Radio interview with Minister Butler and Sabra Lane, ABC AM - 7 December 2023

Read Minister Butler's interview with Sabra Lane on National Cabinet Strengthening Medicare measures; NDIS review.

The Hon Mark Butler MP
Minister for Health and Aged Care

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SABRA LANE, HOST: Mark Butler, thanks for joining AM.




LANE: This new health agreement kicks off in 2025. The Commonwealth will give the states and territories an extra $15 billion over five years in exchange for long term reforms. What reforms are they?


BUTLER: There’s a big reform agenda that will be released as we release the mid-term review of the hospital funding agreement over the course of the next day or two. But essentially, it's about making sure that people are getting the right care, at the right place, at the right time, and that won't always be in the hospital system. But I think the important thing, Sabra, that you saw yesterday was governments working together for Australia. In health, in areas like disabilities, you haven't always seen that. Too often we've seen governments stuck in trench warfare playing the blame game on these critical services and that wasn't the approach we saw yesterday. So, in addition to the additional investment that the Prime Minister announced in our strengthening Medicare agenda - that will expand Urgent Care Clinics that we're standing up right now - you will see that additional support from the Commonwealth to state governments in their efforts to combat ramping and clear some of the elective surgery waitlists that really built up over COVID. At the same time you will see state governments supporting the Commonwealth in our efforts to make the NDIS sustainable and for us to work together to develop a shared system of supports for people who are outside of the NDIS. So, it's a very significant compact agreed by all governments that will deliver much better services for Australians.


LANE: Okay, let's talk about this review that was commissioned earlier this year. There was an interim report and a report delivered up yesterday. Give us a flavour of that. What can people expect? Will they see a major change to the health system within 12 months? Within two years?


BUTLER: Take Urgent Care Clinics for example, Sabra, we’ve stood them up over the course of 2023. By the end of this year, we'll have 58 Urgent Care Clinic operating across the country. That doesn't give national coverage, which is why yesterday the Prime Minister said we want to invest more in this model. But already it means that people who otherwise would have to go to an emergency department or able to get good quality care for non-life threatening emergencies. We've already seen hospital data at some hospitals that that sees emergency department presentations dropping dramatically, because when your kid falls off the skateboard and breaks their arm, you now have an option other than going to an emergency department. It's quicker, it's more effective, it's fully free because its bulk billed, and it's taking pressure off a very strained hospital system.


LANE: Well, just give us an idea there. You said accident and emergency figures have dropped off dramatically. Tell us how much.


BUTLER: Take the Logan Hospital, which has seen an Urgent Care Clinic open over the last few months. Their presentations for the non-urgent categories of presentation - which accounts for about four million out of the eight million presentations EDs see every year - they've dropped by more than 10%. In Ipswich, they've dropped by as much as 20% since the Urgent Care Clinic operated in that catchment area. We've made sure that these Urgent Care Clinics are situated around hospital areas where there are particularly difficult presentation numbers on EDs. Hospitals are really struggling with the number of people coming through their door and what we see already is one third of these presentations are for kids under 15, the sort of kid falling off the skateboard when the family doesn't know what to do in the evening or on the weekend, the only course at the moment is that's open to them has been to go to the emergency department.


LANE: So, you talked about that 58 was the promise by the end of this year, you're on target to meet that, and the extra $1.2 billion for these centres, does that mean - how many more centres does that mean, or does that mean you're just going to bolster the clinics that are in operation?


BUTLER: No. As the Prime Minister said yesterday, there will be more clinics, but that money will also go into some really important work that we've already started with state governments, New South Wales is taking the lead particularly on this, to try and make sure that older Australians don't end up in hospital as often as they currently do. That's much better support for older Australians, including those living in aged care facilities delivered outside of a hospital setting, so, preventing them having to go to hospital if that's possible. But also when they are in hospital what we're finding is that state governments are saying they're stuck in the hospital system, sometimes for months and months because there's nowhere for them to be taken. They're clinically able to be discharged from hospital, but there's not a setting outside of hospital that is appropriate to their level of need. What we'll be doing is building that capability for people, older Australians particularly, who are currently stuck in hospital with quite complex levels of need that might not be able to be dealt with in a standard aged care setting. That will be a very significant piece of reform because I know this is a very serious issue for state hospital systems.


LANE: There will be a lot of anxious people around today thinking they're going to be tossed off the National Disability Insurance Scheme. Will anyone who is on the scheme right now find themselves excluded or will the exclusions apply to new applicants?


BUTLER: Bill Shorten, as you know, Sabra, is standing up at the Press Club today. The NDIS review that Bruce Bonyhady and Lisa Paul have been conducting over months, talking to thousands of people living with disabilities and their families, carers and disability providers, that will be released and it will be very clear the sorts of issues that those two very significant Australians have identified in the NDIS. I think every Australian, whether they're a general taxpayer, whether they care for someone with a disability, or live with a disability, want to make sure that this really crucial reform that's still only 10 or 12 years old is sustainable for the long term, and right now its growth rates are not sustainable. Also, what we agreed with states yesterday is to build a shared system of supports for people who fall outside of the NDIS. Remember, the NDIS was only ever designed for people with very significant permanent disabilities. There are vast numbers of Australians out there, kids with developmental delays, adults with significant mental health issues, who currently sit outside the NDIS because it wasn't really built for that level of need that aren't getting the support they need, and there was a commitment yesterday to build those supports together.


LANE: Okay, Mark Butler, thanks for joining AM.


BUTLER: Thanks, Sabra.


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