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Wednesday, 19 September 2012
Page: 11212


Ms SMYTH (La Trobe) (12:55): I am very pleased to contribute to this afternoon's debate on the Dental Benefits Amendment Bill 2012. I begin by responding to some of the points made in the member for Paterson's contribution. At one point he referred to the government and its consideration of its policies as they affect 'real people'. I should put on record that, in the member for Paterson's electorate, the real people who will be affected by virtue of the announcements made last month by the government in relation to dental health and by virtue of the arrangements in the bill before us today, are some 18,000 children, who will have access to better dental programs as a result of this measure, and roughly some 9,500 families.

When we consider the impacts of this government's policies on real people, we are very clear about our desire to provide better dental health care and better health care overall for the very many people of whatever political persuasion in electorates right around this country. The member for Paterson's electorate, my electorate and all electorates stand to benefit in a very considerable way when it comes to the measures that have been contemplated in the bill before us and in the package of dental health measures announced by the Minister for Health last month.

The member for Paterson also mentioned 'some issues' in relation to the CDDS, the Chronic Disease Dental Scheme. I can confirm that there were certainly some issues with the scheme. The member for Paterson will know, as all members in this place will know, that the government have maintained a policy of shutting down that flawed scheme for some time, in fact since we were elected in 2007. That is because that scheme is fundamentally flawed. It is not means-tested, which has meant that people on extraordinary incomes can get access to over $4,000 worth of free dental care. It is not targeted, which means that patients can get things like caps, crowns and often cosmetic work at the taxpayers' expense, while those who actually severely need dental assistance and dental care may not have access to dental health care.

It was much reported, appropriately, that the cost of the Chronic Disease Dental Scheme blew out by an extraordinary amount. When the Leader of the Opposition was health minister, he estimated that the scheme would cost around $90 million a year, but it has ended up costing us $1 billion each year. Yet we still see, as I will come to shortly, an extraordinary number of people who still face lengthy delays for dental care. We still see circumstances where the dental health of children across Australia leaves much to be desired. It is for those reasons that we have sought for a long period of time to shut down what is a fundamentally flawed scheme and a poor piece of public policy. There have been more than 1,000 complaints lodged about the CDDS. So, when we talk about 'some issues', in the words of the member for Paterson, it is something of an understatement in relation to this very flawed scheme. There has been widespread misuse of the scheme and it has taken us a great deal of time to try to resolve these issues and arrive at a much better set of arrangements as are contemplated in this bill and in the dental package announced by the minister last month.

This is an extremely important initiative, and the bill before us today contemplates a very important part of the $4.1 billion dental reform package, which includes a commitment of $2.7 billion for around 3½ million Australian children who will be eligible for funded dental care, and a commitment of $1.3 billion for almost 1½ million additional services for adults on low incomes, including pensioners and concession card holders and those with special needs, who will have much better access to dental health care in the public system as a result of these measures. And, notably, it includes a commitment of $225 million to expand dental services for people in rural, regional and remote areas. As I will mention shortly, some of those people living in rural and remote areas face very significant deficiencies when it comes to dental health care currently. It is entirely appropriate that the measures, both in this bill and in the package as a whole, respond to those concerns.

In my electorate the measures in this bill and in the overall package will reach more than 20,500 children and around 11,000 families. As someone who goes out and visits schools regularly and meets with children and with many young families who are in my growing electorate, I know very well that this will be extremely well received. It will give a great amount of assistance to parents who might otherwise have to delay or possibly even defer dental treatment for themselves or their children because of the expense associated with that.

In this bill the particularly important measures relating to children are emphasised by some of the findings of the Australian Institute of Health and Welfare's report, Oral health and dental care in Australia: key facts and figures 2011, and it really does make for sobering reading when it comes to the dental health of children and young adults in particular. Amongst the many things that it reveals, the report finds that almost 20,000 children under the age of 10 are hospitalised each year as a result of what should be entirely avoidable dental issues. For children who face hospitalisation it is traumatic, it means that they are likely to have had to endure significant health problems prior to getting to hospital, and it is disruptive for them and their families—and it is a cost for our health system to have increased rates of hospitalisation in circumstances where dental health measures which are fairly basic could have been taken. That is one of the many reasons why prevention in relation to dental health is so important.

The report by the Australian Institute of Health and Welfare estimates that by the age of 15, six out of 10 children will have tooth decay. That is an incredible rate. Very importantly, the report also considers financial barriers which prevent people from visiting a dentist. It found that the proportion of those who avoided or delayed a visit to a dentist due to cost was 28.2 per cent in 2010.    For children aged between five and 14, this was around 14 per cent on average. But if you look at the situation of children aged between five and 14 in families with a household income of less than $60,000, the proportion ranges between around 15 per cent and over 31 per cent. That means that in some of our lowest income households—some of the very poorest Australians—almost a third of children do not get to a dentist or do not see a dentist in a timely fashion. That is entirely unacceptable and that is the reason this Labor government has prioritised real action on dental health, particularly for children and particularly for those people who are on low incomes.

In the general population, the Australian Institute of Health and Welfare's report found that around 19 per cent of people would have a lot of difficulty paying a $150 dental bill. This figure is significantly higher in relation to households with an annual income of less than $60,000. This bill, and the package of measures announced by the government last month in dental care, respond directly to this issue of financial restrictions meaning people defer, delay or avoid entirely taking their children to the dentist or going themselves to the dentist.

Another of the things considered in the report is that, while untreated decay and fillings are at similar rates across income ranges, there is a big distinction between the haves and the have-nots in our society when it comes to missing teeth. The report found that if you earn more than $60,000 a year, you have, on average, seven more teeth than Australia's poorest people. That is a terrible statistic. The report also reveals that you are more likely to be missing teeth or facing dental issues if you live in outer regional and remote areas, particularly if you are one of Australia's poorest people.

I encourage members to look at this report in the context of the dental package that has been announced, because these really are statistics that bear reading by members in this place when they are considering health in Australia and preventative health, particularly preventative dental health. The report paints a very stark picture of the difference between the dental health of those who are on higher incomes and those who are on lower incomes, children and those who live in remote parts of Australia.

According to the report, around 45 per cent of 12-year-olds had decay in their permanent teeth. In 2007, just under half of children aged six attending school dental services had a history of decay in their baby teeth. These are all precursors for poor dental health and increased dental intervention for adults. All of these things that happen at an early age in dental health have very significant impacts on adults' dental health—and for their general health as a consequence.

I know that when my family arrived here from Ireland we certainly did not have a lot of money, and it was a struggle for my parents to meet the costs of sending three children to the dentist. Unfortunately, I know too well that the same struggle to meet dental bills happens in families right across my electorate and right around the country. It is awful to put parents in the position where they have to forgo or delay dental treatment for their children, knowing that it might be causing discomfort or other illness. It is an absolutely awful position to put parents in. I suspect that it has often resulted in parents forgoing things, and I suspect that it often means that a parent will delay a visit to the dentist because they give priority to their children's health.

This bill starts to respond to all of those deficiencies that we see in children's dental health, and it does so in a very significant way. The package as a whole and the measures contemplated by this bill are targeted appropriately, which was not the case in relation to the Chronic Disease Dental Scheme. These are targeted at people who we know are going to receive the greatest benefit—people on lower incomes, people with children and people in remote and regional parts of Australia. It is appropriately targeted, it builds on the significant amount that has already been committed by this government and it is something that comments from the opposition in this debate and in the broader debate outside this place more generally has not been recognised.

In the budget this year the government committed over $515 million to dental spending, including $345 million specifically to take care of adults on public dental waiting lists. So this money is already committed, and it will be available to state and territory public dental systems from January of next year—just one month after the closure of the Chronic Disease Dental Scheme. It is appropriate to reflect on that in the context of some of the comments made by the shadow minister and others during this debate. This is a very significant investment and it will also mean that some 3.4 million children whose families receive family tax benefit part A, Abstudy, the carer payment, the disability support pension, the special benefit payment, youth allowance, the double orphan pension, or payments under the Veterans' Children Education Scheme or the Military Rehabilitation and Compensation Act Education and Training Scheme will qualify for the new scheme, dental for kids.

The provisions in the bill before us and the overall package mean that families will be entitled to receive $1,000 per child every two years over the life of the package. As I have said before, that means more than 20,000 children and around 11,000 families in my electorate will be eligible to receive these payments. In a growing area of Melbourne where people are trying to make ends meet in the family budget, it is a very significant amount being contributed to dental health care. It will mean a bit more peace of mind for a lot of parents and families who would otherwise struggle to meet the costs of dental care.

This package and this bill reflect an investment in prevention. This government is building on a range of initiatives that it has put in place to focus on preventative health, so that we not only improve the health of our children and adults but we also improve the circumstances of our health expenditure into the future as our population ages.

This is an extremely important package and one that I am very proud to stand and speak on here and back in my electorate. I know that it is currently well received. I know that it will continue to be very well received as parents and as children start to see the benefits of it. Accordingly, I commend the bill and the package of measures to the House.