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Wednesday, 8 February 2017
Page: 379


Senator DI NATALE (VictoriaLeader of the Australian Greens) (18:00): I also stand to support the disallowance of the government's cuts to funding for the Child Dental Benefits Schedule. Let me begin by outlining the problem that we have here. Australia is a very wealthy nation, but we have young people, and people right across the board, who are suffering from very poor oral health. When you look at Australia's level of wealth, you see a disproportionately high number of people who suffer from poor oral health—dental disease and so on. Often people assume that having the odd cavity and having problems with dentures and so on is a minor issue, that it is not as important as other health burdens, but increasingly we are starting to understand just how critical it is to have very good oral health. Apart from the obvious things like infections and pain that poor oral health can sometimes cause, and apart from the issues associated with cavities that can be resolved through fillings and so on, having poor oral health has a very significant impact on people's general health and wellbeing. We are learning now that poor oral health is linked to heart disease and to stroke—a whole range of cardiovascular illnesses are a direct consequence of suffering from poor oral health. Indeed, it is associated with adverse outcomes for women who are pregnant.

It is a very serious problem, and it is not just a matter of the direct health impacts. It has a huge impact on people's wellbeing more generally. If you are missing teeth and do not have dentures, it can be highly stigmatising. If you are sitting there in a job interview, for example, it is automatically a marker that puts you behind the eight ball—likewise if you are looking for a rental property. Having very poor oral health compromises your ability in all these sorts of areas. So it has very serious impacts, both directly through the pain caused by infections and the very serious health impacts of diseases like cardiovascular disease but also through the impact on people's self-esteem—their ability to achieve things in life more generally. It can be highly stigmatising, and people with poor oral health will often find that they do not go out in public because they are worried about what people might think of them. As a GP, I would often see people coming in as a result of a tooth abscess or something similar. They could not afford to go and see dentists, so they would come in knowing they would get Medicare funded treatment. But as a doctor there is not much you can do. You would often give some antibiotics and maybe some pain relief, but what they really needed was specialist dental care. One of the big problems in this country is that for too many people dental care is unaffordable.

So that is the problem. In terms of Australia's approach to dental care, one of the great tragedies, in my view, was that oral health and dental care were excluded from Medicare when Medicare was constructed in the 1970s. We decided for some obscure reason, and people will argue about the history of this, that we would somehow treat the mouth as separate from the rest of the body. So if you have an infection on your forehead, for example, you will get Medicare funded medical care but if you have an infection in your gum or your tooth you will not get Medicare funded dental care; you have to predominantly pay for that dental care out of your own pocket.

What is the solution to all of that? If we were designing the system again, the Greens would have Medicare funded dental care. We would do what the Child Dental Benefits Schedule attempts to do. There is a bit of history here that is worth reflecting on. The Child Dental Benefits Schedule is effectively Medicare funded dental care for children. If you are a kid and you want to go and see a private dentist, you have $1,000 to spend over two years that can be basically funded through Medicare. If you present your Medicare card the dentist will provide up to $1,000 of treatment. So, it is Medicare funded dental care. I am very proud of it, because it was one of the outcomes of the power-sharing government involving the Labor Party, the Greens and the Independents. It is one of the outcomes that we achieved through that period of government—and that period of government is starting to look better every day, when you reflect back on that period and then look at what we are seeing at the moment. It is starting to look more like a golden age of stable government. The Child Dental Benefits Schedule was one of the agreements that we struck with Labor. It was something we put to them and we made it really clear that we wanted to see the start of Medicare funded dental care in this country, and, to the Labor Party's credit, they agreed with the proposal and we now have Medicare funded dental care for 80 per cent of kids. It is the only Medicare funded dental program in Australia. Basically, if you have access to family tax benefit part A—which the families of roughly 80 per cent of kids do—you get $1,000 worth of essential and preventative dental treatment over the two years.

Basically, this allows kids to go to private dentists. We know that 80 per cent of the dental workforce comprises private dentists. Families can access the scheme through the dentist of their choice. It allows you to have a relationship with your local dentist and also, importantly, allows you to avoid those huge waiting lists in the public dental system, which I will get to in a moment. It is really important for those people in regional communities. If you live out bush, waiting lists make access to public dental services nearly impossible. People in regional communities who otherwise would have had to travel for hundreds of kilometres to go to a public dental clinic are able to go and see their private dentist for their children's treatment. All in all, it was a really significant win. If the Greens were in government, we would make sure we expanded it. We would expand it so that we would have Medicare funded dental care for all people. That is what we took to the 2016 election campaign.

To the 2016 election campaign, we took a plan to build on the CDBS—or what I think should be called 'Medicare funded dental care for kids'. We would bring in people from disadvantaged backgrounds. And there are ways of doing that—through concessional status and so on, people who have got health care cards—but ultimately we would like to see a universal dental health care system funded through Medicare. The same way you go to your GP, you could go and see your dentist. That is our long-term plan, and that was the plan we took to the election campaign.

Unfortunately, what we have seen is a government that is ideologically opposed—and this is really important; I think this is a ideological attack. It makes no sense on the basis of evidence. This is a good long-term investment. Having people maintain good oral health is good, as I said earlier, for their sense of self-esteem, but it is also good in terms of productivity. Billions of dollars are lost in productivity because of people who have poor oral hygiene. We would go some way into improving the health debate in this country if we recognised that these preventative interventions actually have a long-term pay-off.

But what we saw was the government moving to cut the funding to the CDBS, or Medicare funded dental care for kids, by $300 per child through this regulation. That was basically one-third of the $1,000 that was taken off. It is a direct attack on those kids in regional communities and those people who are unable to access a private dentist because they simply cannot afford the up-front cost or they do not have private health insurance. It was really an attack on those people. I now understand, from a press release from the minister, that they have effectively read the writing on the wall—one of those rare moments of self-awareness from this government—and they are planning to restore the funding back to the $1,000 per child and to restore the scheme as it was originally designed by the Greens.

I know that the minister has been under some pressure from stakeholders. It is good that the new health minister has listened, and I commend him for that. I would also like to congratulate those stakeholders within the dental community who have put the case to the minister and indeed made their views very clear on this. So, given the minister's announcement, I assume that he will support this disallowance motion—given that he has said he will restore that $1,000.

I have to say, it is very clear that the government has been keen to scrap the Medicare funded dental scheme all along. One of the more disgraceful chapters in this saga was when the government on multiple occasions released fact sheets and sent out information to families and to dentists saying they would no longer be able to receive dental care for their children under the scheme because they had a plan sometime in the future to get rid of it, despite never having the agreement of the Senate.

So on one hand they are saying one of the issues with the scheme is that it is underutilised; and then on the other hand they are telling people they cannot utilise it because they are going to scrap it. What do you expect? They have undermined it at every turn. They have consistently fought to scrap this scheme. They have done nothing to promote it. In fact they have done the opposite. They have provided misleading information to the community to say the scheme will no longer be funded and therefore you will no longer be eligible. At Senate estimates time and time again we have caught the department out with false and misleading information being sent to individuals. Each time they corrected it, and then they returned to their dark old ways of providing people with misleading information.

I have to say that, while we are pleased that the government has finally listened—and certainly the new health minister appears to have listened—and while this is an important scheme for children, and 80 per cent of kids have now got access to dental care through a private dental provider funded through Medicare, one of the real concerns here is what this government has done when it comes to funding for public dental health care.

For those people who do not know, the states and Commonwealth jointly fund public dental health clinics. There are many of them around the country, and they are very important because adults who cannot access this Medicare funded scheme, who cannot afford to pay the up-front cost to go and see a dentist, at least have the comfort of knowing that there is a public dental scheme waiting for them.

One of the other significant achievements through that period of power sharing government was that we got a massive injection in funding into the public dental scheme. We had a significant injection, which brought down waiting lists, which in some places are up to three years. We have people who are waiting for dentures, who cannot afford to pay for them out of their own pocket, who have to wait for three years on a public dental scheme to be able to get dentures so they can just have a quality of life that most of us take for granted. Just reflect on that. We are not talking about cosmetic dental care here. We are talking about people who have chronic abscesses; some of them simply do not have any teeth and are waiting for dentures, and waiting for years. We went some way to addressing that through working with the Labor Party and Independents to ensure that we got a big injection into the public dental system.

What have this government done? They have ruthlessly attacked public dental services. In the 2013-14 budget they promised $391 million for 2016-17 public dental services. How much are we seeing now? $107 million per year. So last year the amount was reduced to about $155 million per year, from that $391 million that was promised. Now they have cut it again and they are saying it is $320 million over three years. That is one-third of what was promised in the 2013-14 budget. They have slashed funding for public dental care. Of all the things, all the priorities, all of the areas where we could make savings—and I could list a huge number of those areas ripe for savings.

We have to decide in this country whether we are going to try and balance the budget on the back of this nation's most vulnerable people, some of the poorest people here, or whether we recognise there is a huge and growing gap between the super-rich and ordinary people and start to recognise what our priorities are. Let's talk about the diesel fuel rebate that goes to the mining industry worth billions of dollars. Let's stop propping up investment in the housing market by subsidising people who want to buy their third, fourth or fifth home. Let's tackle negative gearing and reform the capital gains tax discount.

They are the sort of areas where we can make changes. How about a levy on the big banks to ensure that they pay for the guarantee that they get from government, rather than trying to squeeze a few million dollars out of health budgets, attacking vulnerable pensioners and doing what we saw in today's changes to family tax benefits, where the government is saying that the only way we are going to be able to help families is by hurting them.

We have some choices to make in this country. We have to decide whether we as a nation want to ensure that we have a more equal, more caring society. That means cracking down on multinational tax avoidance and ending the rorts that exist in the property market that inflate home prices for young people, who are being screwed at the moment, and see them continue to be left out of the property market and basically denied an opportunity to own their own home. They are the sort of measures that we as a nation could take, rather than what this government is proposing to do, which is to cut essential services that I think are the foundation of a decent society.

The good news is that the government has seen the light today on the Medicare-funded dental scheme for kids, the CDBS. We are pleased about that. What we would like to see is a move to restore funding for public dental care. As I said, the Greens have said now for many, many years that we think the mouth should be considered like the rest of the body. Going to the dentist should be just like going to the doctor: produce your Medicare card, which is effectively a universal health insurance scheme that means we all get access to decent health care, which includes decent dental care.

The Senate is rejecting this cut to the CDBS. As Greens, we will continue to fight not just to protect this scheme but to build it up; to make sure it is available not just to children but indeed, one day, to all Australians. We will challenge this government to restore that funding to public dental health care and to start balancing the budget by ensuring that we tackle that big and growing gap between the rich and ordinary people in this country. There are so many areas where we could make savings, where we could ensure that we have a sustainable budget position. You do not do it by balancing the budget on the back of this country's poorest and most vulnerable people.