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Wednesday, 19 September 2012
Page: 11291


Mr SIDEBOTTOM (BraddonParliamentary Secretary for Agriculture, Fisheries and Forestry) (18:08): For the benefit of the member for Hughes, I notice that he, like the member for Dickson, is either deliberately misrepresenting Labor's dental policy or is just proving that he really does not know what was in, and what is in, the 2012 May budget.

Mr Buchholz interjecting

The DEPUTY SPEAKER ( Mr Murphy ): Order! The member for Wright will cease interrupting.

Mr SIDEBOTTOM: If you listen, you might get the information instead of just trotting ideas out that popped out in a templated answer by the member for Dickson. In the budget, we committed $515.3 million to dental spending, including $345 million specifically for taking care of adults on public dental waiting lists.

Mr Craig Kelly: The waiting list is 400,000.

The DEPUTY SPEAKER: Order! The member for Hughes.

Mr SIDEBOTTOM: I sat and listened to you, thank you—manners. This money will be available to state and territory public dental systems from January 2013, just one month after closure of the Chronic Disease Dental Scheme. So contrary to your comments and to the member for Dickson's comments, the money is there and is available.

Mr Craig Kelly interjecting

Mr SIDEBOTTOM: Thank you, but they are the facts. Read about it, cogitate, ruminate and let it sink in. Australians on a low income should be very happy about the Gillard Labor government's $4 billion dental package. I know I am, even if the member for Hughes is not. This six-year package is great for the country and great news for my electorate of Braddon—an electorate with lower than average incomes and greater difficulty in accessing affordable dental care.

Nationwide, this bill means there will be around 3.4 million Australian children who will be eligible for subsidised dental care just like they are eligible for Medicare funded visits to their GP. This will come in at a cost of around $2.7 billion. This is a lot of money but it is a much needed investment in the dental health care of our younger people. It is also a targeted and much better use of taxpayer funds than previous schemes, which tended to be uncapped and far too open-ended in terms of capacity to pay.

Under this package, our federal Labor government will also provide dental services to more than one million low-income adults and Australians in rural and remote areas, focusing especially on pensioners. Again, this will advantage my region in particular, which is rural and contains remote communities. It also has a comparatively aged population and a proportion of older citizens who rely on the pension for their main source of income. This component will cost around $1.3 billion, and the funding will be provided to the states and territories under a national partnership agreement to expand public dental services for low-income adults. This funding will depend on the states and territories to at least maintain their current level of dental care services. It is, after all, a partnership and it is, after all, an agreement. We do not want to see money skimmed or diverted by states into other areas, which is a practice all too often more the case than not.

In addition to the two components mentioned above, there is $225 million for dental capital and workforce to be provided to support expanded services for people living in outer metropolitan, regional, rural and remote areas. So, Mr Deputy Speaker, if I may, I will take you through the design of the package and its rationale.

The design of this package is based on addressing increasingly poor oral health amongst Australians, particularly people from low- and middle-income families. The need is apparent, which is why this government is acting to tackle it as a priority. Needless to say, those opposite will do as they have done over the life of this parliament—and reinforced by the member for Hughes; surprise, surprise—and vote against it or stymie it. Investment in dental infrastructure will play a key role in supporting the new dental reform package.

Unfortunately millions of Australians do not visit the dentist because they just cannot afford to. We have heard this in our electorates, like Braddon, one after another. Members time and again have raised this matter in and out of caucus. As a government collective we have recognised the problem and we are funding solutions. We know low-income households have more than double the number of family members with untreated tooth decay compared with high-income households. I believe we have a responsibility to ensure the people who are least able to afford to go the dentist should have access to government subsidised dental care, particularly children. Indeed, prevention is the best measure to tackle potential dental health issues.

The kids' dental health package will provide access to dental services to many children who are not currently entitled to access public dental services. There is a distinct, measured need for this. Recent studies showed that children in the poorest areas of the country experience 1½ times the amount of tooth decay and cavities, unfortunately, compared to those in the wealthiest parts. Early intervention can significantly reduce the costs of treatment, limit early extractions and reduce chronic dental disease. The latter is a result of poor dental health care over time, and this aspect of the package is designed to mitigate such an eventuality. Emphasis on child dental care is the most effective use of funding rather than on poorly targeted later-term remediation treatments.

The dental scheme for kids means that parents can decide whether they want to take their kids to the public dental clinics or to their own local dentist. Importantly, it means actually accessing dental specialist care when it is needed by families who struggle to afford such services or are totally unable to.

Children aged two to 17 in family tax benefit part A-eligible families will be entitled to subsidised basic dental treatment. This is capped at $1,000 per child over a two-year period and it aims to address dental decay in children, which unfortunately has been increasing since the 1990s. In my electorate of Braddon, this package applies to around 8,300 families or 15,800 kids—that is nearly 16,000 eligible kids in my region.

Those opposite question why are we funding a range of new dental programs for low-income earners. Why should we change from the current Chronic Disease Dental Scheme introduced by the Howard government? First of all, a fact: one in five of our lowest income earners have not been to the dentist in over five years, if ever. Poor dental health has wide-ranging impacts on speech, sleep, eating and general health and wellbeing—not to mention, in extreme cases, social isolation and depression.

Around 400,000 Australians languish on public dental waiting lists, and millions of people go without adequate dental care. Improving dental health will help relieve the pressure on hospitals and the broader health system. Indeed, I think it is often forgotten just how integral dental health is in the holistic framework of an individual's health and wellbeing. I have often questioned—I am sure some of you have as well—why dental health has managed to be somehow separated from other health related issues covered under Medicare. It is as if our teeth and gums are different from other parts of our anatomy in terms of affecting health and wellbeing and being affected by 'unwellness'—if there is such a term.

I mentioned the current Chronic Disease Dental Scheme before. Why are we acting to dismantle this now? Since being elected in 2007, the government has been trying to shut down the Chronic Disease Dental Scheme and replace it with more effective policies. The Chronic Disease Dental Scheme is not means-tested, which means people with high and very high incomes can get $4,250 free dental care—not subsidised but free dental care—if they are eligible via the medical criteria applied, and this does not include the ability to pay. That is a fact. How can this be equitable or fair or in fact efficiently targeted when there is so much competition for the healthcare dollar in Australia?

It is not targeted, which means patients can get caps, crowns and other, often cosmetic, work at the taxpayers' expense. Now, nobody wishes chronic disease on anyone, but to not apply an income or ability-to-pay criterion on a treatment just does not stand the test of fairness. All the while, people who have bad oral health but no 'chronic disease' have trouble seeing a dentist at all. Added to the inequity I mentioned above, and exacerbating the issue further, is the fact that the cost of the scheme has completely and utterly blown out.

Tony Abbott, the Leader of the Opposition, when he was health minister, said it would cost around $90 million a year; instead, it is now costing almost $1 billion each year, and it still leaves people on public dental waiting lists. The coalition scheme is clearly another example where Tony Abbott did not pay attention to the details—either that or he is not good with numbers.

On top of the cost blow-out, more than 1,000 complaints—which the member for Hughes tried to dismiss statistically—have been lodged about the Chronic Disease Dental Scheme. There has also been widespread, documented misuse of the scheme. This includes some practitioners ordering dentures that did not fit, unnecessary crowns or other work and charging the full $4,250 while doing little or even no work. I note that the Minister for Human Services and his department are currently talking to the Australian Dental Association and the AMA in an effort to deal with anomalies in relation to incorrect claims made in relation to the CDDS.

In contrast to the CDDS, the federal Labor package will address the needs of the Australian community in a fiscally responsible way. We know that people in low-income households are more likely to have poorer oral health than those in high-income households. This package is targeted at people who are least able to pay to see a dentist themselves. At the same time, we will ensure spending on the scheme is sustainable and responsible.

As the new scheme gets closer, more information will be made available to parents, but in essence they will be able to make their claims through Medicare just like they currently do for GP visits. If the dentist bulk-bills for the services, parents will not be required to make any payments. For dentists that do not bulk-bill, a trip to Medicare will see the cost for the service partly reimbursed, along the previously mentioned formula.

So, what about phasing out the current Chronic Disease Dental Scheme? The Chronic Disease Dental Scheme will no longer operate after 30 November. Patients who currently have a GP management plan and team care arrangements or a multidisciplinary care plan which was put in place prior to 8 September 2012 have until 30 November to complete their treatment. Thereafter, the patient will need to pay for the treatment.

The Gillard government, like Labor governments before us, are delivering on our priorities in areas like public health, paid parental leave, aged care and so forth. As I said before, the money that we have set aside in the budget will be available to the state and territory public dental systems from January 2013.

I note that members opposite—certainly the member for Hughes and member for Dickson—continue to support the CDDS instead of backing our fair and sensible reforms of dental policy, which include almost $2 billion for low-income adults and a blitz on public dental waiting lists.

The misused, abused and blown-out CDDS was supposed to cost, as I mentioned earlier, $90 million a year but ended up costing $80 million a month. Let me repeat: $80 million a month, for a scheme that was estimated to cost $90 million a year. I believe the opposition are too proud and too stubborn to admit this has been a policy blunder, so they just ignore the evidence.

Tony Abbott introduced the scheme in the final days of the Howard government and has supported it ever since—the member for Hughes reflects that. Unfortunately, it is poorly targeted, and more than 1,000 complaints were made about the scheme. Those included complaints about dentures that did not fit and so on.

Labor's new investment in dental care began with a $515.3 million budget allocation followed by a $4.1 billion commitment in August. We will deliver on our scheme. It is funded, and it will certainly be eagerly welcomed and appreciated in my electorate.