Radio interview with Minister Butler and Graeme Goodings, FIVEaa Adelaide Mornings - 11 January 2024

Read the transcript from Minister Butler's radio interview on FIVEaa covering Medicare Urgent Care Clinics.

The Hon Mark Butler MP
Minister for Health and Aged Care

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GRAEME GOODINGS, HOST: There's no question our emergency departments in the major hospitals are always full or overflowing. Ramping is a major issue. To take pressure off the EDs, the Federal Government has introduced Urgent Care Clinics. A great concept, but how is it working? There has been some criticism. Joining me now is Federal Health Minister Mark Butler. Minister, good morning to you.
GOODINGS: And to you too. Fewer than one in four Urgent Care Clinics are open the full extended hours. The concept is great, but it's not really working at this stage, is it?
BUTLER: No, it's working tremendously well, Graeme. You're right to say that these clinics, some of which have only been open for a few weeks, aren't yet operating all of the hours that we committed to in the election, which was until 10pm, but here in South Australia, the Northern, the Western, and the Marion Clinic are open till 8pm. They're open seven days a week. I was at the Western Clinic in Royal Park, and they were talking to us about cases that they dealt with on Christmas Day.
Already 130,000 services have been delivered by these clinics that have, in many cases, only been open for weeks or a few months at the most. About 60 per cent of the patients who are going through these clinics are saying if that clinic wasn't open, they'd be at a hospital emergency department. Your last listener was just talking about how pressured hospital emergency departments are, not just here in South Australia, but right across the country. Indeed, after three or four years of pandemic, right across the world, hospital systems are heaving. I don't pretend that this new model of care, and for Australia, it is a very new model of care - Urgent Care Clinics - are going to be working perfectly from day one, 100% of the time for every single person that comes through the door, but I think on any indicator they are working very, very well, delivering care people need in their community when they need it. They need it urgently, particularly for their kids, and it already is taking pressure off hospital emergency departments.
GOODINGS: There's no question, Minister, it's a great concept and it is working in the main really well. And you've said the clinics in South Australia are open till 8pm. The original plan, what the Prime Minister said, they'd be open 8am until 10pm. When are we going to see them fully operational?
BUTLER: You're right, that was our commitment. We also committed to them being open seven days a week, we also committed to them being fully bulk billed. This is a really important thing. You do not need to take your credit card to these clinics, which is the important thing. Just take your Medicare card. If you need care urgently or your child needs care urgently, you will get it delivered there.
Now, we're working with all of those clinics to make sure that over time, they're able to extend to all of those hours we committed to. As I said, the Morphett Vale Clinic, for example, hasn't even been open two weeks yet. The Royal Park Clinic was opened in November. I was down at the Royal Park Clinic only earlier this week. They're still making renovations to their clinic to expand their treatment rooms, so they have more treatment beds. Obviously, all are still recruiting staff. So over time we are committed to making sure these hours are operating and we are working with each of the clinics for them to be able to do that as they bring more staff on, as they bring more nurses on and the like. But already this is making a real difference to the sort of care people are getting in the community.
GOODINGS: Is there always a doctor on duty at these Urgent Care Clinics?
BUTLER: In the ACT there's a there's a different model that operates, which is nurse led, mainly nurse practitioner led. That's something that's been operating in the ACT for a while. It's sort of a quite a unique case there and that's what the ACT Government wanted to work with us on. But beyond the ACT and the rest of the country, there are GPs that are there, as well as nurses and other staff. There are imaging facilities as you know, when you take your kid in because they've got a fracture, they've fallen off their skateboard, we want them to be able to get the x-ray there and have the fracture dealt with there.
Interestingly, Graeme, this was a bit of a surprise to me is we've got the early data, of these 130,000 services delivered only in a matter of months, about a third of them are for kids under 15. This is where your kid gets sick, or your kid falls off the skateboard, often it's on the weekend when your local GP practice isn't open, people are able to take their kids to these clinics. On average they start to be cared for within 35 minutes, I was told this week is the current wait time. Now, it's sometimes going to be longer than that at peak periods but compare that to what your listeners would be used to in an emergency department where, you know, if your kid falls off the skateboard or something, you might be waiting 8 or 10 hours in a crowded hospital emergency department.
GOODINGS: Minister, if I could just take you up on that, there's a text that's just come through saying: urgent care is not working at all, I went with my son with a possible fractured ankle and was told: "you need an appointment, go to the hospital." I'm here so we don't clog up the hospital. We went to the hospital and waited six hours. We weren't the only ones told from this urgent care to go to hospital.
BUTLER: I mean that should not have happened. These clinics are paid to be available for walk in appointments. That's the whole purpose of them. That sounds like exactly the sort of case that should be seen at the Urgent Care Clinic. I can't imagine why that person was sent away. If you've got the details, I'd be very happy for my office to take them from your producer Graeme and follow that up because that is a very disturbing story for me. That is precisely the sort of case that, frankly, is everyday being seen by Urgent Care Clinics on a walk-in basis. We deliberately set these up so that people did not have to make an appointment. Sometimes they will take appointments, but the vast bulk of patients will just walk in. Now, that might mean if you were at a peak time of the day, which is usually sort of mid-morning, you might wait longer than 35 minutes. I mean, that is an average over the course of the day. But people should I'm very disturbed by that case. And I'd really if the if the listener is willing to, I'd be very happy to take that case up if we're able to get the details from you.
GOODINGS: So, the situation is you don't need to make an appointment, but you can make an appointment?
BUTLER: A few clinics are taking appointments. I’d encourage your listeners to have a look online about that. But by and large, they're all walk in. They're all walk in. I saw a story, I think, in one of the papers in South Australia that had a photo of a sign that said, “walk in appointments not accepted” and the story in the in the paper indicated that that was one of our Urgent Care Clinics. I understand, actually that was a sign outside a GP practice next door. There is a bit of information going around as people get used to this new model, whether it's patients, whether it's doctors, there is a bit of information going around that that might be confusing people. But if there's an actual case that your listener described of taking a child in with a potential fracture on a walk-in basis and being told that's not what Urgent Care Clinics are for then I'd be very worried about that. Because I'm hearing case after case after case every single day in all of our Urgent Care Clinics, where precisely that type of care is being delivered on a walk-in basis. That’s what we have funded them for.
GOODINGS: Minister, we're almost out of time but, Rodney has a question for you. Rodney. Go ahead.
RODNEY (CALLER): Yes, good morning Graeme. Good morning, Minister. I went to an Urgent Care Clinic just after Christmas, and obviously the Minister's only being told what he wants to hear because I was there at 10:00 in the morning for a walk in. No problem. Service was fantastic. But by 10:30, they were already telling every single person who phoned up, “sorry, we can't see anyone else today,” walking at 11, 11:30, “sorry we can't see anyone else today, go to ED.” The doctor told me that there is only one nurse and one doctor funded for the entire day. The doctors’ surgery that was in the same building was simply using the Urgent Care Clinic as their overflow. Sorry, we don't take any walk-ins, go to urgent care.
GOODINGS: Minister, a reply?
BUTLER: I obviously don't know which clinic that was, but there aren't that many in South Australia, so I will follow that up. We have seen over the festive season a particularly busy period. That's always the case frankly, our hospital emergency departments always experience a peak period over Christmas/New Year when kids aren't at school, many workers aren't at work. Many GP practices are closed for the festive season so urgent care and hospital emergency departments have experienced a real spike over the last few weeks. That happens pretty much every year. But that case that Rodney has just talked about again is a concern to me. I'll be following that up.
I just want to stress to your listeners, Graeme, this is a new model of care. Before we opened these clinics nothing like this existed. There was no ability for people who got a deep cut, had a fracture, got something in their eye, your listeners know how hard it is to get in to see their usual GP right now, particularly on a weekend or after hours. What we've tried to do is build a model free of charge, fully bulk billed, that doesn't involve people having to go to a hospital for an emergency that needs urgent care but is not a life-threatening emergency where you do need to go to a hospital. Now, it's relatively new. Any new model of care takes a little while to get perfectly right. But this is working for many, many thousands of patients, and I'm committed to making sure it works for everyone.
GOODINGS: Minister, thanks so much for your time today.


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