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Monday, 16 June 2008
Page: 4874


Mr DREYFUS (5:03 PM) —I rise to speak on the Dental Benefits Bill 2008 and related bill. It is no surprise that the member for O’Connor ran out of things to say, because there is indeed not a great deal that the members of the coalition parties could have to say about their record on dental health.


Mr Tuckey —That’s the truest thing you’ve ever said. It’s a dog.


Mr DREYFUS —I am pleased to have the endorsement of the member for O’Connor that the coalition parties’ policies did not provide him with much to say! It was interesting to hear this from him. He said that there had been too much attention paid to money and not enough to outcomes. Well might he say that; for the policies of the previous government in relation to dental care there was—particularly in relation to the Commonwealth dental care program—no outcome, because the primary decision made by the former government immediately on coming to office in 1996 was to scrap the Commonwealth dental program. Well might the member for O’Connor say that not enough attention was paid to outcomes—by the previous government. This government, as part of its commitments to the Australian people made at the last election, said it would take seriously the dental crisis that the country is experiencing. This government is acting, and that is what we see in the legislation before the House. Notably, this legislation will create the Medicare Teen Dental Plan, and that is part of delivering on the commitments made at the last election by our party.

The scale of this crisis is not one which should be understated. Oral disease continues to be prevalent among Australian adults, and it is worth considering some of the national statistics. The first is that one in four adult Australians has untreated dental decay. Tooth decay is Australia’s most common health problem. The second statistic is that one in five Australians cannot afford to get the dental care they need. Additionally: one in six Australians has over the last 12 months avoided eating certain foods because of problems with their teeth; there are about 650,000 Australians on public dental waiting lists; 30 per cent of Australians are reported to have avoided dental care due to the cost of services; and 50,000 people were treated in hospital for preventable dental conditions. I want to speak about the work of some of the community health centres and the waiting list statistics in the dental health area in my electorate of Isaacs, in south-east Melbourne. The Central Bayside Community Health Service has people waiting 39 months for an appointment and 43 months for dentures. The Greater Dandenong Community Health Service has similar statistics—that is, people waiting 39 months for an appointment and 43 months for dentures. The Frankston Community Health Service has very similar statistics.

Each of these community health centres is a very fine local community health service. Despite a major increase in state government funding over the last nine years, these community health centres have found themselves simply unable to meet the demand for dental health services which they are faced with. The lack of Commonwealth government funding to dental health has been a significant contributor to the problems being faced by these community health services.

It is clear that socioeconomic status plays a critical role in determining health outcomes and in no area is that truer than in determining oral health outcomes. There is a very important social dimension to the crisis in dental health, and that is that it particularly impacts on low-income households and upon older people. Commonwealth and, of course, state involvement in dental health is an important public health measure and it is an important social welfare measure. Understanding these facts is important in understanding the scale of the problem.

It is worth pausing to recall and attempt to understand what this discussion about dental health actually means in the day-to-day lives of people. One can do that through meeting people who have been affected by an inability to access dental services. There are very many people in my electorate who have been unable in recent years to access appropriate levels of dental health care. These are people for whom daily life has become exceptionally difficult because, notwithstanding that they live in a prosperous country, they have been unable to access what should be regarded as basic health care. These are people who are chronically ill and have become regular attendees at public hospitals in part because the previous government would not properly address this issue of dental health care.

The fact that there are people in my electorate who have waited years for a dental appointment is simply unacceptable. From the very first day I was preselected as the candidate for the seat of Isaacs in 2006 I was approached by people who had truly appalling stories of the consequences for them of being unable to obtain dental care. These are stories of misery and pain caused by going without adequate care, which has led to problems that have compounded over the years. In very many cases it has led to them being unable to work or to becoming patients at public hospitals with compounded problems that, had they been attended to at an earlier time, might never have arisen.

For the national government to have abdicated responsibility for dental care was short-sighted and indeed shameful. Yet that is indeed what the previous government did on its election in 1996. The previous government abolished the then $100 million Commonwealth Dental Health Program and then for several years did nothing at all. While millions of Australian families were kept away from dental services because of the cost, the previous government did nothing. While hundreds of thousands of Australians were stranded on public dental waiting lists, the previous government did nothing. While tens of thousands of Australians were admitted to hospital for dental conditions that were avoidable given appropriate and timely treatment, the previous government did nothing. Eventually the previous government came up with a poorly implemented and half-baked scheme that assisted far fewer than it was supposed to. The actions of the previous government show in stark terms why the Liberal Party and its coalition partner cannot be left with responsibility for public health. The record of the past 11½ or 12 years shows that the coalition parties do not truly believe in public health programs. The coalition parties do not truly believe in a public health system. For them, any action in this area is simply a matter of political expedience.

For our side, in the Australian Labor Party, access to high-quality health services for all Australians goes to our core values of fairness, equality and compassion. With this legislation that is before the House, indeed with the 2008-09 budget and the new Australian healthcare agreement, this government will address the dental crisis that our country has been facing. Unlike those on the other side, Labor believes that there is a need for government action to protect and improve the health of the Australian people. We believe that government has a legitimate role in this field. I remind honourable members that the government, when in opposition, proposed two very significant programs that would re-establish the role of the Commonwealth in dental health care. The response of those opposite, then in government, to our proposals was to reject them.

This legislation, as I have indicated, introduces the Medicare Teen Dental Plan which, subject to the passage of this legislation, will commence in July 2008. It is a $490 million program which is targeted at those who most need this help. Eligible teenagers aged between 12 and 17 will be provided with up to $150 for an annual preventive dental check-up. It is worth noting that generally Australian children by international standards have excellent dental health but that dental health starts to decline during teenage years. This bill by introducing the Medicare Teen Dental Plan will help to address this problem.

In order to be eligible, teenagers must be living in families receiving family tax benefit part A or be in receipt of the youth allowance. More than one million teenagers will be eligible, on those criteria, for the Medicare Teen Dental Plan. The legislation creates a new Dental Benefits Schedule to operate as part of the broad Medicare arrangements and will include annual preventive dental checks that include an oral examination and other preventive services. Preventive check-ups are very important. It is appropriate that that kind of dental care be funded because it means that problems can be detected and dealt with early. An annual check-up is critical in ensuring ongoing oral health. As has been pointed out, people who visit the dentist for an annual check-up are less likely to attend for a dental problem than those who do not. The plan will help to instil in teenagers the need to visit the dentist regularly and to care for their teeth properly, behaviour that it is hoped they will carry on into their adult lives. Eligible families will receive a voucher from Medicare Australia and will then be able to receive a preventive check-up from their dentist. This will enable them to claim a rebate from their local Medicare office or be bulk-billed by the dentist, with $150 to be reimbursed by the Commonwealth.

I now turn to the Commonwealth Dental Health Program. Through the Australian healthcare agreements that are currently being negotiated with the state and territory governments, the Rudd government is re-establishing the Commonwealth Dental Health Program. This was the program that was abolished by the Howard government upon coming to office in 1996. In contrast to that neglect—indeed, ‘neglect’ is not a strong enough word; it should be ‘abandonment’—of responsibility by the former government, the Rudd government will be providing an additional $290 million over the next three years for dental health.

The Commonwealth Dental Health Program will help the states and territories to fund an additional one million dental consultations and treatments in the coming three years. We are working with the states, not working against them. We are ending the buck-passing and the irresponsible blame game played by the previous government. The Commonwealth Dental Health Program is an example of what can be achieved with the various levels of government working together to deliver policies that address the problems our nation faces. It is part of a broader push to coordinate better the actions of each level of government. It is part of a broader push that we are seeing in many areas of government activity, not simply in this area of dental health care. But, specifically in dental health care, states and territories are going to be required to at least maintain their current funding for their public dental health programs.

This too is, in a very real sense, a targeted program. It will target those in our community who are in the most need. States and territories will be required to ensure that Commonwealth funding is targeted at those who are most in need, such as people living with chronic disease such as cardiac patients and people living with HIV-AIDS, as well as people who have heightened oral health needs, including preschool children, seniors and Indigenous Australians. The re-establishment of a real role for the Commonwealth in the field of dental health, which is what this legislation represents, is a reflection of this government’s belief in the importance of the role of the national government in public health. It reflects this government’s willingness to work cooperatively with the state and territory governments and to deal with the dental crisis presently faced by our nation that the previous government did little or nothing to solve. I commend the legislation to the House.