Radio interview with Minister Butler, ABC Newcastle – 19 May 2026

PAUL CULLIVER, HOST: All right, as we've been talking about, $25 million for up to six new bulk billing clinics for the region, Hunter, Newcastle, Central Coast. And we said, well, we should probably get the Health Minister on to talk about it. Turns out he's come to Newcastle to do exactly that. Minister, hello.
 
MARK BUTLER, MINISTER FOR HEALTH AND AGEING, MINISTER FOR DISABILITY AND THE NDIS: Here I am. How are you, Paul?
 
CULLIVER: I'm very well. Good to have you here to get some detail about this. $25 million, what does that actually get you?
 
BUTLER:  It gets us six new fully bulk billing GP practices. And the reason for that, it's an unusual thing for the Commonwealth to do, to intervene in the market effectively. But I have said for a few years that the big investments we've been making in bulk billing simply are not shifting the dial in Newcastle, parts of the Hunter, particularly the Lower Hunter, Lake Mac, and the Central Coast as well. I mean, you've got a position where there's half as many bulk billing practices in this region than in New South Wales generally. The bulk billing rate's about 15 per cent below the national average, 20 per cent below the New South Wales average, and a whopping 30 per cent below the bulk billing rate people see in Western Sydney and South Western Sydney. Now, there's no rational reason for that. It costs more to run a business in most parts of Sydney, for example. It's a cultural issue. And this is one of the worst markets in the country, and I've said I'm committed to making sure that people enjoy the benefits of our huge investments in bulk billing right across the country. And if there are markets where the culture's just not shifting that, then we'll intervene and we'll create more competition.
 
CULLIVER: All right. I want to talk about what's going on in those other GP clinics that are not bulk billing, but I just want to really drill down on $25 million over three years. Quite literally, what are those dollars being spent on?
 
BUTLER: Establishment costs for new bulk billing practices. You'll see six new general practices open up. They need to be of a certain size. So broadly, we're looking at around 10 GPs per practice at the moment. We'll think about that a little bit more. It maybe a little bit bigger for this region. They'll be chosen in an arm's length tender process conducted by the Primary Health Network here. They've got to be fully bulk billing and they've got to be of that size, and they'll be targeted to parts of this region where we're most worried about the bulk billing rates. Newcastle is an obvious one. And that will mean about 150,000 additional bulk billed visits per year when they're up and running. They should be up and running by the middle of next year. That'll be good in and of itself. There'll be 150,000 bulk billed visits that otherwise might attract a gap fee.
 
But the big change is it will drive competition and it will drive, I hope, cultural change more broadly among general practices in this region.
 
CULLIVER: Yeah, okay. I really want to tease out the economics of this. Are we talking about a net increase of GPs operating in those regions?
 
BUTLER: Yes.
 
CULLIVER: Okay. Where do they come from?
 
BUTLER: The practices will recruit GPs. Being a fully bulk billing GP now is a pretty good salary. Some years ago, a few years ago, before we started investing in bulk billing again as a government, a full bulk billing GP would be earning considerably less than a GP doing a mix of bulk billing but also charging some gap fees. We've flipped that. So a full bulk billing GP in a city, for example, three years ago, on average would have been earning about $280,000 a year after they paid their practice costs. That's now over $400,000 a year. So we think there is the attractiveness for this job.
 
Also, this region is able not just to recruit GPs from around Australia or elsewhere in the region, they can also recruit GPs from the UK and New Zealand very quickly at low cost. And we're seeing a lot of interest from NHS doctors to come and work in Australia. It's obviously a  good healthcare system, better weather and considerably higher wages. So already our changes to make it easier for doctors to come in from the UK, Ireland and New Zealand have meant hundreds more doctors coming into the system, as well as us training more locals to become GPs as well.
 
CULLIVER: Okay. Is there anything to stop these bulk billing clinics just cannibalising staff from other clinics, because they kind of look across the street and go, actually, I'll just go there instead, and we don't actually have an increase in staff and GPs?
 
BUTLER: They're not going to be barred from recruiting a GP. If a GP wants to move to a practice like that from another practice because that practice won't be bulk billing, we can't stop them, and I don't particularly want to stop them. But I'm confident there will be a net increase in GPs. I suspect these practices, as they're working to set up, will be looking to recruit GPs from outside the existing general practice community here in the region, and there will be a net addition to the number of GPs.
 
CULLIVER: But say you're a GP in England right now, and you are looking at a move to Newcastle, why wouldn't you? Newcastle, Australia, that is.
 
BUTLER: Usually beautiful weather.
 
CULLIVER: Usually beautiful weather. If there's a GP clinic here that doesn't bulk bill in their recruiting, why is that any less attractive? You know, for an English GP, why is it that a bulk billing clinic is more likely to get them out here than just another bulk billing clinic down the street in Newcastle?
 
BUTLER: Because these new practices will be actively recruiting. And depending on the practice owners who bid for this, some of them are pretty aggressively recruiting in the NHS right now. They're out there, they're doing campaigns. And so the existing practice that's doing pretty well, they're happy with the existing arrangements, charging gap fees to a number of people, a relatively low bulk billing rate. They might not be doing active recruitment right now, whereas these new practices I'm pretty confident will be doing active recruitment.
 
CULLIVER: Okay. So it's about $4 million. If you end up building six clinics or establishing six clinics, it's about $4 million over three years. So as you say, establishment costs, there's no, like, ongoing subsidy of staff wages or anything like that?
 
BUTLER: The establishment costs will cover a range of things, including some temporary staffing sort of ramp up, if you like. But they are expected- the reason why it's a time-limited funding arrangement is they're expected to become self-financing, and they will be. I'm very confident that there's increasing demand for healthcare right across the country, including in this region. We're becoming slightly older as a community, we're getting sicker, so there's no shortage of demand for healthcare. The problem I'm finding, and I think many of your listeners will be thinking about, is where you can't get bulk billed healthcare, free healthcare through a GP, more and more Australians are choosing not to go to the doctor, particularly if they're on low and fixed income. So it's not just a hip pocket issue, it's becoming an access to healthcare barrier as well.
 
CULLIVER: The Federal Health Minister is here with you today. Mark Butler, of course, for Health and Ageing and the NDIS as well. And there's some issues on that that I do want to get to, but I really want to just tease down some of these bulk billing details. You talked about GP clinics that don't bulk bill in this region, of which there are many. You said that it is cultural that they don't bulk bill. And we've talked to GPs on the radio where they just talk about their cost base. They talk about paying fair fees to their GPs. They talk about making their GP clinics sustainable. So for them to say they cannot afford to bulk bill and you say it's cultural, are you calling them out? Are you saying that that is just not the case?
 
BUTLER: I am calling them out, because every other part of the country is shifting. As I said, the number of bulk billing practices in this region per capita is half the New South Wales average. The bulk billing rate is 30 per cent lower than Sydney, than Western Sydney and South Western Sydney. Now, you can't tell me it's more expensive to run a GP practice in Newcastle or in the Central Coast than it is in Sydney. There is no economic reason.. Socio-economically, and in terms of the cost base of a general practice, there is no material difference between this region and parts of Sydney that see a bulk billing rate of 95 per cent compared to 65 per cent here in Newcastle. What else can you put this down to other than a cultural difference among general practice owners?
 
CULLIVER: Okay. I want to be clear on this as well. By attracting patients away from existing non-bulk billing clinics to bulk billing clinics, do you think there is any risk to the viability, the sustainability of those non-bulk billing clinics?
 
BUTLER: What I want to see is practices that are currently charging gap fees reconsider their position. When we made the big investments on 1 November, only a few months ago, there were 2000 full bulk billing practices in country, a little over 2000. There's now 3800. We've almost doubled the number of practices across Australia who are now bulk billing all of their patients all of the time. But you haven't seen that increase here in Newcastle and parts of the surrounding region.
 
Where we are seeing those increases in pretty much every other part of the country, what you're also noticing is general practices that are charging gap fees are starting to recognise that there's competition in the area. And those practices that are moving to a full bulk billing model are telling me that they're overwhelmed with new patient inquiries. And so, that is driving cultural change. It just hasn't happened here. This investment is designed to kickstart that. And what I'd like to see is the established practices re-examine their existing arrangements so that they can keep their patients.
 
CULLIVER: All right. I want to touch on some other issues. Obviously, health is always important in every part of the country that you go to, Minister. The Health Minister Mark Butler is with you this morning. Urgent Care Clinics, we've got a bunch of them now across the place. Cessnock has been facing some challenges recently. Quite a number of unexpected last-minute closures because of staffing. We've had text messages this morning from people being turned away from the Charlestown Clinic, said, I was turned away one night because the, quote, doctor has reached his limit. What's going on here? If we've got these clinics, the Federal Government touting their successes, but if they can't be open, we don't have the staff, what's the solution here?
 
BUTLER: Occasionally, a doctor falls sick or a nurse falls sick, and practice owners, whether they're an existing practice or a hospital or an Urgent Care Clinic, have to try and find a replacement very quickly. Usually, that's possible. Sometimes it falls short. For Charlestown, which is one of the busier Urgent Care Clinics around the country, we've put extra resources in there to allow them to employ a second doctor at busy times, and I think that's having a real impact.
 
There's no question, like every health service, there are points at which they become overwhelmed and people aren't able to get the service that they'd like, and sometimes need, as quickly as they'd like. And Urgent Care Clinics are no different to any other health service we see in the country.
 
More broadly, though, they are a huge success. Almost 3 million people have gone through those Urgent Care Clinics now in the three years we've had them up and running. And they've all been bulk billed. Half of them say they otherwise would have gone to the local hospital ED, so it's taking pressure off those very busy emergency departments and giving people a better experience than emergency departments. If your kid gets a busted arm playing rugby or playing league, it's  better for them to be in the Urgent Care Clinic for an hour or two instead of an emergency department for eight or 10 hours.
 
CULLIVER: Sure.
 
BUTLER: Staffing is a challenge. And we're working with these Urgent Care Clinic operators to try and make sure that, as they build and as the network becomes more mature, we're able to tweak the arrangements to ensure that people are getting the best service possible. But it's still a relatively new model of care.
 
CULLIVER: Right. So what is it about boosting just the ongoing number of staff that are rostered, that are available through a day, through a week? Like, how do you maintain? Because you do bust your arm. You go to the Cessnock Urgent Care Clinic. It's not open. All of a sudden, it's got no value to that person.
 
BUTLER: They're not open 24 hours a day because there's not much demand for them after  eight or 10pm in the evening, depending on the region. We are working on those very busy clinics like Charlestown and have put additional resources into a number of them. And Charlestown is one of the busier ones in the country
 
CULLIVER: I just want to ask, though, when you say resources, what does that actually mean?
 
BUTLER: Money to employ more doctors
 
CULLIVER: Okay.
 
BUTLER:The wait times come down. Charlestown being one of the busier ones will have two doctors on it at the busier times of the day. Most others are staffed with one doctor, and that's sufficient. But this is a new model of care. It's building, and so we're always monitoring what changes we need to put in place. There were arguments about it when I first announced it three or four years ago. I'm convinced this is working as a model. It's been a missing part of the jigsaw puzzle in Australia. Very common in other parts of the world that we compare ourselves to. New Zealand's had them for decades, US, most parts of the UK and Europe. But yes, it's a new model of care, and we're going to have to continue to monitor it to make sure it works for the local communities.
 
CULLIVER: I don't want to let you go before I do ask you about the NDIS. Of course, you're one of the ministers for the National Disability Insurance Scheme. You're hoping to save $36 billion over the next four years through changes to it. Can I ask you this simple question? We can't get into a lot of the nitty-gritty, naturally, with the time that we have. But to people listening this morning that currently have supports or are looking at what their family members, their loved ones are being supported with, imagining a life without that NDIS, what's your message to them this morning?
 
BUTLER: None of us wants to imagine a life without the NDIS. The NDIS will continue to be the biggest social program we have outside the Aged Pension. Over $50 billion a year, a lot bigger than Medicare, several times bigger than the Pharmaceutical Benefits Scheme. But we've got to get some of that cost growth under control. I'm very worried that it's growing so fast that community support for a scheme that has transformed the lives of hundreds of thousands of people and their families is ebbing away because people think it's too big, it's costing too much, it's growing too fast, and it's riddled with some dodgy providers. We've got to get it back on track to secure it, not just for the near term, but for decades to come. It's hard work. I know it's confronting for people who live on the NDIS right now who are supported by it, but I'm determined to make sure we can secure the future of this amazing scheme for the long term for Australia.
 
CULLIVER: Okay. When do you hope that- obviously, there's a Senate committee looking at it at the moment. I suppose people are living in limbo at the moment to see what the final shape of that legislation will be. What is your hope for when we actually might have some concrete answers?
 
BUTLER: That Senate report comes down in mid-June, about 16 June, and we'll be having a debate in the Senate over the following few weeks there. We want to see that first part of the legislation passed before the end of June. That's really about good financial management. But there is longer-term work that we'll be doing with the disability community and also with states and territories around things like who's in the scheme, who's not in the scheme, who's supported by other supports out in the community. That'll take some months of work, and it will be conducted in very close consultation with the disability community.
 
CULLIVER: Minister, really appreciate your time. You've been very generous with it. I think you've got some press conferences to go to attend, so I appreciate your visit to Newcastle today. Thank you.
 
BUTLER: Thanks, Paul.
 
CULLIVER: Mark Butler is the Minister for Health and Disability and the National Disability Insurance Scheme.