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Wednesday, 10 October 2012
Page: 11989


Dr MIKE KELLY (Eden-MonaroParliamentary Secretary for Defence) (17:26): This afternoon I am very pleased to speak to the Dental Benefits Amendment Bill 2012 before you, Mr Deputy Speaker, because I know that your great concern has been health in rural and regional Australia, as it has been for me. Many of the points that were made by my friend the member for Hasluck have struck home to us. It is a declining situation that is much more severe than can be found in our urban environments. As we all know, that is part of the vicious circle we have in rural and regional Australia: if you do not have health services and good education you start to see people drifting away from country towns. You cannot even attract the professionals who would support a health system, such as doctors and dentists, because so many of them are looking for those kinds of facilities for their own families when they move to live in rural and regional areas. Sixty per cent of doctors now coming through the system are women and they are obviously much more cognisant of issues like supporting a family in a rural or regional environment. So this is critically important to us.

In an extensive survey I conducted of my constituents, I had over 7,000 responses. I am not sure whether many MPs have had such an extensive response to a survey. Of those 7,000 responses, 99 per cent indicated that health was their No. 1 issue. This was obviously something we have to come to grips with. Let's be frank about this: the Howard government dropped the ball on health. We saw the current Leader of the Opposition, when in the health portfolio, rip a billion dollars out of the system and change the mechanism for the proportion of Commonwealth contribution. We were also seeing a situation where health budgets in the states were becoming unsustainable. We knew that in New South Wales by 2045 the health costs will consume the entire state budget. So we are on a track that just cannot be sustained.

I am really proud of what this government has done in that policy area—biting off a huge public policy challenge for groundbreaking reform that has put us on a sustainable track and has broken up the funding responsibility. Mr Deputy Speaker, I know that in your area and in my area we are seeing huge advances in health services as a result. I will come back to that. This is another really important step in that process.

My friend the member for Hasluck referred to some important issues about the associated health effects of dental issues. There is a lady in my electorate whose husband died from septicaemia due to a dental health issue. A young fellow at Captains Flat, from a very low-income family, had been waiting two years to be seen by a dentist, and in the meantime the dental problem really exacerbated. Eventually, he had to drive to Sydney to get it sorted out, and of course there was the expense of driving to Sydney and paying for accommodation. He eventually lost a large number of his teeth as a result of the dental problem. That was a really reprehensible situation.

The Leader of the Opposition was responsible for throwing up this CDDS scheme at the last minute, in the last gasping days of the Howard government. What we saw out of it was a scheme that was intended to cost $90 million a year blow out to $1 billion a year. It was costing almost that yearly budget per month. Clearly that is unsustainable. But worse than that, we had a system that was not targeted—that was obviously being exploited for cosmetic dental surgery by people who did not need to be supported by a scheme like this. It was not means-tested, so we had wealthy people getting paid by the state for their cosmetic dental surgery. That is outrageous and is unsustainable. Obviously, something had to be done about that. We knew there were about 1,000 complaints being made about that old scheme and it was not getting to the people who really needed the help. We had a huge waiting list—400,000 people out there on dental waiting lists—and it was just not right.

In this area we know that an ounce of prevention is worth a pound of cure. You can save a hell of a lot of money down the track in our system if we invest more heavily in preventive health. The key to that in dental health is working with the kids. If you get the kids off on the right track with dental health, you are not going to have these exacerbated and amplified problems in the scheme down the track. So the beautiful thing about this package is the focus of it. We are seeing a $4.2 billion package—nothing to be sneezed at there, a huge commitment to bring us on the right track with dental health—which is broken up into $2.7 billion to address that preventive health measure for our kids and $1.3 billion for about 1.4 million low- and middle-income earners around the country who most need that help. Another component is $225 million for rural and regional issues in relation to both infrastructure and workforce. I will come back to that. In relation to my patch, Eden-Monaro, that is 17,114 kids who are going to be benefiting from that focus on their dental health in particular. Obviously that is going to achieve great health outcomes for them and get them on the right foot.

My friend the member for Hasluck need not worry about this gap issue. The only gap we are going to be fixing is the dental cavity gap. The system at the moment works in conjunction with the states. We are going to be putting $345 million into immediate employment to reduce that massive 400,000-person dental waiting list. That will take effect immediately, and in conjunction with the states we will see support for those receiving this dental support continue with the great alleviation of the state situation by not having to take responsibility for children through the $1.3 billion being injected to sort out their situation. They will be able to commit extra resources to continuing to sustain support for those under the CDDS scheme. So obviously the scheme is well designed to cater for the fact that we need to continue support for those people who most need it.

We know that the scheme needs to be efficient and easy to administer, and parents in relation to their kids will be able to make their claims through Medicare just as they do for normal doctor appointments, so there will be quite a lot of simplicity there. We are going to make sure that we bed down the scheme and take a great deal of care with it so that by the time 2014 comes it is a smooth, efficient system. In the meantime we have waged war on that waiting list and make sure that we have cleaned up the backlog of 400,000 as far as possible. Obviously there is very important targeting in the scheme to deal with the issues that are most important and essential in relation to oral health but not cosmetic surgery, as the current scheme was dealing with.

I come back to the point about investment in the rural and regional areas that I know is of concern to the member for Hasluck and me. It is $225 million. What does that translate to in my patch of Eden-Monaro? That funding is going to enable the expansion of existing dental services that are providing support to our community in Goulburn. A lot of my constituents from Braidwood and Bungendore go to Goulburn for support. There are also Yass, Queanbeyan, Cooma, Moruya and Pambula. Those services will be expanded. One of the big holes in health service in our region was the state of the C2 regional hospital in the Bega Valley. Now we have seen the Commonwealth commit $160 million, $10 million from the state, to build a new state-of-the-art facility.

Within that state-of-the-art facility will be a state-of-the-art dental suite that will be the recipient too of the support from this new scheme. Until then we will see services continue to be provided by Pambula and Moruya facilities on the coast, by Queanbeyan and Cooma facilities in the high country and by facilities in Goulburn and Yass. This is a great investment in our rural and regional services. Some of that money will also go towards helping workforce issues and towards attracting dentists to the region. Funding of about $77.7 million from the Dental Relocation and Infrastructure Support Scheme will provide up to 100 infrastructure grants to accompany that funding as well. These grants will support up to about 300 dentists in setting up practices in rural areas to meet the current shortage of services. My friends who have rural and regional electorates should be really pleased to welcome this.

I mentioned that this reflects the Commonwealth's investment in the lack of services in rural and regional areas. What we see in Eden-Monaro is effectively a package of $327 million to address what was a screaming gap, a gaping hole in those services, and I am proud of that. In addition to the state-of-the-art hospital I mentioned, $30 million is committed to establishing training and accommodation facilities in Moruya, Bega and Cooma to attract student doctors and nurses. If we develop them and their attraction to an area like mine, they will see the lifestyle advantages and then stay on and provide the services that we need. The facilities will attract them as well because we know that is a big issue. Our investment in facilities has helped us to attract extra doctors into the region.

We have seen a massive investment in primary health services right around the region as well. Lots of $500,000 grants have enabled the expansion of training facilities, rooms and services to attract additional doctors and students. Those grants are having a big impact in places like Cooma with the Bombala Street surgery, in Moruya with the Queen Street surgery and the just recently opened facilities at Pambula medical practice. It is really starting to have a significant effect. I am pleased to note the development application has been approved for the transitional care facility at the Moruya Hospital, which was another 2010 election promise delivered to the community. I am really pleased to see that.

It is a total transformation that is going on right across the Eden-Monaro landscape in health services. This is being mirrored and replicated right around the country, right around this nation and is getting us finally in the place we needed to be in supporting rural and regional communities.

The member for Hasluck also mentioned workforce issues as a big problem. It is only going to get worse in New South Wales as a result of the $3 billion slashing of health funding by the O'Farrell government. This is outrageous. This is in addition to the crime that is being perpetrated on our TAFEs and schools in the $1.7 billion cut there. But this $3 billion hit on our health facilities in New South Wales by the New South Wales government is going to be a major setback for what we are trying to achieve. The estimate is that from these cuts we will see something like 3,600 jobs lost in health services. That is on average more than 16 doctors, nurses and allied health professionals sacked from every hospital right across the state. There is no way you can cut $3 billion from the system and not affect seriously the delivery of frontline services. Unfortunately we are seeing a replication of the Sydney-centric approach by this government too. The bulk of the focus of the Infrastructure New South Wales report that has just been handed down is once again on Sydney. We saw very little reference to the needs of rural and regional New South Wales in that report, which is extremely disappointing.

As opposed to the New South Wales approach to cutting and affecting frontline services in health and education, the Commonwealth has achieved savings through efficiencies. We have achieved more than $13 billion worth of efficiencies in the public sector through reducing wasteful spending on travel, better ICT management and more efficient Commonwealth property management—that alone saved $1.2 billion.

There are things like taking greater advantage of online recruiting, instead of newspaper advertising. We have saved $30 million there. If the New South Wales government wants to save money, I accept that; we are all under budgetary constraints and tight situations right now. I would not for a minute complain about attempts to achieve savings to put more emphasis on frontline services, but that is not what we are seeing from this government. They have a lazy approach to cutting—slashing and burning—that is going to hurt not only our situation in relation to health.

We all appreciate how important our TAFE colleges are to rural and regional Australia. I have four of them in my region—in Moruya, Cooma, Eden and Queanbeyan. They are providing great support to the trade training centres that we have built at Bombala High, Eden Marine High and Bega High, supported by the TAFE colleges in Cooma and Bega. We just cannot afford to have this vandalism to our system. Education is an investment in our future and, in conjunction with better health facilities, it will be the way that we maintain our vibrant demographic balance in our rural and regional communities. So I would urge the New South Wales government to think again about these cuts.

But in relation to this dental reform I salute the minister for what she has achieved here. It will transform the landscape in relation to dental services in rural and regional Australia, as well as the nation generally, and I am extremely pleased to be able to support it.