Tanya Plibersek (Sydney, Australian Labor Party, Shadow Minister for Human Services, Housing, Youth and Women) Share this | Link to this | Hansard source

I am very fortunate to have the opportunity to write a column for the Sydney Morning Herald once a fortnight and I wrote one recently about the state of dental care in Australia. Although obviously it is an issue very close to my heart, and I know to your heart also, Mr Deputy Speaker Adams, I was frankly amazed by the response that I had to my office after that column. In the column I spoke about a couple of people whom I had encountered over my time as a member of parliament, including a woman whom I referred to as ‘Jackie’. That is not her real name; I changed her name to protect her identity. She is a constituent of mine and a single mum. She had left a very violent relationship and taken her two young children with her. She lived in a pretty tough part of town in public housing. She had raised the kids on her own and, like many other people in this situation, she had never spent a cent on herself; everything she did was for her kids.

She was incredibly proud when her son was accepted as a scholarship student into a quite prestigious North Shore school. Unfortunately, she could not go with him on his first day of year 7 because her teeth were so bad that she was too ashamed to leave the house. She had been told that she could have her teeth extracted because they were so bad but there was no guarantee of when she would have dentures to replace the teeth that she had lost. It could be months; it could be years—and it was certainly looking more like years than months.

This is not the fault of Sydney Dental Hospital. They do an amazing job with stretched staff and stretched resources, but they are in an impossible situation. They are seeing people every day who are desperate. They are emergency cases. They have got bleeding gums and potential blood poisoning from the infections in their gums. They have got teeth falling from their mouths. Going a step further than dealing with those immediate emergencies, or even dealing with the longer-term care that those people need, let alone taking possible preventative care, is just beyond their resources. It is no fault of theirs. As for the woman I called Jackie, we were able to ask as a special favour that she got some dental care.

People should not have to rely on the intervention of members of parliament or on the pro bono work that a number of very generous dentists do. I know that there are many dentists who do it. In the past the Commonwealth has taken responsibility for dental care at times. The previous Labor government had a $100-million-a-year Commonwealth dental scheme that treated 1½ million people during this time. That scheme was junked as soon as the Howard government came to power. The Commonwealth should have such a scheme. It should be sharing responsibility with the states, and the Constitution suggests that it should. The Commonwealth does need to work with the states, and Labor has committed to doing that to help people who cannot afford to visit the dentist to look after their teeth not just in emergencies but in maintaining their oral health all the way along with preventative care as well.

The second role the Commonwealth has to accept beyond responsibility for public dental care is responsibility for ensuring that dental care remains affordable for people who wish to see their own dentists. It has to work with the private health insurers to make sure that this sort of care is available to people. An Australian Council of Social Service survey estimated that 40 per cent of Australians cannot access dental care when they need it, and the usual reason for that is the cost. An additional issue is the shortage of dentists in rural and remote areas, but the predominant issue is cost.

The third very important role that the Commonwealth has is to ensure that there are enough dentists, dental technicians and dental therapists graduating. The average age of dentists at the moment is over 50, so obviously we are looking at a lot of those people retiring in the next 10 to 15 years. Within the next four years, it is estimated that we will be short about 1,500 dental care providers, and most of those will be dentists. We are graduating only about 250 dental students a year, so the gap between the number that we have and the number that we need is growing all the time.

I made this argument in the Sydney Morning Herald and, as I said, I was struck by the number of people who rang up to tell me about problems of their own, including a woman called Sue who lives in Darlinghurst. She is also a single mum and she raised a problem that is raised with me again and again—the fact that parents almost always put their children’s needs ahead of their own. Sue was telling me that she found it very difficult to afford her daughter’s dental care but that she scraped together enough money now and again to have her daughter’s teeth checked. As for her own teeth, she, like Jackie, had had four years of serious problems with her teeth. In the end her teeth were so bad and her oral health was so bad that the dental hospital had to take out all of her teeth except for two at the front. They had to pull out her teeth because she was facing an overall decline in her health, including, obviously, the risk of extreme pain but also the risk of blood poisoning because of the infections in her gums. She has two teeth left and she was told that her dentures will take perhaps one year, perhaps two years or perhaps even longer to be fitted.

Sue was sent by her Job Network provider for a job interview as a sales assistant at David Jones. Now, you would have to be pretty optimistic, I think, to imagine that a job that relies completely on customer service is going to be given to someone who has only two front teeth. Indeed, Sue talked about the self-esteem problems that she suffered, her loss of confidence, along with the medical problems that she has had. She has taken more painkillers in the last two years, she says, than she has in the whole of the rest of her life. Her doctor is worried about her consumption of painkillers and her consumption of antibiotics because of the continuing infections in her mouth. So, on top of those health problems, her loss of confidence—her inability, she feels, to confidently apply for work—and, worse still, the social isolation that she is suffering make life impossible. Sue also missed her daughter’s high school orientation because she was too ashamed to face the other parents at her daughter’s school.

Sue has been given the names and numbers of some marvellous dentists who do pro bono work, but most of them have criteria for that work: they do young children or they do age pensioners, or they only look after homeless clients. They are doing fantastic work, but Sue does not fit their criteria. She has an appointment in March, and I am hoping that that will see her situation resolved quickly. But it seems cruel and unusual that in a country as wealthy as Australia we have people whose health, livelihood and participation in society are limited by the lack of a few dollars being spent on, particularly, the sort of preventative dental care that stops problems like this from arising in the first place.