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Thursday, 23 August 2012
Page: 6207


Senator SIEWERT (Western AustraliaAustralian Greens Whip) (11:23): Over the past year the Greens—and, in particular, Senator Di Natale—have been putting a lot of effort into reforming the nation's dental health services. We have made that one of our top priorities. In fact, as the former health spokesperson for the Greens, before being joined by my colleagues in the Senate, I worked very extensively on dental health as well. Through this process we have been fortunate to get to know many hardworking people in the dental profession.

Senator Di Natale, shortly after taking his seat in the Senate, was approached by some dental practitioners who were being audited for services provided through the Medicare Chronic Disease Dental Scheme. The more he learned about this situation and the more dentists he talked to and met who were expressing similar concerns and having similar issues, the more he became convinced that something was seriously wrong—as many other people have been articulating in this chamber.

The Chronic Disease Dental Scheme was the first step for most dentists into Medicare. What became apparent, as Senator Di Natale spoke to more dental practitioners and those who had taken part in the scheme, was that the entry into Medicare had not been managed well—and I think that has been very well highlighted in this debate. While the rest of the medical profession are, by and large, now of course very familiar with Medicare, this was not true for dentists and those involved in the dental profession. In those circumstances, the department had a responsibility—and we believe an ongoing responsibility—to make sure that these practitioners were properly educated. Over time we have been increasingly convinced that this was not done at all.

As a result, many dentists who, in good faith, took part in the scheme to ensure delivery of these services to eligible patients who, we must point out, were in urgent need of dental support and care—many of whom had not received it for many years, if in fact at all—have fallen foul of the administrative arrangements for the scheme. In subsequent audits, many of these well-intentioned practitioners were required to repay the entire amount of the benefit they received from Medicare, despite having already provided critical treatment to eligible patients and, in many cases, having spent considerable amounts of money in delivering these services and treatments. This has resulted in enormous stress and hardship for dentists and has in fact threatened the viability of otherwise thriving practices providing very necessary treatment to the community.

We have no sympathy for any medical practitioner who acts unethically and seeks to defraud the public—and I want to make that very clear. It is clear, however, that the vast majority of dental practitioners affected by these audits do not fall into this category. We have made repeated representations to government on behalf of the affected dentists, and we are pleased that we have finally seen some major progress on this front. During Senate estimates on 29 May this year, the Minister for Human Services, Senator Kim Carr, made the following statement:

It is our view that we need a retrospective change to the dental services determination within the near future that creates greater flexibility about the compliance arrangements, while still protecting important principles of public policy. This retrospective change to the determination would bring the compliance arrangements more closely into line with other parts of Medicare and would allow for a more educative approach to be used by the department.

This means that the government are seeking to change the regulation that will enable them to revisit all the audits and change the determinations made in those cases where a significant injustice has been done. The Greens will support this through the parliament and ensure that all dentists who have delivered genuine services are assisted with education rather than the recovery of benefits paid for services that have already been delivered.

The bill that we are debating now, the Health Insurance (Dental Services) Bill 2012 [No. 2], which the coalition has brought into the parliament, would compel the minister to take action on this issue. Although we strongly support the intent of the bill, there are concerns that the bill is structured in a way that would not achieve its aims. In light of the minister's announcement and as a show of good faith we have been trying to talk to the government on their proposed solution. We understand that this is very close to a resolution and continue to believe that the government are acting in good faith on this issue. At the moment we are in the position where we believe that it is better to support the government in their ongoing resolution of this problem as we believe that they are very close to its resolution and we are in fact taking in good faith the government's commitment that they are very close to a resolution. If however they do not deliver this in the very near future, we believe that we will need to either revisit this bill with amendments so that it is structured correctly or in fact support the introduction of a new bill. This is putting the onus back on the government to resolve this issue in the very near future.

As we have always said, the Chronic Disease Dental Scheme is far from perfect.

However, we have voted in the past with the coalition to not support the destruction of this scheme and for the retention of this scheme because this has been the only scheme that has delivered dental services to the most vulnerable people in our community and has genuinely delivered change to people suffering from chronic disease. This is in some cases the first time these people have been able to access dental treatment. So we have very strongly demonstrated our commitment to this dental scheme and the support of the most vulnerable people in our community.

We have never said that this scheme is perfect. There have been some concerns with it. We remain committed to reform of dental care for Australians because, while this scheme was a step in the right direction, it has not gone to the full extent of the reform that is needed. We strongly believe that no scheme will succeed unless the dental profession is properly consulted, fully engaged and strongly supportive of any new scheme. Finding a way to fix this problem with Medicare and the CDDS is critical to maintaining a good relationship with the dental health profession. Although this cannot make up for the terrible months of stress and uncertainty that those in the dental profession and dentists who have been subject to these audit processes have been through, we hope that the move that the government has underway will resolve the issue and allow dentists to get back to what they do best, which is providing the necessary treatment to our community. We will not be supporting the bill. That is on the understanding—and I am very strongly eyeballing the government—that the government is in the process of resolving this most stressful situation for our dentists.