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Thursday, 22 November 2012
Page: 9625


Senator SMITH (Western Australia) (21:42): I rise also to speak on the government's Dental Benefits Amendment Bill 2012. This is an important piece of legislation that aims to tackle some serious problems in relation to dental health. Unfortunately, the way the government has gone about it means that what is being delivered is perhaps not as effective as it might otherwise be. In all the blaze of publicity this government has sought to give to its new scheme, it has been pretty well silent about the fact that it is closing the Chronic Disease Dental Scheme for all patients on 1 December 2012. It is not uncommon for a government to close one scheme and replace it with another. However, the problem in this instance is that the new scheme the government is establishing does not commence until 2014. This will leave some 650,000 people on the public dental waiting lists—those most in need of dental treatment and who were relying on the CDDS to help pay for their dental treatments—without any assistance in the meantime.

The Howard government's Chronic Disease Dental Scheme, which was introduced by the now Leader of the Opposition when he was health minister, is being abolished by this government, and there is nothing to replace it until 2014. Patients who relied on the old scheme are just expected to fend for themselves. The CDDS has been accessed by around one million patients since its inception in 2007. Its costs have not blown out. It has been, for the most part, a well-run, well-managed scheme. Certainly, there were a few isolated problems, but can anyone opposite name a government scheme for which there is not? Yet the government has decided to scrap it, citing massive cost blow-outs—which there were not; the costs were coming down—and rorting, when there was one case out of 1,500. Why? It is because it suits the government's political needs, rather than the community's policy needs.

You have to ask yourself why the government is not replacing the CDDS immediately and why it is waiting until 2014. The answer of course is that the Gillard government is engaged in a series of desperate acts, scrapping and slashing, desperately trying to conjure up a budget surplus for Wayne Swan. This government, unfortunately, cares more about the political imperative of getting a surplus, however thin and however shoddily constructed, than about the dental health care needs of Australians and their families.

I served on the Senate Community Affairs Legislation Committee that examined this bill and we heard from several stakeholders that they are concerned about the way the government has gone about this. I and other coalition senators share these concerns. I point to two sets of comments made by the Australian Dental Association. The first comment, not surprisingly, points to the importance of investing in child oral health from both a health perspective and a financial perspective. The Australian Dental Association said:

Investment in the oral health of children is a sound and sensible investment as it may result in a long-term monetary saving for government and the community by minimizing future deterioration in dental health. There is a substantial body of evidence indicating that early intervention and preventive treatments provided early in life are a proven and well-established method to prevent poor dental health in later life.

I think we would all concur with those sentiments. The Australian Dental Association's other comment focused on its concern that the closure of the CDDS was being pursued in a time frame that was premature. It claimed that many patients will miss out on essential treatment as a result of the 30 November 2012 cut-off. The Australian Dental Association told the inquiry:

A 12-week period, to complete treatment, will mean that patients under the CDDS will not be able to finalise their treatment plans. Treatment of the chronically ill, for which this Scheme was designed, is often complex, requiring an extended period of time. Complex treatments are often staged to allow adequate healing.

…   …   …

The ADA calls on the Australian Government to recognise that it is critical that arrangements are put in place to allow for treatment services to be completed even if this requires introducing a transition process for existing patients on a case by case basis.

That is important evidence because it was made by what we would all regard as the experts in dental health in our community, the Australian Dental Association.

When it comes to adults, Labor's replacement scheme will not commence until 1 July 2014. That is 19 months after the CDDS closes, which is bad enough. But what concerns me greatly is the situation for children. Over 60,000 services have been provided to children through the CDDS. When it closes on 30 November, there will be a 13-month gap for the children currently receiving treatment. These are children in the middle of treatment who will not be able to have their treatment completed by the 30 November deadline. The families of these children cannot afford the full cost of private treatment. There will potentially be serious health, economic and social ramifications for these people as a result of the government's shoddy policy approach.

The government has been unable to say why it thinks these children should suffer for 13 months. They may well suffer for longer than that, of course, because the government has thus far been unable to say anything about the schedule for treatment under Medicare. The government says that issue will be dealt with by a series of amendments to this legislation at a later time. The Gillard government wants us to take it on faith. That is certainly not fair to legislators and it is certainly not fair to the mums and dads of children with important and critical dental health needs.

Frankly, it is a bit rich of this government to expect the public to take it on trust. The people of Australia do not trust this government. They do not trust it for good reason. The list of broken promises grows longer each week. The record of administrative incompetence and policy on the run is a sorry one. How can anyone in this place have any faith whatsoever that this government will ultimately deliver an effective scheme? How can we be expected to believe the government will be able to pay for it? The absence of detail is emblematic of this government's approach: making policy on the run, getting the media release out there and smiling nicely for the cameras, all the while hoping to God no-one starts asking questions about the detail.

If this government had not wasted millions of dollars on pink batts, NBN cost blow-outs and its utterly discredited policies on illegal immigration, it would not now be in the position of having to scrap this scheme and leave dental patients in desperate need of assistance to fend for themselves. The coalition support investment in dental health and it has been a tenet of our policy for a long, long time. The coalition are concerned about the many patients currently receiving treatment under the CDDS and who will be forced to forgo that treatment during this gap period.

What does the closure of this scheme really mean? It means that the means-tested family tax benefit part A or other specified payments entitlement for children aged two to 17 years will not commence until 14 January—13 months after some children lose access to the existing scheme. This proposal is supposedly to provide a $1,000 capped benefit over two years to eligible children, with the government claiming some 3.4 million children will be eligible. Again, the unfunded cost of this is expected to be $2.7 billion. The proposal for adults will not commence until 1 July 2014—19 months after the current scheme closes. Funding will apparently be provided to state governments for public dental services and services will no longer be available for adults through private dentists under Medicare. The unfunded cost of this is expected to be $1.3 billion.

A key element of the package includes a $225 million flexible grants program for dental infrastructure, which will not commence until 2014. The invitation to apply for funding under that grants program will not commence until 2014. This is a critical point that deserves some further examination. As I travel around the great southern region of Western Australia, the needs of regional and rural Australians and their oral health needs are an issue that is constantly raised with me. It is interesting to reflect on the work of a National Rural Health Alliance and the work that it has done in regard to dental care in rural and remote Australia. It has said that there were 57.6 practising dentists per 100,000 population in major cities compared to 28.5 in outer regional and 19.8 in remote Australia; and 33.7 per cent of regional and remote dentists are busier than they would prefer compared to 17 per cent in major cities. They also said that around 73 per cent of all regional-remote dentists are 40 years or over compared to 60 per cent in major cities. Conversely, only 27 per cent of dentists working in regional or remote areas are under 40 years of age compared with around 40 per cent in major cities. It is quite clear from this evidence and the evidence of other coalition senators that dental health needs are important but that this government has been lazy in providing a suitable policy response.

My concern is for the children in the middle of treatment at the moment who will not be able to have their treatment completed. Families have nowhere to turn, and there has been no consideration whatsoever of the impact this will have on those children. The government and the Australian Greens need to explain why these children must suffer for 13 months with incomplete treatment and absolutely no certainty whatsoever on the provision of the schedule of services that are going to be provided. This, of course, is on the proviso that the government can actually deliver on its unfunded promise in 2014.

The coalition supports investment in dental care and does not oppose the intent of the bill, but it has legitimate and necessary concerns about the children who will lose access to that treatment. The coalition is concerned about the children who will not be able to complete their treatment. We have concerns about the unfunded $2.7 billion cost of the measure and we have concerns about the yet to be seen schedule of services, fees and other essential details that are not yet available on this bill.

The oral health needs of Australians young and old deserve better than the lazy policy making demonstrated by this particular legislative proposal.