House debates

Tuesday, 9 October 2012

Bills

Dental Benefits Amendment Bill 2012; Second Reading

12:42 pm

Photo of Teresa GambaroTeresa Gambaro (Brisbane, Liberal Party, Shadow Parliamentary Secretary for Citizenship and Settlement) Share this | Hansard source

I rise to speak on the government's latest unfunded policy farce—the Dental Benefits Amendment Bill 2012—and its astonishing political decision to axe the Howard government's Medicare Chronic Disease Dental Scheme. This farce began on 29 August this year when the Minister for Health, Tanya Plibersek, and the Greens health spokesman, Senator Di Natale, announced an unfunded $4.1 billion dental program that is not even due to commence until 2014, right after the next election. Sadly, policy announcements based on phantom funding to be delivered on the never-never timetable are becoming par for the course under the Gillard government. What is more disappointing is that, despite knowing 'Wasteful' Wayne has delivered a $120 billion budget black hole that is rising by the day, the Gillard government continues in its deceit of the Australian people in making promises that it cannot possibly keep.

The situation keeps getting worse. When the government attempts to explain where this $4.1 billion is coming from, it cannot quite give us the answers. The Prime Minister and the health minister clearly were not reading from the same song sheet on 29 August this year. They had a press conference where they sent out mixed messages as to where the money was coming from. The Prime Minister said:

The announcement today is about a large saving. That is through the closure of a scheme designed by the former government, by the Howard government.

But then the Minister for Health claimed that the scheme would be new money. Apart from contradicting the Prime Minister, the health minister contradicted her own response when asked where the funding was coming from. Yes, where is the funding coming from? The minister's response was that the government will find the savings in the budget which will be outlined in the Mid-Year Economic and Fiscal Outlook later this year. That fiscal outlook is going to show just how badly the Labor government continues to drag the country into debt.

So, after first saying it was going to be new money, which was then contradicted by the Prime Minister, who said it was a savings, the minister then said:

We have a very good record of finding savings in the budget … We found $30 billion of savings in the last one.

The government must come clean; is it a saving or is it a spend? The government's inability to explain where the money is coming from is very disappointing, especially when we remember what Prime Minister Julia Gillard told Australians in a press conference on 11 February last year. She said:

Every time we announce something we properly account for it …

It seems she forgot about that promise. Then again, this is the same Prime Minister who told the Australian people that 'there will be no carbon tax under a government I lead', and we all know how that worked out.

There is a rather unfortunate pattern emerging here of Labor and the Prime Minister promising they will do one thing and then doing completely the opposite. This is their status quo. It would appear from recent media reports that even the Labor caucus is worried. A number of caucus members asked at a meeting a few weeks ago, 'Where's the money coming from?' They are very worried about where the money is coming from. The fact that the government has no money to fund this proposed dental scheme will inevitably lead to higher taxes. We recently heard the government's own Treasury official commenting that there is only one place where money can come from; he outlined a number of areas, and higher taxes were included in that.

The Dental Benefits Amendment Bill does not commence until 1 January 2014. The bill makes some minor amendments to the Dental Benefits Act 2008, changing only the eligibility age of the current Medicare Teen Dental Plan from 12 to 17 years to two to 17 years. It makes other minor terminology changes to provide for a change from the Medicare Teen Dental Plan to the Child Dental Benefits Schedule. A schedule of services, fees and details of how the scheme will be funded is still not available, but this government is always very poor on the detail.

Apart from the fact that there is no money to fund this scheme, the government is rushing the bill through parliament without the detail I have just mentioned, and it does not commence for well over a year; that is, a year after the next election. The government's actions suggest this is all about the politics of the issue rather than some really good policy decisions. The minister has acknowledged that services for most children will cost less than the proposed $1,000 cap. There will be children on the Medicare Chronic Disease Dental Scheme who will require more services but, alarmingly, there is no provision to ensure they will continue to receive adequate treatment, especially in the period before the bill commences.

Available data suggests that well over 60,000 services have been provided to children under the CDDS thanks to the policies of the Howard government introduced by the Minister for Health at the time, Tony Abbott. It seems that whatever the coalition giveth the Labor Party is intent on taking away. Thanks to Labor and the Greens, the closure of the scheme on 30 November will leave a gap of 13 months for many children currently receiving treatment. There are children in the midst of treatment who will not be able to have their treatment covered or completed by 30 November. Those families will have nowhere to turn. This is how Labor cares for Australian families—false promises of future programs with phantom funding. The minister and the Greens should explain why Australian children must suffer for 13 months with incomplete treatment and no certainty of the schedule of services that are to be provided—assuming, of course, that the government actually delivers on its unfunded promise in July 2014.

As I said, the CDDS was introduced by the coalition when we were in government and it has been an enormous success. It is the only Medicare dental scheme that provides treatment for adults. It has provided 4,250 Medicare dental benefits over two years for eligible patients with a chronic health condition, and approximately 20 million services were provided to more than one million patients since 2007. Labor has repeatedly tried to close the scheme for political reasons—simply because it was established by Tony Abbott as health minister and it has been a success in improving access to treatment. Despite Labor's claims of expenditure blow-outs, the average claim per patient, according to the Department of Health and Ageing, is $1,716—well below the allowable $4,250—and some recent estimates suggest the average cost per patient has fallen to below $1,200. The coalition offered to work with the previous health minister to refine and improve the scheme, including working through a process to provide high-cost items such as crowns and bridges, but all offers were rejected.

It was quite amusing to listen to the member for Deakin when he said earlier on that this was a scheme for the rich. Well, it has been reported that 80 per cent of services under the CDDS were provided to concession card holders or low-income earners. It should be noted that Medicare is a universal scheme that all Australians pay for through the Medicare levy and the taxation system. But this evidence suggests that the dental services have been predominantly utilised by low-income Australians. Many of these people would otherwise have been forced to go without treatment or they would have added to the 650,000 people who are already on public dental waiting lists.

Thanks to Labor and the Greens, as from 30 November this year patients will be left without access to treatment and many will be unable to afford the full cost of private treatment. The government's vague promise to provide funding to the states and territories for public services is not due to commence until mid-2014—and we know what a great success that has been in the past when services were not provided to people or there was a go-slow and the states took the money but the delivery of services was very dubious.

Some patients in the midst of complex treatment will not be able to complete their treatment by 30 November. This will have serious health, economic and social ramifications for these people. Under this bill Labor is proposing to provide funding of $1.3 billion to state and territory governments for public dental services, but this funding will not commence until July 2014. It seems as if Labor is hoping it might win the lotto in the meantime to pay for it, because that is the only place it is going to get this money. That is why the government is not saying where the money is coming from. So, from 30 November this year many patients on the CDDS will lose access to treatment and will have to wait 19 months to see if the government delivers on its promise and provides more funding to state governments. Again, not surprisingly there is no detail on how much funding will be provided by the end of the year, with the possibility that the bulk of the money might not be provided until the end of the six-year period, in 2018, if at all. There are already 650,000 people—400,000 adults, according to the government—on public dental waiting lists. The minister has said Labor's plan will only provide 1.4 million additional services over six years. The CDDS has provided approximately 20 million services, including seven million in the last financial year alone.

In 2008 Labor promised the Commonwealth Dental Health Program, which it never delivered. The program promised one million services by providing funding to the states and territories. It was revealed in Senate estimates that the Commonwealth did not assess the capacity of the public dental workforce to provide projected services and the number delivered may have been significantly less than was promised. The number of services to be provided over the full six years under Labor's recent proposals is only 20 per cent of what the CDDS provided last year alone. What is worse is that there are no guarantees that there is any capacity to deliver the proposed services through the public system in terms of workforce or infrastructure. A lack of infrastructure, particularly in the public system, will impede capacity to deliver the projected number of services.

The $225 million measure under the government's proposal to develop infrastructure will not be available prior to the commencement of the new initiative. An invitation to apply for funding under the Flexible Grants Program for dental infrastructure, both capital and workforce, will not commence until 2014 so projects are unlikely to be completed or provide tangible benefits until years later. All in all, this bill does not set out a properly funded dental scheme that inspires any confidence whatsoever.

There is hope, however, for Australian families that the coalition supports investment in dental health. The coalition is very concerned that many patients receiving treatment under the CDDS will miss out on the treatment during the gap period between the closure of the CDDS and the proposed commencement of the government's measure. The coalition renews its commitment to work with the government to refine the CDDS in the meantime, including reviewing the process to provide in certain high-cost items such as bridges and crowns. I call on the minister and all Labor backbenchers and the Independents to put aside their political churlishness and to act in the best interests of Australian families and in the best interests of their dental health.

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