Shayne Neumann (Blair, Australian Labor Party, Shadow Minister for Veterans' Affairs and Defence Personnel) Share this | Hansard source

I'm pleased to support this legislation and the amendment in relation to it. It's a surprise that the Dental Benefits Amendment Bill 2021 comes from the coalition government. It builds on what Labor has done when we were last in government and I will refer to that and to the history of this particular legislation as well.

Effectively, the Dental Benefits Amendment Bill 2021 removes the lower eligibility age restriction of two years to allow eligible children from zero years of age to access the Child Dental Benefits Schedule. That will benefit 2,000 or more children in my electorate of Blair in South-East Queensland. That's very important. About 300,000 children across the country will benefit each year. This scheme operates to provide eligible children currently between two and 17 years of age access to over $1,000 in benefits for basic dental services, with benefits capped over two consecutive calendar years. This is a good amendment, and it is a surprise that it comes from a coalition government.

I'm happy to talk about the background to this particular piece of legislation and the amendment that relates to it. When Labor was last in government, back in 2008, we brought in a new teen dental plan which meant that eligible families—usually people on family tax benefit A and those in receipt of Abstudy or youth allowance—could receive an annual preventive dental check for each child between the ages of 12 and 17. That was to help families fix their kids' teeth and to honour an election commitment we made. It comprised oral examinations, cleans, scales and x-rays, which cost about $290 at the time. The statistics showed that at that time that one in three Australians avoided attending a dentist because of its cost. That has continued in large part. The funding that we announced was to provide welcome relief for families who were struggling to meet the cost of a dentist.

This particular plan was very well received at the time and supported by families. When we were last in government, we brought in a new scheme on top of that, which was benefiting about 25,000 children in my electorate around Ipswich and the Somerset region, making it easier to go to a dentist or see a doctor. The program was called Grow Up Smiling, which benefited about 3.4 million Australian children. It provided subsidised child care and additional services for adults on low incomes, including pensioners and concession card holders with special needs who needed better access to the public dental care schemes run by the states, and additional funding of $225 million for dental capital and workforce, to provide expanded services for people living in metropolitan, regional, rural and remote areas. I will get to that aspect as well. This scheme was very well received. I remember the then CEO of the previous West Moreton-Oxley Medicare Local in my region, Vicki Poxon, saying, 'An announcement like this will go directly towards improving the all-round health and wellbeing of our residents, in particular, children and pensioners, who need it the most.' About 20 per cent of the whole West Moreton region into rural parts of Ipswich and beyond were children under 14 years of age at the time. That particular announcement was very well received.

It's really important that we address the issue of dental decay in children. That is not just because of the chronic long-term impact and not just in terms of their employability, their lifestyle and their future health; it is also a real benefit to our expenditure when it comes to Medicare and public hospital funding in the future. If you can provide preventive health care at the beginning of life and continue that with regular check-ups, it has better outcomes for the health of the country and better economic outcomes. Poor dental health has a wide-ranging impact on speech, sleep, eating and employability. It's important to relieve the pressures on public hospitals and the broader health system.

Labor have a proud record in this space and we are very pleased to see the government has picked up on this after a review in relation to it. It has not always been the case. Like many on our side of politics, I would be very happy to see Medicare extended to cover dental services as well. When in office many, many years ago, the current government—the Liberal and National parties—were not supportive of better health outcomes for Australians. They opposed Medibank when Gough Whitlam and Bill Hayden brought it in in the 1970s and when Malcolm Fraser came into power in 1975 as a result of the coup that took place on that occasion. They then dismantled Medibank—we know it as Medicare today—and it took until the election of the Hawke Labor government to bring back Medicare in the form that Australians anticipated and that Labor wanted to bring it in back in 1972-75. It took until the eve of the 1996 federal election before the then Liberal opposition leader, John Howard, said that he would support Medicare.

As the shadow minister said, the coalition in opposition and also in government have never been comfortable with Medicare. When it comes to dental care, their form remains the same. For instance, when Labor was in government in 1972-75, the Whitlam government brought in the Australian School Dental Scheme, which had a really big impact. In 1997 the Australian Institute of Family Studies, having examined the scheme all the way through the Fraser years and looked at what happened under Hawke and Keating, said that that particular scheme had reduced dental waiting times for most disadvantaged people. Before that program 47.5 per cent of people with health dental cards waited up to a month for dental treatment, and 21.1 per cent waited for more than 12 months. So, while that program was operating, 61.5 per cent of people waited for less than a month for dental treatment and only 11.3 per cent waited for more than a year. So it was a rip-roaring success. Malcolm Fraser and his government tried to dismantle it in large part, but it took until the Howard government to completely dismantle the scheme and replace it with nothing. It got to a point in this country where the Sydney Morning Herald had a headline on 26 January 2007 saying, 'Country aching over dental crisis'—a pretty clever headline, if you ask me!—and a headline on 19 March 2007 saying, 'Dental care is failing the needy'.

On the eve of the election, or not that long before, the Howard government decided they'd bring in a new scheme. They didn't means-test it at all and they said it would cost about $90 million. This was a chronic disease dental scheme, and it was not means-tested. Twenty per cent of the funding for that was high-cost restorative care. What happened was there were rorts galore of the system—a program that was going to cost $90 million per year cost $80 million a month, and it meant people in wealthy parts of the country could get access to the scheme in large part to the disadvantage of people in poorer, regional and remote areas and outer metropolitan areas. When Labor came in, we abolished that scheme and we set about doing the kinds of programs I have outlined.

But when the Abbott government came in, what did they do? Pretty well straight away, the Abbott government did weird stuff—things like cutting $15 million from the Charles Sturt University dental health program, funding which was needed to help the much-needed dentists of the future. It did really strange stuff, like cutting $390 million out of funding to reduce waiting lists. It was constantly being attacked by people like Griffith University professor of dental research Newell Johnson, who described funding cuts as 'a disaster' for dental health. The Australian Dental Association president, Dr Karin Alexander, warned delays would cause waiting lists to double or treble.

This government, when they came to power, set about, under the National Commission of Audit, cutting and slashing and burning. This is the party of the co-contribution on Medicare. They made it harder for people to get access to the kind of support they needed and regularly took steps to try and cut funding, whether it was attempts to cut funding for waiting times at public hospitals—they were constantly at war with the states and territories when it came to health and hospital funding. Even when Prime Minister Turnbull was in, we had to block the kinds of cuts they wanted to do—30 per cent of cuts to health funding as well. They just never cease to try and cut funding.

This particular piece of legislation is very, very welcome, but it's only a little bit of what they need to do. The office of the Queensland health minister, Yvette D'Ath, has provided me with some information in relation to the role the Commonwealth government plays across this space. The most recent national partnership agreement represented, by this government, a reduction in Commonwealth dental funding of approximately $8.7 million, or 30 per cent less compared to the previous NPA. The Queensland government has accepted an offer from the Commonwealth government of a 12-month extension of the NPA, until 30 June 2022. However, there is no long-term certainty in relation to funding. So the Queensland government has repeatedly expressed its concern about the reduction in Commonwealth funding and the increased pressure it places on the state public dental system. The impact of this funding reduction on public dental services in Queensland has made it more difficult for Queenslanders to get access to general dental care at public dental clinics. So it's crucial that this government do things like not just this legislation that's before the chamber but other stuff such as maintaining a long-term funding commitment to make sure that people can get access to timely general dental care at public dental clinics and that we have a sustainable system of dental care in this country.

In the three minutes that I have left, I'm going to talk briefly about the fact that my electorate has been grossly disadvantaged by the change in classifications of the distribution priority areas. I wrote to the previous minister, the member for Parkes, and I want to thank him for coming to my electorate and meeting with a local doctor at Walloon. I found him useful and helpful to deal with, and his office was very good to deal with when he was the minister. Unfortunately he couldn't fix the problem. I've written to the new Minister for Regional Health, Dr Gillespie, about the issue, saying that we've got a really big problem in my area and we've got to fix it. We've got changes of classification which mean that doctors can't get access to other doctors for their medical practices, and the healthcare system will be worse. Minister Coulton said to me in correspondence that the Commonwealth government couldn't change the distribution priority area classifications but they'd have a look at it at some stage in the future if the health outcomes were worse. Why do that? Fix it now.

All I'm asking is to make sure that Ipswich, the lower Somerset region, around Karana Downs and Mount Crosby can get access to doctors. I've spoken to multiple medical practices in my area, and they all tell me about the challenges of recruiting doctors with these restrictions in place. Whether it's doctors at Riverlink, in the same shopping centre where my Blair electorate office is located, or doctors at Karana Downs or Walloon or elsewhere—it doesn't matter where I go—when I speak to local doctors, they all say the same thing. This DPA classification system is claimed to be impartial, but it's arbitrary and it's inflicting worse health outcomes in my area. I'm calling on the new minister to do the right thing, to change the classifications. The DPA classification system is having an adverse impact in rural, regional and outer metropolitan areas.

Dr Magdy El Ashrey, a specialist GP and the owner of the Walloon Medical Centre in my electorate, at Queen Street, Walloon, is having trouble getting doctors to come and work in his regional medical practice. He's been there for 20 years. He's served with distinction the residents of rural parts of Ipswich—indeed, into lower Somerset and urban Ipswich as well. He needs help. His is just one of many medical practices in my area which need help. The government should look at this again. I'm urging the new minister to correct this problem, to fix it and make sure this DPA system operates for the benefit of all people in my area.

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