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Speaker 1: Well, as we've just spoken to the AMA about we

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Speaker 1: know a big announcement this week with the Federal government

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Speaker 1: announcing the largest investment into Medicare since its creation over

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Speaker 1: forty years ago, eight point five billion dollars to deliver

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Speaker 1: an additional eighteen million bulk build GP visits each year.

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Speaker 1: Now it is well really the first time Labour's going

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Speaker 1: to expand bulk billing incentives to all Australians and create

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Speaker 1: an additional new incentive payment for practices that bulk bill

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Speaker 1: every patient. We are also set to see hundreds of

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Speaker 1: nurses trained and thousands more doctors in the largest GP

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Speaker 1: training program ever. On the face of it sounds like

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Speaker 1: a fantastic announcement. How exactly is it going to work

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Speaker 1: and what's it going what is it going to mean

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Speaker 1: for Territorians. We'll joining us on the line is the

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Speaker 1: Federal Health Minister Mark Butler. Good morning to your minister.

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Speaker 2: Good morning Katie, thanks so much for.

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Speaker 1: Your time this morning. Now, Minister, how exactly is this

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Speaker 1: going to work?

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Speaker 2: Well, for many years now, doctors have received an incentive

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Speaker 2: payment if they bulk build pensions and concession card holders,

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Speaker 2: and the year before last we tripled that incentive, so

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Speaker 2: they got even more money if they bold build those Australians.

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Speaker 2: And that's that's really worked very well. I mean, bulk

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Speaker 2: billing even for pensioners and concession card holders were starting

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Speaker 2: to drop across the country and it's turned that around

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Speaker 2: so now well more than ninety percent, comfortably more than

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Speaker 2: ninety percent of pension as a bulk build. And in

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Speaker 2: the in the territory, that led to a five percent

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Speaker 2: increase in bulk billing just last year alone. But for

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Speaker 2: people who don't have a concession card, and that doesn't

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Speaker 2: mean they're on high incomes, like the concession card cuts

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Speaker 2: out at about forty thousand dollars if you're a single

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Speaker 2: or seventy thousand dollars a year if you're a couple,

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Speaker 2: and those Australians have never received any support to be

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Speaker 2: bulk builled. So as you said, for the first time,

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Speaker 2: we're going to pay that in step entive to doctors

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Speaker 2: if they both build those Australians as well, And that's

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Speaker 2: a very big, huge increase to the amount of money

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Speaker 2: a doctor receives from the Medicare system for bulk building

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Speaker 2: those Australians. And on top of that, for the first

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Speaker 2: time we're going to pay an additional payment to general

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Speaker 2: practices who bulk bill all of their clients, all of

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Speaker 2: their patients who come through their doors. So it's the

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Speaker 2: biggest investment in bulk building. It's a lot of money,

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Speaker 2: eight and a half billion dollars, but the AMA says

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Speaker 2: nationally that's effectively the amount of money that Peter Dutton

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Speaker 2: ripped out of the system when he froze Medicare funding

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Speaker 2: ten years ago as Health minister.

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Speaker 1: Now, in terms of ensuring that this does actually get

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Speaker 1: passed on to those territorianes listening this morning, I guess

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Speaker 1: there's no guarantee, but you're hoping that that incentive to

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Speaker 1: the GPS is going to mean that they'll do it.

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Speaker 2: Well. The first thing I'd say is that you know,

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Speaker 2: some of the gps I've noticed have just asked for

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Speaker 2: an increase in Medicare funding with no strings attached. I mean,

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Speaker 2: I can't do that in good faith as the Health minister. Yes,

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Speaker 2: I want to increase money to general practice because it's

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Speaker 2: such an important part of our health system, but I

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Speaker 2: also want to get better outcomes for patients in bulk billing.

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Speaker 2: I mean for labor that was the core promise of

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Speaker 2: Medicare forty one years ago. So we are going to

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Speaker 2: tie the funding so GPS will only get the additional

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Speaker 2: funding if they bold build those patients. But we've also

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Speaker 2: crunched the numbers. I've got really good information about what

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Speaker 2: GPS charge. We get that through the Medicare system, and

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Speaker 2: our modeling shows that the vast bulk of doctors will

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Speaker 2: be better off if they bold build patients under the

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Speaker 2: new funding arrangements that we've put in place. Now, it

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Speaker 2: doesn't mean every single Australian will be bulk builled, you know,

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Speaker 2: gena Ryan Hart's still going to have to pay a

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Speaker 2: co payment probably, but it does mean that we can

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Speaker 2: get to a position we're confident where nine out of

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Speaker 2: ten visits to the doctor will be completely free.

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Speaker 1: Now, we just spoke of the AMA here in the

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Speaker 1: Northern Territory, doctor Robert Parker, and he said, you know,

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Speaker 1: he wonders whether it's time for an overhaul of the

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Speaker 1: models when it comes to you know, when it comes

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Speaker 1: to Medicare, and whether we need a relook at the

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Speaker 1: way in which not just those payments but the way

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Speaker 1: in which it's delivered.

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Speaker 2: Well, I think he's entirely right about that, and that's

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Speaker 2: something I've been working pretty closely with the AMA on

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Speaker 2: now for a couple of years. I Mean, the truth is,

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Speaker 2: you know, when Medicare was set up in the eighties,

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Speaker 2: patients were quite different. You know, we didn't have a

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Speaker 2: lot of chronic disease. Generally, people just went to the

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Speaker 2: doctor when they fell off the ladder or they got

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Speaker 2: you know, got a virus, and they got fixed up,

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Speaker 2: and off they went again until they fell off the

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Speaker 2: ladder again. And that's really how the Medicare system is

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Speaker 2: still set up. It's set up for fixed episodes of care. Nowadays,

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Speaker 2: though more and more patients have pretty complex chronic disease

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Speaker 2: like diabetes and heart disease and the rage of other things,

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Speaker 2: and they don't just go for single episodes of care,

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Speaker 2: getting ongoing care from not just a doctor, but often

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Speaker 2: a team of nurses, diabetes educators and so on and

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Speaker 2: so forth. And the AMA is right, but the Medicare

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Speaker 2: system hasn't really kept up with that change in the

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Speaker 2: nature of our population. And we've got to work on that,

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Speaker 2: there's no question about that. But my first challenge, our

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Speaker 2: first challenge, my first challenge as health minister has been

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Speaker 2: affordability and we've both billing dropping off. After that ten

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Speaker 2: years of funding being caught and neglected under the last government,

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Speaker 2: we're just hearing gap frees arising. More and more Australians

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Speaker 2: are choosing not to go to the doctor because they

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Speaker 2: can't afford it, and that's really the immediate challenge. Yes,

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Speaker 2: the AMA is right, we need to work on some

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Speaker 2: of these longer term reforms.

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Speaker 1: Well, yeah, you spot on. I mean, we are in

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Speaker 1: a situation where it is bloody expensive to go to

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Speaker 1: the doctor, to put it, really mildly to go and

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Speaker 1: SEEUGP And what you find then with some of the

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Speaker 1: families struggling with cost of living is they put it off.

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Speaker 1: They put it off and then you wind up, you know,

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Speaker 1: having to go to the emergency ward for whatever that

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Speaker 1: issue might be. I mean, you know, the cost factory

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Speaker 1: is obviously a huge part, but the other factory is

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Speaker 1: not being able to get in to see the GP.

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Speaker 1: And I do note that one of the other parts

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Speaker 1: of this announcement is the fact that the government's going

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Speaker 1: to deliver more doctors and nurses into medicare four hundred

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Speaker 1: nursing scholarships, the largest GP training program in Australian history,

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Speaker 1: as well funding the training of two thousand new gps

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Speaker 1: a year by twenty twenty eight. What's it going to

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Speaker 1: mean for people in regional parts of Australia, you know places.

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Speaker 1: I mean we here in Darwin consider ourselves not a

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Speaker 1: regional part, but I know that very often it is

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Speaker 1: considered regional. And then when you go even more remote,

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Speaker 1: how are we going to ensure that we see some

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Speaker 1: of those you know, some of those doctors and nurses.

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Speaker 2: Well, the first thing I'm really excited about is the

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Speaker 2: medical school opening in Darwin. Luke Gosling, you know, my

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Speaker 2: colleague up there in the Federal Parliament argued so strongly

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Speaker 2: for that university up there put together a really good case.

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Speaker 2: So really opening the first full medical school in Darwin,

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Speaker 2: it's going to make a real difference.

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Speaker 1: It has been delayed though, hasn't it. Sorry, I thought

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Speaker 1: it had been delayed slightly.

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Speaker 2: Well, I mean it's I don't know about that, but

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Speaker 2: certainly you know, when it's up and operating, it's going

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Speaker 2: to be churning out medical graduates in Darwin, who I'm

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Speaker 2: confident will end up working in the territory. We've also

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Speaker 2: had to make it much easier to be able to

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Speaker 2: recruit overseas trained doctors who do a lot of the

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Speaker 2: heavy lifting in regional communities, so outside our very big cities,

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Speaker 2: and we've cut over the last little while, we've cut

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Speaker 2: a lot of red tape to ensure particularly doctors from

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Speaker 2: systems that we're very confident about, so systems very much

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Speaker 2: like ours and talking the UK Island New Zealand are

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Speaker 2: able to get here much more quickly, much more cheaply,

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Speaker 2: and already that's really lifting the number of overseas trained

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Speaker 2: doctors and nurses we're able to get into the country.

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Speaker 2: They want to come and work here for obvious reasons.

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Speaker 2: It's a great country, great system, and over the last

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Speaker 2: couple of years we've seen more doctors registered in the system,

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Speaker 2: Australian trained and overseas trained, than we've seen for more

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Speaker 2: than a decade. So we've got more work to do,

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Speaker 2: there's no question about that. Sunday announcement was about training

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Speaker 2: more Australians into medicine and nursing and midwifery, but we've

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Speaker 2: been working on a range of other things to ensure

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Speaker 2: that people have access no matter where they're living in

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Speaker 2: the country that they have access to the world's highest

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Speaker 2: quality healthcare.

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Speaker 1: If you have just joined us on the line, we've

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Speaker 1: got the Federal Minister for Health Mark Butler. Now, Minister,

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Speaker 1: it would be well, I need to ask you because

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Speaker 1: it is top of the agenda for so many Territorians

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Speaker 1: at the moment. Health Scope indeed announcing plans to close

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Speaker 1: the maternity ward at the Darwin private Hospital amid closures

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Speaker 1: across the country. It means locals are going to have

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Speaker 1: to have their babies at Royal Darwin Hospital or potentially

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Speaker 1: going to state to access private hospital facilities. How concerning

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Speaker 1: is the reduction in private health services for you, as

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Speaker 1: the federal health Minister.

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Speaker 2: Very concerning. I've had a number of discussions with Luke

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Speaker 2: Gosling about this as well as obviously others who impacted.

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Speaker 2: It's particularly impacting Darwin and TASMANI where I am right now,

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Speaker 2: where health Scope has closed its hospital in Hobart as well,

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Speaker 2: but did a lot of birthing services and maternity services.

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Speaker 2: So you know, this is obviously causing a lot of

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Speaker 2: distress to families who've been banking on that option and

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Speaker 2: frankly paid their hard earned cash to private health insurance

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Speaker 2: at Gold level insurance, which is the only level at

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Speaker 2: which you get maternity cover, expecting that they'd be out,

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Speaker 2: there'd be a private hospital. They're ready to give them

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Speaker 2: that service when the time came, so you know, we're

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Speaker 2: watching it very closely. My understanding is that the insurers

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Speaker 2: and the NT government are working very closely to ensure

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Speaker 2: that there is an appropriate level of service that reflects

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Speaker 2: that investment the families have made when it comes time

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Speaker 2: to give birth to their beautiful babies. And we stand ready,

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Speaker 2: whether it's Tasmania or the NT to that matter, to

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Speaker 2: provide any support that we need to to ensure that

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Speaker 2: that happens. But my advice is that insurers and the

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Speaker 2: NT government are working really well on that beyond Darwin

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Speaker 2: and Hobart where it's really hit over the last couple

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Speaker 2: of weeks, and there are broader challenges we have in

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Speaker 2: the system to ensure that people who do families who

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Speaker 2: do pay their harder and cash for pilate health cover,

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Speaker 2: can be confident that they'll get the service when they

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Speaker 2: need it, particularly for maternity services. And I've pulled together

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Speaker 2: the hospital sector, private hospital sector, that is insurers, the

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Speaker 2: AMA and others put some ideas before them about how

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Speaker 2: we stop this happening more broadly across the country.

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Speaker 1: I think it's a discussion that absolutely needs to be had.

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Speaker 1: You mentioned in a moment ago that that should the

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Speaker 1: Northern Territory need some support, that's something that you'd look at.

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Speaker 1: What could that support look like.

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Speaker 2: Well, they haven't come to us yet. Obviously, you know,

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Speaker 2: we have a very close dialogue. I have that my

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Speaker 2: department has that with every state minister and department. The

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Speaker 2: health systems are so interconnected, so you know, my advice

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Speaker 2: is that the NT government's working really well. They've got

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Speaker 2: that in hand. The insurers, as they should, are coming

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Speaker 2: to the party because at the end of the day,

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Speaker 2: they've received all that revenue from Northern Territory families and

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Speaker 2: Tasmanian families who've been paying their insurance premiums. So they

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Speaker 2: should really do the heavy lifting here and my advice

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Speaker 2: is that they are doing that. But if there's anything

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Speaker 2: we can do as the Commonwealth, obviously I've indicated that

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Speaker 2: to the ntg Luke knows that Luke Goseling knows that

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Speaker 2: where ready to do what we can, recognizing that ultimately

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Speaker 2: these are private operations. Yeah, big private insurers, big private

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Speaker 2: hospitals and a health Scope. It's a very big operation.

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Speaker 2: It's a global private equity firm that's made a lot

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Speaker 2: of money out of this. These private operators that deal

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Speaker 2: with billions and billions of dollars of hardare and cash

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Speaker 2: from Australian famili it's have an obligation to make sure

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Speaker 2: they deliver a service.

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Speaker 1: Well, does there need to be some kind of legislative

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Speaker 1: change to ensure that they do that? Because I certainly

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Speaker 1: take on board what you're saying. I mean they've made

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Speaker 1: millions and millions of dollars of Australians paying for their

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Speaker 1: private health insurance. Then to learn you know that they're

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Speaker 1: not only if they're expectant mums not going to be

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Speaker 1: able to go into that maternity war. But we've also

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Speaker 1: been contacted by listeners who are part of you know,

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Speaker 1: other private insurers and have no cover as of March

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Speaker 1: four due to an ongoing stash of course with health Scope,

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Speaker 1: so they're part of the Australian Health Services aligance. I'm

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Speaker 1: sure that these are issues that you're all over. People

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Speaker 1: are furious about this.

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Speaker 2: Totally. I mean pretty robust negotiations between the insurers and

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Speaker 2: the hospitals has been a hallmark of a system for decades,

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Speaker 2: but they've got pretty robust over the last little while.

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Speaker 2: Health Scope and Booper Booper is probably the second largest

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Speaker 2: insurer in the country. They were looking very very difficult

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Speaker 2: those negotiations until recently they landed a deal. And the

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Speaker 2: alliance you talk about with this group of smaller insurers,

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Speaker 2: I mean I've said to all of the insurers and

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Speaker 2: the private hospital of operators, get around the table and

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Speaker 2: fix this like it is not about your interests. It's

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Speaker 2: about the interests of all of your members and patients

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Speaker 2: who put their hardware and cash on the table to

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Speaker 2: get cover. You've got an obligation to sort out your

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Speaker 2: negotiation and come to a deal. And I say that

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Speaker 2: again to health Scope in the alliance.

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Speaker 1: Well, and it also is potentially going to become a

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Speaker 1: bigger issue for you. I mean if Australians wind up

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Speaker 1: in a situation where they feel like there's no point

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Speaker 1: in paying for that private health insurance and they end

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Speaker 1: up dropping it. And we see, you know, situations around

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Speaker 1: Australia where different you know, different facilities are closing down

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Speaker 1: as a result of those private insurers not seeing them

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Speaker 1: as being viable any longer. All of those patients, all

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Speaker 1: of those people are going to wind up in the

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Speaker 1: public health system.

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Speaker 2: Aren't they exactly exactly, Which is why I'm really pleased

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Speaker 2: that it doesn't matter what your political color is. All

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Speaker 2: of the health ministers that I work with in all

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Speaker 2: jurisdictions bring a united sent for purpose to this at

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Speaker 2: the end of the day, whether a liberal, labor or CLP. Yeah,

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Speaker 2: you know, our job is to brither the best possible

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Speaker 2: healthcare system to all Australians. And thankfully when we come

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Speaker 2: up against some of these very big commercial operators who

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Speaker 2: we're making good money out of the Australian healthcare a system,

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Speaker 2: but they're not delivering to their patients or their members.

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Speaker 2: As a group, where we're completely united in making sure

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Speaker 2: that Australians get value from money.

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Speaker 1: Minister, I know you really pressed for time, but I

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Speaker 1: do just want to pin you on this. You know,

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Speaker 1: as we're talking about there with the Australian Health Services Alliance,

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Speaker 1: we've heard from a number of our listeners, including Territory

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Speaker 1: and Ken Moffatt. I understand he's also written to you

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Speaker 1: urging you to act on this situation as the Health Minister.

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Speaker 1: Is there anything that can be done to help the

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Speaker 1: parties come to a resolution on this for the Northern Territory.

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Speaker 2: Well, look, I mean I think we've generally operated for

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Speaker 2: decades on the basis that these are commercial operators. And yes,

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Speaker 2: there are opportunities to push push the players into mediation

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Speaker 2: and things like that. There are some tools I have

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Speaker 2: at my disposal to really nudge or push these negotiations

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Speaker 2: over the line to settle a deal that's in the

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Speaker 2: interest of patients. You know, I have really urged, thankly

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Speaker 2: health Scope and the Alliance to do what they have

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Speaker 2: that Boopa and Healthscape did and land a deal and

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Speaker 2: if they don't, and if they don't, then I'll have

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Speaker 2: to look at some of those those levers that I

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Speaker 2: have at my fingertips.

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Speaker 1: All right, well, Health Minister Mark Butler, I really appreciate

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Speaker 1: your time this morning. Thank you so very much for

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Speaker 1: joining us on the show.

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Speaker 2: My great pleasure.

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Speaker 1: Thank you.