Radio interview with Minister Butler and Tom Elliott – 3AW Mornings – 24 February

TOM ELLIOTT, HOST: The Federal Health Minister, Mark Butler. Good morning.
 
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: G'day, Tom.
 
ELLIOTT: Well, I think everybody, myself included, agrees that throwing an extra $8.5 billion to improve Medicare and to increase the rate of bulk billing is a good idea. But do we know where the money is coming from?
 
BUTLER: Most of it was provisioned in the Mid-Year Budget update that we delivered in December. And the remainder, the minority part of it will be included in the coming budget or the budget update if there's an election called before that, that's obviously not a matter for me. It will reflect that what we've done over the last few years, which is a responsible approach to budget management, we've delivered two back to back surpluses, the first in 15 years, while also being able to put a lot more money into Medicare. We confronted a pretty dire situation when we came to government with bulk billing in freefall and yesterday’s announcement is the latest in a series of things we’ve done to turn that around.
 
ELLIOTT: Okay, so the $8.5 billion in particular, what exactly are you going to do? Is it more doctors and nurses in emergency wards, or is it mainly more payments to GPs to try and increase the rate of bulk billing, or a mixture of both or what?
 
BUTLER: The vast bulk of it is focused on general practices. A few weeks ago, we announced additional funding to states for their hospitals, which is a big increase to all state governments who I know are really dealing with a lot of pressure in the hospital system, which most systems around the world are dealing with after COVID. But yesterday's announcement was about general practice. When we came to government, the College of GPs told us bulk billing was in freefall after funding freezes for the last decade. We focused the year before last, particularly on bulk billing rates for pensioners and concession card holders. We tripled the bulk billing incentive for that group and that saw their bulk billing rate stop sliding and actually rebound, and they're comfortably now above 90 per cent. But where I'm really worried now is middle Australia. People who don't have a concession card, they're doing it tough with cost of living pressures. Their bulk billing rate is sliding and more of them are saying they're not going to the doctor when they really have to because of cost. We've got to turn that bulk billing rate around and that's what yesterday's investment was all about.
 
ELLIOTT: Can you guarantee, though, that that's what will happen? I mean, call me cynical, but what if you increase the payment to GPs? And the GPs say thank you very much we'll still make people pay a gap fee and we'll just pocket the increase ourselves. I mean, you know, can you guarantee that the extra funding to GPs will result in a greater rate of bulk billing?
 
BUTLER: They don't get the money if they don't bulk bill. That's the thing. You know, there has been some calls for increases in, the general rebate. And we have delivered the three biggest increases to the rebate over the last three years since Paul Keating was Prime Minister. They've got good increases to the rebate. But I've said to doctors groups very clearly, we're not going to pile in a whole lot more money without a guarantee it's going to deliver an outcome for patients on bulk billing. That's why all of this, every single dollar of this is tied to bulk billing outcomes. If a doctor if a general practice decides they want to continue to charge people a gap, well, that's their right, that's how the system operates. We're not the British National Health Service here, they’re private practices. But if they do make that decision, they're not getting the extra money.
 
ELLIOTT: Right. So if a doctor, any GP who charges a gap fee doesn't get a share of this extra funding that's been announced?
 
BUTLER: That's right, We've got a very good level of information. We know what GPs are charging, what they're getting from Medicare, what they're charging by way of gap fees. Our modelling says very clearly the vast bulk of practices are better off under the funding we announced yesterday by lifting that bulk billing rate to where we want it to be, which is about 90 per cent, 9 in 10 visits bulk billed. Now, that doesn't mean that the richest as Gina Rinehart's not going to get bulk billed, but middle Australia, which is where the real problem is right now with bulk billing rates sliding, we're confident practices are better off returning to bulk billing under the funding we announced yesterday.
 
ELLIOTT: Now, you mentioned before that people aren't going to the doctor as often as they should because of the lack of bulk billing. And I would agree, we're actually going to speak to a Director of Chemist Warehouse in about half an hour. But there's a similar stat out there that like 1 in 5 people don't always buy the medicine that they have prescribed to them because they can't afford that either. Now, in New Zealand, some chemists at least give out scripts completely free. Is there a chance we could do that in Australia?
 
BUTLER: We've done a lot, but that is another challenge in the health system. The idea that people get a script from their doctor, that their doctor says, this is really important for your health, and they don't get that script filled because of cost is a real challenge. We've delivered a range of measures to make medicines cheaper. We delivered the biggest cut to the price of medicines ever in the history of the PBS. We've allowed doctors to issue 60 day scripts. That was fought pretty hard by the pharmacy lobby, voted against by Peter Dutton. But it's delivering a lot more 60 day scripts, which means you get 60 days to apply for the price of a single script. You don't have to go back to the doctor as often for repeat scripts and the like. We've done a lot that's already saved Australians more than $1.2 billion. And this year, knowing that more needs to be done, we've frozen the price of PBS scripts for up to five years as well. Cheaper medicines, free visits to the doctor, it's not just good for the hip pocket really of households, which is important, but importantly, it's really good for their health as well.
 
ELLIOTT: Speaking of things that are good for the health; vapes, and you were very strong on this in late 2023. I think you described them as, you know, a health crisis, particularly amongst young people. Now, every day I walk past three shops leaving work to go home that openly sell vapes, they’re tobacco shops, they've got hookah pipes in the window. They have electronics, in one case, a painted sign saying “Vapes here, vapes here, vapes here.” I thought you were going to stamp that out?
 
BUTLER: This is driving me to distraction. I know it's driving parents to distraction as well. People are openly flouting what is now the law and really strong penalties. Before I come to that enforcement question, though, Tom, I know you and I have talked about this a few times. We've had research out over the last couple of months that is showing really good results on vaping rates, particularly among kids. Vaping rates among young people up to 30, teenagers and very young adults is down 30 per cent last year. Interestingly, vaping rates for people over the age of 30 has halved in the last year. It's down by 50 per cent. And one of the really good results we got from this research that's been run year upon year for many years, very reputable research is that school suspensions for vaping are down by 50 per cent just in one year. Schools are reporting look, it's still a bit of an issue, but it's dramatically reduced the behavioural challenge that vaping was presenting to school leaders and to parents. But look, there are too many shops doing this. And I've said I'm deadly serious about the penalties that we put in place in the law; Millions of dollars in fines, the potential of jail time for people flouting these laws. And I want to see these laws enforced. We're doing lots of operations, joint operations with state police and other enforcement agencies. But yeah, but we've got to start prosecuting some of these.
 
ELLIOTT: I know, but I mean, as I said, I walk past three a day. If I catch the tram, I get off the tram stop in Melbourne. There's one right there. I mean, and it has an electronic sign saying “vapes”. Like, I just don't understand. If I can walk past and see them, why don't you just ring up the police and say, go and shut that shop down or arrest someone?
 
BUTLER: I don't necessarily want the police doing that work. There are other state agencies that tend to do that work. We've got a very clear understanding between police agencies and health agencies that  where there's some involvement of organised crime, the police will get involved. But more generally, that's not a job for police. It's a job for other health authorities. But I do want to see more enforcement around the place. This is a serious public health problem. Parents and school leaders have been crying out for action on this for years. It's a problem that just exploded over the last several years. Now we're starting to see good results in terms of vaping behaviour by young people, but we've got to lift the game on enforcement.
 
ELLIOTT: I'm just saying the Herald Sun here in Melbourne has published a list today of all the shops at which you can get either illicit cigarettes or vapes, and within 100m of where I'm broadcasting from there is four illicit cigarette shops and two vape shops. I mean, all the exact addresses and the names of the businesses are right here, so it's not hard to find. Finally, health insurance. When are you going to tell us how much our health insurance will go up this year?
 
BUTLER: Very soon. The health insurance companies submitted their first claims very late last year before Christmas. For your listeners benefit, the way the system works is that the Health Minister of the day has to approve the premium increases that come into effect on the 1st of April. They put in a claim to me. I sent back a very clear message for them to sharpen their pencil. They came back. I sent back another message. I think I've gone back three times to them saying that they haven't done a good enough job. I've got some final advice that I'm just getting now, and we'll be in a position to make that announcement pretty shortly. And I've got a couple of questions. Is this coming before the election? Well, I don't know when the election is going to be. That's a matter for the PM. But I'm, pretty much ready to do this and it will be before the election.
 
ELLIOTT: Alright. Look forward to the results. Thank you. Mark Butler there, Australian Federal Health Minister.