Radio interview with Minister Butler, ABC Radio National – 6 November 2025

SALLY SARA, HOST: Well a government bill to establish an independent Australian Centre for Disease Control is returning to the lower house for final approval after passing the Senate with amendments from the Greens. The creation of the agency was recommended by the independent inquiry into Australia's response to the COVID-19 pandemic. Joining me now in the studio is Mark Butler, the Minister for Health and Ageing. Minister, welcome back to Radio National Breakfast.
 
MARK BUTLER, MINISTER FOR HEALTH AND AGEING, MINISTER FOR DISABILITY AND THE NDIS: Thanks, Sally.
 
SARA: We'll talk about the CDC shortly. Just before we do, on the issue of aged care, what are the latest figures that you have for waiting times for those seeking home care packages?
 
BUTLER: I haven't seen data in the last couple of weeks since we got the additional 20,000 packages out that we got in the last eight weeks to the end of October. We've got another 20,000 that are going out in the coming eight weeks as well. We expect that to change the wait lists quite considerably. We've been looking at the assessment wait lists, as you would be aware, which are coming down, particularly outside of hospitals. They've always been pretty short for people who are in hospital requiring an aged care assessment, which is conducted by state and territory governments, funded by us. But there's no question that I've said to you on this program before, we need to recognise demand for home care, for aged care is growing very, very fast. Given the ageing inflection point we're at right now, and we're working really hard to keep up with that demand, putting additional packages into the system. We've got more than double the number of home care packages in the system than we had five years ago. And that's a huge increase in resources into supporting people at home, which is what we know they want. We've got to get the money into the system. We've got to get workers into the system, and we're doing everything we can.
 
SARA: Are there separate figures available? As you were quite rightly saying, the assessment time for people in hospital is pretty quick, it's often two or three days. Does that affect the median wait times that are being measured, or are there separate figures available on those in hospital and those who are not?
 
BUTLER: I don't have those figures with me. To be frank about it, more people in hospital getting assessments are probably getting assessments for residential care. To go into a nursing home, unfortunately, often they'll have a fall and they're simply not in a position to go back home. Most of the assessments, almost all of the assessments taking place outside of the hospital system will be for home care. Many of those people are already getting some level of support. It might be home support or a lower level of home care package. They're already getting something, but they think they might need something additional to that. As I said, that assessment time is coming down right now.
 
SARA: The government has partially privatised the system for assessment. Should private assessors be involved in this process? The Royal Commission recommended against it.
 
BUTLER: Traditionally, as I said, this was really a system largely conducted out of hospital systems by state and territory governments funded by the Commonwealth. It was conducted by state government employed registered nurses by and large. When we came to government, we inherited a plan by the former government to privatise the whole thing, so to take over the state and territory systems and put private operators in charge of the whole shooting match, if you like. We inherited a largely private arrangement outside of the hospital system, which as I said, is largely for people requiring non-residential care. We've kept that in but we reversed the original decision from the Morrison Government to privatise the hospital-based systems. That was very much also a product not just of commentary from the community, but state and territory governments wanted to continue to operate that part of the assessment system and we agreed with that.
 
SARA: So just to be clear on the assessments for in-home care, in March, you're on Radio National Breakfast talking about assessments for in-home care. And you said people receiving care in their own home will also be done by the same state government teams, we haven't privatised that. Was it privatised?
 
BUTLER: Some of them will be done by the state government teams. We used to have two different schemes and the recommendation was to bring them into a single assessment scheme. Some of those assessments under the single scheme, particularly where people don't really have any interaction with the hospital system, will be done by private organisations. Where there's an arrangement or an interaction with hospital systems, we'll use those long-standing ACAT teams that have been doing this work out of hospitals, very experienced registered nurses for decades now.
 
SARA: So when you were saying in March that that assessment process for in-home care hadn't been privatised, was that correct?
 
BUTLER: What I was saying was that there was already a private system that we inherited. What we also inherited though was a decision to privatise the state government part of the system and we reversed that decision.
 
SARA: Let's move on to the CDC. There's already an interim CDC, Centre for Disease Control, in place. What changes will we see when this legislation passes Parliament?
 
BUTLER: The most important thing will be independence. What we learned from the COVID inquiry report was that there was a huge appetite for an independent authoritative agency in Australia to provide public health advice and to do that in an independent, transparent way. This is not a new idea. Every other OECD country pretty much has this body and it was lacking, frankly, in the COVID inquiry. The lack of transparency about the evidence that was behind decisions that governments were making during the pandemic that had a profound impact on people's lives and their freedoms is a big reason why we've seen such a decline in trust in this area. Setting up independence is a big consequence of the laws that we hope will pass the House of Representatives this morning. Independence and transparency, the requirement for them to publish the advice that they provide to governments about public health.
 
SARA: So they will publish that so people can see what the advice is that government is receiving before policies are made, the kind of which we saw in COVID decisions, which affect where we can go and what we can do?
 
BUTLER: That's right. That was really one of the most powerful themes, I think, out of the COVID inquiry. They said quite shockingly that we're, if anything, in a worse position now than we were in 2020 to manage a pandemic for a range of reasons, some scarring of the healthcare systems, the fact that we have significant debt, a lower capacity like governments all across the world to fund the sort of arrangements we funded like JobKeeper and so on during the pandemic but most importantly they pointed to the decline in trust and if I want one thing from the CDC, I want it to start rebuilding trust. We know that will be a long road. Trust is easily lost. It's hard to win back. But the CDC is central to our plan to do that. That's why it's got the support of every health group, every state and territory government, Liberal and Labor alike. They recognise this is a really crucial reform.
 
It will also, frankly, improve our use of data. We were making decisions during the pandemic based on data we were getting from the UK and the US, and their situation was very different. The place they had in the vaccination program for example, meant that their population was in a different position, but didn't have our own data. When I came to the job as Health Minister in 2022, so two years into the pandemic, I still could not get proper data about who was dying because of COVID, what their vaccination status was, what their indigeneity and other really important things to guide a proper pandemic response.
 
SARA: The independent member for Kooyong, Monique Ryan, who's also a medical specialist, says that one of the biggest issues in the country is chronic disease. And she's saying that one of the priorities for the CDC should be chronic disease rather than possible pandemic preparedness. What do you think of that position?
 
BUTLER: I agree with Monique and other public health groups who want to see this body provide, again, very good authoritative advice and evidence about what we should do about chronic disease. We know that in terms of scale, chronic disease is our big public health challenge. Diabetes, cardiovascular disease, mental health and those sorts of things. But we've decided after a lot of consultation that the first job of the CDC to get it up and running, to establish the systems, particularly the data systems, and establish trust within the health sector and the community more broadly, is to be on infectious disease. That's really the area which led to our decision to put in place a CDC. Pandemic preparedness, but also a whole lot of the day-to-day, year-by-year infectious disease or communicable disease challenges we have, HIV, hepatitis, respiratory viruses and things like that. I've been very clear with Monique and every public health group and others as well, I want over time for the CDC, once it establishes that firm foundation, then to move into the era of chronic disease, which as I said, is really our big public health challenge.
 
SARA: Mark Butler, thanks for coming in again this morning. I appreciate it.
 
BUTLER: Thanks, Sally.