you say that the future decisions and through the CDC evidence-based information is what will guide us. But the trust levels are not just down in government policy and government's reactions. It's in medicine and science as well. So how do we build that up to trust that evidence base if people are innately suspicious of it?
BUTLER: That's right. I said yesterday when I when releasing this report, trust is lost pretty easily and it's very hard to rebuild. It's going to take a while. Having that sort of transparency and central independent source of advice is key to it. But you're right, Sonya, to say it's not just an issue that arose in the direct pandemic response it has bled through into our healthcare system. We've got some really alarming drops, for example, in childhood vaccination rates, sort of 7 or 8 per cent reductions in the number of under five-year-olds being given the measles vaccination, the whooping cough vaccination, to the point where we've dropped below herd immunity levels. This isn't just about the pandemic response. This is bleeding into a whole bunch of our really important public health programs.
SCHILLER: And this comes to vaccinations. I mean, they were easily the, you know, the hot topic. And, you know, the most fraught conversations we had were with people who did not want to get vaccinated and have felt they needed to. Do you think that the vaccination mandate or does this report say that they were too wide, that there were some professions that didn't need vaccination mandates, but still had them?
BUTLER: The report, first of all, says that vaccine mandates at particular stages of the pandemic were important and in particular industries were important as well. But without sort of going through every element of the decision making around vaccine mandates. The report broadly comes back to that theme I talked about and that is where was the evidence for particular mandates and particular areas, and was there enough transparency around it. It was really important that this inquiry not pore over every one of the thousands of decisions in every single state, in every single industry, at every single time. This thing would have gone on for years, and years, and year and been a bit of a circus, frankly. What we wanted was a measured, sober analysis of the structures, the systems in place to ensure that in the future we had a playbook that the community would have confidence in and would give the tools to the leaders we have when the next pandemic comes to put in place the best possible response.
FELDHOLFF: You're listening to the voice of the Health Minister, the Federal Health Minister, Mark Butler, who is dealing with this 900 page report that's been looked into our COVID response and all that's come out of that. Now, Mark Butler, yours wasn't the government in power dealing with this at the time, although as an opposition there was obviously a role there. You are now the Health Minister and your government is in power. Should this happen again, how do you take this difficult news and this difficult outcome from this report and turn it into something that will give us an effective response? Where do you go to from here?
BUTLER: As I said, we announced in very quick time our response to, I think the most important recommendation and that was to establish the CDC. That legislation will go into Parliament next year. We allocated $251 million to it. It will be independent. It will be transparent. It will start building the world class data and surveillance systems that put us in a much better position. But there are so many recommendations here that cross, most of them are health related, but they cross in into the education portfolio around school capability. They cross into the industry portfolio around whether we have enough sovereign capability to produce vaccines to produce personal protective equipment. We will be responding to all of those recommendations as quickly as we can.
SCHILLER: On education, one of the things that really struck me is that Nicola Spurrier, who you know many people on the text line are already saying did a great job, she as a paediatrician, she said we should not shut schools like that should be an absolute last resort. Yet we saw other premiers shutting schools for long periods of time. And I think this is something the report said that there were very inconsistent measures across the state that were very hard for the public, really to understand why is our Chief Public Health Officer saying it's very important for kids mental health to go to school? Yet other states were shutting schools?
BUTLER: That's right. There is quite a deal of coverage of that in the report. They make the point that the Health Protection Committee, which is Nicola and all of her equivalents, the chief health officers of all of the jurisdictions, did not recommend school closures. And there were different approaches in different states to that. They recommend that there should be a chief paediatrician, a medical specialist who focuses on the health of children in that committee at all times. We'll look through that recommendation very, very carefully because I think really one of the strongest themes you see right through this long report is the impact on children and on young Australians of the pandemic response, and that's an impact that endures today.
FELDHOLFF: Minister, more broadly, not just schools and education, but the decisions being taken by individual states and territories rather than on a national level, was also copped a bit of criticism. In a future pandemic, would the CDC be the leading role in all of this, or how would it work, do you think?
BUTLER: The legal power to respond to a health emergency like this rests with state governments, and there's no proposal to change that. Instead, what the report says that there is that there should be much better national advice that is based on grounded in evidence, that is grounded in good data that we didn't have during the last pandemic. But ultimately, the legal power in particular states is going to continue to rest with premiers and state governments -
FELDHOLFF: So states and territories could override that national advice?
BUTLER: Yeah, it would be a brave premier or health minister at a national level or at a state level, I think, who disregarded advice that was grounded in evidence provided by the independent, authoritative body at a national level and provide it transparently. And so, yes, the legal power will continue to rest with state governments elected by their people, answerable to their people, not by some bureaucracy in Canberra. But, the point is they will have evidence before them and the people will have evidence before them.
SCHILLER: But when you say elected a lot of the people making decisions, Grant Stevens here, who you know, many would say did a great job, these were non-elected officials who were making decisions.
FELDHOLFF: And chief public health officers are non-elected, too.
SCHILLER: Do you think that is an issue?
BUTLER: Legislation passed by the federal parliament and by state parliament that are granted to sometimes unelected officials, whether they are military officials, policing officials or health officers. And I don't see that changing. I don't think that should change. That is an important part of an emergency response. Ultimately, though, those powers are granted and circumscribed by parliaments, whether that's the federal parliament or the South Australian Parliament and those people are answerable to their boss, the Premier or the Prime Minister. The question from this report, though, is whether the community and governments, whether they are police commissioners, chief health officers or elected parliamentarians like the premiers and prime ministers, whether they had before them the sort of evidence that would have given them the best tools to respond to the pandemic and that's what the CDC will deliver.
FELDHOLFF: Mark Butler, thank you so much for your time today.
BUTLER: Good to be with you.
FELDHOLFF: The Federal Minister for Health of Australia, Mark Butler. Obviously, South Australia's own.
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