Radio interview with Minister Butler and Dan Cox, ABC Newcastle - 12 June 2024

Read the radio interview with Minister Butler, Dan Cox and Jenny Marchant on Medicare Urgent Care Clinic for the Newcastle-Lake Macquarie area.

The Hon Mark Butler MP
Minister for Health and Aged Care

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DAN COX, HOST: When you were sick, or maybe one of your kids are sick, sick enough that you're worried and need to do something about it right now. You can't get to see your GP, you might feel like the hospital is the best option, the only option. But then, you know, oh, you don't want to take up the time and resources of an emergency department when there are other emergencies. You also don't want to spend hours in a waiting room. You've been triaged to the back of the line.
 
JENNY MARCHANT, HOST: In Cessnock recently, you might have used the option of the new Medicare Urgent Care Clinic. Today, the federal government's announcing another of these Urgent Care Clinics, this one's for Newcastle and Lake Macquarie, designed to take the pressure off the John Hunter ED. The federal Minister for Health is Mark Butler. Good morning, Minister.
 
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Good morning, how are you?
 
COX: Well, thank you. Where in the hospital will we find this Urgent Care Clinic?
 
BUTLER: The Primary Health Network for this region will now undertake a tender process, really. They'll put out a call to the existing primary care services, which are mainly general practices, and ask them whether they're interested in taking their practice up to the next level and become a Medicare Urgent Care Clinic. Doing that will attract a whole lot of funding from the Commonwealth, and they'll continue to be able to bill Medicare, obviously. So it's a competitive process. We opened 58 of these clinics, including the Cessnock clinic that you just referenced there, but also one at Lake Haven. Already we saw a huge amount of interest in local general practices in filling what is a real gap in the health care system in Australia. You referenced really the challenge people have, if their kid falls off a skateboard or if you know someone in the family gets pretty ill very quickly and needs to see someone urgently. It is hard to find a doctor right now and you don't necessarily want to end up at the back of a queue for hours and hours in a hospital emergency department. This option of Urgent Care Clinics is pretty common in other countries, to which we usually compare ourselves. But it's a new model here in Australia. And I have to say, it's a model that's working really, really well.
 
MARCHANT: So it would be located in a GP, an existing GP clinic, that would be funded to expand and operate longer hours and provide these bulk billed appointments. What kind of conditions or injuries would we go to an Urgent Care Clinic with?
 
BUTLER: Really anything that you need to have seen urgently. I mean, some of them are breaks and fractures. 1 in 3 of the patients going through these clinics, so far, are under the age of 15. So it's pretty common on Saturday afternoon, after school sport or local club sport that, you know, your 14 year old has done something on the rugby field and needs to be seen urgently. You can't wait until the your usual GP opens sometime in the following week. So it is those sorts of things that I think people with common sense know needs to be seen urgently, but doesn't necessarily need to go to a hospital. We’ve worked really carefully with state governments, including the state government here in New South Wales, on making sure we’ve got the protocols right, so that people who really do need to go to hospital, go there. But people who might be able to be seen at the Medicare Urgent Care Clinic by very highly qualified doctors and nurses, many of whom have a background in emergency medicine, can use that option. They're seen much more quickly, it's fully bulk billed. Importantly, they're open seven days a week for extended hours. 1 in 3 of the services are delivered on the weekend, when people know they're not going to get in to see their usual GP.
 
COX: Minister, what you've just described there sounds like a GP Access Clinic. Bulk billed, open after hours, designed to see people who shouldn't be at the emergency department. How is a GP Access Clinic different to a Medicare Urgent Care Clinic?
 
BUTLER: You're right to say that in your region there is the GP Access service. This is not a service that you see in other parts of the country. It really is, I think - I've said this before publicly - probably the best after hours service I've seen in the country ,anywhere. As your listeners will know, funding to that service was cut a few years ago, and we promised at the last election to restore that funding, which we did, and that means that service is still now operating. The Medicare Urgent Care Clinics are a bit like that, but they probably offer a slightly expanded range of services. They need to make sure that they’ve got access to imaging and pathology in a timely basis, they’re open into the evening, they’re open seven days a week. So I mean, in the Hunter and Newcastle region, people will now have a range of different options available to them. But we've seen in Cessnock and in Lake Haven that these services are very widely used. If anything, in some of the regional areas, we've had to provide more funding in the Budget we delivered a few weeks ago, because of the level of demand in those regional areas.
 
MARCHANT: Minister, I accept that we're lucky to have that GP Access service in the Hunter. I'm still struggling to understand the difference between the Urgent Care Clinic and the GP Access Clinic - where, for instance, I've had a child on the weekend who's then been sent from GP Access to have an X-ray and to be dealt with and have all those things done through GP Access. Why in the Hunter then, in Newcastle and Lake Macquarie do we need this Urgent Care Clinic?
 
BUTLER: We engage very closely with the state governments about this. This funding round for additional Urgent Care Clinics that we delivered in the Budget a few weeks ago, came out of a National Cabinet meeting in December, where the Prime Minister and the Premiers had a deep discussion about health care. And the two priorities that the states identified were, firstly, more urgent care and secondly, trying to help older patients deal with the hospital system a little bit more effectively, which I'm not talking about much today. But in the urgent care space, we then asked the state governments what were the hospitals that had the most pressure on them with what they called non-urgent or semi-urgent presentations to their emergency department. So these were people coming to their EDs, who obviously needed to be seen for a condition urgently, but didn't need to be seen in a fully equipped hospital. And the John Hunter still has about two out of every five presentations into their ED falling into those categories: semi-urgent or non-urgent. So, I mean, yes, GP Access is a terrific service in the region, but there is still much more demand for that out-of-hours, non-hospital urgent care. And some of that demand will be met by this new Medicare Urgent Care Clinic in the Newcastle-Lake Macquarie region.
 
COX: Let's take the money from the Urgent Care Clinic that you will spend in Newcastle and Lake Macquarie, let's spend it on increasing the number of GPs making their appointments bulk billed. Will that not have the same effect as creating new Urgent Care Clinics? Take that money and spend it on what we have already?
 
BUTLER: They are two different things really. I mean, your bread and butter work of general practice nowadays is not so much dealing with those injuries and those one off illnesses, which might have been the case 40 years ago. I mean, the bread and butter work of a general practice, nowadays, is much more wraparound care for people with ongoing chronic disease. So, your listeners will know much better than me, there is a challenge around bulk billing in the Newcastle and Hunter region. Newcastle, for example, has one of the - if not the - lowest bulk billing rate in New South Wales, it's at down at around 60%. In parts of Western Sydney, the bulk billing rate is well over 95%. And it's hard to explain why there is such a big difference. In the Budget last year, we tripled the bulk billing incentive, so doctors who are bulk billing their pensioner patients, concession card holders, kids under the age of 16 now receive much, much more income for bulk billing that standard consult than they did before. We have seen some increase in bulk billing rates in Newcastle and the Hunter region, but it's still, relatively low compared to other parts of New South Wales -
 
MARCHANT: Yeah, Minister, we hear that frustration from our listeners too.  What then is your plan to increase bulk billing rates in the Hunter?
 
BUTLER:  As I said, it was the biggest investment in bulk billing in the history of Medicare last year. It is making a difference, I mean, in April alone, across the country, there were 420,000 additional free visits to the doctor that wouldn't have happened without that. But the increases in Newcastle and the Hunter, - there have been increases - but they still see Newcastle and the Hunter having some of the lowest bulk billing rates. So today, as I'm visiting the region, in addition to announcing the new Medicare Urgent Care Clinic for the region, I will be talking to GPs in the area along with Pat Conroy and Sharon Claydon and Dan Repacholi will be joining me early this morning. We want to sit down with GPs and see what else can we do for this region. We've done a lot, we've refunded the GP Access program, we've increased the bulk billing incentives, we've made some changes to the ability of general practices in the area to recruit overseas trained doctors, which was another big challenge over the last five years. But we want to know what else we can do because those rates, although they’re improving, are still too low.
 
COX: Minister, if the Urgent Care Clinic is bulk billed and we know visiting the GP can be $100 or more, is there a risk that people will go to the Urgent Care Clinic rather than their GP?
 
BUTLER: People are triaged in the Urgent Care Clinic. I mean, it's quite clear they're not able to deliver standard general practice services that you'd usually go to a GP for. They are there for urgent care. This doesn’t happen very often, but if someone presents, for example, because they’re just due to see a doctor for a particular check-up, they will be told that they need to go and see their usual general practitioner. It doesn’t happen very often. But it’s very clear that these services are only able to bill Medicare for a certain range of items and those are the items that are quite clearly things that people need to be seen within a very short period of time for.
 
MARCHANT: Minister, I hope those discussions with our local GPs are productive,  and we'll look for more news on this Urgent Care Clinic as the process continues, thank you.
 
BUTLER: Thanks very much.

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