November 10, 2021


ROB ‘FAIRSY’ FAIRS, HOST: I must say, we're covering a lot of topics, and we will start off, because I know he's a busy man. ,With Mark Butler, the Federal Shadow Minister for Health and Ageing who is in the state at the moment. Mark, thank you so much for your time and welcome to Tasmania Talks.
FAIRS: I am well. A busy time for you, obviously an election hasn’t been called yet but we know it is coming. That's one thing that's guaranteed. What are you actually focusing on here in Launceston in the North West while you are visiting? Where will you be going?
BUTLER: I've actually just got back. I was in Launceston in the North West over the last few days. It's my second visit for the last couple of months, working in Launceston and spending quite a bit of time in Devonport and Ulverstone and obviously Burnie as well, talking to health professionals, to GPs, talking to hospital workers, but also a range of health groups like Dementia Australia and Carers and a bunch of others who are really worried about the state of our health system right now.
Particularly given - I'm from South Australia so I feel very much the same experience of Tasmania - we know that borders are going to be lifted in the coming weeks, and we're going to start to see COVID creep into a community that has a health system that's already under pressure.
FAIRS: Mark can I ask you, in your opinion and from what people have been saying to you, do you believe Tasmania's hospitals are prepared for COVID? Because it is coming, we are going to get it here. We know that. You know, there's no doubt about it soon as our borders open up it will get here, at some point.
BUTLER: Tasmanian hospitals are already under very serious pressure, there's high levels of ramping, I know that Emily Shepherd and the Nurses Federation have been doing a great job trying to bolster the case for more nurses to be employed in the hospitals down there.
So I think it's clear that hospital systems are under real pressure, but Tasmania is not alone. The hospitals are experiencing exactly the same thing in Queensland, in South Australia, in WA, all other states that don't have COVID right now, and effectively haven't had a flu season either.
The fact that they're under pressure without those two things operating in those states is a cause for concern, and that's why I've called on Prime Minister Scott Morrison to release the modelling that he commissioned from the Doherty Institute, your listeners would have heard of this Doherty Institute that's been doing all of the expert modelling about the National Cabinet plan. They've done modelling about what the hospital systems are going to have to deal with over the coming weeks and months. He's had it since September, but he won't release it. He said on the National Cabinet meeting on Friday, he’d release it in coming days, we really need to see this.
In South Australia our borders are going to be lifted on the 23rd of November, so only thirteen days, less than two weeks. Tasmania, Queensland in the middle of December. We've only got some weeks now, to know what's coming for our hospital system and whether we have a plan to deal with it.
FAIRS: Yeah, absolutely. I totally agree with you. And this habit of getting things out of a last minute, it's just not good enough is it? Personally, I think it's not.
BUTLER: Taxpayers paid for this modelling and taxpayers deserve to see it. Our hard-working nurses and doctors can’t afford for Scott Morrison to pretend this is all someone else's responsibility. Too often that’s happened in the pandemic, the state governments have had to step up, our incredibly hard-working health professionals in the hospitals and elsewhere in the health system have had to step up. It's just time that Scott Morrison stepped up.
We know you don't have to be a Rhodes scholar to work out that business-as-usual in our hospitals is not going to cut it during a once in a century pandemic. Because we also know it's not just hospitals under pressure, General Practice, all the rest of our health system in the community is under real pressure after eight long years, frankly, of cuts and different changes to Medicare.
FAIRS: But also remember too, when Labor was in government they cut millions out of the Tasmanian budget from the health system. We’ve got to be fair, I mean, it's not just the Liberal Party that has axed and taken money away from the health sector. I mean I remember in the past doing a news story, when I think it was Tanya Plibersek who was the Health Minister at the time and took one hundred million dollars out of the budget. So I mean, we do have to be fair.
BUTLER: I don’t remember that, I mean we concluded a hospital funding agreement when we were last in government with the states, that reversed some terrible cuts that had happened about fifteen years ago. And your listeners might remember the last time our hospital system was under real crisis was those last couple of years of the Howard Government, after Tony Abbott as Health Minister had introduced a series of cuts.
But look, that's sort of ancient history, our challenge now is to deal with the current state of affairs in our health system and what we know is coming down the track in coming weeks and months because I think people are worried about making sure our health system is able to cope. You know Premier Gutwein has said that his system is able to cope. But we all deserve to see the modelling that the Prime Minister has, at taxpayers’ expense I again say, commissioned to tell us exactly what those numbers are going to look like.
FAIRS: Yeah I totally agree on that point Mark, absolutely. We do need to see it and it should have been out quite a while ago, because this last-minute stuff does just does my head in to be honest.
When you were here, when you were speaking to Tasmanians, I know in my travels the majority of people are a bit apprehensive. I mean we've got to be realists; Tasmania relies on tourism so much, we do need to open I totally get all that. And we need to support our tourism sector who has been smashed by this COVID pandemic. But generally, percentage wise, do you think there's more people apprehensive than are for opening up again, at this stage here?
BUTLER: I think people are apprehensive. As I said, I'm from South Australia. I was in Queensland over the last couple of days as well and people in those COVID-free jurisdictions are apprehensive. They’re keen to protect the way of life that we've been lucky enough to have over the last several months as we've watched our fellow Australians in New South Wales and Victorian and the ACT languish in these sort of seemingly never ending lock downs, the kids not able to go to school and workers not able to go to work. Huge economic dislocation and loss but also massive mental health impacts.
It’s completely understandable that the people of Tasmania and South Australia and other states want to make sure that we protect what we've been able to safeguard over the last few months but equally, Premier Gutwein, premiers in the other COVID-free jurisdictions are taking public health advice, that given the really fantastic vaccination rates that particularly Tasmania has been able to achieve, that with the right health measures, being careful, knowing what's coming down the track sort of being eyes wide open - that's why again, I say release the modelling to Scott Morrison, that we should be able to get through this.
I've also seen reports this morning just from the AMA, the Australian Medical Association, and some other doctors, of some of the really exciting treatments that are being spread around the world. Pharmaceutical companies are not just working on vaccines, they're working on some really exciting antiviral treatments that mean that if you are vulnerable, if you do get COVID and you're unvaccinated, there increasingly are treatments that should be able to prevent you from getting seriously unwell. So we should be cautious, I know that's what state governments around the country are all doing. But you're right, we all want to see life return to normal as soon as it possibly can, in a safe manner.
FAIRS: And you did mention earlier - access to GPs. That is a massive issue down here in Tasmania, especially those who bulk bill and of course there’s rising gap fees as well. A lot of people cannot afford to pay to see a GP so obviously they're not going, or they’re going to emergency which, unless it is an emergency, that clogs up the system, and that's not what it's designed to do. ‘Emergency’ is really life-threatening emergency situation.
It’s an ever-growing problem down here in Tasmania, finding GPs.
BUTLER: It’s a problem across the country. For six years the Medicare rebate, the amount the government pays for you to go and see your GP was frozen. And so effectively freezing the wages of all of our country’s GPs for six years. Imagine any other occupation having their wages frozen for six years. So understandably, they had to keep up with their own rising costs and gap fees increased. Gap fees have increased amazingly over the last several years and now the average gap fee that you'll pay to go and see a doctor for a standard consult is actually more than Medicare contributes. So for the first time in the forty year history of Medicare people are paying more out of their own pocket to go and see a GP than the doctor is getting from Medicare.
So you're right, you know, that people are finding it harder to find a GP where they live, particularly in a community that's pretty dispersed. It's not just a city-state like mine is for example, in South Australia, where everyone lives in Adelaide It's harder to get in to a GP where you need it and when you need it. I heard in northern Tasmania about extraordinary waiting times for people to see a GP. And what happens in the health system is when bits of it don't work it all ends up at the emergency department. The emergency department ends up as the lightning rod for every other failing in the health system and as you say the emergency department was built for those hopefully once in a lifetime emergencies, heart attacks, car accidents, strokes, those sorts of things. Things that should be able to be dealt with by a GP or in an aged care facility if you have the right staff in place aren't being dealt with there and are ending up clogging up our hospitals.
FAIRS: I’m chatting with Mark Butler the Federal Shadow Minister for Health and Ageing on Tasmania Talks. Let's focus on an area that I am so passionate about, you mentioned at the start with ageing and carers. In this sector they do an amazing job, experiencing this firsthand and you know, credit to them because it's a system or an area that is massively under pressure, it needs so many more resources and help and assistance and financial support, because it's just not getting it. I mean, we're an ageing population and I just find it staggering that it's a second sector that's battling when the stats show that we are an ageing population, you know what I'm talking about don’t you?
BUTLER: Completely. I've worked closely with the aged care sector for three decades and coming back into this portfolio, as the Ageing Minister under Julia Gillard for a number of years, and coming back into this portfolio, a portfolio I know really well, I've been shocked at the depth of the crisis in aged care.
I mean, the Royal Commission into Aged Care said it all when they labelled their report, they titled their report ‘Neglect’. And it wasn't neglect from the workforce because they are extraordinary, they work so hard for very poor wages, often working unpaid time just to spend time with the people they are showing love to and care for. It was neglect from a government that had cut billions of dollars out of the aged care budget back when Scott Morrison was Treasurer. I mean, the stories from that Royal Commission of residents living sitting with maggots crawling in open wounds, sitting in their own filth, almost 70 per cent of aged care residents at risk of malnutrition, billions of dollars get poured into this sector from taxpayers and from the families of residents and yet we don't know where that money's going, because there's not enough accountability in the system.
FAIRS: It's got to be better.
BUTLER: It’s got to be better, and as you say, the numbers of people coming into aged care is about to skyrocket because the oldest Baby Boomer now, my dad is one of those born right after the end of World War II, they’re starting to reach the age where they will start going into aged care, and we know that that's a very big group.
And aged care is not really able to cope with the current level of demand, when demand really starts to pick up with the ageing of the Baby Boomer generation and all the rest of us after that, it's going to be terrible unless we take urgent action. And the critical thing here is workforce. There just aren't enough staff in there. They're not paid well enough to deliver the care that people who after all, built this community, worked hard their entire lives, paid their taxes, raised their families and frankly deserve better than this.
FAIRS: I totally agree with you. Totally. I mean, they're such an integral part and they're treated second rate, as you said, they're not paid enough and they're not supported enough.
BUTLER:  I remember in my town of Adelaide back when I was a Minister, and it hasn't changed since then, that a worker at the zoo caring for animals at the zoo was getting paid several dollars an hour more than people working in aged care facilities. What does that say about the priorities of our community if we continue to expect workers who are doing some of the most important, sensitive work we have in our community, to be paid such poor wages?
FAIRS: Yeah. Is this a priority for, would it be a major priority for the Federal Labor Government if you get in? Can you tell Tasmania right now, that that is going to change and will change and we will see more resources here in Tasmania because it's, obviously, it's right around the country. But here in Tasmania, obviously that's what we were concerned about, because we live here.
BUTLER: Of course. Tasmania is like my state of South Australia, a bit older than the national average. So those issues in aged care that we see across the country are more significant in Tasmania and my state of South Australia, because of the nature of our population. When we were last in government we put in place a big aged care reform package when I was the Minister, and the biggest part of that was a wages deal that would see significant funds put into lifting the wages of aged care workers. Now that wasn't going to fix things in and of itself but it was a start, to start to see wages lifted over time, to ensure not only that workers delivering this work were getting a fair wage, but also that we would be able to attract the workforce that we need.
Unfortunately Tony Abbott, as soon as he was elected back in 2013, cut that money and so we haven't seen that happen over the past. Now the unions including HACSU, which your listeners would know, the Health and Community Services Union in Tasmania, the aged care unions across the country, have put in an application to the Fair Work Commission to start to lift wages in aged care. We've indicated we're very supportive of that. We think it's not only important for the workers themselves, but there's a national interest at stake here. If we're going to have a decent aged care sector, we need a decently paid aged care workforce
FAIRS: I guess we'll have to wait and see because as we know, politicians say a lot of things and the proof’s in the pudding in the end, but it's just a sector that needs so much. I mean, we need more facilities here. I'd love to see a hospice centre or area, a few of them put up around here in Northern Tasmania, in Launceston and places like that, because we need them and the strain on the rest of the health system and all that because we don't have those facilities as you know, it's that flow in effect, isn't it?
BUTLER: Absolutely, and people end up too often having to spend their last days in the hospital. Which is not where people want to spend their last days. They want to spend them as far as possible in their own home, or in their own aged care facility, or in a more community-based setting like a hospice. We know that from surveying older people for many, many years. The last thing they want to do is spend their last days plugged into machines in a clinical, cold hospital setting getting wonderful care no doubt, but that's not exactly the sort of final days that people generally want. So thinking about that more sensitively is something we need to do as well.
FAIRS: Yeah, totally. You just have to ask yourself, where would I like to go, like depart? And it’s certainly not in a hospital wired up to machines unless obviously it's absolutely necessary. But
look, it's an area that I'm really passionate about and I thank you for your time and for your comments on Tasmania Talks. I really appreciate it and let's hope that this is a priority because it is as you've mentioned - and fingers crossed things can improve because it needs to doesn't it.
BUTLER: It sure does. I hope we talk more about it in the election.
FAIRS: I thank you for your time and I look forward to that too. Mark Butler, Federal Shadow Minister for Health and Ageing. Thank you for your time on Tasmania Talks.
FAIRS: Thanks Robert.