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Monday, 16 June 2008
Page: 4890


Mrs HULL (6:20 PM) —I rise in the House today to speak on the Dental Benefits Bill 2008, which has been put into the House by the Minister for Health and Ageing. There has been a process of issues on dental health for some time, ad nauseam, particularly in the time that I have been the member for Riverina in this House. Dental health has always been a problem, and there was always an attempt to get the former government to recognise that there needed to be some assistance programs. Eventually they did recognise this and were able to put in place some good and significant legislation that would assist in many areas. We looked at the issues of workforce because workforce is one of the major factors in the lack of dental health care options for rural and regional Australians. Our policy included funding Charles Sturt University, I am very proud to say, to train our dental students in rural and regional areas because, as I have said time and time again in this House, if you train your rural and regional people in rural and regional settings then you are more likely—most definitely—to keep them practising in these settings.

So these programs were introduced. Some of them were actually very effective. One, in particular, was very effective although it had not a lot of time to run. There was some confusion and misunderstanding I think on the part of the minister previously. I have stood in the House and questioned the minister on her statements that the program ran over four years and serviced very few people in that four years, when in fact we know that that is not the case. That was obviously a very strong misunderstanding on the minister’s behalf. At the time, I provided in the House evidence that came from the minister’s own department, which clearly said that the program was introduced by the previous government in November 2007 and was to be withdrawn from the Medicare Benefits Schedule. It certainly did not run over four years, and that was supported by the department.

I would like to go to the Australian Dental Association’s National Dental Update. I always make a point of looking at the National Dental Update from the ADA because they pretty much have their hands on this whole process and they pretty much understand it. They know what it is going to take to resolve the issues for people across Australia in relation to dentistry. That was the case, as well, when we were in government. I am certainly not for one moment standing here and saying that everything was done correctly or that as much as could be done was done when we in government—but, most certainly, we had some good programs.

I would like particularly to quote from this document, the National Dental Update, May 2008, from the Australian Dental Association. I will quote entirely from this document because I think it tells the story. It says:

Labor’s first and much anticipated Federal Budget has finally arrived. It provided an opportunity for the new Government to show its level of commitment to alleviating Australia’s dental health care crisis. Sadly however, the announcements fall ‘short of the mark’ and simply don’t go far enough.

Whilst the Australian Dental Association (ADA) welcomes targeted federal funds for dental care to financially disadvantaged Australians—

I am sure we all welcome any opportunity for financially disadvantaged Australians to get dental care—

it is concerned that the newly created Commonwealth Dental Health Program—

the program that we are speaking about here now—

and the Teen Dental Plan should have been better linked.

Labor’s dental health announcements included ...

It went on to outline the Commonwealth Dental Health program, the $290 million to be provided over three years to state and territory governments aimed at reducing public dental waiting lists, and the one million additional consultations that will be funded for Australians needing dental treatment. Then it proceeded to the Teen Dental Plan and outlined what was in the media on that plan. However, the ADA then continued in the National Dental Update, May 2008, under the heading ‘Commonwealth dental health program—too little for too few’. The article quoted Dr John Matthews, Federal President of the ADA, who said:

The States and Territories of Australia have failed to meet their obligations to ensure proper delivery of dental care to disadvantaged Australians for far too long. The Rudd Government had the opportunity to rectify some of the specific deficiencies that existed by introducing some coordinated plans that could be built upon or modified to meet future needs.

This is where the article gets to the nub of the issue. The Federal President of ADA went on:

Instead it has provided the State/Territory Health Services with additional funding (less than provided back in 1996) to prop up schemes that have not delivered to date.

The ADA had advised the Government that the previous CDHP was deficient. It failed to seek accountability from the States as to their contributions to the provision of dental health.

Time and time again in this House I have raised the issue of the Keating sunset plan—the Commonwealth Dental Health Program that every member has said we came in and slashed—that was never in the forward estimates. It always had a sunset clause and it had no expenditure provided for it beyond 1996. The states took their money out. The program robbed Peter to pay Paul. The program delivered no better benefits than if it had never existed, because whilst the Commonwealth were putting their funds into this Dental Health Program the states, quite greedily, took theirs out and said, ‘We’ll let the Commonwealth foot the bill on this.’

I think that is the serious issue that the Australian Dental Association have recognised. They have recognised that no accountability was asked of the states in their obligations to ensure proper delivery of dental care. That would obviously be a criticism of how the program was run before, and it seems that this has been duplicated in the proposals and the bill that we see before us.

The ADA has clearly said that despite their calls ‘for the creation of an improved CDHP seeking accountability from the states as a prerequisite for funding, such calls appear to have been ignored’. I cannot understand why we continue, as a Commonwealth, to provide this funding to cash-strapped and broke state Labor governments without seeking their assurance that they will continue to put adequate money into dental health services.

I would never complain about money going to reduce the waiting times or to reduce the pain and agony being suffered by many people who cannot afford a dentist. And many cannot access a dentist, whether they can afford it or not.

The problem that I have with the whole process is that, again, it leaves the states unaccountable and we will slip into exactly the same problem that was experienced with the former Keating program—the problem of states determining that they will take their funds out of their programs because the Commonwealth is foolish enough to put money in without seeking from the states an accountable document that they have to stick with to actually make a difference. What will happen now is that Commonwealth money will just be spent and states’ money will be withdrawn, and we will have fudged figures in the long term that give us no real benefit at all.

We hear carping. We have heard that so many times in the House—carping about it being somebody else’s fault: your fault, my fault, their fault. It just goes backwards and forwards. We have heard about ending the blame game, and yet there is no difference on the other side of the House regarding the blame game now that the Labor Party are in government compared to when the coalition were in government. It is equally as bad. There have been no improvements made on that. I would just like to point out to the House that there has to be a true bipartisan view on how we are going to relieve this crisis and the critical issue of the provision of dental services.

I have raised this in the House before: maybe there needs to be some innovative thinking about how we encourage dentists to relocate to rural and regional areas. When doctors came and set up a practice in rural and regional areas we had a program where we could establish medical centres with our rural and regional fund. I have those in my electorate and I am very thankful for the provision of funding by the former government that has provided my communities with medical centres that have attracted some sensational operators. That has been money well spent. My view has always been that we should have the same program to enable dentists to come and set up, because it is very expensive. When a doctor comes into town, he pretty much has a stethoscope around his neck and a little black bag, and he carries out all his X-rays and major consultations—MRIs and anything that he requires to have done—at a medical imaging facility or a hospital, whether it is a public hospital or a private hospital. A doctor does not have to outlay all of the money to put in all of the equipment whereas a dentist does. When a dentist sets up he has to provide and fund his own X-ray machines and all of his own equipment to ensure that he is giving adequate oral health services. It is very costly for dentists to set up.

I would like to see a program—and I called for this when we were in government—that assists with the cost of setting up a surgery. We have the minister putting health superclinics out there. It would be a sensational thing if we could have superclinics that could include dentistry and fit out a dentistry surgery so that we could even have visiting dental officers practising in a dental surgery in a superclinic. They could relieve the chronic issues particularly for pensioners, disability benefit recipients and low-income earners by enabling them to get access to some form of dental assistance.

I can afford to pay a dentist; I do not have any problems in being able to afford to pay a dentist—I am very fortunate. However, I still cannot get an appointment with my dentist. An appointment is nine or 10 months away, and I can pay, so imagine what it must be like in a rural or regional setting when you are on a low income, a pensioner, receiving disability payments or pension, or similar and you are trying to see a dentist. It is simply almost impossible. But we certainly did make inroads with our program, particularly with the Health Insurance Amendment (Medicare Dental Services) Bill 2007. I am very sorry that the minister has seen fit to remove that program, because it was very successful in treating many of the issues—not all of them; it certainly did not reach everybody, but it did reach a lot of people.

As I stand here this evening, I would like to come back to some of the issues that the ADA have outlined and that the minister, I would hope, would give significant thought to, particularly around the Teen Dental Plan. The $150 voucher for a dental check-up for an eligible teenager—and this does not go to all teenagers; I have learnt from past experience that the word ‘eligible’ means the devil is in the detail—will maybe enable a teen to go to a dentist in rural and regional areas. In my electorate of Riverina there is probably an 18-month waiting time before they can book in for a dental check-up, but it will not enable them to then undertake treatment. They will be forced back onto the public sector waiting list, and that public sector waiting list is years and years long.

By introducing legislation, providing money to the states and not seeking clear accountability as to the way in which the states are going to continue to meet their obligations, there is going to be no reduction in these waiting lists. I can vividly remember standing here in the House as a new member and thinking that everything we were doing was just right and that everything that everybody else had done was just wrong. I am pretty vocal in generally saying what I think in the House, whether it is good, bad or otherwise for my standing in my party, but I clearly remember thinking that we were doing all of the right things. I now look back and think that the advocacy towards having dental health as a major component of policy platforms over the years has been made by so many good members of parliament. I have heard advocacy for good dental policy in our party room time and time again. No particularly special answers have been provided with this legislation, just as there were no particularly special answers provided in the last. Each of them has done something and this will do something, but is it what is required? I can only stand here and say that I believe it is not. I would urge the minister to reconsider or to seriously look at the issues associated with states’ accountability, lest we continue to have the problem that we had many years ago where the states immediately pulled their funding out of any program that the Commonwealth propped up. So in my speech here today I am just urging for that accountability to be placed upon the states.