Radio interview with Minister Butler and Ange McCormack, Triple J Hack – 17 August 2022

Read the transcript of the Triple J Hack interview with Minister Butler on bulk billing, urgent care clinics, youth mental health, and Scott Morrison’s secret appointments.

The Hon Mark Butler MP
Minister for Health and Aged Care

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ANGE MCCORMACK, TRIPLE J HACK HOST: Mark Butler is the Federal Minister for Health and Aged Care. Minister, why do my listeners having to pay, you know, like, $40 to see a GP just for two minutes just to do something really simple like get a medical certificate for a sick day?


MARK BUTLER, MINISTER FOR HEALTH AND AGED CARE: That terrific intro really spelled it out. What we've seen over the last 10 years are cuts and neglect to Medicare and unsurprisingly that's meant that doctors have either had to reduce their level of bulk-billing, and where they do charge gap fees, to see those gap fees climb higher and higher. Now, for the first time in the 40-year history of Medicare, the average gap fee that people are paying for a standard consult with their GP is actually more than the Medicare rebate itself. It’s never been the case before. And in the lead-in to the election, we just heard from so many people across the country, it's never been harder to get into a doctor than it is right now, and it's never been more expensive, which is why strengthening Medicare was right at the centre of our election policy.


MCCORMACK: And I know those cuts happened under the former government, under the Coalition Government. But the freeze started back in 2013 under the Labor Government didn't it? Isn't this partly a Labor responsibility, how Medicare has gone?


BUTLER: What happened back in 2013 is that the annual increase to the rebate was shifted to the financial year, so it would happen at the beginning of the financial year on the first of July. It had previously been some months earlier than that, so that wasn't a freeze. It did mean that doctors had to wait a few more months for their annual increase, but it was made very clear in 2013 that there would still be an annual increase to MBS rebates or Medicare rebates. What then happened was Tony Abbott tried to introduce a GP tax that everyone – pensioners, low-income households, everyone would have to pay. And when he couldn't get that through the Senate, because we blocked it, along with the Greens Party and other people, he then extended a freeze for six full years, which meant that effectively GPs had a wage freeze and, unsurprisingly, they had to increase their gap fees to keep up with costs.


MCCORMACK: Okay, let's look at the future. Last month the Medicare rebate for GP consults went up 65 cents. GPs say that's nowhere near enough. Are you going to raise it more?


BUTLER: We committed an extra $250 million a year to Medicare and I said that I wanted to sit down with doctors and nurses and patient groups and explore the best possible way to spend that money. That money is on the table. As your intro said, we've got a taskforce for this that is meeting on a monthly basis between now and Christmas to work out how best to spend that money. There are different ideas about that, whether it's just an increase to the rebate, or whether it's employing more nurses and allied health professionals in GP surgeries, or many other ideas for that matter. So we're going to work through those ideas, discuss them maturely, and next year the money will start to flow.


MCCORMACK: So people can expect that, you know, these issues with bulk billing, really long wait times, to get a free doctor appointment or bulk-billed doctor appointment, they’re not going to change until next year?


BUTLER: We only just got elected several weeks ago. The money is in the Budget for next year. The first full financial year that we’ll be in government will be when the money starts to flow. That was made very clear in the election campaign. As well as that, we're rolling out urgent care services across the country. Not only to make it easier to see a doctor, but to take pressure of hospital emergency departments.


MCCORMACK: I wanted to ask about those, Minister. How many of those are up and running now? How many of my listeners can go out and access those urgent care appointments? Because for a lot of people on the text line, this is really urgent.


BUTLER: Just reminding that we've been in government for 9 or 10 weeks. And we've committed to rolling them out, they'll go through the Budget in October.


MCCORMACK: So, are any of them up and running in the next month?


BUTLER: No, the money will flow from the October Budget. State governments and GP practices are already expressing interest in setting those services up. They can't be set up overnight. They require new staff, they require new equipment, so these services out of hospitals will have the sorts of equipment that you need, for example, if you have a break of your arm, or you have a deep cut, or you have one of those other minor emergencies that at the moment are clogging up our hospitals. So these things can't be rolled out in a matter of weeks, but they will be rolled out as quickly as possible. They'll be up and running next year and that, frankly, is as quickly as you can get a whole new medical service out into the community.


MCCORMACK: You're listening to Hack on Triple J. I'm Ange McCormack speaking with Health Minister Mark Butler, we are talking about how difficult it is to get a bulk-billed GP appointment at the moment. Charlotte from Brisbane, you say “it's actually ridiculous no doctors in my area bulk bill anymore. I have to take a day off work, just to drive and find one which kind of defeats the purpose and I don't get paid and might as well pay.” I mean, Minister, what's your advice for someone like Charlotte in Brisbane who's not alone and lots of people like her are going through that?


BUTLER: I've been hearing that for the 18 months that I've been back in the health portfolio, that this is an increasingly regular story. One of the things I've talked about over the last several days is we don't actually have good data to tell us the true picture about bulk billing. And the former government used to tell us that 88 per cent of GP services were bulk billed. That just does not gel with what patients, your listeners are telling you, with what doctors have been telling me which is that because of those rebate freezes, bulk billing has been declining. That data is a bit skewed by the fact that there's a lot of COVID-19 related measures like vaccinations and COVID testing and the like that have to be bulk billed by law, so that sort of skews the data a bit.


There is no question in my mind that the truth of the matter is that bulk billing is in decline and there will be no higher priority for our government. I mean, we're the party that created Medicare. There will be no higher priority for a Labor government than to start to turn that around. But I've got to be honest, it's not going to happen in a matter of weeks.


MCCORMACK: Minister, on this program we talk a lot about mental health. Young people can get on a mental health care plan. But to do that they have to go the GP and young people are the ones who need these plans the most. They also have the least money to spare. You can see where I'm going with this. Is this going to lead to an even worse mental health crisis for young people because they can't get into a free GP, or they’re on a waiting list?


BUTLER: Absolutely, that's one of my greatest worries about the situation we confront right now. This is a matter that has been hugely aggravated by the COVID pandemic. I mean, the data that we got from the ABS, the Bureau of Statistics last month show that about 40 per cent of young people had experienced a mental disorder in the previous 12 months. That's through the COVID pandemic. That is such a massive increase on the already big numbers we'd seen before COVID. But I know that there's a lot of young people out there in distress that are not able to access services. We’ve put some additional money into headspace services for example, we’ve got additional services for better access.


MCCORMACK: There’s long waiting lists on headspaces as well though isn’t there?


BUTLER: Absolutely and that’s why we’ve put some money into those services - that money that is specifically aimed at reducing waiting lists and also expanding some of their consulting rooms so that they can employ more staff. This is a really serious pressure out there in the community. I know, I hear that all the time myself. And you’re right, they have to see a GP before they are able to access some of those Medicare-subsidised psychological services.


MCCORMACK: Minister, the news this week just quickly, that former PM Scott Morrison secretly held five portfolios, it doesn't do a lot for my listeners about trust in government and politicians. They feel it's shady. That makes them lose faith. How worried are you about the trust Australians have in politicians?


BUTLER: I'm deeply worried. I mean, this has been a long-time trend over the course of my adult life, there is less and less trust in the political process, not just here in Australia, you see it frankly across the world and it's very much the job of the current generation of politicians to do what we can to lift that trust. Certainly, a big part of that is our commitment to putting in place an anti-corruption commission. We are working very closely with the crossbench on that, with the Greens Party, with all of the new teal independents that were elected at the last election, substantially on a platform of an anti-corruption commission. But this latest revelation that the former Prime Minister, Scott Morrison, had sworn himself in without telling people, into portfolios is frankly just extraordinary and unprecedented. I mean, the Westminster system of government we have here, have had for a very long time, rests on the idea that if you are a Minister of the Crown you have enormous power and influence over your country. But the flipside of that is that you’re accountable to the people. You are accountable to the Parliament. And you can't be accountable if you're not telling anyone that you've been sworn into portfolios. It’s just extraordinary.


MCCORMACK: And just checking, Minister are you the only Minister for Health? You're not job-sharing with Anthony Albanese? Are you sure?


BUTLER: Prime Minister Albanese is a stickler for process, I can tell you. As has every Prime Minister before him been, except apparently the former one.


MCCORMACK: Good to check. It's been a bit of a crazy week so you've got to ask these questions don't you. Mark Butler, thanks so much for talking to me and my listeners on Triple J.


BUTLER: Thanks Ange.

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