JULIE COLLINS, MINISTER FOR AGRICULTURE, FISHERIES AND FORESTRY: Tomorrow, the first of November, is an exciting day for Tasmanians. We are making significant changes when it comes to tripling the bulk billing incentive for all patients. This is the single biggest investment that Federal Labor has made, or that any government has made, into Medicare since Federal Labor created Medicare. We also, of course, have very significant women's health changes on top of the changes that we have already made, and of course, changes to the New Aged Care Act coming into effect from tomorrow, the first of November. What we know is for far too long when it comes to women's health, women have been making choices based on what they can afford when it comes to contraception and their fertility. This is about ensuring that women can make choices that are in their best interests, but also that they have a range of choices, and that's what these women's health changes are all about. And Rebecca is happy to talk more about those. But essentially, what I would say is that this is a significant investment by a Federal Labor Government, the biggest ever since we've created Medicare, and it will mean good news for many, many Tasmanians.
REBECCA WHITE, ASSISTANT MINISTER FOR HEALTH AND AGED CARE: I’m really thrilled to be here with Julie and Marcus, who's the CEO of Family Planning, Tasmania. Family Planning have been a partner with the Federal Government to deliver out Persistent Pelvic Pain Clinics in each region of the state, but they also play a vital role in making sure that women can access cheaper contraceptives. Earlier this year, we listed new contraceptives on the PBS. In some cases, we haven't seen contraceptives listed for 30 years. Finally, we're able to give choice to women to access affordable medicines to make sure that they can just have a good life and be able to participate as anyone should be able to, without worrying that they have to check their bank balance before they can go and have a doctor's appointment. And tomorrow, we're very excited that from the first of November, IUDs will be bulk billed through Medicare rebates that have been massively increased, and this provides, again, greater choice for women who are looking for longer acting birth control that provides them with certainty but also gives them ability to have a conversation with their GP without worrying that they're going to need to find extra money to pay for these medicines or these devices. From tomorrow, we're also listing on the PBS, NuvaRing, which is another contraceptive option for women, which means we've now got a range of contraceptive choices that women can have access to through the PBS, which here in Tasmania, has already saved women over a million dollars since they've been listed earlier this year. This is not only good for their bank balance; it's good for choice. It means women can access affordable health care close to where they live, and that's really the principle that's underpinning our efforts to strengthen Medicare, partnering with providers, just like Family Planning, so that women, no matter where they are in Tasmania, can have an appointment with a GP and be able to access contraception that is on the PBS or subsidised through Medicare, so that they can live a full and productive life.
MARCUS DI MARTINO CEO, FAMILY PLANNING TASMANIA: In 2025 contraception is essential medical service, particularly for women. It empowers them and gives them control over their pregnancy options and choices. We're very lucky in 2025 that we have had a number of really good contraception options, but due to the complex nature of some contraceptives, it's led to some significant out-of-pocket cost for some patients. Some patients end up choosing contraception that was affordable to them, rather than one that was best for them, medically and personally. The changes coming in from tomorrow will help significantly reduce barriers in terms of cost and access to contraception.
JOURNALIST: Do you find that financial barriers are often the main reason why women potentially don't think they have contraception options?
MARCUS DI MARTINO: Certainly, contraception access, as we said, because some of the procedures are complex, particularly IUD and Implanon, we found people were choosing a contraception based on what they can afford, rather than what was best for them.
JOURNALIST: Can you give us an example of that?
MARCUS DI MARTINO: One option would be an IUD, in particular, a copper IUD that has no hormones. That might be an option for a patient that would best suit their body, because they might not have had a good outcome on a contraceptive pill, or they might not have had a good reaction to Implanon. But because of the complexity of an IUD insertion, that procedure might have had anywhere between a $100 and $300 out-of-pocket cost, depending on where you go in the state. That patient, then might say, well, even though the contraceptive pill is not working for me; they continued with the treatment because they couldn't afford the cost of an IUD insertion.
JOURNALIST: And how do you expect that uptake will go, if you can offer more options, are you prepared to take extra patients?
MARCUS DI MARTINO: The whole Family Planning Tasmania team will be able to offer bulk billing services from next week, because of this announcement from the Federal Government and support from the State Government, for all IUD and Implanon insertions. We're looking at our resources, we're looking at our clinic structure and we are expecting an increase in IUD and Implanon insertions. It really is about choice, allowing people to have the best choice for them medically and personally, rather than letting financial constraints determine what contraception they use.
JOURNALIST: Why do you feel this is necessary? And same question, are we seeing financial barriers as the main reason why women are not taking up these contraception options in the first place?
COLLINS: What we know is, that women have been making choices on what they can afford to pay for contraception. When you're talking about an out-of-pocket on the PBS versus hundreds of dollars to have an IUD inserted, people were making the cost-effective choice for them and what they could afford at the time. This is about giving women more choices about their bodies and taking the best choice available to them, because for far too long, people have been making decisions based on what they can afford. Even with the contraceptive pill, we've now seen more than 30,000 Tasmanians take up the new oral contraceptives that we have put on the PBS, which shows that women previously were making different choices because they could not afford it.
JOURNALIST: There's a lot of reasons why clinics don't bulk bill. Can you understand those challenges they face? Why do you think this is enough to get more clinics on board?
COLLINS: We've been working with the sector over many months and years about what we need to do as a Federal Government, which is why we've increased that MBS item, particularly for the IUD insertion and removals and for those longer acting contraceptives, for those longer consultations for women's health. We've also, of course, increased the MBS item for women in menopause, for instance, to be able to go and have that assessment done, because we know that women are taking that up, and they were not because they could not afford that out-of-pocket gap. And with the bulk billing incentive tripling from tomorrow, what we are doing, of course, is for practices that fully bulk bill is we are increasing again, on top of that, an incentive for practices to do it entirely. I'm sure Rebecca can talk more about it, but I know in my own electorate, there's around three GP clinics that have indicated that they're likely to move to entire bulk billing practices, and I think that over time, we'll see more of that in Tasmania. We know Tasmanians have a lot of out-of-pocket expenses when it comes to GP visits, and we know it's been an issue here in Tasmania, and certainly Rebecca and I have had many conversations with Mark Butler, the Health Minister, about, how do we get better uptake of bulk billing practices in Tasmania.
JOURNALIST: I read this morning, it was going to take about four years to get to the number of clinics to meet the goal that government had. Can you talk to that at all?
COLLINS: Our aim is for nine out of 10 clinics by 2030, we do expect that over time, as more clinics see others nearby bulk billing, that we'll get to that. We are making the single biggest investment in Medicare, $8.5 billion. This is the single biggest investment in Medicare since Labor created Medicare. And what we are doing with this is we're making up for the decade of cuts and neglect under the former Liberal Government.
WHITE: Across Australia, we have about 7,000 GP practices, already 1,500 bulk bill and from tomorrow, we understand 1,000 are going to move to fully bulk billing, which is nearly doubling the number of bulk billing practices we have in the country. Here in Tasmania, we will also see an increase in the number of bulk billing practices. Julie's spoken about the increase in Franklin, in my electorate of Lyons, there's about six practices that we're aware of that will move to fully bulk billing from tomorrow. This is really exciting, and that's not just in the southern part of Tasmania, this is in the north and east of the state too, providing access to bulk billing appointments for Tasmanians right around our state, so that they can see GP without any out-of-pocket cost. This is going to be a life changer for some people. It's also why we've been strengthening the PBS by listing more medicines, because we know that people have been making choices about not going to the doctor or not filling their script because they can't afford it. And from tomorrow, Tasmanians and right across the country, we'll see people be able to see a GP and do that for free. It'll be fully bulk billed. And from the first of January, medicines on, the PBS will go down to $25. This is going to be a massive saving for people, but more importantly, it is going to increase their access to good health care.
JOURNALIST: Can you understand why some clinics, especially regional ones, don't choose to bulk bill?
WHITE: In my electorate of Lyons, through the conversations my office has had this week, we've discovered that six practices are moving to full bulk billing practices, and that includes in regional areas like the Tasman Peninsula, the East Coast, parts of the Northwest of my electorate. There are practices who are moving this way because they see the benefit for their patients, but they also see the benefit for their practice. The increase in the bulk billing rebate is a financial benefit for their practice. If they move to a fully bulk billing practice, they get on top of that, a 12.5 per cent incentive that they can share between their practice managers and their GPs. This can see an uplift in the incomes of a fully bulk billing GP to over $400,000 a year. They will now get a salary of about $400,000 a year, which is an uplift, in some cases, of about $120,000 which is a great benefit to them, a great incentive for them, but also a great outcome for patients.
JOURNALIST: Do you agree or disagree with the state government's decision to carry out an independent study into the salmon industry?
COLLINS: I've been on the record for some time about having some more transparency around it. I think what concerns many Tasmanians, when it comes to this policy, but particularly any policy, is what we're seeing from the Liberal minority government is policy on the run. What you're getting is, whoever spoke to the Premier last, they're back flipping and changing their mind on policy, after policy, after policy. And I think that that is the concerning thing for many Tasmanians, when you see, the Spirit of Tasmania, the ports debacle, and what they're doing, we're getting a lot of policy on the run. What we need from a Tasmanian State Government is for them to be more strategic in Tasmania’s best interests.
JOURNALIST: Do you think an independent inquiry is the way to do that?
COLLINS: I've been in Canberra, I haven't seen all of the exact detail of it, but what I would say is, Tasmanians wanted to see more transparency, but what I'm concerned about is this policy on the run, and the ad hoc nature and the back flipping all the time coming from the State Government. They should be clear about strategically, why they're doing something in Tasmania's best interests, and they should stick to it.