October 11 2022
David Bevan, presenter: Mark Butler, Federal Minister of Health, is joining us now. Good morning Mark Butler.
Minister of Health and Aged Care Mark Butler: good morning.
Bevan: You know, there’s a problem, that we have a lot of kids who go to medical school, but very few of them want to be GPs.
But you also have another problem which is that you don’t have any money; You have a very limited budget. How will you solve this?
Butler: First, let’s just explain the problem. You’re right, now, only one in eight medical graduates chooses a career in general practice. Not so long ago, it was four out of eight.
So, we have a very serious problem with the pipeline of new GPs replacing retirees. Patients already tell us that it has never been more difficult to see a doctor than it is now.
Doctors say they feel incredible financial pressure and are concerned about the viability of their business. And I was meeting with state health ministers last week and they were telling me that all of this is putting more pressure on an already strained hospital system.
So, we have a real challenge now and one that could get worse if we don’t reverse the trend in the decisions that medical graduates make.
This is why promoting Medicare was the central part of our electoral policy programme. We have $750 million that we’re reinvesting in Medicare, and I’m sitting down every few weeks now with doctors and nursing groups and patient groups to figure out the best way to invest that money.
We’re giving $220 million in grants to GPs to allow them to improve their IT systems, build urgent care centers and things like that. We have made this a cornerstone of our electoral politics because of all the pressures on the health care system.
A lot, as your listeners know, is what worries me the most.
Bevan: But it’s about the money, isn’t it? I mean, in the end, if you’re looking to be a general practitioner, or a specialist, and you’ve looked at the specialty option, you’re going for that little bit more sum. This is the problem, isn’t it?
Butler: I think money is of the essence. As you know, the Medicare deduction freeze was put in place for six years under the last government, effectively freezing general practitioners’ pay while hospital professionals’ wages continued to rise.
This pay gap is obviously a very big problem, but there are also other issues. I know I’m talking to general practitioners, there’s a sense that the sector has collapsed, which is why we’ve made investing in this sector the cornerstone of our policy platform.
We want to tell clinicians and patients that for us we have no higher priority in health than rebuilding general practice.
There are also some other industry issues that aren’t just wages that young GPs talk about in training. For example, during six years of specialized training as a GP, they may move through a whole bunch of different employers during that time period, so they don’t accrue leave benefits especially that parental leave benefits don’t often accrue, and that’s kind of late They are in their twenties to early thirties, so they might consider raising a family.
We are looking at individual employer sponsorship models so that they are employed during that period by a single employer that accrues these leave entitlements and expands the policy, including in South Australia.
I was just talking to Chris Pickton about this last week.
Bevan: You say there is no higher priority than rebuilding general practice, but again don’t play to the point, it means you should put more money in their pockets.
Butler: And if you look at the financial commitments we made to health in the last election, and leave aside aged care, which has also been a huge priority for us in the health system.
The biggest investment we made was in Medicare. Now, I am not claiming that the work that we do over the next two months to inform the government’s decision in next year’s budget will turn things around in itself.
But it’s an important start. I took the view by speaking to physician groups and nursing and patient groups. Medicare needs an injection in the arm right away, and that’s what we’re doing now.
But I’m not pretending that we wouldn’t need a long-term effort to change this situation, especially if you think about it.
Bevan: If you put up your old guild cap, you used to run a guild, the Miscellaneous Workers Guild. What kind of wage increase would you need in order for GPs to attract people into this sector?
Butler: I think there are a set of things that motivate young medical graduates to choose a career or not in general practice. It’s an exciting field to work in. The work is diverse, you get a very deep connection to your patients and their families over a long period of time, a deep connection to your community you don’t necessarily get in the same way as a hospital.
Bevan: Do you think you can solve this through marketing, and tell people what a really good job they should go ahead and give it a try?
Butler: I don’t think I said that, David, but I think what I said is that I feel there is a future in general practice, that we are updating the way general practice works to provide the kind of care that patients and doctors tell me is necessary nowadays, which With more complex chronic diseases using digital health is much better.
These are the kind of transformations that exist now, but I’m not going to pretend that money isn’t important either. And as you know, we’re talking about more investment in the system.
What I’m particularly committed to, David, is not just as a more mature man who reads summaries and talks to heads of the profession and thinks I can look into the minds of young medical graduates and understand what motivates them. I’m sitting today, as I said, I will try with the group of medical students at the AMA to understand what might change the connection in their minds.
Stacey Lee, presenter: While we have, Secretary, we just heard from the state’s chief public health officer here, Professor Spurrier, about the wave before Christmas that the state is expecting if we see a significant increase in the numbers of Covid cases.
Do you expect that there will be more restrictions imposed, given that these decisions are now made at the national level rather than at the level of one country to another?
Could we see isolation return?
Butler: I am very optimistic that we will be able to manage future waves when they come. And they’re very likely to come, I think Professor Spurrier pointed out with our current arrangements, the new arrangements that we’ve put in place, we’re very focused on making sure that people who are at risk of serious illness or even worse, hospitalization or death are protected, which is why we’ve kept the arrangements. Pandemic-safe is in place in aged care, disabilities, Indigenous health services, and hospitals.
We must ensure that the health care system is able to demonstrate its capacity as new waves emerge. We are very focused on making sure that health care systems are strong, too.
The advice I get, and I think I heard Professor Spurier say this, is that the expected wave in some of the models that might happen in the summer is likely to be smaller than we thought a couple of months ago.
Case numbers, for example, in the wave we just saw during the winter are dropping much more quickly than previously expected. The number of hospitalizations has decreased significantly, and the prevalence of epidemics in aged care facilities has decreased significantly.
I encourage people to get their vaccine shots if you haven’t already. We are working hard to make sure, along with states and territories, that hospitals and aged care systems are strong to handle future waves.
And if they do come back again, people need to consider the virus-safe behaviors of social distancing wearing a mask indoors if you can’t social distancing.
This will be with us for a while now.
Bevan: Before you go, the women’s and children’s hospital that the Malinauskas government plans to place at the heritage-listed Thebarton site. There is a real expectation now that this may end with Tanya Plebersk, the Minister of National Heritage.
Would you have a whisper in her ear saying, listen, Malinauskas, all you do in this hospital is women’s and children’s hospital? Think you can just tag this one?
Butler: Well, I haven’t heard of that possibility, David, but if it were possible, I know that Secretary Bleibersk would make whatever decision she needed to make in accordance with the laws of national heritage, and I wouldn’t consider seeking influence one way or the other.
Bevan: But, it would not be unreasonable for the Federal Government to consider the health needs of South Australians versus heritage needs, I suppose they would simply stick to the legislation. Legislation requires her to do X, Y, Z, then that’s it. The merits of health versus heritage which is how Peter Malinauskas has set up this debate, which she would not have to think about, is how she has to apply the particular rules laid down in the law that are her will.
Butler: All South Australians would like to see a modern women’s and children’s hospital as part of their healthcare system, and I’m no different. The Australian Government wants to see the continuous updating of our hospital system across the country. There is no doubt about that. I haven’t been notified, and I’m not aware of any questions about heritage on the site, so really, I can’t answer that question David.
Bevan: Can you talk about the federal government’s commitment to this hospital in terms of money? Because the state wouldn’t be able to build it on its own, it would need some help. Are you aware of the federal obligation to this thing?
Butler: No, we have not received any request to my knowledge, at least, regarding commitment to this new hospital. Obviously, over the past few months, we’ve committed to expanding and modernizing Flinders Medical Center, which was a big part of our election commitment in May, and I think the biggest capital commitment we’ve made in the hospital system across the country. But I have not received any request about the future of the Women and Children’s Hospital.
Mine: As the Federal Minister of Health, are you aware of any other states with a Women’s and Children’s Hospital, why would South Australia need them to be on the same site?
Butler: You’ll have to talk to Chris Pickton about that, I’ve read the reports of the decision by the state government, and as a South Australian, I’m delighted with the fact that our Women’s and Children’s facility is going to be upgrading.
Mine: But does any other country have it?
Butler: I cannot tell you what is there, what arrangement is in place in each state.
MineMinister: Thank you for your time.