DAVID BEVAN, HOST: Mark Butler, Federal Health Minister, good morning to you, sir.
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Good morning, David.
BEVAN: Now I want to ask you about the Disability Royal Commission because I see you've just stepped away from that presser today. You were there with Bill Shorten and Amanda Rishworth. So, it would be remiss of me not to ask you about that, but we asked you to come on, because of this issue of saline shortages. We've got a whiff of this from one of our listeners a week or 2 ago, and we made inquiries with SA Health. It's turned out it's actually a much bigger issue than just South Australia?
BUTLER: It's bigger than Australia. This is a global shortage that we've been dealing with now for quite a number of months, particularly as COVID activity in the health system in hospitals rebounded after the COVID emergency phase finished. We've seen a big spike in demand for IV fluids, particularly saline, right across the world, including here in Australia and in South Australia. There's no jurisdiction that's not been dealing with this across the country. We've been managing it pretty well. We are very reliant in Australia on one supplier, an Australian supplier, that supplies maybe 80 or 90 per cent of the country's IV fluid. I mean, it's still churning out at usual levels, but because demand has increased, through the TGA, the Therapeutic Goods Administration, which is the Commonwealth body that manages medicine supply, we've approved a number of alternative supplies from overseas, which so far have managed to get us through this period of demand. But we're pretty actively managing it, we're working with states and territories, but also with private hospitals, very carefully to make sure that there's no interruption to activity. And so far, I don't understand there has been any interruption to activity.
BEVAN: Will we run out?
BUTLER: No, I'm very confident we won't run out. We're still churning out that local supply and very carefully working through alternative supplies from overseas, and we've got a number of them already coming in and, we'll be looking to see whether we can get more in as well. But there's a very active discussion between chief executives of all of the health departments, given that they are responsible for so much of the surgical activity in Australia to make sure that we can manage this carefully. For some months we’ve been pretty carefully making sure that we're not wasting this, and that where we need to diversify our supply we're doing that.
BEVAN: You say in this country, one supplier is supplying between 80 and 90 per cent of the country's saline. Is that manufactured here?
BUTLER: That's right.
BEVAN: Okay, so we have to import between 10 and 20 per cent or?
BUTLER: No, there are other local suppliers as well but we have started to import supply. They've just not been able to lift their rate of manufacture to meet the increased demand here in Australia.
BEVAN: You might have already touched on this, I'm sorry, but perhaps you could tease it out. Why is there suddenly an increase in demand for saline?
BUTLER: We're just seeing it right across the world. There's just more activity in the health system across the world, particularly after things returned to more normal levels after the COVID pandemic. You've got to remember that behind the pandemic, particularly across the developed world, there's just a very steady increase in the number of older people in the community and an increase in chronic disease. Many people deferred a lot of care during the COVID pandemic because things, understandably, were shut down or resources were diverted into managing the pandemic. People presenting to hospitals, not just here in Australia, but right across the world. All of my health minister colleagues across the world report this. People are reporting to hospitals, and to their doctors, are a little bit sicker than they otherwise would have been because they weren't getting the care for their chronic disease, they weren't getting cancer screens. There's a bit of a long legacy of the COVID pandemic, which is impacting the health systems right across the world in terms of increased demand. And at the same time, we've right across the world got a bit of a shortage of, supply of workforce and some of these other things.
BEVAN: So how long before we can be confident that the saline supply is sufficient? We don't have to be watching every drop?
BUTLER: We're watching every drop very carefully right now. But this has been an issue for some months, and I'm not aware that it's actually impacted any activity. Now states don't have a formal obligation to report that to us, but I'm not aware informally of any reports, for example, of surgery being cancelled because of a shortage of saline. I wouldn't want your listeners to be worried that this is a really serious threat to our health system. But it is something that we're managing. It's something that health systems across the world are managing right now. We're doing that pretty successfully right now.
BEVAN: It seems this is a one example, perhaps a small example, of the bigger issue that we were discussing with Peter Malinauskas earlier in the week. Now he's a former state health minister. He's now a premier, and we were talking to him about concerns from the local ambulance service, and they said last week that they are less confident the government will be able to deliver, that the government delivering on its promises will meet the demand. I'm not sure if you're aware of those comments, but Leah Watkins from the ambulance union saying, I hope I'm quoting her, I'm being fair, that even if you meet your promises, that doesn't mean you're going to solve the problem you're promised to fix. We put that to the Premier and I got the impression that he's now increasingly laying the problem at your feet, the federal minister saying, you've got to do more things about the GPs, you've got to do more things about aged care, you’ve got to give them more money.
BUTLER: I haven't seen the Premier's comments, I did see the comments from the Ambulance Employees Association. But I think what you've reported, the Premier is saying is not particularly new. I mean, this is something that's been the subject of not just discussion between health ministers like Chris Picton, myself and our equivalents across the country. But it has been a really active discussion at a national Cabinet level between the Prime Minister and the premiers. And as you say, our Premier in South Australia is a former health minister. A number of others over the last couple of years have been as well, which I think means that there's been a really pretty sophisticated discussion at national Cabinet level about what needs to be done to relieve some of these very real pressures on our health system broadly, but on our hospital system in particular. We are working hard on general practice I mean, that has been the major focus of the last couple of years in at, certainly at our level of government, and trying to restore bulk billing, introducing these new Urgent Care Clinics, which have already seen in 12 months 600,000 patients who otherwise would have gone to emergency departments. Importantly, particularly Chris Picton and I have been working together very closely on how we're able to see older patients in hospital move out of the hospital into more appropriate care settings when they're clinically able to do so.
BEVAN: But you just don't seem to be able to get in front of the game. Whatever you do, it just doesn't seem to be enough, Mark Butler.
BUTLER: The hospital systems and health systems are very complex, very big systems that you can't change overnight. I just want to be honest with your listeners about that, and I'm sure the Premier would echo that as well.
BEVAN: But you seem to be failing?
BUTLER: We still have one of the best healthcare systems in the world. That's consistently ranked in the top 3. It's ranked number one for healthcare outcomes and number one for health equity. We can be proud of the healthcare system we have here.
BEVAN: It increasingly feels like a system where if you're in a car crash, it's great that you live in this country. You'll be cared for. But if you have just some sort of low-level chronic disease that may cause you enormous pain and suffering, increasingly you feel like it's not there for you. If you turn up at an emergency, you won't be cared for promptly. It feels like you're failing.
BUTLER: We do want to make sure that emergency departments are there to deal with genuine, once-in-a-lifetime emergencies, which is what hospitals are equipped for. Far too often Australians out in the community feel that their only option is to go to an emergency department, even if they could be more appropriately cared for in a more community-based or primary care setting. Which is why we're developing these Urgent Care Clinics, which is why we're restoring bulk billing rates, because you know that affordability question. Having to pay gap fees was sometimes a really important factor for people on low and fixed incomes. We're very focused on trying to make sure, first of all, that people are able to get the care they need in the community close to where they live and in as timely a fashion as possible, but also relieve this pressure on our hospitals. Hospitals should be there for people who require very acute care. We want to make sure that if your kid falls off the skateboard and busts their arm or has an injury at a weekend sport that you don't have to spend 8 to 10 hours in an emergency department. You can go somewhere and get free, fully bulk billed care in your local community, seven days a week.
BEVAN: Okay, well, let us know when that happens.
BUTLER: It's happening now, 600,000 patients in 12 months have gone through our Urgent Care Clinics, a third of them have been kids under the age of 15 and fully bulk billed.
BEVAN: But it's not happening enough, is it? And that's the point.
BUTLER: No, look, I think that's right. I've just got to be honest, we are not going to change things overnight or even in a very short period of time. We are dealing with years of pressure that have built up on these systems, both our hospital system and also general practices.
BEVAN: Before you leave us, Royal Commission into Disability, what was the point in spending $600 million on a royal commission if you're only going to in full accept 13 out of 172 recommendations?
BUTLER: The vast bulk of the recommendations, there are 222 of them have been accepted, either in full because they're very specific, and we can act on them immediately or accepted in principle, because they really chart a direction that we've got to work on a little bit more.
BEVAN: I'm sorry, I'm reading from ABC News. Is this wrong? ABC News is reporting that the federal government has accepted in full 13 of the 172 recommendations.
BUTLER: There are 222 but almost all of them are accepted in principle and are now the subject of a work plan. Many of them are not particularly Commonwealth recommendations. This was not a Commonwealth royal commission, it was a joint royal commission by all governments. The South Australian Government issued letters patent and many of the recommendations require us to work together, and there’s been a really good level of cooperation between states and the Commonwealth to do that. There are areas in the health portfolio, for example, about increasing the expertise or the capability of our health workforce to meet the particular needs of people with disability. That, again, is not a simple accept today or don’t accept today proposition. What we’re doing is we’re funding programmes to lift that expertise and that is going to take a little bit of time. But there’s a very strong response. For people who have a deep interest in this, we’ve published a comprehensive response plan. It runs to many, many pages, and recommendation by recommendation, it goes through what we are going to do.
BEVAN: Well, again I’m please correct if any of this is wrong, but I’m reading from ABC News. Most of the 13 recommendations accepted without caveat were small legislative suggestions or work already underway, such as updating Australia’s disability strategy. The Government has pledged $369 million towards its initial response, the royal commission cost us $600 million.
BUTLER: But it’s on top of about $3 billion of money that we’ve been announcing through the course of the royal commission -
BEVAN: Yeah, but you could have saved $600 million –
BUTLER: In our response.
BEVAN: But if you didn’t have the royal commission you could have put that $600 million into, actually delivering services, and you’d be they’d be better off than having a royal commission which costs you $600 million and you pledge $369 million.
BUTLER: I haven’t heard anyone argue that we shouldn’t have had this royal commission. It's deeply uncomfortable reading about the situation that too many Australians living with disability have to put up with right across the community in terms of their accommodation, in terms of their experience in healthcare settings, in schools, in employment settings and so on. The point I make, David, is that we haven't been waiting, doing nothing until the royal commission response was delivered and our response was fully developed. We've been spending very substantial amounts of money as the royal commission was underway, and as we were considering the response to put in place responses already. I've been doing that I've got probably more than $300 million of responses that, we've announced over the last couple of Budgets already, and we're just announcing more funding today. But look, this is a really important piece of work for all governments and some non-government organisations that were covered by the recommendations from the royal commission as well. And again, like our health responses, it's not going to change overnight. This is going to require considered deliberate work in partnership with people living with disability.
BEVAN: And just before we go, people are sending us in texts this morning saying that there's a problem with Meals on Wheels. Are you aware of escalating costs, forcing Meals on Wheels to turn people away? Is that news to you?
BUTLER: No I'm not aware of that, and certainly if there is an issue I'd be very open to meeting with Meals on Wheels. I assume it's Meals on Wheels, South Australia.
BEVAN: Yeah.
BUTLER: This is an organisation I've got a very, very, very long relationship with. In a slightly parochial way David, I will say that the first Meals on Wheels organisation in the entire country was set up in Port Adelaide by a terrific woman in the 1950s, Doris Taylor, who, among other things, in addition to setting up Meals on Wheels, also recruited a young Don Dunstan to the Labor Party and encouraged him to run for the seat of Norwood. But this is just such a terrific organisation, terrific service right across the country. I haven't heard those reports, but obviously given the price of food, they don't particularly surprise me. But I'd be very happy to sit down with them and talk about that if they want to contact me directly.
BEVAN: Mark Butler, thank you very much for your time.
BUTLER: Thanks, David.
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