Fiona Phillips (Gilmore, Australian Labor Party) Share this | Hansard source

[by video link] In debate on the Dental Benefits Amendment Bill 2021, I'm pleased to stand in support of the recommended expansion of Labor's Child Dental Benefits Schedule with the removal of the lower age eligibility limit, thus opening the Child Dental Benefits Scheme to infants aged zero to two years. It was the Gillard Labor government's Dental Health Reform Package, nine years ago this month, that ensured basic dental services be made available through the Commonwealth to every qualifying child aged between two and 17 and, additionally, the child's parent, carer or guardian. The Child Dental Benefits Scheme has provided over $2.3 billion in benefits through more than 38 million services to over three million Australian children. Now, if that doesn't put some bright into white, I'm not sure what will. However, there is more potential here for every Australian child, indeed, from the day they are born. With a review of the Dental Benefits Act in 2019, a recommendation was put forward to lower the current eligibility from age two to one. Wonderfully, however, within that time, with stakeholder feedback, the review advised a strong preference for removing the lower age eligibility restriction altogether. By removing the lower age eligibility, it is estimated an additional 300,000 children will become eligible for the program.

Having dental care for infants and toddlers is crucial. Babies are born with 20 primary, deciduous or baby teeth that usually start to come through their gums by the age of six months. All teeth have usually appeared by the age of two or three years, emphasising that care for children's teeth commences well before their teeth arrive. With the appearance of teeth, instantly decay becomes a possibility. I'm reliably informed that one of the most serious forms of tooth decay occurs in babies when feeding from bottles containing sugary drinks, such as fresh fruit juice, for when left in contact with teeth, sugary drinks of any sort will cause decay because the sugar is converted to acid that dissolves the tooth enamel. Prevention is always better than cure, and this bill will help to deliver a positive initial dental experience for more Australian kids and help to curb the unfortunate negative stigma around dental practitioners and oral hygiene.

Speaking of cures, I would like to share with the House some success stories through my electorate office with constituents who were in dire need of overdue dental care. But I do want to start by acknowledging the work of all our dentists and oral healthcare workers. They do highly important work in these very difficult times and the government needs to support them better. My office has seen case after case of people applying through the adult public dental scheme—applying and reapplying—all because of government's cuts to adult public dental funding. The consequence is less availability of adult public dental services on the New South Wales South Coast. Waiting periods of four months are common, and not for a routine appointment, no, this is for urgent dental work.

In the case of Mr Leonard Matthews, a resident of Sanctuary Point, he had been waiting three years for denture moulds—three years! It is difficult to imagine the distress that caused, because dentures are a very big necessity. Mr Matthews' son, David, said:

A massive shout out to member for Gilmore Fiona Phillips. My 88 year old father hasn't had his teeth fixed in 3 years. Finally after months of pain rang the members office and within a few hours found out why (paperwork lost) this happened and then sent a voucher to see a dentist ASAP. I’m so thankful and impressed with her and staff for being so caring and quick to sort this problem. Some politicians do have a go and care for their community.

Glen Harlum from Sussex Inlet, when seeking his appointment, said 'anywhere would do' between Nowra and Ulladulla. NSW Health contacted him saying he remains on a wait list for access to services and was informed if he experiences any pain that there is a way to get access to urgent dental services. But as he is not in pain at the time, he will have to wait. The list is long. Constituent Mr David Lawton of Bomaderry, age 79, received advice through the Illawarra Shoalhaven local health district that an appointment would be made. This application then expired after four months, with no appointment having been generated. Then, if you could believe it, Mr Lawton was advised he would need to reapply and would have to wait another four months.

The federal government's cuts to adult public dental care are nothing short of appalling, for which the government should be totally ashamed. But it doesn't stop with just dental. The shortage of GPs in my electorate of Gilmore is critical and that is why I fully support this amendment to the motion for second reading moved by the member for Ballarat:

That all words after "That" be omitted with a view to substituting the following words:

"whilst not declining to give the bill a second reading, the House:

(1) notes the bill expands access to public dental services; and

(2) urges the Government to do more to address:

(a) access to dental and other health services, including General Practice, in outer-metropolitan, rural and regional Australia; and

(b) out of pocket costs for all Australians accessing these services"—

The GP shortage in my electorate of Gilmore is at crisis point. I want to point out that our local GPs and health workers provide the most amazing and vital support in our communities. They are the champions there every day at the forefront of primary health care, going above and beyond for people in their care. They deserve to be supported more. But in the bay and basin area on the New South Wales South Coast, we have seen doctors retire with the one remaining doctor at the Sanctuary Point Medical Centre retiring soon and no replacement in sight. The minister says again our area is not a distribution priority area. Apparently, according to the statistics, we have too many GPs. In fact, some of our GP practices have been calling to be made a distribution priority area for workforce shortage for some time. Take, for example, the Worrigee Medical Practice, which had 13 full-time equivalent doctors but now has five. Some practices in the bay and basin area of the Shoalhaven have gone from bulk billing to private billing and have closed practices in order to consolidate. This has resulted in the net loss of GP appointments available to communities and poorer patient outcomes, and it has placed enormous strain on remaining practices.

The system is broken. We now have a two-tier medical system, where those who have lost their GP due to a practice closure, retirement or relocation of GPs cannot afford to pay private-billing fees and have little or no access to a general practitioner. Constituents in the Sanctuary Point area contacted me recently with their very real personal stories about accessing a GP, and these are their words. Nancy said: 'When my GP retired, I was at a loss. Being 94 years old, I need someone local. Not so—it's the same old, same old story. Practices had too many patients on the waiting list. Some practices had their GPs retiring, other practices were changing to women's health or COVID-19 vaccine and testing. I feel very frustrated.' Lorelle said, 'My mother had to wait 10 weeks in hospital to be admitted to a nursing home because her doctor had moved and we couldn't find another doctor willing to visit her in the nursing home.'

Leanne said: 'It makes no sense that, at the very least, the number of doctors who have recently retired have not been replaced. It already took weeks to get an appointment before they retired and now the wait time is longer. This is putting more strain on an already-busy Shoalhaven Hospital emergency department. The area is increasing in population, not declining. The number of GPs allocated does not [inaudible]. Wait for a sudden announcement of an increase in GPs just when they call the election so that they can take the credit and say, "We were listening." We need more GPs now.'

Graham said, 'The need for more doctors is an essential requirement for the bay and basin area of the South Coast as the population is growing fast and is also an ageing population.' Estelle said: 'I hope we can get more doctors here, as it used to be. At the moment, it's like living in a third-world country.' Kristy said: 'Where have all the doctors gone? There is a gap, and the minister seems to be in denial. More and more subdivisions are going ahead, with no infrastructure happening or even planned. I'm sure the numbers don't lie, so where is the minister's head on this?' Alan said: 'When our GP retired it took us two months to find another, and not local to me. Every practice was overloaded with new patients. In most cases I was told that one of the GPs at these practices was retiring soon anyway, or one practice was changing its focus.'

Christine said, 'It takes too long to get an appointment because there are not enough doctors.' Thomas said, 'There are not enough permanent GPs.' Leigh said, 'We desperately need more GPs.' Tanya said: 'My doctor I had for years retired and then I found out Sanctuary Point Medical Centre was shutting down, so I decided to try and find a new good doctor. When I finally seem to find a good doctor, the next time I go they're gone. My whole family has been in the situation where we need to see a doctor. Every time I have tried to get in to any doctor, there's a wait—normally a week—so we try and diagnose ourselves. Most of the time we get better and forget about it. My worry is, if one of my family members falls ill with something serious, we will not have one doctor that can see us straight away or that can get to know our family, like our old family doctor. We need permanent doctors out here, and more of them, as I am hearing from so many locals having the same issue. They're really concerned about the current situation.'

Frederick said: 'I'm in my 70s and have reached that time when I'm likely to need more regular visits to the GP. I was disappointed to hear that the Sanctuary Point Medical Centre had not been successful in replacing those two GPs who had resigned. I have a medical condition which requires ongoing observation, and do not feel that seeing a new doctor every visit is providing the level of service that I would expect. Sanctuary Point is a marvellous place to live and I don't see why it's so hard to attract young GPs to the area. As a younger man I would have been very happy to work here and bring up a young family.'

There are many cases, but one thing that strikes me most is when a local GP comes to me for support after having previously had their application rejected to employ a GP to work solely in nursing homes as part of their aged-care program, supporting our most vulnerable. This program literally supports older, vulnerable residents, ensuring they get the care when it's needed. This means less ambulance attendances, less emergency department attendances, lower demand on nursing home care workers, and better coordination with discharge planning and outpatient services, especially palliative care. We've had the Royal Commission into Aged Care Quality and Safety. Isn't this the type of program and employment of GPs that the government should be supporting? Instead, it knocks back supporting it by rejecting the application to employ a GP.

But it doesn't stop there. I'm at a loss as to why a local GP even needed to come to me about support for an application for a GP to work in a COVID clinic. It is beyond belief that that could actually occur. There is so much that needs to be done to improve regional access to GPs. I'm pleased that Labor is listening and that it supported the new Senate inquiry into addressing regional and rural GP shortages. More than ever, the government needs to start listening, to support our GPs, our health workers and our regional communities.

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