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Thursday, 20 September 2012
Page: 11371


Dr SOUTHCOTT (Boothby) (09:40): I second the motion. I am very pleased to speak on this motion that is seeking to retain the Chronic Disease Dental Scheme on Medicare. The Chronic Disease Dental Scheme was introduced by the Leader of the Opposition when he was health minister in 2007. It involved several critical insights. The Leader of the Opposition, as health minister, understood, firstly, that it was access to restorative treatment, not cheques, that people needed, and, secondly, that you needed to unlock the very significant capacity of the private sector in dentistry. And he did that through Medicare.

It was no idle boast when the coalition used to say that we were the best friends Medicare ever had. While the Labor Party introduced Medicare in 1983—and it came into being in 1984—by the time we came to government in 1996 we were strong supporters of Medicare, and we improved on Medicare while in government. We introduced access to dental on Medicare. We introduced access to psychologists through better outcomes and better access to mental health. And we expanded the access for allied health professionals on to Medicare, going through their GPs, with team care arrangements or care plans.

The Labor Party, in the last election, made the spurious claim that the Leader of the Opposition had taken a billion dollars out of the health system. Well, this health minister has, with the stroke of a pen, ripped out $1 billion from Medicare. I find it extraordinary that a Labor minister for health is the first minister for health we have had since Medicare was introduced who had actually removed a whole class of people from Medicare for dental. We all wonder what our legacies might be when we leave this place, but this minister's legacy will be this: health minister; ripped a billion dollars a year out of Medicare.

The Labor Party and the Greens propose to close the Chronic Disease Dental Scheme on 30 November. Also, as a result of their announcement, no new treatments will begin after 7 September. Let us look at the impact of this. I have had one resident of South Australia contact me who had radiotherapy for throat cancer and was referred by the public hospital to a GP to a get access to the Chronic Disease Dental Scheme. He is not eligible to go on the Chronic Disease Dental Scheme as a result of this government's decision. He was referred instead back to the state dental service and was originally told that it would be a 14- to 18-month wait. That is the impact, on a personal level, of what you have done.

Ms Plibersek interjecting

Dr SOUTHCOTT: Minister, there is now a 19-month gap for people with chronic disease, during which they will not have access to treatment. They have to fall on the state dental services, which we know have massive waiting lists. What the Chronic Disease Dental Scheme provided was $4,250 in Medicare dental benefits over two years for patients with a chronic health condition. They had to go through their GP and they had to be on a GP management plan or a multidisciplinary care plan—the same way we expanded access to allied health, the same way we provided improved pathways for people with mental health conditions. A chronic condition is one that has been or is likely to be present for at least six months or is terminal. This applies to patients with diabetes; who have had cancer and radiotherapy; who have suffered strokes; who have heart disease, especially valvular heart disease; who have chronic kidney disease; with osteoporosis; with asthma or chronic obstructive pulmonary disease; and with arthritis. Those are the most common conditions suffered by people accessing this scheme. The scheme allowed for dental assessments, preventative services, the removal of teeth, and fillings and dentures.

If we take a step back and look at the dental situation in Australia. Essentially, half the population are covered by private health insurance and are able to access a private dentist using their insurance. The rest either have to pay to go and see a dentist or they fall on the state dental services. And, what has been very obvious, is that there is a gap in treatment in Australia, and it is largely because the state dental services have massive waiting lists. The waiting lists vary from 18 months to over two years, depending on the state. So, by using Medicare, we were able to come up with a scheme that saw over one million patients treated and over 20 million services provided.

We often hear that this scheme was 'not well targeted'. Well, it is like Medicare—the same principle applies: universal access. That is a fundamental principle of Medicare. While people can say anyone could receive treatment under the Chronic Disease Dental Scheme, 80 per cent of the people receiving the treatment were concession card holders. So what the Labor Party need to do is to explain to people who are on the aged-pension, who are receiving Newstart, who are on the disability support pension, who are receiving any sort of concessional card, why they have removed for them—and why the minister has removed for them, at the stroke of a pen—choice of dentist. Because, under our scheme, they had choice of dentist. Under the government's proposed scheme, which begins in 19 months time—there is a gap of 19 months—they will fall on the states' dental services and it is just a matter of 'join the queue; take what you get.'

Hans Zoellner, from the Centre for Oral Public Health, has described this scheme as 'fantastically successful'—in fact, he suggested that the government could have expanded the scheme to include people on low incomes; that instead of abolishing the scheme, and ripping it from Medicare, it could have been used as the foundation for an expansion of dental services.

As I have said already, 80 per cent of the services under the Chronic Disease Dental Scheme were for concession card holders. As a result of this government's decision, they will be forced to join the queues and waiting lists in the public system—and there are more than 650,000 on these public waiting lists; 400,000 of whom are adults. Whereas, under the Liberal's scheme, using Medicare and using private dentists, they had a choice of dentist; now, it is just take what you get, and you will have to wait as well.

The government have claimed that there have been massive cost blowouts. One point I would make is that the Chronic Disease Dental Scheme was always funded by the previous government. Department of Health and Ageing figures show that the average claim is only $1,716—so it is well short of the cap. Some estimates suggest that this has dropped further, to below $1,200. The coalition has reached across the table to the government and offered to work with them to improve the scheme, to refine the scheme; and this offer has been rejected.

One thing I would like to say to the Independents—to the member for Denison, the member for Lyne, the member for New England and the member for Kennedy: think very seriously about what you are doing here. What you are doing is, for the first time, removing access to Medicare for a whole class of people. What you need to do is be prepared to tell people with cancer, with diabetes, with heart disease, with arthritis, who have had a stroke or with osteoporosis, why you have decided to rip them from Medicare for their dental services and just leave them lost in the waiting lists of the state dental services—and you have to be prepared to look them in the face and explain why you are prepared to do that. What you have to do to those people, 80 per cent of whom are concession card holders, is explain to the aged-pensioners, to the people on disability support, to the people on Newstart why they will no longer be treated on Medicare for dental services but will have to rock up to their local dental hospital.

The shadow minister for health mentioned that there will now be a 19-month gap. This will be 19 months of pain for Australians with chronic disease. And for the children in our children's hospitals around Australia, who previously would have had access to Medicare under the Chronic Disease Dental Scheme, that access has now been closed. They will not have to wait 19 months—that is the good news; they will only have to wait 13 months. That scheme starts on 1 January 2014. After that 19 month freeze, when adults can go on the state public dental services, there is still a further waiting list of, depending on the state, 14 to 18 months to as long as 2½ years. So this involves pain for Australians, pain over the next 19 months, while their dental pain has been forgotten by this government. I find it extraordinary that the party of Neal Blewett, the party of Bob Hawke, the party that introduced Medicare and regarded it as one of its proudest social reforms has now decided to rip pensioners and concession card holders off Medicare for dental. It is an extraordinary thing. This minister is the first Minister for Health to take a whole group of people off Medicare for dental. How does it feel, Minister, to be the first Minister for Health to take concession card holders off Medicare—concession card holders who, for the last five years, have enjoyed a choice of dentists and access, the two things that they never had under the state dental schemes. You, as minister, with the stroke of a pen, by regulation, have now closed this scheme and ripped $1 billion from Medicare.

I urge the Independents to think very carefully about this motion. It is a serious motion. We think that the chronic disease dental scheme is a good scheme. We think it should be preserved. We think it is meeting a need for both adults and children with chronic disease, those who are the sickest in our society, 80 per cent of whom have a concession card.

Ms Plibersek interjecting

Dr SOUTHCOTT: Are you making fun of people with asthma? Are you saying people with asthma should not be getting access to Medicare on dental? That is a disgrace.

Mr Dutton interjecting

The DEPUTY SPEAKER ( Ms K Livermore ): Order! The member for Dickson.

Dr SOUTHCOTT: Asthma is a chronic disease, Minister, for your information. Dear oh dear!

Ms Plibersek: The member for Dickson claims that I said they are not sick. That is absolutely not true.

Mr Dutton: What did you say?

Ms Plibersek: I said there is a difference between asthma and cancer.

Dr SOUTHCOTT: She did not say that.

Mr Dutton: You did not say that.

Dr SOUTHCOTT: Anyway, here we have exhibit A—

The DEPUTY SPEAKER: Order! The minister has the call.

Ms Plibersek: I ask that the member for Dickson withdraw that comment.

Mr Dutton: I withdraw.

Dr SOUTHCOTT: Tanya Plibersek, Minister for Health, ripped $1 billion from Medicare for dental—a proud achievement. It is an extraordinary day: a Labor Party minister, a minister from the party of Neal Blewett and Bob Hawke has been the first Minister for Health, since Medicare was introduced in 1983, to have actually slashed Medicare and removed a whole class of patients from Medicare. These are the sickest people in our society. They are the people who had been forgotten by the state dental services. They are the people who had new hope of being treated with a choice of dentist and through Medicare. It has now been lost. I encourage all members of the House, and the Independents, to support this disallowance motion.