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Wednesday, 10 October 2012
Page: 11969


Mr MELHAM (Banks) (16:01): Mr Deputy Speaker Scott, at the outset can I congratulate you on your appointment as Deputy Speaker. You and I were elected into the parliament on the same date, 24 March 1990—a long time ago—and I know that you have taken great delight in your previous duties as a Deputy Speaker of the parliament, and it is a testament to the high esteem in which you are held that you were elected to this position. It is also a testament to you that you have staved off the ambitions of one from the other side, who, legitimately, has expectations, but the work that you have done over the years has been recognised both at the local level and at a parliamentary level, and I wish you all the best in the discharge of your duties.

As previous speakers on the Dental Benefits Amendment Bill 2012 have indicated, its purpose is to extend the existing Teen Dental Plan to include younger children and to extend the range of services available. This will be done by amending the Dental Benefits Act 2008 to set up the framework for the Child Dental Benefits Schedule to commence in 2014. This is the first step in this government's plan to ensure that, for those who cannot afford it, dental care will be available. It makes no sense that Medicare and free hospital care have been available for many years yet dental care has been unaffordable.

Statistics show that the oral health of our children has been declining since the 1990s. The Australian Institute of Health and Welfare noted in its 2007 report on 30-year trends in child oral health:

Just under half (46%) of children aged 6 attending school dental services had a history of decay in their deciduous (‘baby’) teeth—that is, one or more decayed, missing or filled deciduous teeth (dmft). On average, children aged 6 had almost two dmft per child (dmft = 1.95).

The report went on to say:

Thirty-nine per cent of children aged 12 and 60% of children aged 15 had some history of decay in their permanent teeth …

What was distressing was the high number of children who by the age of 15 had significant issues with their teeth:

The one-tenth of children aged 12 to 15 with the most extensive history of permanent tooth decay had between 5.21 and 8.60 permanent teeth affected, which was more than 4 times the national average of decayed, missing and filled teeth for children of those ages.

Child dental benefits will provide benefits for basic dental services for treatment but, most importantly, given the statistics I have quoted, will also provide assistance for preventative care. Simply being able to ensure regular check-ups and access to professional expertise means that those figures should reduce in coming years. By learning to look after their dental health and not fearing a trip to the dentist means that our children will be able to look to a future with good oral health.

A background note from the Parliamentary Library published earlier this year provides an overview of universal dental schemes. The note makes the point that the definition of exactly what constitutes 'universal' varies. The paper acknowledges that affordable dental health care generally remains out of reach for many Australians. Several reports over recent years have highlighted the issue of poor dental health and access to affordable dental care.

The background paper outlines briefly the history of dental reform in this country over the past two decades. It is worth putting on the record:

The Keating Government introduced a Commonwealth Dental Health Program in 1994 which provided additional funding to states and territories for public dental services for those on low incomes. The Howard Government abolished this but introduced the Chronic Disease Dental Scheme (CDDS) which provides capped Medicare benefits for dental treatment to patients with chronic illnesses. The Rudd Government introduced the Teen Dental Plan—a means tested voucher entitling eligible teenagers to an annual dental health check-up—and promised a revamped Commonwealth Dental Health Program (CDHP) that would deliver an expanded range of public dental services.

Obviously, the government is moving to implement that promise. The minister indicated in her second reading speech that this bill is the first step in implementing the government's reforms.

Federal involvement with any type of provision of dental services started with the introduction of the Whitlam government's school dental program from 1973. This program aimed at providing comprehensive dental treatment for all schoolchildren less than 15 years of age. Trained dental therapists provided the service under the supervision of dentists. The Commonwealth provided funding directly to the states for the implementation of this program although it was effectively subsumed under the Fraser government. Most states and territories, however, maintained some form of dedicated school programs to varying degrees.

I earlier noted the Chronic Disease Dental Scheme. The figures provided by the Parliamentary Library show that, in the three months from November 2007 when a revised version of the scheme was introduced, 171,000 dental services were accessed and around $21.8 million paid in Medicare benefits. From March to June 2008, the number of services increased to 480,000—more than double—with an associated increase in Medicare benefits to $79 million. It is interesting that the majority of services were provided in New South Wales and Victoria with only 184 services provided in the Northern Territory.

The problem with the CDD Scheme has been that some of those benefiting from the scheme were not intended to benefit. One of the key differences between this side and the other side of this chamber is that this government is ensuring that available funding is targeted to those who need it: people on low incomes receiving family tax benefit A or who are in receipt of specified benefits. This is how it should be.

The background paper concluded that, while it is difficult to make direct comparisons primarily due to definitional issues, it is fair to say that, where there is direct dental funding and services provided to children, those children under 12 tend to have lower rates of DMFT—in other words, decayed, missing or filled deciduous teeth.

Currently, Australians primarily meet the cost of their own dental health services; however, it is now understood that there is a public benefit for public funding to support them in meeting these costs.

Poor dental health, as we have seen, is associated with a range serious health conditions such as poor nutrition, cardiovascular disease, stroke and diabetes that can place other burdens on the health system. I would also be contending that treating funding of basic dental services differently to other medical services is contrary to the view that oral health is integral to overall health and an important part of primary health care.

In our community the problem starts young—and I will come to that in a minute. Dental health is one of the first things to go if people are struggling and has a big impact on their lives. That is why the federal Labor government believes we have a responsibility to ensure people who are the least able to afford to go to the dentist, particularly children, have access to government subsidised dental care.

In May this year the minister visited a public health surgery in Hurstville in my electorate. The funding will deliver two additional chairs to that surgery. About 16,400 kids in Banks will now be eligible for government subsidised dental care, just like they are eligible for Medicare funded visits to their GP. As part of the government that has introduced this equitable scheme to benefit those who can least afford dental care I am pleased to commend the bill to the House.

I have had personal experience in the benefits given to people who could not afford dental care. I am one of 10 children. I was born in 1964. My father was a bootmaker and a market gardener. We could not afford dental health care in the sixties. My dental health care came about by getting on the train and going to the dental hospital at Central, so it was the dental hospital at Central that worked on my teeth as a young child. Obviously, as I grew older I went and paid for it.

We need, on both sides of the House, to get these benefits to those who can least afford it. It has a great impact on nutrition, diet, everything else, and those statistics in the Northern Territory show that something is sadly missing if that was the take-up rate.

We should not apologise as a parliament, as a government—indeed as an opposition—on some aspects. We might disagree on certain things, but there are some aspects that we should not disagree on. I am not into welfare for the middle and upper classes and welfare for the business community when it cannot be afforded but I make no apologies for those who can least afford it in our community having decent services and standards. When it comes to dental, we have a mandate. Only eight referendums have been passed in relation to the Commonwealth since Federation. One of them related to giving the Commonwealth the power in relation to dental—that was a referendum passed in the forties. We have a mandate to do it, and it is not something we should be doing exclusively; it is something we should be doing in cooperation with the states and in cooperation with the territories. It should be a partnership approach and we should make no apologies for it.

It is something that I would rather see happen, frankly, than give a tax cut to people who have had the benefit of the tax cut and that tax cut has continued year in, year out and then you hear the cry: 'Too much tax for business. Too much tax for the top end. Where are our further tax cuts?' I am not opposed to tax cuts per se, but if we are left with options we need to be fair dinkum about what is in the interests of our community. We need to make some strategic decisions, and that is why in relation to what the government is doing, this is a strategically correct decision in the society that we have. I commend the bill to the House.