Radio interview with Minister Butler and Matthew Pantelis, FIVEAA - 10 May 2024

Read the transcript of Minister Butler's interview with Matthew Pantelis on attracting more doctors to SA regions; historic changes to Medicare for endometriosis.

The Hon Mark Butler MP
Minister for Health and Aged Care

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MATTHEW PANTELIS, HOST: Mark Butler, we've got him now. The Federal Health Minister. Good morning.
PANTELIS: Good, thank you for your time. So, a new trial has been announced to attract and retain doctors to regional rural SA. Something very much needed. The AMA has been calling for this for quite some time?
BUTLER: That's right. We've actually been running a couple of trials in Australia over the last several years. One in New South Wales and one here in the Riverland and Coorong, supported very much by the local state government and it's shown terrific results. So, we're now rolling out 20 different programmes across the country, including a really big one here in South Australia, which has got great support from the Premier and from the South Australian Health Minister. The problem we've got, Matthew, is that when you're a medical graduate and you're doing your postgraduate training either to become a GP or a surgeon or a psychiatrist or whatever, if you're a GP in training, you'll often work move between a number of different employers over the course of your training period. So, you're not getting continuity of service, you're not getting things like paid parental leave and often, you know, you're at around 30 years of age which is the average age of having your first child. It's a real disincentive for medical graduates to take up general practice which is, frankly, what we need more of.

This single employer model essentially is a program to make sure that these GPs in training have only one employer over the course of their entire training period and that is the state government. It's a terrific initiative where we've had it running so far. It's really lifted the interest and the willingness of young medical graduates to take up general practice training and I'm really confident it will have an impact here in South Australia, too.

PANTELIS: Okay, the Medicare levy and its role in getting more GPs into GP clinics, that needs a look at, doesn't it? The way that is structured that the funding supplied.
BUTLER: We kicked in several billion dollars additional money into Medicare in last year's budget overwhelmingly focused on general practice because I've said, since I've been the Health Minister, that is my highest priority of all of the pressures on the health care system and there are many, particularly after years of pandemic. The biggest challenge is getting general practice up and running again. I mean, it had its income frozen for several years last decade. So, we put in a lot of extra money last year, particularly focused on trying to lift the bulk billing rate. Those new funds only kicked in November and in just the first five months, we've seen 950,000 additional free visits to the doctor. So, visits that people would have had to pay a gap fee for in the past but are now fully bulk billed. We've also rolled out urgent care clinics, including here in South Australia. They've already delivered almost 400,000 completely free visits, so all you need to do is take your Medicare card and leave your credit card at home. So, we're doing what we can but it's going to be a long road because general practice over the last few years has really been in a very, very difficult state. And it is the most important part of our health system. We know if general practice starts to fall down, you'll see the results in our hospitals. People will end up being sicker. They'll end up having to pay more to get care that they used to get in their community close to them from a doctor they knew. We've got to turn this around, Matthew.
PANTELIS: Absolutely, now getting doctors out into the regions is one thing. Getting them to stay there is quite another, isn't it? So, any incentives in this to ensure that happens, that people who decide to move out, do actually remain in the community at least for a considerable period of time, I suppose ten years at least?
BUTLER: Yeah, that's absolutely, right. We do know that if people train in, the country, they're more likely to stay there. That's a good start. We also know, because of some of the improvements we've put in place in general practice there's quite a number more young graduates taking up general practice this year than there were last year, for example. So, we're starting to see right across the country, including here in South Australia, a rebound in the number of young doctors, taking up general practice training. That's a good sign as well.

But you're absolutely right, we've got to find ways to keep them there. We rolled out last year a number of new incentives, additional payments that general practice will get for having a doctor in rural communities compared to in the city, like in Adelaide. We particularly lifted some of those incentives. If those doctors aren't just GPs, but they have some specialisation in emergency medicine or in mental health or in obstetrics and things like that, specialities that are in real scarce supply in the country. We also passed a law in the parliament last year to forgive university debt for those medical graduates who do a certain number of years out in the country. Some of your listeners remember the old days when that used to happen for teacher graduates and a whole range of other areas. It's obviously not compulsory, but we will forgive you your university debt based on the number of years you spend in the country area and how rural that is. The further you go out from the cities, the more you get relieved. It's not just doctors, it's also for some nursing professions as well.
PANTELIS: All right. We should look at that across the board then. I mean, if a bribe works it works. So, if it's teaching, if it's medical, if it's, you know, a whole range of things could benefit from that sort of policy?

BUTLER: Absolutely. I mean, the challenge with general practice unlike teaching or hospital doctors and hospital nurses, is that they're all sort of they're really private businesses. State governments that run the hospital system, run the school system, they've got levers in their hand that they can use. But what we need to do is also try and sort of incentivise the private businesses that run general practice to attract the people that we need. We're not training enough GPs right now to replace the older GPs who are in the process of thinking about retirement. We've got to lift that number. It's an absolutely top priority for me. It's good to see some green shoots of recovery. So, we've got more young doctors looking to general practice and signing up to general practise as their preferred career. But we do need a whole range of things that will get them into that work and as far as possible, as well get them willing to work out in the country.
PANTELIS: Before I let you go, you've made some changes to for women who are fighting endometriosis. Tell us about that?
BUTLER: I'm just in my car, about to head down to a terrific clinic in Glenelg that we funded last year. It's one of 22 clinics across the country set up for endometriosis and pelvic pain. That was a big initiative last year. I'm really glad to see 22 of them are up and running. This morning I've also announced that we're going to double the Medicare fee that gynaecologists receive for those long, complex consultations for women and sometimes teenage girls who are battling endometriosis, chronic pelvic pain or PCOS. The outrageous thing, Matthew, is that up until now, if I go to see a cardiologist, I'll get twice the funds from Medicare as a woman will get to go and see their gynaecologist. It's just it's nothing short of discrimination. And it means that women battling these really substantial, debilitating illnesses have just had to suffer in silence, or they've had to pay out of pocket costs that I wouldn't have to pay to go and see my cardiologist, for example. Certainly, bigger out of pocket costs. So, we're going to fix that. We're going to double the Medicare funds that apply to these longer, complex consultations with a gynaecologist and just start to break down that discrimination.
PANTELIS: Mark Butler, appreciate your time this morning. Thank you.
BUTLER: Thanks, Matthew.

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