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Tuesday, 9 October 2012
Page: 11553

Mr SYMON (Deakin) (12:29): I speak in support of the Dental Benefits Amendment Bill 2012. This bill will amend the Dental Benefits Act of 2008 by setting up the legislative framework for the Child Dental Benefits Schedule to start in January 2014, and it is a component of the $4 billion six-year package announced by the Minister for Health on 29 August this year. In addition to this measure, there was an announcement of $345 million in this year's federal budget to alleviate pressure on public dental waiting lists, a program that commences from January 2013. This package will replace the Chronic Disease Dental Scheme and the Medicare Teen Dental Plan.

On commencement of the scheme there will be around 3.4 million Australian children who will qualify for the Grow Up Smiling dental scheme. This scheme will see the federal government assume the primary responsibility to fund basic dental services for children from their second birthday through to the time of their 18th birthday in families that receive family tax benefit part A, which is a particularly good way to judge where the need should be. The current income cut-off threshold for families with two children for family tax benefit part A is around $112,000. The recent 2011 census figures have come out recently and, for my electorate of Deakin, they show a median family income of $1,601 per week as an annual figure. That works out to be about $83,252. On that measure most families in Deakin with children will have access to the Grow Up Smiling scheme as the median family income is well below the cut-off threshold for family tax benefit part A. It is estimated that 7,147 families with 12,451 children will be covered within the electorate of Deakin.

Up to $1,000 of dental services will be funded over two years for each child in families—not only in my electorate of Deakin of course, but right across the country—that qualify for family tax benefit part A, and this continues for the life of the package. Importantly, because it is hard to access public dental services in my area, it will be the parents' choice as to whether to have these services done in public or private dental services. Services covered by the scheme also include those performed by para-dental professionals such as oral health therapists and dental hygienists, as already covered by the existing Medicare Teen Dental Plan. One of the key aims of the bill is to make a visit to the dentist to be no more difficult than a visit to the doctor for the 3.4 million children that will be covered.

The benefits of preventative health of the population in the future are not always easily quantified in today's dollars because there are so many unknowns. However, I think we can look at statistics and trends to form a good idea of where this record federal government funding in dental services will lead. A great resource that I often look at in terms of health debates is the Australian Institute of Health and Welfare and the reports that they produce on a regular basis, which I know many members in this place do read large sections of. In particular the report titled Oral health and dental care in Australia, key facts and figures 2011makes some very interesting reading. The report goes over a number of years and lists in detail reports of various surveys from 2004 to 2010, so it is not just a flash in the pan or a snapshot.

In 2006, from a survey of children attending a school dental service, the percentage of children with decayed, missing or filled baby teeth increased from around 40 per cent in the four- to five-year-old group up to around 60 per cent in the six- to eight-year old group. I found that to be quite a disturbing figure, but the report brought further concern when it came to the number of children with decayed, missing or filled permanent teeth. That figure rose from 1.4 per cent for children at five years of age up to 29.8 per cent for children at 10 years of age and 58 per cent for children at 15 years of age. That is not baby teeth; that is permanent teeth.

The National Survey of Adult Oral Health from 2004 to 2006 reported that, for adults, the overall average of decayed, missing or filled teeth for a person aged 45 to 64 was 19.8 teeth per person. Of those 19.8 affected teeth, 0.5 were decayed, 7.2 were missing and there were around 12.1 fillings per adult person between the ages of 45 and 64. People without dental insurance had a higher number of teeth missing due to decay and untreated decay, but a lower number of filled teeth. Obviously that is coming from the fact that they would not be able to afford as many visits to the dentist in some cases.

The highest proportion of untreated decay was seen in persons earning less than $12,000 per year, while the lowest prevalence was seen in people who lived in households with an income of more than $100,000 per year. These numbers are just small samples taken from the AIHW report. The report contains many more tables and surveys, including the national dental telephone interview survey of 2010. One particular finding was that the average number of missing teeth was inversely related to household income. That pretty much follows the previous report.

Australia should not be a country where only those on higher incomes have access to proper dental treatment. I believe that Australia should be a country where all children have access to dental services so that the average number of decayed, missing and filled teeth drops as a result of preventative and restorative dental work that is done early in life before many of these conditions become more severe.

I mentioned the Chronic Disease Dental Scheme earlier, a scheme that was introduced in 2007 by the now opposition leader and then health minister Tony Abbott. Over the four years that that scheme ran, the forecast expenditure was $384.6 million. But by May 2010 the benefits paid out by the scheme had already added up to $916 million and the amount of claims and payments have increased at a massive rate since then. The Chronic Disease Dental Scheme is now costing the Australian taxpayer around $80 million a month. A quick calculation is in order here. At $80 million a month, that works out to be around 10 times the amount that the scheme was costed at back in 2007: $8 million a month versus $80 million a month. That is a huge increase. Many times in debates in this place we argue over dollars, but rarely is there such a huge differential between what was forecast and what the outcome was: $80 million a month. With that sort of addition, it is no wonder that, when it comes to election and policy costings, the Liberals have a $70 billion black hole.

But there is not only the direct cost to consider here; there is also the cost of opportunities along the way. The Chronic Disease Dental Scheme is not means tested, and therefore we have seen huge amounts of public money being paid to the well off—the very group that the figures I talked about before show are least in genuine need of welfare or assistance from the government. The rorting of the Chronic Disease Dental Scheme has reached huge proportions and has been reported on consistently over the years. A stream of media reports has come out ever since the federal Labor government tried to shut this scheme in 2008 and again in 2010. In both cases, the Senate disallowed the motion to shut the scheme.

Some of the media reports speak for themselves. Mark Metherell, writing in the Sydney Morning Herald on 14 March 2009, said:

The Senate has twice blocked Government moves to abandon dental Medicare, which costs about $250 million a year and rising.

If you look at the figure, it was $250 million in 2009. It has risen way beyond that. In another article Mark Metherell, this time in the Age on 5 November, said:

Medical leaders have told The Age that dentists are advising patients who are not eligible to seek doctors' referrals, which can authorise Medicare coverage of up to $4250 in dental work, including dentures and crowns. The scheme is meant to be restricted to patients with chronic medical diseases linked to their dental conditions.

In the Australian on 11 March 2010, in an article titled 'Senate block "letting dental rorts thrive"' by Adam Cresswell, the figures had changed. The article said:

Latest figures show the scheme has cost taxpayers $732 million between its relaunch with increased benefits in November 2007 and last December.

The December referred to was December 2009.

The Sunday Herald Sun of 21 March 2010 had an article by Clair Weaver and Sharon Labi which said:

… investigators have uncovered systemic fraud in two programs that allow doctors and dentists to claim generous rebates for writing plans and treating the chronically ill.

Whistleblowers warn the system is being abused, with medicos getting rich and patients who shouldn't even qualify being given thousands of dollars worth of taxpayer-funded treatments.

The dental costs have blown out by 325 per cent to more than $800 million, while GPs who wrote chronic disease management plans have earned $914 million since they were introduced in July 2005. That budget has blown out by 200 per cent …

They are just some examples, and they are actually not recent ones because there has been some work by the department in this area to go after some of the most egregious examples—and that needs to be done in any program—but they are indicative of why the figure keeps rising. As with any scheme where there is no actual budgeted amount, while it may not appear in the budget figures it still has to be paid for. Obviously part of the change from the Chronic Disease Dental Scheme to the dental package we are now going to is that it is going to be something that can be quantified and measured over the years.

In terms of the announcement and the bill we are now talking about, the Consumers Health Forum of Australia puts out a large amount of information on both medical and dental issues. Sometimes it makes very good reading and sometimes it is critical of the government too. Carol Bennett, the CEO of the Consumers Health Forum of Australia, on 29 August put out a press release, which said in part:

Cost is the big barrier preventing a large section of the community from accessing preventative dental services, which in turn contributes to development of chronic conditions that place major demands on our health resources.

She went on to say:

This is a big win for the whole community. If you improve the health of those who can’t afford a decent standard of dental care, you raise the general health of the entire community.

I agree with that statement. We have always found in relation to what the government funds that prevention is far better than attempting to cure. The Dental Benefits Amendment Bill 2012 is a great step along the path to getting prevention to be a natural first step rather than having to get people into the dentist many months or years later to fix problems that have taken a long time to develop. It has always made sense to me that our efforts be directed at prevention so that down the track hopefully we as a nation end up with a far smaller health bill in that area than we do at the moment. I commend the bill to the House.