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Wednesday, 10 October 2012
Page: 12011

Ms PLIBERSEK (SydneyMinister for Health) (19:07): I rise this evening to sum up on the Dental Benefits Amendment Bill 2012. As I said when I was introducing this bill, investment in our children's teeth is an investment in the future. It will mean that, for millions of children, going to the dentist will be as easy as it is now to go to their GP. Children's oral health has been getting worse, not better, since the 1990s, and, unless we reverse this trend, a generation of children with poor teeth will grow up into a generation of adults with poor teeth.

A recent Australian Institute of Health and Welfare report tells us that 45 per cent of 12-year-olds had decay in their permanent teeth, and in 2007 just under half of children aged six attending school dental services had a history of decay in their baby teeth. This level of decay in children so young is a worrying trend, particularly as dental decay is so preventable. We know that the health and hospital system of the future will face increasing pressures from the ageing of the population and from the increasing prevalence of chronic diseases. Poor oral health would place even more pressure on the wider health system. Yet it is a source of pressure that can be addressed reasonably easily with early investments.

This bill will establish the framework for a new scheme called Grow Up Smiling, which will give children in low- and middle-income families access to affordable preventive dental care and basic dental treatment services. Grow Up Smiling builds on the government's existing Medicare Teen Dental Plan. It will make almost 3½ million children eligible for dental care subsidised by the Commonwealth government. Family tax benefit A eligible families will have access for their children from the age of two until they turn 18.

Throughout this debate we have seen a bizarre display by members of the opposition who, despite supporting this bill, have trooped in here one after the other only to criticise the government. Their relentless negativity means that they cannot even be positive about a bill that gives almost 3½ million children access to free dental care.

A number of false claims have been made through the course of the debate and need to be corrected. I have sought to correct these during the course of the debate but member after member opposite has ignored these corrections, it must be assumed deliberately. Although this bill is about establishing a new entitlement for millions of Australian children, those opposite have barely managed to speak about the benefits of investing early in the oral health of children. They have failed to mention that this bill will make it easier for parents to look after their children's teeth and keep them healthy. They have come in here and sought to whip up fear in the community and defend a bad scheme, the Chronic Disease Dental Scheme.

Unlike the range of measures that we have introduced, the Chronic Disease Dental Scheme does not target patients based on their dental needs. A patient with a chronic disease but with relatively good dental health can access around $4,250 of dental care, including work that can be largely cosmetic. On the other hand, a pensioner with a mouthful of rotting teeth but otherwise healthy gets absolutely nothing under this scheme. The vast number of Australian children whose parents do not have the money to take them to the dentist get nothing under the Chronic Disease Dental Scheme.

As I have said, there have been a number of fallacies peddled about the timing of this scheme's closure, including that there is a gap between the closure of the Chronic Disease Dental Scheme and the commencement of new investments in dental health. I want to assure members again, and I have done it while other members have been making this false claim again and again—I have talked about it in the parliament—that there need be no gap. New funding that we announced in the May budget—$515.3 million—can start to flow from 1 December and all I require of the states and territories to sign on to these National Partnerships is that they commit that they will maintain their effort in providing state dental services.

There is a $345 million blitz on public dental waiting lists. Those opposite continue to claim that there are 650,000 people on public dental waiting lists. The number is closer to 400,000—400,000 is way too many—but the Chronic Disease Dental Scheme has not addressed public dental waiting lists. This money, as I said, will be available as early as the beginning of December. There can be a seamless transition from the Chronic Disease Dental Scheme to the new scheme. As I said in the parliament at the time we were first discussing this, it has been a tribute to the number of members who have genuinely raised with me questions of their constituents and how they will continue to receive treatment that, consequently, we have put particular effort into ensuring that this money is available from the beginning of December rather than the beginning of January, as we had originally anticipated.

It has also been incredible in this debate to hear speaker after speaker crying crocodile tears about the lack of capacity in state public dental systems, yet failing to mention that it was the Howard government that axed the successful Commonwealth Dental Health Program in 1996. Our package will repair that damage and improve access to public dental services for those on those waiting lists, with a particular focus on Indigenous patients, patients at high risk of or from major oral health problems, and those from rural areas. The member for Kooyong was talking about a disability pensioner, exactly the sort of person who would benefit under this new scheme.

Importantly, states will be able to use our funds to use private dentists to expand their workforce in areas where there is not access to a public dental scheme. Where there are established medical services, community health organisations, states will be able to contract with any of these organisations to increase their capacity to deliver services on the ground.

Someone must have mentioned that this bill does not include the detail on the services to be provided under this scheme. That detail will come in a schedule. Grow Up Smiling will provide benefits for basic dental treatment like prevention, diagnostics, extractions, fillings and so on. The details and mix of these services will be developed in consultation with dental professionals to ensure that the schedule of services is designed and appropriate for the basic oral health needs of children. Once this work is complete, the schedule of benefits will be established under subordinate legislation.

As I said at the beginning of this debate, Medicare and free hospital care have been a basic right for Australians for decades under policies established by Labor governments. Yet millions of people in this country still go without adequate dental care because of cost barriers. We had the member for Kooyong talking about the media release of the Australian Dental Association. I want to quote that for the benefit of honourable members. It is dated 29 August 2012 and it says:


Today’s announcements by the Hon. Tanya Plibersek have been welcomed by the Australian Dental Association.

Closure of the Chronic Disease Dental Scheme (CDDS) and the Teen Dental Plan with a replacement scheme focusing on Australia’s youth and disadvantaged Australians is a significant initiative leading to a long-term improvement in Australia’s oral health. The ADA has long advocated for a targeted dental scheme as outlined in the ADA’s Dental Access proposal.

It is very favourable press release. On 9 October the Australian Dental Association said:


As parliamentarians continue to debate closure of the Chronic Disease Dental Scheme, the Australian Dental Association calls on members of parliament to listen to the dental profession when it comes to creating the solution to dental care delivery.

The investment of $1 billion per annum in the CDDS was like using a sledgehammer to crack a nut. It was wasting valuable funds on the delivery of care to those who could already access care without government assistance.

And on it goes. There has been a further and consistent deliberate misrepresentation now not only of me and of the government policy but also of the Australian Dental Association, which has been very supportive of these measures, because they know, as we know, that the CDDS was a scheme that was open to misuse, that went from being supposed to cost $90 million a year to costing $80 million a month, that sprayed money around like—well, we do not use sprinklers anymore with water restrictions, but we remember what sprinklers used to work like. It is unfair, it is wrong, it is unjust and it is dishonest to continue to frighten people by suggesting that this money does not start for 13 months or 19 months, as the member for Kooyong suggested earlier. There is $550 million available from 1 December, and all the states need to do is keep doing what they are doing to receive that money.

On this side of the House we believe that access to dental services should be targeted to those least able to access on the basis of need for dental care. That is what these reforms do. I was fascinated to hear the member for Kooyong say that when the opposition returned to government they will go back to the Chronic Disease Dental Scheme. That is the only interpretation of his words—

Mr Frydenberg: We will do better.

Ms PLIBERSEK: If you believe that your scheme is better, the scheme that we are closing, that means you will return to the old scheme. The member for Kooyong, and the shadow health minister yesterday, would not be drawn on this. It is a very interesting question for people to ask the Liberal Party of Australia, whether they do commit to returning to the scheme that they are advocating for now.

I want to commend this bill to the House and I want to say that it pleases me that at least the opposition have agreed to support these extra action measures for children and for low-income Australians through investment in our public dental systems. This is a proposal that serves many more people in a much more long-term way, preventing poor oral health in our children, meaning that generations of Australians will indeed grow up smiling.

Question agreed to.

Bill read a second time.

Message from the Governor-General recommending appropriation announced.

Ordered that this bill be reported to the House without amendment.

Federation Chamber adjourned at 19:21