Radio interview with Minister Butler, ABC Northern Tasmania – 24 February 2025

KIM NAPIER, HOST: Well, it was in January Launceston's Medicare Urgent Care Clinic announced they were trialling extended opening hours. Since it opened in July 2023 the clinic has treated over 26,300 patients. That's an average of around 47 each day. Health Minister Mark Butler is in Launceston today and will make an announcement in regard to the clinic. Good morning to you, Minister.
 
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Good morning. Good to be with you.
 
NAPIER: Have you ever been greeted with a round of applause to a radio interview before?
 
BUTLER: Absolutely, never in a very long career. It sort of threw me a bit, I have to say.
 
NAPIER: Well, there's always a first for everything. So I'm guessing, given the trial, your announcement is around the permanency of those extended hours?
 
BUTLER: That's right. We've got 87 Urgent Care Clinics operating around the country now. They're doing a terrific job. They've seen over 1.2 million patients, often on the weekend and after hours when it's really hard to get into a GP, and they're fully bulk billed. They're still a pretty new model of care for Australia and they're being evaluated as we roll these clinics out. And the terrific clinic here in Launceston operates a slightly different staffing model to the rest of them across the country. They have frankly, a larger number of doctors and nurses on staff. It's a more expensive model, but they see more patients in a shorter period of time. They've been seeing about the same patients as the other clinics, but they haven't been open the same hours across the country. We're going to give them extra funding to be able to open from in the morning at about 9 am up until 8 pm, 7 days a week. That's really what we want all of the clinics operating across the country to operate. They'll still be able to deploy their particular model of care, which I've seen and is a really terrific model. They'll be able to see even more patients than they're currently doing. As you said, over 25,000 people from this part of Tasmania, going through, getting terrific urgent care, completely free of charge. We know from our surveys of patients going through the Urgent Care Clinics, the vast bulk of them, if they didn't have that clinic available, would have ended up at the local emergency department, the LGH in this case. And those beds are already very crowded and people would be waiting hours and hours there.
 
NAPIER: Which is not good enough, really, is it?
 
BUTLER: That's right. This has never been a part of the Australian health system before, this urgent care model that sits somewhere in between your standard general practice on the one hand, and a fully equipped hospital on the other. I looked at the model overseas. They've been operating for decades in New Zealand, for example. And New Zealand has a much, much lower number of people going through their hospitals as a consequence. That's why I promised at the last election we would roll out 50. We've rolled out 87, and they're doing just a terrific job. Really interestingly, and this was a little bit of a surprise to me, that the biggest group of patients going through are under 15. On Saturday afternoon when the child hurts themselves at sport or breaks their arm falling off a skateboard, parents for time immemorial here in Australia have had to take those kids to the emergency department and often because they're obviously urgent but not life-threatening, they get shuffled down the queue, while more life-threatening emergencies like heart attacks and serious car accidents come in the front door of the EDs. I know that the feedback from parents, particularly, has been really positive about the terrific care they get from the doctors and nurses at these clinics, including here in Lonnie.
 
NAPIER: At the Urgent Care Clinic, they can set a broken bone, they can x-ray and set it without going needing to go to the LGH as an example?
 
BUTLER: Absolutely. They have to, as part of their contract, have access to imaging, x-ray usually facilities, some of them have some ultrasound facilities available as well, and also pathology. Now if they're not fully on site they have to be within a reasonable distance. And, as I say, the really critical thing about this, and this is part of our general approach to care outside of hospitals, they're fully bulk billed.
 
NAPIER: Yeah you mentioned that.  
 
BUTLER: That cost issue for people on low and fixed incomes, at a time when households are doing it tough, can be the crunch. It can be the decision about whether they go to the hospital or whether they access care outside of the hospital. That's why making them bulk billed was such an important part of their design.
 
NAPIER: Well, bulk billing has been the topic of conversation since the Prime Minister's visit to the state on the weekend. Labor's $8.5 billion boost to Medicare funding was unveiled, and the Coalition has vowed to match the pledge dollar for dollar. I wonder how does the government plan to make sure that this funding is sustainable in the long term, considering any future financial pressures on Medicare?
 
BUTLER: From my point of view, there's no more important job that government has than to fund the health of its community. We know that the most effective and the most cost-efficient way to care for people's health is in primary care. Your GP is really the backbone of the healthcare system. What we've found as we've seen bulk billing slide, particularly now for people who don't have a concession card, is that more and more Australians are telling us they're not going to the doctor when they should because they can't afford it.
 
NAPIER: So is it futureproof, though? We know all that story, we hear it every day. But is it futureproofed? Can we rely on it well?
 
BUTLER: It is futureproofed in the sense that, as I said, the government has no more important job than  finding a way to make sure they can fund the health care system and this is the most cost-effective way. When we're talking to our state and territory colleagues, doesn't matter what their political persuasion, whether it's health ministers or premiers, they are all telling us their hospitals are groaning under pressure, in part because of the legacy impacts of COVID, in part because we're getting older and we're getting sicker as a community. But they are saying in part because people aren't going to the GP because of cost. And so they're getting sicker and ending up in the hospital emergency department. Of course, you've got to ensure as a government, you've got to ensure that you can continue to fund the healthcare system. There aren't many more important jobs than that. We've taken a responsible approach to budget management that ensures that we deliver to budget surpluses one after the other the first time in 15 years. But we've also been able to fund all of these new Medicare measures, Urgent Care Clinics, bulk billing measures and the like.
 
NAPIER: Local GP, Emma Shoemaker, says the funding announcement is great, but for the funding model to be viable, you have to move through patients a lot quicker, so that's just not feasible, she says, for providing high-quality health care. The AMA says further reforms are needed. Can we expect further announcements with regard to Medicare?
 
BUTLER: You can expect further announcements with regard to Medicare, A Labor government, it won't surprise your listeners, has no higher priority. But in terms of the sustainability and reform, I completely agree with the AMA. We've been working with them to not only make the system more financially sustainable for general practice and for patients, but also to reflect the fact that patients are very different today than they were in the 1980s, when Bob Hawke and Neal Blewitt were building Medicare. And the system doesn't really reflect that. People have more ongoing chronic disease and need care that wraps around them. And it isn't just delivered on an episode-by-episode basis by doctors. We are doing that work with the AMA, and I'm really looking forward if we're able to get a second term in government to continue doing that important work.
 
NAPIER: Well, I have a few more questions, so we'll move through them quickly, but very briefly someone texted to ask: “Will basic dentistry be added at some stage?”
 
BUTLER: I think we all have the ambition to add dentistry to Medicare at some stage. I've tried to be honest and frank with people that it's not going to happen in the short term. My focus right now is rebuilding general practice, which when I came to this job a couple of years ago, I think was in the most parlous state it had been in the 40 years of Medicare. The fact that dental is not in Medicare is this historical quirk really, I think that Gough Whitlam and then Bob Hawke felt they couldn't fight on too many fronts. You've got to remember, doctors opposed Medicare at the time, the Liberal Party opposed Medicare at the time, and dentists opposed dental being put into Medicare. At some stage we'd all like it to go in. It's part of our party platform as a Labor Party. I'm not going to pretend it's going to happen in the very, very short term while we're putting so much effort into rebuilding general practice.
 
NAPIER: Okay. You're also in town for the opening of Launceston's Shepherd Centre, which will provide long or life-changing support for children with hearing loss and their families in the North. Can you outline briefly how this new centre aligns with the government's broader strategy to improve early intervention and support for children with hearing impairments, and what funding or resources would be provided to make sure that this centre is successful?
 
BUTLER: I'm really proud of this announcement. We made this during the election campaign that there would be a Shepherd Centre in Hobart and here in the North because up until now, we're opening the centre here in Launceston today, up until now, families with children with deafness or profound hearing impairment had to travel to the north island to get that sort of support. And that, frankly, wasn't good enough. This has been a model on the mainland that has been operating for a very long time, delivering enormously excellent results to those children and setting them up for a really happy, healthy, contributing life. Frankly, Tasmanian kids with hearing impairment deserve that too. I'm so proud of the fact we're able to open this centre. I'm really looking forward to visiting it later today. As well as having centres here in Tasmania, there's also quite a sophisticated digital or online program that we've set up across the country that will enable families to tap into that with relatively little effort as well. This is about making sure that all kids get the best start in life. It's a relatively modest commitment we've made of some millions of dollars in the scheme of things, given the change it makes to the lives of these young children, that's a terrific investment by community.
 
NAPIER: We have a question I'm hoping you might be able to answer, but an important one, given the cost of living, is top of the agenda this election campaign. “With the agreed financial stress facing so many Australians at the moment, could the Minister justify why federal politicians, on top of what most would consider a healthy income, receive approximately an extra $130 daily meal allowance, while pensioners get approximately $74 a day for all living costs?”
 
BUTLER: I'm not quite sure where that comes from. I've been in the parliament a while, I haven't ever received a meal allowance. I receive a travel allowance for being here in Launceston because I have to pay for a hotel. I'm not aware of any meal allowance operating for parliamentarians.  
 
NAPIER: Okay, you might, need to ask. You could be missing out?
 
BUTLER: I'm pretty sure there's no meal allowance. Certainly for accommodation, we get an allowance when we travel away from home but there's no meal allowance.
 
NAPIER: Alright. I want to ask two questions, and I need them to be fairly quick because we need to move on. Polling shows the Liberals retaining the seat of Braddon at the heart of the salmon controversy and Bass. Can we expect further health funding announcements in Tasmania given those marginal seats? And Lyons is firmly among that list, too. I'm guessing they're crucial to helping secure a Labor victory. So can we expect more announcements for Tasmania? Funding announcements?
 
BUTLER: We know that the health is a really important issue in Tasmania. Like my state in South Australia, we're a little older than the national average. This is a very dispersed community. My state of South Australia, pretty much everyone lives in one city in Adelaide. Delivering services in Tasmania has challenges that most other states don't have as well. Delivering good health funding for this community has always been top of my mind. In all of the years I've been in the health and the aged care portfolio we've worked to deliver it the Northern Heart Centre here in Launceston. We're really looking forward to that being developed over coming years with Commonwealth funding to ensure, again, that people in Northern Tasmania don't have to travel far from home to get the critical coronary care they should get. But of course, your listeners should expect us to say a lot more about health over the coming weeks and months.
 
NAPIER: The listeners also would like an answer to this one. I know it's probably not top of your agenda, but this was a pledge that the Prime Minister made on ABC Northern Tasmania last year.
 
RECORDING OF THE PRIME MINISTER, ANTHONY ALBANESE: What you need is one of those wheels, though, with the flap around, not a virtual one.
 
RECORDING OF HOST, KIM NAPIER: I wanted one.
 
PRIME MINISTER: I can do something about that.
 
NAPIER: Would you?
 
PRIME MINISTER: We don't interfere with the independence of the ABC but surely the Government can give a directive about a wheel?
 
NAPIER: Nothing, Minister Butler. Nothing, so far. Are you able to pass that on to the Prime Minister in case I don't get a chance to chat to him during the election campaign?
 
BUTLER: I'll get straight on the phone.
 
NAPIER: Would you?
 
BUTLER: A very important issue. I'll get straight on the phone.
 
NAPIER: The Health Minister, Federal Health Minister Mark Butler, thank you for your time. Enjoy your day in Launnie.
 
BUTLER: Thanks very much.