Doorstop Interview – Adelaide | Prime Minister of Australia
ANDREW COHEN, CEO FORHEALTH: My name is Andrew Cohen. I’m the CEO of ForHealth. I’m joined today by Dr Carolyn Rosa, our clinical director, and we’re excited to welcome the Honourable Anthony Albanese, Prime Minister of Australia, the Honourable Mark Butler, Health Minister and local member for Hindmarsh, and the Honourable Peter Malinauskas, Premier of South Australia and also in the background, the Honourable Chris Picton, Health and Wellbeing Minister for South Australia.
Before I begin, I just wanted to acknowledge the traditional custodians of this land, the Kaurna People and also pay my respects to elders past, present and emerging. And to personally, you know, pledge my own support for the Voice at the upcoming referendum. ForHealth is the second largest general practice provider in Australia. We serve more than 7 million patient visits every year. And our mission is accessible health for all Australians. We focus largely on lower socio-economic areas, areas like the one we’re in today at Royal Park, where the household median income is, you know, thirty per cent below the national median. We like to think about these centres really as community assets. Hundreds and hundreds of people walk into door. In the centre, maybe four or five hundred people walk into the door every day for the very basic need of seeing a doctor – to get their bloods, to get a CT, to get an x-ray, for chronic disease management. And I guess, in this context that we really commend the Albanese Government for really cutting through the politics of healthcare and actually putting patient access back to the forefront of their health agenda. The Federal Budget, and the tripling of the bulk billing incentive, will make a big difference to this community and to others like it. And you know, for our business, and for many in the sector, it really gives us a renewed sense of purpose and mission. Urgent Care Clinics are another really important change to the system. And, you know, we’re here in South Australia, South Australia and the South Australian government were real pioneers of this change. And it allows our practice, again, to really expand the access that we can give to a community like this. But more importantly, it really allows us to support and reinforce a secondary hospital system that is under significant pressure at the moment. And to put that into context, you know, we’ve had six of these sites in Victoria stood up for a little over six months, and those sites of triage, more than 40,000 patient presentations. Sixty per cent of the people that have come into these sites have stated that they would have otherwise gone to an ED, and nine out of ten of those people would highly recommend the service. So these, you know, these clinics are making a really tangible difference in these local communities, and to the secondary system in these local communities. And I want to thank the Federal Government, I want to thank the South Australian Government for their support and for their pioneering on the concept as well. And I want to thank the PHN for putting their trust in us and also our team for the hard work and standing up, this clinic, for the community of Royal Park and the electorate of Hindmarsh. And I’ll now hand over the Prime Minister.
ANTHONY ALBANESE, PRIME MINISTER: Thanks very much. Well, thank you. And it’s great to be here today for yet another announcement about Urgent Care Clinics and about how we are implementing the commitment that we made prior to the election to roll out Urgent Care Clinics. We committed to rolling out 50. And now, indeed, we’ve upped that to 58 Urgent Care Clinics to be rolled out this year. Making a difference, taking pressure off emergency departments, making sure that people can get the care that they need when they need it in an appropriate way that is timely, that takes pressure off the public hospital system but also makes sure that when people have an urgent care need that it’s not acute or life threatening, they can come here. When little Johnny or little Susan falls off the skateboard or the bike and breaks an arm, when someone needs stitching up from a cut, when someone needs that urgent care that doesn’t mean they have to sit in an emergency department waiting because they kept getting overtaken by a life-threatening condition which another patient arriving at an ED will need. This is an appropriate mechanism in the health system which is making it more efficient, which is delivering the health services that Australians need, and doing it, importantly, through the Medicare system. Our commitment was to strengthen Medicare and there are range of measures that we’re putting in place – this is just one of them.
And today we’re announcing, following expressions of interest, four clinics. The Marion Domain Medical and Dental Centre will be established as the Marion Medicare Urgent Care Clinic, here at Old Port Road, this facility will be the Western Medicare Urgent Care Clinic, the Elizabeth Medical and Dental Centre, somewhere I visited, will be established as the Elizabeth Medicare Urgent Care Clinic and Mount Gambier Family Health will be established as the Mount Gambier Medicare Urgent Care Clinic. These measures are all really important. But so too is the centrepiece of our Budget this year – the tripling of the bulk-billing incentive for Medicare. What that will result in is more people being able to see a doctor for free. And importantly, when people arrived at this Urgent Care Clinic, they won’t need their credit card. They will just need their Medicare card. Making sure that they can get that care for free as a result of my Government’s commitment to strengthen Medicare. On top of that, of course, we have the changes that we’ve made to prescriptions, the first ever reduction in the PBS since it was introduced way back in the 1940s by the then Labor Government. Cutting the costs of medicines from $42.50 down to $30 has made an enormous difference already for South Australians, over $10 million being saved for South Australians in the first period of this year. And of course, the commencement of the 60-day dispensing will also make a difference. Literally cutting in half the costs of getting medicines for people who need that regular medical and pharmaceutical assistance. So my Government is prioritising delivery of primary healthcare. We’re working with states and territories to make sure that the health system operates more efficiently and that Medicare is right at its centre. And we are working with every state and territory government, including the Government here of Peter Malinauskas. And I thank the Premier of South Australia for the cooperation and the work, hand in hand, that we’re doing to make sure that Australians get the healthcare they need, when they need it, through the Medicare system. And I’d ask the Premier to make some comments before we take some questions.
PETER MALINAUSKAS, PREIMER OF SOUTH AUSTRALIA: Well, thank you very much, Prime Minister. It’s great to have you here in the western suburbs of Adelaide. West is best, as Mark Butler will attest to. Chris Picton might have a different view, of course. But it’s great to be here for an important announcement for our health system in South Australia. The Urgent Care Clinics will make a difference to emergency department waiting times. We know in South Australia that over 40 per cent of all the people who attend emergency departments are there for non-urgent issues. 40 per cent. Now, just think about that for a moment. Across our system in South Australia, tens of thousands of people visit our emergency departments every year. Over 40 per cent of them are not there for an urgent case. The ability for Urgent Care Clinics to be able to provide services to those South Australians so they can get attended to for free, through their Medicare card, in a timely way, in a clinically appropriate way, and at the same time taking pressure off EDs, is exceptionally valuable to our system writ large. I’m very grateful for the fact that we have a Federal Government that acknowledges the fact that our public hospital system around the country is under extraordinary pressure – including here in South Australia. Because by acknowledging that we now have a Prime Minister and a Federal Health Minister that we can collaborate with, make policy decisions understanding the challenges, but also deliver outcomes. This Prime Minister and the Federal Government is doing that. It is exceptionally rare for federal governments to invest money directly in the public hospital system. Yet the Albanese Federal Government is doing that at the Flinders Medical Centre with a $200 million commitment to the $400 million refurbishment that is now being undertaken. That is a serious investment. But the Urgent Care Clinics is a really thoughtful policy that will make a difference. If we can just reduce a small percentage of that forty per cent that roll up for non-urgent needs and put them in a more appropriate setting closer to their home, that’ll make a material difference. The locations of these Urgent Care Clinics are also well thought through – Marion, Mount Gambier, Elizabeth, here at Royal Park in the western suburbs. But also, another one set to come in the outer southern suburbs will mean a full spread of these centres being accessible seven days a week for extended hours to help ease pressure on the hospital system. So, we thank you, Prime Minister, for appreciating that this is an issue that state governments can’t do alone. We appreciate the partnership that has led to today’s announcement. And we look forward to working together as we confront this significant challenge over the months and years ahead.
PRIME MINISTER: Thanks very much, Premier. We’re both happy to take questions.
JOURNALIST: How significant do you think this will be in terms of bringing down ramping levels here in South Australia?
PRIME MINISTER: Look, I think this is very significant. We know from the experience that we’ve had already with clinics that have opened up, and we heard some of the figures from Victoria already. That what it does is, instead of presenting at an emergency department because there aren’t other options, people will come here. And here, you have the full suite. You can get your x-rays done, you’ve got your pharmacy, your dental – everything all in one place. Pathology, you can get that done and can get the care that you need when you need it to take pressure off emergency departments. This is, if you like, an interim stage between visiting a GP and ending up in an emergency department. And a lot of people, the surveys have shown that people turn up in emergency departments because that is the option that’s available to them. I don’t know if either of our Health Ministers want to add anything there.
JOURNALIST: What will be the operating hours of these centres? And will any of them be 24 hours to address that surge in presentations in the middle of the night?
MARK BUTLER, MINISTER FOR HEALTH AND AGED CARE: Thanks. These centres will be open seven days a week right across the country and for extended hours. I can’t quite remember exactly what the hours are here, I think we were told 8am until 8pm, seven days a week. As the Prime Minister and Premier said, fully bulk billed – so all the patient will need is their Medicare card. And those hours are really important because what these operators are doing in conjunction with hospital systems is working out when the peak demand time is for hospital emergency departments, particularly for those non-urgent and semi-urgent presentations, and making sure that the opening hours at the Urgent Care Clinic in a particular location reflects that.
JOURNALIST: Is there any thought to having a centre that’s like this that is 24 hours so that people with an urgent case don’t have to present to emergency in the middle of the night?
MINISTER BUTLER: When we consulted about this with hospital systems and with the primary care or general practice system, after a period in the night-time – somewhere between 8pm and 10pm, it varies depending on where you are – into the early morning, there’s actually very little demand for a service like this. So we didn’t want to have these things operating 24 hours a day and essentially be completely inactive for several hours over the course of the night. So there was no submission to us that beyond a certain time in the evening that we should continue operating there. So that’s sort of early, you know, early-ish mid-morning until into the evening, is really the peak demand period the hospital systems have told us they need help.
JOURNALIST: Minister, how would you ensure that there’s enough staff for these facilities?
MINISTER BUTLER: Well, this is a requirement that services like this one have signed up to. This was a competitive process run by the Primary Health Network here in South Australia. Particular conditions were set in the tender or the expression of interest that was put out, that they would be able to see patients, including walk-in patients. That’s the really important thing about this model. You do not have to be a patient of this clinic to be able to walk in with an urgent need for care, show your Medicare card, and receive that care. So there are very clear operational protocols that we negotiated with state governments to make sure that this system fits hand in glove with the hospital and the ambulance system. Everyone’s clear about where patients should be seen. So all of these clinics have gone into this system with eyes wide open. There are expectations and conditions in the contract that they will be able to see these patients. Obviously this, as the Prime Minister said, is a relatively new model for Australia that that sort of midpoint between traditional general practice and the hospital system is quite common in New Zealand and many countries in the Northern Hemisphere. But it’s new here, so we’ll be evaluating it very, very closely to make sure that it does work in the way we intended. And over time, we would hope to be in a position in coming years to consider an expansion.
JOURNALIST: Prime Minister, if the Voice gets majority support nationally but not in the states, does that give you the green light to legislate it, or is that the end of it?
PRIME MINISTER: We have a referendum system in our Constitution where you need a majority support in a majority of states. That is what we’re campaigning for. That’s what I hope occurs. That’s what every state Premier is saying they will vote for across the political spectrum, including in my home state of New South Wales, you have multiple former state premiers all saying that they will be voting Yes as well. This is a simple proposition. It’s a proposition to recognise First Nations people in our Constitution. And secondly, to have a non-binding advisory group so that we can listen to their views about matters that affect them so that we can get better results. That is the question that is before the Australian people. I sincerely hope that the Australian people vote Yes, but we will respect the outcome.
JOURNALIST: What are the implications of a No vote in the referendum?
PRIME MINISTER: Well, I’m focused on a Yes vote in the referendum. And I am hoping that a majority of Australians do vote Yes in this referendum. I’m heartened, it must be said, by the discussions that I’ve had, including here in South Australia. The interaction yesterday, and I might ask Mark to comment on the call from over 100 health organisations right across the spectrum, all saying, we need to do better when it comes to health outcomes for Indigenous Australians and this will help. All advocating a Yes vote.
MINISTER BUTLER: Thank you, Prime Minister. It is hard to name a significant health organisation that did not put their name to the open letter yesterday signed by more than 125 health organisations advocating a Yes vote in this referendum. Because I can’t think of an area of policy where listening to the voices of Aboriginal and Torres Strait Islander people will be more valuable than in health. Because, year after year, we receive the appalling statistics that the yawning gap in health outcomes and life expectancy between Indigenous Australians and Non-Indigenous Australians. And every significant health organisation said yesterday, with the best of their intentions and efforts and substantial investment from all governments the current approach simply isn’t working, and we need a new approach. They understand that good doctors listen carefully to the needs of their patients before deciding on a particular direction of treatment. And their advocacy yesterday was that a wise parliament, a good government, should also listen to the voice of Aboriginal and Torres Strait Islander people.
JOURNALIST: Can you put a number on an exact figure that your Government believes should get the mission of full employment, an exact figure?
PRIME MINISTER: What we say in the Employment White Paper is that we want to see more jobs created, and we want for people who are seeking employment to be able to get that employment and to be able to do it in a timely way. We want to see everyone fulfil the potential that they have and being able to work is a part of that.
JOURNALIST: Prime Minister, can I ask you about the story which aired on Four Corners last night with regards to the NDIS which showed footage of a child with autism being pinned down by six workers in what experts have described as unlawful practice and abuse? What’s your reaction to that footage and should treatments like this be funded through the NDIS?
PRIME MINISTER: I haven’t seen the footage. I had an event last night here in South Australia so I’m not going to comment on footage that I haven’t seen. I did hear this morning on radio some of the, what I take it, was audio from the footage, and I found it very disturbing. And I know that the NDIS Minister, Bill Shorten, will be responding appropriately to that. I do note that, from the report, I believe the audio was from 2020 – correct me if I’m wrong. I listened to RN this morning, and so I heard the report there. I certainly found it very confronting.
JOURNALIST: Regarding these Urgent Care Clinics, how will your Government ensure that there’s awareness out there for people not to go to emergency departments and, instead, if they’ve got a broken arm, for example, go here?
PRIME MINISTER: Well, this will help. This is a part of the process of letting people know. It’s one of the reasons why we are having these openings of Urgent Care Clinics to get that message out there to the community. But one of the things that we’ve found is happening already in Victoria in places where this is open is that people talk about their experience in coming here. And as you’ve heard this morning, overwhelmingly the experience, 90 per cent would recommend it off the experience so far. So we will be, of course, continuing to talk about this. We’ve made sure that the commitment that we made, the election was only in May last year, and to have these clinics up and operating in such a timely fashion has been, I think, a considerable effort by not just the Federal Government but also working with state governments. I don’t know if Mark wants to add.
MINISTER BUTLER: Thank you, Prime Minister. As I think we’ve heard, we’ve had to work hand in glove with hospital systems and ambulance systems through the State Government here and elsewhere in the country so that everyone is clear when patients should go to a hospital emergency department and when they might be able to come to one of these Urgent Care Clinics. We’re very confident that we are very much on the same page with all state governments about those protocols. In addition to that though, we will be rolling out localised communications campaigns. That won’t be national, because there’s not national coverage of these Urgent Care Clinics, But there will be localised communications campaigns. For example, in the western suburbs here in Adelaide, on social media, some outdoor advertising, to lift awareness of a service like this. As well, often the first port of call for patients is to ring Health Direct which is the national assistance line, if you like. And all of the nurses and other staff who staff the Health Direct national hotline will know that if you ring up with your child having fallen off a skateboard, the example the Prime Minister used, and you are in the western suburbs, they will encourage you to go to this clinic instead of to the QEH or to the RAH. So we’re trying to think about a range of different awareness-raising and communications campaigns to make sure these clinics operate as effectively as possible and take that pressure off the hospital system the Premier talked about.
JOURNALIST: Prime Minister, have you spoken to Warren Mundine about his opposition to the Voice?
PRIME MINISTER: No.
JOURNALIST: Prime Minister, how important is it to get this Mike Pezzullo mess sorted out?
PRIME MINISTER: Well, we have, I think, responded very quickly to the reports. Mr Pezzullo has agreed to step aside. We will have the inquiry that’s been established through the Public Service Commissioner, who’s appointed Lynelle Briggs to conduct the inquiry, and we will not respond to the detail before that inquiry. But I see it as an urgent matter.
JOURNALIST: Can he survive as Home Affairs Secretary after this?
PRIME MINISTER: You have an independent inquiry so that you hear from the inquiry, not so that you pre-empt it. That’s what we’re doing. My Government is an orderly Government that sets up structures that are appropriate and then responds to it.
JOURNALIST: Prime Minister, can I ask you about Qantas? Is it time for Richard Goyder to resign as Chairman of Qantas?
PRIME MINISTER: Well, what we know is that Qantas has a lot of work to do to repair the damage that has been done to its reputation, both in terms of workers and in terms of customers. In terms of workers, the decision by the court was something, that people were illegally sacked, was something that was backed up by a submission that my Government made. At the time, I note that the Coalition said that that was the right of the business to act and defended that action by Qantas. Just as they didn’t have much to say way back when I was the Minister when Qantas ground its fleet. There is a need for Qantas, it’s an important Australian company, an important Australian brand internationally, and there’s a lot of work to do to repair its reputation.
JOURNALIST: Australians have now started to cast their votes in the referendum in remote areas. Are you confident that you’ve reached everyone that you need to?
PRIME MINISTER: I’m certainly confident that Indigenous Australians will overwhelmingly be voting Yes in this referendum. All of the figures show that, and my experience in going to places like north-east Arnhem Land, very much reflects that as well. The decisions of the Central Land Council, the Northern Land Council, the leadership that has occurred shows that that is the case. Overwhelmingly, Indigenous Australians came together at a First Nations Constitutional Convention at Uluru in 2017 to make this request. I hope Australians do vote for this. Of course, remote polling booths are an important part of Australian elections, including referendums.
JOURNALIST: Do you think a lack of detail is why the Yes vote is failing in the polls?
PRIME MINISTER: It is a fact that this is a very simple detail which is out there, it’s there in the question. The question is very clear. All the detail is there. The first question is, the first statement, is the recognition bit. In recognition of Aboriginal and Torres Strait Islander peoples as the first peoples of Australia. Then it says there shall be, three points, there shall be a body to be called the Voice. The second is what it would do. It may give advice to Parliament and executive government on matters affecting Indigenous Australians. And the third is very clear, the primacy of the Parliament. To provide for, to make laws or to legislate for the matters affecting the Voice, including, so that ‘including’ word is very important as well, because it makes it all-encompassing, the procedures, compositions, functions of the Voice. It’s very, very clear what’s before the Australian people. What has occurred during this campaign is a lot of information being put out there, including by some who know that it is not true, know that it is not true, they know that the Voice won’t be sitting down with the board at the Reserve Bank determining interest rates or the head of Defence deciding where Australia’s bases will be. They know that it won’t be about future taxes or people won’t lose their homes because of that. I’ve seen stuff saying that all private ownership would disappear, that it is about the United Nations taking control of Australia. We know that there’s a lot of, and that’s before you get to some of the quite unsavoury comments that are being made, or claims that are being made, some of which we saw at the demonstrations that were held last Saturday. This is a positive request from Indigenous Australians. It is a generous request. It is clear, a non-binding Advisory Committee that won’t fund programs, that won’t have the right of veto over Parliament or over legislation. It’s very clear what is being put forward, and that is why I think so many groups, including health groups, people who’ve looked at this and considered it, every faith group in the country has looked at this and said, this is the right thing to do, which is why they are advocating a Yes vote.
JOURNALIST: Prime Minister, as part of your campaigning, will you be making more trips to South Australia, including to the Aboriginal community out at the APY lands?
PRIME MINISTER: I travel to South Australia all the time, and I’ll continue to travel to South Australia not just while I’m Prime Minister but, hopefully beyond as well, for many years to come.
JOURNALIST: Can we see you in the next three weeks that are left of the Yes campaign?
PRIME MINISTER: We’ll see the itinerary, you get lots of notice when I’m here. But I travel right around the country. There’s nothing unusual about me going to South Australia. And the event with Whyalla, for example, was locked in a long time ago, to coincide with the turning off of the coke ovens yesterday, 55 years and 55 days after they were turned on. And I enjoy coming to South Australia, whether it is to Adelaide or whether it be to the regions. I’ve now been to Whyalla and to the Riverland with the Premier of South Australia. I look forward to coming back here not just over the next few weeks, but over many years to come.
JOURNALIST: Just on Qatar, they’ve said that blocking extra flights to Australia wasn’t just Qantas, can you clarify what the national interest was?
PRIME MINISTER: In the normal way that there are air services agreements with different countries and the normal way in which there was an application in 2018 for seven additional flights that took four years to progress, when it was finally granted in 2022. For people who aren’t familiar with air services agreements, this is business as usual. And the airline industry know that that’s the case. I was Aviation Minister for six years. There was a range of decisions made. I can’t think of a decision made to double flights by any airline, by any Minister, since air services agreements were begun. So, you can ask Michael McCormack and the range of Aviation Ministers, why it was that the application in 2018 didn’t result in any change, or 2019, or 2020, or 2021, why that wasn’t the case. Last one.
JOURNALIST: Can I ask you about the Disaster Summit? Are you satisfied that the public sector and the private sector are well enough prepared for the challenges that the nation could face in the coming months?
PRIME MINISTER: I think the challenges are enormous. And it is, I think, beyond doubt that there’s always more that we can do to prepare. Which is why we’re having this Summit. I’ll be travelling directly to Canberra from this and addressing the Summit. Climate change is real. And the extent of natural disasters are now more intense and more frequent. That’s why my Government is not just responding in terms of the long-term, working with the South Australian Government on the transition that will occur, as part of what the whole world needs to do, which is to respond to our changing climate. Because of the impact on the environment, because of the impact on people, but because, as well, of the impact on our economies of natural disasters. We have spent billions of dollars on natural disaster support, from floods here in South Australia, in Victoria, in New South Wales. We have a real challenge ahead of us with the summer that is coming. And that’s why my Government is having this Summit to bring together different authorities to make sure that we do what we can to prepare. Thanks very much.