Radio interview with Minister Butler, ABC Radio Adelaide – 12 June 2025

RORY MCCLAREN, CO-HOST: Mark Butler is the Federal Health Minister. He is also the Member for Hindmarsh in Adelaide’s Western Suburbs. Mark Butler, good morning to you.
 
MARK BUTLER, MINISTER FOR HEALTH AND AGEING, MINISTER FOR DISABILITY AND THE NDIS: Good morning, everyone. I feel a bit outnumbered here, but -
 
JULES SCHILLER, CO-HOST: Yeah.
 
BUTLER: I should’ve brought some friends.
 
SONYA FELDHOFF, CO-HOST: We’ve got the gang together.
 
SCHILLER: We’re the Beach Boys of radio, the four of us together. Anyway, let's get to more important issues.
 
MCCLAREN: Mark Butler, the UK Parliament is reviewing the AUKUS agreement. The Pentagon in the US is reviewing the AUKUS agreement. Is it time for the Australian Government and the Australian Parliament to review this pact?
 
BUTLER: We did review the pact as we came into government with the broader Defence Strategic Review. It was, as I think I heard you say to Premier Malinauskas, a broader review, but at the heart of it was AUKUS. And it's completely unsurprising that a new government would come in and review what is such a very significant industrial and defence agreement with other countries. We did it with our DSR, our Defence Strategic Review. The Starmer Government in the UK has done it, and so it's unsurprising that the Trump Administration would want to kick the tyres on this as well. When you’re in opposition, you get a sense of the agreement. But it’s only when you’re in government and are able to go through the numbers and really get a sense of the detail that you're really able to implement it, so this is unsurprising.
 
I've spoken to the Defence Minister this morning, Richard Marles. He's unsurprised by it. He welcomes it indeed, was the language he used, and will obviously be working very closely with the Americans on the review as we did with the British.
 
SCHILLER: When you did that review, were you concerned that we give all this money to the states, and there is no guarantee at the end of that that they will provide us with a submarine? Surely a review would want to have more safeguards in place for us being left out of pocket?
 
BUTLER: We're very confident about this agreement being implemented. We've worked very, very hard  over the last couple of years across the aisle with Congress, with the former administration and with this administration to ensure that it is an agreement that will be implemented by all three parties. We have very high levels of confidence about that. We've got  about 120 Australian workers working in Pearl Harbour right now on maintaining Virginia-class submarines. Obviously increasing the capability of the Americans, which is important if they're going to be able to deliver three submarines to Australia, but also learning the skills that will be needed. There's money changing hands, there are people crossing oceans between here, the UK and the US. We're very confident this agreement will be implemented.
 
FELDHOFF: If this US review finds that it is in America's interest or it fits the America First Agenda, can it also be in Australia's best interests?
 
BUTLER: We think that's the beauty of this agreement. We think it is in the interests of all three countries, which is why we signed onto it in opposition and why we're determined as a government to implement it. I say that not just as the Member for Hindmarsh in the Western Suburbs of Adelaide, where it will obviously be a huge driver of economic prosperity and jobs, but I say that as a member of the national government. We've looked at this closely. We're an island nation. We need a submarine capability. Our best advice has been a nuclear propelled, conventionally armed submarine is the best way to do that.
 
MCCLAREN: Is the problem here though, Mark Butler, that there is so much that is out of the Federal Government's control when it comes to things like the Virginia-class program, and the fact that the US are already struggling to meet the needs for its own defence force, let alone selling three to us?
 
BUTLER: As you know, Rory, we are putting our shoulder to the wheel there, both in terms of money to support the Americans being able to increase their capability to build New Virginia-class. And as I said, we're sending a workforce over there to contribute to that effort as well as learn the skills that we'll need here to maintain the three Virginia-class submarines when they arrive here and join the Australian fleet. There's a debate in America about this, as there's a debate always in Australia about whether our defence projects are going to be able to be delivered on time. You see that debate in the UK as well. That's not unsurprising, but we still have high levels of confidence in this.
 
SCHILLER: I mean- but the text line, and I know that's not a sample of everyone, but a lot of people don't have high levels of confidence in it today, Minister. I mean, there is almost universal scepticism that we're going to see a Virginia-class submarine in 2030, and you represent many of these people in your electorate. I mean, surely you must realise when people are waking up to this news, they are nervous and sceptical?
 
BUTLER: I completely understand that. And the announcement by the review and the way in which it's been reported this morning, I'm sure, is causing a lot of nervousness in the community I represent, in the west of Adelaide, more broadly in South Australia, and perhaps beyond as well. As the Government, we are not surprised by this review. We think it is a natural thing for a new government to do. We did it, the British did it, it's unsurprising the Americans would do it as well. There's been a really good level of communication since the Trump Administration took talk office in January, including only in the last fortnight between our Defence Minister and the Defence Secretary Pete Hegseth -
 
MCCLAREN: When he asked for more money.
 
BUTLER: Sure, and there's a debate about defence funding, as you know, Rory, as your listeners know, right across the world. It's happening in Europe, it's happening here in the Indo-Pacific as well, and that's not going to go away any time soon, given the level of geostrategic uncertainty in both hemispheres, frankly, in the north and in the south as well.
 
MCCLAREN: Do you agree, and I'm picking up on something that the Premier said to Sonya and Jules before eight o'clock, that basically no matter what happens, there's going to be submarine? If Australia is going to build submarines, they're going to be built at Osborne.
 
BUTLER: Of course.
 
MCCLAREN: Do you agree with that analysis?
 
BUTLER: Yes, of course. We have sunk so much capital as a country into the capability down at Osborne since the 1980s. Mick Young, my predecessor, a key advocate of this, worked really closely with John Bannon at the time. I know the stories, he'd literally park himself in Kim Beazley's office after question time, who was the Defence Minister at the time. And since then, the workforce down there has repaid that trust and repaid that investment. You can’t duplicate that. You’re not going to shift it somewhere else, so I’m very confident about that.
 
What the community wants, what the workforce down there want, is certainty. Over the last decade, it was do we buy them off the shelf from Japan? Do we invest in French technology? We're confident now we've got the right answer to the question, and we've just got to stick with it.
 
SCHILLER: So there's no plan B?
 
BUTLER: No, this is it. We’re -
 
SCHILLER: This is a plan, and if this falls over -
 
BUTLER: This is it. We're very confident it is going to go ahead.
 
SCHILLER: But if it's so important, if we have Chinese warships- and I appreciate what you say and the Premier says, that we need submarines, you're saying there's no plan B if this doesn't work?
 
BUTLER: This is the plan we are working on. We're confident it's the right plan. There were lots of different plans over the last decade. We're confident this is the right plan. We're confident the Americans and the British recognise that, as well as being in their interests. We’ve seen that not just from the former Biden administration, but through the last couple of years from Republicans, including Republicans allied with the now President. We’ve seen it since the new administration took effect in press conferences between our Defence Minister and Defence Minister Pete Hegseth  where he said he supports it and he's confident that the President does as well.
 
FELDHOFF: That's the voice of Federal Health Minister and Member for Hindmarsh, Mark Butler. He's in our studio with Rory, Sonya and Jules here on 891.
 
Let's move to your specific portfolio, Health, and of course this is our first time chatting to you since the federal election. You've been reinstated as the Health Minister, and in the lead up to that, one of the big selling points was obviously the 90 per cent target for bulk billing with GPs. Now, many South Australian doctors who've called us or that we've spoken to say they're just not- they're not signing up to what you're selling. Are you- what are you doing to persuade GPs on the bulk billing front?
 
BUTLER: I'm very confident we'll get there. And for all the doctors who ring in to say to you that they're not yet sold on this proposition, I'm talking to doctors all the time, including practice owners, who recognise this is going to be in their financial interests. I mean, we didn't pluck this modelling out of the air. We have access to every single transaction a doctor does with every single patient. We know what they're currently earning, and we know the vast bulk of them will be better off on the money that we've put on the table, and we'll get to that rate. We're very confident about that, and for bulk -
 
FELDHOFF: Do you have a timeline?
 
BUTLER: By 2030. We've said that very clearly. We don't think it's going to overnight. But we made investments in the 2023 Budget when we recognised and were told by the College of GPs that bulk billing was then in freefall when we came to government, because the Medicare rebate had been frozen for all those years. We tripled the bulk billing incentive that we pay to GPs to bulk bill pensioners and kids, and that's worked. Their bulk billing rate, that cohort's bulk billing rate, again, is up over 90 per cent. But for the rest of the community, it has continued to slide, which is why we said for the first time we'd introduce bulk billing incentives to bulk bill everyone else, and we're confident that they will be better off that.
 
Now look, doctors’ groups came to me before the election and they've made no secret of this, and they said: look, we'd like the additional money. We think the additional money into general practice is a good thing, but we don't want strings attached. Trust us and we'll do the right thing with it. Well, as the Health Minister – particularly, frankly, a Labor Health Minister – for whom bulk billing has always been the beating heart of Medicare, I was not willing to do that. We've invested more in general practice already than any government before us, but I want to see an outcome for patients.
 
SCHILLER: Aren't they worried about the length of consultations? Doctors say that they can't use this model because a lot of consultations go longer than, is it 15 minutes?
 
BUTLER: It's just not right. The modelling I've talked about is based on what they're currently doing, not some hypothetical change to the time of consultations becoming shorter. It's based on what they're currently doing. We know that a couple of years ago, a GP who bulk billed all their patients was earning a lot less than a GP who charged gap fees, tens of thousands of dollars less. On their own earnings calculator, as they describe it, a full-time bulk billing GP was earning about $280,000. From 1 November, they'll earn more than $400,000 here in Adelaide. And in say, Whyalla, they'd be earning $460,000. It’s increased their salary by a huge amount if they stick with the bulk billing model. I'm very confident that over time, as people really crunch their own numbers, the practice owners who've crunched their numbers have said to me, this is good for us. We will be better off under this model, leaving aside the fact that actually this is about making sure that patients are better off, but GPs and their practices will also be better off.
 
SCHILLER: Can I get to specialist fees? Cleanbill have done a study, and they've looked at dermatologists in particular. So their out-of-pocket fees have increased by over 40 per cent, and the rebate has risen by less than 16 per cent. This is from 2017 to 2025. So you can be paying out-of-pocket of almost 200 bucks to see a dermatologist. I know you’ve set up a website, the Medical Costs Finder website, to try and give the public a way to compare specialists’ fees and out-of-pocket expenses, which is very, very important. But only 74 specialists have signed up out of 11,000. So how are you going to keep out-of-pocket expenses of specialists down?
 
BUTLER: Yeah, Greg Hunt, my predecessor, set this website up, and it was set up on a voluntary basis. And that's just -
 
SCHILLER: But you can [indistinct]
 
BUTLER: It would be funny if it wasn’t so serious, that a few dozen of thousands and thousands of specialists have actually agreed to cooperate with the website to disclose their fees. I announced some time ago, just before the election, we would now be mandating, we’ll require those fees to be uploaded onto the website. But we won’t need them to do it, we’re going to do it ourselves.
 
As I said, we have access to all that information. Every specialist in these groups is going to have their gap fees uploaded to the website -
 
SCHILLER: When’s that happening?
 
BUTLER: - whether they like it or not. Now it's going to take a bit of time for us to do that, to build the capacity. I have also said to the AMA, our focus over the last three years has unapologetically been on general practice. That was the part of the healthcare system I was most worried about. But I've said to the AMA, specialist fees are now the barbecue stopper in the healthcare system. It's what people are talking about. It means that families are walking away from private birthing and maternity services options because they just can't afford the out-of-pocket costs, which is creating real problems in the public system as well. I've said to the AMA, I've said publicly, we've got to do better on specialist out-of-pocket fees. The growth has been extraordinary.
 
Also what we're seeing, and I was only getting a presentation from the department about this yesterday, is it's not even across the board. I mean, the vast bulk of specialists in a lot of areas are charging relatively modest out-of-pockets, and then you get a share of them charging exorbitant out-of-pocket fees with no qualitative difference, no quality difference between them. That’s really why a bit of transparency, a bit of choice for patients, is going to be important. It's not the whole thing, but it's an important ingredient.
 
MCCLAREN: One of the barbecue stopper moments in last week's budget lockup was looking at how much additional money the state government had to put into the hospital system in the last six months. It was an overspend of more than $470 million. And since that time, the Treasurer has been pointing out the continued issues that he believes the state's hospital network is having when it comes to bed blockages, and highlighted aged care and NDIS patients. This is a topic that I feel like every time you and I speak, Mark Butler, we cover it in some way, shape or form. So what more can you do in an immediate sense to relieve the pressure, not just on South Australian hospitals, but hospitals across the country?
 
BUTLER: Later this morning I'm flying to Melbourne to meet with all of the health ministers, including Minister Picton. I'm sure this will come up again. The first thing I'd say is that hospital funding from the Commonwealth from 1 July increases by 15 per cent to South Australia, the biggest ever increase in hospital funding. We recognise that hospital systems across the country are doing it tough. That's the biggest increase any state is receiving, frankly, because South Australia historically has not been funded the way in which some of the big states have.
 
We're also funding the state to help with hospital diversion of older patients, particularly from aged care coming in, but we still have a problem with getting older people through the hospital system when they're clinically able to be discharged. And in part, significant part, that reflects the fact there's not enough aged care beds. Anne Ruston as the Shadow Minister and I cooperated in negotiations all through last year to get some reforms through the Parliament just before Christmas, that will improve the so-called investability of the aged care sector, because we need new nursing homes built. And frankly, for years now, they haven't been being built because they just weren't delivering a return on the investment by aged care providers.
 
FELDHOFF: But that sounds like the key. So, have we seen any response to that since then?
 
BUTLER: We’re seeing aged care providers say, we had plans, they had development approval, but our boards weren't allowing us to go ahead because we couldn't get a loan from the bank because it just wasn't going to make a return. This has changed the equation. It still takes a while to build these facilities, so that's the challenge we have. And that really reflects the lost decade. We knew the baby boomer bump was coming in demand. The oldest baby boomers will hit the residential aged care system in big numbers in about two or three years.
 
FELDHOFF: Well, when will that agreement start seeing results on the ground?
 
BUTLER: Investment decisions already are being made now. Lots of announcements across -
 
FELDHOFF: A year, two years, four years, five years?
 
BUTLER: It's going to take a couple of years to build them. It is going to take a couple of years. We had to compress really a decade's reform of the aged care system into three years because nothing was done.
 
MCCLAREN: And then you've also had to delay it, part of the rollout as well.
 
BUTLER: We've delayed it by four months, which is really about systems being put in place by aged care providers. The critical thing was getting that bipartisan support through the parliament. A message to aged care providers: get out there and build. We need to open a ridiculous number of aged care facilities over the next 20 years to deal with the numbers coming in or we're going to have stories like Minister Picton and the Treasurer Mullighan talk about right across the country get much, worse before they get better.
 
FELDHOFF: Sonya, Jules and Rory with you, and you're listening to the voice of Health Minister Mark Butler, who is in our studio with us here on 891 ABC Radio Adelaide.
 
In the last week or so, in fact this year we've heard of two problems with Monash IVF. And of course Repromed, our biggest private provider here in South Australia is owned by Monash. A lot of concern, a lot of people using IVF services. Is it time in this unregulated industry for you as Health Minister to consider regulating this industry?
 
BUTLER: We'll be having a talk about that tomorrow as Health Ministers in Melbourne. I put it on the agenda some time ago because we had some advice from the relevant college who had done a review about whether or not there should be at least more national consistency in regulations. This, your listeners might remember, sort of really cropped up at a state level. It's largely regulated by state governments and also to a degree self-regulated by the clinicians or the College of Clinicians themselves. And I think particularly given the, frankly shocking stories out of Monash IVF which is a- a very old venerable company. It did some of the first IVF birthing 50 years ago. This is not a fly-by-nighter, this is a very serious outfit. But these cases are just shocking, deeply distressing, and undermine confidence in the system. We have about 20,000 IVF births a year. This is not a niche. This is quite central to -
 
SCHILLER: Many of them are asking now to be DNA tested. I mean, you understand if you're an IVF child at the moment, I mean, small chance, but still a chance -
 
FELDHOFF: Because what if these problems haven't been uncovered?
 
BUTLER: That's right. We've got to get some confidence back into the system. I haven't yet had a discussion with state ministers about their views going forward. This will be the first discussion we've had over the next 24 hours or so.
 
FELDHOFF: Why isn't it a regulated industry now?
 
BUTLER: It is regulated, but it's regulated by every state. For example, you’ve got now, these Monash cases. One is in Queensland, one is in Victoria. You've got two different systems now regulating these two cases. In their defence, partly, the company has acted quickly to put in place a very senior silk to review this - Fiona McLeod, who people might remember as the counsel assisting the Banking Royal Commission. A very esteemed KC to look at this. But I think as governments we've got a responsibility to see whether there are better levels of regulation that should be put in place, and to inject some confidence back into a system that delivers such joy to so many thousands of families every year.
 
MCCLAREN: Can we shift gear again, and can we talk about the NDIS? And there's some reporting out of the Australian Financial Review this morning which suggests the government is facing the prospect of a budget blowout of almost $9 billion worth of savings earmarked for the NDIS. Now, the savings the reporting suggests hinge on the government overhauling how participant budgets are set, and the states also striking a funding deal with the federal counterparts, which are both unlikely to happen. Is that the case?
 
BUTLER: I've read that story. I don't agree with the conclusions that the journalist has come to there. And when we talk about savings, essentially what it is is a reduction in growth. When we came to government -
 
MCCLAREN: Because you're trying to cap that, aren't you?
 
BUTLER: That's right. When we came to government, this program, the NDIS was growing at about 22 per cent every year. There's no other program in the government growing that fast. Even aged care, given the growth in the population of older Australians, is growing nothing like that because it's a well-designed program that's quite mature. There was broad agreement you had to get that growth down. There's an agreement between jurisdictions that we'd aim for an 8 per cent growth. I think we're on track for that. That’s the best advice I have. That's what the actuary of the scheme says. We’ve got it down to about 10 or 11 now. We’re continuing to track that down.
 
But we do have to hit some other milestones, which the article talks about. And I’m very confident, as the new minister for the NDIS, I’m very confident we’ll do that. We’ve got a number of negotiations underway with state governments, a new hospital funding deal, NDIS reform, a new system of supports for people outside the NDIS, and we want to deal with those three sets of negotiations as a job lot, and we’ll be starting that again very soon.
 
MCCLAREN: Broadly though, Minister, how do you actually juggle all that in your portfolio mix? Between Health and NDIS, that's a significant amount of work on your plate. How do you make sure you're spreading yourself not too thin, I guess?
 
BUTLER: First of all, I have two terrific junior ministers and some assistant ministers working with me, but there is a lot of overlap here .I think we recognise, certainly the Prime Minister recognised, there's a lot of overlap between health and these adjacent care sectors of aged care and disability care, what we now call the NDIS and workforce overlaps, trying to get some better harmonisation in pricing. There's a lot of benefit to bringing these two things together and treating them more as one negotiation with states rather than three separate negotiations which too often in the past end up competing with each other.
 
SCHILLER: Any comment on the proton therapy machine in Adelaide? Have the state government blown their money on that?
 
BUTLER: This is something again where we're staying very close to the Treasurer and the Health Minister on. This is not just an issue for South Australia, this is a national capability. There was a lot of confidence from the country placed in South Australia to deliver this on the basis that particularly paediatric or child patients, cancer patients would be able to use this, not just in Adelaide but across the country. And obviously the company that was going to deliver this machine to North Terrace has run into all sorts of difficulty. I know the Treasurer and the Health Minister are working really hard to find an alternative solution. We're making sure we're in close contact with them about that and I want to see it delivered as soon as possible.
 
FELDHOFF: Are you stumping up any money to help out on that fund?
 
BUTLER: We won't negotiate through ABC Adelaide as much as I love this institution -
 
FELDHOFF: It’s not so bad.
 
BUTLER: - As you know, Sonya. But we recognise this is a really critical national capability. In the meantime, what we’re trying to do is, at a federal level, make it easier for those children who are experiencing these particular types of cancer and their families to be able to access treatment overseas pending us having our own capability here in Australia.
 
FELDHOFF: Mark Butler, thank you for your time.
 
BUTLER: My pleasure.