Radio interview with Minister Butler and Luke Grant, 2GB - 6 July 2022

Read the transcript of the radio interview with Minister Butler and Luke Grant, 2GB on Telehealth; expanding access to fourth doses; Omicron third wave; boosters and fourth doses.

The Hon Mark Butler MP
Minister for Health and Aged Care

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LUKE GRANT: Yesterday I was alerted to a story causing some distress for local GPs and some of their patients. I spoke to Dr. Ken McCroary . He's a GP based in Campbelltown, in Sydney's south west. As of last week, he, like all doctors, is no longer able to care for many of his more vulnerable patients after the changes made to the telehealth system were rolled back.

Now, the suggestion is it's by the new government, but my mind is open here. Some of these were introduced by the former government to help with COVID, dealing with COVID. It might be that they've  met a deadline, so to speak. That's why I'm about to speak to the Minister. So remote and phone appointments were expanded during the pandemic to include more than 70 services, including more than 30 initial and what are called complex specialist appointments, as well as regular consultations with your GP which run longer than 20 minutes. They're gone now. Doctors are worried because the health needs of a lot of older or vulnerable patients are now not covered by Medicare and some are simply going without the treatment. This is in a telehealth setting, of course.

Just because the changes were introduced in the pandemic, does that necessarily mean that they should remain temporary? And we're not even out of the pandemic. We had Brad Hazzard, the Health Minister, on this show yesterday, in New South Wales, saying, hey, there's a problem here, we’re staring down the face of something, please get your shots, your booster and all that goes with that. And we've got influenza all about the joint. Mark Butler is the federal Health Minister, for Health and Aged Care. And I'm delighted to say the newly appointed minister is on the line. Minister, thank you for your time and thank you for coming on the show I really appreciate it.

MARK BUTLER, MINISTER FOR HEALTH AND AGED CARE: My pleasure Luke.

GRANT: So you understand the situation. I think we sent you some information about what Dr. McCroary was saying. Am I right in suggesting that this was a COVID measure that had an end date and that's why it's not there?

BUTLER: That's right. The former government had extended what had been a temporary measure last year around phone appointments until the 30th of June. Those measures did finish on that date.

I do want to explain a couple more details. I mean, yours was a very comprehensive introduction. A lot of that was spot on.

GRANT: Thanks.

BUTLER: What I want to reassure people of is that phone consultations with your GP are still available for consults up to 20 minutes. That's a standard consult and certainly a short consult, a level A and a level B consult. So if you're bringing about a script or follow up a test, a very short consult on the six minutes, that's all fine still do that on the phone. A standard consult which is the run of the mill consults you have in General Practice, still fine over the phone. Those two things are about six out of every seven consults that have been done on telehealth, have been either a level A or level B, they're not affected.

GRANT: Right.

BUTLER: The longer consults are affected, you can still do them remotely, but they have to be video. So facetime over your phone or something like that.

There has been quite a deal of notice. GPs should have been talking to their patients about that for a considerable period of time because as I say, the former government took that decision many months ago.

There was there was quite a deal of notice given about that. And the advice that I received, and I know my predecessor Greg Hunt received, is that for those longer consults, and particularly for those initial complex consultations with a specialist, you really need to be able to see the patient. Short consults over the phone are fine but for longer consults, given that telehealth is now such an important part of the way in which we do medicine in Australia now, we need to recognise that best clinical practice has a visual image between the doctor and their patient and they've been on notice about that for some time.

GRANT: That's a very fair explanation. However, in the case of someone who mightn’t be tech savvy but are significantly unwell, is there is there something that we can offer those people?

BUTLER: Well, as I say, you can you can have your standard consult still - and six out of seven of them are under 20 minutes - you can still do them over the phone. There are also some exceptions for areas that have poor internet connection or poor mobile connection, particularly in some of the more rural areas, and I know your station extends to them. There are certainly some exceptions, but we really have, this shift to telehealth over the course of the pandemic has been quite revolutionary. People have been talking about it now for 10 or 20 years, and it’s been an extremely positive thing, particularly for people who are not able to get out and about, might not be well serviced by public transport.

That's a wonderful thing, we want to see that remain a big part of the way in which we do medicine in Australia. It's really convenient for a lot of patients but we do want to make sure it's good quality medicine. As much as possible there's a good visual image between the doctor and the patient that is really important to get a good sense of what a patient needs from their doctor. And I know that there are still some people who are getting up to speed with this new technology. I would hope that doctors had been talking to their patients, particularly their regular patients, about this shift that was that was notified many months ago by the former government.

I've also said that I want to help General Practices get their practices well equipped with new new information technology, new hardware. That's why we announced in the election $220 million of infrastructure grants to help GP practices make improvements to their practice.

They've just gone above and beyond over the last couple of years through this pandemic, performed magnificently. But they deserve more than our thanks. They haven't really got any funding from the former government to make sure that as we shift to telehealth, that they have the best IT. That they have the best hardware systems to allow GPs to do this work. I want to make sure they get that support from our government.

GRANT: So let me ask you. The idea that, you know I would call it a cut or whatever, but the change in the way it's being done is not about cost? Because, as you told me it’s only six of seven consultations, which is probably still tens of thousands of consultations. But this is all about the quality of care being provided and the former government, and you by way of accepting and leaving it the way it is, you would maintain that you can't have a long telehealth consult of great quality without seeing the patient at the other end of the consultation.

BUTLER: That's the advice I've got. Look, that's not a unanimous view around the place. I've said to the AMA, to the College of General Practitioners and others, that I recognise this is a very new system. It’s really gone from 0 to 100 in a very short period of time because of the pandemic. I'm very open to continuing discussions with doctors groups, with patient groups to tweak this system as we move forward.

But the very clear advice to me, and to my predecessor Greg Hunt, was that for those longer consults, we should be shifting people on to video consults and really cutting out the phones for people sitting on the phone with their doctor for half an hour.

GRANT: So in the interests of this, and I understand I respect that’s advice you've got. But in the meantime, and you probably say, look they were given enough notice and that might well be true. But whatever's happened, it appears to me that there are a number of patients, vulnerable people, that can't get to a doctor that rely on a potentially longer phone call than 20 minutes and don't have the technology. In the meantime, it seems a little harsh Minister, I know you'll agree with this, to have them a victim of the circumstances. What are what are they and their doctor to do?

BUTLER: Taking all of that background into account, the period of notice, the expectation that doctors would be talking to their patients about this. Whenever there is a change to a system like this, sometimes people are taken by surprise and I deeply regret that and I certainly hope that people are able to continue to get the support and the treatment from their GPs that they need. But at some point, the former government had deferred it from last year and they finally made a decision that it would change on the 30th of June this year. The advice to me is the same advice Greg Hunt was getting. At some point, with a big system like this, you need to make some changes that ensure it's delivering the best quality care to people that is possible.

GRANT: Are we about to enter that that space in health where we have a fourth COVID vaccine made available to everyone? Are we close to that do you think?

BUTLER: As many of your listeners probably have heard, the advisory group of experts that delivers advice to government about vaccines, it's called ATAGI, many people would have heard about them over the last couple of years quite a bit, they're meeting today. They're considering a case that I think should be before them to open up eligibility for a fourth dose. Currently, a fourth dose of the vaccine is only available to people over 65 because we know older Australians are more vulnerable to COVID than others. And also to people under that age who might have compromised immunity for one reason or another.

So it's pretty restrictive. There are other countries that open it up. Not many countries open it up to everyone. But there are other countries that have a slightly lower age threshold, maybe 50, 55, thereabouts. And I think it's time for that to be considered because, you said in your intro that that New South Wales Minister Brad Hazzard said yesterday quite forcefully, this is not just in New South Wales, across the country, we are in the early stages of the third Omicron wave just for this year. People will remember the wave over summer that saw case numbers just skyrocket up to 100,000 in a day at the at the high point. That was the BA.1 subvariant of Omicron. Then there was another wave in April or May, the BA.2 subvariant, which was another type of Omicron, if you like.

We're now seeing the BA.4 and BA.5 hit certainly the Eastern seaboard and it's starting to move over through my state of South Australia and into Western Australia. Most state governments and our advisors think that the wave that's just starting now is going to be just as bad as the ones we saw earlier this year. Case numbers are rising already, hospitalisations are up across the country. There’s probably 800 people more in hospital than there were only a couple of weeks ago. I cannot urge strongly enough people, if you are not up to date with your vaccination, please get up to date.

There are more than 5 million Australians who are overdue for their booster, their third shot who haven't had it. This will greatly, greatly improve your chance of avoiding severe disease, greatly improve your chance. So I ask those, those 5 million Australians to get out and get your booster. Two doses of vaccine is not enough to provide protection against these Omicron variants and we're seeing that in our hospitals.

GRANT: I'm glad we had a chat. I hope we have another one sometime soon. Thank you, Minister.

BUTLER: Good to talk to you too.

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