Radio interview with Minister Butler and Rafael Epstein, ABC Radio Melbourne Mornings - 23 April 2024

Read the transcript of Minister Butler's interview with Rafael Epstein on vaping; opioid dependency treatment.

The Hon Mark Butler MP
Minister for Health and Aged Care

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HOST RAFAEL EPSTEIN, ABC RADIO MELBOURNE: Mark Butler joins us. He is the Federal Health Minister. That of course means he is part of Anthony Albanese's Federal Labor Government. Good morning.  
EPSTEIN: Just before I get on to vapes, if I'm right there won't be a second supervised injecting room, is that a problem? Does the Federal Government have a view on that?  
BUTLER: No we don't. This is not an area I'm familiar with in terms of the debate that you talked about a little earlier and Ken Lay's report, I'm not familiar with that report. I don't know what the Victorian Government has decided to do. We've been working closely with Victoria and other state Governments around the pharmacotherapy that we talked about a little bit earlier. Indeed, we put those treatments, buprenorphine, which are injections, and methadone, which are taken orally on the PBS several months ago. And that means that people dealing with opioid dependence have gone from having to pay maybe $150 or $200 a month for that treatment to paying PBS prices. And often these people are on pretty low incomes, so they're generally concessional patients who would be paying about $7.  
That's a huge change really being able to put that treatment on the PBS, which is where I think it always should have been. And already we were getting feedback from jurisdictions that do have safe injecting rooms that people were moving from injecting onto those opioid dependence treatments. So either buprenorphine or morphine because of the cost reduction, I mean, they just couldn't come at $150 or $200 a month, although those drugs are also very expensive, obviously, but that PBS listing has been a real game changer, I think.  
EPSTEIN: Okay, so just to confirm, you reckon there is actually an increase in people taking that up that option, because it's now available in places like Melbourne?  
BUTLER: This is relatively early days for only a few months into the listing, but that was the feedback we were getting from jurisdictions that have these services available to them. I haven't had an update on that. We'll be watching it closely, but I think as a matter of equity in terms of good public health policy, having those well recognised treatments on the PBS is something that was long overdue.  
EPSTEIN: It's 21 minutes to nine. You banned the importation of big shipping containers of vapes from the start of the year. I think personal importation began - the ban on that began in March. Is it working?  
BUTLER: We're seeing a lot more seizures. And today I'll talk with Border Force and the Therapeutic Goods Administration which are the federal bodies charged with policing these federal laws or these federal bans about another seizure here in Melbourne. We're up to about one or more than 1.5 million vapes having been seized since the 1st of January. Just to give it some perspective to your listeners, I think the whole of last year, we seized about 100,000 or a bit more. A huge increase in the number being seized. We're hearing reports that vape stores and the like are having trouble getting access to vapes.  
I think we were talking earlier about a Chinese industry report. They have vaping industry newspapers over in China that was reporting a reduction of 93% in exports to Australia, because they know that this ban is in place. What we're trying to do is choke off that supply while the legislation that's currently in the Federal Parliament that would actually outlaw the sale through vape stores and convenience stores and the like, choke off that supply early on, then move to a ban on the sale of supply, as well as putting in place a whole lot of supports for people, the many people, including very young people who are now addicted to these things.  
EPSTEIN: I ask the question, is it working? Because I've told this story many times, you might not have heard it. There are three tobacco shops near my house. They're all openly selling illegal tobacco, you don't even need to ask. I walked in there, it must be the way I look, they just opened the drawer and said, what do you want to buy? The illegal tobacco, not taxed. And then there are two vape stores that still seem to me to be selling. So it's not easy to stop this stuff being sold. Are you confident that banning the importation has made a difference?  
BUTLER: It has made a difference. We're seizing a lot more, and as I said, there's already evidence of a behavioural change by these companies. But, you know, we now need to move in the Federal Parliament to ban the sale and the supply in the domestic market. So those vape stores that are opening up down the road from our schools, we know nine out of ten vape stores in Australia are within walking distance of our schools, and that's no accident. It's deliberately set up that way because schools are their target market. You just have to look at the products with their cartoon characters, their bubble gum flavours.  
Remember, people have to remember, this was sold to our community and to communities around the world as a therapeutic product. This was a therapeutic good designed to help hardened smokers kick the habit, middle aged and older people who'd been smoking for decades just couldn't kick the habit. This was another opportunity for them to stop smoking, but that's not the reality anymore. What we know now is this is a product designed to recruit a new generation to nicotine addiction, and the tragedy is it's working. Now, I've never pretended that stopping that is going to be easy. But me, along with all of the Health Ministers we met again late last week, reaffirmed our shared commitment, Liberal and Labor Health Ministers across the country to stamp out this public health menace. But it's not going to be easy, it's exploded over the last five years, and the best time to have dealt with this would have been five years ago, the second best time is now.  
EPSTEIN: Who's going to enforce a ban if Shane Patton, who's our Chief Commissioner, he's actually sat in that chair. He said his officers don't have the time or the resources to enforce the illegal tobacco ban. So, you can walk in, you can buy cigarettes from Indonesia and China, they don't have the health warnings. We're not paying the tax that you'd like us to be paying on that tobacco. Who's going to enforce a ban on vapes if you're not allowed to sell them in a shop?  
BUTLER: When we were first getting advice, we were advised as a group of Governments, we may have to pass laws through all of the eight Parliaments of, or nine Parliaments of the country. So, we now know we can just pass a single law through the Federal Parliament if we get it through. That can be enforced by state health authorities. I think everyone's realistic that policing authorities or police officers are not going to be enforcing things with convenience stores. That is the job of health authorities at a state level. And as happens now, state authorities enforce the Federal Therapeutic Goods Legislation, so that's the plan that all Health Ministers have signed up to. There is some crossover into policing because we now know certainly in Victoria, given the spate of fire bombings that's happened around these stores, that this is a market increasingly controlled by organised crime.  
BUTLER: This is a lucrative source of revenue for criminal gangs who use it to bankroll drug trafficking, sex trafficking and all of their other criminal activities. Where intelligence suggests that a particular seizure, for example, involves organised crime, then obviously that triggers the interests of policing authorities, and we are working very closely, we've had joint meetings with Police Commissioners, Health Ministers and Police Ministers to work out how we sort of navigate that crossover.  
EPSTEIN: Are you really confident you can navigate? I know I'll get texts. I can already see the text. I'm sure I will get calls. If we are failing at the moment and we are failing, right? No one is enforcing the illegal tobacco ban, it is just not being enforced. Why are you confident, then, that a vape ban will be enforced?  
BUTLER: Well, let me come to illegal tobacco because I think we've recognised there's a real challenge here, as there frankly, has been with laws that had huge loopholes around vapes. What we've got to do is close the loopholes on vaping because previously there was this false distinction that said, it's completely fine to sell vapes if they don't have nicotine, it's not fine if they do contain nicotine. What happened is all of the vapes that flooded into the country had these false labels on them that said no nicotine, or they weren't labelled at all. So, if authorities seized a bunch of vapes from a convenience store or vaping store, they had to take them off, get them lab tested, and if they showed that they had nicotine in them, it's just too resource intensive. What we do know is that the overwhelming majority, well over 90% of these things, do contain nicotine. We're closing the loopholes and banning all vapes, all vapes. Unless you get them on prescription sold through a pharmacy, no vape is going to be able to be sold legally in Australia.  
I think people, because they're so impatient about this, and frustrated parents are beside themselves, school communities are beside themselves. They're saying to us, how did this happen? How did this get so out of control? And why haven't you fixed it yet? They look at the vape stores that are still open down the road from their schools and, understandably are complaining to me and my colleagues, why haven't you fixed this yet? Well, I say to them, we've got to get these laws through the Parliament. We've banned the imports, that is starting to choke off supply, it doesn't mean they're not coming in. They don’t come in shipping containers with big signs on the side of them labelled vapes. There are going to be vapes that still get in, but we are starting to choke off that supply. The next thing we have to do is pass these laws through the Parliament and see a ban on the sale and supply, which will see the vape stores shut down from the 1st of July.  
EPSTEIN: I will get to your calls soon. 1300 222 77 for both the enforcement of the vape ban and the fact that the second supervised injecting room will not go ahead, the State Government will announce that later on. You keep mentioning passing legislation Mark Butler, The Nationals don't back a vape ban, so I assume that makes the Senate a bit messy. I don't think The Greens have signed up to the vape ban yet. They're usually on the side of at least decriminalising things if not, legalising things. Is the retail vape ban, is that going to get through?  
BUTLER: I'm still very confident that Parliament will see that this is a huge opportunity to make a meaningful and lasting impact on the public health of Australians.  
EPSTEIN: You can't do it without The Greens, am I right?  
BUTLER: Well, we need the support of the Opposition or The Greens and crossbench, and I'm still hopeful that Peter Dutton will see his way to supporting this. I think one of the challenges is that some are presenting this as a prohibition, an exercise in prohibition. And to that I say this is no more prohibition than the regulation of access to codeine or pseudoephedrine is prohibition. I mean, what we're saying is this is supposed to be a therapeutic good, not a recreational product for kids. This was sold to us as a therapeutic good to help with smoking cessation. Let's return it to that original intent. What big tobacco said this was all about. It's not prohibition, it's treating it as a therapeutic good like any other that you go to your doctor, you get a prescription, you then you go to a pharmacy and get an approved product, it's not prohibition. The second thing is the National Party has accepted the arguments of big tobacco and said we should just regulate this and tax it. Well, I look at examples overseas where this has happened, and it's not worked. I mean, New York State, which is almost as big as Australia, about 20 million people, they did that five years ago, and in the five years they've been doing it, vaping rates have skyrocketed among young people in New York, and they've raised next to nothing, I think last year they raised maybe $25 million.  
You know, David Littleproud says this will raise billions of dollars and we should just raise the white flag and accept it as part of Australia. I didn’t sign up to that, none of my Health Minister colleagues around the states and territories sign up to it. I think we've got a responsibility, five years too late, perhaps, but we've got a responsibility right now to do everything we can to stamp out this public health menace targeted directly at our kids.  
EPSTEIN: Thank you for coming in. Appreciate it. 
BUTLER: Thanks, Raf.  
EPSTEIN: Mark Butler is the Federal Health Minister part of Anthony Albanese's Federal Government. The importation ban is through, the retail ban is the ban they need to get through the Senate. I'll get to your calls in just a moment. 

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