Mal Washer (Moore, Liberal Party) Share this | Hansard source

I thank the member for New England; I share his passion about dental care. That is terrific. The purpose of the Health Insurance Amendment (Medicare Dental Services) Bill 2007 is to amend the Health Insurance Act 1973 in order to increase access to dental treatment under Medicare for people with chronic conditions and complex care needs. In the 2007-08 budget, the Commonwealth government announced an expansion of the current enhanced primary care dental items to provide higher Medicare rebates and more services to eligible patients.

From 1 November 2007, eligible patients will be able to access Medicare benefits for dental services of up to $4,250—including any Medicare safety net benefits, where applicable—over two consecutive calendar years. This arrangement further enhances the measure announced in the budget which provides for patients to receive a diagnostic consultation and a maximum of $2,000 in Medicare benefits for dental treatment each calendar year. A limit of $4,250 over two calendar years will give more flexibility for patients to receive dental assessment and treatment when they require services. This amount may be used for any combination of dental services covered by Medicare under this measure, depending on the clinical needs of the patient.

This bill also enables Medicare benefits to be paid for the supply of dental prostheses, such as dentures, under the new dental items. This will be of particular help for older Australians, many of whom have chronic and complex conditions and require dentures to eat a balanced and healthy diet. The Medicare dental items will be targeted at people with chronic conditions and complex care needs where the person’s oral health is impacting on, or is likely to impact on, their general health. To be eligible, a person needs to be managed under a GP management plan and team care arrangements. Residents of aged care facilities can also access the dental items if they are managed by a GP under a multidisciplinary care plan. All patients will need to be referred to a dentist by their GP.

People with chronic conditions, such as diabetes, cardiovascular disease and cancer, often have poor oral health, which can adversely affect their condition or their general health, so this bill will certainly address this. However, it is generally accepted that you cannot be healthy without oral health. Historically, we have separated medicine from dentistry, and many people are suffering ill health as a result of this terrible decision. If you have infected gums or gingivitis, you can have episodes of bacteria flowing through-out your blood stream. Porphyromonas gingivalis, an important bacteria involved in periodontal disease, has been linked to cardiovascular disease. This bacterium has four identifiable genes which enable it to invade and infect human arterial cells. Oral pathogens can also damage heart valves, infect prosthetic joints and increase the risk of pneumonia—all potentially life-threatening conditions. The Australian Dental Association has challenged that the bill implies poor oral health is important only insofar as it affects a chronic medical condition or its management. This is certainly not the intent. The Medicare dental items will target people with chronic conditions and complex care needs where the person’s oral health is impacting on, or is likely to impact on, their general health.

The importance of this bill is that it helps the most vulnerable. The most vulnerable, often people in our aged care system, do not necessarily get onto waiting lists for the state government to look after them. Many of them have chronic conditions and complex care needs. Certainly the dental treatments of those that are financially disadvantaged and that are currently sitting on lengthy state dental waiting lists are important. However, the states need to pick up their act. The Commonwealth has committed long-term, record funding through the Australian health care agreements. States and territories will receive up to $42 billion under the 2003-2008 agree-ment to meet their commitments including delivery of dental services.

Currently the Commonwealth is directly involved in oral health services through veterans affairs programs, providing dental care for around 300,000 people; the Armed Forces and Army Reserve Dental Scheme; university training for dentists, dental therapists, dental hygienists and oral health therapists—this was further enhanced in the recent budget with a new school of dentistry and oral health; dental scholarships for Indigenous students; subsidised drugs prescribed by dentists under the PBS; dental services provided through community controlled Aboriginal medical services; specialist oral surgery and oral radiography through Medicare; the cleft palate scheme; and dental services on Christmas Island and Cocos (Keeling) Islands.

The Commonwealth also subsidises private health benefits. The Commonwealth’s 30 to 40 per cent private health insurance rebate has enabled private health insurance to be more affordable for many Australians. This has certainly been reflected in the figures. Statistics released last month by the Private Health Insurance Administration Council showed private health hospital insurance has increased for the eighth consecutive quarter with more than 76,000 additional people covered in the June quarter. A record 9.7 million people, or 46.1 per cent of Australians, are covered for private health insurance general treatment, including dental treatment. In the 2007 March quarter over six million dental services were claimed with over $300 million in benefits being paid.

The Commonwealth also recently contributed to an innovation that could have an enormous positive impact on the dental care of Australians, especially those with complex needs such as those in our aged care system. Dr Patrick Shanahan’s innovative antibacterial gel, DentaMed, received $64,000 through an Ausindustry Commercialising Emerg-ing Technologies grant. Historically, the prevention of dental disease has relied on the mechanical removal of plaque using dental floss, a toothbrush and abrasive toothpaste, not on antibacterials. Toothpastes are formulated primarily to improve tooth appearance, freshen the breath and deliver fluoride benefits. They have minimal antibacterial activity. There are several antibacterials that do have an effect on plaque and oral pathogens. These antibacterial mouthwashes are often used immediately after brushing to improve oral health. But dental research has shown they have limited benefit when used like this. The abrasives in toothpastes temporarily remove the tooth pellicle, preventing attachment of the antibacterials and, because these mouthwashes and toothpastes are chemically different, the residual effect neutralises the antibacterials.

Developed and refined over a period of 18 years, DentaMed gel’s technology synergistically uses the saliva, antibacterials, fluoride and a nanoparticle healing and coating agent to maintain the whole mouth. The saliva is the body’s natural mouth protector, coating the whole mouth, including the teeth, with a protein-like material. The gel’s delivery system retains the saliva and uses it to attach the antibacterials. The introduction of nanotechnology further increases these benefits. The nanoparticle chitosan—sourced, incidentally, from crayfish shells—delivers two critical functions. In addition to accelerating healing, it provides a slow-release system for the antibacterials, zinc and fluoride. This provides continuous protection between treatments.

The product has undergone successful clinical trials and is now readily available. It will greatly assist not only those in care and their carers but anyone wanting to improve their dental health. It is thought that around 200,000 patients will access the new enhanced primary care dental items over the first four years of this measure, with an estimated cost of around $384.6 million. There are concerns that some patients may not receive dental treatment under the scheme as most people under a GP management plan could be eligible—around 400,000 patients. However, if the uptake is greater than expected the department has advised that outlays would be increased to cover the level of take-up, much as is the case with any other Medicare item. The expansion of the enhanced primary care dental items proposed by this bill will dramatically improve the dental and therefore overall health of many Australians. I certainly hope that we can get medicine and dentistry back together again.

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