Radio interview with Minister Butler and Tom Elliott, 3AW Mornings – 4 September 2024

Read the transcript from Minister Butler's interview on 3AW Mornings which covered more Victorian Medicare Urgent Care Clinics, dental covered under Medicare, and illegal tobacco and vapes.

The Hon Mark Butler MP
Minister for Health and Aged Care

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TOM ELLIOTT, HOST: Our next guest is the Federal Health Minister, Mark Butler. Minister Butler, good morning.
 
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Good morning Tom, how are you?
 
ELLIOTT: Good. Now you've stumped up - is it $227 million? - to keep seven urgent medical clinics open around Melbourne?
 
BUTLER: That figure is a national figure. We're opening several dozen more Urgent Care Clinics around the country. But we are taking over a number of clinics that were opened by the Andrews Government. I announced urgent care as a policy at the last election in 2022. It's a new model of care for Australia, but it's pretty common around the world. New Zealand, it's very, very common. It's essentially an option somewhere between what your listeners would understand as a standard general practice on the one hand, and a fully equipped hospital on the other. They're open seven days a week, and they're really there for your kid falling off a skateboard and breaking their arm or getting injured at Saturday sport. You need to be seen very urgently, you can't wait 7 or 8 days to get into your local GP, but you don't need a fully equipped hospital. After I announced that policy, Dan Andrews here in Victoria and Dom Perrottet up in New South Wales, decided to open some centres on an interim basis, really while we got ours up and running. We're taking over a number of the Victorian clinics, which don't have any funding available for them, as I understand it, in the Victorian Budget beyond June next year. Otherwise, they'd be at risk of closing.
 
ELLIOTT: Is it a concern, though, that, you know, there's no money available from the Victorian Government for such an important thing and therefore you're sort of forced to intervene and find federal government funds instead?
 
BUTLER: No, I think there's a reasonable argument that this should be a Commonwealth responsibility. We've always had responsibility for what we describe as primary care, GPs and the like, through the Medicare system and states have responsibility for running hospitals. Now, arguably this is sort of a bit of both. But we're the ones who announced the policy at the last election to develop an Urgent Care Clinic model here in Australia. I looked around the world, it operates very well, not only to give people the sort of care they need urgently, 1 in 3 of these presentations, for example, are on the weekend when people just can't get in to see their GP. It gives them free care, fully bulk billed care, when and where they need it, usually for their kids. But it also takes pressure off the hospital emergency departments, which we know right around the country, are under real strain.
 
ELLIOTT: Yeah, well, the Urgent Care Clinics, which will now remain open around Melbourne, include Bendigo, Dandenong, Epping, Glen Waverley, Maribyrnong, Maroondah and Melton, which is good news.
 
Now can I ask you about dental care? The Greens, as we know, are pushing for some huge new taxes which may or may not ever happen. And amongst other things, they're saying they'll put free dental care and tack it onto Medicare. I'm told that some Labor backbenchers in your party think it's a good idea. Is it possible? Could we even afford it?
 
BUTLER: The first thing to say is that the Greens tax grab is never going to happen. I mean, that's the luxury of being a Greens MP you can throw out these thought bubbles about half a trillion dollars in new taxes or $46 billion for dental care, knowing that you're never going to have to deliver it. So it just sounds like an idea, but it's completely impractical. Their $46 billion dental thought bubble has already in the space of only a couple of days, been panned as unrealistic by the dental industry. And even the Parliamentary Budget Office that I think did the costings for the Greens has said that those costings are highly uncertain. We're not going to be following that. But look, Labor MPs, Labor Party members feel strongly and feel very proud about Medicare and they're ambitious for Medicare to do even better than it has done for the last 40 years. But my focus right now is on strengthening the fundamentals of Medicare and that's particularly general practice which is, frankly, being in the most parlous state I think, in the 40-year history of Medicare, because of the cuts and the neglect it experienced over the last decade.
 
ELLIOTT: Well, on that, I mean, look, I accept your argument about dental care, and I know it goes back to the Whitlam era and they just couldn't afford to do it. So for over 50 years it's not. But I mean, I find it odd that most bits of my body would be covered by a public hospital, but my teeth and my gums wouldn't anyway. We'll put that to one side. But you say that the GP system is under strain, and anybody who tries to find a fully bulk billing doctor - that is a doctor that has no gap fee - knows it's increasingly difficult. I mean, doctors say to me that, you know, we just we cannot afford to run a practice and only charge what Medicare gives us the bulk billing fee, you know, so we have no choice. Is it possible you might increase the fees paid to GP out of the public purse?
 
BUTLER: The first thing I'd say is in the last couple of years, two years, we've delivered the biggest increases to the Medicare rebate in 30. So in two years we've increased the Medicare rebate, which is the fee paid to doctors, by more than the former government did in nine long years. And we also tripled the incentive that doctors get to bulk bill. And what that's already done in just seven months is delivered more than 3 million additional free visits to the doctor, 700,000 of them have been here in Victoria. We've seen increases in bulk billing rates for a GP visit right across the country. And really pleasingly for me, Tom, the biggest increases have been in regional communities. So in Bendigo, for example, bulk billing is up by more than 10 per cent in just seven months. Now that's making a real difference to people, but I know it's still tough to find a doctor and particularly to find one who bulk bills. We're committed to doing more because we know - in spite of the fact we've got millions more bulk bill visits, we've got these Urgent Care Clinics that have already seen 700,000 patients, all on a fully bulk billed basis - there's more for us to do, and we're committed to doing that.
 
ELLIOTT: I want to ask you about vapes. I think it was late last year you, um, rightly so, said vapes were a new scourge on people's health, and you wanted to virtually outlaw them. You know, you're only supposed to have a vape now, if you have a prescription from a doctor. Now, I've got to tell you around Melbourne where we are, and I see vape shops everywhere. They have neon signs “vapes, vapes, vapes” flashing at you. Uh, I don't see any decrease in the number of people who appear to be using vapes. Has that policy been a bit of a failure?
 
BUTLER:  The first thing we did was to try and choke off supply at the border. These things were just flooding in over the border over the last several years causing particularly parents and school communities enormous heartache, really. Because we know now this is a product targeted at kids it's not targeted at you and me, Tom. These have pink unicorns on them, they've got bubble gum flavour and they're really about hooking a new generation to nicotine. What we wanted to do was choke them off at the border. And already since the 1st of January, when I introduced an import ban, we've seized around 5 million vapes that shouldn't be imported into Australia. The next step is to start to enforce the ban in retail shops, so in convenience stores, in tobacco stores, to see those fully, sort of vape stores shut down, which legally they should be from the 1st of July. I mean, parents are really distressed that nine out of ten those vape stores were deliberately set up within walking distance of a school, and so we have to start seeing those shut down. And we're working with state governments on getting out to retail premises, making sure that they understand now that selling vapes is illegal and after a period of education, we're determined to start to put in place the penalties that are contained in our new laws and they're very serious penalties -
 
ELLIOTT: Oh, I get that. But I mean, every day I catch the tram or most days to and from work. And when I get off the tram, where I alight is a vape shop. It's right there and it advertises them. And I just find it astonishing that I've never seen a police officer going in saying, by the way, what you're doing is illegal.
 
BUTLER: I don't think any of us want police having to do this job. I mean, police are involved in this market, to a degree, because it's controlled by organised crime, and it's delivering a very serious stream of revenue for their other criminal activities like sex trafficking and drug trafficking. But by and large, enforcing this new retail ban, which only came into effect several weeks ago, is a job for health authorities at a state level and consumer affairs authorities. I know that around the country, vape stores are closing down, and convenience stores are starting to surrender their vapes. But there are still stores that are doing the wrong thing and over a period of time, we're going to make sure that they understand that these serious penalties that are now contained in these new laws, fines of more than $2 million, jail terms of up to seven years. We are deadly serious about making sure that they take effect, because I am absolutely determined to protect young Australians from this public health menace.
 
ELLIOTT: Well, good luck with that, but it will need a lot of enforcement. Now look, finally and very quickly, illegal tobacco. It's reported today in the Herald Sun that probably 1 in 3 cigarettes being smoked is illegal so excise is not being paid to the federal government. This is, you know cigarettes that are smuggled into Australia. And I get people ringing me all the time saying they can pay $30 like we had a caller before, 30 bucks for 100 illegal cigarettes versus $50 for 20 legal ones. So they go to the illegal ones. Would you ever consider lowering the excise on legal tobacco to divert people away from the not legal or illegal tobacco?
 
BUTLER: No, I don't think I would. The advice that I receive from tax experts as well as health experts is you do need to continue to sort of have that price signal that deters people from smoking. But I am really concerned about how much illicit tobacco there is in the country. The tax office, which has responsibility for this area and Border Force have a lot of resources to try and crack down on that import market. But it's harder to pick up, frankly, than vapes. I mean, vapes have a lot of metal in them. They're easier to detect at the border which is why we're having such success in seizing them. Illicit tobacco does flood through the border at the moment, and we've got to do better, which is why last year we put a lot of additional resources into Border Force. What they're doing now is not just waiting at the border for those things to come in and try to seize them, you know, at Melbourne Port or at Sydney Port, they're also going to the source countries and working with them. When Premier Li from China, for example, was over in Australia a few months ago meeting with our Prime Minister, one of the things they did talk about was in the communique from the two leaders, was the need for us to cooperate around the trade in illicit tobacco and vapes. That's a really important development. But it is hard. This is a relatively low risk, high reward market for organised crime, and they are working very hard to get around the authorities at the border. We've got to do better.
 
ELLIOTT: All right. Thank you so much for your time. Mark Butler there, the federal Health Minister.

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