August 14, 2023

HAMISH MACDONALD, HOST: Governments are scrambling across the country to stop the spread of vaping, particularly amongst young children and teenagers. This week, state and territory health ministers will receive advice on how to crack down on vapes, looking at how to reform legislation and close loopholes to stop them being sold on the black market. But there's still no timeframe on when this reform will begin and how long it will take to see results. Mark Butler is the Minister for Health and Aged Care. He joins me now. Good morning to you.


MACDONALD: It's three months since you announced plans to ban all disposable vape products. Why has that crackdown been delayed?

BUTLER: It hasn't been delayed. We're working on it furiously with eight other jurisdictions. We’re working very hard to make sure that we get a uniform approach across eight different state and territory jurisdictions and at our international border, because I’m not willing to see any further legal loopholes.  
MACDONALD: So, when will it actually start? 
BUTLER: We haven't got a timeframe yet. As you said in your introduction, we are receiving advice this week. What we've really been working through is whether we're going to be able to deal with this through one piece of Commonwealth legislation, which would be preferred, or whether every single parliament in the country is going to have to enact effectively mirroring legislation which will be, difficult, complex and probably take some time. That's really why we're working through this. We know that there will be a furious response by the industry. There has been every time we've tried to regulate nicotine or tobacco. So, we want to make sure that we get this right. This is also pretty new. There aren't countries around the world that have taken as determined a response to vaping as iron out three months ago. So, a bit like plain packaging ten years ago, we're really out there at the Vanguard trying to take on this new public health menace.
MACDONALD: Can you explain exactly what is being targeted? Because there's different kinds of vaping, isn't there?
BUTLER: There is and there isn't. There are there's often a lot of discussion about nicotine versus non-nicotine vapes, But frankly, non-nicotine vapes are vanishingly rare. It's pretty hard to find one.
MACDONALD: So when we see kids and teenagers standing around with vapes, they're probably got tobacco in them?
BUTLER: Not tobacco, nicotine though. Almost without variation, they're nicotine. One of the real problems is we don't know how much nicotine. This black market that's flourished, cynically targeted at kids. You can tell that through the fact that they're bubble gum flavoured and they've got pink unicorns on them. It's not as if those sorts of things are targeted at the middle aged, hardened smoker, which is what we were told was the purpose of vapes. These are increasingly dangerous. You're hearing and I'm sure your listeners are hearing, very regular reports of high school kids being taken to emergency departments with nicotine poisoning. The Victorian poisons hotline only recently said they've already had 70 cases of toddlers under the age of four poisoned through ingesting vapes. This is becoming a very serious public health crisis and we're determined to get the response right. But it is going to be difficult because I don't want to pretend to your listeners otherwise. This black market has flourished. Now, about 1 in 5 young Australians, and 1 in 7 high school kids are vaping.
MACDONALD: What about this stuff getting in through the border? I know that the Border Force Commissioner Michael Outram has previously told Senate Estimates that he didn't think a prohibition at the border would actually solve the problem. What's your view on that?
BUTLER: We know from a whole range of other things that aren't allowed to come in through the border that some of them do get through. I think the Border Force Commissioner was just being honest about that. That's why cooperation with state and territory governments is just so critically important. We need as the Commonwealth to take strong action at the border and that's really what's been lacking over the last several years. To his credit Greg Hunt tried to do that. He tried to put in place an import control regulation, but he was overruled by his own party room within a few days. So, the border has effectively been open. That's what we have to do at the Commonwealth level. But that won't be much good if there's not also on the ground policing at a state and territory level to make sure that these things aren't still coming through in very small packages and being sold in convenience stores or even worse, these vape stores that are often open just down the road from schools. The thing is, Hamish, they're not coming in big shipping containers with a big vapes sign on the side. So, the Border Force commissioner is being honest about the fact that this is hard work for Border Force. Just as tracking down illicit drugs and other things that shouldn't be coming through the border but unfortunately are.
MACDONALD: I'm talking to the Federal Health minister, Mark Butler. We've been reporting this morning on a federal court ruling in favour of a junior doctor in an underemployment case in Victoria. There's obviously simultaneous class actions underway in a number of different jurisdictions. Understand that this is a matter for states and territories in terms of any compensation but do you want to see these matters resolved? It is widely and well known that junior doctors have been underpaid chronically.
BUTLER: I'm sure every state government that might be involved in a case like this would want to make sure that they clean this up very quickly. Just because it's the right thing to do, but also because we are desperately short of doctors and nurses. Every young person that wants to go into medicine needs to be treated properly. We are desperately in need of more young people, training to be health professionals. But most importantly, obviously, paying people properly is the right thing to do.
MACDONALD: We're a we're talking about a bill potentially of hundreds of millions of dollars in Victoria alone. So, the cost to the taxpayer of dealing with this would be significant. I suppose the question is, do you want to see those jurisdictions deal with it promptly?
BUTLER: Of course, I do. And I think any leader would and I'm sure any health minister at a jurisdictional level would as well. It's the proper thing to do. It's a simple matter of complying with the law as I understand it unless there's some possibility of an appeal and there's some uncertainty about that. But I can't stress enough just how short we are of health professionals, and that's not an Australian thing, we're seeing that right across the world right now. Good terms and conditions, a good place to work is critically important if we're going to get the young people working in health that we need.
MACDONALD: But isn't a result of this likely to be that the states and territories come to you, the Commonwealth, and say, look, actually we need more money if we're going to pay them properly?
BUTLER: Well, no, they're already funded to pay their doctors and nurses properly. That's already a very clear expectation in the hospital funding agreement. 
MACDONALD: On the question of pharmacies and the 60 day dispensing rules for prescriptions, obviously, there was this failed attempt to block the government's changes last week. They come into effect on September 1st. I was interested in some of the comments being put by the Nationals, David Littleproud, talking about the impact on regional and rural pharmacies, you know, fairly thin business model there and what this might do to those operations. Do you acknowledge that this might be a hit for some of those small pharmacies?
BUTLER: We acknowledge that smaller rural pharmacies are often operating on a different business model to some of the bigger ones in the cities They will rely less on sort of retail, if you like, and more on the dispensing income they get from prescriptions, which is exactly why we've put in place a very large transition package for small rural pharmacies.
MACDONALD: So, what will they get?
BUTLER: We've already doubled the allowance they received just to stay open That came into effect on the 1st of July. And in addition to that, there's a very big package of support over and above that, which means that small rural pharmacies, which is the vast bulk of them, will receive 100 per cent of the reduction in dispensing income. That's over and above the additional investment we're making in all pharmacies across the country, which will amount for most of them to hundreds of thousands of dollars in funding from taxpayers through the course of this four-year period.
MACDONALD: On one final matter, you will have heard most likely in the news this morning, Minister, that Mary-Louise McLaws, the epidemiologist, has died at the age of 70. She'd been battling a brain tumour. Clearly, she was a voice of, I suppose, sanity and clarity during some fairly dark times. I know ministers and governments didn't necessarily always like what the epidemiologists were saying during the COVID pandemic, but I know to listeners here on RN Breakfast she was she became a very familiar voice. Any thoughts, any reflections on the role played by the likes of Mary-Louise McLaws?
BUTLER:  Oh, this is such sad news. I mean, hers was an incredibly calm, articulate voice at a time that was very frightening to Australians. And so to hear her on programmes like yours, to see her on TV outline in a very calm but authoritative and articulate way, the best way we could protect ourselves was a source of great reassurance to the Australian people. But it was only a small part of a lifelong career she gave in epidemiology and infectious diseases, particularly in New South Wales in areas like HIV and viral hepatitis. I'm sure her colleagues will miss her terribly. But most importantly, her family and friends will be desperately sad at this news over the weekend.
MACDONALD: Indeed. Mark Butler, thanks very much for your time.
BUTLER: Thank you, Hamish.