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Wednesday, 19 September 2012
Page: 11277


Mr LAMING (Bowman) (17:06): This is an opportunity for me, which I appreciate, to put on record some more context around the dental scheme that is being proposed by this government and to provide a better understanding, I think, than we have seen so far in much of this debate on exactly how the economics of dental care in Australia work.

I already pointed out in my first contribution that dentistry in Australia is a predominantly private enterprise and that any solution will always rest privately with dentists. It was something that was respected by this side when in government, that devised the Chronic Disease Dental Scheme. The great myth that is being perpetrated by the other side about the coalition's scheme is that it blew out in cost. I think you need to remember some basic facts about public dentistry in this country, which has been perennially underfunded. On average there are up to three-quarters of a million Australians who, at any one time, are seeking out dental care which they cannot afford privately. That cohort are predominantly older and, more frequently than the rest of the population, have chronic disease. What is most important of all is that they find it virtually impossible to afford private dental care.

The scheme proposed by the coalition increased in its initial estimates from around $100 million to close to $1 billion a year. Let us step back and see whether that is a failure or in fact a success. The first piece of evidence in favour of this scheme is that dental waiting lists in the public dental facilities decreased by 40 per cent during this period of Commonwealth investment in dental care. Secondly, if you have three-quarters of a million people, each needing between $1,000 and $2,500 worth of dental care which they cannot afford, then you know what? That adds up to over a billion dollars. If anything, the success of the Chronic Disease Dental Scheme is that it reached out to the most vulnerable cohort.

I pointed out in my earlier contribution that the one thing that this program focused on was looking after the sick. And what we are seeing over here is, on the one hand, a Labor government criticising us for that and instead devising a system that looks after concession card holders; but, on the other hand, they are actually devising a children's dental scheme which runs almost identically to the Chronic Disease Dental Scheme in its functionality, as far as a dentist is concerned. So what we have is a 'mini-me' dental scheme, starting of course not tomorrow or next year, because the budget pain felt by this government is simply greater than the dental pain felt by Australians—no, it is a program that starts in nearly two years time. When it starts, it will be exactly the same: a cap of $1,000 every two years for dentists to look after young people's teeth. So the criteria in that scheme make us just as at risk of the rorts that have been criticised in the previous scheme, except that they will be treating a person with a birth certificate that has a smaller number on it than the coalition scheme did.

The complaints about rorts and irregularities in the CDDS were around one per 1,500 patients. That is quite consistent with a lot of our MBS data. Did the government act to fix the problem? No, they did not. They have had four to five years to fix the problem and they have elected not to. In fact, offers have been made by other parts of this chamber, and they have been passed up. This government preferred to see this program run up to close to $1 billion a year, when simple changes and modifications to it as it was rolled out could have saved $330 million a year.

The second very important piece of evidence is that the use of the scheme was in decline as the burden of disease was being treated—and we know that from the per-case figures: $2,225 for adults; $2,125 for children. But this had fallen to $1,174 by this year. And the whole program itself, within two years, was likely to fall to $374 million a year; quite affordable, and not that far away from the estimates when this scheme was set up. The fault of the CDDS, if there is one, is that it simply mopped up the public waiting list of dental disease, and it did it very effectively.

I know, over there, they were talking about all those millionaires getting their dental treatment. Well, I will remind you of one thing: millionaires pay their taxes, and they have paid their way handsomely. Once you start denying Australians basic universal health care, I dare you to do the same to Medicare. Go on: cut them out of Medicare. But you will not do that, will you? No, these millionaires paid their way. What percentage of the CDDS were people on concession cards? Eighty per cent. So, 80 per cent of the CDDS clients were not millionaires; they were concession card holders getting the dental care they needed.

The government listened to some unusual sources of information. One of them was a doctor by the name of David Rivett, who said just recently, in an AMA publication:

… a loud Hooray for the termination of the—

CDDS—and:

This program has been a real burden for GPs, with patients often supported by family members, aggressively demanding dental funding …

How outrageous! How frustrating for those poor doctors having patients coming in saying, 'We want dental care, and we know there's a scheme that can look after us.' His second criticism is that an 'elderly diabetic' was 'referred for dental care under the scheme to improve her nutrition' and she came back 'two weeks later' with a $4,000 bill, including 'fillings and some descaling work.' I don't know if Mr David Rivett can even read a receipt on dental work—I don't think he's got any dental training—but I am glad that diabetics in this country were getting the dental care they could never get in the public system.

I have one minute left, and I will take you through a very important journey. If you are a sick kid, you were getting care under the coalition's program—$2,125 a year. That sick kid will wait for two years and, when they finally get the care, it will be cut to $1,000 every two years. That will be cut-price dental for that kid. Those sick kids are worse off. Now, children who are not sick have always had to go to private dentistry or public hospitals—and they will still have to do exactly the same thing until 2014. The sick adults that have been getting care under the coalition scheme now have to wait; they miss out—and they will miss out because, if they are not concession card holders, there will be nothing for them, and the paltry $212 million a year transferred to the states will simply be soaked up, but will not make much difference to those dreadful year-after-year waiting lists in public dental. This is a bad move. And the most vulgar part of it is the 15 to 19 months where there will be nothing for Australians in dental care. That is a great shame and that is why we will be opposing the bill.