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Wednesday, 19 September 2012
Page: 11222


Mr LAMING (Bowman) (13:37): We could detain this House for a long time traducing each other's dental policy. What we are talking about here today, in this debate on the Dental Benefits Amendment Bill 2012, is exactly what this federal government is doing to dental care in Australia over the next 19 months. This government, which is responsible for continuity of care, has abandoned it with its program—a program launched to great fanfare but which is completely unfunded. That is right. Absolutely no financial arrangements have been made for the dental package it announced a couple of months ago. Why? This is a clever government with no money left. This government borrows every dollar it needs from the Middle East or overseas—because this nation is in debt to the tune of more than $100 billion a year. But this government will keep making billion-dollar promises until the polls improve. That is the reality of what is happening on that side of the chamber.

I will run through a quick history lesson in the seven minutes we have available. We know that state funded public dental care has long waiting lists. Up to three-quarters of a million people are waiting for care. What is the reality of that? With state funded dental care, unless you have a massive dental emergency, you simply do not get seen. Seniors who have chronic dental disease never get a chance—they have to roll up to private services. Australia has a private dental model. The 10,800 dentists around the country are almost exclusively in the private sector. How mad would you be to work in the public sector when you can make so much more money in the private sector? In Tasmania, as an example, there is a 30 per cent shortage of dentists when assessed against the per capita need—and dentists there earn 30 per cent more. It is a completely supply constrained private dental system.

It is true we are graduating 600 dentists a year and it is true we are graduating 300 hygienists and oral health specialists and therapists. But those numbers are not increasing fast enough—and there has not been any effort on that side of the House to look at what jobs can be done by the people who work with dentists. If that work were done by allied health professionals, it would free up dentists to do the work which can only be done by them. This is a government which has abandoned that frontier.

This is also a government which has abandoned the Chronic Dental Disease Scheme. That scheme was conceived by the current Leader of the Opposition, Tony Abbott. He started from a simple proposition. He said that, if people are genuinely sick and dental issues are part of that chronic disease, they deserve treatment. That is placing the needs of the sick first. This Labor government are supplanting that. They are saying, 'No, it does not matter how bad your teeth are; if you are poor, you go to the front of the queue.' In a developed economy like Australia's, the reality is that dental disease is relatively evenly spread throughout the community. Having a concession card does not suddenly make your teeth bad. Earning a salary or getting a job does not suddenly make your teeth good. This is a government which has replaced a system designed to meet the needs of the sick with a system designed for the poor. The reality is that you have to look after both.

But this is a government which says—at least to adults—'For the next 19 months, if you have dental pain, our political pain comes first.' That is right. They are saying: 'We need a surplus, so you can all wait. You can all go back on the state dental lists and rot.' That is the reality. We know what states invest in dental care. We know that the ACT and NT lead the way. We know that New South Wales and Victoria are the poorest investors in state dental care. Those are the states where you wait the longest. In fact, you do not wait—because you never get the care. That is because the Labor state governments which set up those systems underfunded public dental care and have done so for eons. This mob over here says, 'We will find $1½ billion two elections from now and we will hand it to the state governments.' What will the state governments do with that money? This government will just hope the states spend it on dental care.

If you have a dental emergency, you can turn up to public state funded care and get that tooth pulled. If you need preventative care, those places will turn you away. What did Tony Abbott's scheme do? You went straight to the GP, you established that you had a chronic disease and your teeth were fixed through Australia's 95 per cent private dental system—immediately. It cost around $2,220 on average. For kids with chronic disease, it cost $2,125 on average. What did Tony Abbott's scheme do? Tony Abbott's dental plan slowly worked its way through the sickest Australians, fixing their teeth. For mental health patients, who have never known a health system to help them out, Tony Abbott's scheme put them at the front of the queue, got their teeth done, fixed their gingivitis and fixed their bridges and crowns. It got people with severe chronic disease teeth they could be proud of for the first time in their life.

Were there are a few cosmetic procedures in that scheme? Yes, there were. Was there a health justification for them? Yes, there was. Those of you on that side of the chamber talk about rorting—one in 1,500 cases. Does it happen any less with doctors than with dentists? Surely it happens in Medicare with doctors. Of course it does—probably in roughly the same proportions. Doctors are no different from dentists in that respect. It is part of the trust built into a universal system.

The state public dental waiting lists were reduced by Tony Abbott's scheme. The waiting times in New South Wales were cut by 40 per cent thanks to Tony Abbott's scheme. We have a GP centred health system. We allowed the GPs to work out who was sickest and who needed dental care most. That was the justification for Tony Abbott's scheme.

What was the second justification? The cost of getting your teeth fixed through the Chronic Dental Disease Scheme was indeed $2,225 per patient. What was it this year? It had fallen to $1,117. Why? Because all the serious work was done. We were seeing the scheme drop down a level to perform the role of surveillance, monitoring and long-term care of Australians' teeth. The hard work had been done.

That all stops now. That all stopped on 9 September when a government with no money left evoked an image of dental care 19 months from now—and they said: 'Our political pain is greater than your dental pain. If you have a dental problem, you can wait. Go back to the public scheme.' But the public scheme is already overrun because state governments underfund it. Let us go back to 1996 when the coalition government, inheriting someone else's economic mismanagement—Paul Keating's—said: 'You know what? That is the end of providing money to state governments, who don't use it well.' That is why the Howard government cut the scheme—because the more money you gave the state governments, the less got done. Nothing has changed. This government will see the same thing under their arrangement. They do not understand how dental economics works. The people who most need this care will not, if they do not have a concession card, get that care.

This government criticise dentists for overcharging, but then they conceive a scheme which gives $1,000 every two years to young people. Do they think that won't be open to abuse? Their scheme is exactly the same as Tony Abbott's scheme—except that it is treating kids instead of chronically ill seniors. It is a political shift to kids—doing that was worth more votes to the Prime Minister. Good luck to those kids who get a thousand dollars worth of care. But the government have not addressed any of the risks of overcharging in the system. Preventative dental care for teens and young kids, which could be done by hygienists, is being done by dentists at double or triple the cost. The government have not created any more oral health graduates—the numbers have increased by only a few per cent and the number of dental therapists has fallen by six per cent. So the work which could be done by allied health dental workers is being done by dentists at a much greater cost. At every level this is an unfunded, imaginative scheme that may never happen. It has been planned by a government that is trying to survive to the next election and that has in the same process traduced a scheme that looked after the chronically ill seniors who needed it most.

Debate interrupted.