SCOTT LEVI, HOST: It always seems to boil down to health on the Central Coast, followed by education. So arguably, if you have the job as federal Health Minister, you're the most important person in the land and that person is here on the Coast to take our temperature, to check our pulse. When it comes to health on the Central Coast. Minister for Health and Aged Care Mark Butler, good morning.
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Morning Scott. A little triggered by your intro on the football given what happened to my team on Friday night at the hands of the Swans.
LEVI: I'm sorry about that.
BUTLER: I’ve started to recover, but I've regressed back a little bit. But I'm looking forward to driving up to the Central Coast in the next hour or so.
LEVI: Yeah, sorry about to bring back that, but they had a pretty good year. They were second at the end of the regular season and you know made it to the last 4.
BUTLER: Last 4, we've done that 3 times in the last 5 years. We're a great team on the field, forward entries let us down on Friday night as it had a couple of times over the course of the season. But your team, I gather you're a Sydney Swan, your team looked terrific on Friday night, and I'm really looking forward to watching the Grand Final.
LEVI: Surely the people in Adelaide would be so chuffed that there's no Melbourne team there, though. That's a huge rivalry, isn't it?
BUTLER: That's a big bonus, I'd have to say. A very big bonus. Brisbane gave us a shellacking a few times 20 years ago, so I think I'll be barracking for the Swans on Saturday.
LEVI: Alright, thanks for that. You're on the Coast today. You're just about to jump in the car and head up. What is on the agenda today?
BUTLER: Really a bit of a listening tour. I haven't been here for some months. I'll be with Gordon Reid and Emma McBride, the local members on the coast who are both health professionals. I think Gordon pulled a shift at the Wyong Emergency Department last night. People would know he's a very talented young emergency physician, and Emma McBride is one of my assistant ministers in rural health and mental health. And she's remarkably only the first female pharmacist ever elected to the Commonwealth Parliament. I rely very heavily on them, as you say, particularly representing an area where health is a real priority for the community. I've learnt that over the years, being involved in the health portfolio and visiting this region on many, many occasions.
We'll be at an aged care facility, will be at a Medicare Urgent Care Clinic talking to GPs, dropping into some pharmacy and also looking at the headspace at Lake Haven, which I think I opened about 12 or 13 years ago when I was the Mental Health Minister. So really seeing how some of our initiatives to strengthen Medicare, to drive bulk billing back up, to recruit more GPs and to make medicines cheaper, how they're impacting on the Coast.
LEVI: We had major, major talkback on that last week. We had GPs calling in; they are in crisis, they're really struggling, they're not being replaced. This is what one of them had to say:
CALLER: I'm totally in agreement with Brad. It's time the government recognised being general practice is a speciality of its own. The Labor government have taught people that it is their right to be bulk billed. It's about time they realised we've got to make a living and pay receptionists and pay practice and pay indemnity insurance. And where does the money come from? The current bulk billing doesn't in any way cover costs.”
LEVI: Yes. So they're saying that the model is broken, that they need more money for those Medicare bulk billing rebates.
BUTLER: For us, bulk billing is the beating heart of Medicare. It's absolutely central to Medicare and has been for 40 years. And when we came to government bulk billing was in freefall because for 10 years, the Medicare rebate was frozen for 6 of them and then under-valued for the rest of them. We've ploughed money into Medicare and I've unashamedly focused on general practice, because general practice is in the most parlous state that it's been in the 40 year history of Medicare. We can't have general practice in crisis, it is the backbone of our health system. And when it's not working properly and people can't get the care they need in their local community, it all reverberates through our hospital system. We're seeing that not just in New South Wales we're seeing it right across the country right now.
We have given the Medicare system the 2 biggest increases in 30 years. Last year was the biggest increase, this year was the second biggest increase since Paul Keating was the Prime Minister, since before Port Adelaide even entered the AFL, Scott – a very, very long time. And we've increased that rebate in 2 years by more than the former government did in 9. But the big thing we've done is triple that bulk billing incentive. And that was what the College of GPs asked us to do. They said this was the critical measure that would turn around bulk billing. We have seen bulk billing start to increase again in every state and every territory, including here on the Central Coast, where I know bulk billing was a very, very serious concern for patients.
LEVI: Well, it went out the door backwards. You say they're the beating heart, but really they're saying they're in cardiac arrest. That it's just not covering costs. The model is not viable. Do you need to give them more?
BUTLER: We're continuing to work with the College of GPs. I meet regularly with the AMA only again yesterday, and I want to come and visit and talk to GPs about what they need. We increased investment in a whole range of other areas in general practice to allow them to employ more practice nurses and other allied health and a range of other things as well. But as I say that, central investment was the biggest increase for bulk billing in the 40 year history of Medicare, and it has started to make a difference. In just the last 4 months, we've seen more than 3.2 million additional bulk billed visits, because of that investment. Bulk billed visits that wouldn't have happened. On top of which, of course, we've got our network of Medicare Urgent Care Clinics. There's 2 on the Central Coast, they're delivering bulk billed visits 7 days a week to people who need urgent attention, urgent care. Often they are kids who've experienced a sporting injury or fallen off a skateboard, but they don't need to go to the hospital emergency department and too often that's been what they've been doing.
LEVI: ABC Central Coast. We're speaking with Mark Butler, the Minister for Health and Aged Care, visiting the Coast today, just about to jump in the car and go. Vapes, we've still got shops openly advertising them on the Central Coast. Who's policing this? Nobody seems to know. We contacted police who told us it was a health matter, this is a state health matter. Health didn't seem to know what the protocols were. No one seems to know because they say it's a federal issue. What can the federal government do to crack down on these illegal shops?
BUTLER: We're cracking down on the borders. And since I put in place a border control on vapes coming into the country on the 1st of January, we've seized more than 5 million of them, vapes that have effectively been taken out of the hands of our high school students. Even our primary school students have been starting to vape. But the enforcement at a retail level rests with the state and territory governments. I've been talking very regularly with particularly state health ministers. The police are right to say it's not a police issue – unless, of course, they receive intelligence about the involvement of organised crime –
LEVI: Well, these places are absolute hotbeds for organised crime and they're bursting into flames every second day with arson attacks.
BUTLER: It started in Victoria, there were dozens of tobacconist stores, convenience stores that were selling vapes and illicit tobacco that were firebombed as there was a feud between 2 gangs who wanted to control this market. I've been really clear: my overriding concern about this market of vapes is the health of young people, because so many of them are vaping. We only learned last week, I think it was, from some late research that high school students who vape are 5 times more likely to take up cigarettes. And really worryingly, a 12-year-old who vapes – and there are a lot of 12-year-olds who are getting their hands on these things – they are 29 times more likely to take up cigarettes. We're determined to stamp this out. But the police and police ministers, I know the Australian Federal Police are also really concerned, that this has become a really lucrative source of revenue for organised criminal gangs to bankroll all of their other criminal activity like drug trafficking, sex trafficking and the like. Although this is primarily a health responsibility and state health or consumer affairs departments are starting to police this ban in the retail sector, there is a crossover into policing, where we do detect a very clear involvement of organised criminal gangs.
LEVI: And just finally, um, aged care is a huge industry here on the Coast. How many of the Royal Commission into Aged Care recommendations have you been able to implement, and how are the mandated registered nurse numbers and ratios in aged care going on the Central Coast?
BUTLER: Look, I'm sorry, I don't have that number off the top of my head. Anika Wells, the Aged Care Minister, has been doing a terrific job with that. Only 2 weeks ago, we announced a whole tranche of reforms that would lift that number. I think there are about 168 recommendations all up, and we are well on the way to closing that number down, we've done an enormous amount.
We were told that we wouldn't be able to get registered nurses back into aged care, but we funded that. We funded the wage increase for the nurses so that they could be attracted back to aged care and I'm really pleased to say that 99 per cent of the time now in Australia, in aged care facilities across the country, there is a registered nurse. We haven't quite got to 100 per cent, but we've made a huge difference. We're also delivering about almost 4 million additional minutes of care to residents in aged care because we've lifted the number of carers in the sector as well, and that was a recommendation of the Royal Commission.
LEVI: Minister Butler, thanks for joining us. I know you've got to get on the road to visit the Central Coast. Appreciate your time.
BUTLER: Thanks, Scott.
LEVI: Mark Butler there, the Minister for Health and Aged Care. So many questions. Such a big portfolio, so important to all of our lives, but so little time.
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