Radio interview with Minister Butler, ABC Northern Tasmania – 26 March 2025

EVAN WALLACE, HOST: An $8.5 billion boost hoping to boost the number of GP visits that are bulk billed. It's an announcement that was made when Federal Health Minister Mark Butler was last in Launceston. Mark Butler, good afternoon to you.
 
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Good afternoon.
 
WALLACE: The Treasurer said that because of this funding boost, nine out of 10 GP visits should be fully billed. The key word there is should. You're relying completely on GPs to follow suit, aren't you?
 
BUTLER: We can't force them to bill a certain way. What we can do is incentivise them to do it. There's a huge, literally huge amount of investment in Medicare available from last night's budget. But in return, we expect doctors to lift their bulk billing rates.
 
Now, the year before last, we tripled the bulk billing incentive. That's the payment GPs receive, if they bulk bill pensioners or people with a concession card and that's had a real impact. Last year, the bulk billing rate in Tasmania increased by about 7 per cent, the biggest increase of any state, and there were about 170,000 or 180,000 additional free visits to the doctor. Now, what that means now is that pensioners and concession card holders across the country, across Australia, have a bulk billing rate comfortably north of 90 per cent. But for the rest of Australia, people who don't get access to a concession card, their bulk billing rate is continuing to slide after, frankly, a decade of cuts in Medicare.
 
The investment we put in the budget last night is about extending that bulk billing support to GPs who bulk bill other patients. Patients who don't have a concession card or are not an aged pensioner. We're very confident that over time, you'll see that same increase in bulk billing again, because frankly, right now bulk billing is in freefall for those patients.
 
WALLACE: So you're confident and you mentioned the situation in Tasmania, let's take a closer look. According to the online healthcare directory Cleanbill, there are no GP clinics in Tasmania that bulk bill new adult patients. And the average cost to see a doctor is $54. What assurance can you give to listeners that this is actually going to change?
 
BUTLER: I'd take that data with a grain of salt. This is a private company that seeks to make money out of doing random phone calls to general practices, that's Cleanbill, I'm talking about. It's not a substitute for the hard Medicare data that we publish on a quarterly basis. We have data that reflects every single visit to a doctor in the country. As I said, bulk billing has gone up by about 7 per cent last year in Tasmania it's now in the mid 70 per cent. It's quite different, I have to say, it's much lower in Hobart than it is in the northwest of Tasmania. The data you see published by this private company does not reflect what's actually happening in general practices.
 
WALLACE: Well, what people here in Launceston and across Tasmania's north are telling us, Minister, is that it is impossible to find a bulk billing doctor and that it's incredibly expensive. Can you give those listeners as part of your say, push that assurance that they will be able to find a clinic if they're not a pensioner, that will bulk bill them?
 
BUTLER: That's what this investment is all about. That's why we're engaging so closely with doctors to explain to them what we think the benefits for them will be if they take up this very significant additional funding that's now on the table. Now, we're not going to give it to them with no strings attached. That has been the request of some of the doctors’ groups to just increase Medicare funding without any quid pro quo. If we are going to use very sort of hard earned taxpayer funds through the budget to increase Medicare funding, which obviously as Health Minister, I want to do. I also want to see some hard outcomes for patients and for a Labor Government that created Medicare and put bulk billing right at the heart of Medicare. Bulk billing is the key metric for me. That's the key outcome I want to see improved for patients.
 
WALLACE: I think everyone would like to see that that's coming through very clearly across the state. As we're asking people what's on their mind ahead of the federal election. But it does sound as though you are really relying on GPs to follow through on this. Is it time, Mark Butler, for a radical overhaul of health funding? Maybe legislate to remove out of pocket fees completely?
 
BUTLER: There's a curious sort of legal restriction in Australia on me doing that, frankly. Back in the 1940s, a bit of a tour back in history, but back in the 1940s, the then Labor Government led by Ben Chifley, was looking at introducing something like the Brits were introducing at the time a National Health Service. And that was strongly resisted by doctors, that was strongly resisted by the Liberal Party. And there ended up being a provision put into the Constitution that prohibits a federal government essentially from conscripting doctors, so forcing them to do particular things. That's why we have incentives in place. At the end of the day, I don't employ GPs, unlike the National Health Service in the UK, where effectively GPs are employed and so can be directed to do certain things. GPs are private practices here in Australia, and what we need to do is put funding on the table that convinces them that the right thing to do by their practice and importantly, the right thing to do by patients, is to bulk bill and ensure that people can visit the doctor for free. Because we know this is one of the really serious concerns out in the community right now, which is why it's been such a big focus of our term in Parliament.
 
WALLACE: Over the last few weeks. We've been in Latrobe, Longford, Launceston and people are saying it's not only expensive to see a doctor, but it's also impossibly expensive to get an MRI. The wait times to see a specialist are detrimental to our health, and people are putting off getting the care that they need from the dentist because it just costs too much. But the people here are saying that the system is broken. Are they right?
 
BUTLER: The system is under real pressure. I'm still very proud of the healthcare system we have in Australia. It is I still, I think, if not the best, one of the few best systems in the world. I want to defend those core promises that were made 40 years ago about Medicare. That means that every Australian can get access to some of the best healthcare available anywhere on the planet for free. That's what all of our reforms, all of our investments have been about. But I don't pretend that after ten years of cuts and neglect to Medicare, I can turn that around in a year or even 2 or 3 years. There are some areas that are causing real pain to people specialists. Non-GP specialist fees are skyrocketing. That's why several days ago I made an announcement that we would start publishing the out-of-pocket costs for every single specialist in Australia charges people. People need to be able to compare fees. We've found that the fees that are charged by specialists vary enormously in particular markets, in particular cities like Loni or Hobart or any of the other cities where there might be a number of specialist practices. This is another challenge we have in the healthcare system. A lot of our focus this term has been on general practices. But I know the fees that people are being charged for imaging and to see non-GP specialists are going up as well, and that will be a very serious focus over the coming couple of years.
 
WALLACE: Minister, you said that you're proud of what you've done over the last three years, but have you been bold enough when it comes to health reform?
 
BUTLER: We've introduced new models of care as well. They were opposed at the time I announced Medicare Urgent Care Clinics, for example by the Opposition. They were opposed by doctors’ groups, by the College of GPs and by the AMA. But I'm convinced they are the right thing to do. They've already seen about 1.3 million patients across the country since we started opening them about 18 months ago, every single one of them is bulk billed. And the vast bulk of them tell us that if the clinic wasn't available, they would otherwise have gone to the hospital ED they’ll spend hours and hours waiting in a crowded hospital emergency department.
 
We want to expand them. We already have them operating in Devonport. They've seen almost 20,000 patients there. Seven days a week, extended hours. Launceston is one of the really outstanding Urgent Care Clinics in the country. We announced additional funding a couple of weeks ago to allow them to extend their hours. They've seen 25,000 people, every single one of them bulk billed. Most of them would otherwise have ended up in the hospital. Relieving that pressure on EDs. And if elected, we'll add another Medicare Urgent Care Clinic in the north in Burnie as well, because I know there's demand there. We have tried to introduce new models of care that meet the needs of patients, that relieve pressure on our hospitals, but always have that principle at the heart of them, which is people should be able to access this care free of charge. Bringing along their Medicare card, leaving their credit card at home.
 
WALLACE: And while we're talking about health costs, the cost of seeing a dentist, it's pretty high on the list for people across the north of the state. Can you ever imagine applying the Medicare rebate to dental care for adults Mark Butler?
 
BUTLER: When we were last in government, we introduced a Medicare Dental Scheme for kids, and that's been very, very successful. But as some of your listeners might know, Medicare when it was introduced and Medibank before that, when Gough Whitlam introduced that in the 70s, neither of the schemes had dental care in them. That was really a product, frankly, of the sort of very deep opposition at the time by dentists. The government were fighting doctors at the time, they were fighting the Liberal Party. I think Bob Hawke just took the view he couldn't fight on so many fronts. But, our party in its policy platform has an ambition to introduce dental care into Medicare at some point. But I've tried to be as frank as I can be and as honest as I can be with the Australian people in saying it's not going to happen tomorrow. We've got a very serious job ahead of us just to strengthen Medicare as we understand it, general practice in particular. But some of those things that your listeners are ringing in about specialist fees, out of pockets, imaging access, some of those things as well have frankly got to be done before we would consider a very significant, expensive expansion of Medicare to dental care.
 
WALLACE: Mark Butler, appreciate your time this afternoon. Thanks so much for chatting with us on Northern Tas Drive.
 
BUTLER: My great pleasure.