Radio interview with Minister Butler and Stacey Lee, ABC Adelaide Breakfast - 27 April 2023

Read the transcript of Minister Butler's interview with Stacey Lee and David Bevan on cheaper medicines; hospitals; Urgent Care Clinics.

The Hon Mark Butler MP
Minister for Health and Aged Care

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STACEY LEE, HOST: Good morning, Minister. 

MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Morning Stacey and everyone else.  

LEE: I was a little bit confused yesterday. Can you clear up for us, is the dispensing fee the only thing that, according to you, pharmacists will lose out on, or will patients actually be getting 60 days, two months' worth of medicine for the price of one month? 

BUTLER: Both. Both of those things are true. The government will save about $1.2 billion out of this measure which I said yesterday, will be fully reinvested back into community pharmacy so we're not taking a Budget save that returns to the bottom line from this. Every single one of those dollars will be reinvested into pharmacy programs, so, trying to get pharmacists from out behind the counter delivering services to customers, which is what they have told me for years they want to do, really utilising all of their skills and their training. In addition to that, about 6 million patients will see the cost of medicines to their hip pocket halved. They won't have to go to a GP to get a script as often, at the moment they have to go at least twice a year for a medicine that they might have been on - some cases - for decades for cholesterol or blood pressure. That will be halved and they'll only have to go to a pharmacy 6 times a year, instead of 12 times.  

As your listeners know well, every time you go to a pharmacy in addition to them getting a fee from the government, they also get a fee from the patient, and that will be halved as well. So, we’re trying to be very honest about this. There will be a hit to the bottom line of pharmacies, but some of the numbers out there, frankly, are not right. The pharmacy sector at the moment earns about $26 billion in revenue a year. If you look at that over the next four years and assume even no growth, that’s more than $100 billion over four years. The pharmacy sector in the last four years grew by 30%, so it will grow - let's say it's $100 billion, there will be a hit of about $1.6 billion, somewhere in the order of 1 to 1.5% of revenue will be impacted by this measure, so it's not nothing, I acknowledge that. But it is - in the context of growth - something we think the pharmacy sector can sustain, and I think will be improved by the commitment we made to reinvest every single dollar we save as the Commonwealth Government, back into pharmacy programs. 

DAVID BEVAN, HOST: That's the voice of Mark Butler, the Federal Health Minister, who is also a South Australian MP. Dominic has called 891 ABC Radio Adelaide. Good morning, Dominic. 

DOMINIC, PHARMACIST: Good morning, David and good morning, Mr Butler. How are you today?  

BEVAN: What do you do for a living?  

DOMINIC: I'm a pharmacist and a business owner in Henley Square in the electorate of Hindmarsh, which is the Minister's electorate I believe. And I was really just calling to find out how the Minister is going to help us from potentially closing our doors, because whilst I support any incentive to make medicines more affordable for the community, this is going to have a massive impact on our revenue, and if we are only seeing our patients once every two months, potentially 6 times a year, this might impact on the way we provide our services. Ultimately, we may have to reduce our trading hours, we may have to lay off staff and this will impact on the way we provide, you know, primary health care to the community. So, I was just wondering what the Minister was going to do to prevent my business from closing down? 

BUTLER: Good to hear from you, Dominic. I have just outlined what we've modelled as the impact on revenue. I think some of the numbers that have been put out in this debate don't reflect the reality of what this measure is going to do. We've decided to phase this measure in over a couple of years rather than introduce it in one fell swoop, which was some of the speculation that the pharmacy lobby group was putting about, that was never our intention, we never indicated we would do that. Instead, it will be phased in over three tranches to make to make sure that the new delivery arrangements operate smoothly, but also to mitigate that impact that Dominic just talked about on pharmacies. I mean no one more than me wants to see a strong, sustainable community pharmacy sector. I've talked about this for all of my time in the health portfolio. I want to see pharmacists delivering more health services, spending more of their time out from behind the counter delivering services to their patients. That's what they've told me. 

BEVAN: Let's just go back to Dominic. And Dominic, have you crunched the numbers? What will this cost you?  

DOMINIC: Yeah, so look, I mean essentially, we're giving people two months for the price of one, and so that's the forecasting we're predicting is at least 30% reduction in our prescription revenue, and I know Mr Butler has mentioned that every dollar saved is going to go back into community pharmacy, but so far the incentives they've mentioned are opioid replacement programs, National Immunisation Programs, aged care providers and the rural pharmacy incentive. Now none of those are really going to save my business. I mean we're already providing opioid replacement for maybe three clients and they're paying for that service already. I don't believe that the government's going to give me significant revenue in that area. The National Immunisation Program and vaccinations - we're already doing, we're already getting paid for that. So, I can't see how much extra they're going to give us for that. I'm not an aged care provider, so that's not going to help me, and I'm not a rural pharmacy. So I don't see how any of the reinvestment is going to help me staying afloat.  

BEVAN: So, by the time these measures come in and you lose 30% in your prescription revenue, do you think you're going to have to close your pharmacy?  

DOMINIC: Well, it will either be closing my pharmacy or reducing my hours, or laying off staff, because I don't believe that I can sustain the current model if my prescription revenue is going to be cut significantly, and that's what we're predicting at the moment.  

BEVAN: Mark Butler, Dominic's not buying what you're selling? 

BUTLER: I've said in the next few days we'll be releasing more detail about the investments that we're going to make. And obviously, we're going to monitor this situation very closely. But David, this is a measure that has been recommended to government for more than five years. The former government decided to do nothing about it and as a result, literally millions of patients were forced to front up to their pharmacy every month, front up to their doctor at least every six months for arrangements that don't exist in any other country we usually compare ourselves to. These 60-day dispensing rules operate in pretty much every single country we usually compare ourselves to. New Zealand, UK, Canada, all the European countries we usually look to, states in the US. So really, I was confronted with some advice from the experts in this area, the Pharmaceutical Benefits Advisory Committee about introducing something they - as the experts - recommended as clinically appropriate, and saving six million Australians who live with chronic disease, many of them low-income Australians and pensioners. Or I could have done nothing, which is what the former government did. I just could not walk past that advice and simply do nothing. Now we are going to try to introduce this in a phased way, in a way that reinvests every single dollar we save as a Commonwealth back into community pharmacy. But at the end of the day, at a time of unprecedented cost of living pressures, I am determined to do everything I can to make medicines cheaper for Australians. 

LEE: While we've got you Minister, the Federal Budget is in a couple of weeks. Right now, I'm looking at a photo from the ramping at Queen Elizabeth Hospital last night, there's about seven ambulances there, and a couple of police cars sitting there. When we talk to the State Government about it, they always mention help from the Federal Government because this is an issue that every state is facing, will you have a lifeline in the Federal Budget for your state mates - Chris Picton, Peter Malinauskas? 

BUTLER: I'm focused on relieving pressure on hospitals right across the country, including here in South Australia. And you’re right, the sort of pressures that hospitals like the QEH, which is my local hospital are facing are being replicated right across the country, and frankly right across the world. If you look at all of those developed country health system's, COVID has really hit them hard. It’s hit workforce hardest, and it's meant that people weren't able to get the care they needed during COVID because of lockdowns, because of restrictions on general practice. So, they're now turning up at hospitals, much more unwell than they otherwise would have been. Our job as a Commonwealth Government is to give as much support to state hospital systems to relieve that pressure, and we're focused, for example, on rolling out Urgent Care Clinics across the country so that people who do need urgent care, but not life-threatening - not once in a lifetime care of the sort you do need an emergency department for – can get it out in the community rather than presenting at emergency departments. And we’re also at the back end of the hospitals, if you like, working very hard with them to try and ensure that people who are in the hospital beds for a long time, but are clinically able to be discharged, often to aged care or to NDI: the National Disability Insurance Scheme, that that's working more effectively as well. 

BEVAN: But whatever you and Peter Malinauskas are doing isn't working? 

BUTLER: I was about to say David, I'm not going to pretend to your listeners that this is going to be fixed overnight. These are very deep pressures on our health systems, which always end up at the emergency department. There are pressure across our health system, the lightning rod for all of those pressures, ends up the hospital emergency department, you see that right across the world. 

BEVAN: There must come a time, Minister, where you do fix the problem, or are we going to be having the same conversation in a year's time, and then the year after that and you would say: look, these things take a long time. So, it never ends? 

BUTLER: I'm being honest with you and your listeners, David, that these things are not easy, a lot of them are related workforce - 

BEVAN: We know it's not easy, but you have to do something that will actually make a difference in the next Budget? 

BUTLER: We are, is what I'm saying. I'm working very closely with my Health Minister colleagues and the Prime Minister is working closely with his Premier and Chief Minister colleagues. There's a National Cabinet meeting later this week on Friday. The National Cabinet, so the leaders of all of our governments have determined - as I think I've said on your program before - their priority for this year is the health system. That's how important - not just Health Ministers, and you and your listeners regard this - the heads of all of our governments regard this as their most significant priority this year. You'll see a lot of discussion coming out of the National Cabinet meeting this Friday.  

LEE: Ok. And with the Budget a week and a half away also, I guess we'll wait and see. Minister, thank you for your time. 

BUTLER: Thanks for having me. 

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