Television interview with Minister Butler, Sunday Agenda - 23 February 2025

HOST, ANDREW CLENNELL: Live now to the Health Minister, Mark Butler in Tasmania. Mark Butler, thanks for joining us. I see you got a Medicare sign behind you. Angus Taylor just said you're returning to Medicare to where it was. Apart from the fact they're going to match you, which I was surprised by. But they say that in terms of the full national accounts of all Medicare visits: 2012, the GP bulk billing rate was 82.5; 2014, 84 - and that was when Peter Dutton was health minister - and in 2019, 86. Yet as of December 2024, it was just 77.7%. Have they got a point?
 
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: The first thing I'd say is don't take health policy advice from Angus Taylor, Andrew. The second thing I'd say is that, frankly, they were cooking the books on bulk billing data. The data that Peter Dutton trumpets all the time was called by the College of General Practitioners “skewed” and “misleading”. We've been very transparent about the bulk billing data that we have published on a regular basis since we came to government. It's by state, it's by region, it's by suburb. It's all out there for people to see - for the first time. We didn't have that before we came to government.
 
But the point I'd make is that Peter Dutton in 2014 tried to abolish bulk billing altogether. And when he couldn't do that, when the Senate blocked him, doctors opposed him, instead what he set about doing was effectively to strangle bulk billing slowly by freezing the Medicare rebate. Now, to their credit, Australia's doctors hung on for as long as they possibly could, after six years of having their income frozen while their costs continued to rise. But at some point, the thing broke and we inherited a situation when we came to government of bulk billing being in “free fall”. They're not my words. They were the words of the College. Bulk billing was in “free fall”. So I'm not going to take lectures on bulk billing from a guy who tried to abolish it. Peter Dutton tried to abolish it. The situation we face now, with bulk billing in free fall, out of pocket costs soaring, and more Australians choosing not to go to the doctor because they can't afford it, is a direct result of a deliberate decision made by Peter Dutton.
 
CLENNELL: Alright. In 2019, these figures, national accounts of all Medicare visits in Australia, was 86%, it's now 77%. What do you think the real figure was in 2019? If you say, and you have made the accusation, a serious accusation, that they, quote, cooked the books?
 
BUTLER: It was hard to know because they weren't transparently publishing what really matters to Australians, and that is: the bulk billing rate for GP visits. They sort of bolstered the numbers with all of these other things, particularly during COVID. I know you're talking about 2019, but particularly during COVID, with all of those COVID vaccinations and other things, that by law had to be bulk billed. So what we did when we came to government was directed the Department to publish data on GP visits, and not all the pathology and all the other things that happen in the Medicare system, all of the Covid vaccinations that happened during the pandemic. And what that confirmed is what the College of GPs said was: that after six years of a rebate freeze, income being frozen by doctors, that bulk billing was starting to slide quickly. Now, the investment we made in 2023 to triple the bulk billing incentive paid in respect of pensioners and concession card holders did the trick. It stopped that slide for that cohort in the community. And now bulk billing rates for that group, pensioners, children and cardholders, again is comfortably above 90%. But it is still sliding for people who don't have a concession card, who've never got any support to be bulk billed through the Medicare system. And today we're announcing, for the first time all Australians will get bulk billing support through the Medicare system, and general practices for the first time will get support to become fully bulk billing.
 
CLENNELL: Is the hope of this announcement that pretty much all Australians won't have to pay to visit the doctor anymore.
 
BUTLER: Every Australian will get that bulk billing support. Every practice will have the ability to receive incentive payments to become bulk billing practices. Our modelling suggests that about 4800 general practices will be better off if they take up our offer. That's a tripling of the number of bulk billing practices that currently exist in Australia. For the first time, every Australian, whether you have a concession card or not, will get support to achieve that core promise of Medicare, which is that every Australian should have the right to access the world's best health care, no matter what their means.
 
CLENNELL: Do you accept it looks like you're buying votes here?
 
BUTLER: No, I don't accept that at all, Andrew. That's a ridiculous suggestion. For 41 years, the Labor Party consistently has defended bulk billing as the beating heart of Medicare. You would never, surely, expect the Labor Party to sit back and see that core promise, bulk billing, start to unravel because of a decade of cuts and neglect that we've seen. Of course a Labor Government is going to do everything we can to restore bulk billing, because we know that when people are faced with the choice of paying some other household bill or paying to see a doctor, often they won't go to see the doctor. And frankly, we end up paying anyway further down the track with people sicker than they otherwise would be, often accessing a more expensive part of the healthcare system, like an emergency department in the hospital. So of course a Labor Government, which has defended Medicare against year after year of attack by the Liberal Party - that's never basically supported the core philosophy of the system - of course, we're going to act.
 
CLENNELL: 8.5 billion over four years. At MYEFO, Jim Chalmers announced decisions taken but not yet announced of $5.5 billion. Now, as I understand it, some of this money is out of that provision of funds. How much?
 
BUTLER: All of that will become clear at the next Budget Update. That's the usual way in which we manage these things. I will make the point that because fewer people are going to the doctor now, in MYEFO we also reported that there was a reduction in MBS expenditure because fewer people were going to the doctor. So this is about not just delivering on that core promise of Medicare - access for all, no matter what their means - but it's also making sure that there's a policy that's not just good for people's hip pocket, it's good for health. That people feel that they can go and see their doctor when they need to, and that their government will be supporting them to do that free of charge. That's really been the driving force behind our cheaper medicines policies. When we heard that too many people weren't getting scripts filled because of cost, you know, we've saved them more than $1.2 billion in out-of-pocket costs at the pharmacy. That's been good for their hip pocket. That's put downward pressure on inflation. And importantly, it's been good for their health.
 
CLENNELL: Minister, won't this send more people to the doctor? You're suggesting it costs less because there's less people in recent years going to the doctor. But this will send more people to the doctor, won't it?
 
BUTLER: It means that people who are currently choosing not to go to the doctor because they can't afford it, will go to the doctor. People don't go to the doctor for fun, as you know, Andrew. They go when they're sick and they go when they feel they need some support and care from, frankly, the world's best healthcare system.
 
CLENNELL: Is there any modelling on how many more? Is there any modelling on how many more people might go to the doctor because of this measure?
 
BUTLER: We've done modelling that shows there'll be 18 million additional free visits to the doctor almost because of this measure. We've seen a substantial reduction in the number of people feeling that they can go to the doctor when they need to because of affordability concerns that, unsurprisingly, has been particularly acute in lower income households. Young Australians aged between 16 and 30, the number of them not going to the doctor when they need to because of cost has tripled in recent years. We will see more people going to the doctor. And that is why today also, we're announcing substantial investment to increase the number of doctors, the number of medical graduates overall, but particularly the number of graduates who choose to go into general practice. We've seen that climb over the last couple of years. This year, we've got more junior doctors in general practice training than we've ever seen in our country's history. We've got more GPs coming in from overseas, from the UK, from Ireland and New Zealand, fast tracked because of changes we've made. We do need more doctors in the system. We need more advanced nurses in the system. We've got funding for that delivered today, but I do want to see a situation where people go to the doctor if they feel they need to.
 
CLENNELL: Minister Butler, I just want to ask again about this decisions taken but not yet announced. So I don't understand you promising $8.5 billion. Why you can't tell us where the money is coming from, is this leading to higher deficits? Is it because the government's banking extra revenue from somewhere else? Why can't if there is a decision taken but not announced component in this, can't you tell us it's 1 billion or 3 the whole 5 billion that's coming out of that?
 
BUTLER: I can tell you, Andrew, that of course a number of measures are going to be rolled out over the course of coming weeks. And the way in which they're accounted for will be made clear in the usual way at the next Budget Update. That has always been the way in which governments and oppositions have operated, and that's the way that we'll be operating as well. We have run a very responsible budget over the past two and a half, three years that we've been in government. You know, we've delivered two Budget surpluses. The former government managed none, out of nine, in spite of promising that every one of their Budgets would be in surplus. So the Australian people can be confident that we are managing this Budget responsibly. The cost of living relief that we have put in place has been responsible, has been designed to put downward pressure on inflation as much as it possibly can and to achieve as much as possible a dual purpose - which is particularly what we've done in health - downward pressure on costs, downward pressure on inflation, while also achieving good health outcomes for Australia.
 
CLENNELL: Is the next Budget Update an economic statement as opposed to a full Budget?
 
BUTLER: That's a matter for the Prime Minister. We've got a Budget set on March 25th. I'm a member of the Expenditure Review Committee, we've been working towards that. Ultimately, whether there's a Budget or whether there's an election, obviously is a matter for the Prime Minister. We're working as ministers to ensure that either of those options deliver the best outcome for the Australian people and the Australian Budget.
 
CLENNELL: But if so, there's not a full Budget, there'll be an economic statement by the Treasurer.
 
BUTLER: The usual arrangements will apply, Andrew.
 
CLENNELL: Do you expect the election to get called next Sunday?
 
BUTLER: I think all of us who have an interest in politics speculate a bit about when the election will be. I've been around long enough - as have you, Andrew - to know that ultimately that's in the mind of the Prime Minister. He'll make that decision. And our job as ministers is to make sure that we're in the best position possible to offer a compelling vision to the Australian people. That's what I've been working hard to do in health: to strengthen Medicare, to deliver cheaper medicines, to do things like we did a couple of weeks ago for women's health, which has been neglected business for far too long. We're working hard on doing that. The Prime Minister will call the election when he calls it.
 
CLENNELL: You're a South Australian MP as well as Health Minister. We saw this $2.4 billion announcement during the week in relation to Whyalla Steel. Is this sort of bailout the best use of taxpayers money, and particularly when there's some doubt about the use of green hydrogen for green steel as the government is trumpeting?
 
BUTLER: The global steel industry is going through a transformation. It's not going to be an overnight transformation, but moving to a cleaner way of producing what is such an important product for the global economy is something I know has been underway for many years and will continue for many to come. Our immediate challenge, though, is securing that second blast furnace. It is just so important, not just for the South Australian economy, but for the national economy as a whole. It produces structural steel. That's important in construction, important in rail construction and things like that. No government can sit back or sit on the fence, like I heard Angus Taylor do in your interview earlier, and pretend that this is not a core issue of national interest. Now we're working very closely with the Premier of South Australia, Peter Malinauskas, who's been terrific in this area, forward leaning. He recognises that this is a critical part of the South Australian economy, but important more broadly for the national interest.
 
CLENNELL: And finally, can I just ask about this live firing incident involving Chinese warships between Australia and New Zealand? How concerned should we be about this after there was again live firing yesterday?
 
BUTLER: Our Australian Defence Force is conducting surveillance exercises to ensure that we have a good line of sight on these operations by the Chinese. They're in international waters, just as we operate in international waters, including up in North Asia. It's our right to do that. It's China's right to do that. It's the right of every nation to do that. But of course, we are watching closely. We have maritime and aviation assets in the area. The ADF published their understanding of this as much 10 days ago. And the Defence Minister has been in the media pretty regularly, reassuring Australians that we have a good line of sight of this, obviously. We're engaging with China at diplomatic level, both here in Canberra but also in Beijing. And as I think you know, Andrew, Foreign Minister Penny Wong has been talking to her counterpart from China while she's been in the G20 Meeting in South Africa. We're confident we have a clear understanding about this, where we've had some questions, I understand that we've been engaging with China diplomatically. I see the Opposition using a bit of loud hailer diplomacy again here for domestic political purposes, presumably because they haven't actually put a suggestion about what alternative we should do.
 
CLENNELL: They keep saying your PM's weak. They keep saying your boss is weak. What do you say to that?
 
BUTLER: What do they say we should do? What do they say we should do? This is juvenile. This is student politics. They have not said one thing they would have the ADF do that we're not currently doing. The ADF know how to manage this. I have complete confidence in their ability to manage it. They've been across it for a considerable period of time. Right now, they've been conducting surveillance activities, as every Australian would expect our Defence Force to do. Our diplomats have been engaging with China here in Canberra, in Beijing. And all you have from the Opposition is yelling and screaming. What have they suggested we should do differently? Nothing. It's all about the politics, including, bizarrely, in relation to national security.
 
CLENNELL: Mark Butler, thanks so much for your time.
 
BUTLER: Thanks, Andrew.