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Wednesday, 10 October 2012
Page: 12004


Mr NEVILLE (HinklerThe Nationals Deputy Whip) (18:32): I rise today to speak to the Dental Benefits Amendment Bill 2012 and the Health Insurance (Dental Services) Amendment Determination 2012 (No. 1). These implement one component of the government's recent dental announcements, which include replacement programs that are targeted at low- and middle-income people and will cost $4.1 billion. The coalition does not oppose the intent of the bill; however, it does have legitimate concerns about a number of issues. Some of these concerns include the point that the programs will not commence until 2014—in the case of children, early in that year; in the case of adults, in the middle of that year—or how the programs will be funded. There are bland assertions that certain amounts of money will be required, but how that money will be raised and how it will be distributed, especially to the states, is another matter.

The main components of the announcement include revision of the existing Medicare Teen Dental Plan to establish the Child Dental Benefits Schedule and the abolition of the Medicare Chronic Disease Dental Scheme, the CDDS. The first is a program that covered teenagers at a time in their lives when they need to have dental work done. All their milk teeth are gone, they are going out into the world, they will need to have their secondary teeth attended to and they will be going to university, seeking jobs or whatever it might be. The plan covered the group from the age of 12 to 18. The new scheme will cover people from the age of two to 18, so that opens the door very wide to the number of people that potentially will be covered.

Let me state from the outset that the coalition supports investment in dental health, and this is evidenced by the introduction by the coalition when in government in 2007 of the Medicare Chronic Disease Dental Scheme, which has had an enormous success. It is the only Medicare dental scheme that provides treatment for adults. This service has already closed to new patients, and I think, quite frankly, that is a disgrace. We know that in many instances it will be 19 months before they can get any treatment—that is assuming they qualify then.

As I have said, the Chronic Disease Dental Scheme was introduced by the coalition and provides $4,250 in Medicare dental benefits over two years for eligible patients with chronic health conditions. It has delivered approximately 20 million services to over a million patients since 2007. That should say something to the government about where the need is. The government has said that this is a scheme for the rich, so when you get a really good scheme and you want to demonise it because it is a Tony Abbott scheme and you want to try to make it look not really successful and it is only playing to the top end of town, you call it a scheme for the rich. But the reality is that 80 per cent of the services under the CDDS have been provided to concession cardholders; four out of every five. Many of these people would have otherwise been forced to go without treatment or be added to the queue at public hospitals and public dental clinics, where the numbers on waiting lists at present are somewhere in the order of two-thirds of a million people; 650,000 people are waiting on those lists. I know of some hospitals where they are waiting for up to seven years. For God's sake, the tooth would be rotted and gone and irretrievable after seven years. So people who fall into that category may get dental treatment, if they are lucky, after seven years.

On 30 November patients will be left without access to treatment. We are talking now about the ones who are currently under the CDDS. Many are unable to afford the full cost of private treatment. Add to this, the government's vague promise of providing money to the states and territories for public services is not due to commence until mid-2014, July of that year, so we are looking 19 months out.

I have had a bit to do with the scheme and one case sticks in my mind. It is the case of a woman who had all of her top teeth removed. That is a pretty horrendous thing for a woman, pride in her appearance, femininity and all that sort of thing. She lost her top teeth. The mouth concaves into the top of her mouth and the fact that she had her bottom teeth meant it looked even worse. She was given a plate by a dentist and she had a defective palate. Because of that, the false teeth in the upper part of the mouth would not stay in. I got on to a person whose correct title I do not know but let us call her the chief dental officer in Queensland, in Brisbane. I told her of this case and asked whether there was money still available under the CDDS as we needed to do something for this woman. She was very good. She got on to the manager of the dental service in Bundaberg. I do not know exactly what they did but I have seen where those sorts of things occur where they built a plate that does not go over the palate but is locked into the jaw by two pillars. She would never in a month of Sundays have got that sort of treatment had it not been for the $4,250. She probably would have gone through the rest of her life with some incomplete solution or bulging or false teeth that fell out for the rest of her days. I think that the humanity of that scheme provided people with care.

As shadow minister Dutton said, there are people who are going through chemo treatment for chronic disorders now and they may not be able to get the dental work associated with that completed before November. What happens to them? You are going through the worst period of life with cancer and your mouth, which is essential to good health, is just going to be put on the scrap heap for 19 months. That is simply not acceptable by any standards. As I said, we are not against the principle of some of the things the government is doing but you cannot put people on the periphery, on some sort of scrap heap, and say, 'We might get to you further down the track.'

A man from Bargara and a woman from Harvey Bay contacted my Hinkler electorate office just in the last few days. They are in the same boat, perhaps not to the same extent as people with cancer but, nevertheless, they will not be able to get their treatment completed by 30 November. That is very sad for them. It is very disturbing to find people in the midst of their treatment not being able to complete that treatment. The end of November, I think, is an unrealistic deadline.

Labor's alternative to the CDDS, the National Partnership Agreement for Adult Public Dental Services, sounds all right on the face of it. They are going to give $1.3 billion to the state and territory governments. I spent 15 years on a hospital board where we had a dental clinic and we worked very hard on dental waiting lists. We considered that a very serious matter. We got the waiting list down to two years at one stage or it might have been under two years, but getting people through the system was almost impossible due to the combination of facilities in the hospital and getting dentists in.

The government says it will give $225 million to the states to develop the needed infrastructure. That will commence in 2014. But to get to there, you have got to assess the hospital or the current free-standing dental clinic, you have got to find out what the repairs or extensions are going to be like, how big they have to be and how many chairs you are going to have. Is it going to be two, three or four extra chairs? Then you have got to get the dentists. In country areas, let me tell you, it is not easy just to pluck dentists out of the air like that. So I would think that it could be 2015, perhaps even early 2016, before the effects of this $225 million—if indeed that is enough—come into play. As we said earlier, we already have 650,000 people on the list of whom 400,000 are adults. So all these other adults that will not be in the government's new program or have been cut out of the CDDS, what are they going to do? They are going to be on a scrap heap. As I said before, that is simply not acceptable. Worse, there is no guarantee that the workforce and infrastructure capacity to deliver the proposed services through the public system will be ready or developed in time for 2014. My prediction is 2015 or perhaps even early 2016. If you have worked on a public hospital board you know how slowly those processes work. They should not work slowly but they do.

When you sum up the scheme, there are some good features in it. I personally think this could have been even better delivered. I am a great believer in the school dental clinics, the caravans that go around to schools and some that are on a semi-permanent basis in schools, because you can get to young kids earlier. I believe we should also make more money available at the top end for adults. As I said, there are 650,000 and 400,000 of those are adults. The ones coming on that would normally have gone on to the CDDS, ones with chronic problems, should be seen immediately but they will be waiting at least 19 months and if they are the unlucky ones waiting for new chairs in some provincial hospitals they might be waiting even longer. I think the government could have done a lot better than this. We support the principle of it, but we think that, like most other measures in health and education, for example, they have made a hash of it once again.