Radio interview with Minister Butler and Sabra Lane, ABC AM - 5 November 2024

Read the transcript of Minister Butler's interview with Sabra Lane on scope of practice.

The Hon Mark Butler MP
Minister for Health and Aged Care

Media event date:
Date published:
Media type:
Transcript
Audience:
General public

SABRA LANE, HOST: The Federal Health Minister joined me earlier. Mark Butler, these recommendations could completely reshape Australian health care. What do you think of the report and how quickly will you respond?
 
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: One of the areas where we need reform is how we use the best trained health workforce on the planet. This report really makes clear that there are all sorts of artificial, inefficient restrictions on what nurses, pharmacists, GPs, and other health professionals are allowed to do that bears no relationship to their training.
 
LANE: That does seem crazy. How determined are you to see that change?
 
BUTLER: I'm very determined about this, along with improving the digital capability of a system that uses still far too many fax machines and too much paper. This is a really important reform opportunity, because at a time where demand for health is growing and will grow, as long as I can see into the future, and workforce is hard to come by, it just doesn't make sense not to use every skerrick of skills and training that all of our health professionals have, from GPs through to nurses through to pharmacists, physios and more.
 
LANE: These reforms could mean that allied health professionals could directly refer patients to specialist doctors without first sending them back to a GP for a referral, for example, allowing a podiatrist to refer a patient to an orthopaedic specialist without involving a family GP for a referral, getting rid of that extra cost and the waiting time. That just sounds like common sense?
 
BUTLER: I'm not going to respond to each of the ideas. We want to consider them, but a lot of them do have a lot of common sense. If a GP has referred someone to a psychologist for mental health treatment, and that psychologist with all of their training takes a view that the patient needs to see a psychiatrist, do they really have to go back to the GP? I think it's important that GPs are kept in the loop and that goes to that question of digital connection, so that the GP knows the psychologist has referred their patient to a psychiatrist. There are all sorts of inefficiencies that mean that a lot of precious time of our GPs is being soaked up through these sort of back and forth of referrals.
 
LANE: Also, in rural areas, I know nurse practitioners have been willing to pop up their hands to help out, even with sitting with patients in video, consults with specialists in capital cities, allowing the nurses to do the physical checks If you like to save the patients time and money, travelling hundreds of kilometres for those appointments. Is the system up for that kind of change? Because there'll be turf wars.
 
BUTLER: There are turf wars in health. At its worst, frankly, I think sometimes this sector reminds me of factories back in the 1970s with very strict demarcations. We were able to break them down, get much more efficiency into manufacturing, and much more value and reward for the workers involved. I know that this is not only going to be good for patients and make a more efficient system, but it's also going to be good for health professionals because we know that they are much happier and more likely to keep working when they feel that all of their skills are being valued. Nurse practitioners are a great example, these are registered nurses who've done all of that training, who've then gone on to do a master's degree and have very, very extensive practical experience. In some parts of Australia where there is not a doctor, those nurse practitioners are leading really important healthcare.  Is there more they can do, are they able to make more direct referrals for diagnostic services like x-rays and blood pathology instead of someone having to drive a very long distance to have a GP sign that form.
 
LANE: Since Medicare started, it's been focused on a fee for service model. This report talks about broadening a scheme of blended payments. For listeners who aren't familiar with that, in simple terms, what are we talking about? What could it look like into the future?
 
BUTLER: Currently, Medicare is very much based on the idea that you go to a doctor for a 20 minute consult or you go to a pathology centre for a particular blood test and there's a fee for that specific service. What this report gets to really is the reality that people aren't simply going to a doctor for a one-off service because they fall off the ladder, or they have a particular bout of infectious disease. Increasingly, people have ongoing chronic disease and they need ongoing care from not just their doctor but a multidisciplinary team. Doctors, nurses, diabetes educators, physios, podiatrists, wraparound care that is ongoing. The system doesn't really reflect that in terms of what that health team gets paid. We are already looking at what's called blended funding models. You see that overseas quite a lot and it will take time. This report makes clear there's a very long runway that will be needed to move to a system like that. We're right now trying some areas where that might work for, example, older patients in residential aged care and we'll look at that recommendation very closely.
 
LANE: How quickly do you want to see change. This will involve maybe political fights. Have you got the gumption to see it through?
 
BUTLER: Last week we made change for nurse practitioners and endorsed midwives. We got rid of the old restriction that required them to be working in collaboration with a doctor, effectively having a doctor look over their shoulder as they went about their very, very skilled work. We're already making change in this area, but this report makes really clear just how much opportunity there is to unleash the full skills and training of, as I said, the best trained health workforce on the planet.
 
LANE: Mark Butler, thanks for talking to AM.
 
BUTLER: Thanks, Sabra.

Help us improve health.gov.au

If you would like a response please use the enquiries form instead.