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Speaker 1: Last week I spoke with both the Health Minister, Chris

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Speaker 1: Pickton and the Premier Peter Melanowskis on the program and

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Speaker 1: amongst the other issues, one of course being health that

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Speaker 1: comes up all the time. Both increasingly frustrated. It is

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Speaker 1: the right word in regards to the situation in our

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Speaker 1: hospitals where there is bed block, particularly in getting elderly

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Speaker 1: patients out of hospital and into aged care, and they're

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Speaker 1: looking at the federal government to do much more. In fact,

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Speaker 1: the day the Premier was in the Health Minister was

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Speaker 1: meeting with my next guest, the Federal Health Minister, Mark Butler.

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Speaker 1: Mister Butler, good morning, mining matter any resolution to this

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Speaker 1: because this is a problem, isn't it aged care beds

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Speaker 1: not available for elderly people in hospitals to move into.

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Speaker 2: Well, that's right, and this reflects some really serious challenges

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Speaker 2: in the age care sector outside of hospitals, but also

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Speaker 2: in parts of the health system like general practice that

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Speaker 2: we've been working really hard on the last couple of years,

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Speaker 2: trying to make sure that people are able to get

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Speaker 2: the care they need in the community rather than having

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Speaker 2: to go to hospital in the first place. So part

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Speaker 2: of this is about a front door strategy to try

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Speaker 2: and prevent people having to go to hospital in the

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Speaker 2: first place. Then, as you say, if particularly older patients

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Speaker 2: end up in hospital, how are they able to move

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Speaker 2: through the system and be discharged as soon as their

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Speaker 2: doctors say that's clinically possible. So yes, we are working

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Speaker 2: very hard, not just with South Australia, but frankly every

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Speaker 2: state government is having this challenge after ten years of

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Speaker 2: real pressure on our Medicare today.

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Speaker 1: Isn't the answer though more federal government investments than to

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Speaker 1: create these places and aged care beds.

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Speaker 2: Well, we're working on creating more age care beds. This

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Speaker 2: is a very difficult piece of reform that we're undertaking.

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Speaker 2: We're trying to have discussions with the opposition. You know,

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Speaker 2: they've been very constructive at trying to reach a bipartisan

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Speaker 2: position on reform to age care that leads age care

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Speaker 2: sector to build all of the beds that we need,

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Speaker 2: not just now, but particularly over the coming five or

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Speaker 2: ten years as the large baby boomer population starts to

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Speaker 2: reach the age of residential age care. And in the

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Speaker 2: meantime we've got a lot more funding going into first

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Speaker 2: of all, general practice to try and stop people ending

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Speaker 2: up in hospital in the first place, but also a

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Speaker 2: big package we're en out in the May Budget to

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Speaker 2: support the South Australian government and other state governments to

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Speaker 2: move older patients through the hospital system more smoothly.

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Speaker 1: There's the Aged Care task Force that is recommended strongly

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Speaker 1: you move on this urgently to get more beds created.

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Speaker 1: The task force's final report saying that we need a

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Speaker 1: new Aged Care Act, but we're all we're doing is

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Speaker 1: pushing out the timelines further and further into the future

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Speaker 1: in terms of doing anything. So currently in South Australia,

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Speaker 1: the Minister telling me some two hundred and eighty people

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Speaker 1: waiting to move into an aged care bed. That's just

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Speaker 1: unsustainable for the hospital system here.

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Speaker 2: You're right, it is, which is why we put more

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Speaker 2: than fifty six million dollars into the South Australian system

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Speaker 2: and the budget particularly focused on moving longest stay, older

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Speaker 2: patients out of the hospital system. We're also in the

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Speaker 2: middle of negotiations to frankly, just put more money into

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Speaker 2: hospitals from the Commonwealth, more than thirteen billion dollars, additional

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Speaker 2: funding that the Prime Minister committed at the December National

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Speaker 2: Cabinet meeting he had with Premier and Malamascus to better

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Speaker 2: support our public hospital systems. But in terms of the

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Speaker 2: Age Care Task Force, you're right, this is a very

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Speaker 2: important opportunity for once in a generation reform of the

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Speaker 2: age care sector. And as I said, we're having very

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Speaker 2: constructive discussions with the opposition led by Anne Rusten, a

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Speaker 2: South Australian senator who has responsibility for this area in

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Speaker 2: the opposition federally, because we know this is important reform,

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Speaker 2: but it's also sensitive and it is always better done

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Speaker 2: on a bipartisan basis than potentially going into a political storm.

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Speaker 1: When's it going to happen? Though? When are we going

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Speaker 1: to see that bed block ease next year?

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Speaker 2: Well, it's not going to be switched on or off simply.

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Speaker 2: I mean, as you said in your introduction, I had

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Speaker 2: a meeting with Chris Pickton and his lead official, the

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Speaker 2: head of essay Health, last week and as we're doing

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Speaker 2: in some other states, we're working to a system where

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Speaker 2: we can seriously case manage every individual patient to see

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Speaker 2: whether we can find them an aged care bed. That's hard, Yaker,

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Speaker 2: It really is a hard slog that frankly, our officials

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Speaker 2: just have to keep working at together, working between the

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Speaker 2: Commonwealth which has responsibility for age care, and the Essay

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Speaker 2: Health officials who are running our hospital systems. But as

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Speaker 2: I said, we're putting more money into the very innovative ways. Frankly,

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Speaker 2: the Essay Health is thinking of, first of all, stopping

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Speaker 2: older patients coming to hospital in the first place if

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Speaker 2: they can be properly cared for out in the community.

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Speaker 2: So we've got hospital outreach teams that are now going

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Speaker 2: out visiting age care facilities where someone takes a turn

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Speaker 2: for the worst and trying to give them the care

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Speaker 2: that they need there rather than simply putting them in

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Speaker 2: an ambulance and sending them to hospital, which often means

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Speaker 2: they stay there for weeks and weeks, if not months

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Speaker 2: and month.

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Speaker 1: Can we talk about the other issue that people will

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Speaker 1: ring this station about during this chat and have over

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Speaker 1: the last few weeks. The gap at doctor's clinics is

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Speaker 1: just widening. One person who works here it tells me

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Speaker 1: her mum, who's a pension that is charged one hundred

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Speaker 1: dollars as a gap. Other people will ring in and

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Speaker 1: I've heard people on air and people into this program

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Speaker 1: say fifty to sixty seventy dollars regularly is the gap

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Speaker 1: that's just becoming unsustainable. So therefore people are turning up

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Speaker 1: at hospitals bang the ramping problem gets even worse than

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Speaker 1: it is as a result of people trying to save

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Speaker 1: that fifty seventy one hundred bucks. That's unsustainable long.

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Speaker 2: Term, and that's why I'm last to this budget. We

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Speaker 2: invested the most that's ever been invested in bulk doing,

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Speaker 2: tripled the bulk billing incentive and already that has made

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Speaker 2: a very substantial increase in bulk billing rate. Now, those

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Speaker 2: rates were in free fall when we came to government

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Speaker 2: because the Medicare rebate had been frozen for most of

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Speaker 2: the last decade. But we've delivered the two biggest increases

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Speaker 2: to the Medicare rebate in thirty years. And on top

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Speaker 2: of that, we tripled the bolt billing incentive, particularly for pensioners,

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Speaker 2: for concession cardholders and for kids. And last months alone

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Speaker 2: in June, the last record of months had delivered an

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Speaker 2: additional nine hundred thousand free visits to the doctor. Nine

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Speaker 2: hundred thousand additional visits to the doctor. In May and

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Speaker 2: in South Australia, we've seen the bolt billing rate in

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Speaker 2: just seven months climb by almost six percent. So not

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Speaker 2: only have we stopped the decline the free fall that

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Speaker 2: we inherited when we came to government, you are starting

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Speaker 2: to see that bulk billing rate climb in South Australia

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Speaker 2: and in every other state and territory. Now there's more

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Speaker 2: to do but these agreed sheets of recovery, but we

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Speaker 2: are starting to see a turnaround in bulk billing, which,

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Speaker 2: for labor is the beating heart of Medicare. And on

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Speaker 2: top of that, we've also rolled out a network of

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Speaker 2: urgent care clinics, particularly for people who need urgent care

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Speaker 2: but don't necessarily need to go to the hospital and

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Speaker 2: urgency department, and that's delivered well over six hundred thousand

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Speaker 2: services in just twelve months, every single one of which

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Speaker 2: was fully bold builled.

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Speaker 1: So to those people that are still paying a gap,

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Speaker 1: what are you saying, Just wait and you'll see those

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Speaker 1: benefits down the track at some stage because people are

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Speaker 1: still paying it.

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Speaker 2: I know, And again I just want to be honest

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Speaker 2: with your listeners, Matthew. I mean a decade of cuts

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Speaker 2: and neglect. We cannot turn around overnight, but we are

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Speaker 2: starting to see those green shoots of recovery. Bulk billing

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Speaker 2: is turning around. Urgent care services are working fantastically well

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Speaker 2: across the country, delivering services seven days a week, one

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Speaker 2: in three of them to kids, often who fall off

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Speaker 2: their skateboard or get injured in Saturday or Sunday sport. Otherwise,

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Speaker 2: these people would be lining up at hospital emergency departments

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Speaker 2: if their twelve year old breaks their arm coming off

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Speaker 2: a skateboard. Instead, they're getting high quality care seven days

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Speaker 2: a week, fully bolt build. So I know that we've

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Speaker 2: not been able to turn things around overnight, but we

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Speaker 2: are starting to see these green shoots of recovery. Because

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Speaker 2: for the Labor government there's nothing more important than strengthening

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Speaker 2: Medicare the.

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Speaker 1: GP care clinics around the place, what do you say

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Speaker 1: to the AMA that says that's just fragmenting the health system,

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Speaker 1: that OK, they're performing a role, but they're not ultimately

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Speaker 1: helping anything because it's just placing more pressure on GPS,

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Speaker 1: which is where people end up after that emergency.

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Speaker 2: Well, that's not what the six hundred thousand patients have

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Speaker 2: gone through these clinics are saying to us. They're saying

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Speaker 2: that the vast bulk of them are saying if the

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Speaker 2: clinic wasn't available, they'd have ended up at a hospital

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Speaker 2: emergency department. Remember a third of these on weekends. On

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Speaker 2: the weekdays, a significant number are after hours. These are

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Speaker 2: people who need care urge. So it's not just standard

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Speaker 2: general practice care. This is urgent care because there's been

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Speaker 2: an injury, there's been a deep laceration, there's a very

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Speaker 2: serious respiratory illness, and the vast park of these people

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Speaker 2: say otherwise they'd go to a hospital emergency department. It's

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Speaker 2: not fragmentation in the sense that these clinics I know

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Speaker 2: are also passing the report back onto the person's usual GP,

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Speaker 2: so their usual GP is very clear about the service

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Speaker 2: that they got in these urgent care clinics. This is

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Speaker 2: a very important gap in the Australian healthcare system that

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Speaker 2: we have started to fill with these urgent care clinics.

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Speaker 2: Most countries we usually compare ourselves to have this sort

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Speaker 2: of service, a service sort of in between a standard

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Speaker 2: general practice on the one hand and a fully equipped

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Speaker 2: hospital emergency department on the other.

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Speaker 1: Not enough gps. What are we doing to fund more

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Speaker 1: doctors places? And this is somewhere else that the federal

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Speaker 1: government needs to spend some money. Isn't it to create

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Speaker 1: more training positions for GPS ultimately GPS doctors in general.

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Speaker 2: Absolutely. I mean, it wasn't too long ago, maybe thirty

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Speaker 2: years ago, Mattive it at about one in two junior

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Speaker 2: doctors or medical graduates chose to become GPS. Now it's

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Speaker 2: only one in seven. So one in two down to

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Speaker 2: one in seven. That's going to have an impact. And

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Speaker 2: we know that without a well functioning general practice system,

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Speaker 2: which is the bedrock of a good healthcare system, we're

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Speaker 2: going to see these impacts continue to reverberate through our

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Speaker 2: hospitals and through age care and such lights. So you know,

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Speaker 2: I've got no higher priority than rebuilding general practice. I'm

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Speaker 2: really pleased that this year twenty percent more junior doctors

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Speaker 2: are choosing general practice, and they did last year again

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Speaker 2: green shoots of recovery. I'm not pretending that's changing the

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Speaker 2: world overnight, but we're going back in the right direction.

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Speaker 2: And part of that, I think is those young doctors

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Speaker 2: and those general practitioners who work so hard out in

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Speaker 2: the community, who dealt with a decade of cuts and neglect,

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Speaker 2: finally see our hope a government in Canberra that values them,

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Speaker 2: that recognizes that general practice is the bedrock of a

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Speaker 2: high quality healthcare system.

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Speaker 1: Minister, with great respect, you talk about how health is

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Speaker 1: so important to the Australian Labor Party. Without funding the

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Speaker 1: aged care beds, without bringing on more GPS, without creating

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Speaker 1: the bulk billing that we were used to years ago

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Speaker 1: with Medicare, without that being in place sooner than later,

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Speaker 1: it's all just words floating through the ether. If it

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Speaker 1: doesn't happen and people are paying fifty to one hundred

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Speaker 1: bucks to go visit the GP in a gap, if

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Speaker 1: we don't have enough GPS, and you look at the

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Speaker 1: College of General Practitioners saying in years to come we're

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Speaker 1: going to be short some ten thousand GPS. If we've

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Speaker 1: got bedblock because there's not enough aged care beds, well

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Speaker 1: the system falls down and your words ultimately are meaningless.

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Speaker 2: I'll try to be honest with your listeners and with

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Speaker 2: other Australians, Matthew. The damage done over the last decade

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Speaker 2: can't be fixed overnight. But we've put the biggest investment

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Speaker 2: ever in bulk building and already in just seven months

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Speaker 2: that's delivered millions of additional free visits to the doctor.

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Speaker 2: We're rolling out the network of urgent care clinics that

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Speaker 2: are delivering hundreds of thousands of bulk build urgent care services.

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Speaker 2: We have seen an increase of about twenty percent in

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Speaker 2: junior doctors coming back to general practice, and we need

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Speaker 2: to build on that. I completely agree with you, Matthew.

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Speaker 2: We've invested billions of dollars into age care, which is

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Speaker 2: putting nurses back into nursing homes. Now, yes, we need

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Speaker 2: to do the next stage of age care reform, which

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Speaker 2: is why we're working hard with the opposition to try

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Speaker 2: to come to an agreement so that that's got bipartisan support,

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Speaker 2: doesn't just chop and change election to election. But I

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Speaker 2: want to reassure your listeners that our government is so

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Speaker 2: focused on this. We want to support our public hospitals better,

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Speaker 2: which is why we've put thirteen billion dollars additional money

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Speaker 2: on the table with state premiers like Premier al Anauskus

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Speaker 2: and the rest of them, because we know turning this

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Speaker 2: around is not easy but is absolutely essential. We've got

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Speaker 2: probably one of the best healthcare systems in the world,

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Speaker 2: but we can't rest on our laurels. We have to

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Speaker 2: work hard to make sure it stays that way.

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Speaker 1: Appreciate your time this morning, Minister. Thanks Matthew Mark Butler,

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Speaker 1: the federal health Minister, on those issues,