Radio interview with Minister Butler on ABC Adelaide Drive

NIKOLAI BEILHARZ, HOST: Of course, for a long time we've been talking about the ramping crisis here in Adelaide. When it comes to emergency departments and hospitals, the pledge of the State Government to try and reduce how many hours South Australians spend sitting in ambulances on ramps. Well, the federal government has announced the potential for more funding for public hospitals to the tune of $1.7 billion nationally. Mark Butler is the Federal Health Minister and joins us this afternoon. Minister, thank you for your time.
 
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Oh my pleasure.
 
BEILHARZ: Will this fix ramping?
 
BUTLER: This will give state governments more of the funding they need to be able to deliver a high quality hospital system. We know hospitals - not just right across Australia, but frankly, right across the developed world - are under enormous pressure right now. You know, we're getting older, we're getting sicker. We're still dealing, frankly, with the legacy of a lot of COVID and that's providing enormous pressure on all of our hospital systems. What state governments, including South Australia, need is a reliable partner from the Commonwealth and that just hasn't been the case enough over the last ten years. This deal that I announced yesterday, along with the Prime Minister, that the state government and other state governments signed up to over the last 24 or 48 hours, will deliver a 15 per cent increase in Commonwealth funding for South Australia's hospital system next year. An additional $300 million that will allow Chris Picton and his hard working doctors, nurses and support staff in South Australia to deliver much more care than they otherwise would.
 
BEILHARZ: And is that funding guaranteed now? Is it locked in or is it contingent on your government being re-elected?
 
BUTLER: I don't know what the attitude of the Opposition will be. We know when Peter Dutton was the Health Minister in 2014, one of the first things he tried to do was rip $50 billion out of the hospital system. He's not got a great track record in this area. But we're determined to win the election. We're determined to continue to work closely with all state governments, Liberal and Labor alike. And we're also determined to keep doing our job, particularly, which is to reduce the pressure from outside the hospital system by delivering more doctors, more bulk billing, more Urgent Care Clinics as well.
 
BEILHARZ: But just returning to the question, so it sounds like it is contingent on the outcome of the election, then?
 
BUTLER: The money's budgeted there. It's in the Budget. If there was a change of government, of course a new government could rip the money out of the budget, like Peter Dutton tried to do after Tony Abbott won the election in 2013. I haven't heard what Peter Dutton proposes to do. In 2013, he said there'd be “no cuts to health” but there were huge cuts, not just to hospitals. He tried to abolish bulk billing. He tried to introduce a fee for every person who went to an emergency department. As I say, he's not got a great track record in this. But I'm focused on my job as the Health Minister and what we want to do with state governments, it doesn't matter whether they're Liberal or Labor, to deliver a strong public hospital system. Because you can't have a strong Medicare without strong public hospitals.
 
BEILHARZ: How much of a difference will this make on the ground? When you make an investment like this or plan to make an investment like this do you actually say, right, this will cut ramping times by this many minutes at these hospitals?
 
BUTLER: We're in the process of trying to secure a longer-term, five-year deal with all state governments, and we haven't been able to do that in time for the start of the new financial year on the 1st of July, for a couple of reasons. One: the Western Australian Government has gone into caretaker, they're about to have an election. And also, this is all tied to reform of the National Disability Insurance Scheme - the NDIS. All parties; every state government, every territory government and the Commonwealth, they want to see longer-term funding, security and certainty. But also they want to see a better hospital system: some real reform there that ensures that hospitals and other parts of the health system are meeting the needs of patients today. We do want to see that improvement. But we haven't been able to get the five-year deal done in time, which is why we're not going to nickel and dime states. That's why we've found $1.7 billion for the next 12 months to give them some funding certainty while we finish those negotiations.
 
BEILHARZ: Does that mean, though, that there's no expectation of an improvement of performance? There's no you'll get this money if we see an improvement.
 
BUTLER: There are no specific detailed conditions on 12 months, but there will be in the longer-term, five-year deal. We're continuing to negotiate now on that. I'm very hopeful that we'll secure that final agreement that won't only include additional money from the Commonwealth, but also will include some agreement between all jurisdictions about how we deliver a better hospital system and better results for patients. That's what we all want.
 
BEILHARZ: Rory McClaren on our mornings program spoke with Doctor John Williams, he's the President of the Australian Medical Association here in South Australia. Here's a little bit about what he had to say about this funding.
 
RECORDING OF THE AUSTRALIAN MEDICAL ASSOCIATION SOUTH AUSTRALIAN PRESIDENT, DOCTOR JOHN WILLIAMS: “It's fantastic to get that money and it will help our system. We'd just like to see a longer-term agreement between the Commonwealth and the states. This is not a problem that's going to go away soon. We know that EDs will need more capacity. We need more capacity to do elective surgery. So these are long term problems that need long term funding.”
 
BEILHARZ: We also heard earlier this week on 801 ABC Radio Adelaide from Doctor Michael Edmonds, who's an emergency medicine consultant and is involved with the Australasian College for Everyday Medicine. One of the key points that he was making is that he was saying the problem isn't too many people turning up to the ED, it's too many people getting stuck in the hospital system because they can't get discharged. Is that where this money should have gone towards looking at the discharge rather than into the system, the hospital system itself?
 
BUTLER: The best advice I get is that it's not an either-or proposition. There is a challenge with too many people going in the front door of the emergency department. That's why we've focused so much on building Urgent Care Clinics around the country, because that gives people the option of going to an Urgent Care Clinic for a non-life threatening emergency, particularly on the weekend, particularly late at night, instead of going to a crowded emergency department so that those EDs can really reserve their work for those life-threatening emergencies they're built for.
 
But there's no question that we are having a problem moving people through the hospital system as quickly as is clinically appropriate. Particularly, older patients and frankly, some also covered by the National Disability Insurance Scheme. I struck an agreement with Chris Picton last year for some additional funding from the Commonwealth to support some really innovative work that Chris Picton and his people in the South Australian health system are doing to move particularly longer stay, older patients out of the hospitals when they're clinically able to be discharged. At the moment, too often they're stuck in the hospital, sometimes for weeks or even months longer than they need to be there, because we have trouble finding an aged care facility for them, or we have trouble getting them back to their home with the right supports. Your earlier interviewer is spot on but it's not an either-or proposition. We want to work on trying to reduce pressure on emergency departments, but also ensure people are moving through the hospital system as quickly as is clinically appropriate.
 
BEILHARZ: The aged care system, though, does sit federally, so surely there's more responsibility to try and fix that bed block problem at a federal level rather than a state level?
 
BUTLER: There is, which is why we provided additional funding to all state governments, including South Australia. South Australia had been doing some of the most innovative work I'd seen in the country. Doing great outreach from hospital systems into aged care facilities, which would include geriatricians, nurses visiting aged care facilities to stop older people having to be transferred to hospital in the first place. We've provided funding to the South Australian government to bulk up that sort of work. But also it was really important that we were able to deliver the aged care reforms that we did at the end of last year. They were negotiated between us, I must say, with the strong support of Anne Ruston, the Shadow Minister for Health and Aged Care from the Liberal Party - obviously a South Australian too. That will lead to much more building of new aged care beds, because we are finding there just wasn't enough new capacity being introduced into the system at a time when we know demand for aged care is rising as the population ages.
 
BEILHARZ: Mark Butler, thank you for your time this afternoon.
 
BUTLER: Thanks, Nikolai.