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Wednesday, 10 October 2012
Page: 11975


Ms KING (BallaratParliamentary Secretary for Infrastructure and Transport and Parliamentary Secretary for Health and Ageing) (16:28): Mr Deputy Speaker, I congratulate you on your election to the position of Deputy Speaker. I am delighted that you are in that position and I look forward to a long, constructive working relationship with you. I promise to try to not interject as much as I have in the past.

I rise today to support the Dental Benefits Amendment Bill 2012. I have spoken in this chamber at some length over the course of my time here about the issues with dental care. In fact, I have very strong recollections of many constituents who have seen me over the course of that time with issues of dental health—not just about dental health itself but the social isolation of having poor dental health, particularly for people on low incomes and those from low socioeconomic backgrounds, as well as the lack of employment opportunities many of them have faced and the lack of opportunity to participate within their own communities, in ways that other people would be able to.

Being here for a little while gives you the opportunity also of having some history when it comes to particular public policy issues. I know the member for Wright genuinely means his heartfelt contribution to this debate, but I find it passing strange, frankly, coming from his party, when the first act of the Howard government was to cut the Commonwealth dental scheme. For you to now somehow or other be trying to reinvent yourselves on dental is, frankly, a bit rich.

The Commonwealth dental scheme was a very important scheme. It was the first time a Commonwealth parliament—a Labor government but a Commonwealth parliament—took the decision that the Commonwealth had a role to play in oral health. It was a very important scheme, and what we saw under that scheme was a reduction in public dental waiting lists. It targeted the poorest people in our community, and what it attempted to do was to reduce the gap in equity on oral health issues. One of the first acts of the Howard government when it came to office was to get rid of that scheme. So I have a long history with this. I know what you did in government.

The Howard government got rid of that scheme. The reality of what then happened in my community was: dental waiting lists had got down to around 18 months, which was still way too long; they blew out to four years because of the decisions of the Howard government. Belatedly, the Howard government took the decision to introduce the Chronic Disease Dental Scheme. That scheme was designed to be quite a limited scheme that was going to cost $90 million a year. It was particularly designed to look at people who had a chronic disease and whose chronic disease was being exacerbated by, or was exacerbating, poor oral health. It was meant to be a very limited scheme. It was not a big scheme; it was a very small scheme: $90 million a year. That scheme is now costing $80 million a month. It is doing what it was never designed to do.

I understand that people feel unhappy that the scheme is now to be closed. I understand that the opposition feels unhappy that their scheme has now been exposed for having been literally expanded beyond what it ever imagined it to be. If any members of the opposition honestly believe that if they were in government they would not be means-testing this scheme, they have got to be kidding themselves. You may have decided to keep it, but you would be absolutely cutting it back. You would not be allowing it to be costing $80 million a month. So let us have a really clear idea about what this policy debate is about.

What we have tried to do with this policy is to retarget it. There are scarce government resources; we all know that. That is the reality that health faces. That is the reality that other areas of public policy face. But, with scarce government resources, governments have to make decisions about: 'What are the most important areas? What are the areas that we believe most strongly need government assistance?'

What we believe, fundamentally, on oral health is that you have to look at the equity issues. You have to look at what is happening for people who are on low incomes. You have to look at pensioners. You also have to look at what you are doing in the space of prevention, because we do know that if we set kids up with good oral health to start with, the chances of us experiencing, down the track, some of the chronic conditions that we have now are going to be lessened.

It has been a complete shock to me to find, when I have gone into childcare centres and schools in my constituency fairly recently, that there are four-year-olds who have blackened teeth. That is not acceptable under any circumstances. We have to do something about that. I have heard a few contributions from members opposite about four-year-olds, saying, 'Prevention is not really a big deal. Kids don't have problems with their teeth.' Well, you need to start to have a look at what is actually happening. In communities like my own—and we have not had fluoridation of water; it has only recently been introduced—the rate of dental caries amongst children is huge, and it is an ongoing, long-term issue for those people. Most of them have lost their teeth well and truly by the time they are teenagers. It will be too late if we leave it until they have a chronic disease and then try to do something about it.

So the package of measures that we have in this program and that are represented in this bill are very much designed to actually deal with prevention. They are actually designed to continue to help people who are on low incomes but to target it in a better way. That is what we are trying to do. So I do not want to hear this nonsense that there has been no policy thought in this. This is all about policy; it is absolutely about policy.

The other issue that seems to have been continuously raised, and which the opposition does not seem to acknowledge at all, is that in fact many of the people who are eligible under the Chronic Disease Dental Scheme will be eligible for public dental services under this scheme. We are trying to undo the damage the Howard government did with the abolition of the Commonwealth dental scheme. We are actually trying to reduce public waiting lists. It is critically important that we get those waiting lists down so that people can actually access what they historically should always have been accessing by spending more money on public dental care, which is an incredibly important thing to do to get public dental waiting lists down, to do what has been done historically throughout this country, to support the state governments' initiatives to actually look at public dental care and how you actually deal with and help people from low socioeconomic backgrounds. It is about equity in oral health. That is what the policy is all about.

So I really do support this bill. I certainly support the closure of the Chronic Disease Dental Scheme. I want to reassure people that pensioners, concession card holders and those with special needs will be eligible for treatment under the government's scheme. It is a $4 billion-plus dental package. Our $515.3 million commitment in the May budget to dental spending includes $345 million specifically for taking care of adults on state government public dental waiting lists. The money will be available to states' and territories' public dental systems from January 2013—that is, one month after the closure of the scheme. States and territories have always been responsible for the treatment of eligible high-needs patients in their public dental systems, and with this extra Commonwealth money they will be able to treat more people sooner. The members opposite fail to tell their local communities about that assistance and continue to run a fear campaign on the closure of this scheme.

I reiterate: the Commonwealth dental scheme has been costing $80 million a month. It was never, ever designed to be that expensive or to cover some of the procedures—and even some of the people—that it currently is covering. This bill before us amends the Dental Benefits Act to replace the Medicare Teen Dental Plan with the new Child Dental Benefits Schedule. That schedule is one of the most significant pieces of the Dental Health Reform Package.

Across the country, as I said, we are investing some $4 billion to improve dental health, and that level of commitment is certainly one I know many organisations have welcomed. We know that there are over 400,000 people on public dental waiting lists. Many of these people are from low-income households and have a high number of family members with untreated tooth decay. On this side of the House we want to support equity in oral health.

What we have seen in some of the stats, particularly for children's dental health, is pretty shocking. Oral health of children has been declining since the mid-1990s. Almost 20,000 kids under the age of 10 are hospitalised each year due to avoidable dental issues. By age 15, six out of 10 kids have tooth decay. Untreated decay and fillings are similar across income ranges, but if you earn more than $60,000 a year you have, on average, seven more teeth than Australia's poorest people, who are on less than $20,000. And 45.1 per cent of 12-year-olds had decay in their permanent teeth. In 2007, just under half—46 per cent of children aged six who were attending school dental services—had a history of decay in their baby teeth.

That is why I am supporting these packages. This is about changing the emphasis of programs to actually look at prevention and long-term prevention for kids' oral health; $2.7 billion is going to 3.4 million children to receive subsidised dental care—what an amazing thing, frankly: actually setting those kids up for a long-term future of good oral health. That is absolutely critical for anybody who is serious about good public policy in this country.

This means that for almost 3½ million children a trip to the dentist is going to be much like a trip to the GP. Across my electorate alone, well over 20,000 children will be eligible for government-subsidised dental care—and they are children from families who receive family tax benefit part A, ABSTUDY, carer payments, disability support pensions, parenting payments, special benefits, youth allowance, double orphan pension, veterans' children's entitlements, or benefits under the Military Rehab and Compensation Act Education and Training Scheme.

They will qualify for the new dental for kids scheme and will be eligible for $1,000 per child every two years. The government's dental health reform package will see $1.3 billion allocated for 1.4 million additional services for adults on low incomes, including pensioners, concession card holders and those with special needs. There is also a further $225 million to support expanded services for people living in outer metro, regional and rural communities.

In this debate I particularly want to focus a little on dental services in my electorate of Ballarat. I have been talking about dental issues for well over a decade. I am very proud to have in the last budget announced a substantial amount of funding for a dental clinic in the electorate of Ballarat. We announced that $8.4 million from the government for a dental clinic to be built within Ballarat. I visited the site of that new clinic recently. It is going to be on the grounds of Phoenix College in Sebastopol in my electorate. That expansion will double the current number of chairs available to 20 and enable a significant reduction in waiting times for dental care. It will increase the capacity to deliver publicly accessible dental services and reduce waiting times from the current 30 months to around 18 months. I would like to see that reduced even further. There are 61,000 adults and children in the region who are eligible for the service.

Under the project, we will see the replacement of aged dental equipment, including oral X-ray equipment, sterilising equipment, an instrument washer and 120 sets of hand pieces and dental hand instruments. Ten of the chairs in the new facility will be available for dental training for students of the dental school at La Trobe University's Bendigo campus. The new dental clinic will cater to eligible people not only from Ballarat but also across the local government areas of Golden Plains, Hepburn and Moorabool Shires and eligible members in the Maryborough community. It is specifically designed to reduce public dental waiting lists in my electorate.

Not only that, we have also provided $2.6 million in funding to develop residential accommodation for the 20 La Trobe University allied health and dental students while they are on their clinical placements at Ballarat Health Services. We want to make sure that we have lots more dentists trained in our region who will hopefully stay in our region. At the same time as they will be being trained they will be providing very important dental services to my community.

I also want to briefly mention that for the first time ever the Ballan community, because of the government's commitment to and funding of the Ballan GP superclinic—the first opened in the country—has access to a dental chair. Putting money into dental infrastructure is a critical part of this package. We have made the commitment as part of this package that there will be funding announced for dental infrastructure, particularly in rural and regional communities. That will increase the capacity of their public dental services and reduce public dental waiting lists. That is very critical, particularly for people on low incomes.

I want to reiterate my support for this bill. This is all about good public policy. I understand the concerns that some people have about the closure of the Chronic Disease Dental Scheme. But I reiterate that that scheme has been doing far more than the opposition ever intended it to do. There is no way that it would keep it in its current form. I support good public policy to address the current and future oral health needs of children and to deal significantly with issues of equity in oral health, particularly for those people who are eligible for public dental services.