Jill Hall (Shortland, Australian Labor Party) Share this | Hansard source

As the member for Riverina has finished her contribution to the debate on the Health Insurance Amendment (Medicare Dental Services) Bill 2007, I would like to say that, while I know she is a member who cares for her constituents and would get in there and fight for them, I disagree with her that a bill deserves to be supported just because having it is better than nothing. The bill before us today seeks to extend a policy, which was in legislation previously brought before this House by the Howard government, that has failed abysmally in the community.

This is the government’s attempt to make unworkable legislation work. It is legislation that addresses a very small proportion of the problem that we have in dental care, and it provides services only to people with chronic illnesses. So those 650,000 Australians who are on dental waiting lists throughout this country will not get to first base under this legislation unless they suffer from a chronic illness. I think that is a really important point to make up front.

At the beginning of my contribution I would also like to point out that today the Labor Party has made an announcement that I believe will address the issue for all Australians who have been on the dental waiting list for years—those 650,000 Australians. The Labor Party’s announcement today will provide almost $400 million for one million new dental consultations. This will address the backlog that exists—a backlog that has been created by the Howard government.

The Prime Minister said in question time today that when the government came to power there was a Commonwealth Dental Health Program. The Prime Minister said that the government got rid of that because the dental waiting list was under control. Well, Mr Prime Minister, I say to you that by getting rid of the Commonwealth Dental Health Program you have created an uncontrollable dental health waiting list. This has created great hardship, angst and misery for a number of people, because dental health is a very important component of a person’s overall health. Because dental health has been allowed to blow out in this way—through the Prime Minister, his health minister and all the members of the government saying, ‘It’s a state issue that’s got nothing to do with us’—there are now 650,000 Australians who cannot access dental treatment when they need it.

To be honest with you, it is not good enough. It is very easy to come into this place and blame the states for the problem. The role of the federal government, the Australian government, is to take responsibility, show leadership and deal with the problem. This legislation provides a monetary limit of $4,250 over two consecutive calendar years, which will be set out in a ministerial determination which we have not seen yet. Under the new dental items, Medicare benefits will be paid for the supply of dental prostheses such as dentures. That will be welcomed by those few people who qualify for it.

The government’s Medicare dental program is for people with chronic conditions and complex care needs. It was first established in July 2004. It has been hampered by a low take-up rate and by the complexity of the system—both from an administration point of view and from the point of view of being able to access it.

About three months ago I had a constituent come to see me. He had a very severe medical condition—mouth cancer—and, because of the ray treatment that he had had for the cancer, he had to have very specialised dental treatment. This person needed to have all his teeth removed and had big problems with infection and decay of his teeth, but no dentist would touch them. He had been on a waiting list for over one year when I first met him. He had a letter which the doctor had sent to the dental clinic saying that this was an urgent matter and this person’s health was starting to deteriorate because of the problem he had with his teeth.

I pointed out to my constituent that there existed a Commonwealth dental health program, under the Enhanced Primary Care Program. I had to download all of the information from the computer and give it to my constituent, who then took it to the doctor, who was very surprised to find out that this scheme existed and had existed since 2004. Subsequently, my constituent was referred to two different dentists for opinions. He is still waiting for treatment and is over $100 out of pocket. He will probably benefit from this scheme but I argue that he will still be significantly out of pocket because the scheme will not cover his complex needs. This is a prime example of how the scheme, which has been in place since 2004, has not worked, how doctors do not know about it and how it is an administrative nightmare. I argue strongly that we are expanding a scheme that has failed in the past and is destined to fail in the future. It is a scheme that will provide a service to a very small group of people.

Whilst I am talking about the ineffectiveness of the scheme I will give you another example. I was talking to another constituent at a seniors forum I held. This constituent had heard about the Enhanced Primary Care Program for dental care. His doctor had referred him to a dentist. He had had the dental treatment and he paid for the treatment—it was itemised under Medicare—and then he took it to the Medicare office.

The Medicare office said, ‘We can’t pay this; this isn’t covered under Medicare. Dental care is not covered under Medicare.’ I have now picked up this case and will follow it up with my local Medicare office. But, once again, this shows how the current system does not work because the people who work in the Medicare offices do not understand how the scheme works. Firstly, we have doctors who do not understand how it works; secondly, we have Medicare officers who do not understand how it works; and, I suppose, thirdly, we have people that we represent in this parliament who can only find out about it through contact with people like us. I think that the two cases I have raised here in this parliament tonight demonstrate how the current system is failing Australians dramatically.

In question time today the shadow minister for health asked the Minister for Health and Ageing whether he could inform parliament why the government’s chronic disease dental program has assisted only 14 preschoolers since its inception and only 70 children between the ages of 14 and 15. I must say that the answer that was given by the minister was less than satisfactory. I put it on the record that, between 1994 and 2004, hospital rates for children under the age of five increased by a staggering 91 per cent. Over the decade there has been a hospital rate of 91 per cent for children with dental health problems. Recently MBF released figures that showed a 42 per cent increase in children being treated in private hospitals for dental cavities. This shows a system that is not working. The government would argue that people who do not have chronic illnesses are being assisted to obtain dental care through private health insurance or through the 30 per cent rebate. We on this side of the House support the retention of the 30 per cent rebate, but there are still many people who cannot access dental health care because they cannot afford private health insurance. If they do have private health insurance the gap is enormous, and they are left with large bills.

I am a member of the House of Representatives Standing Committee on Health and Ageing, and in November 2006 we tabled a report called The blame game: report on the inquiry into health funding. In that report there was a section on dental care. Initially, we were not going to look at dental care, because we were looking at health costing, but we were overwhelmed with submissions and evidence in relation to dental care. The recommendation was:

The Australian Government should supplement state and territory funding for public dental services so that reasonable access standards for appropriate services are maintained, particularly for disadvantaged groups. This should be linked to the achievement of specific service outcomes.

This legislation deals only with people with chronic health problems. This does not go to assisting those people who are particularly disadvantaged. The Healthy mouths healthy lives: Australia’s national oral health plan 2004-2023 report was endorsed by the AHMC on 29 July 2004. This report identifies a range of issues, particularly relating to funding arrangements for a dental workforce. That brings us to the point of highlighting the chronic shortage of dentists in Australia. We have an ageing dental workforce, a workforce that will go nowhere near meeting the needs of Australians as they go forward throughout this century. In 2003 research highlighted that there would be a shortage of 1,500 dental professionals by 2010, and in 2004 dental graduation levels were found to be at their lowest level in the last 50 years. We took evidence from dentists when we put together this report. In addition, I have been strongly lobbied by dentists who work within the public system who pointed out to me that there is just not enough money put into the training of dentists and not enough money put into funding dental care in Australia. It has been argued by many people in our community—professionals and people who need dental health care services—that dental health care should be no different from any other service. I cannot see why a constituent of mine should have to go without dental treatment and because of that be forced to live on soft foods for long periods of time, as was a constituent who lives in Toukley, whose plight I raised in this parliament last year.

Recently, I received a letter from a constituent that I found particularly moving. This person lives in the Lake Macquarie part of the electorate and has a son who is on a disability support pension. She explained that her son had had his molars removed but was still needing additional dental treatment. Initially, he was told that he would have to wait several months for the treatment. Then, within the last three weeks, his mother called the dental health clinic and was told, ‘No, it is not several months; it will be over a year.’ Her son has significant health problems. It is not only the problems that he has with his teeth but also the whole-of-body problems that are being caused by his dental health problems. He can only eat softish food, and he is gaining weight because the kinds of foods that he can eat make him gain weight. He has to take vitamin supplements to enable him to maintain a state of semi-healthiness. It only enables him to maintain his health at a very low level. He has had very bad flus and has been very sick. His mother attributes this to a large extent to the fact that he has been unable to get the dental care that he needs.

I think the government stands condemned for its inaction in the area of dental health. It stands condemned for ripping out the Commonwealth Dental Health Program in 1996. At that time I was in the state parliament and I saw the difference that program made. People who were previously able to get dental treatment when they needed it were coming to my office because the waiting time had blown out. Prior to going into state parliament, I worked in rehab, and many of the people that I worked with there were able to access that treatment. In one fell swoop, the government turned the insignificant waiting list that the Prime Minister talked about today in question time into the situation that we have today with 650,000 people on the waiting list. That is just not good enough.

Each and every day, members of the Howard government stand up in this parliament and refuse to take responsibility for their actions by blaming the states. That is not leadership; that is abrogating your responsibility. It is about time that the Prime Minister, his health minister and other members of the government took this issue seriously. It is not only people with chronic health problems that have issues with dental health; everyone does. We should ensure that each and every Australian can access quality dental health treatment when they need it. That is what the ALP’s policy announcement today will allow them to do.

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