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Wednesday, 18 June 2008
Page: 2666


Senator COLBECK (11:57 AM) —The Senate is considering the Dental Benefits Bill 2008 and the Dental Benefits (Consequential Amendments) Bill 2008. As has been indicated in the other place by my colleague the shadow minister for health, Mr Hockey, the coalition is supporting these bills. It has long been known that dental health and general health are closely linked. Historically, public health efforts to combat tooth decay have had significant beneficial effects on general health. We are fortunate in this country to have had, for many years and in the majority of the larger population areas, enlightened local governments who have supported the provision of fluoride in our public water reticulation systems. Fluoride as an essential agent for oral health is largely unchallenged in this day and age. But it was not so many years ago that there was a strong debate in the community about its effectiveness and desirability in water supplies. The first three major cities to have fluoride in their water supplies in 1964 were Hobart, Canberra and Townsville. My home state of Tasmania had a royal commission into the question in 1968, chaired by the distinguished judge, Sir Peter Crisp, and I am proud that many of his findings paved the way for large-scale fluoridation of urban water supplies in Australia.

It has been mentioned in debate in the House of Representatives that a staggering figure of 50,000 Australians are hospitalised each year with preventable dental disease, and this is in a country where we pride ourselves on having a very good record on dental health. I was proud to be part of a government which, recognising the strong link between oral and general health, last year established Medicare dental. The uptake in the first two months of operation of Medicare dental—November and December 2007—was 16,000 services. In January this year, according to statistics provided by Medicare, 20,443 services were administered. In February the figure was 40,497 services and in March it was 94,617. Therefore, from July 2007 to March this year, Medicare dental provided something like 172,000 services. In estimates, evidence was given that the total number of services to date was more in the vicinity of 300,000 plus.

It is therefore clear not only that there is a serious need for Medicare dental but also that the take-up rate by Australians with complex oral health problems is increasing. And yet, for an inexplicable reason, the Rudd government is moving to dismantle Medicare dental. I foreshadow that I will be moving a motion to disallow changes to the relevant regulations which abolish Medicare dental. There is absolutely no logic in abolishing a public health initiative for which there is a demonstrated and growing need, and the coalition will do what we can to prevent that from occurring. The reason Medicare dental was so successful was that it allowed dental patients to get access to necessary care—something they could not get previously because of the consistent neglect of local dental services perpetrated by state governments.

We will not oppose the legislation currently before the Senate, but I foreshadow that I will be moving an amendment to provide for a review of the Teen Dental Plan established by the Dental Benefits Bill 2008 after 12 months and periodic reviews at three-year intervals. The amendment will require that the minister appoint a review panel that will comprise the Commonwealth Chief Medical Officer, a nominee of the Australian Dental Association, a nominee of the Consumers Health Forum of Australia—a body which is currently represented on the Medical Services Advisory Committee—and two other persons appointed by the minister, at least one of whom must be a qualified dentist or medical practitioner. We think that this is an entirely reasonable review mechanism and it mirrors similar provisions in other legislation. I hope that it receives support in the committee stage.

The reason that we are proposing such an amendment is that we are very concerned that the Teen Dental Plan is destined for either failure or a significant cost blow-out. The Teen Dental Plan duplicates systems already in place in the states which have been allowed by the states to run down. Some, I concede, are much worse than others. Waiting lists for dental care in the states are very long. One estimate is that there are about 700,000 Australians waiting for dental care, and that is of course an alarming figure. The bill provides that up to $150 worth of vouchers will be available to 12- to 17-year-olds receiving family tax benefit part A, youth allowance or Abstudy, for the purposes of a preventative dental check, plus a scale and clean.

The ALP, when it announced this plan, costed a check-up, scale and clean and X-ray at $240. The scheme provides no funds for subsequent treatment if a problem is detected. People will have to either go into the state dental clinics or seek private dental consultation. It is a bit like giving someone a shiny new car but then not providing the funds for the petrol. This is a scheme that has clearly not been thought through. If a dentist finds something which needs further attention, what does he or she do: refer a patient to join the end of a long queue for attention in the state dental clinics or offer to do the work themselves, for a fee? The problem is exacerbated when one notes that fewer than 10 per cent of dentists practising in Australia are in the public system.

Under the coalition’s Medicare dental, patients who were assessed by their GPs as having complex dental conditions could have a primary care plan. From this care plan they could be referred to a private dentist and receive up to $4,250 worth of treatment over two years—rather better than what the current government is proposing. Of course, with the government’s decision to raise the Medicare levy surcharge threshold, many people with private dental insurance through their private health scheme will be inclined to abandon their cover, again putting more pressure on the public system.

What the Minister for Health and Ageing really needs to do is to go back to cabinet and admit that they should rethink some of the decisions that they have made in this portfolio and take advice from the various health professionals who actually know what the problem is, rather than stick to their old-fashioned policy. Australian health policy has largely been bipartisan. The current minister is doing her level best not only to jettison that approach but also to return to an overburdened public system which simply does not have sufficient funds to provide the necessary care. As I said, we will not be opposing the bills.