Television interview with Minister Butler, Sky News – 26 August 2025

ANDREW CLENNELL, HOST: Another big issue for the Government this week has been the announcement that the Government is going to take autistic kids off the NDIS in order to facilitate budget repair. I spoke to Health Minister Mark Butler earlier. Well, thanks for your time.
 
MARK BUTLER, MINISTER FOR HEALTH AND AGEING, MINISTER FOR DISABILITY AND THE NDIS: Pleasure, Andrew.
 
CLENNELL: How confident are you that you can get the NDIS to a 5 to 6 per cent growth rate a year? And can you reform it to cut it even more?
 
BUTLER: It's come down from 22 per cent where it was when we came to government three years ago, an extraordinary growth rate for a social program, on track to get to 8 per cent next year. We've still got more to do, but we're on track to get it down there. But I said last week, that's not a sustainable position for a social program going forward. The current projections are 8 per cent as far as the eye can see. Aged care is growing at 5 per cent in spite of a very significant ageing of the population. Medicare is growing at 5 per cent. We've got to do the hard work to get it down something closer to that.
 
CLENNELL: Can you give us an example of what might happen to a mild or moderately autistic kid who's on the scheme presently, how their life will change as a result of this?
 
BUTLER: If they're on the scheme presently, they'll stay on the scheme. If they're enrolled to the scheme between now and 2027, which is when I'm aiming for Thriving Kids to be fully up and running, they'll stay on the scheme then as well. But for kids who are being considered after 2027, the Thriving Kids program is intended to be much more broad-based, much more mainstream, located in services that families will be really familiar with infant and maternal health systems that they touch very significantly in the first six, 12, 18 months of life. Primary care, early childhood settings, community settings, so much more, what it was before the NDIS.
 
CLENNELL: Could this mean a rush from people by 2027 to get on the NDIS, this deadline that you put up? Surely.
 
BUTLER: Look, there might be. That sometimes happens in the nature of things but there are some natural sort of constraints on that in terms of getting a diagnosis. One of the things parents complain about very understandably is the only way into the NDIS is to get a diagnosis in the first place, which can take months and months and months of time on a waiting list and then cost thousands of dollars. There is a real equity issue there as well as a time lag. What we want is a system that's easy to access for parents, that's calibrated to the needs of the child, readily accessible in community settings that they're familiar with, and takes account of some of the best practice that people have been talking about, frankly, since my Press Club address, which are often not the one-on-one individual therapy that you see so much in the NDIS.
 
CLENNELL: I had Allegra Spender on the show yesterday, and she said the NDIS should be cut back to GDP growth, so I guess 2 to 3 per cent at the moment. Seems sensible. Is that achievable?
 
BUTLER: I think that's really hard to achieve. I thought carefully about the numbers I talked about at the Press Club, took advice on it. The key indicator is the general inflator for this sort of a program. We see that in health generally. On top of that, though, there is a bit of ageing of the population within the NDIS, which means they need more services than they might have when they were a little younger, and then there's population growth on top of that. They're the sorts of things that in social programs like aged care, Medicare, and now the NDIS we start to think about in terms of a reasonable growth rate.
 
CLENNELL: Are you concerned the states won't play ball in relation to Thriving Kids, and what happens if they don't?
 
BUTLER: The first sort of thing practically is to say is that this is part of a national grand bargain that includes hospital funding as well as broader NDIS reform. So, I mean, they made a commitment more than 18 months ago to accept a recommendation from the NDIS review to set up this sort of a system not just for kids, but in the longer term for adults with serious psychosocial disability who are outside the NDIS as well. That commitment is connected to the promise we've made of negotiating an ongoing five-year hospital funding deal. But beyond that sort of practicality, I think states recognise we've got to do something in this area. This is an area where they've got a long history of providing services at different ages.
 
CLENNELL: In that National Cabinet Agreement in 2023, the commitment was the Commonwealth would lift its health funding share to 42.5 per cent by 2030 and 45 per cent by 2035. Are you still committed to that?
 
BUTLER: There were two elements to the deal that was put on the table. One was that as a contribution rate from the Commonwealth. But very importantly, our contributions as a Commonwealth have always been subject to growth caps. We don't run hospitals. We don't have control over some of the cost rises you see, whether it's through wages or the purchase of equipment. The only constraint that we can put in place on Commonwealth exposure is that growth cap. Yes, there was that 42.5 per cent ambition by the end of the decade, but it was always subject to a growth cap in Commonwealth funding as well.
 
CLENNELL: So you might not need it?
 
BUTLER: Obviously, there have been changes in the hospital pricing over the last 18 months, which slightly changed that equation. I think states are aware of that. They've been talking about that publicly as well. But I've got a responsibility, as does the Treasurer and the Finance Minister, to constrain Commonwealth exposure in hospital funding as we do in the NDIS or Medicare or aged care.
 
CLENNELL: So it's been put to me the share of Commonwealth funding actually continues to decline from 43 per cent 2020 to 35 per cent this year and is the lowest in 10 years. Do you accept that?
 
BUTLER: The Commonwealth contribution rate is essentially swimming against the tide of very big price increases in the hospital funding system. A lot of them are driven by wage deals that state governments are agreeing to, which we have no line of sight of or certainly don't really have any control over. But I will say that this year, for example, we've increased the Commonwealth contribution to the hospital system by 12 per cent across the country. That's the biggest increase that I can remember the Commonwealth making to hospital funding. Now, I get that costs are going up, I get that states are agreeing to these wage deals that are feeding some of those price increases, but the Commonwealth increase in terms of our funding for hospitals is up 12 per cent this year.
 
CLENNELL: Was the NDIS announcement deliberately timed around the roundtable to say, we're talking about tax reform here but we're doing something about spending here?
 
BUTLER: I'd actually set a date for the Press Club some time before, but I think the coincidence of those two things was really important. One of the days of the budget roundtable, the economic roundtable sorry, was about budget sustainability, and everyone, whether it's economists or state governments or just people in the street that I'm talking to, are worried about the growth in NDIS costs. There's still a lot of support for this scheme. People recognise it has transformed the lives of hundreds of thousands of people with a disability.
 
But I also talked last week about some research that shows that while still seven out of 10 Australians love the NDIS and what it's done for people with disability, seven out of 10 think it's costing too much, and it's riddled with inefficiencies and dodgy providers. Even six out of 10 said it was broken. We've got to square that circle, bring that social licenses aspect of the scheme back onto the rails.
 
CLENNELL: It's four months since the election and Peter Dutton's political body isn't even cold and you're saying we're doing NDIS cuts and looking at tax. It's pretty soon after you're sort of changing direction as a government, isn't it?
 
BUTLER: This is growth. We're talking about growth in a scheme. I said last week, there's not a significant or material change in disability prevalence in the community. This scheme is now fully rolled out, it’s supposed to be fully rolled out by 2020. The Productivity Commission said last decade that once it was fully rolled out, you should really have a growth in the scheme's costs of around 4 per cent. Now, I think it should be probably higher than that given some of the ageing in the population covered as well, but we're talking about how quickly it grows, not cuts, but how quickly it grows. And frankly, there are enormous amounts of inefficiencies in this system - whether it's the regulation of providers that is far too skinny; the pricing in the system; the evidence base for some of the services that are being provided. I'm very confident we can get this scheme under control in a pricing sense without compromising services to people with disability.
 
CLENNELL: This is a bit left field. Is the heavy use of iPads by small children partly responsible for more kids developing difficulties, which have seen them go on the NDIS?
 
BUTLER: I'm not the right person to ask about that. Firstly, I'm not a clinician, I'm not an expert in that area.
 
CLENNELL: But have you had any advice to that effect?
 
BUTLER: I think I said last week, again, there's a lot of advice and debate, as there should, be about the impact of screen time and what's on screens, particularly social media on the mental health of young Australians. Now, whether that goes into some of these other conditions, I'm not qualified to say that. But I think we are, as a country, trying to get ahead of the curve on this stuff. We're leading the world in many respects on this. But I know in the area of mental health, for example, that it's still the subject of quite considerable debate among researchers and clinicians.
 
CLENNELL: Is it time the Government looked at an advertising campaign to encourage adults to get off their phones, their screens? How worried are you about that phenomenon in our society? I mean, you're looking at the under-16s with the social media ban, but what about more broadly?
 
BUTLER: Obviously we're worried mostly about kids and I think some of the things we've done already have transformed behaviour in school yards. If you talk to principals and teachers, since phones have been taken off kids it has transformed learning behaviour, but importantly as well, the way in which kids interact. I was driving past a school bus, which were always pretty robust environments it certainly taught you a thing or two. But the idea of seeing kids on school buses just looking at their phones instead of interacting in that really important way of socialisation, I found really depressing.
 
CLENNELL: But I see adults doing that.
 
BUTLER: Yeah, but then also you see - I've got to say, as a parent I think it's a really important lesson for every parent about not being on your phone while you're with your kids. Like, I think there is something there for adults to think about, not just in terms of your own health, but the example that you are setting and the way in which you're interacting, engaging and communicating with your kids. Now, I don't think it's really for politicians to tell people how to parent, but this is a new phenomenon. We do have to sometimes slap ourselves a little bit, sort of wake up to what this new phenomenon is doing to the way in which, including as adults, we engage with other people around us, including our children.
 
CLENNELL: In a way, the PM hasn't done you any favours in giving you this tough NDIS portfolio on top of Health, has he?
 
BUTLER: I'm a really strong supporter of bringing these three portfolios together. I argued the case for it. I’m delighted that it's happened.
 
CLENNELL: You wanted it?
 
BUTLER: Means a little bit more work. I wanted it, I did.
 
CLENNELL: Alright.
 
BUTLER: I think having Health and those two big adjacent care sectors of aged care and disability care together is the right way to manage these portfolios, explore the opportunities but also deal with the many challenges. There's so much overlap in terms of the services provided, the workers providing them, the organisations that work in the sector and there's a lot to learn from each other. We've talked about some of the things that disability has to learn from aged care and Health in terms of the regulation of providers, the assurance people have that the right services are being delivered. Also, there's a lot to learn in other sectors from disability, the choice and control that gives to participants, the sense of empowerment, I think is a good signal for other sectors as well.
 
CLENNELL: What happens if the states just say, no, we're not signing up to this Thriving Kids thing? That must be your worst fear?
 
BUTLER: I mean but this is all connected to hospital funding. They need us for hospital funding as well. That's, in a way, the beauty of this grand bargain. We need them to get the NDIS into shape. I talked about the NDIS entering its adolescence. That's a wonderful time, but also a time where you really need to watch the risks and the challenges and have a judicious dose of supervision and management of your teenage children. We do need to bring this scheme back on track and the states need us to partner with them on some of the pressures on hospitals.
 
CLENNELL: The Medicare target you set at the election, 90 per cent of GP consultations bulk billed by 2030, are you confident of meeting that target?
 
BUTLER: It's a tough target but I'm confident we'll meet it. We worked very carefully on getting those sums right. We know, because we have access to every little bit of billing that a general practice does, every one of them, the thousands of them in the country, what they bill Medicare and what they bill as a gap fee. We know that three quarters of them will be better off if they move to 100 per cent bulk billing, they'll be financially better off. Obviously, their patients will be, but they will be as doctors and as practices. For those that aren't better off, they'll still probably stay at about 70 per cent bulk billing. Now, you do those sums and you get to 90 per cent bulk billing over the course of the coming few years.
 
It's tough though, I accept that. We've had to turn this around. It worked when we increased the bulk billing incentive for concession card holders, that rate is now over 90 per cent again, but it's sliding still for people who don't have a concession card. And many of them are not well off and it means they're not going to see a GP because of cost.
 
CLENNELL: Just finally on tobacco excise. Now, is it time to drop the rate? Chris Minns wants it dropped, the New South Wales Premier. The Budget Paper said, having it at such a high rate actually costs the Budget $4 billion a year. And it's obviously led to multiple illegal tobacconists and organised crime. So, is it time, even though you might think that's a bad example to set, to drop that excise rate?
 
BUTLER: Dropping the price of cigarettes I fear on all of the evidence, will lead to more people smoking. And I don't accept the sort of -
 
CLENNELL: They're smoking illegal smokes.
 
BUTLER: Yes, but the rate of smoking, we're confident, is still going down. And the biggest tool in the toolbox, if you like, has been the price change over the last 15 years. Now, what I do know is that has achieved very good public health outcomes. What I don’t accept is the direct causal connection that you’re making between the increases in the rebate, that largely happened under the former government, they increased excise by over 200 per cent. We’ve increased it since we came to Government by 24 per cent. Now, what’s happened is, organised crime has increased its operations in the illicit tobacco market. You see that in countries with much cheaper legal cigarettes than we have, in the US and other jurisdictions as well.
 
What we’ve got to do is crack down on the criminals. This is the biggest threat right now to our public health objectives of driving down smoking rates. I’m under no illusions about the size of this threat, but I also don’t agree that simply reducing the price of legal cigarettes is going to fix. It’s just not. We’ve got a bigger problem with the role that organised criminal gangs are playing in this market.
 
CLENNELL: Mark Butler, thanks so much for your time.
 
BUTLER: Thanks, Andrew.