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Tuesday, 9 October 2012
Page: 11534


Mr BANDT (Melbourne) (11:04): After the last election, of which everyone knows the result, the voters of Melbourne put me in the fortunate position of being able to sit down with the now Prime Minister to negotiate the formation of government. On behalf of the people of Melbourne I said that we would support the Labor government on a number of conditions.

We have stood by this government and provided our rock solid and stable support. I am very happy that we are now seeing one of these conditions being met by the introduction of the Dental Benefits Amendment Bill 2012. We said when we sat down and negotiated the formation of government that we wanted to see action on climate change, we wanted to see the study into high-speed rail completed and we wanted significant reform in the area of dental health. As a result of that agreement struck back in 2010, we now have the Dental Benefits Amendment Bill 2012. I am very happy indeed to rise to speak in support of it.

This bill is a big step forward for Australian health care. It heralds a massive investment in the dental health of Australia's children. That is a smart investment and it will be handsomely rewarded in the future. It is also an achievement that the Australian Greens are proud of. By working with the government on this dental reform package, we have delivered for Australians. We have demonstrated what can be achieved by a minority government when different sides of politics work together. It is not a moment too soon that we in this chamber have turned our attention to dental health. Australians are lucky to have an excellent health system. It is a system that, with few exceptions, is there for us when we need it. We have a universal system. Anybody can access it, whether or not they have insurance and whether they are rich or poor. There is room for improvement in our health system, but we can say that no Australian who is sick needs to suffer alone or fear the financial consequences. That is surely something to be proud of.

That is all true unless you are suffering from a certain type of medical problem. If you have a broken toe or damaged spleen, we will look after you. But if the problem is in your mouth you are out of luck. When it comes to teeth, getting help can be out of the reach of many people. This has terrible consequence for the health of the nation. That dental care was left out of Medicare is a historical accident. Today, the vast majority of dentists work in private practice. Spending on dental health mostly comes straight from the hip pocket, either directly or through health insurance. Dentists set up shop where people can afford to see them—generally in big cities and in more affluent areas. Dental care is expensive. That comes as no surprise to any Australian.

That means that for certain segments of the population, going to the dentist is a luxury that they cannot afford. Unfortunately, when you do not get the health treatment that you need your health gets worse. Simple dental decay can become an infected abscess. A cheap filling can become a hospitalisation. Life can become a misery for some people. Because so many struggle to find the money to get to the dentist, dental visiting patterns in Australia are poor. About a third of people do not go as much as they need to for good oral health. About the same number report delaying visits or delaying the treatment that they need due to cost. The data shows that this trend is worsening over time.

If you do not go to the dentist regularly, you lose teeth. You are four times as likely to end up with an extraction as somebody who goes as often as they should. You have four times the decay. You end up with fewer working teeth in your mouth. And unfortunately income is an excellent predictor of oral health: the lower your income bracket, the worse your indicators are. As someone who represents the electorate that of all electorates in the country has the largest number of public housing dwellings, I speak from firsthand knowledge when I say that it is incredibly important for the people of Melbourne that this reform is made. I know that the number of decayed, missing or filled teeth doubles as you go from the highest income bracket to the lowest.

If you are Indigenous, the situation is worse. Indigenous Australians in their late teens have eight times the decay and 11 times the incidence of periodontal disease than those in their late teens in the non-Indigenous population. Older Australians also suffer. One in five people in aged care are suffering pain or discomfort due to dental issues at any time. In regional and rural Australia, services are even more difficult to access, so country Australians fare worse than those of us who live in big cities. All of this adds up to massive inequity.

And the problem is only getting worse. The oral health of our kids was once among the best in the OECD. But it has been steadily slipping. It is high time to act to address this growing health crisis. I am pleased to be speaking to a bill that begins to do precisely that.

The Australian Greens have been campaigning for dental healthcare reform for a long time. Nothing is more important than the nation's health. We recognise this and have made getting dental care into Medicare one of our top priorities for reform. Our vision is for comprehensive dental health care that is universally accessible. We have not been shy about saying that. It is a vision that we continue to strive for and one that Australians share. People know that getting access to adequate dental care can be a challenge. I have spoken to many constituents and others around Australia about it. When you point out that it does not have to be this way—that the country could afford to bring dental care into Medicare—you have an instant policy convert. Why can't it be covered? There is no good answer.

When the Greens signed the agreement with the Labor Party to form government, we made dental health a part of that understanding. We know that reform will be an incremental process, but it has to start somewhere and it started with the Greens. We have consistently defended the role of Medicare. We know that a single-payer model is the most efficient. Australia must avoid going down the road of treating public health care as a safety net, only available for those who cannot afford top quality health care. We do not want a two-tier US-style health system here. It is less efficient and it is less equitable. We should not only not chip away at Medicare but we should expand it. Dental health is the obvious omission.

To advance this cause, we worked with the government to get the National Advisory Council on Dental Health established. They were an independent panel of dental experts tasked with assessing the reform options for Australia. The options that they came up with are consistent with a long-term universal access scheme. This is a goal that many in the health sector share. But this is not just a health issue. It is as much an issue of social justice as a health issue. The pain of poor dental health affects the poor. It affects migrants and those of diverse backgrounds. It affects Indigenous people worst of all. In a practical sense, it can affect your chances of finding meaningful work able to sustain you and your family. If you front up for a job interview with your teeth missing, you are less likely to get that job.

These statistics translate into real consequences for people, such as constant pain, loss of sleep, malnutrition and sometimes even a life-threatening infection. Sometimes the consequence is social exclusions. As I said, getting a job or even getting a rental property is all the more difficult if your health is bad, let alone if you have missing teeth. Imagine being too afraid to smile lest somebody see the gaps and judges you for them. The Greens care for people. Dental health reform is for the people who are falling through the cracks and suffering as a result.

I am pleased to say that we are making progress. By making dental health a priority, we saw over half-a-billion dollars in the last budget put into dental health initiatives as a down-payment on a bigger reform. Now, by working with the government, we have achieved the next phase of reform. In August, a $4 billion dental reform package was announced. This includes $1.3 billion in new money for the nation's public dental services so that they can hire more dentists, build new infrastructure and stay open longer. We also achieved $225 million for grants so that nobody will miss out. Rural and remote communities and other areas that are missing out will be able to access this money to ensure that every Australian has access to services when they need them.

But the biggest reform of all is a new Medicare entitlement for kids, with $2.7 billion to be spent over four years to give all kids in families receiving family tax benefit A access to essential preventative and restorative dental care. That is 3.4 million kids who will be able to go to the dentist of their choice, hand over their Medicare card and get seen. This is the biggest dental reform in Australia's history. It is a big injection of funds and it means millions of Australians will get better care sooner. It is also a better investment. By investing in the dental health of our children, we ensure that there will be a generation of adults who have better dental health than many of us could boast today.

This bill implements the first stage of this reform. It alters the Dental Benefits Act to enable all children in family tax benefit A families to access a schedule of services that will enable them to get good dental care. This entitlement can be used in public or private clinics. You can take the kids to the dentist that you prefer, from the family dentist to the dentist in the school dental van. The entitlement will be for $1,000 in services every two years.

Unfortunately, part of this reform involves the closure of the Chronic Disease Dental Scheme. This scheme had many inefficiencies. It was also inequitable, as it was not means-tested. Some people could get thousands of dollars in treatment while others who did not qualify under the uncertain definition of 'chronic disease' could get nothing. Still, it was publicly funded dental care and we do not deny that many people got treatment. That is why the Greens kept it open for an extra four years while we negotiated something for the future. It is regrettable that some people will lose an entitlement, but as part of this package we have ensured that the public system will have as many extra resources as possible so that those in dire need will have somewhere to go. In the end, the new reform will lead to greater equity. More people will get the services that they need to stay healthy.

The Greens believe that everybody deserves access to the best in dental care. Nobody should miss out. We will continue to build on this reform until we have achieved that vision and nobody is excluded. This bill is consistent with that goal. By establishing the Child Dental Benefits Schedule we have taken a big step towards universal dental care, giving 3.4 million young Australians access to Medicare funded dental care. But it is only a first step. One day, going to the dentist will be like going to the doctor. We are a rich nation and we can afford to do it. We should strive to lead the world in health care. There can be no better way to spend the dividends of our prosperity than on better health care. There can be no more equitable way to spend than to share that care with those who presently cannot afford it.

Yes, we are not there yet. If we had our way, the Greens would get us there much faster. This bill and this reform involved many compromises. But they serve as an excellent example of what a minority government can do when people from different sides of politics get together to work in good faith. I congratulate the government on this reform and I am proud of the role that the Greens and the people of Melbourne have played in it. It will make a difference in the lives of many people, and not a moment too soon. I commend the bill to the House.