Television interview with Minister Butler, Sky News – 24 February 2025

TOM CONNELL, HOST: Labor at the election, promising to make 9 in 10 GP visits free to patients by the end of the decade. The Coalition has been quick to not only match the $8.5 billion pledge, but say it's going to spend more on health. I spoke to the Health Minister, Mark Butler, a short time ago, started by asking him about that extra 12 per cent of patients who will be effectively getting these free medical appointments.
 
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: What we have really is two cohorts in the Australian community, Tom. We have pensioners and concession card holders that have always got a bulk billing incentive applied to them, and we tripled that incentive in 2023. That means now that their bulk billing rate is comfortably above 90 per cent. But for the rest of the community who don't have a concession card, so middle Australia, they're seeing their bulk billing rates slide, they're down to about 60 per cent now. They're seeing their gap fees rise. This record investment that we announced yesterday for the first time gives doctors bulk billing support so that they can ensure those people are visiting the doctor for free.
 
CONNELL: In terms of whether that happens or not. We look at metro appointments, so the maximum GP gets under this scheme is $69.56, that's if their bulk billing every patient. The AMA says that amount will mean some practices don't do any increased bulk billing at all. Now there's nothing you can do about that if that's the case is there?
 
BUTLER: Ultimately this is a decision for doctors. We don't have a British National Health Service, NHS type scheme here where I can direct doctors and I employ doctors, this is a decision for private practices. But we've modelled this very carefully. We have very good access to data about what they're currently charging patients, and we're confident that the vast bulk of practices will be better off under the record investment we announced yesterday. We're saying this pretty conservatively. We're saying we'll get to 9 in 10 visits free of charge by the end of the decade. But the funding starts to flow this year, so there's no reason why GPs can't adjust their billing arrangements obviously earlier than the end of the decade. Obviously we're this is a choice for doctors. But we've carefully calibrated this amount. We've been working on it for a considerable period of time.

When we tripled the bulk billing incentive for pensioners it had exactly the effect we wanted. It stopped that slide in bulk billing that we'd inherited when we came to government and turned it around for some of the lowest income Australians. Now we're focused on middle Australia. They don't qualify for a concession card, but they're still doing it tough. They're under real cost of living pressure, and too many of them are saying they can't afford to go to the doctor when they need to. This isn't just good for their hip pocket, this is a really good health measure as well. Ensuring that people get access to healthcare when and where they need it.
 
CONNELL: Given though, as you said there, you can't do anything about it. I understand we don't have the NHS, but did you look at another option, perhaps a minimum bulk billing rate, whatever that might be for any GP practice that wants to get the increased bulk billing incentive rate?
 
BUTLER: We looked at a range of different ways in which we could maximise the incentive for doctors to bulk bill. Obviously applying for the first time, this very big bulk billing incentive to all Australians is the big thing. That means for a standard consult here in a city like Melbourne, that's an increase of more than 60 per cent to the income doctors get. But out in the regions, it's as much as doubling the income they get for a standard consult for someone currently without a concession card.
But the big thing, the big kicker, Tom, is for the first time, we'll also pay general practices an additional loading of 12.5 per cent if their bulk billing everyone that comes through their door. We think that will about triple the number of bulk billing practices around the country. It's now down to about 1,500 out of 8,000 or so. We think that will triple to almost 5,000 practices who bulk will everyone that come through their door. And that is going to make a huge difference to patients.
 
CONNELL: We're hearing as well from doctor’s groups that this won't do anything for the so-called GP deserts out there. So those people are struggling to get bulk billing or any appointment at all. Is there anything on that front that's coming still?
 
BUTLER: We know we need more doctors. Over the past couple of years, 17,000 new doctors have been registered to practise in Australia. That's the highest number in more than a decade. Many of them are coming in from overseas to fill those deserts, as you call them in regional Australia. We're fast tracking that. We've cut a whole lot of red tape, particularly for GPs from systems or countries where we have very high confidence in their training, for GPs, that's UK, Ireland and New Zealand. We're doing the same for anaesthetists and other health professions as well. And we're doing it also for nurses. We're recruiting a lot more doctors and nurses into the system. I'm really pleased though, that this year we're training more junior doctors here in Australia in general practice than we have at any time in our history. We've got to convince more junior doctors to choose general practice as their preferred career.

Yesterday's announcement also contains a lot of measures to boost the attractiveness of general practices. There'll be more general practice trainees getting up to 2,000 a year. 2,000 new GPs trained here in Australia coming into the system. And we've provided a lot of financial incentive for medical graduates when they're making that decision “Do I want to be a GP or do I want to be a hospital surgeon?” Currently, there's a big financial disincentive for them to choose general practice training. We're providing incentive payments, we're providing access to parental leave, which currently GPs in training often don't get to make sure that they make that choice based on the career they want, rather than some of these financial issues that have dogged the system for too long.
 
CONNELL: We're obviously on the cusp of an election. I'm not going to waste a question by saying, when will that be. But it's going to be very soon. So the wind must have been knocked out of your sails a little bit. The Coalition matching this as soon as they heard of it effectively. Surely you can't just roll out the ghost of the GP co-payment? That was 11 years ago. If people hear that the coalition is doing this, they'll welcome it, won't they?
 
BUTLER: You've got to be sceptical about it, Tom. You can only judge a man on his record. And his record is appalling. It's not just scary, it's terrifying. It's why doctors voted him the worst Health Minister in the history of Medicare. And the important thing about this, Tom, is it would be one thing if he'd owned up to it. Been strong enough to say, “I made a mistake and I apologise for what it's done to the health care system”, because the reason we are in the bulk billing challenge that we have right now, no one contests, is traced back to decisions he made as the Health Minister. Until he owns up and says, “look, I was wrong, then I've had a complete change of heart and I'm now a convert to the long Labor mission of Medicare, which says everyone should have access to health care, no matter their income or their means.” Until he does that, people are entitled to be sceptical about things like yesterday's rushed announcement. You judge a person on his record on what he says. He's never said he's a convert to bulk billing. The only thing we have on his record is he says there are too many free Medicare services, and he tried to abolish it altogether.
 
CONNELL: So if he says, “yep, I was wrong on that”, then you'll believe him. Will you?
 
BUTLER: I'm not going to hold my breath. I'm not going to hold my breath. It's been 11 years since he delivered the worst health budget in the history of this system, and he's never said he got it wrong. He's never said that he made the wrong decision there. Let's be clear, the budget he delivered as Health Minister reflected long standing philosophies of the Liberal Party. His mentor, the father of the modern Liberal Party John Howard, said “bulk billing was an absolute rort.” He said, “Medicare was one of the Hawke government's greatest failures.” The fact is the Liberal Party has never supported Medicare in the way in which we designed the scheme, a universal health insurance system. After they gave up trying to abolish it altogether, they've only ever regarded it as a safety net scheme. That's not our view, and I don't think it's the view of the Australian people either.
 
CONNELL: Okay. Minister Mark Butler, appreciate your time today. Thank you.