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Tuesday, 16 September 2008
Page: 51


Senator SIEWERT (6:13 PM) —The Greens will not be supporting this motion either. We are deeply concerned about the dental health of Australians and deeply concerned about a dental program that is now proving to be effective. The Greens are well aware that it was not as effective before as it became in November, when the threshold went up over two years to nearly $4,500. That meant that many people could access dental treatment for the first time. Many people for the first time ever were finally able to access dental treatment. These are people who are suffering from chronic illness and this dental treatment made and is making a very significant impact on their lives. I will read through a few stories shortly.

The Greens position, as the Minister for Health and Ageing quite correctly pointed out in the media today, has for a very long time been one of support for a Commonwealth dental scheme. There is absolutely no doubt about that. Just as the Greens very strongly support a universal public health scheme, so do we support some sort of universal dental plan. However, we would like to point out that the program that we are now talking about getting rid of, dentistry is for the first time part of mainstream health and funded under Medicare. Therefore, this actually meets a key part of Greens policy. So, far from the Greens now voting against their policy, we are actually supporting a key part of our policy—to fund dental services through Medicare.

The government said to the Greens that it is one or the other. The Minister representing the Minister for Health and Ageing here today said, ‘If you do not support this motion we are not going to be able to fund our Commonwealth dental health program, so we will have to cut this other funding program.’ It is not the Greens fault that the government has decided to invest $31 billion worth of surplus money into tax cuts. The government made the decision, so do not try to shoot it home to the Greens—thank you very much—that we are the ones that are going to be doing in the Commonwealth dental health plan. You did it in yourselves by deciding that you were going to provide $31 billion in tax cuts and to, unwisely, cut into this country’s surplus. I agree that money should be invested into dental health outcomes for Australians and particularly for those low-income Australians who cannot afford adequate dental health cover and who have never or very rarely been able to access dental health services. Don’t come back and blame the Greens for your bad decisions. It is very disingenuous. The Greens are very well aware of our dental policy and we do not need to be reminded of that by the government, thank you very much.

This program is helping thousands of Australians who have been accessing these health services, in some cases for the first time. The numbers accessing the services have doubled, as Senator Colbeck said. When the minister for health first announced these changes earlier in the year, she said that the program had failed. That word has been used here tonight and it has been used in the media—the scheme was failing and had not been providing proper support. In the past, it had not been. But the numbers that we have been provided show that, since November, there has been a doubling in the uptake of this program and that over 640 services have been provided to the chronically ill.

I must point out here that the accusation has also been made that this is for rich people—that it is not means tested. The Greens position is, as I have said, that we have a universal health system, so of course we do not agree that it should be means tested. We have done a lot of consultation on this. I acknowledge that we voted differently last time but since then we have carried out a lot of consultation. We have talked to a lot of patients, dentists and doctors who have very clearly pointed out that it is low-income people who have been accessing these services.

May I just ask members in the chamber how many wealthy people who have chronic illness they see running around with bad teeth? I tell you what: dental pain is one of the worst pains you can deal with. People talk about it being one of the most shameful things that they have to deal with. It affects your whole life. So, if you can afford it, you go and get it fixed. The people that have been accessing these services are overwhelmingly those that cannot afford these services.

Dr Passmore told us that he participates in two practices, one in a wealthy suburb and one in a non-wealthy suburb, and that the people in the non-wealthy suburb are the people who have been accessing his services. It was also pointed out that some states have not been accessing these services as much as New South Wales but  it would be interesting to know how they have been promoted and whether doctors have been particularly focused on this issue in New South Wales. That there is an overburden of people with chronic illness in New South Wales who have dental problems is quite obvious. The reason may be that New South Wales is not investing enough in dental services; however, to make the chronically ill and the people who can least afford it carry that can is not fair either. Yes, state and territory governments need to be fixing that, but do not expect the chronically ill to pay for it literally through their teeth.

There are already 650,000 people on waiting lists. The people who would be able to access these services are now going to be forced back onto those waiting lists. We have been told tonight that the new system is going to fund 995,000 services, yet there are 655,000 people already on the waiting lists. So the people who urgently need this dental work will be forced back onto the waiting lists and will not be able to access the most immediate remedies that they need and which they can actually access now through this program.

There is also a dispute about how many people have already been to their GP, have been referred, who should have been receiving treatment and have not been able to receive treatment because we did not know whether the program was stopping or starting. One of my staffers rang up Medicare for some advice and got two different answers. If a person who is usually pretty good at working their way through the system got two different answers, I suspect that Australian punters out there who have been ringing up to try and work their way through the maze will also have had different answers. I suspect, too, that GPs and dentists have. I do not think it is true to say that people knew what was going on. To say that Aboriginal people have not been accessing it is partly true—I have seen the figures; I know they are not accessing it as much—but I have also taken the trouble to speak to a dentist who is working in a remote community and was told that, as we all know, dental services are stretched in remote communities for various reasons, including unfamiliarity with some of the Medicare administration requirements. Dentists up there have only just started making use of this provision and it was around the same time, unfortunately, that the minister announced it was being withdrawn.

That dentist spoke of people’s shame—Aboriginal people suffer the same shame that non-Aboriginal people do when they have bad teeth. When they are having their front teeth in particular extracted, they will not smile. He said that this program had just started to be taken up and had just started to make a difference. He was dismayed at the ending of the scheme because he thought that it was a good way of delivering a service to Aboriginal people in remote communities.

If one of the reasons that the figures are skewed is that the information on service provision has not been good or people have not been able to access the information, you do not then cut the service. Surely, you improve the information available to dentists, to doctors and to the community about the service, which is, as I have said, highly valued by the community. My office has been overwhelmed by the number of people who have contacted us to tell us their stories and how much this program has meant to them. They have told us what a difference it has made to their lives, to their wellbeing, to their self-respect and in some instances to them being able to get a job because they have felt so bad about their dental problems that they have not felt confident enough to participate in the workforce. The service has multiple impacts on people.

I think every member of the Senate has received the photos that show absolutely what this program means to people. My office received a phone call today from a lady in very tragic circumstances. She is suffering from cancer and I am not going to go through the whole story. She was dismayed when she found out that she probably was not going to be able to access the service. Now she is not going to be able to get the funding she needs to do some very important dental work that would mean a difference between a good quality of life and an extremely poor quality of life for her.

We heard of another example of people who were suffering from chronic hepatitis C, who were unable to eat the more nutritious food that they needed because of their poor dental health. Instead of eating soft food, which is more likely to be high in sugar and fat and which only adds to their chronic illness, if they were able to access this sort of program, it would greatly assist them in terms of their quality of life and their health outcomes.

If this program disappears, these people will go back onto waiting lists and their conditions will worsen. For example, a person suffering from a severe iron deficiency was told to increase his consumption of red meat. He was unable to do so because he could not chew due to his rotten teeth. By the time he finally got to see a dentist under the scheme, all his remaining teeth had to be removed and he was provided with false teeth. That is what happens when you are stuck on waiting lists. The problem gets worse and worse.

The Commonwealth dental health plan, which is what the government said they want to replace this service with, was supposed to begin on 1 July. It did not. It is dependent on funding agreements with the states, and these are to be signed in the very near future, but that has not happened yet. If the scheme is withdrawn now, people who are currently receiving treatment will have nowhere to go. Even if they have somewhere to go at the moment, they will go onto waiting lists, and the funding that is available for those services is not going to provide the sort of care that they need and which they can receive under the current program to deal with the extent of their problems.

I am not here by any stretch of the imagination defending the coalition, because I do not agree with a lot of their health policy plans, so I do not want anyone running away with that wild idea. However, this program was a good program. It is genuinely helping people who are suffering, who have chronic illnesses and who have poor dental health. They need support. I am not about to support a motion that cuts off that little support. It is quite obvious that it is fulfilling a desperate need out there. The doubling of the use of the service in that short space of time says there is a big need out there.

Yes, the Greens support a Commonwealth dental health scheme, but not at the expense of those people who are currently receiving much needed support. Funding has been cut to public dental services and the states have not been performing properly, but I say again that you do not then inflict that pain on low-income workers—on the people who have the least capacity to pay. It is the wealthy people who have the capacity to pay; low-income people do not have the capacity to pay. If we support this motion to rescind the disallowance of the dental services determination, the minister would whip in another instrument to get rid of this program. It would not immediately be replaced with a Commonwealth dental scheme as they say. The time frame is quite loose on that and there is absolutely no guarantee that the people who are currently being treated under this scheme or who would be eligible to be treated under this scheme will be able to be treated in a timely manner that deals with their problems and symptoms immediately under the new scheme.

The government need to come back with a better funding proposal for their dental scheme. They need to show the Greens how they are going to properly look after the people who currently are able to access treatment under this scheme, which is proving extremely valuable and worth while and delivering results to thousands of Australians. They need to show us how these people can be treated and also how they are going to get their Commonwealth dental plan up.

Don’t dare blame the Greens if the government decide they are not going to fund their Commonwealth dental plan. When they announced those tax cuts, they made a decision about how they were going to spend that money. Australia can afford both—don’t you try to tell me that we cannot. We can. We are a caring society and we can afford both. Don’t try and blame the Greens when this goes down.