Radio interview with Minister Butler, David Bevan and Stacey Lee, ABC Adelaide – 15 August 2022

Read the transcript of the ABC Adelaide interview with Minister Butler on the costs of visiting a GP and strengthening our GP workforce.

The Hon Mark Butler MP
Minister for Health and Aged Care

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DAVID BEVAN, HOST: South Australian MP and Federal Health Minister Mark Butler joins us now. Good morning, Minister.




BEVAN: Did we know how many people are actually being bulk billed?


BUTLER: Well, the Institute of Health and Welfare tells us that about one in three patients pay a fee. So that would tell you about two-thirds of patients are being bulk billed but as your intro said in some of the newspaper articles this morning have said the numbers are hotly contested by GPs and some of the larger corporate companies that run multiple GP practices.


What does appear very clear to me talking to patients and to doctors alike over the last couple of years is that the rate is going in the wrong direction. I mean, patients tell me and have for a while that it's never been harder to see a doctor than it is right now. Wait times are blowing out and it's also ever been more expensive.


The official data tells us that if you are paying a gap, say the gap has gone up considerably over the last nine years, particularly because there was a freeze on Medicare rebates put in place by the last government for six years. Right now, the official data tells us if you're paying a gap fee for a standard consult, it's now more than the Medicare rebate itself for the first time in Medicare’s history.


BEVAN: Right. And there's also a quote in The Australian today on the front page that you're concerned that some of the figures have actually been sugar-coated over the last few years and another suggestion that maybe the figures are distorted by the pandemic, people getting some services bulk billed, and that's distorting the figures.


BUTLER: I think pretty much everyone accepts that the pandemic has seen that the official data kick up a bit because there's a whole lot of COVID related Medicare items that had to be bulk billed. Vaccines, for example, the pathology, the COVID testing all is required to be bulk billed so that skewed the data over the last couple of years.


The reason why that sugar-coating is that what you saw over the last couple of years from the former minister is, you know, trumpeting of this 88 per figure that says that 88 per cent of consults are bulk billed. Now sometimes that was, that was presented as 88 per cent of patients being bulk billed but we know that that's not the case, it’s about two thirds are being bulk billed at the most. It also reflects some lack of clarity which have asked to be investigated, because doctors tell me, patients tell me that sometimes what you get is a doctor might have to charge a couple of different Medicare items if you're seeing him or her for a for a for a complex consultation. They might bulk bill one of the items, but then charge you a cap for the other item. It's all very it's very opaque. Medicare is just so important for our health system, such an important part of our social fabric. We should understand very clearly what is happening and that's why I'm trying to sort of put a spotlight on this issue over the last week or so.


STACEY LEE, HOST: And it does seem to be something we are seeing in increasing rates that doctors your regular GP is now charging a gap or if you were always paying a bit of a gap, maybe it has increased.


Health Minister Mark Butler is it inevitable that bulk billing will come to an end?


BUTLER: Not on my watch. You know, bulk billing is a very important element of Medicare now. You know, there have always been people who pay a gap, who can afford to pay a gap.


I went to my fantastic GP last week. I paid a gap and that fine as far as I'm concerned, I can afford it. But when you're talking about the gaps potentially being levied on people, on low incomes, particularly people on fixed incomes like pensioners or young children, particularly young children and concession card families, then we've seriously got a problem. I think that's why so many GP organisations are drawing attention to this. Certainly, patients have been telling me this for some time and that's why Medicare was right at the heart of our election platform a few months ago.


I'm already working with doctors and patients and nursing organisations in our Strengthening Medicare taskforce. I chair that taskforce that meets every month. It's got a very substantial investment fund to plough back into Medicare to strengthen it. There's no question that Medicare, I think, is in the most parlous state we've seen it in its almost 40-year history.


BEVAN: So fair enough. You're asking for more information because you need good information before you can make decisions. But your gut is telling you and all the anecdotal evidence is telling you that it's in the most parlous state has been in for a very long time. Okay.


BUTLER: And it's going and it's going in the wrong direction. And what that does is start to feed itself. The other really terrifying statistic is that only 15 per cent of medical graduates right now are choosing to go to general practice so it's not that long ago that that figure was about half. Half of the medical school graduates would choose to go to general practice and that figure is now only 15 per cent, which is, which is what it is and we don't turn that around so then we're going to have a huge shortage of general practitioners over the next 5 to 10 years because we know that. But there is a group who are looking to retire who are particularly exhausted, frankly, by the workload of the pandemic and they're just there's just not a pipeline of enough young GPs ready to take their place to deal with the health needs of the country.


BEVAN: But bottom line her you know you're going to have to increase the amount of money the government gives doctors, that is GPs.


BUTLER: We've made a very substantial commitment into Medicare at the last election. $750 million for strengthening Medicare. We also committed to 50 urgent care clinics, all bulk billed across the country, including four in South Australia—complementing the work the South Australian Government is doing that area as well. For those minor emergencies where otherwise you end up waiting for hours and hours at crowded emergency departments and also a range of infrastructure grants just to strengthen general practice itself.


LEE: Yeah but so far none of that appears to have worked. Is it the case? Will we actually see doctors who...


BUTLER: We have been in government for ten weeks.


LEE: Yes, we're looking we're looking towards the future now. And is it the case that those doctors that have changed the rules recently and introduced a gap or have maybe increased the gap, being realistic, we're not ever going to see them go back and remove that gap are we?


BUTLER: What we want is to relieve the pressure on general practitioners and to strengthen their practice. They all tell us whether it's the media or politicians like me or their own patients, they're under real pressure and I understand why. Six years of a freeze in Medicare rebates is effectively a wage freeze for the nation's general practitioners for six long years. And on top of that, you've then had the pressures uncovered and on top of that, you've just got the general pressures on our health system from a population that's getting a little older where there's more chronic disease, more mental health presentations. It's just been pressure after pressure after pressure on our general practitioners. And that's why I've said very clearly that's at the top of our list of all of the myriad challenges in our health system. Rebuilding general practice is my top priority, not only for its own sake, but also because we know that patients can't get the care they need out in the community in general practice, they end up at crowded emergency departments, putting even more pressure on our hospital system.


BEVAN: Now, Minister, we appreciate if you can't stay with us, but we're now going to go to Dr Danny Burn, if you can by all means do but we appreciate you filling us in while you're driving in a in a car that you're not doing the driving.


BUTLER: I have to leave, but thanks. Thanks. Thanks.


BEVAN: Thank you very much, minister. Federal Health Minister Mark Butler

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