The Hon. Greg Hunt MP
Minister for Health and Aged Care
29 October 2021
Topics: New funding to support COVID-19 cases at home; COVID-19 vaccination rollout;
Well, welcome everybody. I’m joined today by Dr Karen Price, the President of the Royal Australian College of General Practitioners, and by Professor Alison McMillan, the Chief Nursing and Midwifery Officer of Australia.
Today, we are announcing a $180 million package to support primary care to support cases of COVID at home and in the community.
As we open up, we know that there will be more cases that will be treated at home because people will be fully vaccinated. They may not require hospitalisation, and so the balance will shift from hospitalisation to community care.
And to assist our GPs, we always knew we were coming to this moment. We’re very pleased to be able to support them. It’s a package we’ve worked on with the Royal Australian College of GPs and other members within the medical community.
And this is ultimately about giving people the opportunity to be treated at home, to assist the states and territories, and it’s the next phase as we open up.
There are a series of elements, and I’ll start. Firstly, there is a $25 Medicare item as a face-to-face bonus for GPs that are treating COVID-positive or suspected COVID-positive patients in the clinic. That will be attached to any other item which is the appropriate one that the general practice is using.
So it will be up to the doctor to determine the appropriate treatment. But then there’s a bonus to them for seeing patients face to face and recognising the additional costs of cleaning and of other items.
The second thing is, as patients are being treated at home, we will make available – and I’ll let Karen and Alison explain the work – the pulse oximeters.
Pulse oximeters effectively allow for an oxygen reading, but it’s a critical part of making sure that we identify whether any patient who is COVID positive and at home is starting to deteriorate in any way, shape or form.
It’s an early indicator easily available, and the National Medical Stockpile will ensure that any patient who’s being at home, through their GP, will have access to this treatment, which will allow the GP to support the patient.
The third thing that we’re doing in particular is that we will be supporting home visits, and that will be support for a program of practice nurses of the medical deputising services. All of this is in addition to what we already have in place for our GPs to make home visits.
The fourth thing is we’ll keep the general practice respiratory clinics operating until at least the 30 June 2022. So we’re extending the role of the general practice respiratory clinics, and they will have three roles ultimately: that’s about helping to diagnose patients that may be COVID positive, to treat patients, and to continue the vaccination program. They’ve played an important role alongside our GPs.
In addition to that, we will have extra support for online services through what’s called healthdirect. healthdirect has been providing services throughout the course of COVID, well over two million services, and then we’ll be working with the GPs, and Alison is leading this on behalf of the Government, to put in place COVID-positive treatment pathways through community care and in particular to make sure that we have very strong clinical guidelines.
The last thing is for pharmacies. We are expanding out the pharmacy support by continuing the dispensing program for home and continuous dispensing.
So what does that mean? It means that if you are at home, COVID positive, you’ll continue to have your medicines provided, and you may not need to have your scripts extended through an additional visit to the doctor. You can have them extended as of right in such a circumstance.
So all of these things are coming together with a really simple proposition, and that is to ensure that, where possible, patients who are fully vaccinated, they’re not at risk of COVID becoming a greater health issue for them, will have that treatment at home.
And in some cases, unvaccinated or partially vaccinated people who are not deemed to be at risk will also be naturally treated through that pathway.
Just in terms of understanding the role of our GPs, we’ve now passed over 35.25 million vaccinations across Australia, and our GPs and our primary care system has delivered almost 20 million of those.
And so they have been the backbone, Karen, the GPs have been the backbone of the vaccination program, the diagnostic program, and the treatment program for COVID-19. And so as we move to a more community-based care program, as we open up, this supports the opening up.
We’ve now passed, extraordinarily, 87.9 per cent of first doses, and I think very hearteningly, 76.2 per cent of second doses around Australia. So well more than three-quarters of the eligible population have now had their second dose.
I just also want to note a very important thing, and that is for our over-50s. So the older you are, the more vulnerable you are. 85.2 per cent of that population have now had a second dose, so over 85 per cent of over 50s are fully vaccinated.
And extraordinarily, we have reached, for our over-70s, 98.9 per cent; 98.9 per cent of our over-70s have had a first dose, and we’re almost 90 per cent of our over-70s with a second dose. And so, huge progress.
And just under 800,000 doses to go to achieve the 80 per cent fully vaccinated mark for the nation, and we’re expecting that in the coming 10 days, if not sooner.
And so, Australians are coming forward to be vaccinated, but I’d encourage you, if you haven’t been vaccinated yet, please do so. And if you are due for your second dose, please do so.
And in relation to the booster program, we’ve had advice that not only has the first of the aged care doses been delivered, we’re working to ensure that disability and general population are occurring, and we’ve had reports this morning, Karen, of GPs that are already delivering boosters around the country. They’re doing that 10 days earlier than the official start, which is great news.
So I’d now invite Karen Price to speak and then Professor Alison McMillan, who’s leading the program for the community care treatment of COVID-positive patients.
Thanks, Minister, and hello everybody. Karen Price, President of the RACGP. And I would like to congratulate all of the GPs out there working so hard for their communities – not only GPs, but their practice nurses, Alison, who work well with us and also our reception staff, who’ve done a magnificent job for Australia.
So this is about returning to community-based care because basically the Australian community have stepped up and got vaccinated, and that means that we’re only really going to experience, we hope, mild disease in the community. But it does need to be watched.
And Minister Hunt has released a suite of assistance that will help us look after you in the community and escalate you appropriately if needed, and we’re really welcoming that development. And it also saves our hospitals from having to manage a lot of these kinds of presentations, which is equally very important for those people who still need to attend hospitals for other acute injuries and illnesses.
So, we’re looking forward to this because it also signals a new era in what I would call an integrated health system where the state health system, which is largely hospital-based and the community health system, which is GP and practice nurse based, are working together for Australia’s health system, which has been a really historic event coming out of an international pandemic.
If there is a silver lining, I hope that’s one that will continue. So, I would encourage everybody to keep going with their vaccination program. It’s so important because that means we can go on with looking after you in the community where you want to be with your families.
And we are looking forward to continuing the telehealth initiatives to help you and help us manage patients in the community and in practises, and also the trusty oximeters which we’ve, Alison and I have brought today to manage some patients at home, and they’ll be available for us in general practises through the PHN.
So we really welcome these initiatives to support community-based care and to look after the Australian community at home where they want to be.
Thanks, Karen. Thank you, Karen and Minister.
I think the important message for everyone is firstly, to remind everyone of the need to get vaccinated. We know this is the greatest protection we will get from COVID-19.
But as I’ve done over now a long period of time, remind everyone that we still need to take all those additional measures that we know work so effectively.
So even when vaccinated, remember you can still contract COVID, but you are likely to have very mild symptoms and you’re well protected from severe disease and hospitalisation.
But those things we know, masks where we can’t socially distance, the hygiene of your hands, the cough etiquette, are still things that we should keep as a part of our society going forward.
For those who do test positive for COVID, and as suggested by the minister, we do anticipate that we will see increased numbers as we open up, as we will see, for instance, this afternoon in Victoria.
And so we will see increase in numbers, but many and most of those people will have mild symptoms. If you test positive, remember you do still need to remain at home.
And we are describing here today a program of work led by general practise that will support people who are COVID positive in their homes, that’s through the use of technology through healthdirect and through small devices like this that measure your blood oxygen and can help us identify if at any time your condition deteriorates.
Those supports will be there through general practise and the connection with people at home to give them the reassurance and confidence that they are being okay and that they can manage their symptoms safely.
So those pathways and work has been developed across the system. Again, as Karen has said, it’s a terrific initiative to see our hospital systems and our primary health systems working in partnership to benefit people so that they can remain in their homes and have their COVID positive condition managed.
Thank you, Minister.
Thanks to Karen and to Alison, I’ll start with those online and then come to Annika in the room. To Rachel Clun?
Thanks, Minister. Australia is at the point now where we have millions of excess COVID vaccine doses. Why haven’t we given more away to date? I think it’s about 3.6 million so far.
And how much should we be giving to developing countries in our region?
So we are actually just in the process of making another large delivery, I think the final information is being gathered.
So within the next 24 hours, there’ll be another major delivery, and I think the prime minister will be in a position to have that final detail and to announce that at the G20. So it’s an entirely fair and reasonable question.
The second thing is, very sophisticated process, which Operation COVID Shield is focussing on at the moment, and that’s making sure that they’re looking around the country at any doses which may be nearing the expiry date, making sure that they’re allocated as a priority. And so they have that process of where there are doses that have been distributed but not yet used.
One of the things is that our wastage rate has averaged just over 1.2 per cent for the program. At the moment, it’s slightly higher at about 1.8 per cent, the global benchmark is 10 per cent. And so the active management of stocks in the field is something that COVID Shield does, and it reallocates where there’s a surplus.
And then the GPs have done an incredible job of self-monitoring. Because they are able to order on a weekly or fortnightly basis, they are themselves making sure that if they have surplus stock, they’re not over ordering.
So we’re in that happy situation where every Australian who wants a vaccination can get a vaccination, whether it’s their first dose, their second dose or their booster, if they’re due.
Then the last thing is, at this point in time, we’re allocating 60 million doses overseas, and those 60 million doses are backed by half a billion dollars of funding.
But as we have more information around our Australian suppliers and confirmation, for example, when Novavax arrived subject to its being approved by the TGA, then that will give us more options for additional supplies overseas.
So whilst the 60 million is pledged, we see that as a minimum, and then as we have confirmation of further supplies arriving in the country and the ability to meet all of our needs, we’re also in a position to add to that.
Thanks for taking our questions, Minister. Can I ask, do you think a change in thinking is needed from some people in Australia about what to do if you are positive with COVID?
I think most people would expect to be admitted to hospital, but it seems as we open up and case numbers grow, increasingly, people will be treated at home.
And a political question, if I may, is voting misrepresentation a problem in your seat? Do you think voter ID laws are needed in your electorate?
So look, I’ll do with that one. And then in terms of the COVID positive cases and the treatment at home, I’ll ask Alison and Karen to add something.
Look, in terms of voter misrepresentation, I think it’s very important that we’re on watch against fraud.
We have to protect our democracy, and I won’t single out any one electorate. I will say that this is a challenge and a risk for which we have to be on notice.
And we’re used to providing our ID when we go into a cafe in Victoria. Or if somebody is picking up a takeaway order in the ACT. They have to make sure that they scan the QR code.
And so I think at the bare minimum of providing identification or making a declaration vote so every single person in Australia is guaranteed that they can vote if they go to the voting booth, or if they’re seeking a postal vote, every single person in Australia is guaranteed that they can vote.
What we want to guarantee is that that small number of unscrupulous people cannot vote twice. Pretty simple. Everyone gets to vote, but vote once and nobody gets to vote twice.
In terms of community care, I think Karen and then Alison, the real pathway about setting people’s expectations as to how and where they’ll be treated.
Well, first of all, these are integrated pathways so that those with severe illness will be looked after in hospital.
However, because most people have been vaccinated, as Alison indicated, we’re likely to see large numbers of people who may have very mild disease or may not have any symptoms at all, but still be COVID positive.
And that’s because people have received their vaccination, but they still need to undergo isolation and they still need to undergo monitoring.
Now the national government, as well as each state jurisdiction and also our college, have developed pathways which categorise and triage patients into appropriate levels where you will be kept safe.
The doctors and nurses in practises will be working together to initiate things like home visits if needed. We will work with our locum services if needed, or provide home visits as needed.
So telehealth, as I mentioned and so forth, using monitoring tools, including heart rate, respiratory rate, temperatures and these little devices, the oximeters, we’ll be working together with our practice nurses to keep you safe. We’re in the best place for you, and for many people, that’s going to be at home.
So again, I’ll let Alison talk about the nursing aspect of that because our practice nurses are also vital to this, and GPs and their practise nurses have always worked well together for the good of their community, and it’s a real pleasure to talk about that today.
Thanks, Karen, Minister.
So, yes, I said the majority of us are now fully vaccinated with two doses, and that it will protect us from severe disease and death, and so our management of COVID positive can be done for the majority of people at home.
But that doesn’t just say that you’re alone. There’ll be services there to support you if you do test positive, and to make sure that you stay well, and if for any reason you might deteriorate, we can identify that.
And then through the pathways that have been developed between the primary health system and the hospital system, if necessary, you will be taken to hospital in a way that it can be managed.
So the important thing is to keep informed and stay safe. And that’s- the system we’re building here is to keep people safe at home when they’re COVID positive and therefore allowing our hospital systems to be able to manage those that do develop significant disease or- and require hospitalisation.
I might just add something to this, and that is the most significant study to date was New South Wales and the ACT in terms of the impact of vaccination.
And there were 47,000 people that were diagnosed as COVID positive as part of that study. And of those, four per cent had been fully vaccinated, and of those that passed away, one per cent had been fully vaccinated.
And so what we see is that it’s not an absolute prevention. We’ve always been very clear about that vaccination, but it dramatically reduces your chance of being diagnosed COVID positive, reduces your chance of being ill, and significantly reduces your chances of hospitalisation or death. And so we’ll see cases, but fewer hospitalisations.
And already the hospitalisation trends both in New South Wales, the ACT, and Victoria are ahead of- in a positive way, they are ahead of the expectations we had from the early modelling. So vaccination is working better and more effectively than we’d anticipated.
Anika, who’s been very patient.
I have two questions. Firstly, as a Victorian, Victoria is going to open up tonight and there’s still 1600 cases. I just wondered, as high as the vaccination rates are, there’s still going to be 20 per cent of people that aren’t double vaccinated, and a lot of people moving around. How confident do you feel, I guess, that hospitals won’t be overwhelmed, and what’s your position on Victorians going into this new phase?
So I welcome the fact that Victoria is opening up today. There are mental health reasons, there are social reasons, there are fundamental human rights reasons, and we do have a population which is extraordinarily vaccinated in Victoria.
The first dose rate is well over 90 per cent now so I think it’s appropriate, it’s safe. It’s in line with the national plan. It will help give people back their lives. But today, these announcements are about supporting the opening up of Victoria safely. That’s what today is about.
Community care means we know that there will continue to be cases, but in a highly vaccinated society, more of them will be treated at home.
We’re providing the additional support for our GPs and our nurses to support people at home. The hospital system around the country is strong. The hospital system has been tested in New South Wales and Victoria, and has passed that test with flying colours.
It’s not easy, it is challenging, and our nurses, our doctors, our hospital administrators, everybody associated with it has worked hard and has worked under pressure. But together, they have been well prepared.
This is a plan we started over 18 months ago, and now is the time when it’s been put to the test and it’s passed the test.
And in terms of- you spoke about rate of vaccination across Australia, but I wanted to ask about the rate amongst NDIS participants and in the broader disabled community. How are they tracking? They were a bit lower last month?
Yeah. So we’ve seen strong growth in disability vaccinations. And so for disability residents they’re at 82.4 per cent. And disability residents’ second doses is at 76.6 per cent, so ahead of the national second dose rate.
For NDIS participants, they’re at 76.8 per cent, so that has grown significantly. We do know that there has been hesitation in the disability community, and so we’re putting an enormous amount of community consultation in.
It’s not a question of access. Disability leaders, the NDIA and others and working just this morning, in fact, with COVID Shield. We’re all focussed on that confidence. It’s a group which historically has been less vaccinated across a range of different types of vaccination.
And so the in-reach program, the booster program will see a very significant in-reach component. All of these things are being done to give confidence and to continue the access.
So great progress. I’m very pleased that it’s continued to go forward. But all up, I think that’s good.
Mat, was there someone I had to.
And I apologise. Channel 10 is also on the line.
Hi, Minister, Antoinette Lattouf here. I actually have a question for Dr Price.
There was a media release put out by your college with concerns about people presenting with anxiety concerns and asking for exemptions from the vaccine.
Could you explain what some of your members are seeing? And there’ve also been reports of GP’s being offered bribes to issue vaccine certificates?
Could you please speak to that?
Yeah. Look, this has been one of the, I guess, concerning elements of the national vaccine program. And I think the most concerning part is the organised part of applying for an exemption based on anxiety.
So that has been a concern, because it’s been an organised process, and that potentially might be a problem for trust in the therapeutic relationship that a doctor normally has with their patient.
If a patient has some genuine anxiety concerns – anxieties can be anything from a mild to a serious illness and presentation – we are really happy to help compassionately and manage that concern.
It’s not a vaccine exemption, but we can take you through a process where you will feel more comfortable about approaching a vaccine.
Now that anxiety could be a needle phobia, which is relatively common. Or it could be because there’s been what I call a dose of misinformation.
What we don’t want to see is a templated letter from a particular organisation that’s sent around Australia, but doctors are very quick to spot that. So that’s been a concern.
And yes, there have been case reports of bribes offered, anything from $200 to $5000, which have been rejected, of course, and that’s just been another disturbing element.
But I would suggest it’s a minority. It is a disturbing minority, but as you can see from the vaccination numbers, most people are heeding a scientific advice.
They’re going to their doctor to get the right advice. And that’s what we really want to see, and we want to encourage that.
We’re really happy to answer questions. It’s really normal to have questions. There is a lot of trying to sort out information that’s appropriate for you, and both doctors and nurses are very skilled at doing that. We do that every day in every other condition, and so we’re happy to continue to do that.
And particularly for anxiety, which, you know, it can be a very scary proposition to walk into a doctors. But we’re used to dealing with it and we’re comfortable dealing with it, and we hope that we can put you at ease with both good information and also compassionate care.
Great. So I’ll just finish with that and note, Annika is patient, she’s in the room. Come on. One more.
In Victoria last night, some laws passed that could- pandemic laws about the role of the premier and the health minister in terms of putting in more health measures should we need them in the future.
I just wondered how comfortable you were as a health minister at a federal level with that sort of power being used and those sort of laws.
So look, let me speak for myself not being an expert on the Victorian laws, I apologise. I would say that I’ve had as the custodian of the Health Minister’s role, the biosecurity powers.
We have exercised them very carefully. The protection of democratic rights in a time of emergency is a fundamental duty on the custodians of those who are in the position at that time.
And so very early on with the Prime Minister and the Attorney-General, we put in place strong protocols that I would have to follow to make sure that we were protecting human rights. And so we have exercised the federal laws very carefully, only ever on medical advice, and always in a way which was to minimise disruption.
And they’ve always been difficult decisions, which we’ve weighed up. And so from our perspective, we’ve treated the law as something which is an absolutely sacred trust to minimise the impact on people’s lives.
So I’ll just say that when I look around the states and territories, I hope that everyone takes the responsibility of protecting human rights as seriously as we’ve done.
Then just to finish: today’s a great day for Victoria and around the country. We’re seeing the opening up. But as we do this, we have to recognise that patients have to have options both in hospital and in the community.
Today, we’re supporting our doctors and nurses, support our community. And to Karen and Alison, our nurses and our doctors have been our heroes through the pandemic and they will continue to be.
Thank you very much. Take care.