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Monday, 16 June 2008
Page: 4881


Ms HALL (5:40 PM) —I am pleased to hear the member for Ryan encouraging young people in his electorate to adopt good dental health practices. He might also like to encourage them to access the Teen Dental Plan. This program will benefit young people in the Ryan electorate, just as it will benefit young people in the Shortland electorate. He should be out there making sure that every young person who is eligible to benefit from this program does so. I trust that that will be the action he will take.

This dental benefits legislation recognises the fact that oral health is paramount for overall health. It also recognises that prevention is better than a cure for dental problems, as it is for most health problems. You are much better off if you can prevent the problem rather than have to deal with the consequences. The Dental Benefits (Consequential Amendments) Bill 2008 establishes the legislative framework to allow the government to deliver on a key election commitment. No issue was bigger in the electorate that I represent in this parliament than dental care. People in the Shortland electorate have been waiting for a very long time to access dental treatment. On a daily basis I was hearing from my constituents just how difficult it was to get the vital treatment that they needed.

The government gave a commitment prior to the election to implement the Teen Dental Plan. This is the first part—I emphasise ‘first’—of the government’s plan to improve dental health in Australia. The Teen Dental Plan is going to benefit many young Australians. It is part of the overall plan that the Rudd government has to deliver dental health care to Australians. In this year’s budget the government announced $780 million over five years for these two new dental programs: the Commonwealth Dental Health Program and the Teen Dental Plan. The government will be providing $490.7 million over five years for the legislation we are discussing today—that is, the Teen Dental Plan—and $290 million over three years for the Commonwealth Dental Health Program.

In July 2008 the government will provide towards a preventive check-up up to $150 per eligible teenager between the ages of 12 and 17. I certainly hope that not only the member for Ryan but all members on the other side of this parliament publicise this program and make sure that the young people in their electorates utilise it. It will be available for families receiving family tax benefit part A and teenagers in the same age group receiving youth allowance or Austudy. Approximately 1.1 million Australian teenagers will benefit from this plan. As I said at the outset of my contribution to this debate, prevention is much better than treating the problem.

These bills also provide the legislative framework for the payment of other dental benefits under the dental benefits schedule, and the DBS could be expanded to include other dental benefits items in the future. The DBS is broadly modelled on the relevant provisions of the Health Insurance Act 1973 relating to the payment of Medicare benefits but, unlike the Medicare Benefits Schedule, it is not a universal program. The DBS provides an opportunity for dental benefits to be targeted to specific groups of patients. This program will provide financial assistance to parents to keep their teenagers’ teeth in good condition and to young adults to take responsibility for their own oral health and give them a good start in life.

This is a contrast to what happened under the Howard government. Under the Howard government we saw the Commonwealth dental health scheme withdrawn. This was one of the first acts of the Howard government. At that time I was in the state parliament of New South Wales. As a state member I saw constituents on a regular basis. They were able to get the dental treatment that they needed. Overnight, those dental waiting lists absolutely skyrocketed. The Howard government stands condemned for that one action in relation to dental health—along with many others, I might add. Their failure to continue the funding for the Commonwealth Dental Health Program has created problems for thousands and thousands of Australians.

We need to look at dental health care and what has happened with our dental health over the last few years. Over the last three or four decades, dental decay has actually reduced, but—and this is an important factor—there are still 19 million people with dental decay whose teeth have been untreated. These are people who have not been able to access dental treatment because they cannot afford it or because there is not a program out there that they can use—people who are among the 650,000 Australians waiting on the public dental waiting list to see a dentist and people who did not qualify for treatment under the Howard government’s dental health program. I will talk about that program in a moment. I do not know whether members of this House are aware that each year 50,000 Australians end up in hospital because of problems with their oral health—such as tooth decay or abscesses—and these are non-essential admissions to hospital. If they had had the treatment prior to their dental health condition deteriorating to the stage it did, they would not have been in hospital. That emphasises the need for us to concentrate on prevention rather than treatment.

It is interesting to look at the funding of dental health within Australia. In 2005-06, the combined government expenditure was $995 million, with $480 million from the Commonwealth. As members on the other side of the House have frequently told me, the Commonwealth’s obligation has been met through funding of the 30 per cent private health insurance rebate. Then there was $515 million for the states. I have sat in this House and listened to members on the other side arguing that it is not the Commonwealth’s responsibility to contribute to dental health, other than through the 30 per cent rebate. We on this side of the House do not believe that. We believe it is a Commonwealth responsibility. We believe it is everyone’s responsibility to put money into ensuring that all Australians have good oral health and consequently good overall health. In 2005-06, individual Australians were the ones who contributed the most to their own dental care—$3.5 billion was contributed by individual Australians. We in the Rudd government want to address that. We believe that there is a role for government.

The teen dental health program will put an extra $490.7 million into dental health. The Commonwealth Dental Health Program will put an extra $290 million into dental health. All up, there will be $780 million put into dental health from the Commonwealth government—big change and big moves. This is a significant increase in funding, and it is a move to address the most prevalent chronic health condition in Australia. I do not know if members of this House are aware that dental health problems are the most prevalent chronic healthcare condition in Australia. I base that statement on information from the Australian Institute of Health and Welfare.

The other issue which impacts on people’s access to dental care is the workforce issue. Under the Howard government, the chronic shortage in the dental workforce has ballooned. This is something that we on this side of the House have already taken steps to address in the last budget.

The Howard government’s dental health program was a poorly targeted program. It was only available to people who were suffering from some sort of chronic disease. It did help a number of people, but it also meant that a lot of people in desperate need of dental health care were unable to access it. Pensioners, people who found it very difficult to make ends meet, people who had some sort of concession card and people who were struggling were unable to access the Howard government’s dental health program. It was available to everyone with chronic disease, no matter what their income level was, whereas the programs that we are introducing are targeted to those people who have the greatest need. If you look at the people who have the poorest dental health, socioeconomic factors play a very big part in that. People who have the least money have the most chronic and the worst dental problems.

In the last parliament, I was the Deputy Chair of the House of Representatives Standing Committee on Health and Ageing at the time that we brought down the report, which I have in front of me, The blame game. This is the report that the member for Fadden said that the member for Fairfax had been responsible for. I would like to put on the record that every member of the committee, including the member for Ryan who just spoke, contributed to this report. It was a report that brought down a recommendation that:

The Australian Government should supplement state and territory funding for public dental services so that reasonable access standards for appropriate services are maintained, particularly for disadvantaged groups. This should be linked to the achievement of specific service outcomes.

I am sure it will be no surprise to the House that the Howard government did not even respond to this report. Labor has looked at that recommendation and tonight I have referred to two programs that actually do exactly what recommendation 3 of The blame game report said. Under the dental care heading the report also went through and identified a number of issues. One of them at 3.112 was that dental care should be given in a timely manner. It also recognised the fact that it can significantly affect a person’s life and future health costs. The Australian Dental Association noted:

Like the health system generally, the organisation and delivery of dental care in Australia is characterised by the involvement of Commonwealth, State and territory, and Local Governments. Unlike the health system though, dental care in Australia is largely financed by individual out-of-pocket expenses ...

I refer back to the point I made earlier in my contribution in this debate where I said that in 2004-05, $3.5 billion of treatment had been paid for by the individual. That means that those people who can least afford it are the ones who miss out and in this legislation we seek to address that very issue. A person’s financial ability will not determine whether or not they get dental treatment; rather, it will be determined by a person’s need. The Teen Dental Plan is available for all young people between the age of 12 and 17 and is one that will be utilised by and benefit all people in that age group. It is a preventive program, as opposed to one that targets chronic illness. It is a program that will stop our young people developing chronic dental problems throughout their lives.

Paragraph 3.114 of The blame game stated that there was a need for the Commonwealth to show leadership and that was also identified by the Australian Dental Association. You have no idea, Mr Deputy Speaker Washer, how disappointed I was when the Commonwealth did not show leadership under the Howard government. I was extremely disappointed that they would not make sure that everybody, no matter what their financial status was, was able to benefit from and access dental health care.

One of the other issues identified in this report was the waiting time for public dental health services. Under our programs we aim to address that. We aim to make sure that people do not languish on waiting lists for two or three years and then end up ill and taking up an acute care bed in our hospitals. We have before us today a totally different approach to dental care, an approach that will ensure young people who need dental care will be able to access it. It will happen from 1 July this year when the government will provide up to $150 towards an annual preventive check for eligible teenagers aged 12 to 17 in families receiving family tax benefit A. As I mentioned earlier, this will benefit approximately 1.1 million teenagers who will be eligible for the Teen Dental Plan. The dental treatment services will be for oral examinations and will include things like X-rays, scale and clean and other preventive services.

This will set in place a sound grounding for young people in learning how to care for their teeth. It will ensure that they develop good oral health practices. At the same time, if they need other treatment, they will be able to be referred on to have that treatment. The dental health program is partly funded by the redirection of funds from the previous government’s chronic disease dental program, but this is an ongoing commitment to the oral health of all Australians. It is a new era in dental health and it is recognising that if a person does not have good oral health, if a person does not have in place good prevention strategies, then they will develop chronic problems, and the burden to them and to Australia as a whole will be enormous.

Debate (on motion by Dr Stone) adjourned.