Latest / The Morning Edition / Mark Butler on the NDIS, private health and vaccine hesitancy

Transcript

Mark Butler on the NDIS, private health and vaccine hesitancy · The Morning Edition

0:00
S1: Hi everyone, it's Paul from the Sydney Morning Herald and
0:02
S1: the age. Welcome to Inside Politics. When the NDIS was
0:07
S1: created in 2013, it was proof that a rich society
0:10
S1: could find the money to create a decent life for
0:12
S1: the disabled. This was social democracy at work. 12 years on,
0:16
S1: it's turned into a $52 billion behemoth on track to
0:20
S1: cost more than the aged pension. It's become a symbol
0:23
S1: of government largesse, and stories of fraud and scams have
0:26
S1: been widespread. The Albanese government last week admitted the scheme
0:30
S1: was at risk of collapse. It announced a root and
0:33
S1: branch overhaul to remove 300,000 Australians off the NDIS over
0:37
S1: the space of a few years. The man late in
0:40
S1: the contentious reform agenda is the health minister, Mark Butler.
0:44
S1: The 55 year old South Australian has emerged as one
0:46
S1: of Labor's most energetic ministers, taking on big tasks in
0:50
S1: aged care, tobacco control and disability support. He's even been
0:54
S1: asked if he might be the next labor leader after
0:57
S1: Anthony Albanese. He joins us now. Welcome, Mark Butler.
1:01
S2: Thanks, Paul.
1:02
S1: Mark, you're having a bit of a moment at the
1:04
S1: moment in politics. On the one hand, you're being asked
1:07
S1: for the first time in your quite long parliamentary career,
1:10
S1: whether you want to be the next leader of the
1:11
S1: Labour Party. On the other hand, you're ripping support away
1:15
S1: from about 160,000 Australians on the NDIS. Can you give
1:19
S1: us the elevator pitch on what you're doing to the
1:22
S1: NDIS and why it's needed now?
1:24
S2: Well, really, last week's announcement and a whole lot of
1:28
S2: work that I had done, but Bill Shorten and Amanda
1:30
S2: Rishworth had done in our first term, was really focused
1:34
S2: on securing the future of the NDIS. It's moved into
1:37
S2: its teen years, as I described it last last year
1:41
S2: when I was talking about thriving kids. It's a reform
1:44
S2: that is now pretty mature. It's a program that's matured
1:47
S2: in terms of its period of rollout and like a
1:51
S2: lot of social programs, talking to people who've been around
1:53
S2: a while, this happened in Medicare several years after its introduction.
1:57
S2: It's had growing pains and needs a very good review.
2:00
S2: It's growing too fast. It's too costly. It's expanded in
2:05
S2: its scope well beyond the original intention of the scheme
2:08
S2: when it was first set up 13 years ago. And
2:12
S2: so we're doing some very serious work to get it
2:15
S2: back on track for its own sake in the immediate term,
2:19
S2: but to make sure that this extraordinary reform, which has
2:23
S2: transformed the lives of hundreds of thousands of people, is
2:25
S2: secured for the long term.
2:27
S1: Whether or not it was the intent at the start
2:29
S1: of the scheme, successive governments allowed many Australians to jump
2:34
S1: onto it, and many now derive some part significant or
2:38
S1: small part of their incomes from this game. This will
2:40
S1: cause misery to a lot of families, right? Do you
2:42
S1: acknowledge this process will be messy and very hard for individuals?
2:45
S2: Well, I certainly acknowledge change is really confronting and significant
2:50
S2: change particularly is confronting. And this is going to involve
2:53
S2: significant change. I mean, this builds on the Announcements we
2:58
S2: made last year to move under nine year olds with
3:03
S2: more mild to moderate support needs to a new program
3:06
S2: called Thriving Kids. And when I say new, it's not
3:09
S2: really new in the sense that we had to pull
3:11
S2: a blank sheet of paper out. This was really the
3:13
S2: sort of supports that kids like that got well before
3:16
S2: the NDIS. I mean, before the NDIS, there were a
3:18
S2: whole range of programs, many of them delivered by state
3:21
S2: governments located in the community, generally heavily curated by government.
3:26
S2: So not this individualised market based approach to the NDIS
3:31
S2: has which parents were able to access if their children
3:35
S2: weren't hitting developmental milestones or had some autism symptoms, with
3:41
S2: more mild to moderate support needs. So rebuilding sort of
3:44
S2: what was there before the NDIS for people who were
3:47
S2: never intended to be covered by the NDIS was something
3:51
S2: we built on really. We did last year for that,
3:54
S2: that cohort. And this year we're building on.
3:56
S1: Do you think taxpayers who are now footing the bill
3:59
S1: for a scheme that's almost as expensive as the age pension,
4:02
S1: as well as all the individuals who'll be worried about
4:04
S1: whether to stay on whether they can stay on the scheme,
4:07
S1: deserve an apology from the government. This was Labour's scheme
4:10
S1: at its outset under the Gillard government.
4:12
S2: Well, I think it's I tried to be pretty frank
4:15
S2: last week at the Press Club that that a lot
4:18
S2: of the issues with the NDIS now reflects some, um, frankly,
4:26
S2: flaws in its design and implementation and governments from the
4:30
S2: time it was.
4:31
S1: And there Labor's flaws right. Labor made this scheme well.
4:34
S2: We designed the scheme and it was implemented over nine
4:37
S2: years by the former coalition government. I tried to be
4:41
S2: as apolitical as I could be about this. Um, last
4:44
S2: week at the Press Club, we should acknowledge as a
4:47
S2: as a labor party that, um, that some of the
4:50
S2: issues that we have here go back to the scheme design.
4:53
S2: I've tried to be honest about that. Some of it
4:56
S2: was some effectively a product of the implementation of the
5:00
S2: scheme by the former government. There's not much merit really,
5:04
S2: in in sort of going over all of that and
5:08
S2: trying to allocate little bits of blame to one party
5:11
S2: or the other.
5:12
S1: Hey, maybe not for the Labor Party. It's unhelpful for
5:14
S1: the political legacy of the scheme and the legacy of
5:17
S1: the last Labour government.
5:18
S2: Yeah, but well, I mean, what I tried to do
5:19
S2: was to say this, this this really is a set
5:24
S2: of issues we have that that goes back to the
5:27
S2: design of the scheme in some senses. And and then
5:31
S2: in other senses, the implementation. I mean, for example, the, the,
5:35
S2: the creep of the scope of the the scheme, I think,
5:39
S2: really reflects the way in which people have been able
5:41
S2: to be signed on to it. I talked about the end,
5:43
S2: for example, of the diagnosis gateway.
5:45
S1: We'll get to all this.
5:46
S2: Yeah. Those access lists were designed to be a tool
5:50
S2: to get the scheme up and running and to be
5:52
S2: replaced eventually by a more evidence based assessment tool, which
5:56
S2: I talked about last week. So 13 years on, I mean,
5:59
S2: should that have should that have been introduced earlier during
6:02
S2: its implementation? The type of market we have, which is
6:05
S2: heavily unregulated with unregistered providers, is as much a product
6:10
S2: of the implementation of the scheme as the design. So,
6:13
S2: you know, we can go over that for, for a
6:15
S2: long period of time. I'm sure people will sort of
6:17
S2: uncork a bottle of claret and, and sit down in
6:20
S2: the armchair and analyse that. I guess what I tried
6:22
S2: to do was, to be honest last week about the
6:25
S2: fact that there are some scheme design issues that we
6:27
S2: need to address and then start looking forward.
6:30
S1: I'm interested in the politics of it just quickly and
6:32
S1: then we'll get into some detail. Some commentators have analysed
6:36
S1: this reform from last week, have said this is one
6:38
S1: of the first moments where the Albanese government has showed
6:41
S1: an appetite for big reform. This is a significant change.
6:44
S1: It will be hard to prosecute in the public debate.
6:47
S1: There's obviously a narrative that this government has been somewhat cautious.
6:51
S1: There are mixed views about that hypothesis on this government.
6:54
S1: Do you see this as a bold reform, or is
6:56
S1: this cleaning up a mess at a time when the
6:58
S1: budget needed to be reined in?
7:00
S2: Well, as I again, I said last week, I mean,
7:03
S2: this is a plan I would have taken to the
7:04
S2: Prime Minister and to the Expenditure Review Committee and cabinet. Frankly,
7:08
S2: regardless of the budget position, I think it's the right
7:11
S2: plan for the scheme. It's the right plan for participants
7:15
S2: to ensure, at this point in its life that it
7:18
S2: is secured for the long term. So this is not
7:21
S2: really a response to any particular budgetary position. It's a
7:24
S2: response to our analysis of where the scheme is, where
7:28
S2: the NDIS is, and about the ability of the things
7:32
S2: we've tried to put in place to grip to get
7:35
S2: that cost inflation down. So. So I don't see it
7:39
S2: as really a response to the budget position. It's a
7:41
S2: response to where we think the scheme is at. As
7:43
S2: for where it sits in the sort of list of
7:45
S2: reforms of our government, I think our government has been
7:48
S2: a reformist government and a whole range of areas, including
7:51
S2: some of them I have responsibility for like aged care
7:54
S2: and and parts of health. This is a very big deal.
7:59
S2: This is a big change to a scheme. Now that
8:01
S2: is aside from the aged pension, our biggest social program,
8:05
S2: our fastest growing social program, and one that impacts hundreds
8:09
S2: of thousands of participants directly but indirectly, family members and
8:13
S2: a whole lot of providers as well. So. So I'm
8:16
S2: under no illusions really about the scale of this reform,
8:21
S2: the difficulty of landing it in a way that works
8:24
S2: for participants, most importantly, but for taxpayers and the market itself.
8:29
S1: It might be tricky, particularly with the states co-funding the
8:32
S1: scheme to get them on board with the changes. But
8:34
S1: the opposition's reaction, which has been largely supportive and public polling,
8:38
S1: would suggest that there is community support for this change.
8:41
S1: So rather than being a bold reform where you're trying
8:44
S1: to shift the public narrative, it seems like some something
8:47
S1: where you've gone where the public already is.
8:50
S2: Well, it seems pretty clear from the research and I
8:53
S2: talk I've talked about some of that going back to
8:55
S2: last year, that the community is deeply concerned about where
8:58
S2: the NDIS is, and providers and participant advocates have talked
9:03
S2: about the fact that not too many years ago, the
9:05
S2: NDIS was really voiced even by those who had no
9:10
S2: direct interaction with it as a source of real national pride.
9:13
S2: And that has shifted. Um, as I said last week,
9:17
S2: 7 in 10 Australians think it costs too much and
9:20
S2: is riddled with dodgy providers. 6 in 10 think it's
9:24
S2: they actually use the word broken. So I think there's
9:27
S2: substantial risk that the social licence that sits behind a
9:32
S2: $50 billion a year scheme is slipping away. But also,
9:37
S2: as you say, an openness in the community for for
9:42
S2: some significant change.
9:44
S1: You mentioned autism. That's one of the fastest growing parts
9:47
S1: of the scheme. I think 43% of the current participants
9:50
S1: are having autism diagnosis. Clearly not the intent. The other
9:54
S1: outside of the NDIS. There's a huge explosion in ADHD
9:57
S1: diagnoses at a societal level. What do you make of
10:00
S1: this phenomenon? What's going on here? How much of this
10:05
S1: is legitimate diagnoses and how much is not?
10:07
S2: Well, I think a lot of people are thinking very
10:09
S2: deeply about that, not just here in Australia, but but
10:12
S2: across the world, frankly, particularly the Western world. And in
10:16
S2: some areas, even particularly the Anglosphere, if you have a
10:20
S2: look at some of the work around youth mental health,
10:23
S2: I know you didn't mention that, but a bit adjacent
10:25
S2: to some of these issues, big inflation in diagnosis numbers, um,
10:31
S2: is more pronounced in English speaking countries, which starts to
10:35
S2: raise questions about the role of social media as well.
10:39
S1: But tell us more about that.
10:41
S2: Yeah.
10:41
S1: Well, is there a trend?
10:42
S2: There's a there's a big trend. I mean, there's a
10:45
S2: very significant trend in in anxiety and depression Diagnoses among
10:50
S2: young people. That's probably been going for 20 years. It's
10:53
S2: more pronounced in English speaking countries. For example, in in Canada,
10:57
S2: it's more pronounced in the English speaking states or provinces
11:01
S2: than Quebec.
11:01
S1: And largely higher income parts of those states.
11:04
S2: No, not particularly, not particularly, I don't think. But but
11:07
S2: I mean, this really goes to the question of the
11:09
S2: role of social media in this and the way in
11:12
S2: which social media, um, are not reports, news, but reports
11:17
S2: sort of world events really in a way that's sort
11:19
S2: of quite anxiety inducing. Anyway, these are, these are still
11:23
S2: questions that are the subject of a lot of research.
11:25
S2: Alongside that, there's no question there's been a very big
11:28
S2: increase in, um, autism diagnoses that to some degree reflects
11:33
S2: a change in the diagnostic manual for this, that move
11:36
S2: from autism being a sort of a discrete condition to
11:40
S2: becoming more a spectrum, um, spreading from what used to
11:44
S2: be thought of as Asperger's right up to what, was
11:48
S2: seen as quite a severe condition of autism. Whether there's
11:52
S2: been any inflation in the diagnosis beyond that is still
11:55
S2: the subject, frankly, of of debate. And I think trying
11:59
S2: to unpack that is part of the reason why we
12:02
S2: want to get rid of the diagnosis lists and and
12:06
S2: really focus on functional capacity. Frankly, whether someone has autism
12:11
S2: or any other type of disability, the, the, the lodestar
12:15
S2: of the scheme really should always be a significant reduction
12:19
S2: in functional capacity that impacts daily living needs.
12:22
S1: I'm way too young to start any sentences with back
12:26
S1: in my day, but when I was at school, there
12:28
S1: was nowhere near the level of diagnosis on ADHD or autism.
12:32
S1: Part of the conversation around your changes to the NDIS
12:34
S1: is how many new supports will be required in schools
12:37
S1: and other places to service the people who will no
12:40
S1: longer be on the scheme. Is it the case in your.
12:43
S1: This might be a personal view rather than something that
12:45
S1: can be attributed to research. But is there a chance
12:48
S1: that because of this huge diagnosis gateway that's been created,
12:51
S1: that there are many thousands, potentially tens of thousands of
12:54
S1: people on the NDIS who don't require any kind of care,
12:58
S1: that outside supports don't need to be created for these people,
13:01
S1: that they should not have been diagnosed.
13:03
S2: I've never had that put to me. Certainly, I'm pretty confident.
13:07
S2: I'm very confident that that a big number, particularly of
13:12
S2: of children who have been enrolled on on onto the
13:15
S2: NDIS with developmental delay or autism could be properly supported
13:22
S2: by other systems outside of the NDIS who have more
13:27
S2: low to moderate needs. And it doesn't mean that they're
13:30
S2: not going to benefit substantially from support. But that support, um,
13:35
S2: probably shouldn't be delivered by a scheme that was designed
13:38
S2: quite deliberately for permanent significant disability. If you go back
13:43
S2: to that original design, you set up a program for
13:47
S2: people who will have severe lifelong disability. Very differently to, um,
13:52
S2: to low to moderate or temporary support needs. That's why
13:56
S2: it is so individualized. That's why it does really allow
13:59
S2: much more choice and control for people to determine the
14:03
S2: nature of their supports and where they get that from.
14:05
S2: Then other social programs, like health programs or aged care programs,
14:09
S2: or most pediatric programs for that matter. I mean, the
14:12
S2: NDIS works really if you're 4 or 5 year old
14:15
S2: is enrolled onto it because they have some developmental issues,
14:19
S2: the parent will receive a plan budget and then be
14:21
S2: expected to go and work out how to spend it themselves. Uh,
14:25
S2: traditional programs for childhood support, pediatric support would really have
14:30
S2: the parent direct it to a series of supports that
14:33
S2: they could access in their community.
14:35
S1: What's that?
14:36
S2: A special class, heavily curated family centers. Those supports would
14:39
S2: be delivered in places the parents were probably quite familiar
14:43
S2: with in the community, um, in group settings where parents
14:47
S2: are able to interact with other parents going through the
14:50
S2: same issues. That's certainly what used to exist before the NDIS.
14:54
S2: Most of those systems were, if not entirely dismantled, certainly
14:59
S2: wound back very substantially. And rebuilding them really as the
15:02
S2: focus of thriving kids.
15:03
S1: So there'll be a new diagnosis tool created. We know
15:06
S1: we don't have the details on precisely how.
15:08
S2: It's not really a diagnosis tool. It's a it's an
15:11
S2: assessment tool.
15:11
S1: Assessment.
15:12
S2: Tool that focuses very much on their functional capacity, no
15:15
S2: matter what their diagnosis.
15:16
S1: So will that assessment tool, uh, take into account diagnoses
15:21
S1: of autism provided, for example, by telehealth service? Or will
15:25
S1: the assessment tool itself make the determination about whether a
15:29
S1: condition is severe enough to be on the scheme? How
15:32
S1: will it alter the way people are getting diagnoses and
15:35
S1: feeding that diagnosis into the system?
15:37
S2: Well, quite substantially, because up until now, if you have
15:41
S2: a particular diagnosis, say level two autism, then you're pretty
15:47
S2: much on the scheme. And instead this will, without preempting
15:50
S2: the sort of detail of a process that it's going
15:53
S2: to take some time and be conducted in close partnership
15:58
S2: with states and with the disability community. This will be
16:01
S2: relatively blind to the label that you might have, and
16:04
S2: look instead at your functional capacity, whether you are, whether
16:08
S2: you have quite high support needs or substantially reduced functional
16:12
S2: capacity or not, and be relatively blind to whether you
16:15
S2: bring a diagnosis of autism or down syndrome or a
16:20
S2: more physical quadriplegia or paraplegia, for example. And instead look
16:25
S2: at how your daily living needs are assessed.
16:28
S1: So you're drastically reducing the incentive to go and seek
16:31
S1: out a diagnosis.
16:32
S2: That's right, that's right. And I think that has been
16:34
S2: a real lottery for people who, particularly parents of children,
16:37
S2: who might have difficulty finding the right specialist to see
16:42
S2: Sometimes waiting very long periods of time a year or two,
16:46
S2: which when you're talking about a 4 or 5 year old,
16:49
S2: is an eternity. And then having to pay thousands of
16:52
S2: dollars to get the report. Now, for people who live
16:55
S2: in areas which, which have relatively high numbers of those
16:59
S2: specialists and have the ability to pay those bills, that's
17:03
S2: one thing. But in outer suburban areas, in regional areas,
17:07
S2: for people on low incomes, that's been a real barrier
17:10
S2: to getting the support their children needs, particularly given that
17:12
S2: the NDIS, as I've said, and Bill shorten used to
17:16
S2: say quite regularly, has become a bit bit of a
17:19
S2: life buoy in an ocean or the only port in
17:21
S2: the storm.
17:22
S1: You want to reassess all people who are currently on
17:24
S1: the scheme over the next couple of years, who will
17:27
S1: actually facilitate the assessment tool. Will there be a new
17:29
S1: workforce created to do this?
17:31
S2: Well, again, that that's work we have to do over
17:34
S2: coming months. The agency, the independent agency, which is effectively
17:37
S2: a statutory agency that runs the scheme, will have oversight
17:41
S2: of that. You know, everyone everyone being reassessed will obviously
17:46
S2: be be a little bit calibrated according to, uh, functional capacity.
17:51
S2: There will obviously be some people, uh, for whom there's
17:55
S2: really no question about their, their ability to stay on
17:58
S2: the scheme and others who will be at the edges.
18:00
S1: And they'll still need to go through the assessment tool,
18:02
S1: the severely disabled people.
18:03
S2: Yeah. But I think one of, one of the threshold
18:06
S2: questions for the group and the technical advisory group that
18:09
S2: supports it, that is going to do this work will
18:11
S2: be really whether there's a light touch first, first stage process,
18:16
S2: which sorts people who unambiguously, um, have functional needs that,
18:22
S2: that mean they're going to stay on the scheme for
18:24
S2: the rest of their lives on the one hand, and
18:26
S2: others who might be more at the edge on the other.
18:28
S1: Yeah. Okay. Over the last ten years or so, there's
18:31
S1: entire professions that have been built up around servicing people
18:34
S1: on the NDIS, OTS, allied health, speech therapists. Arguably, this
18:38
S1: has hurt the productivity of the economy. There's various economists
18:41
S1: who say that the care economy is less productive. It's
18:43
S1: grown substantially. And so therefore it's having a dampening effect
18:46
S1: across the whole economy. I asked Jim Chalmers about that
18:48
S1: rather than you, Mark Butler. What do you expect to
18:51
S1: happen to that workforce? Do you see them operating in
18:54
S1: small clinics or businesses charging hourly fees, or will other
18:58
S1: models of service be created?
19:00
S2: Well, I mean, the that workforce has been an important
19:03
S2: part of the health and social care ecosystem forever. Um, even,
19:09
S2: even as long as I've been around Paul, which is
19:11
S2: much longer. Um, but they are much more concentrated in
19:15
S2: the NDIS now. So really it's not just a productivity issue.
19:18
S2: I mean, one of the things about how fast the
19:20
S2: NDIS has grown and the nature of the market that
19:25
S2: that underpins the NDIS is that it's had a very
19:28
S2: distorting effect on the rest of the system. So it's
19:32
S2: now very hard to find an OT or a Speechy. Uh,
19:36
S2: and in some cases, psychologists and physios outside of the NDIS,
19:40
S2: it's hard to find them in veterans care, in aged care,
19:43
S2: in the public health system, because there's been this very
19:46
S2: big gravitational pull in this market that pays relatively well
19:50
S2: for all of those health professionals to shift to the
19:53
S2: NDIS scheme. Not just those who might have 20 years
19:56
S2: of experience in this area, but new graduates are often
20:00
S2: simply setting up a business immediately upon graduation operating in
20:04
S2: the NDIS. Now, this will have an impact on the
20:07
S2: way in which that market works. I talked about that
20:09
S2: last year when I was announcing the Thriving Kids program.
20:13
S2: It's still going to be plenty of work for those people,
20:16
S2: but that might mean that they're doing a little bit
20:18
S2: more of their work in those other parts of the
20:20
S2: health and social care system, which have found it very
20:24
S2: hard to get those allied health professionals for people who
20:28
S2: stay in that, for example, childhood area, they might be
20:31
S2: doing some of their work in the NDIS, but also
20:34
S2: some of the work through the Thriving Kids program. That's
20:36
S2: certainly how I'd like to see say things roll out,
20:39
S2: but that'll that'll involve some change in the way in
20:43
S2: which that workforce operates.
20:44
S1: One part of your announcement last week at the Press
20:47
S1: Club was in what's called social and community participation. You
20:50
S1: announced a big blowout in this part of the NDIS.
20:52
S1: One of your quotes was that, quote, too many participants
20:55
S1: tell us that support workers are spending more time on
20:57
S1: their phones than engaging with them and providing support. How
21:00
S1: do you fix the quality issue? There are there are
21:02
S1: there people servicing this part of the NDIS who should
21:05
S1: not be disability workers?
21:07
S2: Well, there's certainly a lot of people in this part
21:09
S2: of the system who appear to have very little background
21:12
S2: in disabilities, um, and probably very little training as well.
21:17
S2: For many, it's a part time job. It might be
21:20
S2: supplementing their, their education as students. Um, and that's, and that's,
21:25
S2: that's good to an extent. But what I try to
21:28
S2: emphasise last week was the importance of the social and
21:31
S2: community participation stream of the program. I mean, it's $12
21:36
S2: billion now, which is about the same as we spend
21:38
S2: on the whole pharmaceutical benefits scheme. It's grown in five years,
21:42
S2: from 4 to 12 billion tracking to 20 by the
21:46
S2: end of this decade. And you know that that's frankly unsustainable.
21:51
S2: Just looking at it from that perspective. But the quality
21:53
S2: of it is, um, highly variable. I mean, this this
21:58
S2: stream was set up with the intention of participants really
22:02
S2: finding ways to make friends and engage in genuine social
22:06
S2: and community participation. Now, getting out of the house and
22:10
S2: going to the local shopping centre is is valuable, is great,
22:16
S2: but it can't be the whole thing. So what we
22:18
S2: want to do is also give some support to some
22:23
S2: of those traditional community groups, some of them a traditional
22:26
S2: disability groups, but others will be mainstream sporting groups and
22:29
S2: arts groups to be able to host those sorts of activities.
22:35
S2: So there's a fund that I announced last week, $200
22:38
S2: million to to sort of energize that part of the
22:43
S2: scheme so that participants have choice. It's not it's not
22:47
S2: a choice between staying at home or going to the
22:50
S2: local shopping center with a, an individual support worker. That
22:55
S2: might be what you want to do, but I want
22:58
S2: there to be other choices as well, which involve more
23:01
S2: genuine community participation than just a one on one. Um, yeah.
23:05
S2: Excursion from home.
23:06
S1: We'll move into other parts of your portfolio, but just
23:08
S1: one more. I'm not sure if you've come across this,
23:11
S1: but online in recent months, I've seen a lot of commentary,
23:13
S1: particularly on X, but also Instagram on fraud in the NDIS.
23:18
S1: And this is not so much the organised crime element
23:21
S1: of fraud. This is, you know, our mums and dads
23:23
S1: in the suburbs becoming rich off this scheme. And is
23:26
S1: that problem widespread? There was a video from Drew Pavlou,
23:29
S1: the online activist, which had millions of views that was
23:32
S1: going into migrant communities and showing the extent of this problem,
23:36
S1: the alleged extent of this problem. You might also be
23:38
S1: aware of the disability fraud issue in Minnesota, which went
23:42
S1: viral not just in America but across the world. How
23:45
S1: much did this conversation factor into your thinking? Were you
23:48
S1: worried that the NDIS was becoming a stand in in
23:51
S1: the argument on, you know, largesse and fraud of government
23:55
S1: services in in the suburbs?
23:57
S2: Uh, you're right. I don't follow, uh, social media closely. Um, but,
24:03
S2: but certainly people had been reporting to me a bit
24:05
S2: of a spike in this sort of commentary in Australia recently.
24:10
S2: It didn't, it didn't factor into our thinking particularly, um,
24:14
S2: we'd been, we'd been preparing this work before. I think
24:18
S2: that spike had really started.
24:19
S1: When was that spot? What did that spike look like?
24:21
S2: I think it's the last couple of months. Um, really
24:24
S2: that we've, that we've seen it, but there's been a
24:26
S2: bubbling conversation, I think, in the community about, um, the
24:31
S2: unregulated nature of this market and certainly in the commentary,
24:34
S2: but also anecdotally, just among individual members of the community,
24:38
S2: this idea that it's a little too easy to set
24:41
S2: up these businesses without necessarily a background in disability services.
24:46
S2: I think people understand that that providers aren't registered in
24:50
S2: the same way they are in other parts of the
24:52
S2: health and social care system. So, you know, providing better
24:56
S2: market stewardship through the registration of providers, particularly those who
25:01
S2: are involved in in more risky, intimate or high risk,
25:06
S2: intimate parts of the personal care, those sorts of things
25:10
S2: is an important part of our reform. We've been progressively
25:13
S2: doing that over the last couple of years. And frankly,
25:16
S2: some pretty basic systems, like a digital payment system that
25:20
S2: allow us a better line of sight about where the
25:22
S2: money is going and who the Ndia wasn't.
25:24
S1: It is wasn't looking at receipts. Right. They there were
25:28
S1: receipts submitted which weren't read, some weren't legible, and they
25:32
S1: were all approved.
25:32
S2: I made the point that that that today we will
25:35
S2: we will review more claims today than five years ago
25:40
S2: were reviewed in an entire year and still a whole
25:43
S2: bunch aren't aren't reviewed. So, you know, this is a
25:47
S2: system that I think has 6 or 700,000 claims made
25:50
S2: a day. It's a very big, very big system. So
25:54
S2: we've got to have some some basic market stewardship and
25:57
S2: some integrity systems, like a digital payment system, which I
26:00
S2: announced last week.
26:01
S1: Would you have liked to, in an ideal world, just
26:03
S1: start from scratch on a disability scheme rather than rework
26:08
S1: the NDIS?
26:09
S2: No, because there's a there's a lot that's terrific about
26:11
S2: the NDIS, you know, and I think, you know, I
26:14
S2: want to make sure that we keep keep an eye on,
26:17
S2: on the degree to which this is genuinely transformed the
26:20
S2: lives of people.
26:21
S1: How much has it done that? What are some what
26:23
S1: are some ways of to understand how, um, how this
26:26
S1: has made our country a better country?
26:28
S2: Well, it's in my lifetime. I, you know, my early
26:32
S2: working life. I spent a lot of time at disability
26:34
S2: institutions and frankly, also at what we used to call
26:37
S2: the psychiatric hospitals. But in the disability institutions, people might
26:43
S2: have been first placed there as a very young child
26:47
S2: and die there as an adult, spend their entire lives there.
26:50
S2: I visited them very regularly every few weeks in the
26:54
S2: early 1990s for, for years, um, and saw people in
26:59
S2: these institutions that housed hundreds of people that were well
27:03
S2: cared for by people who loved their job. But the
27:06
S2: deinstitutionalization process through the 1990s to where we are now,
27:12
S2: where people can live independently and have the sort of
27:15
S2: supports that that allow them to be involved in their community.
27:20
S2: The degree of choice and control and dignity that has
27:23
S2: given people in, frankly, just a generation is one of
27:26
S2: the great human rights advances of our time. And, you know,
27:30
S2: I've seen it in my working lifetime for the last
27:33
S2: 30 or 35 years. And we should never underestimate that,
27:38
S2: that that profound change to the lives of hundreds of
27:41
S2: thousands of people. So being able to meet someone now who,
27:45
S2: who might be in their early 20s with a severe
27:48
S2: permanent disability and compare their position today to their equivalents,
27:54
S2: I was talking to 35 years ago is, is beyond profound.
27:58
S2: It really is beyond profound. So no, I don't want
28:01
S2: to go back and start again because this has delivered
28:03
S2: a truly profound change for the better. In Australia, deinstitutionalization
28:09
S2: was a really important human rights change, both for mental
28:13
S2: health and for other disabilities. But we've got to make
28:17
S2: sure we're secure those advances for the long term.
28:19
S1: Yeah. Well, it's good to see there's bipartisan support to
28:21
S1: rightsize this and hopefully keep it in appropriate shape for
28:25
S1: many decades to come. Just quickly on a different matter. Um,
28:29
S1: you spoke last week at the Press Club, obviously about
28:32
S1: the NDIS, but it sounded like it may not have
28:34
S1: even been the top concern in your portfolio. You talked
28:36
S1: about the ageing of the population as a problem that's
28:40
S1: about to explode onto the country. You've been obviously talking
28:42
S1: about it for many years, but it's coming into into
28:47
S1: sight in coming years. You mentioned that you were worried
28:50
S1: about the 90,000 people turning 80 next year. Tell us
28:54
S1: about the scale of that problem. We're not building anywhere
28:57
S1: near enough aged care homes. How do we start doing that?
29:00
S1: What do we need to do over the next few years?
29:02
S1: What are you thinking of doing?
29:03
S2: Yeah, what? I've been trying. I've been trying to do
29:05
S2: this for 15 or 20 years is just give a
29:08
S2: sense of the scale of, of change that is involved
29:12
S2: in the baby boomers ageing. I was aged care minister
29:15
S2: 15 years ago, and then sort of 16 or 17
29:19
S2: 000 people turned 80 every year. This was the depression
29:24
S2: generation when birth rates had really plummeted. So if you
29:28
S2: take that as the sort of key metric of demand
29:30
S2: for aged care, 16 or 17,000 people, we were building
29:34
S2: enough beds to to cope with that, um, 90,000 next year.
29:39
S2: It's just, it's, it's like five times the number. And
29:43
S2: when you go back, do the maths, what's 2026 -80.
29:47
S2: You're talking 1946. This is this is the the the
29:51
S2: beginning of the baby boom that four years after the war,
29:55
S2: 46 to 51, the numbers were just extraordinary. And and
30:01
S2: so we've got to I said, open a new aged
30:03
S2: care facility every three days.
30:05
S1: How often are we currently opening one.
30:07
S2: Not every three. No. We're nowhere near three days. And
30:09
S2: we've got to do that not just for a couple
30:11
S2: of years. We've got to do it for 20 years
30:13
S2: because the the echo boom, my generation, generation X was
30:18
S2: just as big. A lot of other countries in Europe,
30:20
S2: particularly in Japan and Korea, their baby boomers were a
30:24
S2: spike and then dropped away very quickly. Ours kept going
30:28
S2: for decades. And so this is the new normal. What
30:31
S2: we're entering is the new normal. It's not a spike. And, um,
30:35
S2: you know, frankly, the work we did 15 years ago
30:38
S2: to set up what I hoped was going to be
30:41
S2: a rolling period of reform that got us ready for
30:44
S2: the second half of the 2020s went nowhere. It just
30:48
S2: went nowhere. Um, you know, for the forgive me for
30:52
S2: being political about this, but in a couple of the
30:54
S2: budgets in the mid part of the last decade, money
30:56
S2: was taken out of aged care. Instead of starting to
31:00
S2: build on the construction, uh, and, and we ended up
31:03
S2: in a terrible position. We had the royal commission into
31:05
S2: aged care. Then we went into the pandemic where aged
31:08
S2: care performed pretty badly in some parts of the country.
31:12
S2: And we're now sort of well behind where we should
31:15
S2: be in 2026. So last week, we announced Sam, Ray
31:20
S2: and I announced a big change to the incentives for
31:23
S2: building new facilities. We think that will add about 5000
31:27
S2: or so new beds every year. But we've got to
31:30
S2: get higher than that. That builds on what we did
31:31
S2: last term. We've still got more to do to get
31:33
S2: to the construction level that we need.
31:36
S1: So what will that require?
31:39
S2: Probably closer to ten, 10,500 beds a year.
31:42
S1: What types of policy changes? I imagine there's lending capital assistance.
31:45
S2: Probably. So we talked when we passed legislation a couple
31:48
S2: of years ago. It was really about incentivizing providers to
31:52
S2: build new facilities for people who can pay their way.
31:55
S2: If you like. What I announced last week with Sam,
31:58
S2: Ray was more for people who can't pay their way,
32:01
S2: so don't have the financial means. Providers probably also in
32:05
S2: some areas, need some capital assistance from government, whether that's
32:09
S2: in the nature of low interest loans and things like that.
32:12
S2: So Sam Ray will now start a process of consultation
32:15
S2: with them about that, that third tranche of of consideration.
32:19
S1: In the building.
32:20
S2: Yeah. That's right. And, you know, we're just behind where
32:23
S2: we should be. Frankly, we lost we lost years. And
32:26
S2: so when I say I'm probably more worried about that
32:29
S2: than any other area of the portfolio, it's because a
32:33
S2: lot of the pressure is just just a product of demographics.
32:37
S2: It's just the raw numbers that are happening out there
32:40
S2: in the community. I don't see it as a crisis
32:43
S2: or a problem. I've always been a huge advocate of
32:46
S2: the benefit of aging. You know, in 100, 100 years
32:49
S2: or so, we've added 25 or 30 years to life expectancy.
32:52
S2: That's something we should celebrate. It's one of humanity's greatest triumphs,
32:56
S2: but it does bring some some logistical challenges in making
33:00
S2: sure that that generation who are entering their 80s get
33:05
S2: the care and the dignity that that after a long
33:07
S2: life of building this country they deserve.
33:10
S1: I was going to say this is in some ways
33:11
S1: a first world problem because we are such a healthy society,
33:14
S1: and that's a brilliant thing. But it brings social challenges
33:16
S1: as well. But something that's not that's done a bit
33:18
S1: more in Non-first world. No, that's not a term we
33:20
S1: use these days. But developing nations have a greater culture
33:23
S1: of Uh, having older people stay with the family as
33:27
S1: they get older, is that something we've lost in our society?
33:29
S1: Is there a way to encourage more of that to
33:31
S1: we have.
33:31
S2: I mean, I think I've looked at this. Um, I
33:34
S2: looked at this quite a lot. I mean, that is shifting.
33:37
S2: It's shifting in, in Confucian traditions, shifting in some of
33:41
S2: the Mediterranean European traditions where it is, you know, often
33:45
S2: thought of as much more deeply rooted than mainly maybe
33:49
S2: some of the Anglo-Celtic traditions. Um, so you are seeing
33:53
S2: a shift across the world. Um, you know, a country
33:55
S2: like China that is also aging very, very fast, uh, and,
34:01
S2: and doesn't have the demographic benefits that we have of, of, um,
34:06
S2: strong immigration and relatively healthy birth rates over the last
34:09
S2: several decades, like their working age population is going to
34:13
S2: shrink by 80 or 100 million this, this decade. So
34:17
S2: they're aging at a time where they're still a middle
34:19
S2: income country and their workforce is shrinking. They are having to, um,
34:25
S2: talk to us, talk to the Japanese who are a
34:27
S2: bit ahead of them in the aging space, about how
34:30
S2: they build an aged care system very, very quickly. So
34:33
S2: this idea that, that, you know, there are a whole
34:35
S2: lot of other countries where older people are cared for
34:39
S2: in their family and they don't need an aged care
34:41
S2: system isn't really standing the test of time. It really
34:45
S2: other countries are having to do this as well.
34:47
S1: That's interesting. Just on private health insurance, you made a
34:49
S1: change last week to equalise the rebate for older and
34:53
S1: younger Australians, reversing the Howard era change. The AMA had
34:57
S1: also spoke at the Press Club last week and talked
34:59
S1: about the challenges in the private health care system. How
35:01
S1: broken is private health, and are you considering ways to
35:05
S1: become more heavily involved in the private health system on
35:08
S1: pricing and other issues that might run into constitutional concerns?
35:14
S2: Well, I wouldn't describe it as broken. It's under pressure.
35:17
S2: It's under very serious pressure. Um, the, the levers that
35:22
S2: Howard put in place 25 years ago worked well to
35:25
S2: to underpin private health membership. I think that that change
35:30
S2: to the rebate that was particularly targeted at older Australians,
35:33
S2: it's hard to justify on policy grounds if there's any
35:36
S2: cohort that's going to respond to an additional incentive or
35:41
S2: subsidy to take up private health insurance. It's not the
35:44
S2: older cohort, it's actually the younger. So it was probably
35:47
S2: more an electoral ploy, frankly, to be cynical about it
35:51
S2: than than a real policy.
35:52
S1: Mark Latham was ascendant, which feels hard to recall.
35:55
S2: Yeah, I recall it. Uh, but, uh, but I think
35:59
S2: more broadly in private health there, there is a need
36:02
S2: to deal with a few things that I think will
36:05
S2: be the subject of more work during this term of Parliament, um,
36:08
S2: specialist fees. So non GP specialist fees are out of
36:11
S2: control and they genuinely are becoming a barbecue stopper. Uh,
36:15
S2: you know, much more I think now than the bulk
36:18
S2: billing rates in general practice, which was the focus of
36:20
S2: a lot of our work in the first term and
36:23
S2: was a big concern in the community. That concerns really
36:26
S2: shifted to stories of people not going to a specialist
36:29
S2: because they can't afford the out of pocket, or not
36:32
S2: having a procedure because they can't afford the out of pocket,
36:35
S2: or if they do have the procedure, getting news about
36:38
S2: the out of pocket only the day before. So, so
36:41
S2: that has got to be a focus of more work.
36:43
S1: Can you do controls there? What's the.
36:45
S2: Mechanism? I've said to the AMA and said publicly, frankly,
36:48
S2: as far as we're concerned, every option is on the table.
36:51
S2: I mean, they've been for a long time arguments that
36:54
S2: there are constitutional limitations on our ability to regulate specialist fees.
37:00
S2: We intend to test the boundaries of that. That's how
37:03
S2: concerned I am about this, because it's become a genuine
37:06
S2: access to care barrier. I think more broadly, there is
37:11
S2: work that that our department has been doing with the
37:14
S2: CEOs of the big hospitals, private hospitals and the big
37:18
S2: insurance funds, because There are some real pressures on the
37:22
S2: financial viability of the system that I don't think are mean.
37:26
S2: It's broken in any sense. To go back to your
37:29
S2: first question, but mean that we do need to pay
37:31
S2: some attention to whether or not those funding mechanisms are
37:35
S2: keeping pace with a change in the way in which
37:37
S2: private health services are delivered. So there's more hospital in
37:41
S2: the home. There are fewer overnight stays because surgery is
37:46
S2: getting much better. People don't have to stay for several days.
37:49
S2: If they've had a procedure in the way they might
37:51
S2: have 10 or 15 years ago. Is the financing sort
37:54
S2: of incentives really keeping up with that is something I
37:57
S2: think we need to pay attention to.
37:58
S1: Is there a third item that you had?
37:59
S2: The our workforce is probably the third. The third issue.
38:03
S2: Do we have the right specialist workforce in the right place?
38:06
S2: And are they are they wanting to do the sort
38:08
S2: of work that we need them to do? So psychiatrists, frankly,
38:12
S2: are not doing the same level of admission work in
38:14
S2: private psychiatric hospitals as we would have seen 5 or
38:19
S2: 8 years ago. That means that private psychiatric hospitals are
38:22
S2: suffering real viability pressures, not because there's not the demand
38:25
S2: for mental health support in the community. There is. It's
38:28
S2: just they can't get the psychiatry psychiatrists to do it.
38:31
S2: We're having some of the same pressures in maternity services,
38:35
S2: where we struggle to get obstetrician gynecologists to work in
38:39
S2: some parts of the community. So, uh, families, young families
38:44
S2: who might take private health insurance out expecting that they'd
38:47
S2: have choice about how they have their baby delivered in
38:51
S2: some regional communities in Australia are finding at the end
38:53
S2: of the day, they don't have that choice because the
38:55
S2: right workforce is not there. So we've got to deal
38:58
S2: with some of those some of those pressures.
39:00
S1: Two more and we'll let you go. The immunization rates
39:03
S1: are quite troubling post pandemic. The rate I think of
39:07
S1: full immunization is from 95% down to about 92. But
39:11
S1: far fewer suburbs and regions are hitting their targets. Um,
39:15
S1: I was talking to a pollster last week who said
39:17
S1: that one of the underrated elements of the One Nation
39:20
S1: rise is distrust towards government post the pandemic, in a
39:23
S1: sense that the major parties are shouldn't be running the show.
39:29
S1: Do you think we should have done more to inquire
39:30
S1: into the pandemic and have a public discussion about what
39:33
S1: went on then? How do we how do we address
39:35
S1: this public anxiety around healthcare?
39:38
S2: Yeah, there's quite a bit in that. Yeah. I don't
39:42
S2: think there's any question. There's a, there's, um, a level
39:45
S2: of vaccine hesitancy and fatigue that still hangs over from
39:50
S2: the pandemic. I think that's mixed in a way that's
39:53
S2: hard to separate with a whole lot of misinformation and
39:56
S2: disinformation online, uh, that people are seeing about vaccines and
40:03
S2: risks that frankly, aren't substantiated by the evidence. Uh, how
40:07
S2: you unpack that is really is really difficult to say. Well,
40:10
S2: how much would have been there even if we didn't
40:12
S2: have a once in a century pandemic? I mean, I
40:14
S2: think the Covid inquiry that we undertook was was well calibrated.
40:18
S2: I think it was pretty, pretty bare bones and, and
40:23
S2: didn't pull any punches about what we did right as
40:25
S2: a country and what we didn't do well. And the
40:28
S2: degree to which trust in good health care systems was
40:34
S2: damaged by some of the way in which decisions were
40:37
S2: made without evidence being presented to the community.
40:41
S1: What were they?
40:42
S2: Well, I mean, I think.
40:43
S1: Even in broad terms, were the public health officials given
40:46
S1: too much authority by state governments?
40:48
S2: Well, I think really the take out, the take out
40:51
S2: for me from that inquiry was if we had to
40:54
S2: do it again next year, probably the community wouldn't follow
40:57
S2: the directions that were put in place in 2020 2021,
41:01
S2: such as the damage to trust, frankly, and that the
41:04
S2: issue with trust was that that governments were were not
41:10
S2: as transparent as they should have been about the evidence,
41:14
S2: including the costs and the The benefits of decisions that
41:18
S2: they were making that impacted people's lives so, so substantially,
41:23
S2: profoundly in some areas.
41:25
S1: To be more.
41:25
S2: Balanced, school closures and things like that were probably the
41:29
S2: main issue that the inquiry focused on. So I think
41:32
S2: we did have a really good inquiry. It didn't it
41:36
S2: wasn't the sort of months and months long public inquiry
41:40
S2: that the UK had, for example, that had had an
41:43
S2: inquiry trawling over people's WhatsApp messages that maybe some people
41:48
S2: would have liked. But in terms of you.
41:51
S1: Might have liked it if Scott Morrison was still around, though.
41:53
S2: Everyone had WhatsApp messages. Um, it bounces both ways. But look,
41:58
S2: we deliberately didn't decide to go down a path that
42:01
S2: would involve, frankly, whether it's state premiers or Australian prime
42:06
S2: ministers having to having to go through that sort of process.
42:10
S2: And I think it was the right balance in terms
42:12
S2: of immunization. Generally, though, you're right to say that the
42:15
S2: national rate decline is a cause of concern. We're seeing
42:19
S2: it right across the world. The World Health Organization is
42:22
S2: talking about this, so it's not particularly Australian, which is
42:26
S2: unsurprising given it was a global pandemic. And the sort
42:29
S2: of misinformation disinformation I've talked about is global. It's not Australian.
42:33
S2: So we're thinking carefully about the way in which we
42:36
S2: prosecute information campaigns, particularly with parents, about the benefits of
42:41
S2: childhood immunisation. Um, you know, I think there's a bit
42:45
S2: of a bit of mythology out there that this is
42:49
S2: an issue in Byron Bay and some of the hinterland
42:52
S2: areas that, um, around the Gold Coast and things like that.
42:56
S1: The Maha crowd.
42:57
S2: Yeah. And it is um, but it's also the CBD
43:00
S2: of Adelaide has childhood immunisation rates of under 80%, there
43:05
S2: are parts of Western Sydney that have those sorts of
43:08
S2: childhood immunisation rates. So this is actually much more complex than,
43:12
S2: than some of the you know, some of the first
43:15
S2: reactions might be to this. We have to think about
43:17
S2: this carefully and really give parents access to the best
43:21
S2: available information they can have to do what every parent
43:25
S2: wants to do, which is to keep their child safe.
43:28
S1: Can I ask you about your future before we go
43:30
S1: this conversation? I just got a nod there for listeners,
43:33
S1: but a tentative nod.
43:35
S2: Well, I mean, it could mean a range of things, Paul.
43:38
S1: It's almost a jarring conversation to be having. It's odd
43:41
S1: that it's come up, but last week there was a
43:43
S1: story in the West Australian newspaper about how labor MPs
43:47
S1: are speculating about your potential ascension to the leader of
43:52
S1: the Labor Party at some point in the future. We're
43:54
S1: obviously about a year away from the last election. The
43:57
S1: Prime Minister just had a thumping win. So it's in
43:59
S1: some ways, as I said, jarring to be talking about
44:01
S1: this because he's probably in it for the long haul.
44:04
S1: But the conventional wisdom has been that the next leader
44:07
S1: will be one of Richard Marles, Jim Chalmers or Tony Burke,
44:12
S1: all from the right. The left is now the ascendant
44:16
S1: faction inside the caucus, and you're widely regarded as one
44:19
S1: of the most competent ministers, very close ally of the
44:22
S1: Prime Minister, and someone who people close to the Prime
44:25
S1: Minister have quietly told me for years now could be
44:28
S1: in the mix, even though I think you've previously told
44:30
S1: colleagues that the leadership of the party is not what
44:33
S1: you see for yourself. Has that changed over time?
44:37
S2: I've sort of I'm a bit befuddled about why we're
44:41
S2: having this conversation. As you say, it's not even a
44:43
S2: year since the Prime Minister won a very significant victory.
44:47
S2: He's got a huge agenda. We we laid out some
44:51
S2: of it last week at the Press Club, and we're
44:53
S2: in the middle of the worst global fuel crisis that's
44:56
S2: hit the country, if not ever, then for at least
44:58
S2: 50 years. And he is in it for the long haul.
45:03
S2: And as one of his closest supporters, I want him
45:06
S2: to be in it for the long haul. I, I
45:09
S2: feel privileged to be serving under him. I've got a
45:12
S2: job that I absolutely love and I focus on every day.
45:17
S2: I think it's the best job in government health and
45:19
S2: disability and aging. It keeps you so in touch with
45:22
S2: the community. It's deeply human portfolio. I don't really understand
45:27
S2: why why we're having this conversation, frankly. I, you know,
45:31
S2: the Prime Minister has made it clear he's in it
45:33
S2: for the long haul. And there's no one who would
45:36
S2: be more delighted than me about that.
45:38
S1: I've got no doubt about that. But you've you've demonstrated
45:41
S1: in your career a really deep interest in policy. I
45:44
S1: don't think anyone would doubt that having the power of
45:47
S1: the leadership of the party would allow you to do
45:49
S1: a lot in terms of reform. Does the idea attract
45:53
S1: you to Labor Party and run the show?
45:55
S2: Well, that's just not something I'm thinking about. And frankly,
45:58
S2: I don't think anyone in government is thinking about. We're
46:01
S2: not yet a year from being re-elected. Um, you know,
46:05
S2: in a really volatile political environment. Um, we don't take
46:08
S2: that for granted. We know what a, what a privilege and,
46:11
S2: and what an investment of trust that involves from the
46:15
S2: Australian community and, and that we have to be involved
46:17
S2: every single day in focusing on them, not these sorts
46:22
S2: of discussions. So it's just not something any of us
46:24
S2: are thinking about. Certainly I'm not.
46:26
S1: I acknowledge it's a very, um, below the radar conversation,
46:29
S1: but is it something you might think about in coming years, three,
46:32
S1: four years down the track, or is it not an
46:33
S1: option for you?
46:34
S2: Well, it's just not something I'm thinking about. I've got
46:36
S2: a very big list of things to do for the government,
46:40
S2: for the Australian people, and that's what I'm focused on.
46:42
S1: We appreciate you joining us, Mark.
46:43
S2: Thanks, Paul.
46:47
S1: Today's episode was produced by Kai Wong with help from
46:50
S1: Debbie Harrington. Our executive producer is Tammy Mills, and our
46:54
S1: podcast are overseen by Lisa Muxworthy and Tom McKendrick. Before
46:58
S1: you go, follow Inside Politics and leave a review for
47:00
S1: us on Apple or Spotify. I'm Paul Satchell. Thanks for listening.