Television interview with Minister Butler on ABC Afternoon Briefing

PATRICIA KARVELAS, HOST: Public hospitals will be fully funded in a one-year deal with Prime Minister Anthony Albanese today, committing to an additional $1.7 billion to cut wait times and to also ease pressure on emergency departments. The Health Minister is Mark Butler and he's in the studio with me. Mark Butler, welcome.
 
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Thank you, Patricia.
 
KARVELAS: You say the blame game on funding infuriates Australians and everyone watching is going to agree with that, when the states and the Commonwealth blame each other, it is infuriating and then we need to deal with wait times. So what is the guarantee around what will happen over the next year with this funding? Do you have a guarantee on how much it will cut down emergency wait times?
 
BUTLER: We know that hospitals are under really unprecedented pressure. Some of that really reflects some trends in the population. We're getting older, we're getting sicker, we've got more complex chronic disease. But they're also dealing with a long tail of COVID legacies. People weren't able to get the care they needed during that time, so they're sicker than they otherwise would be. We've also got workforce pressures that in part reflects the strain on the system during those 2 or 3 years. We do have a hospital system, like pretty much every other system around the world under enormous pressure, and the existing funding arrangements just aren't fit for purpose. The Commonwealth funding share is dropping well below 40 per cent because of the growth caps in the agreement that Scott Morrison concluded. That's why we're putting more money into the system. We know they frankly just need it. It's a partnership, not particularly with states, but more with the doctors and the nurses and the health professionals who are working as hard as they can to make this system work.
 
KARVELAS: They clearly need it but also, if you're going to hand over that kind of money, do you need some guarantees that they will be able to implement shorter wait times so that emergency departments aren't the mess that they are. Do you have that agreement?
 
BUTLER: There's a bigger negotiation underway between states, territories and the Commonwealth for a five-year hospitals funding deal. That was part of the National Cabinet decision late in 2023 that effectively tied a longer-term funding deal around hospitals to state and territory commitments to cooperate NDIS reform. There's a lot of work going on between jurisdictions to make sure the NDIS is sustainable. Build a new system of foundational supports for people outside the NDIS and do a genuine reform deal in hospitals that provides funding certainty for those jurisdictions but gets those sorts of reforms that you talk about that give the community confidence the hospital system is working as well as it can. We just haven't been able to do the five-year deal in time.
 
KARVELAS: You mentioned in your press conference today, that I was watching closely, that was because WA has gone to the election. But you've had actually lots of time. Sure, they now are starting their election, but you've had the last six months to sort this out?
 
BUTLER: Yeah, I certainly wasn't attributing the failure of a five-year deal to WA, it's just a factor. We can't do state by state deals, which we've been doing, for example, around schools. The federal legislation requires us to do an all-in deal with every single jurisdiction at once - to have everyone sign on at once. And also, the Prime Minister made it clear and was agreed by premiers and chief ministers that NDIS reform and hospitals were linked. NDIS reform is just taking a little bit longer than hospital funding and so we did pause that negotiation in agreement with the jurisdictions until NDIS reform was able to catch up. We're getting there. We're confident we'll do a deal that not only one that delivers funding certainty to states, but delivers that reform that people want from our hospital systems.
 
KARVELAS: Are the states resistant to some of the demands you're making around slowing down the growth of the NDIS and making them take on some of the responsibilities that had gone to the Commonwealth?
 
BUTLER: No, there's been really good cooperation between jurisdictions, between leaders at Premier and Treasurer level, but obviously disability ministers as well. It's a big job though. There are a lot of rule changes that have been recommended by the NDIS review that ministers are working on. The time frames that we're keen on seeing accomplished are, we think, within reach. There's also a new system of foundational supports that we need to work up as well. We're very happy with the progress, but it's just not going to allow the five-year deal to be struck, as I said, before WA goes into caretaker, which they did today. And also, before we have to have funding arrangements in place to kick in on the 1st of July. That's why we've delivered this one off $1.7 billion top up in funding that will really help state governments that are struggling with wage pressures, with activity increases on their hospitals, and achieve that central principle of Medicare: you can't have a strong Medicare without strong public hospitals.
 
KARVELAS: In some of your language you talked about Peter Dutton, his previous record as health minister, which you've been trying to make a political point of. This kicks in after the election. Are you using this as a kind of election point? Is this your point that only if Labor is elected with this one-year agreement continuing what guarantee can you give beyond that one year if it's only just a quick rollover?
 
BUTLER: Negotiations are continuing and I want to see that deal struck as soon as it possibly can be. But it would really have had to be struck by now in order to kick in on the 1st of July.
 
KARVELAS: So when do you start again? We've got an election by May. What happens then?
 
BUTLER: We'll have bureaucrats continuing to work through the next couple of months. Obviously, decisions can't be taken by government, but they'll continue to work on wording and costings and all those sorts of things.

The point I made about Peter Dutton is that you need to look at his record to understand what he would do as a prime minister. When he last had his hands on Medicare, he tried to cut $50 billion from public hospitals. He tried to walk away from that reliable partnership that is central to the Medicare system, that the Commonwealth government will help fund public hospitals, to ensure that principle that every Australian has access to public hospital care completely free of charge, is assured, is delivered. It's important that I point out what the clear choice at the next election is on health.

In terms of the status of this deal, it's been agreed by all premiers and by treasurers and heads of treasury. It will kick in on the 1st of July, unless there was a decision of a new government to take the money off the table. And frankly, given Peter Dutton's form, that's a risk. What I want the Australian community to understand and those hard working doctors and nurses in our public hospital system, there's about half a million of them, is that in a Labor government in Canberra they have a reliable partner that's still committed to that Medicare principle that's more than 41 years old.
 
KARVELAS: You've talked about the growth cap being not fit for purpose. I think it's constrained at about 6.5 per cent at the moment. What do you think it should rise to?
 
BUTLER: There are growth caps on the table in the longer-term agreements. They are 13 per cent in the first year - a very big one-off increase to allow some of that catch up.
 
KARVELAS: But 13 per cent wouldn't become the new normal?
 
BUTLER: No, it then drops into something higher than 6.5 per cent but lower than 13 per cent. We think that's about right. But every jurisdiction is going to bust through their 6.5 per cent growth cap in 25/26. That's why it's been so important that we come to the table as a reliable partner and ensure that the public hospital system is serving the needs of the community. They'll bust through that growth cap, partly because of wages pressure in the system, nurse wages, doctor wages and the like, but also because more people are presenting to public hospitals. we have an ageing population. We've got more complex chronic disease. There is still the long tail of the COVID legacy, and other parts of the health system aren't working as well as they should, because of a decade of cuts and neglect that Peter Dutton kicked off.
 
KARVELAS: Okay, I've got another health question on another issue and then I'd like to ask you about some other issues. On the review you announced, I think it was at the end of last week in relation to trans and gender diverse children and their access to gender affirming care, as it's known, puberty blockers and hormones just for those who are not across this very complex issue. You've announced a review, but you demanded of the Queensland Government that it halts its review. Will they?
 
BUTLER: I wouldn't say I demanded it of them. I had a conversation. I asked them. Ultimately, it's a matter for them. These services are delivered by state governments through clinicians employed by state governments. I'm respectful of the role of state governments, whether they're Liberal or Labor, in operating their health systems. I did say to Minister Nicholls that I thought that given that the National Health and Medical Research Council has a statutory charter, which it does under Commonwealth legislation, to put in place these clinical guidelines and that they would operate consistently across the country, that the proper thing would be maybe to park their evidence review and let the NHMRC do a national job. But ultimately, that's a matter for them. I understand they intend to continue to push through with that, but ultimately, when the NHMRC has done its work, it will be the authoritative work for the country.
 
KARVELAS: So, you're saying that whatever this other review finds, will not be authoritative and should not be relied upon?
 
BUTLER: I don't know what the Queensland Government has in mind: who's going to do it, what the terms of reference are going to be, what the authority will be. What I do say is there is no question anywhere in the health sector, I don't think, that the National Health and Medical Research Council is the authoritative body to develop and promulgate clinical guidelines. They've been doing it for decades. They have a statutory charter that they've had through Liberal and Labor governments alike, and they are one of the most highly respected organisations in the world for this sort of work.
 
KARVELAS: Mark Butler, we have to talk about Gaza. The US President says that the US wants the Gaza Strip, it wants to redevelop it. Surely you can just say that you don't think that's acceptable?
 
BUTLER: The Prime Minister has responded to this question in the last few hours, and he's made it clear again, he's not going to provide a running commentary.
 
KARVELAS: But it’s not a running commentary. It's a really controversial thing to say. Many of our viewers I know are concerned about this issue. We're talking about people of Middle Eastern backgrounds who want to hear what the Australian government's position is, is it acceptable?
 
BUTLER: The Prime Minister has made it clear he's not going to provide a running commentary. Our position is clear and has been consistently articulated by the PM and also by the Foreign Minister. We remain committed to the long-standing position of Australian governments of both political persuasions, to pursue a two-state solution, with Palestinians and Israelis living in peace alongside each other. And to that end, a ceasefire that is we're glad to see underway right now. The PM's not going to do a commentary. The Health Minister certainly is not going to do a commentary.

KARVELAS: What you're saying, I'm trying to work it out, is if you believe in a two-state solution, this idea can't possibly be part of that?
 
BUTLER: This is not a matter for the Health Minister on the day of the US president has made this announcement.
 
KARVELAS: So what do you say to people watching who are concerned about this and want to hear some differentiation from the Australian government?
 
BUTLER: Our position is clear. The job of the Prime Minister and the Foreign Minister is to articulate Australia's national position. That has been clearly consistent going back to John Howard and before, to pursue a two-state solution.
 
KARVELAS: Which doesn't involve the US controlling Gaza?
 
BUTLER: The PM's made it clear he's not going to run a daily commentary on what the US president or other national leaders do. We're going to continue to articulate our position. And as I said, you're not going to get the Health Minister to step in and do something.
 
KARVELAS: Isn't it, though, the role of the Australian government, to be really clear that we don't think these sorts of ideas are okay?
 
BUTLER: The job of the Australian government is to articulate our position, and our position has been consistent. It's articulated in accordance with what we think are Australian values. It's been a bipartisan position for a long time.
 
KARVELAS: It’s not Australian values to have the US develop Gaza?
 
BUTLER: Our job is not to provide a running commentary on what another administration or government does. Our job is to articulate our government's position and to try and progress that on the global stage.
 
KARVELAS: Mark Butler, it's been enjoyable to talk to you. Thank you for coming.
 
ENDS