April 18, 2022





ALI MOORE, HOST: Mark Butler is the Shadow Minister for Health and Ageing and the Member for Hindmarsh, and of course health has been one of the big focuses in the first week of the campaign. And going into the second week yesterday, it was the Government's promise around glucose monitoring for diabetes. Prior to that it was Labor's urgent care clinics and also the Greens plan to include dental care in Medicare. And we had the announcement that Greg Hunt, who is retiring, will be replaced by Anne Ruston as Federal Health Minister if the Government wins the election. Mark Butler, good morning.


MOORE: Happy Easter to you too. Mixed response for your leader at blues fest? How do you think you're traveling just broadly heading into week two?

MARK BUTLER MP, SHADOW MINISTER HEALTH AND AGEING: It's still very early days, obviously, week one of campaign is always a bit of a bit of a process of settling in. And, you know, Anthony made a mistake at the beginning of that week one which has been reported on pretty widely. I think the difference about that is he didn’t pretend it didn't happen or blame the Canberra bubble or the media, he owned up to it and took responsibility and sort to move on to our task, which is arguing the case for a better future for Australia, and that Australia can't afford another three years of Scott Morrison's failures and his rorts.

MOORE: I'm surprised you just actually brought up the mistake, because I didn’t raise it. I thought maybe you were hoping for a bit of clear air and a less side-tracked week?

BUTLER: We're going to focus very, very strongly on policy this week. As I said, arguing for a better future for Australia. We've already talked a lot about health policy, you mentioned the glucose monitoring announcement by the Government yesterday. That's something we've been talking the diabetes sector for a long time about as well. We've been waiting, I think, for the whole of this parliamentary term for some action on the Government on this fund and we announced that we would match that announcement so that the diabetes community those tens of thousands of people living with Type 1 diabetes and their families know that whatever the outcome of the election, there will be better support waiting for them on the other side.

MOORE: Can I also ask you about your urgent care clinics, this announcement last week, $135 million dollars to trial 50 clinics over four years? First question is, do you know where they'll be?

BUTLER: We're analysing information to make sure we get them into the right areas. Primarily, that information will be based on activity in hospital emergency departments, because this is really all about making sure that it's easy for people to see a doctor when they have these sorts of minor emergencies. I've talked about your kid falling off a skateboard and busting their arm or a very deep cut, something caught in the eye, things where it's often very, very difficult to get into a GP, particularly after hours. And so people end up waiting hours and hours in hospital emergency departments which are already overcrowded.

MOORE: So if you're going use business or traffic numbers in hospitals, how quickly do you think you can get your first one up and running?

BUTLER: We've committed to getting them up and running, if we win the election, in 2023/24. We'd like to see them up and running in the middle of next year in 50 regions around the country. Obviously, that's not going to provide universal coverage for this really important new model of care. We want to see how that works in 50 regions. We've seen overseas, it works wonderfully well in the UK in the US, particularly in New Zealand, which probably has the best model. And we know that in New Zealand it makes it profoundly easier for people to see a doctor. And as a result, they have the lowest level of presentation to emergency departments in the developed world. Way, way lower than the ED presentation levels we have here in Australia. It frees up EDs to do what they're built to do, which is really to cater for those once in a lifetime emergencies like heart attacks and strokes.

MOORE: Sure and given they're so important, and they've been so successful, do you commit that 50 is just the beginning. So 50 over four years? What sort of numbers would Australia need to be totally covered?

BUTLER: I think that's really why we're putting in place that number as a trial because it allows us to work out how the model works in Australia, every country is slightly different, has a slightly different general practice system, a slightly different hospital system. So those are the decisions we take over a period of a few years where we have these 50 up and running, able to be assessed able to be evaluated properly, you know, working closely with state hospital systems, obviously, but also the Primary Health Networks that oversee our general practice system and health planning and governance of those systems.

MOORE: And when we look at costing of this policy, there was a little bit of a correction on that last week. It's not been costed by the Parliamentary Budget Office, but it is based on work done by them. So you're budgeting, if my maths is right, I think 675,000 per clinic per year, for seven days a week long hours - that's the whole purpose of these urgent care clinics so you're comfortable that your funding is going to be enough?

BUTLER: First of all, the funding is about $750,000 per clinic per year, it only starts in 2023/24. So over the forward estimates, the four year budget is about $135 million. There is also capital grants available to these clinics, these are existing GP practices, it's important to say, we're not building new clinics.

MOORE: So you've got to haven't set up costs?

BUTLER: We're going out there asking for GP practices who want to take their practice to a new level, it will operate seven days a week, they've got to operate seven days a week, at least from 8am to 10pm, and be fully bulk billed. So there'll be no gap fee whatsoever for this particular type of presentation. And already I've been contacted by a number of different GP organisations, who want be a part of this. They know that this will make a real difference in their local community, making it easier and cheaper to see a doctor. And I reached that figure, that $750,000 recurrent funding figure, by talking very closely to GP organisations about what they would need to make this model viable. A number of GP practices have been trying to do this but under the existing Medicare rebate system, it just isn't viable. They need additional funding to make sure they can get that staffing in place and get the equipment, the facilities that you need for these sorts of minor emergencies.

MOORE: And you say yourself, of course, the aim of the clinics is to take the pressure off the hospital sector, and anyone who works in that system will tell you it's underfunded. Will Labor commit to increasing total funding and if you look at the policies of the AMA or the RACGP, will you split the costs with the state's 50/50 and will you remove the 6.5 per cent cap on funding growth?

BUTLER: As you know, there's a hospital funding agreement the States signed with the Commonwealth a couple of years ago that runs from 2020 to 2025. That essentially reflects the deal that was done under Julia Gillard as Prime Minister for a 45 per cent Commonwealth contribution to funding. We tried under Kevin Rudd to reach a 50/50 deal with the states, we weren't able to do that. And that followed, really, the Howard Government walking away from the long standing position in the past of the Commonwealth and the States effectively going halves.

MOORE: So would you try again?

BUTLER: The next government, whether it's a Liberal government, or a Labor government is going to have to renegotiate this hospital funding agreement with the states. And it's quite clear that states are going to come to the table, this time seeking a 50/50 deal. They signed a 45/55 deal a couple of years ago with Scott Morrison, and they signed that same deal five years earlier with Malcolm Turnbull.

MOORE: But if you were in government as a Labor federal government, would you put 50/50 on the table, along with the removal of the cap on funding growth?

BUTLER: I'm not going to pre-empt negotiations that would take place in the next term of Parliament. What I will say is that Labor's got a very proud record on this going back to the Hawke Government, Kevin Rudd seeking to restore the funding, which had dropped us low, I think, is about 4 per cent, under John Howard, which had put the hospital system into deep crisis. When Tony Abbott sought to walk away from the Julia Gillard deal, we oppose that as well.

MOORE: But can I just ask you about now. You're not going to pre-empt but are you committed to 50/50 funding?

BUTLER: What I've said is I'm not going to pre-empt the negotiations that the next government would have to have whether it's a Labor or Liberal government with the states. I think it’s very clear on what the states want, we're very clear on the position of the AMA, and a number of other key organisations,

MOORE: Is it not a policy position on this?

BUTLER: I've talked about the position that Labor has taken to this this matter over the last couple of days.

MOORE: So are you holding to that position or has your policy position changed?

BUTLER: It's been a very significant matter between the Commonwealth and the States, but I'm not going to pre-empt the negotiations that will take place during the next parliamentary term.

MOORE: It's rather a core policy position, though, isn't it? Because hospital funding is so essential. So if we're talking as we are going to be after nine o'clock, about actually being able to look this and test the policies, it's hard when you don't tell us what the answer is?

BUTLER: All I can say is the next government is going to have to sit down over a period of time really into 2025, so some years away now, and secure a new deal on hospital. In the meantime, right now, the best thing a commonwealth government can do to take pressure off our hospitals is the sort of reform that we've talked about in urgent care to get those millions of presentations that are currently taking place for people who could quite adequately be cared for outside of a hospital if those settings existed. And also fixing the aged care crisis, which is seeing huge numbers of vulnerable older Australians removed to hospital who really shouldn't be there. So right now, that's the best thing the Commonwealth Government can do, and they're the promises were making in this election.

MOORE: Mark Butler, thank you very much for talking to us this morning.

BUTLER: Thanks Ally.