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Monday, 21 May 2012
Page: 4883


Mr LYONS (Bass) (11:39): I rise today to speak on this legislation introduced by the member for Dickson in March this year, the Health Insurance (Dental Services) Bill 2012. A lack of universal access to high-quality dental health services has a significant impact on the health outcomes of Australians. As seen in our recent budget, delivering more affordable oral health and improving access to dental services for Australians is a major priority of the Gillard Labor government. We have much work to do to improve dental services. A prime example of this is the Chronic Disease Dental Scheme, where people are able to get high level crowns and bridges and cosmetic work, whilst there are children in rural and remote communities who cannot see a dentist when they have rotting teeth. We need a targeted dental system that sees money go to where it is needed.

The Chronic Disease Dental Scheme was established by the member for Warringah at the 11th hour, before the 2007 election, when he was health minister. It was a lemon. Since the inception of the scheme, $19.97 million has been identified as being incorrectly claimed from Medicare by dentists. The Chronic Disease Dental Scheme was designed to allow patients with a chronic condition to access up to $4,250 worth of dental services as part of their treatment for that chronic condition. Patients are referred to a dentist by their treating GP. There has been much criticism of this program since its inception. Much of it has revolved around the use of the term 'chronic condition'.

There have been a number of recent media reports about dentists who are being required to repay incorrectly claimed benefits. Like all health practitioners claiming Medicare benefits, dentists must fulfil all of the requirements when making a claim. This is no different from anyone seeking to claim public money for any cause. The government has a responsibility to ensure taxpayer dollars are spent appropriately. We make no apologies for this. Dentists have been provided with regular information about what they need to do in order to make a claim.

Whilst the government believes that that CDDS was poorly designed, the rules governing the scheme have been publicised to dentists many times by both the government and the Australian Dental Association. This communication includes several direct letters, journal articles, fact sheets, a booklet, a phone inquiry line, website information and a compliance checklist.

A number of steps were taken to ensure that dentists had the opportunity to understand their legal obligations prior to submitting claims for Commonwealth benefits. In September 2007, prior to the commencement of the scheme, the then health minister, the Hon. Tony Abbott MP, wrote to all practitioners and outlined the scheme's requirements. I am also advised that, upon commencement of the scheme in November 2007, the Department of Health and Ageing wrote to all dental practitioners, dental specialists and dental prosthetists describing the scheme and its requirements. The Department of Health and Ageing also issued a fact sheet, as well as the Medicare Benefits Schedule Dental Services Book, which specifically outlined the requirements of the scheme and the related eligibility criteria.

May I also note that included in this reference material was a referral to a Medicare Helpline and a checklist designed to further assist dental practitioners in complying with the requirements of the scheme. The checklist appears in the same booklet that dentists would refer to to check Medicare item numbers for claiming purposes. There should be no grey area with regards to what a dentist could claim. Medicare has an obligation to ensure compliance with the legislative requirements of the scheme and to ensure the taxpayer funds are paid out in accordance with the law. This is reasonable and it is what the Australian people rightly expect. The audits undertaken by Medicare are not random in nature. Practitioners are selected for audit as a result of complaint or tip-offs received from members of the public and/or where high claiming patterns raise concerns. Currently, less than 100 audits have been closed with fewer than 50 dental practitioners required to repay incorrectly claimed benefits.

In order to make a claim, dentists are required to inform patients and the referring GP about the course of treatment the patient will receive and make sure the patients understand the full costs of the treatment they receive. These aspects have never been voluntary. They are set out in Health Insurance (Dental Services) Determination Bill 2007

Medicare has provided dentists and the Australian Dental Association with regular information about their obligations on dozens of occasions. We know that Medicare conducts audits in a fair and professional manner, giving dental practitioners time to respond to audit requests and present information while still providing ongoing care to patients. Yet many dentists claim to be confused.

It has long been the Gillard government's policy to close the Chronic Disease Dental Scheme. While the CDDS provides services for some parts of the population, is not well targeted to provide assistance to access dental services to those Australians most in financial need. We have been clear on this. However, the Senate has twice prevented the closure of the CDDS, which means the government has been unable to put in place a more appropriate scheme.

Since 2007 the government has made a range of other important investments in dental health, including the establishment of the Medicare Teen Dental Plan, which provides up to $163.05 per person towards an annual preventative dental check. Since its introduction, this program has provided over 1.5 million checks for eligible teenagers, $11 million for Indigenous dental services in rural and regional areas and $52.6 million over four years in the 2011-12 budget to establish a voluntary dental internship program to help boost the dental health workforce. These welcome moves were warmly received.

The $515 million investment in dental health announced during the recent budget will lay the foundation for a new way of providing dental services, ensuring those most in need will receive care when and where they need it. The government is making a targeted investment of $515.3 million over four years in oral health for Australians who are least able to afford dental care. The new spending will see a blitz on public dental waiting lists, oral health promotion, a boost to the dental workforce and improved dental facilities in rural and remote areas. This package includes the important foundational work needed to make significant improvements to the dental system and represents a major step towards a new national dental scheme.

The 2012-13 budget included funding of $345.9 million for a public dental waiting list blitz, which would, according to the National Dental Advisory Council, address the current 400,000 people on waiting lists around the country; $10.5 million for oral health promotion and to develop a national oral health promotion plan to promote dental services and better oral health; $35.7 million for an expansion of the Voluntary Dental Graduate Year Program to offer 100 places per annum from 2016 to increase the dental workforce to deliver more dental services through a national scheme; $45.2 million for a graduate year program for oral health therapists to support 50 placements per annum; $77.7 million for rural and remote infrastructure and relocation grants for dentists to provide up to 100 infrastructure grants and up to 100 relocation grants to support up to 300 dentists in setting up practices in rural areas to meet the current shortage of dental services in rural and remote areas; and $450,000 to non-government organisations to coordinate further pro bono work by dentists.

Anyone claiming funds from the Australian taxpayer has an obligation to do so in accordance to the law. Dentists are no exception. Quite simply, the government does not support this bill. It is the government's intention to close the CDDS and put in place more appropriate policies. I therefore reject this bill.