Radio interview with Minister Butler and Raf Epstein, ABC Drive – 18 August 2022

Read the transcript of the ABC Drive interview with Minister Butler on Hospitals, COVID-19, Vaccine Rollout and Scott Morrison’s secret appointments.

The Hon Mark Butler MP
Minister for Health and Aged Care

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RAF EPSTEIN, ABC MELBOURNE DRIVE HOST: Mark Butler. He's part of Anthony Albanese cabinet. He is, of course, the Minister for Health and Aged Care. Good afternoon. Good afternoon.
EPSTEIN: Ambulances ramping, overcrowded hospitals, you know what the problems are like. Do you even know when we're going to start turning the problems around? Do you know when we're going to start improving things?
BUTLER: This third Omicron wave just this year has really hit hospitals hard. They were already just so exhausted, really overwhelmed by the usual pressures you see in a hospital system in winter. We had a flu season that was a bit earlier than it usually is, but the first flu season we've had for a couple of years and then we got whacked with this third Omicron wave as well. It's just been an absolutely terrible winter for hospitals across the country. At the same time, we've got an aged care system in crisis, a lot more aged care residents are removed from facilities to hospitals than really should be the case or might have been the case a few years ago. And general practice is in a really parlous state, a lot more people who are finding themselves unable to get in to see a doctor or if they can, they’re having to pay unaffordable gap fees or ending up in emergency departments as well. The thing about the emergency departments, as you know Raf, is they end up being the lightning rod for every failing elsewhere in the health care system. If you can't get healthcare where you need it, when you need it, you end up going to the emergency department and overcrowding and pressuring a system that's already, frankly, heaving with pressure all at the same time as a whole lot of health…
EPSTEIN: I appreciate that complexity Mark Butler. And you know, a radio station like this, we have a ton of people working in the health system who understand it's a decades long and multifaceted problem. But..
BUTLER: When is relief coming?
EPSTEIN: When's it going to turn around and do you even know when it's going to start getting better?
BUTLER: In the immediate sense, I think what we're seeing, we're seeing this third wave drop off much more quickly than we thought only four or five weeks ago. I think the modelling that pretty much all governments had in front of them indicated that this wave might continue climbing through August, but actually it peaked very late in July. Hospitalisations are down by almost 2000 across the country. We got up to more than 5000 people in hospital with COVID a few weeks ago, that's about one in 12 hospital public hospital beds across the country. It's a little bit lower than that in Victoria, but still about 800 and something people in public hospital beds in Victoria as well. That's already come down by a few hundred. We're getting a bit of relief from the COVID wave earlier than we thought. The flu season peaked very early, so there are very few people across the country in hospital with flu.
I think we're all certainly hoping that over the next few weeks this COVID wave will continue to ebb. in a couple of weeks after you see those big case numbers drop, then you'll see hospitalisations reduce as well. But there are still some very big structural pressures on that hospital system. A lot of deferred care, people were unable to get the sort of care that they needed during those big lockdowns, particularly in Victoria and New South Wales. And so they got more sick and they're ending up in hospital right across the country. I think we'll see relief over the coming few weeks, but it doesn't mean there's not going to still be a very big pressure on our hospital system.
EPSTEIN: And this is. I don't know if this is worth saying. This is not a gotcha question, but to ask that question a third time. I hope you think it's a reasonable question. Do you know when things will substantially improve or is it you just can't tell when things will substantially improve?
BUTLER: I think they will substantially improve over the coming few weeks, but it doesn't mean it's going to be beer and skittles. The hospital system is going to continue to be under pressure, after this third Omicron wave has largely ebbed away. We don't know when the next wave of COVID is going to come. As you said in your introduction, the pandemic is not over. At the moment, around the world, we're seeing waves, it's not yet settled into the sort of 12 monthly seasonal virus that you see with the flu, for example. We just don't know whether there will be another wave in four to six months or whether there will be another variant of concern.
We need to be prepared for the worst and hope for the best. I think we'll see some relief over the next few weeks but there's still a lot of pent-up demand in the system.
A lot of people weren't able to get the care that they needed through those difficult lockdowns.
EPSTEIN: Mark Butler is Anthony Albanese’s Health Minister. Mark Butler as Health Minister, you've been with the Federal Government, also previous coalition government. 50/50 is the COVID setting for the Federal Government to pay 50% of hospital funding and the state government to pay 50%. The normal setting is less than that. Realistically, you're going to have to stick with 50/50 for a few years, aren't you? You're not going to be able to wind that back are you?
BUTLER: We've got we've got a funding agreement that all of the states signed on to which runs to 2025 and will start renegotiating that next year. One of the first things, or the first thing that the new Prime Minister, Anthony Albanese, negotiated with all of the premiers at their first National Cabinet meeting was an extension of that 50/50 COVID fund.
EPSTEIN: That ends next month. Is that right?
BUTLER: No, no. It runs till the end of the year. And at some point, at some point, COVID arrangements in hospitals will become a normal part of hospital activity. But I understand that next year we are going to have to negotiate a new general hospital funding arrangement. In the meantime, what the Commonwealth is doing in addition to extending those COVID supports that I talked about, as well of COVID supports in sectors like aged care, which is critically important as well. We're trying to bolster general practice in aged care. I mean, one of the big pressures on the hospital system is that people aren't able to get the care they need out in the community and they end up at hospital emergency departments when frankly, they shouldn't really be there. They should be able to get the care they need in general practice or in their aged care facility.
EPSTEIN: But if I could focus your mind on the end of the year, forgive me I got that wrong, September. You're going to have to extend the 50/50 passed the end of the year, aren't you?
BUTLER: Well, no at some point COVID operations or COVID patient care in hospitals will become a normal part of hospital activity, hopefully a much smaller part of hospital activity. But, you know, at some point we can't continue to have two separate funding agreements, it will have to become one. And the agreement from the Premiers and the Prime Minister was that would take place at the beginning of the new year in 2023.
EPSTEIN: I wonder if that'll still be their position. Mark Butler, of course, is the Minister for Health and Aged Care. If I can switch our attention to COVID Mark Butler. Three and a half thousand people have died in Victoria this year with COVID. 5000 since the pandemic began. Do you think we could have prevented some of those deaths?
BUTLER: I think to be blunt about that Raf, there were always going to be a bigger number of deaths given the highly infectious nature of these new variants, Omicron. I mean, generally the advice is that it is just so infectious, so much more infectious than the previous variants, that that even the sorts of measures that we saw in 2020 and 2021, whether it was lockdowns, even if there was a community appetite for that, this thing would end up getting through our best defences and you would start to see vast community transmission. Our focus really over the course, particularly this winter, has been to try to protect the most vulnerable, the people who are most at risk of getting severe illness, moving into hospital, and potentially then dying or dying in our aged care facility. And I think we've really been playing a bit of catch up there, frankly. Not just our country, but around the world. One thing, for example, is these new, highly effective antiviral treatments only really came onto the system over the last few months. When we came to government, they really were stuck in warehouses, not getting out into the community where they needed to be. Once we've been able to expand access to those antiviral treatments, we've seen hospitalisations drop off much, much more quickly. The state health ministers tell me that their advice is that a very big part of the reason why hospitalisations have dropped off so much over the last few weeks is because people have been able to get these antiviral treatments that prevents them from getting severely unwell and obviously prevents a risk of death as well. I think an increase in mortality or death numbers with this new highly infectious variant, while we're still across the world, frankly—not just here in Australia—trying to get access to these new, highly effective treatments was to a degree inevitable. But always, as governments and as the community your job is to reduce that number as far as you possibly can.
EPSTEIN: And Mark Butler, I do want to ask you a constitutional question in a moment, but one more important COVID question. There's been a National Audit Office review of the vaccine rollout. Both GPs and the Audit Office criticised the former government for announcing changes to the vaccine rollout before GP's even heard about it. Do you think that's a fair criticism? We wanted to know everything the government was doing about the vaccine rollout as soon as they had made the decisions. I appreciate it makes it harder for GPs, but the previous government didn't have any choice with that particular aspect, did they?
BUTLER:, I just talked to GP practice after GP practice that were already overwhelmed with work, but then they were overwhelmed with people calling in, wanting to take advantage of vaccine arrangements that their Prime Minister had told them, you know, were becoming immediately available to them. But that wasn't the case.
EPSTEIN: But we all wanted to know as soon as they made the decision.
BUTLER: You've got to be measured about the way in which you communicate that. Too often the former Prime Minister, I think, stood up sometimes at night, and made announcements without putting in place the plans and the logistical arrangements to ensure that those people who ultimately had to carry out whatever it was he was announcing were in a position to do so. That they were able to make bookings, that they had vaccines in their practice that they were able to start administering. And I think that's really what came out of the Audit Office report yesterday is that there was just a profound lack of planning by the by the former government.
And we knew that they were late in ordering proper supplies of the vaccines, which is why we were really the slowest developed country in the vaccine rollout through that critical year of 2021. But also, they didn't put the plans in place with state governments. They didn't put the plans in place with General Practice. They brought pharmacy into the system way too late, months after they were intending to, they didn't properly plan to in reach into aged care facilities to make sure they were properly vaccinated before the winter of 2021 and we saw the consequences of that.
EPSTEIN: Just a question on the Governor-General’s statement yesterday, another transparency question in some ways. His statement said he had no reason to believe the appointments would not be communicated. He's essentially saying he had no reason to believe Scott Morrison's multiple ministries would not be announced. Didn't he have every reason and every cause for concern last year when he was signing bits of paper a year after things had not been revealed? Do you think that statement was enough from the Governor-General?
BUTLER: I think this this whole extraordinary saga, really quite unprecedented saga, is a matter that reflects on the former government and the former Prime Minister in particular. But broadly, the former government. And the Governor-General of the day acts on the advice of the Government.
EPSTEIN: Doesn’t the Governor-General also stick up for the system and just check that stuff is announced.
BUTLER: At the end of the day, the Governor-General’s job is to act on the advice of the government. They’re not elected, they’re appointed to act on the advice of the government. And our criticism is of the extraordinary secrecy, just unprecedented secrecy, and lack of transparency by the former government. And that’s really what we’re examining.
EPSTEIN: Appreciate your time today.
BUTLER: Thanks, Raf.


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