Radio interview with Minister Butler and Sabra Lane, ABC AM Radio - 29 April 2024

Read the transcript of Minister Butler's interview with Sabra Lane on bulk billing.

The Hon Mark Butler MP
Minister for Health and Aged Care

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SABRA LANE, HOST: The Federal Government's trumpeting new data showing bulk billing rates are up 2.1% from last November, when the Government tripled the rate it paid to GPs who see patients under that scheme. Bulk billed patients pay no out-of-pocket expenses to see a doctor. The Health Minister is Mark Butler. Mr. Butler, thanks for joining AM.
LANE: The 2.1% increase is a figure the Government reported in February this year. Is the Government considering additional investments to further increase the bulk billing rate?
BUTLER: No, we're not right now. We've seen an additional 950,000 free visits to the doctor since these new incentives came in on the 1st of November. So, they are working to arrest, first of all, the free fall in bulk billing that we inherited when we came to government. They're providing, I think, much better remuneration to GPs who are bulk billing their pensioners, their health care cardholders and children under the age of 16. And we are seeing a pleasing rebound in bulk billing, particularly in some of those areas I was most worried about. So, Tasmania is up 5%, which had the lowest rates of bulk billing of any of the major states, and we're seeing big increases in regional Australia as well.
LANE: Concerns were raised, though last week that the benefits of tripling the bulk billing incentive have been eroded because some states have changed the way that they interpret payroll tax, meaning that GPs now are counted as employees rather than contractors, with the states increasing their tax take from those GPs. And the doctors say that's coming from their pockets, have you got a handle on just how big a problem that is? And what are you saying to the states?

BUTLER: I have said to states a number of times publicly that I'm urging them to sit down with doctor representative groups and make sure that these changes in the interpretation of existing payroll tax rules don't impact the GPs in a way that effectively neutralises the impact of the massive investments we've made in last year's Budget.
LANE: Have you got a handle on how big it is, the problem?
BUTLER: It varies from state to state because each state government is taking a slightly different approach to this question, and it would be good to have some uniformity across the country. That would give certainty to general practice and, I think, to patients who have seen over the last several years, it's never been harder, never more expensive to see a GP than it has been over the last few years. Which is why it was our highest priority when we came to government.
LANE: Sorry, so you don’t know how big a problem it is with the states?
BUTLER: The states are still really negotiating the impact of these things. They’re still talking to doctors' groups about potential amnesties and which general practices might or might not be subject to these changes. So by and large, they haven't yet impacted general practice. But understandably, general practice is very worried that in the future they might see changes that really do neutralise the impact of these significant investment we made in general practise in last year's budget.
LANE: You mentioned Tasmania there at the start. I am Hobart-based, and many people here struggle to see a GP in a timely fashion. And we have another example here of Risdon Vale Clinic. It closed a week ago because they cannot find GPs and that's affected 1,400 patients. What can the Commonwealth do to ease those problems?
BUTLER: We also have this year seen a really pleasing increase in the number of junior doctors choosing to take on general practice as their vocation, an increase of about 130 additional junior doctors taking up general practice training compared to last year. But this is not going to be a change we see overnight. It has never been harder to see a GP than it is right now. I'm really pleased -
LANE: Can you say anything to those people? I mean, even your colleague Minister Collins said it was distressing.
BUTLER: It is distressing. We have seen general practices around the country close down and particularly in regional areas. It's been very hard to attract general practitioners. We've got a range of things underway in those areas, particularly in regional Australia, where we rely heavily on overseas trained doctors to make it easier to recruit them from overseas and have them working in regional Australia, providing those vital services.
LANE: Are you going to deliver further assistance in the Budget to help smooth that passage? Because, I mean, those 1,400 patients are looking for help now.
BUTLER: I'm not going to announce any Budget initiatives on this programme, Sabra. But this is a piece of work that Health Ministers from a state and territory level and I are working on very, very regularly. We only met again the week before last to talk about the progress of the recommendations we received to make it easier to recruit doctors from overseas. But at the end of the day, we also need to recruit more junior doctors into general practice here in Australia. We’ve seen, really over the last several years, the lowest rates of interest from junior doctors in general practice ever. It used to be the case that about 1 in 2 medical graduates chose general practice as their preferred career. That got down to about 1 in 7. I'm really pleased that this year, I hope because of the confidence that they see in general practice, more junior doctors are taking up general practice as their preferred career. But that's not going to be seen overnight. I mean, it takes some years to train a new general practitioner, unfortunately.
LANE: What about the patients who can't get bulk billing? What's happened to the amount they're charged under the Medicare benefit schedule since November? Are their out-of-pocket costs going up?
BUTLER: We had seen out of pocket costs going up very significantly over the last several years. I mean, the bulk billing rate that I've talked about today indicates that there still is some substantial bulk billing of people who don't qualify for the bulk billing incentives. So those incentives apply to pensioners to health care card holders, concession card holders and kids under the age of 16. But we do see -
LANE: But to the point of that question, sorry?
BUTLER: People who don't qualify for those incentives do still receive bulk billing in some parts of the country. So in Western Sydney there are still significant bulk billing rates. But where you are in Tasmania, it is the case that people who don't have that health care card are often not bulk billed.
LANE: Mr. Butler, thanks for talking to AM this morning.
BUTLER: Thank you Sabra.


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