Steve Georganas (Adelaide, Australian Labor Party) Share this | Hansard source

[by video link] I would like to acknowledge the Kaurna people of the Adelaide Plains and pay my respects to them. It is from the Adelaide Plains in the electorate of Adelaide that I speak today. I wish everyone well and I hope that everyone is safe in the ACT, Victoria, New South Wales and wherever else there are lockdowns. It gives me pleasure to speak on this particular bill, the Dental Benefits Amendment Bill 2021. As my colleagues, the member for Blair and the member for Cooper, and others from outside of politics have previously said, we support this bill. It is a good measure because it expands the eligibility of the Child Dental Benefits Schedule, known as the CDBS, which Labor brought in a number of years ago, and that is a good thing. It will remove that lower age eligibility of the Child Dental Benefits Schedule and open it up to children aged between birth and two years of age—to monitor, to check et cetera to see if there are any issues—which will then build a good foundation for the rest of their lives when it comes to oral hygiene and dental care.

This scheme was an important initiative introduced by the Gillard government in 2012. It provided eligible children aged between two and 17 years access to up to $1,013 in benefits for basic dental services, including examinations, routine cleaning, fillings, monitoring and root canals. The scheme covers children who live in lower- and middle-income households, those who receive family tax benefit part A and other payments from the Commonwealth, and the benefits are capped over two consecutive calendar years. Since its introduction, it has provided over $2.3 billion in benefits—that is, $2.3 billion for children who, in other circumstances, perhaps, would not have had their teeth checked, perhaps would not have had work done on their teeth, which then brings in poor oral hygiene for the rest of their lives. We know how important dental care is.

All of us in our electorates speak to constituents who, on a regular basis, speak to us about not being able to afford to get the dental care that they require. I have been a big advocate in my electorate, from day one, when I was first elected in 2004, calling on the Commonwealth for a national dental health scheme. We heard the member for Blair touch on it earlier. We see constituents on a regular basis, pensioners and people who are on very low incomes, who cannot afford to have their teeth fixed. For the life of me, I can never understand why, if you break an arm, Medicare will cover it, because it is a bone and you need to operate your arm. But if you break a tooth, which is, again, a bone, it is not covered. Yet that broken tooth will lead to poor dental hygiene, will lead to poor diets because you can't eat the correct foods and will then spiral into other negative health outcomes, which will then cost the government even more. I have always been a big advocate. I have pursued it and I have raised with governments over the years that we should have a national dental scheme, especially for lower-income people who perhaps cannot afford to have their teeth fixed.

The changes we are debating today are very welcome and have been praised by many stakeholders. There is clear evidence that supporting and establishing a positive dental experience at a very early age, between one and two, makes sense. If parents are practising oral hygiene with their children at this early stage, it will not only aid in the prevention of more serious dental problems in old age and as children are growing up but it will also give them a sense of how important dental hygiene is and how important it is to have regular check-ups and how important it is to see a dentist on a regular basis. It will also, importantly, help curb the negative stigma around dental practitioners and oral hygiene from an early age. If a child's initial experience with dental care is one which is not positive or one requiring perhaps serious treatment, they could be traumatised for a long time if it is not a positive experience. This is really important: if a child is introduced to dental care from a very early age, not only can they avoid serious and painful treatment but the chances of that child going through life having positive experiences with oral hygiene grow considerably the earlier we start. It's estimated that, thanks to this particular scheme, some three million Australian children have avoided worsening physical and mental health impacts from untreated dental conditions. This has enormous flow-on benefits at both a personal and a social level.

It's estimated that, each year from January 2022, 15 per cent of children in this newly eligible age group will access the dental benefits schedule. That's roughly 45,000 children per year—45,000 kids with better oral health, better physical health and better mental health. That's up to 45,000 families with fewer worries about being able to pay for the dental care their kids need. And that's 45,000 kids with a better relationship, better experience and better view of dentists because they've been exposed to a dentist early in life and have the benefits of that flowing into the rest of their lives. That's why, on this side of the House, Labor supports this bill and commends it to the House.

These changes will also help address the fact fewer children appear to be accessing the scheme compared to initial expectations. According to reports, the Commonwealth initially expected about 80 per cent of eligible children would use the scheme. However, as we heard earlier, according to the Grattan Institute less than half of the children eligible for this scheme appear to be involved, so this figure hasn't changed much in the eight years of this government. It is unclear why the figure is so low. It could be that not many parents are aware that the child dental scheme exists and that their children are eligible for care under the scheme. Whatever the reason, one thing is clear: we must do more in this area. We should work more closely with the states to promote the scheme and to boost that uptake. It may be that people are unaware of it or have no idea they're eligible, so we need better promotion of this scheme. There is no doubt we need to make a greater effort in this important policy area and in the process. We need to get more kids to the dentist to have those dental check-ups and to have the dental work that's required.

Australia performs well, and even better than many countries, on a range of healthcare indicators. However, there are some areas where we do need improvement, and they're clearly needed. Comparing Australia with other OECD countries, especially those with universal or near-universal dental care schemes, shows that Australia lags way behind comparable countries when it comes to dental care. I spoke earlier about a national universal dental care scheme. It's quite clear in the Constitution—under section 54—that dental care is the Commonwealth's responsibility. If you look it up, it's in there. It says 'medical and dental care'. For the life of me, I cannot see why we discriminate between those two areas. If you break an arm, you go to a doctor. They fix it for you and Medicare will pay for it. If you break a tooth, it impacts on what you can eat, on the intake of vitamins et cetera that are required for a healthy body. It has detrimental effects, if you can't chew and swallow, and ends up costing the government more in health care, but we don't cover it. I really think we should look at a scheme that covers people's health care, because it is an important part of health. Most doctors and health experts would agree with me: it's an absolutely important part of health, especially as we get older. Bad dental health relates to heart conditions, diabetes and a range of other things.

We heard the member for Blair speak earlier about the scheme Labor brought in for low-income earners, especially pensioners. I can't remember the exact amount, but they were given just over $1,000 per annum to have dental care done at a private dentist instead of waiting on those very long lists, where you can wait for up to six to 12 months to get a pair of dentures or to have your teeth looked at or even a filling. You can imagine a pensioner, someone over the age of 65, 70, 80, 85 or 90, waiting 12 months for a pair of dentures. Our scheme that we had back then provided just over $1,000 per annum for a person to go, with a referral from their doctor if the need were pressing—and it would have been pressing—to a private dentist. We helped and supported many people in our electorate. We got them to go to their GP. They received a letter of referral saying that it was an emergency that they receive their dentures, and they had dentures done within a period of months. It was a great scheme which helped those people then have good oral hygiene and not cause further problems for their health.

We've seen newspaper reports of people who cannot afford to have dental treatment. Recently I had some dental treatment and it cost thousands of dollars. Now, I was in a position where I could pay for it, but the majority of people cannot pay for such treatment. The majority of people go on those public waiting lists. Their dental problems deteriorate, which then has an ongoing effect on their health. It's wrong. I feel it's very wrong, and at some point we should think long and hard about a means-tested national dental scheme that will cover people so they can get the dental care that they are required to have.

We've seen newspaper reports of people who have done self-dentistry with alcohol and a pair of pliers. That has been reported in the papers. It is so sad to see people who have worked all their lives, have paid their taxes and, because they're on a Commonwealth pension, cannot afford to go and see a dentist and have to go on these long, long dental waiting lists that can take up to 12 months. What do we do for those people? We can't just shrug our shoulders and say, 'Dental is not our responsibility.' It is our responsibility, because it affects health. So I'd urge all of us in this place to think long and hard about a scheme that perhaps the Commonwealth could come up with to ensure that we have a dental scheme similar to that of other OECD countries that have national dental schemes that are working well. As I said, I cannot see why we separate dental from our national health scheme.

This is a bill that will go some way towards helping people to have good dental hygiene. We know that if those foundations are put in place very early there is the likelihood that they will help and assist people to maintain that good hygiene so they will have good dental care over the years. I know that we need to go even further and look at people who are entering old age, where teeth deteriorate in a rapid manner. We need to be able to show some care to those people and help them as well.

I know that, when we talk about health in this place, we have a government which historically has opposed Medicare. After Gough Whitlam had brought in Medicare, the next Liberal coalition government that came in under Fraser abolished it. It took another Labor government to come in and bring in a national health scheme so that we could all have cover from Medicare. I'm know that what I'm saying today may fall on deaf ears, but I'm hoping that under a future Labor government we will look at some sort of scheme that will cover health in a way that also includes dental care. As I explained, we went some way towards doing this when we were last in government, with the scheme that assisted teenagers and their dental hygiene, the Medicare Teen Dental Plan. We also had a plan for pensioners that covered them for around $1,000 a year for emergency dental treatment. When you need dentures and you have no teeth, dentures are an emergency. I'd like to see some of those things come back.

We're supporting this bill. I think it's a good, positive step going forward to ensure younger people build those foundations that are required for better dental hygiene and for better experiences at the dentist, ensuring that it puts in place good oral hygiene for their lives. I commend the bill to the House.

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