Radio interview with Minister Butler, ABC Sydney – 27 May 2025

HAMISH MACDONALD, HOST: We know if you live on the Northern Beaches, you're probably quite worried about the future of the Northern Beaches Hospital right now. Healthscope CEO Tino La Spina was adamant when we spoke to him earlier this morning that it is business as usual at Northern Beaches and elsewhere that Healthscope runs hospitals. This is Tino La Spina on 702, about 8.45 this morning.
 
[Excerpt]
 
TINO LA SPINA, HEALTHSCOPE CEO: The operating companies themselves are open and are not subject to any receivership and operate business as usual. This is not about closing down hospitals, making people redundant. I just want to make your listeners absolutely clear, it is business as usual. They will continue to receive the fantastic care from our dedicated doctors, nurses and support staff.
 
[End of excerpt]
 
MACDONALD: He's provided all sorts of assurances both to the public and to those that work in the hospital on the Northern Beaches. Healthscope actually runs more than a dozen private hospitals in New South Wales alone, including Campbelltown, the Nepean, the Hills, Prince of Wales in Randwick. So is it genuinely business as usual? Federal Health Minister Mark Butler is here. Very good morning to you.
 
MARK BUTLER, MINISTER FOR HEALTH AND AGEING, MINISTER FOR DISABILITY AND THE NDIS: Morning, Hamish.
 
MACDONALD: Do you agree with that assessment? It's business as usual? Nothing much has changed?
 
BUTLER: It is. We've been watching this very closely for some time. As you probably know, your listeners would know, there's been speculation about the future of Healthscope for a considerable period of time, so we've been engaging very closely because it is a very important part of our broader healthcare system. We can't afford to see any interruption to the operations, the procedures at 38 hospitals across the country, including, as you say, about a dozen in New South Wales. About 650,000 patients receive a procedure every year at a Healthscope hospital, so any interruption to that obviously causes distress to them, to the 19,000 really hard-working doctors and nurses and staff at those hospitals, but would also put even more pressure on an already pressured public hospital system.
 
MACDONALD: So I guess we can all imagine what that might look like if that pressure flowed onto the public system. Why then won't the Commonwealth step in here?
 
BUTLER: They're private operations. And many of them- the Northern Beaches is a unique situation. It's a public hospital contracted out to Healthscope, and I'm happy to talk about that separately. But the rest of the private hospitals have often been running for decades as private hospitals, parts of their community doing a lot of elective surgery, doing a lot of births where families choose a private birth, and they're basically good operations. It's just that the particular ownership structure that Healthscope currently has after it was bought out by a private equity owner several years ago just hasn’t worked. I think now we need to find a better way forward with more stable owners so that patients and staff can have confidence that these hospitals have a long-term future.
 
When I spoke to Tino La Spina yesterday and I specifically sought reassurance for the thousands and thousands of Australians who have planned a birth, or booked a procedure like a knee replacement at a Healthscope hospital over coming weeks, I want an assurance that those procedures will go ahead. And I got that assurance and I'm very confident we'll be looking very closely to make sure that commitment is carried out.
 
MACDONALD: You've said though that this doesn't indicate a system-wide problem, but you've also said that reform is required. Can you see why that might be a bit confusing for people particularly that might be due to receive treatment in one of these hospitals?
 
BUTLER: As I said, I've sought that specific assurance. Healthscope has given it. They've got, as I'm told again by the CEO this morning, by Tino La Spina, they've got 12 months forbearance by their lenders, which is also capable of being extended. So that's more than enough time to arrange a stable sale to new owners and see these hospitals continue well into the future.
 
MACDONALD: But if you're accepting that wider reform is needed, obviously there's an argument about how much private health insurers get paid by the insurance companies when a patient comes in for a procedure. If you're acknowledging there's a need for wider reform, then isn't this a broader system-wide problem?
 
BUTLER: I do acknowledge there is the need for broader reform. I think you and I have talked about this before. For example, a few months ago, I said to the private health insurers who essentially fund private hospitals, that I expect them to pay more of their income to hospitals. We've seen a big drop in the- or substantial drop in the share of the revenue that private health insurers earn actually go to hospitals that deliver the care. More of the money is going to private health insurer profits, and in some cases management expenses. I have been very explicit about that. I've given them a particular timeframe. If they haven't resolved that over coming weeks, I've said that I reserve the right to act. That is a private hospital-wide issue. There are challenges around the viability long term of private hospitals, but I do want to stress that Healthscope is a unique case. It was a big private hospital operator, the second biggest in the country, bought out by an overseas private equity firm and subject to some very complicated and ultimately unsuccessful arrangements about how that was financially structured.
 
MACDONALD: So do you have a view as to whether the Northern Beaches Hospital, the public part of it anyway, can in fact be disentangled from the setup that exists currently? Because no one seems to be able to answer that question categorically, and I guess for everyone listening this morning, no one is providing any guide on how much it’s going to cost for taxpayers to get it back.
 
BUTLER: I don't have any line of sight of that contract between the New South Wales Government and the company and Healthscope. I've seen comments from the New South Wales Government. I’m a Labor Health Minister. I've never supported the privatisation of public health services, and I know that's the position of the New South Wales Premier and the New South Wales Minister, Ryan Park, who I'll be talking with over the course of today as well. Ultimately, these things can be very complicated to unravel once a Liberal government has put them in place. This is not just a New South Wales issue. We've seen them elsewhere in the country. My first dealing with Healthscope was 30 years ago when the South Australian government here outsourced a hospital to Healthscope and that ended up in tears as well. This is not a new situation, but I've seen the comments from the New South Wales Health Minister and Premier. I know they want to do the right thing by New South Wales patients with this.
 
MACDONALD: I'm talking to the Federal Health Minister, Mark Butler, this morning. You're now in charge of the NDIS as well after the cabinet reshuffle post-election. A major change is happening to NDIS funding now. We're hearing from various listeners who've been receiving notifications about what's going to happen to them. It seems quite a few people worried about what happens with their funding after a certain point. Can you explain exactly what you're trying to do?
 
BUTLER: I think what you're referring to there, Hamish, is a decision that the agency that runs the NDIS has made to move a lot of participants from a 12-month budget, where they receive all their money up front for their plan, to a quarterly budget, so they receive their funds on a three-monthly basis. They consulted very widely and deeply about this and heard from a lot of participants that they were finding that receiving all of their funds in one lump sum up front effectively made it harder for them to budget. A lot of participants ended up in the position where they, through no fault of their own, they had spent all of their plan, for example, seven, eight or nine months into the year. This is really a decision that we've taken, or the agency has taken, an operational decision to help smooth the way in which people receive their funds. They'll still receive exactly the same dollars over the course of the year, but it will be smoother. It will be easier to budget.
 
MACDONALD: Okay. Do you acknowledge that some people are quite concerned about it, though? I mean, we've heard from listeners this week already about it.
 
BUTLER: Yes. Look, all changes to this scheme, all changes to aged care, other services that I have responsibility for, can cause distress to people. We acknowledge that. That's why the agency has consulted so deeply about this. This was a message we heard, or the agency heard, from participants themselves. We had many, many cases where people were essentially getting only partway through their 12 months having spent all of their planned money and ending up in trouble. This is going to be good for participants. Certainly, if they’re concerned about the impact that this might have on their individual plan, they should contact the agency. I'll give you the number if you want to give it to your listeners, 1-800-800-110, and talk to them about that. But I think this, once it's implemented, it will really reflect the feedback we got from participants. They'll get exactly the same dollars, but they'll get it in a more manageable way.
 
MACDONALD: Now, in terms of the election result, obviously people in the seat of Bradfield on the north shore of Sydney still waiting for a result. Pretty close, incredibly close, you might say.
 
BUTLER: As close as it can get, I think.
 
MACDONALD: There's been reports of increased informal votes at aged care facilities and hospitals. What are you doing to look into this? Like, it's a significant jump, right? Triple the number of informal votes in some circumstances. What can you do about this?
 
BUTLER: After every election, as I'm sure you know, Hamish, there's a very deep parliamentary inquiry into the conduct of the election. There will be this time as well. There have been a number of features of the campaign that just happened that I think warrant very close attention from the Parliamentary Committee on Electoral Matters. This is a cross-party committee, it's not just the government, and that will be conducting an inquiry over coming months as it does over the election. I know the Special Minister of State Senator Farrell will be very much sure to make sure that this question of informality is considered by the committee.
 
I said yesterday, given my responsibilities in aged care and disabilities, that ensuring that people, particularly in aged care facilities or disability homes, have the right to exercise their democratic right to vote is really critical. Any evidence or any suggestion that that hasn't quite worked as it should, I think needs to be thoroughly examined by the Parliament.
 
MACDONALD: Mark Butler, thank you very much for your time.
 
BUTLER: Thanks, Hamish.