Mark Butler

Answer from Mark Butler (Minister for Health and Ageing)

The minister stated that the changes were necessary to fund additional aged care beds and support at home packages. He argued that the changes restored the rebate to its original design, which did not differentiate based on age. He dismissed concerns about membership drops as misinformation, citing government modelling and independent analysis from the University of Melbourne, and noted that previous industry predictions of mass exodus from insurance had not materialised.

Answer from Hon. Members

Honourable members interjected, preventing a formal answer from being recorded.

Answer from Mark Butler

The minister explained that the government secured an expedited PBS listing for triptorelin, an alternative to Zoladex, which was being withdrawn. The new drug will be available from 1 October at a cost of $25 per script, compared to the previous price of $1,350. He highlighted the anxiety caused by the withdrawal of Zoladex and the government's collaboration with health communities to find an equivalent treatment to prevent women from making irreversible surgical decisions.

Answer from Mark Butler

The minister stated that hard decisions were necessary to fund significant additional investment in aged care, including more beds and support at home packages. He argued that the changes restored the rebate to its original design, removing age-based differentiation introduced by the Howard government. He cited government modelling indicating an average impact of 70 cents per day and around 44,000 people potentially withdrawing from insurance, dismissing industry predictions as self-serving and inaccurate.

Answer from Mark Butler

The minister explained that the $3 billion saved would be invested in aged care beds, Support at Home packages, and reversing co-contributions for hygiene services. He stated that the decision was necessary to provide adequate care for an ageing population and that the rebate would revert to its initial structure, which was not age-discriminatory.

Answer from Mark Butler

The minister announced that a new drug, Qalsody, would be listed on the PBS from 1 October for patients with a specific SOD1 protein mutation. He noted that the drug had shown extraordinary results in halting disease progression for some patients. He stated that the treatment would cost $25 per script instead of over $28,000, benefiting approximately 70 patients per year.

Answer from Mark Butler

The minister stated that the rebate changes were necessary to fund $3 billion in aged care services. He explained that the reform returned the rebate to its original design, removing age-based differentiation so that subsidies were based solely on income. He noted that the average affected member would pay an extra 70 cents per day. He challenged the opposition to explain how they would fund the aged care expansion without the rebate savings.

Answer from Mark Butler

The Minister noted that the current government had increased tobacco excise by just under 40 per cent, compared to a 215 per cent increase under the former government. He argued that the previous government did not reinvest excise revenue into enforcement or public health campaigns, leading to a flood of illicit tobacco and vapes. He stated that the current government was boosting enforcement resources and cooperating with state governments to combat organised crime. He expressed openness to sensible ideas that did not prejudice public health campaigns.

Answer from Mark Butler

The Minister highlighted the expansion of PBS listings for Keytruda to cover every cancer type, eliminating previous gaps where patients faced high out-of-pocket costs. He noted that similar pan-tumour listings had been made for Opdivo and Yervoy earlier in the year. He described this as a world-first achievement that delivered equity in cancer care. He expressed confidence that other immunotherapies would follow suit, ensuring affordable access to effective treatments for all Australians.

Answer from Mark Butler

The minister acknowledged the high bulk-billing rates in Fowler but noted the challenge of training more GPs, stating that 350 additional Commonwealth supported places had been added to medical schools. He explained that current distribution levers prioritized rural and regional areas for overseas doctors, which sometimes disadvantaged outer-suburban areas with low doctor-to-population ratios. He stated that the government was engaging with medical and patient groups to find a more forensic way to address these shortages, though he noted the complexity of balancing rural and metropolitan needs.

Answer from Mark Butler

The minister stated that the government would not join the coalition in a price-discounting war with organized crime, arguing that the opposition's policy assumed criminals would not lower prices and failed to consider public health impacts. He cited evidence from Canada where smoking rates among young people increased after tax cuts. He criticized the opposition for not funding enforcement during their time in government and stated that the government's focus was on shutting down illicit stores and taking legal action, rather than lowering taxes.

Answer from Mark Butler

The minister acknowledged that the illicit share of tobacco smoking had grown but disputed the claim that overall smoking rates had increased. He cited the Institute of Health and Welfare, which reported that daily adult smoking rates had declined by about half a million over the last three years. He noted that tobacco excise had increased by 215 per cent under the previous government and less than 40 per cent under the current one. He criticized New South Wales and Victoria for being slow to implement enforcement powers compared to Queensland and South Australia.

Answer from Mark Butler

The minister said that female patients used roughly 60 per cent of healthcare services and pointed to new PBS listings for birth control, menopause care, and endometriosis drugs. He noted that over 400,000 women had obtained lower-cost prescriptions for contraception and more than 500,000 had gained access to budget-friendly menopause care. He referred to the rollout of bulk-billed IUDs and contraceptive implants, as well as an extended menopause health assessment used by 140,000 women. He confirmed that all 33 endometriosis and pelvic pain clinics were open, claiming these measures corrected years of oversight.

Answer from Mark Butler

The Minister noted that tobacco excise had increased by less than 40 per cent under the current government, compared to over 215 per cent under the previous administration. He highlighted a $350 million increase in enforcement activity and tripling of border interceptions. He pointed to Queensland and South Australia as leaders in enforcement, contrasting them with slower responses in other states. He emphasised that smoking rates were still declining and warned that cutting excise, as proposed by the opposition, would likely increase consumption, particularly among young people.

Answer from Mark Butler

The Minister highlighted the opening of the Torquay Medicare Urgent Care Clinic, which provides seven-day-a-week bulk-billed urgent care. He reported that bulk-billing rates in Corangamite had risen from 65 per cent to over 80 per cent following government investments. He thanked the member for her work on the NDIS joint standing committee, which informed recent reforms to tighten controls on fraud and integrity. The Minister affirmed that despite these changes, the NDIS would continue to grow as a major social program.

Answer from Mark Butler

The minister stated that the Senate had passed reforms to make the NDIS sustainable, addressing issues of cost and fraud. He assured participants that the scheme would remain the largest social program outside the aged pension. He highlighted that new eligibility tests were being developed to focus on significant and permanent disability, while state governments were rebuilding support systems for lower-needs individuals. He noted that all states except Queensland had finalized plans for the Thriving Kids program, with rollout expected by the end of next year ahead of eligibility changes in January 2028.

Answer from Mark Butler

The Minister stated that the NDIS had grown too large and costly, becoming a target for fraud. He reported that the Senate would consider legislation to make the scheme sustainable, including 33 additional amendments to clarify protections for high-support-need participants and tighten fraud controls. He thanked the shadow minister for constructive engagement on fraud and integrity amendments, emphasizing that the reforms would ensure the scheme's long-term viability.

Answer from Mark Butler

The minister stated that foundational supports were agreed to be in place by 1 January 2028, following a 2023 National Cabinet decision. He noted that $10 billion had been committed to fund these supports, shared between the Commonwealth and states. He mentioned that Thriving Kids was underway and would ramp up from 1 October, with full rollout expected by 1 January 2028 for children under nine. He affirmed that the government would ensure no Australians were left without adequate assistance.

Answer from Mark Butler

The Minister disputed the $1,000 figure, stating the average impact would be $220 to $250 per year. He explained the changes were necessary to fund aged-care services, including more beds and Support at Home packages. He noted the reforms returned the rebate to its original design, ensuring equal subsidies for households on the same income regardless of age.

Answer from Mark Butler

The Minister stated the decision was necessary to fund aged-care expansion, addressing neglect from the previous government. He explained the change returned subsidies to their original position, removing age differentiation. He cited Treasury modelling predicting only 44,000 people leaving private health insurance, less than half a per cent of membership, and noted that membership was increasing. He challenged the opposition to propose an alternative funding source for aged care.

Answer from Mark Butler

The Minister highlighted the success of urgent care clinics, citing over 65,000 visits in Launceston. He reported that bulk-billing rates for retirees and concession card holders in Bass had risen from 80 per cent to over 90 per cent, with increases for non-concession holders. He stated bulk-billing was up in every state and territory. He contrasted this with the opposition's history of cuts and lack of health policy, noting the shadow minister had asked the department for a definition of Medicare.

Answer from Mark Butler

The Minister said the government did not intend to levy a charge on sugary drinks. He pointed out the low take-up of the childhood dental benefits scheme and noted that front-of-packet labelling would become compulsory. He referred to talks with industry about reformulating foods to cut sugar, citing differences in beverage sugar levels between Australia and the UK.

Answer from Mark Butler

The Minister reported that bulk-billing rates for pensioners, children, and concession card holders had risen to over 93 per cent nationally, up from a low of 75 per cent. He noted that recent extensions of bulk-billing support to all Australians had lifted the national rate to 84 per cent. The Minister highlighted significant increases in specific electorates, including a 25 per cent rise in Whitlam. He contrasted this with the opposition's lack of understanding of Medicare, referencing a recent inquiry where the shadow minister questioned the definition of the system.

Answer from Mark Butler

The minister explained that the change addressed inequities where households with the same income received different support based on age. He stated that modelling indicated approximately 44,000 people, or 0.4 per cent of health insurance membership, would change their status. He noted that overall health insurance membership has been growing by two per cent annually and would continue to do so.

Answer from Mark Butler

The minister highlighted that Tasmania's public hospitals received an additional $160 million, a 20 per cent increase, freeing them from previous funding caps. He noted that bulk-billing rates had increased significantly, reaching over 93 per cent for pensioners and 97 per cent for those without concession cards. He criticized the opposition for attempting to rebrand themselves as the party of Medicare despite their history of cuts.

Answer from Mark Butler

The Minister highlighted a bulk-billing rate over 94 per cent in the member's electorate. He noted that public hospitals received $37 billion in funding, triple the previous agreement. He mentioned new menopause and perimenopause support items and clinics. He also stated that 10 new medicines were added to the PBS, including treatments for cancer, growth hormone deficiency, severe asthma, and myasthenia gravis.

Answer from Mark Butler

The Minister explained that funding adjustments were due to a transformation in health access, particularly the rollout of 1800MEDICARE, which provides 24/7 nurse advice and free telehealth GP services after 6 pm. He noted that 1800MEDICARE had responded to 700,000 episodes of service since January. While acknowledging that urgent care clinics do not cover every regional community, he stated that the combination of 1800MEDICARE, urgent care clinics, and bulk-billing incentives was delivering a stronger Medicare service. He confirmed that the specific service in question would receive reduced funding for 2026-27 reflecting lower service volumes.

Answer from Mark Butler

The Minister stated that the government had funded Cancer Australia to research the causes of the increase in early onset bowel cancer. He noted that the causes were not yet fully understood. The Minister mentioned that the government was working with the college of GPs to provide materials and resources to help doctors recognize symptoms in young patients. He also highlighted the role of campaign groups in raising awareness among young Australians to report symptoms.

Answer from Mark Butler

The Minister stated that bulk-billing rates had climbed by more than 10 per cent for non-concession card holders since November. He noted that 137 urgent care clinics had been delivered, with over 3.2 million Australians using them. The clinics were staffed by doctors and nurses, open seven days a week, and fully bulk-billed. The Minister emphasized that these clinics were a permanent feature of Medicare, backed by the trusted Medicare brand.

Answer from Mark Butler

The minister noted that over 460 new medicines had been listed on the PBS since the government took office, with 10 more to be listed on 1 July. He highlighted the listing of Tezspire for severe asthma, which affects one in 10 Australians. He stated that without the PBS listing, patients would pay up to $1,600 per injection, but with the listing, they would pay PBS prices. He emphasised that this would provide life-saving relief to patients who could not control their asthma with inhalers alone.

Answer from Mark Butler

The Minister noted that H5N1 had been detected in migratory birds and that the government had been preparing for years across portfolios including Agriculture, Environment, and Health. He emphasized the seriousness of the risk to industries and public health, citing international experience. He criticized a Liberal senator for dismissing the threat as a pharmaceutical conspiracy and accused the Leader of the Opposition of lacking leadership by not addressing the issue.

Answer from Mark Butler

The Minister reported that all 137 committed urgent care clinics were open, operating seven days a week with extended hours and bulk-billing. He noted they had treated over 3.2 million patients, with four in five Australians living within a 20-minute drive. He stated that half of patients would otherwise have visited emergency departments, reducing pressure on hospitals.

Answer from Mark Butler

The Minister highlighted investments in Medicare urgent care clinics and cheaper medicines. He stated that bulk-billing incentives for GPs had been tripled for pensioners and concession card holders in 2023 and extended to all Australians in November. He noted that in Bendigo, the general bulk-billing rate had increased from 68 per cent to 89 per cent since 2023. He emphasized that these investments were improving access to healthcare and reducing costs for households.

Answer from Mark Butler

The Minister reported that 450 new or amended PBS listings had been made since the government took office. He highlighted new listings for blood cancer treatments, Blincyto and Calquence, which reduce costs from $230,000 and $7,000 per month respectively to PBS prices. He stated that nearly $3 billion in co-payment savings had been achieved by Australians, and pensioners have received 90 million additional free scripts. The maximum co-pay for concession card holders is frozen at $7.70, and non-concession holders pay no more than $25.

Answer from Mark Butler

The Minister noted that the bulk-billing rate in the member's electorate had reached 90 per cent, a 23 per cent increase since 2023. He highlighted the opening of the 136th urgent care clinic in Darwin and a 30 per cent increase in hospital funding for the Northern Territory. The Minister emphasized that these investments were reversing previous underfunding and improving access to care, particularly for those without concession cards.

Answer from Mark Butler

The Minister stated that bulk-billing rates had plummeted under the previous government due to frozen Medicare rebates. He noted that the government had tripled the bulk-billing incentive for pensioners and concession card holders, raising the rate to around 93 per cent, and extended support to all Australians. He reported that over 1,400 general practices had shifted to 100 per cent bulk-billing since November. He acknowledged that bulk-billing rates in Newcastle, Lake Macquarie, the Hunter, and the Central Coast were below the NSW average and announced funding for six new clinics in those regions that would fully bulk bill to increase competition and spread benefits.

Answer from Mark Butler

The Minister acknowledged the member's personal loss and the campaigners' efforts. He stated that additional funds had been released, resulting in double-digit growth in donor recruitment in 2024 and a 30 per cent expansion in the current financial year. He addressed the question of raising the age limit for registrants from 35 to 40, noting that clinical advice favored younger donors but that the need for a wider donor base was also important. He committed to reviewing progress and directing the new provider to seek clinical advice on raising the age limit and other ideas from the Life-saving List campaign.

Answer from Mark Butler

The Minister highlighted the launch of a national information campaign to break the silence around menopause. He noted that a new Medicare item has been used by over 105,000 women and that three new treatments were added to the PBS, saving users up to $580 annually. He also mentioned updated clinical guidelines and increased training for health professionals to improve care.

Answer from Mark Butler

The Minister reported that 11 people had contracted hantavirus, with three deaths, all from the ship. He stated that human-to-human transmission is rare. Six passengers were being repatriated to Australia, with a flight landing in the Netherlands before heading to RAAF Base Pearce in Perth. The passengers were symptom-free and tested negative. They would be quarantined at the Centre for National Resilience in Bullsbrook for at least three weeks under strict conditions developed by the CDC.

Answer from Mark Butler

The Minister disputed the $1,600 figure, stating the average impact would be between $230 and $250 per year. He explained that the government does not see a rationale for providing different levels of support based on age for households on the same income. He stated that the $3 billion in savings would be invested in aged care services, including more beds and better care, to address rising demand.

Answer from Mark Butler

The Minister stated that the budget provisioned $25 billion in additional hospital funding, with Tasmania receiving almost $1 billion. He noted that Medicare urgent care clinics were made permanent, with the Devonport clinic seeing more than 40,000 people. The Minister highlighted that in Braddon, seven out of 10 general practices bulk-billed all patients, and 212 million cheaper scripts had been provided. He also mentioned investments in mental health, including a new centre in Devonport and upgrades in Burnie.

Answer from Mark Butler

The Minister stated that the government was determined to get the NDIS back on track due to rapid cost growth and fraud. He announced that legislation would be introduced to implement financial controls. The Minister noted that only nine per cent of NDIS participants were registered as CALD, despite 30 per cent of the population identifying as such. He mentioned that a CALD strategy had been co-designed with over 800 people and that an expert advisory group would be expanded to include reforms relevant to the CALD community.

Answer from Mark Butler

The Minister stated that the NDIS was growing too fast and costing too much, with costs blowing out by more than $13 billion since December. He announced that legislation would be introduced to control scheme and plan inflation. The Minister outlined four pillars: fighting fraud, slowing cost increases, clarifying eligibility, and delivering quality supports. He projected that the NDIS would cost $55 billion by the end of the decade, down from $70 billion, but would continue to grow annually.

Answer from Mark Butler

The Minister stated that the budget included approximately $500 million in new funding to increase Medical Research Future Fund disbursements to $1 billion annually by the end of the decade. He noted that a unified strategy had been delivered to the government by Rosemary Huxtable. The Minister indicated that he would wait for budget outcomes regarding MRFF disbursements and the one-stop shop for clinical trials before releasing the strategy, but would have more to say in the coming days.

Answer from Mark Butler

The Minister stated that hantavirus had been listed as a human disease under the Biosecurity Act, allowing for quarantine orders. Five Australians and one New Zealander were being repatriated from Tenerife to the Netherlands and then to Australia. They would be flown into RAAF Base Pearce and transferred to the national resilience centre at Bullsbrook for a three-week quarantine, staffed by personnel from Darwin. This was described as the strongest quarantine arrangement among governments receiving repatriated passengers.

Answer from Mark Butler

The Minister highlighted the Murrumba Downs Medicare urgent care clinic, which was 100 per cent bulk-billing and had seen almost 35,000 patients. He noted that 135 clinics were open, with two more opening soon, totaling 137. These clinics had seen about three million patients, with half reporting they would otherwise have used emergency departments. The clinics were fully bulk-billed and open seven days a week. The budget would lock in urgent care as a permanent part of Medicare with $1.8 billion over five years.

Answer from Mark Butler

The Minister thanked the member and highlighted a new PBS listing for Keytruda covering three new cancer types: locally advanced cervical cancer, renal cell carcinoma, and locally advanced head and neck cancer. The listing took effect the next day, reducing the cost from over $15,000 per infusion to $25. Over 10,000 patients annually were expected to benefit. The Minister shared testimonials from patients who expressed relief and hope due to the listing. He emphasized the government's commitment to making medicines affordable.

Answer from Mark Butler

The Minister noted that over 20,000 Australians battled myeloma, with a five-year survival rate of 60 per cent. He highlighted the listing of Darzalex in November, reducing treatment costs from $440,000 to PBS prices for around 1,300 to 1,400 patients annually. He announced the upcoming listing of Elrexfio for relapsed cases, reducing script costs from $5,000 to no more than $25. He also mentioned progress in finalizing a deal for Carvykti, a CAR-T cell therapy. The Minister thanked community leaders and clinicians for their advocacy and emphasized the value of the PBS in providing affordable access to new medicines.

Answer from Mark Butler

The minister reported that bulk-billing had improved since the government tripled the bulk-billing incentive and extended payments to all Australians. He stated that the count of Spence general practices providing full bulk-billing to every patient had tripled since November, with two out of three practices now 100 per cent bulk-billing. Nationally, 3,621 general practices were bulk-billing all patients, achieving the 2028 target early. He highlighted new health services in Adelaide's north, including an urgent care clinic, a headspace service, and a perinatal mental health centre.

Answer from Mark Butler

The minister rejected the characterization of genocide but acknowledged the member's interest in the area. He stated that the government was working to improve food security through the Low-Cost Essentials Subsidy Scheme, which subsidized essential items in remote communities, saving up to 50 per cent in about 113 stores. He noted that the government was seeking to build renal services in remote communities to allow dialysis on country. He emphasized the commitment to addressing the public health challenge of diabetes and improving access to affordable food.

Answer from Mark Butler

The minister stated that 134 Medicare urgent care clinics were open, having seen more than 2.7 million Australians, all bulk-billed. He noted that over 60 per cent of general practices were bulk-billing 100 per cent of patients. He highlighted the success of clinics in Cairns and Melbourne, contrasting the government's approach with the opposition's lack of health policy.

Answer from Mark Butler

The Minister highlighted the listing of over 400 new medicines on the PBS, including Ultomiris for myasthenia gravis, reducing costs from $25,000 to $25 per script. He noted that pensioners and concession cardholders had received 90 million free scripts due to safety net changes, with maximum script prices locked at $7.70. For general patients, script prices were capped at $25, saving Australians over $2.3 billion. The Minister emphasized that these measures improved affordability and health outcomes.