Radio interview with Minister Butler and Neil Mitchell, 3AW - 18 November 2022

Read the transcript of the radio interview with Minister Butler and Neil Mitchell on COVID-19; GP shortages; the Alfred Hospital.

The Hon Mark Butler MP
Minister for Health and Aged Care

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NEIL MITCHELL, HOST: On the line is the Federal Health Minister Mark Butler. Good morning.

MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Morning, Neil.

MITCHELL: Any good signs in this or not?

MINISTER BUTLER: I've only heard the Victorian numbers on your report. The national numbers should be out over the next one or 2 hours.

MITCHELL: We've got them - nationally, an increase of 47.3 per cent in cases, 11.9 per cent increase in hospitalisation.

MINISTER BUTLER: Those were last week's numbers. There'll be a further update published in the next couple of hours. We get all of the state numbers and then we'll put out a national report sort of middle-late morning on Friday and I expect there will be an increase in case numbers and hospitalisations.

It's still way below where we were in late July, so we were up at around 5,5000 hospitalisations in late July. And 55,000 new cases every single day.

Last week's report we were down about 85 per cent on that. But I don't think there's any question case numbers and hospitalisations are going to increase for a little while.

The question is, how soon is this wave going to peak? And the advice I'm getting is this is likely to follow the trajectory of Singapore – it's a very similar variant XBB, another cousin of the Omicron family, and Singapore has pretty similar vaccination rates to Australia.

And their wave, in the words of the technical advisors that we receive advice from, is it was short and sharp and it's come down very quickly. So there was an increase in hospitalisations, there was an increase in case numbers. There was not a huge increase in deaths because this is not a more severe variant, being of the Omicron family, but it's certainly something we're alert to and monitoring very closely.

MITCHELL: Okay. So when is the hope that it will peak? It was originally said the end of November, which is really the end of next week. Is it that close?

MINISTER BUTLER: We're not going to know really until we get into the next couple of weeks. But that's generally the advice across the country.

MITCHELL: What's your approach on masks? And I know they won't be mandated and nor should they be. But are you encouraging people to wear masks?

MINISTER BUTLER: We're encouraging people in crowded indoor spaces where you can't socially distance to wear a mask. I've said that, the Chief Medical Officer has said that, the Technical Advisory Group on Immunisation has reiterated that, and I think that's the advice at state level, too, particularly important advice for people who might be vulnerable to severe COVID.

MITCHELL: Many people are telling me or asking me, particularly people over the age of 65, when can I have my fifth shot? I mean, it's a long time since they’ve had their fourth. These are people that might have some comorbidities, but they haven't got, they're not immunosuppressed or anything, they're saying, when can I have my fifth shot? They can't have it yet, can they?

MINISTER BUTLER: No, they can't, unless they're immunocompromise, but the Technical Advisory Group on Immunisation, which we've all become familiar with, called ATAGI, considered this issue over the last several days. I received advice on Monday which I considered and accepted after a discussion with the Chief Medical Officer. They decided at that stage not to recommend a fifth dose. They’ve said that they anticipate new booster recommendations in early 2023 in preparation for winter, which is obviously going to be an important part of our preparation strategy. But they’ve decided not to recommend that at this stage.

They’ve said, for example, that any decrease in transmission by adding a fifth dose at this time would, in their words, likely be minimal. And also, they say that there's still strong protection if you've had four doses, strong protection against severe disease and death. 

MITCHELL: Okay. The variant responsible at the moment seems to be XBB, a second variant I think has turned up particularly in the wastewater testing BQ.1. What do you know about that? 

MINSTER BUTLER: They're both derivations of the existing family of variants, BA.2 and BA.5. One of them is a bit of a hybrid. So they're all part of the Omicron family and all have sort of similar traits in the sense they're quite infectious, they're much better than previous variants at evading immunity, such as if you've had vaccination, that's not a rock-solid guarantee you're not going to get it. If you've had an infection before, it's not a rock-solid guarantee you're not going to get it.

But like the other variants we've seen over the course of this year, they're substantially less severe than these than the earlier variants, like the Delta variant that hit Melbourne and Sydney very hard last year, for example.

So there's not a great deal of difference, it doesn't appear, to BA.1 which hit us in summer, BA.2 which hit us in autumn, and the BA.4 and 5 variants that hit us in that very big winter wave we’ve just sort of come out of over the last few months and it's certainly still here.

So this is a bit different to the previous waves in the sense we've got what people are describing as a bit of a variant soup. There's a whole bunch of variants now in Australia you're seeing that are overseas as well, but they're all pretty similar in the sense that are all cousins in the Omicron family.

MITCHELL: We had the Grand Princess dock here yesterday which had COVID cases on board. Do you know how many?

MINISTER BUTLER: No, I haven't got a report on that. There were 800, well I was advised, 800 when it docked.

MITCHELL: No, a different ship.

MINISTER BUTLER: Sorry.

MITCHELL: This is one that came in from New Zealand, docked in Melbourne, COVID cases on board. Nobody will tell us how many.

MINISTER BUTLER: I haven't got a report on that. We've got a meeting of Health Ministers this afternoon. I'll be seeking briefings before we have that. Obviously, the Victorian Minister won’t be at that because of the caretaker period there. But I imagine the Victorian bureaucrats will be attending. I've got a briefing before that where we'll go through a range of measures including that one.

MITCHELL: I'm told the cruise line has said you must wear a mask on board at all times now, except when eating or drinking. Do you think we will look at extending mask recommendations in Australia? Is this current wave likely to get that bad where we’ll say wear your mask more often in these circumstances?

MINISTER BUTLER: There may be changed advice in terms of encouraging people to think about wearing a mask in particular situations. I think also in sectors like aged care, obviously there's much more focus now on mask wearing than maybe there was a couple of weeks ago or a few weeks ago.

But in terms of a broad-based society-wide mask mandate of the type that we had seen earlier in the year. My advice is that there's no evidence that that is going to be called for over the course of this wave. But that doesn't mean there won't be different levels of advice coming from health experts, from political leaders, if the case numbers continue to climb to say, look, if you're in the shops, if you're in this situation or that situation, put a mask on.

MITCHELL: Would you ever go back to a mandate if necessary? As distinct from recommendation, would you go back to mandating?

MINISTER BUTLER: The critical words Neil there are, if necessary. I mean, of course, if the advice was a very bad new variant came through, and we were facing a situation where there was going to be widespread severe disease, the possibility of widespread deaths - then of course, every government would have a responsibility to look at whatever tools they could deploy.

We're not in that situation now. The advice that we're all getting, including overseas, is that these variants are much more of a type that we've been dealing with over the course of this year and a more targeted approach, certainly in vulnerable settings, like health care settings, aged care setting, disabilities, and the like, you do need to have some pretty clear rules in place.

But more broadly than that – going more broadly than that, I think what you're seeing is a different level of sort of advice from health experts and political leaders, as we see an increase in cases to wear a mask if you're in a crowded indoor space where you’re not going to be able to socially distance. That will keep the case numbers down and see this thing peak earlier than it otherwise would.

MITCHELL: There’s some hope. Do you believe that we are into the tail of the pandemic?

MINISTER BUTLER: That was the advice from the head of the World Health Organisation over the last month or two. He said that this is a marathon and we can see the finish line, but we're not at the finish line. That’s the important point he made, and we don't really know what this thing is going to throw at us over the next little while.

All of the experts in Australia are watching the northern hemisphere winter very closely, obviously, they're heading into that. I've just been reading some material this morning about the preparations Japan is putting in place.  I had a meeting virtually with the Secretary of Health in the United States yesterday morning, they're putting preparations in place for winter as well.

So we'll watch that very closely, see whether other variants emerge that are different in type to the ones we've been dealing with - the ones we're dealing with now, which aren't more severe than what we've seen over the last 12 months. And hopefully that is the trajectory we'll continue on - we'll be able to continue to live with COVID which is this sort of phase people have started to talk about. 

MITCHELL: So with luck we get through summer with a bit of relief? 

MINISTER BUTLER: That’s right. I think that is the advice that this will peak and have started to fall before Christmas but we can only wait and see. 

MITCHELL: Couple of quick things in other areas if I might. Have you organised yet a summit of all the health people to try and sort out the cumbersome system we've got operating? Are you looking at that? The hospital system doesn't, you know, it really needs rebuilding from the ground up, not in a physical sense but the way it operates. All the medical people tell me that, you know, the aged care complications, the NDIS complications, the ambulance complications. Would you look at an all in summit of them, everybody, all the main players in the health system? 

MINISTER BUTLER: The really important thing there, I think, is the National Cabinet. So the Prime Minister, our Premiers and Chief Ministers have considered this at every single meeting they've had since we won government back in May.  

As a Health Minister, there's nothing better than having your leaders focused on your portfolio, it means there's real momentum behind it. And they've given us as a group of Health Ministers a range of tasks, particularly to deal with those interfaces you mentioned between aged care and hospitals, disabilities and hospitals. I know Bill Shorten, the Disabilities Minister, is working really hard to help get people who are NDIS participants who are stuck in a hospital sometimes for months upon months, into more appropriate disability accommodation.  

So as a group of Health Ministers, we're meeting. Pre-pandemic they maybe meet a couple of times a year. We're meeting every couple of weeks. We’re meeting for a couple of hours this afternoon to work through all that stuff.  

The other thing we're doing is, is with all of the private sector groups, so in the Medicare system, AMA, the College of GPs, nursing groups, patient groups, I’m meeting with them every month to work out how we can put more investment next year into Medicare to start to deal with a real crisis in general practice, that I think, is probably the most terrifying of a range of real pressures in the health system.  

MITCHELL: Terrifying?  

MINISTER BUTLER: I think genuinely it is, Neil. I don't use that word lightly.  

I think people tell us all the time, and have for some time, that even before the pandemic it has never been harder to see a GP than it is right now. If you get in and you're paying a gap, the gap has never been higher than it is.  

And if you think it's hard now, the thing I've pointed to is that right now, less than 14 per cent of medical graduates are choosing general practice as their career. But not too long ago it was 50 per cent – we would rely upon half of the medical graduates coming out of uni choosing to be a GP. If we don't turn that around, you think it's hard to get a GP now, that pipeline of general practice is genuinely terrifying. I don't use that word lightly. We're working very closely with doctors, groups and others, to find ways to strengthen general practice. But general practice is in a real state of crisis right now.  

MITCHELL: Are you aware of the case of the Hennessy family - Jason and Kylie Hennessy. She has brain cancer and needed to go to South Australia for a functional MRI, because there wasn't one adequately available within Victoria, are you aware of that case? 

MINISTER BUTLER: No I’m not. 

MITCHELL: Her husband’s written to you a couple of times and there hasn't been an answer. If you like, we can forward those letters on through your office. They've gone to your office, but it’s got lost in the bureaucracy I’d say. He's pleading for more functional MRIs in public hospitals. 

MINISTER BUTLER: Please, if you could forward that, you know, we get, as you can imagine, a mountain of correspondence. I'm sorry that hasn't come to my attention. But if you could forward that, we'll have a look at that.  

MITCHELL: And last one, promise, last question. State opposition is going to rebuild the Alfred Hospital - good idea or not? 

MINISTER BUTLER: Well, the Alfred is one of the absolute jewels in the nation's health system, not just the Victorian health system. It's the leading academic hospital in the country.  It’s old, there's no question about that. I went through the ICU only a few weeks ago, I visited the Alfred and the research institutes that sit in that at least two or three times since I took the Ministry. I'm very familiar with that hospital, have been over many years. Ultimately this is a decision for the Victorian Government and Opposition to work through, they've got a much better sense of the priorities there. But the Alfred is genuinely a jewel, not just in the Victorian hospital system, but right across the country. We all benefit from the research and the learnings that you get out of what they do at the Alfred, they’re a terrific group. 

MITCHELLL: Thank you so much for your time. I really appreciate it. Mark Butler, Federal Health Minister.

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