MATTHEW PANTELIS, HOST: Last week I spoke with both the Health Minister, Chris Picton, and the Premier Peter Malinauskas, on the program and amongst other issues, one of course being health that comes up all the time, both increasingly frustrated is the right word, in regards to the situation in our hospitals where there is bed block, particularly in getting elderly patients out of hospital and into aged care, and they're looking at the Federal Government to do much more. In fact, that day the Premier was meeting with the Health Minister who is my next guest. Federal Health Minister, Mark Butler, good morning.
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Morning Matthew.
PANTELIS: Any resolution to this? Because this is a problem, isn't it? Aged care beds not available for elderly people in hospitals to move into?
BUTLER: That's right and this reflects some really serious challenges in the aged care sector outside of hospitals, but also in parts of the health system like general practice that we've been working really hard on over the last couple of years. Trying to make sure that people are able to get the care they need in the community rather than having to go to hospital in the first place. Part of this is about a front door strategy to try and prevent people having to go to hospital in the first place. But then, as you say, if particularly older patients end up in hospital, how are they able to move through the system and be discharged as soon as their doctors say that's clinically possible? Yes, we are working very hard, not just with South Australia, but frankly, every state government is having this challenge after ten years of real pressure on our Medicare system.
PANTELIS: Isn't the answer, though, more Federal Government investment spent to create these places and aged care beds?
BUTLER: We're working on creating more aged care beds. This is a very difficult piece of reform that we're undertaking. We're trying to have discussions with the opposition. They've been very constructive at trying to reach a bipartisan position on reform to aged care that leads the aged care sector to build all of the beds that we need, not just now, but particularly over the coming five or 10 years as the large baby boomer population starts to reach the age of residential aged care. And in the meantime, we've got a lot more funding going into, first of all, general practice to try and stop people ending up in hospital in the first place. But also a big package we announced in the May Budget to support the South Australian government and other state governments to move older patients through the hospital system more smoothly.
PANTELIS: There's the Aged Care Taskforce that has recommended strongly you move on this urgently to get more beds created. The Taskforce's final report saying that we need a new Aged Care Act, but we're all we're doing is pushing out the timelines further and further into the future in terms of doing anything. So currently in South Australia, the Minister telling me some 280 people waiting to move into an aged care bed, that's just unsustainable for the hospital system here?
BUTLER: You're right, it is. Which is why we put more than $56 million into the South Australian system in the Budget, particularly focused on moving longer, stay older patients out of the hospital system. We're also in the middle of negotiations to, frankly, just put more money into hospitals from the Commonwealth. More than $13 billion additional funding that the Prime Minister committed at the December National Cabinet meeting he had with Premier Malinauskas to better support our public hospital system. But in terms of the Aged Care Taskforce, you're right. This is a very important opportunity for once in a generation reform of the aged care sector. And as I said, we're having very constructive discussions with the opposition led by Anne Ruston, a South Australian Senator who has responsibility for this area in the opposition federally, because we know this is important reform, but it's also sensitive and is always better done on a bipartisan basis than potentially running into a political storm.
PANTELIS: When's it going to happen, though? When are we going to see that bed block ease next year?
BUTLER: It's not going to be switched on or off simply. As you said in your introduction, I had a meeting with Chris Picton and his lead official, the head of SA Health last week. And as we're doing in some other states, we're working to a system where we can seriously case manage every individual patient to see whether we can find them an aged care bed. That's hard yakka. It really is a hard slog that frankly, our officials just have to keep working at together. Working between the Commonwealth, which has responsibility for aged care, and the SA Health officials who are running our hospital systems. But as I said, we're putting more money into the very innovative ways, frankly, that SA Health is thinking of, first of all, stopping older patients coming to hospital in the first place if they can be properly cared for out in the community. We've got hospital outreach teams that are now going out visiting aged care facilities where someone takes a turn for the worse and trying to give them the care that they need there, rather than simply putting them in an ambulance and sending them to hospital, which often means they stay there for weeks and weeks, if not months and months.
PANTELIS: Can we talk about the other issue that people will ring this station about during this chat and have over the last few weeks, the gap at doctors clinics is just widening. One person who works here tells me her mum, who's a pensioner, is charged $100 as a gap. Other people ring in, and I've heard people on air and people into this programme say $50, $60, $70 regularly is the gap that's just becoming unsustainable. So therefore, people are turning up at hospitals. Bang, the ramping problem gets even worse than it is as a result of people trying to save that $50, $70, $100 bucks. That's unsustainable long-term?
BUTLER: And that's why in last year's Budget, we invested the most that's ever been invested in bulk billing. We tripled the bulk billing incentive and already that has meant a very substantial increase in bulk billing rates. Now, those rates were in freefall when we came to Government, because the Medicare rebate had been frozen for most of the last decade. But we've delivered the two biggest increases to the Medicare rebate in 30 years and on top of that, we've tripled the bulk billing incentive, particularly for pensioners, for concession card holders, and for kids. Last month alone in June, the last recorded month, that delivered an additional 900,000 free visits to the doctor, 900,000 additional visits to the doctor in May. In South Australia, we've seen the bulk billing rate in just seven months climb by almost 6 per cent. Not only will we stop the decline, the free fall that we inherited when we came to Government, you are starting to see that bulk billing rate climb in South Australia and in every other state, and territory. Now there's more to do but these are the green shoots of recovery, but we are starting to see a turnaround in bulk billing, which for Labor is the beating heart of Medicare. On top of that, we've also rolled out a network of Urgent Care Clinics, particularly for people who need urgent care but don't necessarily need to go to the hospital emergency department. That's delivered well over 600,000 services in just 12 months, every single one of which was fully bulk billed.
PANTELIS: So to those people that are still paying a gap what are you saying? Just wait and you'll see those benefits down the track at some stage, because people are still paying it?
BUTLER: I know, and again, I just want to be honest with your listeners, Matthew, a decade of cuts and neglect we cannot turn around overnight, but we are starting to see those green shoots of recovery. Bulk billing is turning around. Urgent care services are working fantastically well across the country, delivering services seven days a week, one in three of them to kids often who fall off their skateboard or get injured on Saturday or Sunday sport. Otherwise, these people would be lining up at hospital emergency departments if their 12-year-old breaks their arm coming off a skateboard. Instead, they're getting high quality care seven days a week, fully bulk billed. I know that we've not been able to turn things around overnight, but we are starting to see these green shoots of recovery because for a Labor Government, there's nothing more important than strengthening Medicare.
PANTELIS: The GP care clinics around the place, what do you say to the AMA that says that's just fragmenting the health system, that, okay, they're performing a role, but they're not ultimately helping anything because it's just placing more pressure on GPs, which is where people end up after that emergency.
BUTLER: That's not what the 600,000 patients who've gone through these clinics are saying to us. They're saying that the vast bulk of them are saying if the clinic wasn't available, they'd have ended up at a hospital emergency department. Remember, a third of these are on weekends. On the weekdays, a significant number are after hours. These are people who need care urgently. It's not just standard general practice care. This is urgent care because there's been an injury, there's been a deep laceration, there's a very serious respiratory illness. The vast bulk of these people say otherwise, they'd go to a hospital emergency department. It's not fragmentation in the sense that these clinics I know are also passing the report back onto the person's usual GP. Their usual GP is very clear about the service that they got in these Urgent Care Clinics. This is a very important gap in the Australian healthcare system that we have started to fill with these Urgent Care Clinics. Most countries we usually compare ourselves to have this sort of service, a service sort of in between a standard general practice on the one hand, and a fully equipped hospital emergency department on the other.
PANTELIS: Not enough GPs. What are we doing to fund more doctors’ places? And this is somewhere else that the Federal Government needs to spend some money, isn't it? To create more training positions for GPs? Ultimately GPs, doctors in general?
BUTLER: Absolutely, it wasn't too long ago, maybe 30 years ago, Matthew, that about one in two junior doctors or medical graduates chose to become GPs. Now it's only one in seven. One in two, down to one in seven. That's going to have an impact. We know that without a well-functioning general practice system, which is the bedrock of a good healthcare system, we're going to see these impacts continue to reverberate through our hospitals and through aged care and suchlike.
I've got no higher priority than rebuilding general practice. I'm really pleased that this year, 20 per cent more junior doctors are choosing general practice than they did last year. Again, green shoots of recovery. I'm not pretending that that's changing the world overnight, but we're going back in the right direction. Part of that, I think, is those young doctors and those general practitioners who work so hard out in the community who dealt with a decade of cuts and neglect finally, see, I hope, a government in Canberra that values them, that recognises that general practice is the bedrock of a high quality health care system.
PANTELIS: Minister, with great respect, you talk about how health is so important to the Australian Labor Party, without funding the aged care beds, without bringing on more GPs, without creating the bulk billing that we were used to, years ago with Medicare, without that being in place sooner than later it's all just words floating through the aether. If it doesn't happen and people are paying $50 to $100 bucks to go visit the GP in a gap if we don't have enough GPs. And you look at the College of General Practitioners saying in years to come, we're going to be short some 10,000 GPs if we've got bed block, because there's not enough aged care beds. Well, the system falls down and your words ultimately are meaningless?
BUTLER: I've tried to be honest with your listeners and with other Australians, Matthew, that the damage done over the last decade can't be fixed overnight, but we've put the biggest investment ever in bulk billing. And already in just seven months that's delivered millions of additional free visits to the doctor.
We're rolling out the network of Urgent Care Clinics that are delivering hundreds of thousands of bulk billed urgent care services. We have seen an increase of about 20 per cent in junior doctors coming back to general practices. I mean, we need to build on that I completely agree with you, Matthew. We've invested billions of dollars into aged care, which is putting nurses back into nursing homes. Now yes, we need to do the next stage of aged care reform, which is why we're working hard with the opposition to try to come to an agreement so that's got bipartisan support, doesn't just chop and change election to election. But I want to reassure your listeners that our Government is so focused on this. We want to support our public hospitals better, which is why we've put $13 billion additional money on the table with state premiers like Premier Malinauskas and the rest of them. Because we know turning this around is not easy, but it is absolutely essential. We've got probably one of the best healthcare systems in the world, but we can't rest on our laurels. We have to work hard to make sure it stays that way.
PANTELIS: Appreciate your time this morning, Minister.
BUTLER: Thanks, Matthew.
PANTELIS: Mark Butler, the Federal Health Minister, on those issues.