Radio interview with Minister Butler, ABC Adelaide – 18 September 2025

SONYA FELDHOFF, HOST: Mark Butler is the Minister for Health and Ageing, and also the NDIS. He’s also South Australian. Mark Butler, good morning to you.
 
MARK BUTLER, MINISTER FOR HEALTH AND AGEING, MINISTER FOR DISABILITY AND THE NDIS: Morning Sonya.
 
FELDHOFF: Now, Mark Butler, the Asthma Handbook that you launched yesterday has new recommendation for millions of Australians on the way they use their puffers. Why was this change necessary and how is it different?
 
BUTLER: This is a handbook that has served Australians really well for about 35 years now. And the latest publication is something that I really urge doctors and nurses to familiarise themselves with, but also the three million Australians who live with asthma, or their children, their parents as well. There is a significant change in this version of the handbook, particularly around the use of short-term puffers, also known as blue puffers, which the clinicians and experts who've been reviewing the handbook are finding are associated with some less than ideal symptoms and some real risks in the long term. It's important that people look at this, particularly doctors. If you've got a question about what this might mean for you as someone who lives with asthma or has a kid living with asthma, I urge you to have a talk with your GP. The broad advice from the handbook for a long time has been pretty basic. That is to have a written asthma management plan that you're very familiar with. You work that out with your GP, and also to make sure that you carry an anti-inflammatory reliever with you at all times. As we head into spring and there's more pollen in the air, that's more important than ever.
 
But the people who do this handbook are just terrific. Before the handbook was introduced in 1990, about 1,000 Australians died every year with asthma. That rate has halved. It's still a lot. It's still almost 500 Australians every year. But this updated, cutting-edge clinical advice is really important.
 
FELDHOFF: But people who have been using their asthma puffers on old recommendations, shall we say, and perhaps going through more blue puffer use than what currently is being recommended, they're putting themselves at risk, are they?
 
BUTLER: I'm reluctant to give clinical advice because I'm not a clinician, but that really is the key feature of the updated handbook. A shift away from the use of blue puffers, a sense that over time they do cause risk, in some cases serious risk. This is just an opportunity as the latest advice informed by the latest research is put in the hands of Australians to have another conversation with your GP about the best position you can be in or, as I say, if your child has asthma, your child can be in to make sure that they're able to live a productive, contributing life.
 
JULES SCHILLER, HOST: Let's get to the health ministers meeting that happened, I think, last week or the week before. South Australian Chris Picton, he argued that your government's mismanagement of the aged care sector is causing an acute bed block in hospitals across the country. They referenced 2,400 older Australians are stuck in hospital for no medical reasons including about 280 here in South Australia. Did you accept what he had to say and accept responsibility for causing these bed blocks?
 
BUTLER: I'm not sure that's quite how Chris Picton characterised it, but we all agreed, we had a really good discussion over the course of Thursday night and over Friday, we all agreed that we need more aged care beds in the system. That's why we put so much energy and frankly more money into aged care in our first term of government than I think other area of policy because when we came to government there were no new beds being built, staff were leaving the system in droves, we just had a Royal Commission report that described the sector in one word, “neglect”, and we were confronting a position and are right now confronting a position where the very large baby boomer generation is starting to hit the age of aged care.
 
We all recognise, state ministers and certainly I as the Federal Minister recognise, we need more aged care beds, and we need them urgently. That's why we passed legislation last year that the aged care sector told us would lead them to build more beds. We're seeing some good signs of bed numbers increasing in terms of building intention, but it's not quick enough. We all agree this is obviously a major pressure in the community because we want older Australians to receive the care that they deserve and need when they need it. But it's also becoming a real pressure on the hospital system. I acknowledge that.
 
SCHILLER: I mean, we're putting people in hotels at the moment.
 
BUTLER: That's right. Look, aged care facilities are pretty full in South Australia They're full around the country. Aged care beds in South Australia are probably a little fuller than they are in other states. Ours is a state where we need the aged care sector building more beds and building them quickly. In the meantime, we're putting more money into South Australian hospitals to help them deal with this pressure. The hospital funding increase from the Commonwealth this year is the highest I think ever, a 15 per cent increase. We're funding innovative ways to move people out of hospitals when they're ready, but we just need more nursing homes built and we need it quickly.
 
SCHILLER: Have you got a figure on how many aged care places will be available in South Australia during your term?
 
BUTLER: If you mean this term of Parliament, we are tracking the number of builds right now. We think that across the country the number of aged care beds that will be built next year will be about double this year, but that's still well short of what we need across the country. As I said, South Australia is one of the states where there is probably the highest rate of occupancy in our existing facilities. We do need to have the sector get on and start building them quickly.
 
But at the meeting on Thursday and Friday that I had with all the health ministers, not just South Australia, and this is an issue across the country, not just in our state, we did commit to continuing to doing more work to see whether there are other ways we can fill the gap, because even when an aged care provider for example, this week we're going to build a new facility in the western suburbs of Adelaide or the eastern suburbs, it doesn't magic up overnight, obviously. But they've got to get the approvals, and they've got to get the thing built and fitted out. And that's really what is concerning me and Minister Picton and others, that gap between today and when the sector builds it, because we just confronted a situation of real crisis when we came to government three years ago.
 
FELDHOFF: So when do you anticipate we'll start seeing the flow-on effects of this big build aged care program?
 
BUTLER: We'll start to see it over the coming year or two. Providers have already indicated they're more willing to build now because of the legislation we passed, but I'm going to be frank with people and I know Minister Picton will be as well, because of the time we lost over the last several years when there just wasn't enough being built, we are confronting some real pressure. So we're putting more home care places into the system, we'll be delivering another 20,000 home care places over the next several weeks, another 20,000 in the couple of months after that. But the pressure on the system because the oldest baby boomers are this year hitting the age of 80 is very, very significant.
 
FELDHOFF: But even those packages you're talking about have been delayed already. I mean, that's taking longer than was anticipated again.
 
BUTLER: We've been delivering additional packages every budget and every budget update every year that we've been in government. We've brought forward 20,000 of the packages that were intended to happen after 1 November, so in a few weeks' time. We've brought them forward to now, so they'll be released over the next couple of weeks. Another 20,000 between 1 November and New Year's Eve and more again next year.
 
One of the challenges we're having with the number of packages we release is we’ve got to make sure that there are people to be staffed. Right across the country, aged care staff are hard to get. Again, we’ve got a shortage of beds, some challenges getting enough qualified staff into the system. But we’re pretty confident given the assurances that the aged care providers have given us. The packages we’re rolling into the system right now and again before Christmas, will be able actually to be delivered to older Australians.
 
SCHILLER:  Minister, can I ask you about the PBS? We heard yesterday that Donald Trump and Anthony Albanese are going to be meeting. And we know back in March, American medical giants wrote to the Trump Administration, urging it to consider our PBS as an unfair trade practice and urging Trump to consider reciprocal tariffs. What sort of faith do you have in the integrity of the PBS, I think, which has just come down under pressure from a potential Trump Administration threat of tariffs?
 
BUTLER: We're very confident about the integrity of the PBS. We'll be defending it to the hilt. It is one of the critical pillars of our healthcare system. If anything, we're determined to make medicines even cheaper, and the medicine prices will come down again on 1 January to a rate they haven't been at since 2004. But you're right to say that the US Administration appears determined to cut the price of medicines in their own country. They've written to the Administration, or the President has written to the 17 biggest drug companies. They're not just American, obviously, many of them are European, and told them they expect those drug companies to cut the price of medicines sold in America to something closer to the price of medicines that we see in Europe and countries like Australia as well. Now, we've been trying to understand what impact that might have on Australia. I know the Europeans, and the British, and the Japanese and many other developed countries are doing the same. As we are across the trade spectrum, having discussions with the Americans to understand that better. I'm also having discussions with the pharmaceutical industry very regularly just to understand what impact that might have on access to medicines here in Australia, because we are absolutely determined to make sure that those key elements of our medicine system, access to the best medicines in the world at affordable prices, continues into the future.
 
SCHILLER: You're worried about shortages, potentially?
 
BUTLER: No, it's not so much shortages. It is a question of whether big pharmaceutical companies continue to supply all of their medicines into all of the markets. This is not particularly an Australian issue. I know the Europeans and, as I said, the other developed countries in the world are very focused on this right now. And frankly, the pharmaceutical industry is very focused on it, trying to understand what the impact of the American decision will be. America's the most important market for the pharmaceutical industry by a long way. They make about 70 per cent of all of their profits from the American market. If there's a change there, there is a knock-on effect to the rest of the world, and we are just determined to make sure that that knock-on effect doesn't impact the integrity of our PBS.
 
FELDHOFF: Just want to return to the aged care side of things, Minister, if I can, because texts are coming through. And look, I'm reading things here of people who are waiting long times for respite to get help. And we've got a text from Mary, who says: “look, packages are not coming. I'm not sure if this is Mary herself or someone she knows, but a 95-year-old waiting for 14 months and no package.” I mean, it's hard to believe that we can't give help to a 95-year-old potentially living their home. Can you give Mary and others confidence that things are changing on this front?
 
BUTLER: Every one of those stories, Mary's story and many other stories I hear, just reinforce our determination to continue building an aged care system that people like Mary deserve. This is a sector I've worked in for 30 - 35 years. If you can't provide support to people who've worked all their life, paid their taxes, what sort of a society are you? That's why, as I said, we did more in our first term in aged care than I think any other area of policy to start turning what was a crisis that we inherited around. So 20,000 more packages over coming weeks, an additional 20,000 before New Year's Eve will help the system. But I'm not going to pretend that we aren't going to have to be working on this day and night for years to come as we see that demand increase.
 
SCHILLER: Just quickly, Minister, we spoke to you, and I think even the Prime Minister a few months back, about medical school places. We're not training enough doctors that we need in this country. You've announced, I think, 100 new medical school places. Do universities have to bid for those, and do you think any will be available here in South Australia?
 
BUTLER: Yeah, they do have to bid, and that number will rise to 150 by 2028, and follows the opening of new medical schools in Darwin and in Cairns and another one in Brisbane. Because you're right, we're not training enough doctors, and it has been hard to expand the number of medical school places in the past. There's been a lot of opposition from doctor’s groups, particularly the AMA, but I think they also understand that we need more university places. There's a process open now. Universities are able to bid for this. We're particularly asking them to demonstrate that these additional places will focus on general practice. They’re not just training more surgeons or anaesthetists. We want to see more general practitioners trained. Already we're seeing a big increase in the number of junior doctors take up general practice training. There's more doing GP training this year than we've ever had before, but we do need more.
 
FELDHOFF: Is there anything to ensure these places actually go to GP training and not just training more specialists in other areas?
 
BUTLER: That's a condition of the tender that is open right now. Any university can bid, including the city universities because over the past few years, our focus has been trying to increase medical school training outside of the major cities. But this will be open to universities in cities like Adelaide, but they've got to demonstrate a focus on general practice training.
 
FELDHOFF: Just eight weeks ago that we spoke to you about the situation around Bedford, one of our NDIS providers. At the time, you were gravely concerned about Bedford. Have those concerns eased at all for you?
 
BUTLER: No, I don't think they have eased. If anything. I think we've over the last several weeks understood in more detail the depth of the financial problem that Bedford has got itself into, or more to the point, Bedford management has got the organisation into. The intervention of Premier Malinauskas has been incredibly important to buy us all time to understand the depths of the challenge of this big and quite diverse organisation, an organisation so important to our state. And to have McGrathNicols, which is effectively the administrator that the State Government put into the organisation, have them understand those details and start to develop a plan to get the organisation out of it, if at all possible. We’re working at a federal level very closely with McGrathNicols to understand what that plan looks like, and what we could do to ensure that it is a success.
 
SCHILLER: But you’re not confident?
 
BUTLER: I’m not blasé about the depths of the challenge here. The financial challenge, I’ve said from the time this really broke into the news, is very, very deep and it’s not going to be easy to pull the organisation out. That’s really why the intervention of Premier Malinauskas to buy us time, to have McGrathNicol in there, looking at the books and using its expertise to see if they can craft a restructuring plan that gives this terrific South Australian icon a future, has been so important. But I don’t want to send a message that this is easy. It’s not going to be easy.
 
FELDHOFF: Mark Butler, thank you for your time. He’s the Minister for Health and Ageing and the NDIS.