Radio interview with Minister Butler, ABC Perth Drive – 21 August 2025

GARY ADSHEAD, HOST: Mark Butler is the Federal Minister for Health, thanks for your time. Now, one of the significant questions from listeners was how you're going to go about taking those people with these issues, these mild and moderate autism issues out of the NDIS.
 
MARK BUTLER, MINISTER FOR HEALTH AND AGEING, MINISTER FOR DISABILITY AND THE NDIS: The NDIS was set up for permanent and significant or profound disability, and that's the critical bit of the equation here, this question of significance or profound disability. What's happened over time, though, is that it started to take on children with mild to moderate levels of developmental delay or autism, largely because that was the only port in the storm for parents. They didn't have access to the sort of mainstream broad-based supports that used to exist before NDIS for kids with that level of need. What I announced yesterday, really, was the need to rebuild that system. That was a recommendation from the NDIS review that was accepted by the National Cabinet, which is all the premiers and the Prime Minister. But yesterday I tried to give shape to that based on feedback I got from states and from the community and the sector about really what was needed to support parents with children with that level of need.
 
ADSHEAD: So the acceptance there, you think, is that those parents that have gone down the NDIS path, if they'd had another option before that would have taken it?
 
BUTLER: That's right and that's where they would have been referred and guided to by their doctors, by infant and maternal health systems, by community health and others. It's just that many of those systems were dismantled across the country in order to put money into the NDIS. This is really an unintended consequence of the establishment of the NDIS, one that's been pointed to in reviews of the scheme by a number of people. It certainly recognises there's a need there for children to get support, a really important need. This is a critical part of their life. But because this is a relatively mainstream, broad-based issue that affects a lot of children, we've taken the view it should be provided in mainstream, broad-based services, the sorts of systems that people are very familiar with. Those infant and maternal health systems, your local GP, allied health, services in community health, and other community centres. These are systems with which families are very familiar, but we've got to bolster them, we've got to focus them, so that this is a place for parents to take kids to make sure that they have confidence their kids are going to thrive.
 
ADSHEAD: How quick can you do that realistically, change that sort of system and those pathways?
 
BUTLER: As I said, National Cabinet gave us that work now probably 18 months ago or more. We've been consulting on that; states have made a couple of things pretty clear. They wanted ongoing funding from the Commonwealth for it, and I committed that yesterday. They also want the Commonwealth to lean into it a little more and that was certainly the response from the community. The community doesn't want eight different systems developed in different states and territories. Obviously, states are an important partner here, they have a lot of the levers to provide those supports. WA has leaned in probably more than any other state and territory into this area already. They've got terrific programs being delivered through their infant and maternal system, which is called Child Health, as you know, Gary, in WA. Programs like Inklings, which have been shown through 10 years of clinical research to work with very, very young kids who are showing difference about the way in which they communicate. It's a program that comes out of the Kids Research Institute in Perth, one that's starting to roll into other states as well.
 
We don't have a blank sheet of paper and a pen here. We've got systems that have existed for many, many years, pre-existed the NDIS. We just need to reinvigorate them, bolster them, focus them and give parents confidence. There is a broad-based system of support there that will help them make sure their kids can thrive.
 
ADSHEAD: And that takes you to the point of those parents not needing a diagnosis, because clearly that diagnosis of autism and then their children going in through an NDIS program somewhere has, what you're saying, exacerbated the system somewhat.
 
BUTLER: Yeah, and it's been an enormous stress to parents, I know, talking to them. It can take ages and ages to get that diagnosis. It can cost them thousands and thousands of dollars. If you don't have that money, that really presents some really serious equity issues as well. Really, this is something I think was unintended from the establishment of the NDIS. Parents understandably have gravitated towards the NDIS because it's been the only port in the storm. Of course that's what they do, they're desperate to get whatever support is available for their children. But what's been really clear to us now is that we need to build that alternative system of supports for kids who aren't hitting those developmental milestones or who might be exhibiting relatively mild to moderate symptoms of autism. They need support, but that support shouldn't be from a system that was set up for permanent and very significant disability.
 
ADSHEAD: Talking to Health Minister, Mark Butler, can I ask you whether you've done the sort of maths around whether that brings the budget in terms of NDIS looking in a better state? That cohort that we've just been talking about there, is that what's needed or is there more needed?
 
BUTLER: There’s more needed, there's no question about that. The scheme has grown very, very fast, well beyond projections and it's still growing fast. The costs of the NDIS are still over 10 per cent per year. In terms of growth, that's well beyond any other social program that we have. And I reaffirmed yesterday, we've got to get that down, partly to make sure it's sustainable for the budget on behalf of taxpayers. But also, I'm very worried that the social licence, that broad community support that has existed for the NDIS since it was introduced, is under pressure. Research shows that. Research shows that seven in 10 Australians are convinced this has been a terrific scheme, transforming the lives of hundreds of thousands of participants. But they're also very worried it's costing too much, it's growing too fast, there are too many dodgy providers in it. Indeed, six in 10 Australians think that it's broken. I'm really determined to make sure we secure the future of this scheme for the long term. It's that important. For our community, but particularly for Australians living with disability.
 
ADSHEAD: Just my last question on that front. Jordan Steele-John, of course, Greens Senator from Western Australia, says that children with autism are being used as a political football. What do you say to that?
 
BUTLER: That's a comment that should be beneath Jordan, really. It's just not a serious contribution to an important debate. I have said very clearly that all Australians, particularly Australian children with autism, need very strong supports. But it's very clear that the NDIS was set up for people with very significant and permanent disability. Now, a number of people with autism will qualify for the NDIS and should be supported through their life because of those needs. But for children with mild to moderate developmental delay or relatively mild to moderate symptoms of autism, I'm convinced that is not the right scheme for them. It was not designed for that group of children or indeed for that group of adults. But we've got to design an alternative system because at the moment parents haven't had one.
 
ADSHEAD: Can I turn to the health system now? And you're fully aware of the fact that the system over here has been under pressure recently. There's been some pretty bad headlines around maintenance in hospitals and more record ramping. Okay, and you know the argument that the Premier's put. He says that the Federal Government needs to do more with aged care beds. What do you say to that? Because even organisations that represent the aged, they say that there's not enough home care packages, et cetera, and certainly not enough beds for them to go to if they're stuck in hospital. What is your response?
 
BUTLER: We've been doing a range of things to support states like WA. And frankly, every state is experiencing that level of pressure generally in their hospital system because of the change in the population, getting older, getting sicker. But it's a particularly tough time in winter for hospital systems, as you know, Gary. But broadly, what we're doing is we're increasing our funding to hospitals very sharply. This year, every state received a double-digit increase in hospital funding. On average across the country, a 12 per cent increase this year alone, the biggest that I can remember in a very, very long time. But we're also trying to take pressure off the hospital systems, stopping people going there in the first place. We're funding innovative programs to stop particularly older people having to go to hospital from nursing homes, as well as obviously our network of urgent care clinics. We only opened yesterday tenders for the new urgent care clinics in WA that I promised at the last election. We want to see more aged care beds built, there's no question about that.
 
We need that as the baby boomer generation starts to hit the average age of entry into aged care, which they will in the next three or four years. That's why we passed such important legislation at the end of last year. We did that with a very clear eye to making sure that that sector was, to use their terms, investable, that they would start building new facilities. Now really the wood is on those providers. We made the changes, we unleashed the money for them, the providers have to start building those new beds.
 
ADSHEAD: So you're saying that when the Premier and the Health Minister do meet with you, which is scheduled, you're not necessarily going to give them a swag of money to come back to Western Australia with?
 
BUTLER: We've given them a swag of money this year. I know they're going to be asking for a swag of money for the next five years, as all states are. I've said we've got to secure a deal for hospital funding by the end of this year if that's possible. We've got other things to negotiate in those as part of that deal as well. But I'm looking forward, I understand Roger's bringing a number of colleagues over to Canberra next week and of course I'm looking forward to meeting with them.
 
ADSHEAD: Alright we'll wait and see what comes from that. Appreciate you joining us today.