1
00:00:00,400 --> 00:00:03,000
Speaker 1: Please to invite and welcome into the studio here this

2
00:00:03,080 --> 00:00:06,480
Speaker 1: morning the Federal and Aged Care Minister Mark Butler.

3
00:00:06,559 --> 00:00:08,080
Speaker 2: Good morning morning, Matthew.

4
00:00:08,200 --> 00:00:09,960
Speaker 1: Thank you for coming in and if people want to

5
00:00:09,960 --> 00:00:11,880
Speaker 1: call in of course eight double two to three double

6
00:00:11,960 --> 00:00:14,320
Speaker 1: o double oh lots to have a chat about aged care.

7
00:00:14,400 --> 00:00:18,680
Speaker 1: Let's start with that legislation currently before the Parliament which

8
00:00:18,840 --> 00:00:24,480
Speaker 1: will result in self funded retirees, particularly paying more for

9
00:00:24,520 --> 00:00:27,520
Speaker 1: their aged care moving forward. Is that going to hit

10
00:00:27,560 --> 00:00:30,800
Speaker 1: people who are potentially vulnerable and some who might be

11
00:00:31,280 --> 00:00:35,360
Speaker 1: close to borderline in being a self funded retiree paying

12
00:00:35,400 --> 00:00:37,640
Speaker 1: more for age care in the future could tip them

13
00:00:37,680 --> 00:00:40,640
Speaker 1: into all the poverty side of the balance sheet, couldn't it.

14
00:00:41,120 --> 00:00:44,360
Speaker 2: No, we've been very careful in our design of the

15
00:00:44,520 --> 00:00:48,199
Speaker 2: new co contribution arrangements for age care. Our challenge, really, Matthew,

16
00:00:48,360 --> 00:00:50,839
Speaker 2: was that we had a royal commission delivered to the

17
00:00:50,960 --> 00:00:53,479
Speaker 2: previous government about the state of age care and many

18
00:00:53,520 --> 00:00:56,480
Speaker 2: of your listeners will remember all of the pretty shocking

19
00:00:56,560 --> 00:01:00,280
Speaker 2: stories about the state of the sector. It became worse

20
00:01:00,400 --> 00:01:03,080
Speaker 2: during COVID in many parts of the sector, and so

21
00:01:03,120 --> 00:01:07,360
Speaker 2: there were dozens and dozens of recommendations from those Royal

22
00:01:07,400 --> 00:01:11,959
Speaker 2: commissioners about how to build a system that was decent today,

23
00:01:12,360 --> 00:01:16,319
Speaker 2: dignified today, but also one that was sustainable for the future,

24
00:01:16,319 --> 00:01:18,959
Speaker 2: because we know we've got a very big increase in

25
00:01:19,040 --> 00:01:23,640
Speaker 2: demand coming our way. Baby boomer generations in particular are

26
00:01:23,800 --> 00:01:26,680
Speaker 2: about to hit the age care sector. So the oldest

27
00:01:26,680 --> 00:01:29,880
Speaker 2: baby boomers born in forty five, forty six, forty seven,

28
00:01:29,959 --> 00:01:34,160
Speaker 2: like my dad, they're now hitting the average age of

29
00:01:34,200 --> 00:01:37,039
Speaker 2: home care packages, so the big increase in demand for

30
00:01:37,080 --> 00:01:40,080
Speaker 2: home care packages, and in about five years they'll hit

31
00:01:40,120 --> 00:01:42,760
Speaker 2: the average age of entry into nursing homes or age

32
00:01:42,760 --> 00:01:45,720
Speaker 2: care facilities, and we don't have enough, like we really

33
00:01:45,760 --> 00:01:49,680
Speaker 2: are in a bit of strife because there's been effectively

34
00:01:49,680 --> 00:01:53,760
Speaker 2: a capital strike by agecre operators. The system has not

35
00:01:53,840 --> 00:01:56,559
Speaker 2: been giving them the returns that they need to build

36
00:01:56,640 --> 00:01:59,600
Speaker 2: new facilities and build new beds, so banks haven't been

37
00:01:59,600 --> 00:02:02,480
Speaker 2: willing to lend to them. So there's been a whole

38
00:02:02,600 --> 00:02:05,080
Speaker 2: range of different challenges. How do we build a system

39
00:02:05,080 --> 00:02:07,360
Speaker 2: that works for people, How do we build a system

40
00:02:07,400 --> 00:02:09,760
Speaker 2: that keeps people living in their own home for as

41
00:02:09,800 --> 00:02:12,760
Speaker 2: long as possible, which is what everyone wants, but also

42
00:02:12,840 --> 00:02:15,360
Speaker 2: one that has enough beds in age care facilities. To

43
00:02:15,440 --> 00:02:18,000
Speaker 2: deal with the demand that is coming down the way

44
00:02:18,040 --> 00:02:20,760
Speaker 2: and so the problem with the Royal Commission report was

45
00:02:20,800 --> 00:02:23,760
Speaker 2: that it didn't give a clear recommendation about how to

46
00:02:23,840 --> 00:02:27,760
Speaker 2: finance the show sustainably. There were two Royal Commissioners and

47
00:02:27,800 --> 00:02:30,760
Speaker 2: they both had different ideas unfortunately, so we had to

48
00:02:30,960 --> 00:02:33,440
Speaker 2: come up with our own idea. We made it very

49
00:02:33,480 --> 00:02:35,799
Speaker 2: clear we were not going to put in a new

50
00:02:35,880 --> 00:02:39,079
Speaker 2: tax and that was also a position Peter Dutton made

51
00:02:39,160 --> 00:02:41,680
Speaker 2: clear from the opposition, and we said we were not

52
00:02:41,800 --> 00:02:44,680
Speaker 2: going to change the treatment of the family home. People

53
00:02:44,720 --> 00:02:47,840
Speaker 2: want to have security over their family homes. We made

54
00:02:47,840 --> 00:02:50,919
Speaker 2: that commitment as well. And what we've done instead, after

55
00:02:51,080 --> 00:02:53,840
Speaker 2: a lot of work the AGECRE Minister Anaka Wells has

56
00:02:53,919 --> 00:02:58,960
Speaker 2: led with the sector with consumer groups representatives of older

57
00:02:59,000 --> 00:03:03,000
Speaker 2: Australians is come up with a system of co contributions

58
00:03:03,720 --> 00:03:07,520
Speaker 2: that we think is fair and sustainable and will deliver

59
00:03:07,600 --> 00:03:09,880
Speaker 2: a much better AGECRE system. So it's not just that

60
00:03:09,919 --> 00:03:12,040
Speaker 2: people might pay a little bit more where they've got

61
00:03:12,400 --> 00:03:14,880
Speaker 2: the capacity to pay. In the future, we're going to

62
00:03:14,880 --> 00:03:19,000
Speaker 2: deliver a much better system, hundreds of thousands of more packages.

63
00:03:19,040 --> 00:03:22,280
Speaker 2: They're going to be better packages, so shorter weight times

64
00:03:22,480 --> 00:03:24,600
Speaker 2: and a whole range of other benefits for people to

65
00:03:24,720 --> 00:03:26,799
Speaker 2: keep them at home as much as possible as well.

66
00:03:26,880 --> 00:03:28,880
Speaker 1: It isn't the fact though, taxo, isn't it. You're asking

67
00:03:28,919 --> 00:03:31,560
Speaker 1: people to pay either way, it's a tax. You're certainly

68
00:03:31,600 --> 00:03:34,880
Speaker 1: charging them forward in the future self funded retirees. How

69
00:03:34,880 --> 00:03:36,440
Speaker 1: long before the levels increase?

70
00:03:37,000 --> 00:03:40,240
Speaker 2: Well, we think this is sustainable. We've designed it very carefully.

71
00:03:40,280 --> 00:03:42,960
Speaker 2: We've projected over ten years that this means that the

72
00:03:43,000 --> 00:03:46,920
Speaker 2: AGECRE system and still will continue the agecare budget, that

73
00:03:47,040 --> 00:03:50,320
Speaker 2: the amount taxpayers are kicking into the AGECRE system will

74
00:03:50,360 --> 00:03:53,920
Speaker 2: continue to grow quite sharply over the coming ten years.

75
00:03:54,120 --> 00:03:56,480
Speaker 2: We get that growth rate down a little bit, but

76
00:03:56,880 --> 00:03:59,920
Speaker 2: the important thing is that taxpayers are still funding the

77
00:04:00,240 --> 00:04:02,840
Speaker 2: vast bulk of age care. I mean, we do ask

78
00:04:02,880 --> 00:04:05,640
Speaker 2: people to contribute to that cost where they have the

79
00:04:05,680 --> 00:04:06,720
Speaker 2: capacity to pay.

80
00:04:07,320 --> 00:04:09,440
Speaker 1: That means they're paying twice, doesn't it They've paid through

81
00:04:09,440 --> 00:04:11,440
Speaker 1: their taxes and then they're paying again.

82
00:04:11,520 --> 00:04:13,240
Speaker 2: Well, just to give you a bit of a sense, Matthew,

83
00:04:13,320 --> 00:04:17,320
Speaker 2: I mean, currently taxpayers pay about seventy six percent of

84
00:04:17,680 --> 00:04:20,719
Speaker 2: the total cost of residential care. That'll come down to

85
00:04:20,760 --> 00:04:22,919
Speaker 2: seventy three percent, So I mean it's a bit of

86
00:04:22,920 --> 00:04:26,919
Speaker 2: a reduction in the taxpayer a bit of an increase

87
00:04:26,960 --> 00:04:29,280
Speaker 2: in the amount people pay for their own age care,

88
00:04:29,320 --> 00:04:33,000
Speaker 2: but it's not a massive change. Seventy six to seventy

89
00:04:33,000 --> 00:04:35,920
Speaker 2: three in the home care system, so people getting support

90
00:04:35,920 --> 00:04:39,840
Speaker 2: in their own home. Currently taxpayers pay for about ninety

91
00:04:39,839 --> 00:04:42,520
Speaker 2: five percent of that cost. Now we'll get that down

92
00:04:42,600 --> 00:04:45,680
Speaker 2: to eighty nine percent, but still pretty much nine in

93
00:04:45,720 --> 00:04:49,279
Speaker 2: every ten dollars is being paid by taxpayers. And we

94
00:04:49,400 --> 00:04:52,680
Speaker 2: know that the number of people out there in the

95
00:04:52,720 --> 00:04:57,360
Speaker 2: workforce paying taxes is shrinking as a proportion of the population.

96
00:04:57,720 --> 00:04:59,840
Speaker 2: There's no surprise. We've known that was coming for a

97
00:04:59,880 --> 00:05:03,160
Speaker 2: lo long time as the population ages, and we are

98
00:05:03,279 --> 00:05:06,279
Speaker 2: just going to have to adjust these things carefully to

99
00:05:06,360 --> 00:05:09,880
Speaker 2: make sure we're able to finance a decent, dignified age

100
00:05:09,960 --> 00:05:11,680
Speaker 2: care system in the long term.

101
00:05:11,920 --> 00:05:14,560
Speaker 1: The agecare system and people living in their own home.

102
00:05:14,640 --> 00:05:16,240
Speaker 1: So I read an email I think it was last

103
00:05:16,240 --> 00:05:19,719
Speaker 1: Friday from Memory Tommy who emailed in talking about the

104
00:05:19,720 --> 00:05:22,240
Speaker 1: fact their age care provider charged them one hundred and

105
00:05:22,240 --> 00:05:24,920
Speaker 1: fifty dollars for a service they'd canceled. That was a

106
00:05:25,000 --> 00:05:28,919
Speaker 1: cancelation fee. We let and Bill Shorten, as NDIS Minister,

107
00:05:29,000 --> 00:05:32,000
Speaker 1: have spoken of the ripoffs and the NDS over a

108
00:05:32,040 --> 00:05:34,600
Speaker 1: long period. But to cancel a pediatrist, I think it

109
00:05:34,640 --> 00:05:37,800
Speaker 1: was appointment one hundred and fifty dollars charge. That's just

110
00:05:37,880 --> 00:05:39,040
Speaker 1: ripping off the taxpayer.

111
00:05:39,600 --> 00:05:43,240
Speaker 2: Well, that's right, and those things should not be where

112
00:05:43,240 --> 00:05:47,120
Speaker 2: there happening. Complaints should be made to our Complaints Commission,

113
00:05:47,120 --> 00:05:50,880
Speaker 2: which has been long established. I was the age chemist

114
00:05:50,960 --> 00:05:54,880
Speaker 2: of twelve or fifteen years ago, and the Complaints Commission

115
00:05:54,920 --> 00:05:58,880
Speaker 2: was in place then. And the difference really with the NDIS, Matthew,

116
00:05:59,000 --> 00:06:02,200
Speaker 2: is that that's a relative new system. It's still sort of

117
00:06:02,200 --> 00:06:06,720
Speaker 2: building its compliance systems. There are thousands and thousands of

118
00:06:06,880 --> 00:06:10,800
Speaker 2: unregistered providers in the NDIS. Bill Shorten's only said in

119
00:06:10,880 --> 00:06:13,280
Speaker 2: recent days that they should get registered so that we

120
00:06:13,320 --> 00:06:16,760
Speaker 2: can have confidence that they comply with standards and so on.

121
00:06:17,560 --> 00:06:21,120
Speaker 2: That's long been the case in age care. Providers are registered,

122
00:06:21,279 --> 00:06:25,000
Speaker 2: they have clear, accountable standards, and when they do the

123
00:06:25,000 --> 00:06:28,400
Speaker 2: wrong thing, there is a well established complaint system to

124
00:06:28,480 --> 00:06:31,040
Speaker 2: deal with them. And so you know, when there are

125
00:06:31,120 --> 00:06:35,720
Speaker 2: cases like that that do inevitably arise. System as big

126
00:06:35,800 --> 00:06:37,839
Speaker 2: as this, people should be hauled in.

127
00:06:38,040 --> 00:06:40,720
Speaker 1: Yeah, absolutely, because it's us, it's all of us. That

128
00:06:40,760 --> 00:06:42,800
Speaker 1: are paying that cost. I mean, no one minds a

129
00:06:42,839 --> 00:06:45,760
Speaker 1: reasonable cancelation fee. I don't know, twenty thirty bucks one

130
00:06:45,839 --> 00:06:48,080
Speaker 1: hundred and fifty You got to shake your head at

131
00:06:48,120 --> 00:06:53,440
Speaker 1: that both billing. We need more doctors, we need more

132
00:06:53,480 --> 00:06:56,200
Speaker 1: GP training places, We need more of them out in

133
00:06:56,400 --> 00:07:01,320
Speaker 1: the community offering the services. Medicare rates should they rise?

134
00:07:01,800 --> 00:07:04,000
Speaker 1: What needs to happen here to make the GP system

135
00:07:04,040 --> 00:07:05,919
Speaker 1: work more effectively for all Australians.

136
00:07:06,040 --> 00:07:08,200
Speaker 2: Look this, Of all of the pressures in the health

137
00:07:08,200 --> 00:07:12,240
Speaker 2: system that your listeners will be very familiar with, they

138
00:07:12,240 --> 00:07:14,920
Speaker 2: were there before COVID, but they were aggravated by COVID.

139
00:07:15,000 --> 00:07:17,560
Speaker 2: You know, COVID really did hit the health system hard.

140
00:07:17,560 --> 00:07:19,480
Speaker 2: It hit all of us hard, but hit the health

141
00:07:19,480 --> 00:07:22,360
Speaker 2: system hard. Of all of the pressures in the health system,

142
00:07:22,400 --> 00:07:24,720
Speaker 2: the thing that has worried me most over the last

143
00:07:24,720 --> 00:07:28,239
Speaker 2: several years is general practice. It was run down terribly

144
00:07:28,280 --> 00:07:31,360
Speaker 2: over the past ten years. The Medicare rebate, which is

145
00:07:31,400 --> 00:07:34,720
Speaker 2: the main income source for GPS, it was frozen for

146
00:07:34,760 --> 00:07:36,800
Speaker 2: the best part of a decade, So you freeze the

147
00:07:36,840 --> 00:07:39,960
Speaker 2: income of GPS for their costs are continuing to go up. Well,

148
00:07:39,960 --> 00:07:42,880
Speaker 2: you know what happens They start charging gap fits and

149
00:07:42,920 --> 00:07:45,000
Speaker 2: so when we came to government, bog building was in

150
00:07:45,040 --> 00:07:47,440
Speaker 2: free fall and for us as a labor party that

151
00:07:47,520 --> 00:07:51,080
Speaker 2: created Medicare, bolg billing is the beating heart of Medicare.

152
00:07:51,240 --> 00:07:55,120
Speaker 2: So we've put a lot of money into not just Medicare,

153
00:07:55,160 --> 00:07:59,000
Speaker 2: but particularly into general practice. We've increased the Medicare rebate

154
00:07:59,200 --> 00:08:02,280
Speaker 2: over the last two years and our two budgets by

155
00:08:02,400 --> 00:08:05,000
Speaker 2: more than the last government did in nine years.

156
00:08:05,040 --> 00:08:07,760
Speaker 1: Well, that hasn't stopped doctors increasing that bulk billing. Well

157
00:08:07,960 --> 00:08:08,840
Speaker 1: the gap rate though.

158
00:08:09,240 --> 00:08:11,320
Speaker 2: Well I'll come to that. Yeah, But so that the

159
00:08:11,400 --> 00:08:14,720
Speaker 2: two biggest increases in the Medicare rebate in thirty years,

160
00:08:14,760 --> 00:08:17,480
Speaker 2: the first and the second biggest. In addition to that,

161
00:08:17,680 --> 00:08:20,760
Speaker 2: we tripled the bulk billing incentive. So this is the

162
00:08:20,800 --> 00:08:24,200
Speaker 2: extra payment GPS get if they bulk bill someone coming

163
00:08:24,240 --> 00:08:27,080
Speaker 2: through their doors. And that had been the claim or

164
00:08:27,080 --> 00:08:29,960
Speaker 2: the ask if you like, from the College of GPS.

165
00:08:30,040 --> 00:08:33,000
Speaker 2: They said, this is what's needed to turn around bulk billing,

166
00:08:33,040 --> 00:08:35,280
Speaker 2: and we did it last year, the biggest ever investment

167
00:08:35,600 --> 00:08:38,199
Speaker 2: in bulk billing. Now it only took effect in November,

168
00:08:38,840 --> 00:08:41,280
Speaker 2: so it hasn't even been going for a year, but

169
00:08:41,400 --> 00:08:46,000
Speaker 2: already We've seen well over four million additional free visits

170
00:08:46,080 --> 00:08:49,679
Speaker 2: to the doctor that would not otherwise have been bulk billed.

171
00:08:50,240 --> 00:08:52,840
Speaker 2: That's a lot of additional free visits in less than

172
00:08:52,880 --> 00:08:55,520
Speaker 2: twelve months. And here in South Australia, just in the

173
00:08:55,600 --> 00:08:58,400
Speaker 2: last four months there have been about two hundred and

174
00:08:58,400 --> 00:09:02,920
Speaker 2: sixty thousand additional bulk build visits to the doctor. Now,

175
00:09:03,160 --> 00:09:05,440
Speaker 2: you know that is making a real, real difference. It

176
00:09:05,480 --> 00:09:09,240
Speaker 2: doesn't mean it's not still tough to get a doctor appointment.

177
00:09:09,320 --> 00:09:12,680
Speaker 2: It's not still tough in some areas to get bulk billing.

178
00:09:12,800 --> 00:09:15,480
Speaker 2: But what was a situation that was falling off a

179
00:09:15,520 --> 00:09:18,120
Speaker 2: cliff has turned around. We're seeing bulk billing rates go

180
00:09:18,240 --> 00:09:21,040
Speaker 2: up in every state, in every territory. And one of

181
00:09:21,040 --> 00:09:23,520
Speaker 2: the highest increases in bulk billing rates in the last

182
00:09:23,600 --> 00:09:26,280
Speaker 2: ten months or so has been here in South Australia.

183
00:09:26,400 --> 00:09:28,240
Speaker 1: I reckon, if I ask people now how much have

184
00:09:28,280 --> 00:09:30,840
Speaker 1: you paid at your last doctor's visit, I'd get calls

185
00:09:30,880 --> 00:09:33,720
Speaker 1: of forty dollars, sixty dollars, even up to one hundred.

186
00:09:33,800 --> 00:09:36,120
Speaker 1: We had a person telling us one hundred dollars.

187
00:09:36,280 --> 00:09:38,800
Speaker 2: Recently, I hear them around the country and you know,

188
00:09:38,840 --> 00:09:41,640
Speaker 2: we're doing We're doing what we can to turn that around.

189
00:09:41,760 --> 00:09:44,400
Speaker 2: I was really worried that bulk billing was going to

190
00:09:44,440 --> 00:09:50,160
Speaker 2: start to disappear here in South Australia. For GP visits,

191
00:09:50,840 --> 00:09:53,880
Speaker 2: the bulk billing rate is now over seventy five percent. Again,

192
00:09:54,040 --> 00:09:56,760
Speaker 2: so three and four visits a bulk build, but you know,

193
00:09:56,840 --> 00:09:59,880
Speaker 2: for one in four people are paying a gap fee.

194
00:10:00,080 --> 00:10:02,520
Speaker 2: Want to see that bulk billing rate continue to go up.

195
00:10:02,800 --> 00:10:04,920
Speaker 2: And one of the other points you made, Matthew, which

196
00:10:05,000 --> 00:10:08,439
Speaker 2: is really worrying to me, is we're just not getting

197
00:10:08,559 --> 00:10:12,520
Speaker 2: enough junior doctors choosing general practice as their preferred career.

198
00:10:12,600 --> 00:10:15,800
Speaker 2: I mean, thirty forty years ago, about one in two

199
00:10:16,120 --> 00:10:19,400
Speaker 2: medical graduates would go into general practice and the other

200
00:10:19,800 --> 00:10:24,320
Speaker 2: half would go into surgery and the rest. That's down

201
00:10:24,520 --> 00:10:26,800
Speaker 2: from one in two to about one in seven.

202
00:10:26,960 --> 00:10:28,520
Speaker 1: Okay, what do we do to reverse that?

203
00:10:28,880 --> 00:10:31,120
Speaker 2: Well, we have to make general practice more attractive and

204
00:10:31,120 --> 00:10:35,800
Speaker 2: that has been part of my very clear commitment to

205
00:10:36,200 --> 00:10:38,959
Speaker 2: reviving general practice. I mean, the vast bulk of our

206
00:10:39,000 --> 00:10:43,160
Speaker 2: investments into strengthening medicare have deliberately, quite deliberately and una

207
00:10:43,480 --> 00:10:47,720
Speaker 2: apologetically been into general practice because that was my first priority.

208
00:10:47,840 --> 00:10:50,320
Speaker 1: So funding places in Uni. Do we need to do that.

209
00:10:50,520 --> 00:10:54,599
Speaker 2: Yeah, I'll come back to that. But this year the

210
00:10:55,080 --> 00:10:58,600
Speaker 2: number of medical graduates choosing general practice is twenty percent

211
00:10:58,720 --> 00:11:01,000
Speaker 2: higher than it was last year. That's a good sign.

212
00:11:01,080 --> 00:11:05,000
Speaker 2: It's green shoots of recovery. It's not glasses down. This

213
00:11:05,120 --> 00:11:07,400
Speaker 2: is all fixed by any stretch of the imagination. We've

214
00:11:07,400 --> 00:11:09,600
Speaker 2: got a long way to go, but again, like with

215
00:11:09,679 --> 00:11:13,240
Speaker 2: bolk billing, we're starting to see things heading in the

216
00:11:13,320 --> 00:11:17,440
Speaker 2: right direction again. Chris Picton the terrific South Australian Health

217
00:11:17,480 --> 00:11:19,640
Speaker 2: Minister here, a number of his colleagues have made the

218
00:11:19,679 --> 00:11:23,160
Speaker 2: case to us that we need more medical school places,

219
00:11:23,200 --> 00:11:27,160
Speaker 2: so we need more medical graduates into the system, and

220
00:11:27,280 --> 00:11:30,240
Speaker 2: we are considering that. That was also a recommendation from

221
00:11:30,280 --> 00:11:34,520
Speaker 2: the university's accord that the Education Minister Jason Clair received

222
00:11:34,559 --> 00:11:37,079
Speaker 2: a little while ago. But I also want to make

223
00:11:37,120 --> 00:11:40,880
Speaker 2: sure that if we are having more medical school places

224
00:11:40,880 --> 00:11:44,120
Speaker 2: and medical graduates, that they're going into the areas we

225
00:11:44,200 --> 00:11:47,920
Speaker 2: most need. General practice is top of the list, Psychiatry

226
00:11:48,040 --> 00:11:51,040
Speaker 2: is an area of shortage as well, and aesthetics is

227
00:11:51,280 --> 00:11:53,760
Speaker 2: an area that state governments say they're a little short

228
00:11:53,800 --> 00:11:55,959
Speaker 2: on as well. So we need to get a better

229
00:11:56,040 --> 00:12:01,920
Speaker 2: sense as governments about where these highly prized junior doctors

230
00:12:02,040 --> 00:12:02,600
Speaker 2: are going.

231
00:12:03,080 --> 00:12:07,280
Speaker 1: Okay, you mentioned Chris Picton and the state go by

232
00:12:07,280 --> 00:12:09,640
Speaker 1: the way, Mark Butler's my guest, Federal Health minister. Any

233
00:12:09,679 --> 00:12:12,280
Speaker 1: questions eight double two to three double o double oh.

234
00:12:12,360 --> 00:12:15,360
Speaker 1: Chris Picton and the state government's promised to win ramping.

235
00:12:15,440 --> 00:12:17,439
Speaker 1: Now you can look at that from afar from above

236
00:12:17,480 --> 00:12:19,400
Speaker 1: if you like, as the federal minister and say, well,

237
00:12:19,440 --> 00:12:22,480
Speaker 1: that's your problem. But it is aged care that is

238
00:12:22,600 --> 00:12:26,079
Speaker 1: one of the big factors. People in hospitals who should

239
00:12:26,120 --> 00:12:28,880
Speaker 1: be in the nursing homes. So it's going to take years,

240
00:12:28,920 --> 00:12:32,720
Speaker 1: isn't it. Once your bill passes and aged care providers

241
00:12:32,840 --> 00:12:36,559
Speaker 1: ramp up services, we're still talking years before hospitals are

242
00:12:36,559 --> 00:12:39,040
Speaker 1: cleared of the people in hospital beds who should be

243
00:12:39,080 --> 00:12:39,920
Speaker 1: in an age care bed.

244
00:12:40,920 --> 00:12:43,839
Speaker 2: That's well, I am the federal Health Minister, but I'm

245
00:12:43,880 --> 00:12:47,840
Speaker 2: also proud South Australian, as you know, Matthew, So you

246
00:12:47,840 --> 00:12:50,280
Speaker 2: know I watched this closely, but I talk to health

247
00:12:50,320 --> 00:12:53,480
Speaker 2: ministers across the country who are experiencing exactly the same

248
00:12:53,520 --> 00:12:56,760
Speaker 2: pressures that the state government here is experiencing. You know,

249
00:12:56,760 --> 00:12:59,640
Speaker 2: we've got the aging population. I talked about a lot

250
00:12:59,640 --> 00:13:02,200
Speaker 2: of people didn't get the care that they should have

251
00:13:02,280 --> 00:13:06,480
Speaker 2: got during COVID because people were locked down. There were

252
00:13:06,520 --> 00:13:10,280
Speaker 2: density restrictions on things as simple as but in important

253
00:13:10,320 --> 00:13:12,840
Speaker 2: as cancer screening and all the rest. So hospitals are

254
00:13:12,960 --> 00:13:15,360
Speaker 2: under very real pressure. Either side the sort of winter

255
00:13:16,120 --> 00:13:20,600
Speaker 2: flood of respiratory illnesses that everyone's experiencing right now, we

256
00:13:20,720 --> 00:13:23,640
Speaker 2: are doing. We're doing all that we can at a

257
00:13:23,679 --> 00:13:26,360
Speaker 2: Commonwealth level, and I'll just talk about a few of them.

258
00:13:26,840 --> 00:13:29,240
Speaker 2: The first thing is that the Commonwealth, frankly has not

259
00:13:29,320 --> 00:13:33,600
Speaker 2: been providing enough financial support to state governments to run

260
00:13:33,640 --> 00:13:36,880
Speaker 2: their public hospitals. So in December last year, at a

261
00:13:36,920 --> 00:13:39,319
Speaker 2: meeting of the Premiers and the Prime Minister, our government

262
00:13:39,360 --> 00:13:44,080
Speaker 2: committed at least thirteen billion additional dollars into the hospital system.

263
00:13:44,120 --> 00:13:46,640
Speaker 2: And the biggest winner of all of the states from

264
00:13:46,679 --> 00:13:50,280
Speaker 2: that would be South Australia, because, for some curious reason

265
00:13:50,360 --> 00:13:53,440
Speaker 2: that I don't think anyone understands, South Australia has got

266
00:13:53,559 --> 00:13:56,880
Speaker 2: less funding from the Commonwealth than say the big states

267
00:13:56,880 --> 00:13:59,480
Speaker 2: of New South walest and Victoria. So our commitment to

268
00:13:59,559 --> 00:14:02,520
Speaker 2: lift it lift all boats up to up to a

269
00:14:02,600 --> 00:14:06,840
Speaker 2: much higher level. But an equitable level across borders would

270
00:14:06,840 --> 00:14:09,080
Speaker 2: be a very big win for South Australia, so we

271
00:14:09,120 --> 00:14:09,600
Speaker 2: need to do that.

272
00:14:09,679 --> 00:14:11,760
Speaker 1: You're a South Australian minister, though, why an't you lobbying

273
00:14:11,760 --> 00:14:12,080
Speaker 1: for more?

274
00:14:14,400 --> 00:14:17,360
Speaker 2: I am. We've made that commitment. We're in negotiations with

275
00:14:17,800 --> 00:14:21,760
Speaker 2: state governments to finalize that hospital funding deal, but it's

276
00:14:21,800 --> 00:14:24,560
Speaker 2: money we've already put on the table. The second thing

277
00:14:24,640 --> 00:14:28,720
Speaker 2: is that bulk billing question. We hear stories all across

278
00:14:28,760 --> 00:14:31,000
Speaker 2: the country if people can't get in to see a GP,

279
00:14:31,680 --> 00:14:33,760
Speaker 2: or if they are on low and fixed incomes and

280
00:14:33,760 --> 00:14:36,720
Speaker 2: can't get in to see a bulk build GP too

281
00:14:36,760 --> 00:14:39,040
Speaker 2: often they feel their only option is to go to

282
00:14:39,080 --> 00:14:42,240
Speaker 2: the EDS. So increasing bulk billing rates is important. We've

283
00:14:42,280 --> 00:14:46,200
Speaker 2: also set up this network of urgent care clinics. This

284
00:14:46,280 --> 00:14:49,880
Speaker 2: is something I promised at the last election. We set

285
00:14:49,920 --> 00:14:53,479
Speaker 2: up fifty eight last year, including five here in South Australia,

286
00:14:54,000 --> 00:14:56,440
Speaker 2: and we're doing more to get up to eighty nine.

287
00:14:56,840 --> 00:15:01,360
Speaker 2: They are seeing people who have minor emergingencies. They need

288
00:15:01,400 --> 00:15:04,080
Speaker 2: to be seen urgently, but they don't need to go

289
00:15:04,160 --> 00:15:07,880
Speaker 2: to a fully equipped hospital. So the classic is they're

290
00:15:07,960 --> 00:15:11,200
Speaker 2: very busy on Saturday afternoons right they operate seven days

291
00:15:11,200 --> 00:15:14,520
Speaker 2: a week. They're fully bolt build. There's one in the north,

292
00:15:14,680 --> 00:15:16,320
Speaker 2: there's one in Marion, there's one in the south.

293
00:15:16,320 --> 00:15:18,440
Speaker 1: There's got good reports from people they ring in tell

294
00:15:18,520 --> 00:15:19,120
Speaker 1: us good stories.

295
00:15:19,240 --> 00:15:22,520
Speaker 2: Yeah, the kid gets a broken mum. You know you

296
00:15:22,520 --> 00:15:25,080
Speaker 2: can't wait seven or eight get into a GP. But

297
00:15:25,160 --> 00:15:27,920
Speaker 2: equally you don't necessarily have to wait eight ten hours

298
00:15:27,920 --> 00:15:32,280
Speaker 2: at the locally d That is taking pressure off emergency departments,

299
00:15:32,280 --> 00:15:34,280
Speaker 2: off the front door, if you like, at the hospital.

300
00:15:34,560 --> 00:15:37,520
Speaker 2: But you're right to say that there are too many

301
00:15:37,760 --> 00:15:41,680
Speaker 2: older patients in hospitals right across the country who are

302
00:15:42,000 --> 00:15:45,080
Speaker 2: effectively languishing in hospital beds when they don't need to

303
00:15:45,080 --> 00:15:48,160
Speaker 2: be there. They've been clinically assessed, is able to be discharged,

304
00:15:48,200 --> 00:15:51,240
Speaker 2: but there's nowhere flowere back and that's why they're building

305
00:15:51,280 --> 00:15:53,280
Speaker 2: more age care facilities. Is a really.

306
00:15:53,160 --> 00:15:56,360
Speaker 1: Important But again that's what two three years away, right.

307
00:15:56,400 --> 00:15:59,800
Speaker 2: I mean we've already had providers announced that they've had plans,

308
00:16:00,120 --> 00:16:02,920
Speaker 2: got development approval from the local council. They just haven't

309
00:16:02,920 --> 00:16:05,880
Speaker 2: been able to get the finance since our announcement of

310
00:16:05,920 --> 00:16:10,680
Speaker 2: the deal last week, which Anne Rustin, a local senator,

311
00:16:10,760 --> 00:16:14,720
Speaker 2: was involved in negotiating with the government already. Providers have

312
00:16:14,800 --> 00:16:17,200
Speaker 2: said we're ready to go, but you're right, you know

313
00:16:17,360 --> 00:16:17,800
Speaker 2: you can't.

314
00:16:17,960 --> 00:16:21,080
Speaker 1: And realistically then that means ramping will continue for that long.

315
00:16:21,240 --> 00:16:23,640
Speaker 2: Well, we've got to find some interim ways to help

316
00:16:23,720 --> 00:16:26,560
Speaker 2: get older patients out of hospitals. We can't just wait

317
00:16:26,640 --> 00:16:29,080
Speaker 2: for new facilities to be built over the next two

318
00:16:29,160 --> 00:16:31,720
Speaker 2: or three years. So Chris Pickton and Iron ounced a

319
00:16:31,760 --> 00:16:35,120
Speaker 2: couple of months ago some funding that we'd committed to

320
00:16:35,200 --> 00:16:38,280
Speaker 2: all state governments to help older patients get out of hospitals,

321
00:16:38,320 --> 00:16:44,160
Speaker 2: to effectively create some new bespoke services outside of hospitals,

322
00:16:44,560 --> 00:16:48,560
Speaker 2: particularly for people who were going to struggle to be

323
00:16:48,600 --> 00:16:51,880
Speaker 2: properly cared for even in a well staffed age care facility.

324
00:16:51,920 --> 00:16:54,760
Speaker 2: They might have very high level dementia, they might have

325
00:16:54,880 --> 00:16:58,680
Speaker 2: quite complicated medical needs that don't need a fully equipped hospital,

326
00:16:58,760 --> 00:17:01,480
Speaker 2: but do need more medical let's mention, then you're seeing

327
00:17:01,520 --> 00:17:04,440
Speaker 2: a standard age care facility. So we're rolling out that

328
00:17:04,480 --> 00:17:07,360
Speaker 2: fifty six million dollar commitment as soon as we can

329
00:17:07,400 --> 00:17:09,360
Speaker 2: here in South Australia, and I've done the same thing

330
00:17:09,359 --> 00:17:10,040
Speaker 2: in other states.

331
00:17:10,080 --> 00:17:14,200
Speaker 1: Okay, David's called in from Elizabeth. Dave, good morning, Good morning, guys.

332
00:17:14,200 --> 00:17:17,080
Speaker 3: How are you good. I just want to let you

333
00:17:17,200 --> 00:17:20,800
Speaker 3: know I had a bend and radiology appointment the other day.

334
00:17:20,840 --> 00:17:22,800
Speaker 3: They want to meet a pace six hundred and fifty

335
00:17:22,840 --> 00:17:27,640
Speaker 3: five dollars for for a CT scan. You get back

336
00:17:27,680 --> 00:17:30,639
Speaker 3: four hundred from Medicare. So it's two hundred and fifty

337
00:17:30,680 --> 00:17:33,880
Speaker 3: five dollar gap and one hundred meters up the road

338
00:17:33,880 --> 00:17:37,920
Speaker 3: of RADIOGSA completely free. Is this price? Gudgeing?

339
00:17:40,760 --> 00:17:43,600
Speaker 2: Well, thanks for calling in, David. I'm not sure what

340
00:17:43,640 --> 00:17:47,639
Speaker 2: it was what it was for, but yeah, no, but

341
00:17:47,680 --> 00:17:49,879
Speaker 2: what what the what it was particularly for and what

342
00:17:50,000 --> 00:17:52,840
Speaker 2: the NBS item. There are hundreds of them, and they're

343
00:17:52,880 --> 00:17:56,040
Speaker 2: at different prices. But you know, I mean the private

344
00:17:56,080 --> 00:17:59,840
Speaker 2: operators like the one you mentioned, will will try to

345
00:17:59,840 --> 00:18:02,159
Speaker 2: make money that they can, which is why it's so

346
00:18:02,200 --> 00:18:06,000
Speaker 2: important to have different operators who might be bulk building

347
00:18:06,080 --> 00:18:07,960
Speaker 2: as well. I mean, I've talked a lot in the

348
00:18:08,000 --> 00:18:10,760
Speaker 2: interview that I've just had with Matthew about bulk building

349
00:18:10,800 --> 00:18:14,960
Speaker 2: for general practice. You know, GP visits are critically important,

350
00:18:14,960 --> 00:18:17,120
Speaker 2: but I know that people are paying out of pockets

351
00:18:17,400 --> 00:18:21,000
Speaker 2: to see non GP specialists. They're paying not so much

352
00:18:21,040 --> 00:18:23,520
Speaker 2: for pathology that tends to be very high levels of

353
00:18:23,520 --> 00:18:27,760
Speaker 2: bulk billing for blood tests and things, but increasingly radio

354
00:18:27,560 --> 00:18:31,239
Speaker 2: for imaging. Yeah, and that's something that we do have

355
00:18:31,320 --> 00:18:35,680
Speaker 2: to focus on. And so thanks for your call in.

356
00:18:36,000 --> 00:18:39,320
Speaker 2: And you know, those sorts of cases are really important

357
00:18:39,320 --> 00:18:41,160
Speaker 2: for me to have my head around as we think

358
00:18:41,160 --> 00:18:43,080
Speaker 2: about how to get those costs down as well.

359
00:18:43,119 --> 00:18:46,320
Speaker 1: They vary too, the radiology type of things. I mean,

360
00:18:46,359 --> 00:18:48,199
Speaker 1: I paid two hundred a year or so ago for

361
00:18:48,280 --> 00:18:51,600
Speaker 1: a knee scan an MRI, and you think, well, why

362
00:18:51,680 --> 00:18:53,960
Speaker 1: why is it that much? And six hundred for Dave.

363
00:18:54,000 --> 00:18:55,080
Speaker 1: That's just extraordinary.

364
00:18:55,200 --> 00:18:58,840
Speaker 2: Yeah, that's extraordinary. We made some decisions in the budget

365
00:18:58,840 --> 00:19:02,639
Speaker 2: this year to try and expand options in imaging. We

366
00:19:03,560 --> 00:19:07,159
Speaker 2: hadn't indexed some of the not particularly MRIs, but particularly

367
00:19:07,160 --> 00:19:10,000
Speaker 2: the nuclear medicine like pet scans and things like that

368
00:19:10,040 --> 00:19:12,520
Speaker 2: for more than twenty five years. That was starting to

369
00:19:12,560 --> 00:19:15,920
Speaker 2: flow into out of pocket costs as well, and we've

370
00:19:16,000 --> 00:19:19,000
Speaker 2: tried to expand the number of MRIs. We're going to

371
00:19:19,000 --> 00:19:20,720
Speaker 2: do that over the next couple of years that have

372
00:19:20,840 --> 00:19:25,919
Speaker 2: Medicare entitlements, because too often people are should be getting MRIs,

373
00:19:25,960 --> 00:19:29,200
Speaker 2: but there's not one available that's Medicare license that attracts

374
00:19:29,240 --> 00:19:32,520
Speaker 2: Medicare rebates. So people end up getting a lower quality

375
00:19:32,640 --> 00:19:35,920
Speaker 2: CT scan instead. So it's not just about the out

376
00:19:35,920 --> 00:19:38,960
Speaker 2: of pockets in imaging, it's also making sure that people

377
00:19:39,000 --> 00:19:40,400
Speaker 2: are getting the best technology.

378
00:19:40,640 --> 00:19:43,520
Speaker 1: Just while we're talking imaging, and just finally and perhaps quickly,

379
00:19:43,560 --> 00:19:45,280
Speaker 1: I'm not sure how it cross you are as the

380
00:19:45,320 --> 00:19:48,719
Speaker 1: federal minister on the proach on machine that was going

381
00:19:48,800 --> 00:19:51,400
Speaker 1: to go into the BRAG Center. Some issues with that

382
00:19:51,600 --> 00:19:54,000
Speaker 1: in terms of the supply and not being able to

383
00:19:54,000 --> 00:19:56,760
Speaker 1: meet the contract the state government looking elsewhere, are we

384
00:19:56,800 --> 00:19:58,680
Speaker 1: any closer to getting that? Well?

385
00:19:58,680 --> 00:20:01,080
Speaker 2: The state government here is les on this, but the

386
00:20:01,080 --> 00:20:03,520
Speaker 2: Commonwealth does have skin in the game in a sense

387
00:20:03,560 --> 00:20:06,600
Speaker 2: that we provided quite a substantial grant for the machine

388
00:20:06,640 --> 00:20:11,439
Speaker 2: itself and ultimately this would be the well when it

389
00:20:11,560 --> 00:20:14,840
Speaker 2: was first decided by the former governments several years ago,

390
00:20:14,960 --> 00:20:17,360
Speaker 2: it would have been the first in the Southern hemisphere,

391
00:20:17,800 --> 00:20:21,359
Speaker 2: so a very significant addition to our ability to fight cancer,

392
00:20:21,400 --> 00:20:24,280
Speaker 2: particularly for children. Yes, children often have to go to

393
00:20:24,320 --> 00:20:26,119
Speaker 2: the US to get the sort of treatment they'd be

394
00:20:26,160 --> 00:20:28,960
Speaker 2: able to get on and all those sorts of things.

395
00:20:29,000 --> 00:20:32,159
Speaker 2: This is very very high level technology. So we paid

396
00:20:32,240 --> 00:20:35,480
Speaker 2: for the machine at the commonwealth level and also we

397
00:20:35,880 --> 00:20:39,280
Speaker 2: developed the Medicare rebates that would be attracted as well.

398
00:20:39,359 --> 00:20:42,760
Speaker 2: So we're obviously involved in these discussions about how to

399
00:20:42,920 --> 00:20:46,639
Speaker 2: land this capability here in Australia, but South Australia is

400
00:20:46,880 --> 00:20:49,840
Speaker 2: leading on the details of that.

401
00:20:49,920 --> 00:20:51,479
Speaker 1: So are we any closer to getting it?

402
00:20:51,640 --> 00:20:54,600
Speaker 2: Well, I'm not in a position to say that right now,

403
00:20:55,600 --> 00:20:58,520
Speaker 2: and I'm sure the South Australian government will keep your

404
00:20:58,520 --> 00:20:59,800
Speaker 2: listeners informed as and when.

405
00:21:00,080 --> 00:21:01,760
Speaker 1: Tars A Mariach Mark Butler, thank you for your time

406
00:21:01,760 --> 00:21:03,679
Speaker 1: this morning. Thanks for your Federal Health Minister