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Wednesday, 19 September 2012
Page: 11295


Dr SOUTHCOTT (Boothby) (18:23): I rise to speak on the Dental Benefits Amendment Bill 2012. What this bill does is implement part of the government's $4.1 billion unfunded dental commitment. Last month, on 29 August, the Minister for Health together with the Greens health spokesperson announced this $4.1 billion unfunded dental program. It involves the closure of the extremely successful Chronic Disease Dental Scheme now and a program commencing not this year or next year but in 2014—well after the next election.

I would like to speak firstly about the Chronic Disease Dental Scheme, which is being closed. The Chronic Disease Dental Scheme was one of a number of measures introduced by the Howard government which showed how flexible Medicare could be and how you could expand access to Medicare. We expanded access to Medicare in the area of mental health. With a referral from a GP, people could access, on Medicare, psychologists and other allied health professionals. We did it in the area of GP care plans. Where a GP decided it was appropriate, there could be up to five allied health visits on Medicare.

And we did it, most importantly, in the area of dental health. This was very much the passion of the Leader of the Opposition. He also recognised that the important thing in dental health was not the checks but the access to restorative treatment. When you consider dental health, one of the problems with past Commonwealth schemes has been a heavy reliance on state dental services. That really ignores the significant capacity of the private sector to deliver outcomes. That is why we did it through Medicare. Many of the government speakers have said that this scheme was poorly targeted and mentioned that there were no income or assets tests. That is the Medicare system. The system is based on universal access. It is a social health insurance scheme based on universal access.

The government have announced that Chronic Disease Dental Scheme will close on 30 November. People who did not already have treatment underway by Friday, 7 September are not eligible for the Chronic Disease Dental Scheme, new services stopped being provided after 7 September, and all treatments must be completed by 30 November. On 30 November, patients will have no access to treatment, and many will be unable to pay for it privately. It is extraordinary that it is the Labor Party who is ripping almost $1 billion a year out of Medicare. They often have a lot to say about the Liberal Party and Medicare, but it was no idle boast that the Liberal Party in government were the best friend Medicare had ever had.

Patients in the middle of complex treatment will be left high and dry, with semi-completed work, when the Chronic Disease Dental Scheme closes. I have already been contacted by a number of constituents who are concerned that they will be unable to complete their treatments by 30 November. This will potentially have serious health consequences for these people, who will be left to languish in the lengthy queues of the state public dental systems.

The Medicare Chronic Disease Dental Scheme was introduced by the coalition government in 2007. It provided for $4,250 in Medicare dental benefits over two years for eligible patients with a chronic health condition who were referred by their GP. Since it was introduced, it has provided treatment to over one million patients and provided around 20 million individual services.

Since coming to power, Labor have continually undermined the Chronic Disease Dental Scheme for their own political reasons. They have attacked it because it was started by the Leader of the Opposition when he was the Minister for Health and Ageing. They have attacked it because it has been successful. They have persecuted dentists for minor and inadvertent paperwork mistakes. They have claimed it has been rorted. Despite the government's cries of expenditure blow-outs, the Department of Health and Ageing has stated that the average claim per patient has been $1,716—well below the maximum limit. More recent estimates claim that this has dropped even further, to below $1,200.

The coalition has offered to work with the government to refine and improve the scheme, to look at things like caps, but these offers have been rejected and the Chronic Disease Dental Scheme has been scrapped. Eighty per cent of services under the CDDS were provided to concession card holders. These people from now on will be forced to go without treatment or to join the 650,000 people on public dental waiting lists.

The coalition supports investment in dental health and we do not oppose the intent of this bill. But we do have some legitimate concerns with the government's proposal. One of the major concerns is where the money is coming from. They made this announcement but with no idea of where they are going to find the money to actually pay for it in 2014. It has been described as a budget saving dressed up as a dental announcement because the government know their budget is in trouble.

The government's announcement leaves patients high and dry for up to 19 months while the government pockets the savings from closing the Chronic Disease Dental Scheme. The government's scheme will provide for a $1,000 capped benefit over two years for eligible children. The scheme will be a means tested entitlement for children aged two to 17 years who are the children of someone receiving family tax benefit A, and it will not commence until January 2015. The adult scheme will not begin until mid-2014. A part of this, $4.1 billion, is for the state governments to receive direct funding for public dental services.

The question I have got is: how does this scheme address the very real workforce issues in the public dental schemes? It is possible you could give more money to the state dental schemes but unless you have got the dentists working in the public sector you will not see those waiting lists, 650,000 people and 400,000 adults, start to come down. Very significantly, as a result of this bill and as a result of the government's determination to close the Chronic Disease Dental Scheme, adults will no longer be able to access services through private dentists under Medicare. The government has removed the access for adults to receive dental services under Medicare.

The bill also does make some minor amendments to the Dental Benefits Act, changing the eligibility age for the current Medicare Teen Dental Plan from 12 to 17 years to two to 17 years of age. The schedule of services, fees and details is not yet available. The government have been very quick to introduce this bill but not so quick to tell us where the money is coming from. They are rushing this legislation through without allowing the parliament the opportunity to properly scrutinise this scheme. The question is: why the rush? The scheme does not commence for well over a year, and after the next election.

The government have acknowledged that many children will not use the $1,000 cap under this announcement. What they have not acknowledged is there will be children who are currently eligible for the Medicare Chronic Disease Dental Scheme who will require more work than the new $1,000-cap. What happens to these children? Over 60,000 services have been provided to children under the Chronic Disease Dental Scheme. Many of these children will be left mid-treatment when the scheme closes on 30 November. These children will then face a 13-month gap until they will be eligible for the new scheme. What do the minister and the government say to these children who will suffer 13 months with incomplete treatment between the closure of the Chronic Disease Dental Scheme and the new scheme in 2014?

What is not clear from the announcements made by the government is how this new scheme sits with the school dental service component of the state dental schemes. There is some variability between what each state does in this area. To what extent is the Medicare scheme replicating what is already happening in the school dental services? Is this intended as a top-up scheme? In many of the areas of joint responsibility, the Commonwealth has introduced a requirement that the state governments maintain their effort. Is there any requirement for state governments to maintain their effort in the school dental services? The question is: to what extent does this replicate what is already going on? Are we going to have duplication or are we going to see state governments actually pulling back in the area of the school dental services?

The coalition is worried that patients receiving treatment under the Chronic Disease Dental Scheme will now miss out on treatment during the gap between the scrapping of the CDDS this year and the 2014 commencement of the government's new dental scheme. The coalition will be moving to disallow the closure of the Chronic Disease Dental Scheme. We will do this to protect those patients who will miss out in the 19 months until Labor's scheme starts in 2014. We are committed to working with the government to refine the Chronic Disease Dental Scheme, including a review of the process for providing high-cost items.

The coalition has been a great supporter of investment in dental health. But closing the Chronic Disease Dental Scheme and removing access for adults from Medicare for dental items is a retrograde decision and will have a serious impact on many Australians with chronic disease.