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Wednesday, 19 September 2012
Page: 11215


Mrs PRENTICE (Ryan) (13:10): I rise to speak on the Dental Benefits Amendment Bill 2012. The coalition supports investment in dental health. When the Leader of the Opposition was Minister for Health and Ageing in the Howard government, he introduced the Medicare Chronic Disease Dental Scheme, CDDS, in 2007, a program of which the coalition is very proud, in terms of it giving access to dental care to those who need it most. This program is now being dismantled by the Gillard government and will be replaced, eventually, with their Child Dental Benefits Schedule and a program for adults that is not intended to start until July 2014—after the next election and 19 months after the CDDS closes.

As a result, we in the coalition are very concerned that many patients receiving treatment under the CDDS will be forced to forgo treatment during this gap period. My office has received many calls from constituents about what services they will be able to receive under their GP care plan and whether they are in danger of being cut, because they are receiving very mixed messages from this government.

The closure of the CDDS has been in the Labor Party's plans for many years indeed. In this instance, it is not another broken promise from the Rudd and Gillard governments. But their reasons for wanting to close down the member for Warringah's dental scheme have been political from the beginning, and it is a political attack on an effective policy which provides up to $4,250 over two years for eligible patients. We are talking about a scheme which has provided approximately 20 million services to over one million patients since 2007.

The government has form when it comes to this dental scheme. In 2008, Labor proposed the Commonwealth Dental Health Program, which it never delivered. The program promised one million services by providing funding to the states and territories. Since that time, it has been revealed in Senate estimates that the Commonwealth did not assess the capacity of the public dental workforce to provide the projected services and the number delivered might have been significantly lower than that promised.

Fortunately, the coalition and the Greens were able to block Labor's plans to abolish the scheme, but there is the fear that this is now a done deal with the formation of the Labor-Greens coalition government. It was the Minister for Health and the Greens health spokesman, Senator Di Natale, who on 29 August announced not only the closure of the CDDS but the unfunded $4.1 billion dental program that is not due to commence until 2014. The government announced then that no new patients—that is, those Australians without a pre-existing GP care plan—would be able to access services after 7 September 2012.

The most prominent concern is where the money to fund the program is going to come from. Australians are right to be concerned, when they have a health minister saying she does not know where the money is coming from and a Prime Minister simultaneously telling the media that the health minister has announced a 'savings measure'. Depending on who you listen to from Labor, this is either a good move or a bad move for the budget. As much as Labor wishes it to be true, it cannot be both an unfunded cost measure and a savings measure, and the health minister has reiterated that the government had previously accounted for the closure of the CDDS—thus, these dental measures are indeed cost measures that are unfunded.

The Labor Party has indicated that it will cost the government $4.1 billion, split into three categories. Following the closure of the CDDS on 30 November 2012, there will be, firstly, the means-tested family tax benefit entitlement for children aged two to 17 years, which will commence in January 2014. This will be 13 months after some children will have lost access to the CDDS. The proposal is to provide a $1,000 capped benefit over two years to eligible children. The government claims 3.4 million children will be eligible and the unfunded cost for this measure will be $2.7 billion.

Secondly, the proposal for adults will not commence until 1 July 2014. This will be 19 months after the CDDS closes. Funding will be provided to state governments for public dental services. Services will no longer be available for adults through private dentists under Medicare. The unfunded cost for this measure will be $1.3 billion. Thirdly, an invitation to apply for funding under the Flexible Grants Program for dental infrastructure—both capital and workforce—will not commence until 2014. The unfunded cost for this measure is $225 million.

The government is rushing this bill through the parliament without having the necessary detail and without the proper scrutiny by parliament, even though it is not scheduled to commence until after the next election. I note that a specific schedule of services, fees and details of how the scheme will be funded is still not available. Even worse, the explanatory memorandum, for billions of dollars of spending, is just three pages long.

There is real concern in the community and with the Association for the Promotion of Oral Health, which the minister has acknowledged, that services for most children will cost less than the proposed $1,000 cap, but—and it is an important 'but'—there will be children on the Medicare Chronic Disease Dental Scheme who will require more services. As it stands at the moment there is no provision to ensure they continue to receive adequate treatment, especially in the period before the bill commences.

I understand that more than 60,000 services have been provided to children through the CDDS. When it closes on 30 November, there will be a 13-month gap for the children currently receiving treatment. These are children in the middle of treatment who will not be able to have their treatment completed by 30 November. With many unable to afford the full cost of private treatment, this will potentially have serious health, economic and social ramifications for these people. As such, it is those families that will have nowhere to turn.

The shadow minister, the member for Dickson, has already called on the health minister and the Greens to explain why these children must suffer for 13 months with unfinished treatment and no certainty of the schedule of services that are to be provided, even if the government actually delivers on its unfunded promise after the next federal election. Going on recent form, it is highly dubious that a Labor government would actually deliver on its promises.

The coalition does have legitimate concerns, and many members have raised their concerns today. The coalition has in the past offered to work with the previous health minister to refine and improve the scheme, including through a process for providing high costs items such as crowns and bridges, but these offers were rejected. As I have noted, we are also concerned about the children who will lose access to treatment on 30 November with the closure of the CDDS. We are also concerned about the children who will not be able to complete current treatment by 30 November. And we are concerned about the unfunded $2.7 billion cost of the measure. Equally concerning is that the schedule of services and fees and other essential details are not available, as the bill is being rushed through parliament. Therefore, the coalition proposes an inquiry with respect to these issues and then reserves the right to consider the findings and then will provide a policy response as required.

There have been claims that there were some dentists rorting the CDDS, and some use this as a justification for its repeal. I would say first that rorting has never previously concerned the Gillard Labor government, despite many warnings, in the pink-batts fiasco, in solar panel subsidies, or in the Building the Education Revolution. However, as a result of these claims, dentists have been pursued for minor and inadvertent paperwork mistakes. Of course, the coalition never supports rorting and does support this in any way. What we do support is a transparent and appropriate audit process to detect fraud and the misuse of taxpayers' funds. In most cases, the dentists being caught by the audit process did provide appropriate services to patients in need but merely did not comply fully with a technical requirement to provide general practitioners with treatment plans and patients with treatment plans and quotations for services prior to commencing treatment. As this was many of the dentists' first interaction with Medicare, you would expect some adaptation problems along the way to occur—teething problems you might say.

The information that we do have available from the Department of Health and Ageing is that the average claim per patient is $1,716, well below the allowable $4,250. Some recent estimates suggest that average cost per patient has fallen to below $1,200 per patient. It is reported that 80 per cent of services under the CDDS have been provided to concession card holders, and the evidence suggests that dental services have been predominantly utilised by low-income Australians. Many of these people would have otherwise been forced to go without treatment or added to the already 650,000 people on public dental waiting lists.

The government's vague promise of providing money to states and territories for public services is not due to commence until mid-2014, still leaving a gap of service provision. There are already 650,000 people on public dental waiting lists. Yet the health minister has said that Labor's plan will only provide 1.4 million additional services over six years. There are significant concerns that the lack of infrastructure, particularly in the public system, will impede the capacity to deliver the projected number of services as promised by Labor. The coalition will move to disallow the closure of the Chronic Disease Dental Scheme to protect patients who will otherwise have to go without treatment for at least 19 months for adults and 13 months for children.

The health minister's recent announcements and today's legislation are a political attack on an effective policy set up by the Leader of the Opposition. I note that the coalition has renewed its commitment to work with the government to refine the Medicare Chronic Disease Dental Scheme and will work closely with providers and the public to ensure that real action is taken in the provision of dental care. We will build on the very proud record of the Leader of the Opposition's previous role as health minister.

Today's measures are not scheduled to come into effect until after the next federal election. The choice at that next election will be to vote for the coalition to provide hope, reward and opportunity for sick Australians requiring dental care.