LEON COMPTON, HOST: The federal Health Minister Mark Butler will be in Tasmania a little later on today, opening what's known as an Urgent Care Clinic in Bridgewater in Tasmania's south. The clinic will be open from 10am to 8pm, seven days a week, and the aim is to provide bulk billed care and, critically, to keep people with non-urgent cases out of the emergency department in Tasmania's hospitals, and particularly in this case, of course, at the Royal. Mark Butler is federal Health Minister, good morning to you.
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Good morning, Leon.
COMPTON: And thank you for talking with us. There's now significant evidence about the work that -- or the place that Urgent Care Clinics have. What do the statistics say about the role of Urgent Care Clinics in taking pressure off our hospitals?
BUTLER: Sometime this week, we expect the one millionth patient to go through the network of Urgent Care Clinics we've opened in the last 12 to 18 months, and they're delivering really high quality, urgent care to people close to their community in a really timely fashion. And importantly, they're fully bulk billed. One in three patients going through them are under the age of 15 - which was a little bit of a surprise to me, that's higher than I thought it would be. But your listeners can imagine: kids falling off a skateboard, getting injured at footy and Saturday afternoons, and your GPs usually aren't open at that time and if they are, it's pretty hard to get in. Up until now, families have really been spending hours and hours in hospitals like the Royal Hobart or its equivalents right around the country. And instead of doing that, they're now able to access this high quality urgent care, free of charge, close to their community. We know already that this is leading to a reduction in that type of presentation to hospital EDs - what the hospitals describe as non-urgent or semi-urgent presentations - have started either to flatline, instead of increasing like everything else is in hospitals, or in some areas near the Urgent Care Clinics, they're actually starting to reduce. Which means that hospitals can spend more time on the things that really they were built for, which is life-threatening emergencies.
COMPTON: On Mornings around Tasmania. I suppose one might ask the question, Minister, if Tasmania actually had enough GPs and enough of them were bulk billing, would Urgent Care Clinics be necessary at all?
BUTLER: Look, I'm really confident this is a missing piece of the jigsaw puzzle for the Australian health system. Most countries we usually compare ourselves to have this model of care somewhere in between the standard general practice model on the one hand, and a fully equipped hospital on the other. It's not just a question of how general practice is operating. It really is, I think, a model of care that needs to be put in place in Australia. It's never been here. We're evaluating this model as we go, because it is a new model of care. But, you know, 12 to 18 months into this new development, I'm really convinced it's the right thing to do. Now, at the same time, we're really focused on general practice. I said before the election and since the time we were elected to government, it was my highest priority in health: to rebuild general practice after a decade of cuts. We now have more doctors and we have more bulk billing in general practice and that's a terrific thing. Over the last couple of years, more doctors entering the system than any time in the last decade. We've got more junior doctors choosing general practice as their preferred career, which is a really important development. And Tasmania has seen the biggest increase in bulk billing of any state, after we tripled the bulk billing incentive last November.
COMPTON: I'd be interested to hear from our GPs listening in the audience this morning about the impact that that's had and what they're seeing in their facilities at the moment. My guest this morning is Mark Butler, the Federal Health Minister. Via text this morning, “We've been to the Newstead Urgent Care Clinic multiple times last year with our six-year-old boy, including a broken arm. They were amazing, quick and caring. The $160 fee is too steep, though”, says a Launceston family via text. So the service is good, but the cost is steep. Why $160 for visits to an Urgent Care Clinic?
BUTLER: That person must not have gone to the Medicare Urgent Care Clinic. There are some private clinics around the place offering this service, I've noticed across the country, on a fee for service basis. Our Medicare Urgent Care Clinics are free of charge. No one is being charged for the service or for the X-rays that they're required to have available, or the blood pathology. They are completely free of charge. If someone's been charged a fee at a Medicare Urgent Care Clinic, I want to know about it, because the requirement for the contract with the relevant practice is that everything is fully bulk billed. Now, there are some other private Urgent Care Clinics I know around the country, so your listener might be talking about one of them. But the government's Urgent Care Clinics are strongly badged, there's a lot of green on the front door, there's a lot of Medicare signs. And they'll get a service free of charge in those clinics.
COMPTON: Okay, I should mention there's other texts coming in, people talking about their experience of Urgent Care Clinics. “I've taken my elderly mother to urgent care. It was fantastic. Definitely kept her out of accident and emergency. Both consults were fully covered.” That's Karen from Launceston as well this morning. “Can you please ask the Minister why the Urgent Care Clinic on Liverpool Street in Hobart has changed its hours from closing at 8pm to closing at 5pm. How does that effectively take pressure off the emergency department?” That's from Jake in Taroona.
BUTLER: Yeah, we've been really clear. We want these operators running into the evening. Some of them have taken a little bit of time to get to that, because there are workforce constraints getting the right doctors, the right nurses in place. But if they're not operating into the evening, they've got a requirement to stay in contact with my department and assure us that if there is an interruption to that evening service, then they're working to fix it, they're working to put in place the workforce to do that. I wasn't aware of that change for that particular clinic. But now I'm coming down to Tasmania in the next few hours, I'll ask my department for some advice about that. Because being open in the evening, particularly being open on weekends, which is when about one in three of these services are being delivered, is a really, really important part of the service and very important in terms of keeping that pressure off hospitals.
COMPTON: Health Minister Mark Butler is our guest. That listener's texted back from the Launceston family. It was a Saturday night and the reception told me it'd be $160 at the Newstead Urgent Care Clinic. We will follow up and find out if that's a private clinic that opens longer hours, or if it is indeed the federal government backed Urgent Care Clinic in Launceston.
BUTLER: I'll be following that up too Leon.
COMPTON: We will be following it up.
BUTLER: Thank you.
COMPTON: We'll follow up and let you know what's going on, because if there is a charge and that may well be possible and we'll find out what is going on there. You're on mornings around Tasmania. Mark Butler: “still no Medicare rebate for dental work. Why does an eye test qualify for medical rebates or Medicare rebates but not dental?” Asks a listener this morning via text.
BUTLER: Look, this is really a product of history. When Gough Whitlam was introducing Medibank opposed by the Coalition, opposed by doctors groups, opposed by dentists groups at the time as well. He made really what was a sort of a pragmatic decision that he could only fight on so many fronts. And dental was not included in Medibank. Your listeners might remember Medibank was then abolished and Bob Hawke had to reintroduce a scheme we now know as Medicare that's been in place for 40 years, and he took the same decision.
Now, you can argue that conceptually, what's different about the mouth compared to the eye or the knee. If anything, good oral care has a whole lot of health impacts. But it's never been included and that was largely a decision by a Labor government that was fighting on so many different fronts to get our ambition of universal health coverage up. Now, I know in my own Party, people are ambitious for dental to be covered by Medicare. Brian Mitchell, who's retiring at the next election, he included it in his valedictory speech and he's not alone. A lot of people do. But I've just tried to be honest with people that my focus right now is strengthening Medicare as we currently have it. It's under real pressure after a decade of cuts and neglect, after a once-in-a-century pandemic. And I can't say to people that in the short term there's going to be any change to dental. But I do recognise in the longer term there's a lot of ambition for dental to be covered. I think there's a slightly different view from the dental sector itself, which was very strongly opposed 40 years ago, but probably has a more constructive view today. But it's not going to happen tomorrow, Leon.
COMPTON: If not now, when? Is that a second term agenda item, if you’re returned in what's expected to be a March to May federal election, Minister.
BUTLER: I'm just saying really my focus right now is on, as I said, general practice. We've got a lot of focus on mental health that is also under real pressure. Over the next 24 hours, I'll be in further talks with my state and territory colleagues. We're having a meeting of health ministers down in Hobart over the next 24 hours, including with the relatively new Tasmanian Minister, Jacquie Petrusma, and we'll be talking about a new hospital funding agreement. There's a lot of work for us to do. There really isn't going to be anything happen in the short term on dental. We do fund state governments to deliver state dental services. But I do recognise that over time we are going to have to come back to this issue.
COMPTON: And I'm being told now and lots of people texting in Newstead Urgent Care is a private clinic. Thanks to everybody texting in and letting us know that's a private operation. That is good, says a listener, but charges everyone $160. Thank you for the text this morning. 043892936 if you'd like to get in touch this morning, Mark Butler is our guest. “Can you please ask Minister Butler if there are any plans to make long acting reversible contraception, such as Mirenas, cheaper for women, as for many, the out of pocket cost is prohibitive”, says Sandra via text this morning.
BUTLER: It's a really good question. We had a terrific Senate Inquiry on reproductive health, including the fact that we use - the technical term is long-acting contraception - but people would more commonly know as IUDs. We use them less in Australia than other countries that we'd usually compare ourselves to and this inquiry delved into why that would be the case. They're often more convenient over the long term, certainly more affordable and, frankly, better for a lot of women in terms of their other impacts as well. We're looking at that inquiry very deeply. Part of it goes to the fee that doctors will charge for implantation and we're looking at that. But I don't have anything that I can announce quite today on that. But we've got some really good material before us.
COMPTON: On mornings around Tasmania. You can join us to question for the Health Minister. This is from Leah in Taroona, “We've got a national preventative health strategy to keep people well and away from the health system. The web page hasn't been updated since 2021, and there's no investment by government to implement its recommendations. Why is this not a priority and when will we see this change please.” Asks Leah in Taroona via text.
BUTLER: Thanks for the update on the webpage. I'll go and have a look at that. But we have been very focused on preventative health in our last couple of years. If you think about really the three big drivers of preventable poor health, they're: smoking alcohol and poor diet. And I think there is more work for us to do in the area of diet and diabetes. We've got again, a really good Parliamentary Inquiry report that I received a few months ago about that. But I've had a huge focus over the last couple of years on tobacco control and particularly on vaping, which is really risking all of the hard fought inroads that we've made over 50 years in driving down rates of smoking. The only cohort right now where smoking rates are increasing is very young people, because vaping has proven to be a gateway into cigarettes for them. That was, after all, the objective that Big Tobacco had in mind when they introduced vaping. I don't accept that we haven't been focused on preventative health. I've had a huge focus, particularly on the area of tobacco control, which is still the biggest cause of preventable disability and death we have in the country. But I accept there's more for us to do, and I'd really love the opportunity to do more in the next couple of years.
COMPTON: On mornings around Tasmania. Please ask when menopause hormone therapy is going into the Pharmaceutical Benefits Scheme. You would well know Mark Butler that menopause is being talked about much, more widely than even a decade ago in Australian society and that is no bad thing at all. Menopause, hormone therapy, um, increasingly sought by women on their perimenopause journey. When might that therapy be going into the PBS?
BUTLER: I've asked for some advice about this. I'm really welcoming this, frankly, this new level of discussion around women's health issues that are being kept in the shadows for far too long, whether it's about reproductive health, menopause and really good treatments and supports for women going through menopause. Or, as I was dealing with over the weekend, endometriosis - which affects 1 in 7 women as well. We listed the first treatment for endometriosis - on the weekend - in 30 years onto the PBS. It's a real life changer that will impact hundreds of thousands of women. Across those three areas of reproductive health and contraception, endometriosis and menopause, we've got some really good material before us that we're looking through right now. And I really welcome the new level of community discussion about the need for the country to do better by women in these three areas.
COMPTON: Mark Butler is our guest this morning. Federal health minister, are you looking forward to meeting your US counterpart if he gets confirmed? Robert F Kennedy Jr. You talked about promoting just healthier lifestyles. That seems to be something for some of his many other interesting utterances, something he will prioritise if he gets confirmed. Will you be looking to set up a meeting with your counterpart in the US?
BUTLER: Health ministers don't interact across the globe in the same way or at the same level that foreign ministers do, and defence and so on. But there is a level of interaction that we have through the World Health Assembly and through the G20, where health ministers have been coming together, particularly to put together better arrangements for the next pandemic. Because unfortunately, we know there will be a next pandemic. America is a really important partner, as they are in so many other areas. We work with health ministers, secretaries of health across the world, no matter what their political persuasion, and I'm sure we'll do that in the future with the new US Secretary, whoever that might be. Assuming that it's Mr. Kennedy confirmed by the Senate, of course we will.
COMPTON: Let's talk about local interactions for a moment. You're about to catch up with the states’ health ministers, and people might understand the sort of complexities of overlapping responsibilities in the world of health. What is the priority issue going to be when you sit down with Jacquie Petrusma, Tasmania's new Health Minister?
BUTLER: I've already had a really productive discussion with Minister Petrusma over the phone. I haven't yet had the opportunity to meet her face to face, but we will tonight and through the course of tomorrow, at our regular meeting. We do a lot of work together as jurisdictions on not just running the health system, for example the regulation of doctors and nurses and all those sorts of thing - that sort of business-as-usual for us, when we get together. But right now, there is the question of the next hospital funding agreement. It's a really important issue for state ministers, frankly, whether they're Liberal or Labor, they're all very focused on making sure their hospital systems are operating well. We've put an additional $13 billion, at least, on the table. That was put on the table by the Prime Minister last December, but we still haven't got a final agreement. I think as health ministers, we could get pretty close to that. But the next hospital funding agreement is also tied up with the question of NDIS reforms, to the National Disability Insurance Scheme. We're not entirely operating alone. We are in a way connected to the progress of reform with the NDIS. But I fully expect to be put to the grill by Minister Petrusma and all of the other state and territory health ministers over the next 24 hours, about when they're going to see that extra money for their hospitals.
COMPTON: Can I ask you a question about NDIS reform? It's a story we've been discussing much on Mornings this week, and in fact, we're about to continue the conversation. Minister, we've been inundated with families from around Tasmania really troubled by the impending loss of music therapy for their young people and talking passionately about the critical role it plays in giving their young person the best chance in life. And you're planning to significantly reduce the funding for it, or cut it altogether. Are you reconsidering that?
BUTLER: That's not a matter that I'm directly responsible for, I know -
COMPTON: And I should mention that we're hoping to talk to Bill Shorten tomorrow about this on the programme. But you did raise NDIS reform, and I thought we'd throw it to you, given how much concern we're hearing from across Tasmania.
BUTLER: Yeah. And look, I've read reports about this. I mean Minister Shorten has been working really hard with his state disability minister colleagues, because this is a scheme that's co-run, if you like, by all jurisdictions and everyone has an interest in it running well. I'm not really directly involved in the question of musical therapy. I don't want to give some level of detail that's not exactly right and I'd encourage you to talk to Minister Shorten.
COMPTON: Just a final one that's come in from our audience around Tasmania, and then we'll let you go. Mark Butler will be in Tasmania later on today to open a new Urgent Care Clinic in Bridgewater. Mark Butler, why is it taking so long for people to get what are deserved access to Home Care Packages across Tasmania? Up to 12 months for category three, people identified with category three level needs and 12 months or more if they're identified as being category four. Is that acceptable to you?
BUTLER: No. We want to see the waiting periods far shorter than that. That's why we've put an additional 24,000 or 25,000 packages into the system that are rolling out now. And that should see the waiting periods come down. And one of the great achievements of the last fortnight of the Parliament was to pass a new Aged Care Act, which will introduce an entirely new system of Support at Home, with hundreds of thousands of additional packages. And they'll be better packages too, particularly for those higher level needs - those currently level three and level four packages - there'll be much more money available to them. There'll be better types of support. So better access to assistive technology, better access to palliative care at the end of life. We've got a real focus on this. But demand for these packages, particularly given that the oldest baby boomers in the country are really right now hitting that age of average age of entry to Home Care Packages. There's a big skyrocketing demand that we're having, it's a job of work to keep up with that. But as I said in this year's Budget, we put 25,000 additional packages into the system. And they're rolling out right now. But we do really want to get that waiting period down.
COMPTON: Appreciate you being part of mornings this morning as ever. Thank you, Minister.
BUTLER: Thanks, Leon.
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