Radio interview with Minister Butler, ABC Sydney Mornings – 24 February 2025

HAMISH MACDONALD, HOST: Mark Butler is the federal health minister. He was on stage with the Prime Minister making this announcement. Very good morning to you.
 
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Morning, Hamish.
MACDONALD: How will this actually work? As I understand it, you can't necessarily force the GPs to actually offer the bulk billing?

BUTLER: No, that's right, it's an incentive payment. So just to step this out, for many years now, GPs have been paid an incentive to bulk bill pensioners and people with a concession card. And in 2023 we tripled that incentive. I'll come to Kim's case in Newcastle because Newcastle is a particular challenge. But what that's meant across the country is that bulk billing for that group, pensioners and concession card holders has stopped sliding, it’s turned around. It's now comfortably over 90 per cent across the country, although, you know there are some pockets of concern still. The concern right now is people without a concession card and bulk billing rates for those adults often on not particularly high incomes. The concession card cuts out at about $40,000 for a single or $70,000 for a couple. Their bulk billing access has been sliding considerably, particularly because of the funding freeze from the last decade that Peter Dutton put in place when he was health minister. And that's down to about 60 per cent for adults without a concession card. What it means is that people are paying big gaps, but really concerningly more and more Australians are saying they're not going to a doctor because they can't afford it. We heard a bit of that from Kim just then. So for the first time, we're providing the same bulk billing incentive for GPs for all Australians. So not just concession card holders. And on top of that, we're also going to pay an additional bonus to general practices if they bulk bill all of their patients. And that's what the money's being spent on.

MACDONALD: Can you help us understand, though, if you're offering all this money to GPs, why can't you force them to offer bulk billing?

BUTLER: That's not how our system works. It's not like the British National Health Service, where government employs all the doctors in general practice and effectively can do all of that stuff. That's not how our system was set up back in the 1940s. We can incentivise doctors. We've done modelling on this because we have pretty good information about what doctors are charging. We know almost 5,000 practices, which is the very clear majority of general practices in the country, would be better off if they bulk billed all of their patients under the funding that we announced yesterday.  We're pretty confident this means that we can get to 90 per cent across the population, not just for pensioners, and we'll triple the number of practices that become bulk billing practices, that means they bulk bill everyone who comes through their door.

MACDONALD: So as I understand it, this won't start until November. The Opposition saying they're going to match this. It seems like there's agreement on this idea. Barnaby Joyce has been on the television, the breakfast television this morning, saying he thinks she should recall Parliament so it can be done right away. This is what he said.

BARNABY JOYCE MP, RECORDING: There must be the discussion around the budget about exactly how this works. And in that process, you will definitely see, Angus Taylor saying how he's going to pay for it, how we're going to pay for it. We're going to see how the Labor Party is going to pay for it. So if you don't go back for a budget, you don't know how you're going to pay for it.
 
MACDONALD: So regardless of whether it's Labor in government or the Coalition in government, I suspect we all want to know that this can be paid for. Where does the money come from?
 
BUTLER: Most of it was provisioned in the Mid-Year Budget update, so I'm not really quite sure what Barnaby is talking about there. I saw Peter Dutton talk about Parliament being recalled to allow this to happen. There's no legislation required for this, so I'm not quite sure what he was talking about there either. This will be put into the budget update in the usual way, Like every other announcement we've got a record of delivering two budget surpluses over the past couple of years. The first time you've had back to back surpluses at the federal level in 15 years and of course, we'll make -
 
MACDONALD: Sure sliding into deficits for quite some time. We're all conscious of, the tight fiscal constraints.
 
BUTLER: As we are. We've been very responsible about the way in which we've tried to find space to deliver cost of living relief to households, particularly in areas like health, while also making sure that we've got a responsible approach to budget management. And that's not going to change because of the announcement yesterday, but I can't -  
 
MACDONALD: So does this come at the cost of something else or this is just added to the overall  budget spend?
 
BUTLER: Budgets of course are about choices. There are always a million things that governments could do. A Labor Government, of course, will always prioritise Medicare. That's what we've always done. I think people are entitled to be pretty sceptical about the Opposition's announcement yesterday, because that's exactly what Peter Dutton said in 2013, that there'd be no cuts to health. And then within a few months, as Health Minister, he tried to abolish bulk billing completely. And when he couldn't do that, he froze Medicare funding for six years, which has led to the challenge we have today with bulk billing for middle Australia.
 
MACDONALD: But do you have any evidence that actually he's going to do anything other than what he's saying he's going to do on this?
 
BUTLER: Yeah, his record. As Health Minister it is pretty clear for you  to see his record And people say that when I point out his record that it's some scare campaign, his record is pretty scary. If anything, it's actually quite terrifying. He was judged by doctors, voted by doctors as the worst Health Minister in the history of Medicare, for very good reason. He tried to abolish bulk billing and ripped tens of billions of dollars out of hospitals.
 
MACDONALD: We'll put questions to Peter Dutton when we speak to him about that. Priya from Five Dock, how much did you pay yesterday to go in and see a GP?
 
PRIYA, CALLER: I paid $154 for my 15-year-old who'd sprained her ankle at sports on the weekend. But they did tell me there was Sunday rates involved.
 
MACDONALD: And what did you think of that? Do you think it was reasonable?
 
PRIYA: Well, look, they've got to pay time and a half or double time, I guess, for the nurse and for their receptionist. I understand why the clinic has to do it. Am I happy? Not really, but, yeah, you know, nothing's free. And look, it saved me going on a weekday and pulling her out of school.
 
MACDONALD: And do you remember the last time you went to a GP and got the bulk billing?
 
PRIYA: Oh, not in my area. I haven't had bulk billing for many years prior, and I'm in the inner west.
 
MACDONALD: Thanks for your call.
 
BUTLER: Hamish, can I say to Priya that her case is exactly why we've rolled out 87 Medicare Urgent Care Clinics.  They've already seen 1.2 million patients. They're designed to take people out of the hospital emergency departments where they need care for an urgent but non-life threatening emergency. And 1 in 3 of those patients are under 15. They've generally been injured on the weekend at sport or fallen off the skateboard. And they are fully bulk billed. Every single one of them is fully bulk billed.
 
MACDONALD: I'm talking to the Federal Health Minister, Mark Butler. You will have seen the stories that we all saw, heard, watched at the end of last week about the dreadful story of Joe Massa, who died  just short of his second birthday in the Northern Beaches Hospital last September. An investigation found serious failures in terms of individuals and systemic in the hospital's management. Does there need to be more scrutiny of our private hospitals in the way they're run Minister?
 
BUTLER: Obviously, that was just the most unimaginable tragedy for parents involved in the broader family and friends of that poor young, kid. I had a long talk with Sophie Scamps, who is the local member and also a doctor as well, about the case. And we do want to look at the way in which particularly triage arrangements work at our emergency departments. This is something I've been talking to a range of people about, well, before this tragedy. It's just so important that patients, particularly young kids who aren't necessarily able to verbalise exactly what they're feeling, are triaged in the best possible way so that, you know when you have to sort of accelerate them up the queue. I think there's a lot to learn from this tragedy. This is obviously a quite an unusual circumstance where a private company is operating effectively what is a public hospital. I know that Ryan Park, the New South Wales Health Minister, is, looking at those arrangements, because the Northern Beaches Hospital is quite an unusual case.
 
MACDONALD: We'll have to leave it there. Mark Butler, thanks for coming on this morning. Appreciate it.
 
BUTLER: Thanks, Hamish.
 
MACDONALD: That's the Federal Health Minister, Mark Butler.