Radio interview with Minister Butler and Sabra Lane, ABC AM - 9 February 2023

Read the transcript of Minister Butler and Sabra Lane on Strengthening Medicare Taskforce; general practice.

The Hon Mark Butler MP
Minister for Health and Aged Care

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SABRA LANE, HOST: The Health and Aged Care Minister is Mark Butler and he joins us now this morning. Good morning and welcome back.


LANE: You've already said that Medicare is in the worst shape it's ever been. Some Labor MPs who are doctors, Mike Freelander and Gordon Reid, are worried about the lack of urgency in fixing this. Will the fix for Medicare be in the May Budget and when will Australians notice a discernable improvement?

BUTLER: We are already acting on Medicare, a week or two ago the Prime Minister and I were down in Tasmania with the Tasmanian Premier to announce a really innovative way in which would support new GPs, so GPs in training, particularly in rural and regional areas where the GP shortage is most acute. Last week we were in Perth announcing the rollout of our first tranche of Urgent Care Centres, so 50 of them around the country with bulk billed extended hours, dealing with those non-life-threatening emergencies that too often see people having to go to an emergency department, which is frankly not necessary. So we are acting. But I completely understand the impatience of people like Mike Freelander and many others, passionate advocates for good health policy in this Parliament. There will be a delivery of the $750 million package in the May Budget. We have said that, and we're committed to that. And it will reflect and be guided by advice from the strengthening Medicare Taskforce. But I want to be honest that we're not going to fix Medicare in one Budget. I've tried to be really clear with people. This is long term focused work that we're committed to as a government.

LANE: Being honest too, when will Australians know and feel a difference with it?

BUTLER: As I said, there are measures that we're putting in place this year to ameliorate what people are dealing with right now. But we need to do a whole host of things. We can't just put more money into the existing Medicare system. As you say, it was designed for a very different health profile in the country where you went to a doctor with short episodes of illness that were fixed and then you didn't come back until your next episode. It's very different today with an older population with much more chronic disease, much more mental health issues in the community as well. So we've got to remake Medicare as well as deal with some of the financial pressure on it after six years of a Medicare rebate freeze that Peter Dutton started.

LANE: The Grattan Institute, a report found late last year that Australia has more GPs per person than ever before, and more GPs than most wealthy countries, with record numbers in training. Will your changes look at how to get doctors to the areas where they are needed most - rural areas, outer suburbs?

BUTLER: We've already started doing a little bit of that. There were changes made by the former government that pull GPs away from some of our regional centres in particular, that we sought to reverse that really, really aggravated an already existing shortage in, for example, the Hunter Valley was an area hit very hard. The other thing we need to do, though, is to make sure our GPs are being used most effectively. There are many tasks that Medicare requires GPs to do that frankly, should be done by practice nurses and by allied health professionals. That was a very big focus of the Taskforce. So how do we make sure that we're using every health care professional, not just our GPs, in the most effective way, using the fullest extent of their skills and training, and that means GPs as well. So instead of GPs doing tasks that could be done by a practice nurse, they can focus on those long, complex consultations with the patients who have probably been coming to them for years and really need very focused work. The Taskforce does talk a lot about that blended health care model. I'm not sure that people really know what that is. It's having sort of teams under one roof with doctors, nurses and other allied health professionals all working together to care for patients with chronic conditions.

LANE: Some doctors are pushing back against that idea because they want to be in charge. They don't want to sort of give up that power. How are you going to overcome that turf war? But not only that, we've got a huge workforce shortage anyway. You're going to struggle to find those extra allied health professionals.

BUTLER: Well, we do. And there's increasing demand for health care. Leave aside the impact of the pandemic, which has been substantial even before that, the demand for health care with an ageing population, rising incidence of chronic disease - as is the case in every developed country in the world - has been increasing and our workforce hasn't been keeping up with that. There's no question about that. But at a time of increasing demand and constrained supply of workers, the point I've made is it doesn't make sense not to have every single health care professional operating to their fullest extent, and the current myriad of regulations and turf wars and, you know, all of these historical battles have to end. It just has to end. And when I talk to individual doctors, they want to be able to work at the top of their scope of practice, that they want to be able to delegate a whole bunch of functions which can and often should be performed by other health care professionals. So if you're a diabetes patient with chronic type two diabetes, yes, you want your care led by a GP, but you often want the different services you get coordinated by the local practice nurse who you know very well those service will include, you know, work by podiatrists, work by diabetes educators, perhaps an exercise physiologist. We've got to design a system that allows all of those people to be working together as a team, seamlessly as a team. And the system doesn't work that way right now.

LANE: Respected public health authority Stephen Duckett says that health care needs a lot more money than what you're promising, an extra $250 million per year. Is there a chance of that money coming or in these financially constrained times that's it?

BUTLER: I've been clear that these are financially constrained times. There's no easy money lying around in the Federal Budget. I think everyone in health understands that, as they do beyond this portfolio. But, you know, I've been very clear this is not going to be fixed in one Budget. You know, we will have to keep working at improving and strengthening Medicare because there have been nine years, frankly, of neglect and in many cases real cuts that are putting it in, I think, it's most parlous condition it's been in its almost 40-year history.

LANE: Medicare rewards doctors for speed rather than need, are you considering the idea of an independent rebate tribunal to set fair indexation payments to take it out of the government's hands and into an independent sense.

BUTLER: No that wasn't the subject of any discussion in the Taskforce. It's not on the table right now.

LANE: Mark Butler, thank you so much for joining us. We'll have you back to discuss aged care.

BUTLER: Thanks, Sabra. 


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