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Monday, 19 November 2012
Page: 9081


Senator EDWARDS (South Australia) (21:37): I too rise tonight to speak on the Dental Benefits Amendments Bill 2012. This bill presents me with an opportunity to talk about the terrible decision Labor is making in closing the Chronic Disease Dental Scheme. It also gives me a chance to highlight the inferior dental healthcare outcomes people in rural Australia have, compared to their urban counterparts.

We on this side of the chamber know how important dental care is. It was Tony Abbott, when he was health minister, who established the Chronic Disease Dental Scheme. It has helped countless people with chronic diseases access dental care. These chronic diseases include: asthma, cancer, cardiovascular illness, diabetes, arthritis, mental illness, musculoskeletal conditions and stroke. I support investment in dental care for those who are suffering from chronic disease.

I also support investment in dental care for our children. We all know how important good dental care is, especially for our young, and ensuring that they establish good dental care early can help prevent more serious conditions later on in their lives. I know that people out there in rural South Australia need assistance. Any research you care to look at shows that people in the country have poorer dental health outcomes than their city cousins. My close friend is a dentist in the Clare Valley and he can attest to this anecdotally—and I am sure we could get him to write it down and prove it for us. And that is only 150 kilometres from the city, before you go out to the mining areas of South Australia, Western Australia and Queensland, where I am sure that the health outcomes are far less satisfactory than their city cousins. People living in rural areas stand alongside Indigenous Australians and low-income earners, who are regularly cited as having the worst oral health outcomes in Australia.

As with access to most services, rural Australians are at a disadvantage when it comes to oral health. The research shows that economic disadvantage and living in rural areas are two of the greatest risk factors for poor oral health in Australia—and I agree with you, Senator Di Natale, on those very matters. The Australian Dental Association states that in rural South Australia there are only 27 practicing dentists per 100,000 people, which is well below that found in Adelaide, where there are 66 per 100,000 residents. The problem is particularly clear on the York Peninsula and in the lower north of South Australia, where there are just over 22 dentists per 100,000 residents.

A report from the National Advisory Council on Dental Health shows that rural residents have a higher incidence of unfavourable visiting patterns: 38 per cent compared to 27 per cent for the urban residents. It states that these visiting patterns increase the risk of poorer oral health in rural residents, compared to urban residents, which is supported by survey data. For example: 31.7 per cent of rural residents have untreated decay, compared with 24.8 per cent of urban residents; and 32.8 per cent of rural residents have moderate to severe periodontal disease, compared to 26.1 per cent of urban residents. Everywhere you look, the rural people of Australia are at a disadvantage. Of the total dentate population, 18.5 per cent of rural residents have fewer than 21 teeth, compared to 13.8 per cent of urban residents. There are a lot of figures in there. But it does point to a lack of focus on the rural areas of Australia.

I reiterate how important dental care is for our children, and establishing good dental hygiene from an early age is critical. I remember having to continually nag my four children to brush their teeth before bedtime. Obviously it was not a pleasant task for them—until they finally worked out that it was a good way to stall bedtime. Needless to say, they now have some nice pearly whites to go through life with.

However, not all children have such good teeth. A report released on 25 October by the Australian Institute of Health and Welfare, called Families and their oral health, showed that 16.7 per cent of children surveyed had experienced dental problems in the past year. In families where children had such dental problems, some 23.2 per cent of their parents reported similar dental problems over the same period. Children who experienced an oral health impact in the last 12 months were more likely than children who did not, and they are likely to be from the families who report difficulty in having to pay the $150 dental bill.

Clearly, we have some problems to address in this country when it comes to rural people and children's dental health. Those two areas are standing behind the door when it comes to this bill. This government is going to make matter worse by shutting down the Chronic Disease Dental Scheme—go figure!

This scheme operated by allowing someone with chronic disease to be referred by their GP to a dentist, where important work was undertaken by that dentist. The scheme has been used with incredible success; millions of Australians have accessed essential dental services because of it. The end of the Chronic Disease Dental Scheme would put the health of many older and low-income residents at risk. Eighty per cent of patients under the Chronic Disease Dental Scheme are concession card holders, and they are being left stranded by this government. The government has said it will replace the scheme with a more limited program, but that will not start for adults until July 2014, which is a 19 month wait, in anybody's order.

Once again, Labor is going down the path of mismanaging a program. If you have serious dental treatment underway that will not be concluded by December this year, you lose out—either you pay or you do not finish your treatment. Those who can afford it or who can get family support for it will get the treatment to ease the pain and improve their health. For everyone else who cannot afford major dental treatment, this is a serious problem. The news is a little better for sick children who are using the scheme. They will have to wait only 13 months, until January 2014, when they will have their benefit cut from $4,250 to $1,000 over two years.

The coalition has repeatedly offered to work with the government to achieve bipartisan reform of the scheme to ensure that it is sustainable and better provides for all Australians. The government is refusing these offers perhaps because it cares more about some political point-scoring than it does about the dental health of Australians. More likely, it is a case of looking a bit like a rabbit in the headlights in trying to achieve the Treasurer's rolled-gold promise of a budget surplus this year. The Gillard government has chosen to abruptly close the scheme on 30 November 2012, just weeks away, regardless of people having incomplete treatments and no alternative treatments likely for years. The government has offered an alternative that is little more than an election promise, with the following flaws. Under Labor, adults will have to wait until at least July 2014, and even then the public dental clinics could never match the prompt personal care of a local dentist. Under Labor, children with chronic disease will have their benefit cut from $4,250 to $1,000.

I would like to address some of the unfunded plans that Labor are promising to implement—just more unfunded plans with the promise in the never-never time of the future. This bill will replace the Medicare Teen Dental Plan with the Child Dental Benefits Schedule. It will change the current scheme where the age eligibility is 12 to 17 years to one that covers children from the ages of two to 18 years—on the surface, this would be a plus. I have four children and they are now all in their teenage years, and not too many of them had problems with their milk teeth. What you are seeing is a benefit. What you are being sold seems to be a wonderful thing. But very little dental work is done on children from the ages of two to 12. Again, it is the smoke and mirrors which we see so often from this Gillard Labor government regime. They will give you a little bit extra, but the reality is that it does not mean much at all. For all those supposed changes, there is still no schedule of services, fees or details of how this new $2.7 billion Child Dental Benefits Schedule will be funded. It is a bit like the NDIS, it is a bit like Gonski—again, we have no idea of how this is all going to be funded.

The scheme for adults will not commence until July 2014. There is only a 19-month wait, as I have already highlighted. The government has said that it will provide the states and territories with $1.3 billion for adult public dental services. This new system for adults will provide only 1.4 million additional services over six years. Labor has also announced $225 million for the development of dental infrastructure, capital and workforce measures through applications to the flexible grants program; but, of course, there is a wait. These grants will not be available until 2014. There is a theme here, isn't there? It is called the budget in May 2013—and that just happens to be an election year. The funding for all of these schemes has been rolled out to 2014, with the benefits not set to come through until some years after that.

Taken as a whole, this dental package comes with a $4.1 billion price tag and, at this stage, is unfunded. This is in stark contrast to the lived reality of the many people who have access to the Medicare Chronic Disease Dental Scheme, which provides them with $4,250 in Medicare dental benefits—

Debate interrupted.