Radio interview with Minister Butler and Raf Epstein, ABC Melbourne - 21 November 2023

Read the transcript for Minister Butler's interview with Raf Epstein on vaping; health workforce.

The Hon Mark Butler MP
Minister for Health and Aged Care

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RAF EPSTEIN, HOST: Mark Butler is the Federal Health Minister. He is part of Anthony Albanese's Government and he joins us this morning. Thanks for having a word to us.




EPSTEIN: What's the latest information on when the vaping ban is actually going to come into place?


BUTLER: The first wave of the ban will be made before the end of the year. Over the next few weeks we'll be making a regulation to ban the import of certain vapes and this will close a loophole that's existed for some years. To his credit, Greg Hunt, who was the Minister in the former government, recognised this was going to become a major health problem. He tried to close this loophole but was rolled by his own party room. So, we're going to close that loophole by the end of the year. And then, over the course of the months of next year, we'll introduce legislation which will also ban the manufacture of these vapes in Australia. Not that there is manufacturing right now, as we understand it, they're all imported. But if we're going to shut the borders on these things, we also want to make sure that we don't get this squeezed balloon effect where people start working out that they can make money from locally manufactured vapes. So, pretty quick.

Also, all of the health ministers of the country are meeting with all of the police ministers and the police commissioners later this week to talk about enforcement issues, which is obviously important as well. I can't remember when health ministers and police ministers came together for a meeting like this. It's a very significant thing and we've all received instructions from our leaders, the Prime Minister and also the Premiers, have indicated they want a whole of government approach to stamp out this public health menace that's afflicting our kids.


EPSTEIN: Are you confident you can actually stop people selling vapes? I think you've persuaded a lot of people it's a good idea to get rid of them, but not nearly as many people are actually persuaded you can stop them being sold?


BUTLER: I've been around a while, I know that there's still illicit drugs that are sold in the country in spite of them being illegal for a long time. I don't pretend that absolutely every single vape will be stamped out. I think the thing that's most concerning parents and school communities is the vape store that deliberately opened up down the road because they worked out that their target market is high school kids and increasingly even primary school kids. They're worried that the vapes coming into the country, when we were told this was all about trying to help hardened, usually middle or older aged smokers kick the habit. But when they have pink unicorns on them or are bubble gum flavoured, they're so obviously targeted at very young people. Parents and school communities expect their government, I think, to do everything it can to stamp them out. I'm not naïve enough to think that there won't be some that are sneaking through the border. They don't come in usually in big shipping containers labelled “vape” on the side. But Border Force, the TGA, the Therapeutic Goods Administration, they're going to be working very hard to do our job as a Commonwealth government to stop them coming in the first place. We will need some cooperation from state governments about the supply, if you like, on the ground through some of these stores.


EPSTEIN: Does that mean you blame them? Because we've got you know, we've now got about 1,000 illicit tobacco stores. I've had the police commissioner here. He's not shutting down those illicit tobacco shops. Again, I think a lot of people are with you on the sentiment, Minister but are they actually going to stop being sold?


BUTLER: This is the thing we'll be talking about with police ministers and commissioners later this week. I think what we're finding increasingly in terms of the intelligence we're getting from our policing authorities at a federal and at a state level, these are not good people who have created these markets. This is increasingly becoming something that sees, some of the worst in our society, organised crime working out that they can make significant money from selling vapes to young people. This is now becoming quite a web, that I think is sparking the interest of policing authorities. We recognise that policing authorities have got a lot to do. They're very busy catching traditional criminals, if you like, and just adding another job on top of their very substantial job is not something we can do without resources. We've committed to Border Force and to the Therapeutic Goods Administration at a federal level that what resources they need to do this job, we will give to them.


EPSTEIN: Do you think the massive rise in tobacco tax again, I think a lot of people are with you, not as many people are smoking, but the price of a pack of cigarettes has basically tripled something like that in the last decade. We've created this massive black market. Why are you so confident that we can get somewhere with vapes? If we've created a massive black market in tobacco, it's going to be even bigger, isn't it the black market in vapes?


BUTLER: This is something we're going to have to monitor very closely. Our first job as we see it, is to deal with the fact that schoolchildren tell us through every survey that they find it very easy to get their hands on vapes. As I said earlier to your listeners, and I think many of them who are involved in school communities would know that increasingly these stores are opening up close to schools. They're doing a pretty lively trade before and after school. School communities tell us this is now the number one behavioural issue in our schools. We've just gone through a year 12 exam period where around the country I'm being told that there are student after student who has to have nicotine patches on while they're doing their exam because they're that addicted to nicotine. This is a major public health challenge for young people. It's not just the vaping itself, although that is very unhealthy and very damaging to the young person. What it's meant is that the only cohort in our community right now where smoking rates of cigarettes are going up, is the youngest group in our community. That's exactly what this thing was designed to do, which is why big tobacco is pushing these things so hard is because they recognise this is a gateway to cigarettes.


EPSTEIN: Just briefly, does Victoria need to licence tobacco stores? We don't. We've got more of them. Other states do licence them. Does Victoria need to?


BUTLER: There’s a mix, my state of South Australia doesn't do that. I think maybe they're looking at that. I've got my own job trying to run federal health policy. I'm not in the job of telling states what they should or shouldn't do. The thing about our federation, when we come together as health ministers and we do probably more frequently than any other group of ministers, particularly arising out of COVID, there's a really healthy exchange of experience. One state will say, look, we've been doing this for a while and we've seen this particular result, and other health ministers will take that on. That is one of the upsides of a federation.


EPSTEIN: 1300 222 774 is the phone number. The vape ban is coming. Will it be enforced? Let me know what you think. The Federal Health Minister Mark Butler is with us. Minister, yesterday we spoke to a GP in Pearcedale. It's about ten minutes from Frankston. You know how much of a struggle it is just to ring and find a GP in Pearcedale. Do you need to allow more foreign doctors to work in more GP clinics in more places? Do you need to loosen those rules?


BUTLER: I think the short answer is yes. But, that's a relatively easy answer to give. The question then is how you draw the boundaries. We've never never allowed, certainly not in anyone's memory, allowed overseas trained doctors or international doctors to work absolutely everywhere. The inner-city parts of Melbourne, and my city of Adelaide, might be pretty well served in terms of doctor numbers. We've always had a problem in the country and increasingly we're having a problem in those peri urban areas, so right at the edge of the city. Sometimes in a city like Pearcedale, where there's a question really whether you are in the city or not. Frankston is another where we did quite an examination through a Senate Inquiry a couple of years ago and found the doctor to population ratios in Frankston were very low, which was why a change was made there. I think the system we've got now is a bit too blunt. It uses largely local government catchment areas. There can be real variation within those. I've started a review to look at that system.


EPSTEIN: Do you need to review it? It sounds like you're pretty familiar with the issues. Do we need a review? Don't you just need to pull the lever?


BUTLER: The question is where you draw the boundaries. What doctors and communities in rural communities say to me is that they don't want international doctors being able to practice in Toorak because if they come from overseas, given that given the choice between practising in the country or practising in inner-city Melbourne, for example, too many of them will choose to go to Melbourne. If we're bringing doctors in from overseas, we want to try and ensure that we can place them in areas of highest need. What flows from that is, well where do you draw that boundary? Pearcedale is a very good example of a community effectively on the boundary. It's not Melbourne, but it's not the country either. Wherever you draw that boundary, there is a debate about the community or the GP practice that ends up on the wrong side of it, which is the situation we have in Pearcedale.


EPSTEIN: So can I interrupt Minister, you said they're on the wrong side of it. Sounds like you are going to change it for Pearcedale?


BUTLER: The wrong side of it certainly from their point of view. The Casey South GP catchment area was examined last year and as a broad catchment area it was found to have a GP ratio, so a number of GPs above the national average. Now that's clearly not the experience of Pearcedale and it just highlights that sometimes the way in which we do this analysis is too blunt a tool. Those are the issues that I've asked the reviewers to have a look at. The other thing we're having a look at, the behest of National Cabinet, the Prime Minister and the Premiers told us to do this, is to review the way in which we do recruit overseas trained doctors and nurses in particular. I think we've always assumed that, well, this is Australia, of course everyone will want to come and work here, but actually we're finding, particularly after COVID, there is a global workforce shortage. Competitor countries like Canada, the UK and others like that are working very, very hard to attract the doctors and nurses that we want to attract here. Highly skilled doctors and nurses who might want to come to Australia and practice. As a result of that direction from National Cabinet, we're also working through as a group of health ministers a range of recommendations to make it much easier for, example, a British doctor or an Irish nurse who wants to come and practice here to get here and actually start practicing rather than land in Melbourne and end up spending months and months working in a cafe.


EPSTEIN: It sounds like that'll take time to work out. Don't we need them now? 


BUTLER: I mean it's much quicker than training a whole lot of new Australian doctors, which takes more than a decade. I think what we're trying to be pretty honest about is there's no silver bullet here. What we need to do is look at a whole range of things that will ensure we have the best possible mix of health workers across all of our communities and deal with some of the long-standing inequities that afflict, particularly communities outside our major cities


EPSTEIN: Mark Butler is the Federal Health Minister, part of Anthony Albanese’s government. Minister, thanks for joining us.

BUTLER: Thanks Raf.

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