Tanya Plibersek (Sydney, Australian Labor Party, Deputy Leader of the Opposition) Share this | Hansard source

Today I am rising to speak to the Dental Benefits Legislation Amendment Bill and the amendments moved by the shadow minister for health, who is doing such an excellent job of informing the Australian community about the importance of dental health and of government investment in it. Not long after I was elected I had a man come to me about a friend and neighbour of his—a woman he had known for some years who had had a very difficult life. She was living in public housing. She had left a violent relationship. She had two children she was doing her very best to look after; she was a beautiful, dedicated mother struggling to bring her kids up right. She was so proud of the fact that her son had won a scholarship to go to a quite prestigious school. She had worked hard to give him a secure background, despite her own difficulties, and her great sadness was that she could not go to school with him on his first day of high school because she had no teeth. Her teeth were so bad she thought, 'If I turn up with this boy on his first day of school, he will be embarrassed by me. He will be ashamed of his mother and I don't want him to start school in that circumstance.' This neighbour of hers came to me and said, 'She's not going because she's got no teeth; can you help?' We were able to help. We had some very generous support and she was able to get dentures sooner than she had expected. She had had her teeth pulled out at the dental hospital because they were completely decayed. The dental hospital was able to speed up the replacement of her teeth with dentures, and she was able to go with him. That story has stayed with me for many years because it is such an important illustration of not only the health consequences of an inadequate dental health system but also the social consequences. It is pretty hard to get a job if you do not have teeth. I have met many people over the years who have said that they are embarrassed and that they cannot smile in public. They have no confidence and when they go into a job interview they do not want to speak. It is impossible to overstate how important it is to have decent dental care, particularly for very low-income Australians who have missed out along the way.

This is one of the reasons we introduced our health package when we were in government, and one of the things I am proudest of, as the former health minister, is the work that we did in dental care. When I was the health minister we introduced a $4.1 billion dental health reform package that followed previous substantial investment of $515 million. This dental health reform package focused on helping low- and middle-income families, children and those in outer metropolitan, regional, rural and remote areas. The member for Lingiari was speaking earlier about the communities that he represents and how important the investment has been in those communities. The package had a number of key measures, ensuring dental health for young Australians, ensuring dental health for low-income Australians and investing in the dental workforce and infrastructure. Unfortunately, so many of those measures that we implemented are today at risk and under threat—in some cases, already reversed.

The Child Dental Benefits Schedule is a fantastic investment in the future dental health of our children. You will not grow up to have good oral health if you do not start as a kid. It reminds me of another story. One of our previous members of parliament was once a social worker. There was a girl who was about 15-years-old who used to get $2 dollars a day for her lunch; one day she would buy hot chips and the next day she would buy a two-litre bucket of ice-cream. As a social-worker teacher, my colleague said to her—I think her name was Tammy—'Tammy, you really need to look after your health better. Have you been brushing your teeth?' 'No, I haven't been brushing my teeth,' came the reply. My colleague said, 'Well you'd better start brushing your teeth or you're going to lose them.' Tammy replied, 'It doesn't matter if I lose them. I lost the first lot and they just grew back.' So there was not even the most basic level of education in that young woman's home about good oral health. If you do not start life with good teeth then you do not get them as an adult.

We decided to invest in the teeth of our young people from families on middle and lower incomes so that going to the dentist for this generation of young Australians would be as easy as going to the doctor. I am proud of that. So three million kids between the ages of two and 17 would get access to a benefit of about $1,000 over two years so that they could get a check-up, get fluoride treatment and get fillings and a whole range of basic dental work. We hope that that investment at this early age means that they will develop life-long good oral health. We also hope that the number of young people who are hospitalised every year because of avoidable dental issues—20,000—will continue to reduce. There are kids who have a general anaesthetic because they are too young to have explained to them that it is important to sit still and have dental work done. They are under a general anaesthetic having all of their teeth pulled because their teeth are so rotten. You can imagine not only the health effect of that but also the distress that it causes those children and their families.

According to the Australian Institute of Health and Welfare, 58 per cent of 14-year-olds experienced decay in their permanent teeth in 2009. And I will tell you what: there is a big difference between kids in the poorest areas and kids in the wealthiest areas. Low- and middle-income families have 1½ times the amount of tooth decay and cavities of those in the wealthiest areas.

In the first five months of the Child Dental Benefits Schedule operating around the country, we have seen 1,522,393 services, including 15,000 in remote and very remote areas—the kids that my friend the member for Lingiari was talking about earlier. It is a wonderful scheme, and the thing that worries me is that we have a health minister who is saying now that he has concerns and that he is deeply troubled by the Child Dental Benefits Schedule. In his second reading speech, the minister said:

I put on the record some early concerns about the way in which the Child Dental Benefits Schedule was structured.

Seriously, he is the minister. He has been the minister for more than a year. If he has concerns, maybe he should put some effort into fixing them rather than just flagging what he is planning, which is a future cut to this wonderful scheme.

We also invested $1.3 billion in this same package for around 1.4 million additional services for adults on low incomes, including pensioners and concession-card holders and those with special needs, to grant them better access to dental care in the public system. That is on top of our initial $515 million dental package, which was the original public dental blitz. Around 205,000 additional public dental patients received treatment in 2013 because of that blitz. But, of course, this government has cut funding to this scheme and other dental programs in the 2014 budget. There has been $400 million cut from public dental schemes that were helping so many Australians. The member for Lingiari talked about the importance of workforce measures, particularly in communities like his—remote communities where it has been particularly hard to get a dental workforce. We provided $225 million for dental capital and workforce to support expanded services for people living in outer metro, regional, rural and remote areas. We wanted to ensure that Australians had the same access to dental care no matter where they lived.

This government has cut that program, as well, in the 2014 budget. They cut $229 million from the dental infrastructure scheme, which was helping build vital services in rural, regional and outer metro areas. They cut $15 million from Charles Sturt University's program to establish dental clinics on the Central Coast. They cut $40 million from the Voluntary Dental Graduate Year Program, as the member for Lingiari pointed out. How distressing for people who have been waiting so long for some decent dental care to have this government come in—despite saying, 'No cuts to health'—and cut hundreds of millions of dollars from dental care! We undertook these reforms because the previous—

Mr Ewen Jones interjecting—

So you support these cuts, do you? Yes, he supports the $400 million cuts.

Mr Ewen Jones interjecting—

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