Local advocacy groups win with Labor's Dental Health Reform Package (09/10/2012)

13 January 2013

Tanya-and-Alice-Scott-group2.jpgFor over a decade now members of the Illawarra Dental Health Action Group have been campaigning for reform in dental care. The action group is chaired ably by Ms Alice Scott, a constituent of mine, who is a very active member of the community, not only in dental care but in a whole raft of other areas of community life. This group has been agitating not only for an improvement in existing services but in pointing out where local dental providers are not doing the right thing under existing government schemes, advocating on behalf of local community members, particularly members on low incomes who are attempting to get access to the public dental scheme, and, lobbying government, having come here to Canberra on several occasions with a bigger than life-size pair of teeth to draw attention to their cause.

So they have been working for over 10 years to see some reform in the way dental health is delivered in this country. Their objective, quite simply, is to ensure that the mouth is treated no differently to any other part of the body when a person seeks medical or health treatment. That is, if somebody has a problem with their oral health then they are able to deal with it through a Medicare provided service in the same way that they could have an ailment in any other part of their body treated through a primary health care provider and paid for by the Medicare system.

So I am not surprised that when the Minister for Health announced the government's $4.1 billion Dental Health Reform Package on 29 August this year it was welcomed by the Dental Health Action Group. It was a guarded welcome, I have to say, because their long-term objective, as I have said, is the full Medicare-isation of dental health care, but they could see that this was a first and significant step.

What we are doing through this $4.1 billion dental reform package is ensuring that, for about three million children, going to the dentist will be just like seeing a GP3.4 million children whose parents get family tax benefit part A or are receiving a range of other government income support benefits will be able to have access to the government's dental care package for kids. Families will be entitled to $1,000 per child every two years through the package to provide for dental care for their kids. Parents will be able to take their children to either a private or a public dental service to access the program. In addition to the dental care for kids arrangements, the reform package will provide additional services for 1.4 million adults on low incomes, including pensioners and concession card holders and those with special needs, to give them better access to dental health care in the public system.

We must remember that this does not stand alone. It builds on the nearly half a billion dollars that was set aside in the Labor government's last budget to fund a state government blitz on public dental care waiting lists. As you would know, Madam Deputy Speaker O'Neillbecause you represent a similar electorate to minemany people who are currently on public dental waiting lists are seeking access to free or significantly subsidised dental care simply because they cannot afford it themselves. This package goes a long way towards ensuring that those people have that much-needed dental care.

The issue of dental care for children is particularly important. We know that the oral health of children in our community has been declining since the mid-1990s. Almost 20,000 kids under the age of 10 years are hospitalised every year because of avoidable dental issues. By the age of 15, six out of every 10 kids have tooth decay. We know that if we nip this in the bud early we can ensure not only that we are improving the oral health of these kids but that we are saving both them and the public system a hell of a lot of money down the track. If tooth decay is prevented or treated early then a child's problems can be treated by way of a filling instead of removal of a tooth or several teeth and instead of long-term gum disease. It is a significant investmentand I say it is an investment because we are investing in the oral health of our children to ensure that we do not need to pay significantly more down the track when significant dental disease occurs.

So this has been very much welcomed by the dental health advocates within my electorate, and it will mean a lot to kids within my electorate. There are about 52,000 kidsabout 28,000 familiesin the region who will be able to gain access to the government's subsidised dental care. That is indeed a significant benefit for people in the Illawarra and Southern Highlands. In my own electorate around 19,000 kids, coming from around 10,000 families, will have direct access to the scheme. They will see a benefit, straight up, that they do not currently enjoy. It will enable us to tackle, head on, that decline in oral health standards that has been occurring since the 1990s, particularly in kids from low- and middle-income families.

A number of comments have been made within the course of this debate, including by the last speaker, about why we were closing the chronic diseases scheme. I think he used the words, 'If it ain't broke, why fix it?' Nothing could be further from the truth. In my own electorate I have received numerous complaints from constituents who have accessed the scheme only to find that they have been treated for ailments that they did not believe they had and that, on second opinion, they found they did not have; that the cost of the treatment they received was wildly inflated so as to access the entirety of the Chronic Disease Dental Scheme budget for their individual allocation; and that shoddy work was performed on more than one occasion.

I had somebody come into my office and seek my assistance because they had been provided with a dental plate that did not fit. They were unable to eat in the normal way that you and I would expect somebody who has just undergone significant dental treatment and had a new plate fitted to be able to do. They could not even chew on a sausage, such was the poor quality of the work. So somebody saying, 'The scheme isn't broke, so why fix it?' shows that they are clearly out of step with the community and out of touch with realityand that is before we get to the cost of the scheme.

The scheme that was introduced by, I believe, the current Leader of the Opposition, who was the then Health Minister. He brought in the legislation to bring about the Chronic Disease Dental Scheme. We were told it was going to cost $90 million a year. It is currently costing over $1 billion a year, so no more evidence is needed as to why something is wrong. We have heard numerous examples of how the scheme has been rorted. It is not means tested. It is poorly targeted. So it was a poorly designed scheme from the get-go. Its aims, I will say, were absolutely laudable. I think the aim of ensuring that people with chronic dental diseases have a mechanism by which they can have those diseases treated, and treated in an affordable wayand treated quicklyis laudable and would enjoy the support of all members in this place. But to have a scheme that is aimed at ensuring that extended from everyone on a pension to those on multimillion-dollar salaries, and to have a scheme which is so poorly designed as to allow the sorts of rorting that has gone on, is not in the public interest. That is why we are moving, through this legislation, to reform the scheme and replace it with one that is means tested, that is targeted and that I hope will become the Medicare-isation of dental health care in this countryand it matters a lot.

This is aimed at children and aimed at improving the public health dental waiting list. But there is another group of people we should be focused on. On more than one occasion I have had employers talk to me about this issue and the importance of dental health to improving somebody's employability. If they have two job applicants come through the door and sit down for a job interview, and one starts to talk and they have are poor, decayed and gapped teeth, and the second person, sitting alongside them, has all the same aptitudes but does not suffer the same diseases and the same problem, the second person is more likely to be employed. I do not endorse that approach, but it is a reality. I have had job seekers say the same thing to me as well. So it is not just a cosmetic thing, and it is not just a health thing; it actually impacts on somebody's capacity to look for work and to be successful in job applications. I think the bill before the House is a first and important step in overhauling this scheme and will provide real benefits to people who live in electorates like mine.

I will conclude by once again congratulating the tireless work of the Illawarra Dental Health Action Group, its chairperson, Alan Scott, and the many people who have campaigned for over a decade to provide support to local constituents and advocated on behalf of public dental health patients. It has been an important organisation in ensuring that we get the sort of change that we are debating in this chamber today. I commend the legislation to the House.