Television interview with Minister Butler and Kieran Gilbert, Sky News - 1 February 2024

KIERAN GILBERT, HOST: Today marks 40 years of Medicare, the health insurance scheme opened its doors on February 1, 1984, under the Prime Ministership of Bob Hawke. Universal public healthcare was originally brought in by the Whitlam Government nearly a decade earlier under the name Medibank. That model was scaled back and ultimately dissolved under Malcolm Fraser. 40 years on, Prime Minister Albanese has credited Medicare as the reason Australia has one of the best health systems in the world. Let's bring in the Health Minister, Mark Butler, who's live from the electorate of Dunkley today, an important race there in terms of the byelection a few weeks away. But on Medicare, Minister, we look at the improvement in bulk billing in the last couple of months off the back of the tripling of the bulk billing incentive by Labor. Has it turned the corner in your view?
 
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Well, they're early days, Kieran, but the important thing to stress is our first job was to stop the slide. When we came to government, bulk billing for GP visits, which is such an important part of Medicare, visiting your local GP, bulk billing for GP visits was in freefall and it was accelerating. And we were being told by doctors groups that if something's not done, bulk billing runs the risk of becoming a piece of history, rather than the core beating heart of Medicare. So, what we saw since the announcement we made in the May Budget is that slide start to stop. And really pleasingly, over the last couple of months, since the money actually started to hit general practices, we've seen an increase in bulk billing. 360,000 additional free visits to the doctor in just two months, in November and December. But really pleasingly, we've seen increases in bulk billing in some of the markets I was most worried about. Tasmania has had some of the lowest bulk billing rates for a very long time. Their bulk billing rate increased by almost 6% in those two short months. Most of the additional free visits are in regional Australia, where it is harder than in the cities, perhaps, to get in to see a bulk billed doctor. So there's more to do, Kieran, no doubt about that. But the situation we inherited after ten years of cuts and neglect to Medicare was parlous and we've managed to stop that slide. We want to see bulk billing for GP visits, particularly to continue to increase.
 
GILBERT: One of the key elements to it is clearly, and I know you've spoken about it, is to get more young medical graduates into general practice. Talk about a slide: there's been a dramatic slide in recent decades, hasn't there, from 50% of medical graduates going into general practice to much, much less than that these days.
 
BUTLER: You're right. Not too long ago it was 1 in 2. 1 in 2 medical graduates will go into general practice, the rest would go into the other specialities: surgery, anaesthesia, cardiology, psychiatry and the rest. It's now 1 in 7, so only 1 in 7 medical graduates are choosing general practice. This is a worldwide phenomenon. We're seeing a shift away from general practice right across the world, particularly the developed world. It's something countries across the world are grappling with. But the PM and the Premiers and Chief Ministers as a National Cabinet, have particularly tasked me and my Health Minister colleagues with lifting that rate. It's not going to be easy, frankly, but the first thing we thought was important was to get a government in Canberra that demonstrably saw general practice as the core, as the backbone of our health care system. That's why unapologetically, the vast, vast bulk of our investment in strengthening Medicare in last year's Budget was targeted at general practice. We've got to get that back up and running, rebuild general practice, rebuild bulk billing in general practice. Because we know if general practice starts to slide, that reverberates right through the system: people end up at the hospital ED or just getting sicker and sicker. So, rebuilding general practice unapologetically was our priority.
 
GILBERT: And I guess to give certainty to GPs about the trajectory of the bulk billing incentives is a big part of that. As we mentioned, you tripled it late last year. There's been a 2% increase in bulk billing rates. Does it really just come down to more dollars? Is that what we're talking about here for GPs?
 
BUTLER: That was the first thing. We needed an injection of funds into general practice. I mean, the freezing of the Medicare rebate that Peter Dutton kicked off as Health Minister really effectively ripped billions of dollars out of primary care. We needed an injection of funds. That's what the College of General Practice and many others told us. Now, tripling the bulk billing incentive effectively means for a standard consult, a standard visit to your general practitioner, their income for bulk billing that visit increases in the major cities by more than a third. So, it's a really big increase in the income of general practices. But it's even bigger out in the regions. Bulk billing a standard consult now earns you 50% more as a GP than it did before the 1st of November. So we're really hopeful that sends a strong message to general practitioners that we value the work that you do, and we want you to bulk bill as many of your patients as possible, particularly pensioners, concession card holders and kids who are brought in sick by their mum and their dad.
 
GILBERT: Just a couple of other matters, quickly, the Human Rights Commission calling for a Royal Commission into COVID. A couple of other experts saying that as well. Is the government open to revisiting its position when it comes to a Royal Commission. Particularly, the concern is that your approach doesn't necessarily scrutinise the states’ response.
 
BUTLER: A couple of things to say about that here. Firstly, I heard Olivia say that we promised a Royal Commission before the election. That's not right. What we said, the PM and I said, is that there needed to be a deep inquiry, "a Royal Commission or some other form of deep inquiry". And we've set up a group of very eminent public policy and health experts, as well as a health economist, to inquire deeply into our response as a country. Obviously, the stuff that was initiated by state governments, the broad lockdown arrangements, density requirements, all of those sorts of things are going to be considered deeply by this Covid inquiry. But we want this to be a sober, expert process. We don't want it to be, you know, a witch hunt or a bit of a show that rakes over every single one of the thousands and thousands of decisions. Otherwise, we just won't learn the lessons of the pandemic in the sober, evidence-based way that I think we need to. Now, no one has actually pointed to anything that this inquiry can't consider, like any piece of evidence. All of the relevant decision makers who media suggested might not be part of the inquiry have indicated that they're more than willing to give evidence to the inquiry. I'm not aware of anyone who's refused to participate in this inquiry. I'm really confident that once it's done, people will be very satisfied with the sober, evidence-based way in which they've gone about their work.
 
GILBERT: Health Minister, Mark Butler joining us from Dunkley today. Thanks. A big day for the health system. We appreciate your time. Thanks.
 
BUTLER: My pleasure Kieran.