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Tuesday, 17 June 2008
Page: 5076


Mr MARLES (7:18 PM) —I rise to speak in support of the Dental Benefits Bill 2008 and related bill. I start by thanking the member for Cowan for his contribution in this debate. As he set out the description of the difficulties that have been faced by people in his electorate, he neatly set out the very basis on which these bills are now required. The fact of the matter is that the parlous state of dental health care in this country is absolutely the reason for the need for these bills, because of the years of neglect by the Howard government. As the member for Cowan asked the question, ‘When is the blame game going to end?’ and raised the concern about buck-passing, I could only look at him and think that on that side of the House there is an enormous amount of buck-passing. The reason we are in this situation is a blame game which was pursued for 12 long years.

We on this side of the House do take responsibility, and the buck does stop here. The buck stops with the Rudd government. For that reason, we are actually doing something about the issue of the parlous state of dental health care in this country, and that is very much what these bills are about. These bills provide for a legislative framework which is aimed at delivering $780 million, through two dental health initiatives, to this country. Of course, these measures were announced as part of the budget that has recently been announced. It is just another budget measure which is being put forward to overturn the 12 years of neglect and noninvestment that we have seen in this country as a result of the former Howard government.

Fifty thousand Australians each year are hospitalised for preventable dental conditions, and Australian adults rank second worst in the OECD for their overall dental health. That is a disgraceful and shameful position that we find our country in. The measures proposed in these bills will seek to alleviate Australia’s dental health crisis and assist our overall health system. If we look at the state of dental health in our country at the moment, it makes for very sad reading. Six hundred and fifty thousand Australians are on public dental waiting lists. In 2007 the Australian Institute of Health and Welfare reported that 30 per cent of Australians reported avoiding dental care due to cost, 21 per cent said that costs had prohibited them from having recommended dental treatment and 18 per cent reported that they would have considerable difficulty in paying a dental bill of $100 or more. Further statistics indicate that tooth decay ranks as Australia’s most preventable and prevalent public health issue, with more than a quarter of Australian adults having untreated tooth decay. One in six Australians over 15 have avoided particular foods due to poor dental health. In New South Wales, the hospitalisation rates for children under five for dental conditions rose 91 per cent in the decade between 1994-95 and 2004-05.

Our poor state of dental health is not only a public health issue—although it is a very considerable public health issue—but also a social issue. There is a significant link between dental health care and socioeconomic status in terms of both the cause of dental problems and how people’s dental health contributes to their overall social interaction. The fact of the matter is that if you have broken teeth it leads to poor self-esteem and it makes it difficult to interact within our society. Dr Anne Sanders from the Australian Research Centre for Population Oral Health, based at the University of Adelaide, made a comment about exactly that link when she said:

If we could grade the social conditions of society from excellent to poor we would find that population oral health status followed precisely the same gradient. Where social conditions are excellent, oral health status tends also to be excellent. Where social conditions are poor, oral health likewise is poor. This is so because the oral health of populations is socially determined.

This is also a fact, or a phenomenon, which has been identified in Victoria. In 2002 the Victorian Auditor-General’s report on the state of oral health of Victorians said:

 Poor oral health may cause people to avoid social interaction and personal contact, reducing their quality of life.

So poor dental health in this country is not only a public health issue but also a very significant social issue, which is why it is absolutely critical that it be addressed, and the Rudd government means to address it.

In Geelong, where my electorate is, we face all these problems, as does the rest of the country. Currently in Geelong the approximate waiting times for public dental health assistance amount to 30 months for general dental care and 37 months for denture care. Statistics provided by the Barwon Health Community Dental Service in Corio in February this year were that there were 2,249 patients waiting for general dental care and 571 for denture care, a 43 per cent increase on the previous six months.

While dental health may not be on the radar of the Commonwealth opposition, the Victorian Liberal opposition do at least recognise that dental health care is a problem. The Victorian state opposition health spokesperson, Ms Helen Shardey, recently asked this question: ‘When will the Brumby government realise the dental problem is not just a small toothache but an excruciating pain across Victoria?’ In that question Ms Shardey has correctly identified that dental health is an issue but she has completely missed the mark in terms of laying the blame for why this issue has come about and how it needs to be fixed. It is absolutely ironic that she should be pointing to the state Labor government when it is in fact the neglect of the former Howard government, in its refusal to properly fund public dental health, that has given rise to not only small toothaches but also large and excruciating pain.

The Rudd government understands that a proper dental health service cannot be provided by our states if it is not first funded by the Commonwealth government. The Howard government did not do that. In 1996, when the Howard government came to power, one of its initial acts was to scrap the Commonwealth Dental Health Program, which was introduced by the Keating government, and in doing so it ripped $100 million from public dental health services. After eight years of Howard government neglect, in 2004 it started to take some dental health measures through Medicare in relation to those who were suffering chronic illness or who had complex care needs. But the criteria for the program that was put in place at that time was so restrictive and the process for gaining access to that program so complex that the program was, at the end of the day, an utter failure. It assisted 7,000 people at an expense of $1.8 million to the public purse over three years, despite the program originally being forecast to assist 23,000 people at an expense of $15 million. By September last year only 14 preschoolers had had their dental needs addressed through that program.

The reality is that the Howard legacy on dental care is one of failure and neglect. They started by ripping money out of the system and then they designed programs that were so intricate that, at the end of the day, they were guaranteed to fail. As with so many other areas of public policies, 12 years of neglect has resulted in the current parlous state of dental health care in Australia. The Rudd government is absolutely committed to addressing that neglect, to building a system that can meet the public need for dental health care and to ending the blame game over the issue of dental health.

As I mentioned, the Rudd government is providing an initial investment through the budget, of which this bill is a part, of $780 million to address the current state of dental health. This money is going to be provided through two schemes. There will be $290 million over three years provided to the Commonwealth Dental Health Program and $490 million provided over five years for the Teen Dental Plan, which of course is the subject of these bills. That is in stark contrast to the Howard government initiatives, which over four years to April 2008 provided less than $50 million. This government’s programs are deliberately targeted to assist those who are currently most in need of dental services, and they will be done in partnership with the states and territories, precisely so that we end the blame game and start a cooperative approach to the way in which this country is governed.

Could I mention briefly the Commonwealth dental plan. This assists states to reduce waiting times. It will provide for up to one million dental consultations over the next three financial years. The funding is being provided in accordance with strict conditions targeting people with chronic diseases as a priority; for example, cancer, cardiac patients and those suffering from HIV-AIDS. It seeks to meet the challenges left by years of the Howard government’s neglect and ineptitude and it will assist the most vulnerable and the most in need, in particular by prioritising Indigenous people and preschool children.

The Medicare Teen Dental Plan, which is of course the subject of these bills, is a very important initiative. It will provide up to $150 per eligible person towards an annual preventative check-up, which can be used at a private dental clinic. Those who are eligible are persons aged between 12 and 17 in families receiving family tax benefit part A or persons in the same age bracket who are receiving either the youth allowance or Abstudy benefits. It is estimated that ultimately this will cover about 1.1 million teenagers.

The preventative check will cover the examination and, where clinically required, X-rays, scaling and cleaning of teeth and other preventative services. The plan will be administered by Medicare using client eligibility data from Centrelink. It will operate on a calendar-year basis without just being distributed in January of each year. Following the first year of the program, vouchers will be valid for the entirety of the calendar year, even if the family circumstances alter during that year.

As I said at the start, dental health is not only a public health issue but also a social issue. So this program provides for an intervention during the teenage years of a person’s life—a critical point in their life—where they can go forward with good dental health. They will be able to engage in the normal social interactions, so if they are looking for jobs or engaging in study or other social activities their dental health will not be an issue.

This bill, along with the Dental Benefits (Consequential Amendments) Bill 2008 also provides for the dental benefits scheme. These two bills will have the combined effect of legislating for the creation of a new dental benefits scheme which will be established to implement the Teen Dental Plan program. The DBS will also provide the legislative framework that will allow the Minister for Health and Ageing the discretion to make dental benefit rules whereby the minister may seek to make additions to the scope of dental benefits items in the future. Unlike the Medicare Benefits Schedule the DBS allows provisions to be targeted to specific groups—for example, by means testing or by age.

In summary, these bills absolutely cut to the core of what the Rudd government is all about—that is, providing services to those who are most in need—and in doing so rectifies the neglectful practices of the Howard years. This program seeks to cut through the red tape of previous programs to provide much greater access and to provide a much less complex system. It is a program that will be delivered hand in hand with the states, precisely so that we can end the blame game.

The Rudd government understands the pressures on working families when it comes to prioritising household incomes, and the Rudd government believes that these bills will allow families to prioritise preventative dental health care in their family budgets, both for their benefit and also for the benefit of the wider community by alleviating the strain on the public health system. These measures will greatly benefit the people of Corio and the people of Australia, and I commend these bills to the House.