Joanna Gash (Gilmore, Liberal Party, Shadow Parliamentary Secretary for Tourism) Share this | Link to this | Hansard source

I rise to speak on the Dental Benefits Bill 2008 and cognate bill. It is no secret that I have been very outspoken about dental care and that the Labor Party went to great lengths to try and embarrass me because of my passion and outspokenness on this very emotive issue for so many in Gilmore. Ever since being elected in 1996 to represent the electorate of Gilmore, constituents with issues to do with accessing public dental services have featured prominently in my work—and little wonder: Gilmore has a higher than national average population of aged persons, has a low socioeconomic demographic and is in a regional-rural area. It has been shown that the significance of those statistics under a Labor government is that the people of Gilmore get the short straw when it comes to government services. The public dental service is no different, and I use the word ‘service’ loosely, because only one word can aptly describe the product that the NSW government delivers: abysmal.

Without a doubt, when it comes to teeth, pets are better looked after than our pensioners. Waiting for four years for a fundamental dental service is the norm. One woman I know—in fact, more than one—had been waiting over seven years. Finally she was accepted under the coalition plan, and what happened? Half of her work had been done when this Labor government axed our program overnight. That is right; she could not have her dental work completed. How cruel and mean can you get?

Aside from the pain of bad teeth, there are other, accompanying medical problems. Ever since I was elected, the then Carr Labor government and now the Iemma Labor government have ignored the problem. Not only have they ignored it but, as the howls of protest rose, they started to blame the federal government. ‘It was all their fault,’ they said. ‘They cut the Commonwealth dental services.’ What the spin plainly failed to do was explain that the Commonwealth had met its obligations under the funding agreement and it was actually the Labor government that was failing to meet its recurring cost obligations. But let us give credit where credit is due. The Carr government and its successor were the experts of spin, not so much by what they said but through what they omitted. It is almost comical to see that constant negative spin, that propaganda, that we had so become used to suddenly dry up as soon as their Labor colleagues took power in the federal arena. Suddenly, it is not the federal government’s fault—but it is still the coalition’s fault.

Even the Minister for Health and Ageing, in her second reading speech, could not resist the temptation to put the boot in, saying that the ‘dire state’ of the state government’s public dental service ‘should be laid at the feet of the Howard government’. What a load of bollocks. She believes her own propaganda. The dire crisis that she speaks of was brought about by the failure of successive state Labor governments to invest in vital services. In fact, it was the Howard government that stepped in to help them out. Now the list of those waiting for dental care is chronically long, excessive by even Western world standards, but they cannot even find enough dental practitioners to serve in the public dental system. It is pathetic. Yet, despite the obvious, the states continued to carp that it was all the federal government’s fault—at least up until 24 November last year, when they suddenly fell silent. The neglect that the New South Wales government have engaged in since 1995 is a travesty and they should hang their heads in shame. So for the minister to suggest that the previous Commonwealth Dental Health Program is the villain is specious in the extreme.

Further into her speech, the minister said 50,000 people end up in hospital each year as a direct result of unattended dental problems. If that is the case and you know that, and you state that as a fact, then why on earth did you dismantle the coalition government’s Medicare dental scheme which, even in its relatively short life, proved so immensely popular? Why on earth did you introduce such an inferior scheme as this bill represents? You acknowledge publicly the state of affairs amongst the poorest and neediest is alarming. They are our pensioners, and they are part of the 50,000 waiting—not the younger generation. And, to correct the member for Shortland, they are the very people you said could not access the program; how wrong you are. Yet you have done nothing to help them. They are worse off under your scheme than they were seven months ago. Sixteen thousand Australians accessed the treatment they required under our scheme in just three months, yet you have chopped the funding that brought much needed relief and that at that stage allocated $4,260 to be paid by Medicare to each and every person over two years. Instead you have given the matter back to the states, who created this mess in the first place.

As commendable as it may be to provide preventive dental treatment for our young people, that is not the priority, even by your own admission. The Australian Dental Association and the Association for the Promotion of Oral Health have both indicated their disappointment with the government’s plans. Both organisations are concerned about the lack of follow-up money for the treatment of teen dental problems and about the potential for longer waiting lists as a result of both teens requiring treatment and the cancellation of the coalition program.

But it is the poor who are the neediest. They are our pensioners and older citizens, of whom the electorate of Gilmore has such a disproportionately high number. Even during the election campaign Mr Rudd promised a Teen Dental Plan with funding of $510 million over three years yet failed once again to recognise our older population of pensioners and self-funded retirees. In the budget, this program was cut to $490 million over five years, and it still failed to include funding for follow-up treatment. All it does is provide a $150 voucher to a dentist, if you are lucky enough to find a dentist. The Medicare dental plan announced by the Howard government in 2007 was a $384.6 million plan providing care for people with chronic and complex conditions. The $200 million offered by Mr Rudd will not meet the demand for services.

As it is, in New South Wales alone there are over 160,000 people waiting for dental services and they have been waiting a long, long time. The NSW government recognises this, because apparently NSW Health has recently taken to writing to all those on the waiting list to ask them if they would opt out of the queue. It is shocking but true. I have seen the letter and I think this approach is deplorable. It is the NSW government rolling over and giving up. If the NSW government has taken the desperate measure of ‘inviting’ people off the waiting lists—and these lists are chronic and growing—what is Mr Rudd’s paltry alternative going to achieve? I will tell you: a small blip, a tiny and momentary reversal, just in time for his much threatened early election around the end of next year. Mr Rudd is simply putting in place measures to make sure potential embarrassments are swept under the carpet. It has nothing to do with the noble ideals he is espousing; it is all about timely housekeeping.

Politics is very much like show business—it is all in the timing, and this bill is transparently political. It has got little to do with the welfare of the poor and needy and much to do with securing a second term. So, when I read the minister’s second reading speech and the effusive back patting in the summary, and when I look at how much seniors did not get out of the budget, I cannot help but think—to paraphrase the Leader of the Opposition—it is ‘Mr Iemma comes to Canberra’.

Given the fact that Labor has chopped the coalition program and introduced a second-rate model, I really have no option but to support this bill, as pathetic as it is. The elderly in Gilmore have been suffering long enough under the failed NSW Labor regime, and even the small gesture contained in this bill has to be accepted. But I do so reluctantly and I hope that the paltry $290 million is used where it matters and is not diluted by being used to fund self-promoting advertising, which is the favoured hallmark of the Iemma and Rudd Labor governments.

This comes down to common sense. The coalition government delivered a program to bring relief to those with chronic dental care needs. The program has been unceremoniously axed by the Rudd Labor government. In its place they have put a grab bag of programs that leave many of those who would have received treatment under the coalition plan out in the cold—with dental work half completed in some instances. The people of Australia and Gilmore deserve better.

Amanda Rishworth (Kingston, Australian Labor Party) Share this | Link to this | Hansard source

I rise in support of the Dental Benefits Bill 2008 and the Dental Benefits (Consequential Amendments) Bill 2008. Dental health is not only a critical component of a person’s general health but also plays a special role in dictating their enjoyment of life and emotional wellbeing. Few chronic ailments are more frustrating and painful than dental problems. Poor dental health can exacerbate many health conditions.

While working as a psychologist, I treated many people whose dental health problems significantly impacted on their quality of life and their self-esteem. Residents in my electorate of Kingston regularly tell me of the time they have spent on public dental waiting lists, and their stories share a common thread of immense agony and frustration that their problem could be fixed if only they could have an appointment with a dentist. Many of these people are seniors who worked in low- to middle-income jobs for much of their working lives, paid their taxes year in and year out and understandably expected that when they retired there would be a dental system that they could rely on.

Research has shown that the growing dental waiting lists are putting pressure on the rest of the healthcare system, with 50,000 people per year presenting to our public hospitals with preventable dental conditions. This situation is not only unacceptable because of the undue suffering it causes, it makes it clear that underinvestment in preventive and primary dental care costs much, much more in the long term. Rather than investing more in dental care and taking real action to address waiting lists, one of the first actions of the previous government was to abandon the Commonwealth Dental Health Program and cut a $100 million in funding from Australia’s dental healthcare system. The attitude and ideology of the previous government with regard to Australia’s dental care system provides a case study of their border approach to government. They slashed the Commonwealth investment. This meant that a visit to the dentist took more money out of the pockets of working families or meant that they could not afford to go at all.

I am disappointed to hear during this debate that those on the other side continue to believe that the Commonwealth should shirk its responsibility when it comes to investing in dental health. Earlier in this debate, the member for Fadden said that the funding for dental care was wholly the responsibility of the state governments. The people that I talk to in my electorate of Kingston who are in need of dental care are not persuaded by the ‘blame it on the state’ approach advanced by the member for Fadden and those on the other side. They just want their dental complaints attended to.

After dismantling the Commonwealth investment in dental care, the previous government bowed under immense public pressure and introduced a lacklustre, limited dental program that only assisted people who had dental problems in conjunction with other chronic illnesses. It did not matter if you were in excruciating pain and were a pensioner in desperate need of assistance—if you did not have a chronic disease, you were ineligible. The facts bear out that this program not only was a bureaucratic nightmare for providers but also denied care to some of the people in our community who were most in need.

The Rudd government is taking real action to fix the dental healthcare crisis. This bill delivers on the commitment that we made at the election to deliver better dental care to Australians and to make it easier for families and for their teenage kids to visit the dentist. The new Commonwealth Dental Health Program is an additional investment of $290 million over three years into dental care in Australia and will provide funding for up to one million extra treatments and consultations. This extra investment shows the government’s commitment to our public dental system and will begin to help the 650,000 Australians currently on the public dental waiting lists.

This new program will deliver for the most needy in our community, including pensioners, preschool-aged children and Indigenous people. The investment has been warmly welcomed by many whom I have spoken to in the electorate of Kingston. Many of my constituents report waiting over two years for an appointment in the public dental system. The Commonwealth investment will have a significant impact on these waiting lists and ensure that many people in my electorate will be able to be seen in the public dental system, including in services such as those situated at the Noarlunga Health Village. Certainly, as I go around speaking to people, dental care comes up time and time again. I attended the dental program at the Noarlunga Health Village and saw the immense number of people waiting there. The room was crowded with people waiting, and as I went round I spoke to these people. Some had been waiting two, three or four years for services, and indeed some people reported missing their appointment, for reasons outside their control, after waiting for two years and then being required to wait another two years to get in. This is just unacceptable and a real problem.

People I speak to know that the previous government did shirk their responsibilities. They did not invest in dental care, and this became a real problem. In addition, as also became quite evident in my visits, there was a lot of concern about workforce shortage, whether it be in doctors, nurses or dentists. This is an issue that the previous government continued to ignore. As I have learned by speaking with dentists, doctors and nurses around my electorate, it becomes a problem and a real issue in the outer metropolitan areas of Kingston. I will continue to advocate on their behalf to ensure that we do address this workforce shortage.

Another major program that is delivered by this bill is the Medicare Teen Dental Plan, which delivers on another commitment that the government made at the election. This program will provide up to $150 per year to eligible persons towards the cost of annual preventive check-ups by a dentist. I think this initiative is particularly important in its emphasis on prevention. Prevention is key whatever health area you look at, whether that be dental care, mental health or general health issues. The importance of preventive health care for individuals to stop suffering is immeasurable, but the cost to the public purse is also important. Making sure that prevention does occur is essential when it comes to dental care, and I really commend the Rudd government for this important initiative.

About 1.1 million teenagers aged between 12 and 17 in families receiving family tax benefit part A, youth allowance or Abstudy will be eligible for the scheme. Families can choose to use the rebate at a dentist of their choice, regardless of whether it is public or private. This will be very important in allowing people to access a dentist who may live near their home. It does not make sense to have to travel a long way to access a dentist, so being able to access a dentist who is located near the family home does take added stress off the family. Helping teenagers visit the dentist will mean that minor dental problems can be identified and fixed before they become major health issues. As I mentioned, this is really essential, not only for the individual but also for the public purse. Getting teenagers into the habit of visiting the dentist regularly will put them in good stead for adulthood and provide an opportunity to teach young people about the importance of looking after their health. There is nothing more important than getting young people into the routine of checking their teeth, brushing their teeth and generally practising good dental hygiene.

Labor governments have never shied away from making sure that good health care is available to all Australians, and these new programs demonstrate the Rudd government’s commitment to a dental health system based on fairness and human decency, not on squabbling about constitutional details of service delivery or on an ideological obsession with privatising Australia’s healthcare system. Really, the dismantling of the Commonwealth dental care program that John Howard had in his first term can only be seen as an ideological drive to push people into private health care. Private health care has a place; however, as I said in my maiden speech, it is essential that we do provide adequate health care to everyone, no matter how much money they have in their purse, and that we ensure that these people have a good quality of life. I think that this investment, one of our key election promises that we are delivering in our first budget, is essential to ensuring that we deliver to the community, and it has been especially welcomed in my community in Kingston. I believe that this will deliver real outcomes to the most needy in our community, and I am very proud to be part of a government that is delivering this budget initiative. I commend this bill to the House.

Kay Hull (Riverina, National Party) Share this | Link to this | Hansard source

I rise in the House today to speak on the Dental Benefits Bill 2008, which has been put into the House by the Minister for Health and Ageing. There has been a process of issues on dental health for some time, ad nauseam, particularly in the time that I have been the member for Riverina in this House. Dental health has always been a problem, and there was always an attempt to get the former government to recognise that there needed to be some assistance programs. Eventually they did recognise this and were able to put in place some good and significant legislation that would assist in many areas. We looked at the issues of workforce because workforce is one of the major factors in the lack of dental health care options for rural and regional Australians. Our policy included funding Charles Sturt University, I am very proud to say, to train our dental students in rural and regional areas because, as I have said time and time again in this House, if you train your rural and regional people in rural and regional settings then you are more likely—most definitely—to keep them practising in these settings.

So these programs were introduced. Some of them were actually very effective. One, in particular, was very effective although it had not a lot of time to run. There was some confusion and misunderstanding I think on the part of the minister previously. I have stood in the House and questioned the minister on her statements that the program ran over four years and serviced very few people in that four years, when in fact we know that that is not the case. That was obviously a very strong misunderstanding on the minister’s behalf. At the time, I provided in the House evidence that came from the minister’s own department, which clearly said that the program was introduced by the previous government in November 2007 and was to be withdrawn from the Medicare Benefits Schedule. It certainly did not run over four years, and that was supported by the department.

I would like to go to the Australian Dental Association’s National Dental Update. I always make a point of looking at the National Dental Update from the ADA because they pretty much have their hands on this whole process and they pretty much understand it. They know what it is going to take to resolve the issues for people across Australia in relation to dentistry. That was the case, as well, when we were in government. I am certainly not for one moment standing here and saying that everything was done correctly or that as much as could be done was done when we in government—but, most certainly, we had some good programs.

I would like particularly to quote from this document, the National Dental Update, May 2008, from the Australian Dental Association. I will quote entirely from this document because I think it tells the story. It says:

Labor’s first and much anticipated Federal Budget has finally arrived. It provided an opportunity for the new Government to show its level of commitment to alleviating Australia’s dental health care crisis. Sadly however, the announcements fall ‘short of the mark’ and simply don’t go far enough.

Whilst the Australian Dental Association (ADA) welcomes targeted federal funds for dental care to financially disadvantaged Australians—

I am sure we all welcome any opportunity for financially disadvantaged Australians to get dental care—

it is concerned that the newly created Commonwealth Dental Health Program—

the program that we are speaking about here now—

and the Teen Dental Plan should have been better linked.

Labor’s dental health announcements included ...

It went on to outline the Commonwealth Dental Health program, the $290 million to be provided over three years to state and territory governments aimed at reducing public dental waiting lists, and the one million additional consultations that will be funded for Australians needing dental treatment. Then it proceeded to the Teen Dental Plan and outlined what was in the media on that plan. However, the ADA then continued in the National Dental Update, May 2008, under the heading ‘Commonwealth dental health program—too little for too few’. The article quoted Dr John Matthews, Federal President of the ADA, who said:

The States and Territories of Australia have failed to meet their obligations to ensure proper delivery of dental care to disadvantaged Australians for far too long. The Rudd Government had the opportunity to rectify some of the specific deficiencies that existed by introducing some coordinated plans that could be built upon or modified to meet future needs.

This is where the article gets to the nub of the issue. The Federal President of ADA went on:

Instead it has provided the State/Territory Health Services with additional funding (less than provided back in 1996) to prop up schemes that have not delivered to date.

The ADA had advised the Government that the previous CDHP was deficient. It failed to seek accountability from the States as to their contributions to the provision of dental health.

Time and time again in this House I have raised the issue of the Keating sunset plan—the Commonwealth Dental Health Program that every member has said we came in and slashed—that was never in the forward estimates. It always had a sunset clause and it had no expenditure provided for it beyond 1996. The states took their money out. The program robbed Peter to pay Paul. The program delivered no better benefits than if it had never existed, because whilst the Commonwealth were putting their funds into this Dental Health Program the states, quite greedily, took theirs out and said, ‘We’ll let the Commonwealth foot the bill on this.’

I think that is the serious issue that the Australian Dental Association have recognised. They have recognised that no accountability was asked of the states in their obligations to ensure proper delivery of dental care. That would obviously be a criticism of how the program was run before, and it seems that this has been duplicated in the proposals and the bill that we see before us.

The ADA has clearly said that despite their calls ‘for the creation of an improved CDHP seeking accountability from the states as a prerequisite for funding, such calls appear to have been ignored’. I cannot understand why we continue, as a Commonwealth, to provide this funding to cash-strapped and broke state Labor governments without seeking their assurance that they will continue to put adequate money into dental health services.

I would never complain about money going to reduce the waiting times or to reduce the pain and agony being suffered by many people who cannot afford a dentist. And many cannot access a dentist, whether they can afford it or not.

The problem that I have with the whole process is that, again, it leaves the states unaccountable and we will slip into exactly the same problem that was experienced with the former Keating program—the problem of states determining that they will take their funds out of their programs because the Commonwealth is foolish enough to put money in without seeking from the states an accountable document that they have to stick with to actually make a difference. What will happen now is that Commonwealth money will just be spent and states’ money will be withdrawn, and we will have fudged figures in the long term that give us no real benefit at all.

We hear carping. We have heard that so many times in the House—carping about it being somebody else’s fault: your fault, my fault, their fault. It just goes backwards and forwards. We have heard about ending the blame game, and yet there is no difference on the other side of the House regarding the blame game now that the Labor Party are in government compared to when the coalition were in government. It is equally as bad. There have been no improvements made on that. I would just like to point out to the House that there has to be a true bipartisan view on how we are going to relieve this crisis and the critical issue of the provision of dental services.

I have raised this in the House before: maybe there needs to be some innovative thinking about how we encourage dentists to relocate to rural and regional areas. When doctors came and set up a practice in rural and regional areas we had a program where we could establish medical centres with our rural and regional fund. I have those in my electorate and I am very thankful for the provision of funding by the former government that has provided my communities with medical centres that have attracted some sensational operators. That has been money well spent. My view has always been that we should have the same program to enable dentists to come and set up, because it is very expensive. When a doctor comes into town, he pretty much has a stethoscope around his neck and a little black bag, and he carries out all his X-rays and major consultations—MRIs and anything that he requires to have done—at a medical imaging facility or a hospital, whether it is a public hospital or a private hospital. A doctor does not have to outlay all of the money to put in all of the equipment whereas a dentist does. When a dentist sets up he has to provide and fund his own X-ray machines and all of his own equipment to ensure that he is giving adequate oral health services. It is very costly for dentists to set up.

I would like to see a program—and I called for this when we were in government—that assists with the cost of setting up a surgery. We have the minister putting health superclinics out there. It would be a sensational thing if we could have superclinics that could include dentistry and fit out a dentistry surgery so that we could even have visiting dental officers practising in a dental surgery in a superclinic. They could relieve the chronic issues particularly for pensioners, disability benefit recipients and low-income earners by enabling them to get access to some form of dental assistance.

I can afford to pay a dentist; I do not have any problems in being able to afford to pay a dentist—I am very fortunate. However, I still cannot get an appointment with my dentist. An appointment is nine or 10 months away, and I can pay, so imagine what it must be like in a rural or regional setting when you are on a low income, a pensioner, receiving disability payments or pension, or similar and you are trying to see a dentist. It is simply almost impossible. But we certainly did make inroads with our program, particularly with the Health Insurance Amendment (Medicare Dental Services) Bill 2007. I am very sorry that the minister has seen fit to remove that program, because it was very successful in treating many of the issues—not all of them; it certainly did not reach everybody, but it did reach a lot of people.

As I stand here this evening, I would like to come back to some of the issues that the ADA have outlined and that the minister, I would hope, would give significant thought to, particularly around the Teen Dental Plan. The $150 voucher for a dental check-up for an eligible teenager—and this does not go to all teenagers; I have learnt from past experience that the word ‘eligible’ means the devil is in the detail—will maybe enable a teen to go to a dentist in rural and regional areas. In my electorate of Riverina there is probably an 18-month waiting time before they can book in for a dental check-up, but it will not enable them to then undertake treatment. They will be forced back onto the public sector waiting list, and that public sector waiting list is years and years long.

By introducing legislation, providing money to the states and not seeking clear accountability as to the way in which the states are going to continue to meet their obligations, there is going to be no reduction in these waiting lists. I can vividly remember standing here in the House as a new member and thinking that everything we were doing was just right and that everything that everybody else had done was just wrong. I am pretty vocal in generally saying what I think in the House, whether it is good, bad or otherwise for my standing in my party, but I clearly remember thinking that we were doing all of the right things. I now look back and think that the advocacy towards having dental health as a major component of policy platforms over the years has been made by so many good members of parliament. I have heard advocacy for good dental policy in our party room time and time again. No particularly special answers have been provided with this legislation, just as there were no particularly special answers provided in the last. Each of them has done something and this will do something, but is it what is required? I can only stand here and say that I believe it is not. I would urge the minister to reconsider or to seriously look at the issues associated with states’ accountability, lest we continue to have the problem that we had many years ago where the states immediately pulled their funding out of any program that the Commonwealth propped up. So in my speech here today I am just urging for that accountability to be placed upon the states.

Jodie Campbell (Bass, Australian Labor Party) Share this | Link to this | Hansard source

I rise today to speak in support of the Rudd government’s Dental Benefits Bill 2008. I do so because I am all too aware of the legacy left us by the previous government when it comes to dental health and wellbeing. Across Northern Tasmania there are people, young and old, who have languished on waiting lists for far too long. Under this government’s $780 million plan, teenagers will receive preventive dental checks in order to ease the pressure on waiting lists. This is about prevention, something which the previous government appears simply not to have understood. It was all too prepared, it would seem, to sit back, wait for problems to emerge and then do absolutely nothing about them.

I am pleased and proud to be able to say to the people of Bass and to communities across Northern Tasmania that this government is different. One of the first acts of the Howard government was to scrap the Commonwealth Dental Health Program, essentially doing away with $100 million a year for the public dental system. This was an absolute disgrace. Is it any wonder, then, that we are now faced with waiting lists groaning under the pressure? All too late, the Liberals introduced a dental scheme, but so complex was its referral process that barely anyone could actually access it. In my home state only eight people up to the age of 24 actually received these services over the course of four years. That is an average of two per year. Tooth decay is our country’s most prevalent health problem and it is incumbent upon the government of the day to act, not only to treat the problem but to arrest its rise. By targeting teenagers across Bass, across Tasmania and throughout the country, the Rudd government is acting to secure the dental health of future generations. Can I add, too, that the Tasmanian government is acting to address dental waiting lists.

An ageing workforce and a growing national shortage of dentists mean that governments, both state and federal, have to be innovative in how they implement dental health strategies. In Tasmania, a workforce re-entry program exists to assist those returning to dental therapy after more than five years absence, and consideration of options for undergraduate training for both Bachelor of Dental Surgery and Bachelor of Oral Health. No-one on this side of the House is suggesting for a second that any of the steps we are taking can fix all the issues surrounding dental health immediately. But we are acting. The Commonwealth Dental Health Program will fund up to a million dental consultations and treatments. From the beginning of next month, the government will provide $290 million over three years to bring much-needed relief to the 650,000 people on dental waiting lists across the country. Negotiations with the states and territories will ensure that needy patients with chronic care needs will receive treatment.

This bill is about delivering on our election commitments. It is about saying to the people of Northern Tasmania, ‘Here is a plan, and here we are actually acting on it.’ Prevention, as the adage goes, is better than cure, and that is something to which this government subscribes. People across Bass are entitled to know that if they need dental treatment urgently they will get it. Teenagers in Northern Tasmania are entitled to know that the resources and commitment are there to help keep them off dental waiting lists into the future. That is why I am very pleased that the Rudd government is committed to the Medicare Teen Dental Plan. The government will provide up to $490.7 million over five years for the new Medicare Teen Dental Plan. This program will provide up to $150 per teenager towards an annual preventive check for teenagers aged 12 to 17 in families receiving family tax benefit part A or teenagers receiving youth allowance or Abstudy. Around 1.1 million teenagers will be eligible for dental services under the Medicare Teen Dental Plan.

Much has been said about ending the blame game between the states and territories and the Commonwealth government. This is more than simply speaking about it. This bill will see funds committed and action taken to treat a problem which was allowed to develop and compound during the bleak Howard years. The hard decisions have been made to address ineffective programs and replace them with accountable and transparent funding across the board.

On a personal level—and I have said this to the House many times now—it gives me enormous satisfaction to know that the promises I made on behalf of the Rudd government during the election campaign are promises which have been met. Whilst campaigning the length and breadth of my electorate of Bass I met teenagers, parents and the elderly, many of whom had horror stories to tell about the neglect they, and their teeth—or, in some cases, their dentures—had suffered under the previous government. I do not think that as a government we would be doing our job if we were not acting to address what is a very real crisis. I also do not think it unreasonable that when people across Northern Tasmania need access to dental care that care is there. It gives me great satisfaction to add my voice in support of this bill. It heralds a new era in dental care. I commend the bill to the House.

Mark Coulton (Parkes, National Party, Shadow Parliamentary Secretary for Ageing and the Voluntary Sector) Share this | Link to this | Hansard source

I welcome the opportunity to speak on the Dental Benefits Bill 2008 tonight. Like the member for Bass, the previous speaker, I too have a lot of constituents who contact me about problems with dental health. In a rural area particularly, such as the electorate of Parkes, I think the effects of poor dental health are magnified. There are many towns in my electorate that do not have adequate dental services, and I need go no further than my home town of Warialda; we have not had a dentist in Warialda for many years now. Our nearest dentist is in the town of Inverell, which is 70 kilometres away. If you have a hole in a tooth, or you have a chipped tooth, unless you are in absolute agony you cannot get an appointment in Inverell for 4½ months. I think that puts it into perspective. When we are looking at obtaining the services of dentists, the real problem out there is that there is a lack of dentists. I know that my constituents are not the only ones. We have heard speech after speech here today on this bill about the lack of dental services in Australia.

I must say that I am not critical of the new government. Some of the measures that have come in are, I think, well intentioned, and I think that $150 a year for a preventive check for teens is a move in the right direction. But the problem in my area is that there is a lack of dentists who can deliver that. Once again, maybe without intention, this bill favours urban areas and cities rather than regional areas.

There is another problem. I know that children in my electorate are having massive problems with their teeth—I know this from firsthand experience with children that I know—but the $150 to see the dentist is only the first bit if they require massive dental work. As has been said previously here today, your mouth is part of your body and should be part of your overall health. But those services are not available. Under the previous government’s scheme, up to $4,500 was available for dental treatment that was health related and, while it fell short in some areas, it was excellent. If you had chronic dental problems that were affecting your health, you could get the money to fix it. I know that two or three years ago an elderly lady, a pensioner not far from where I live, out of desperation removed one of her own teeth with a pair of pliers. I think that in this day and age in a country such as ours it is a terrible thing that a lady in her senior years removed her own tooth with a pair of pliers.

The second part of this legislation relates to the Commonwealth dental health program. The government will give $290 million over three years to the states and territories to reduce public dental waiting lists. Again, I have no doubt that this proposal is well intentioned but, once again, in an electorate such as mine we have very few dentists in public hospitals; there are practically none. The other problem is that it has been funded and funnelled through the states. In her speech the member for Bass indicated that it was to stop the blame game and get the money to the states. I do not know what it is like in Tasmania, but in my state of New South Wales the New South Wales government is inept and incapable of managing the health system that we have. I am afraid that the Commonwealth funds are going to get gobbled up in the mire that is the New South Wales Department of Health. That is a tragedy because I think that if the money went directly to local communities there would be a possibility that that could do some good. But just giving more money to the New South Wales Department of Health is throwing it away.

The real problem is a lack of dentists. I will give the previous coalition government credit because they had started to tackle this problem. One of the programs they implemented, which is now in the process of coming to fruition, is at the School of Dentistry and Health Sciences at Charles Sturt University. There are several campuses in the Charles Sturt University network, and in my electorate a clinic is going to be built in Dubbo next year or in the later part of this year. The clinic not only will provide a training ground for rural and city people who want to study dentistry in a rural setting but also will give the residents of Dubbo and surrounding areas the opportunity to obtain dental services that they cannot get now, and a lot of the people who will obtain those services are from the Aboriginal community and pensioners and the like.

I think this is a practical move, because we need to train the dental professionals in the rural areas if we want them to stay there. I would encourage the Rudd government to follow the progress of the Charles Sturt University dental program and keep an eye on it, because I think there is a great will there. I have met with Professor Goulter, Vice-Chancellor of Charles Sturt University, on several occasions. He is hopeful that this is just the first stage and that when these core dental centres are operating then maybe we can have students and lecturers rotating through smaller towns such as Dunedoo, Coolah, Coonamble and Walgett and places like that that do not have dentistry at the moment; that once these schools of dentistry get going they can service a wide area. Once students get an understanding of country practice in medicine and in dentistry, they will not be frightened by it and I think that that will provide real results in the long run. The previous government committed $65.1 million to the School of Dentistry and Health Sciences, and I think that was money very well spent.

There is another thing that I would like to be considered with regard to oral health and getting professional help out there. In Gunnedah there is a proposal for a health service in association with training medical practitioners and in association with the local hospital and the local GPs, and there will be provision in that centre for a dental chair. The opportunity for a dentist to come through on a rotating basis or for a local dentist to undertake to train dental students in their final years is also a possibility. This Gunnedah health service is a service along the lines of the GP superclinics but with a few added extras. I have approached Minister Roxon and her office about this centre, because I think that training in the process of providing a service is certainly the model to use.

The other model that I would like to comment on is once again in my home town of Warialda. The much-maligned Regional Partnerships program provided $120,000 to help Gwydir Shire Council set up a walk-in, walk-out medical centre. I am proud to say that that medical centre is probably only a couple of weeks from completion. That will provide the opportunity for medical professionals, GPs, to come through and work there without the added burden of having to purchase a clinic. In this new Warialda medical centre there is provision for dentistry, speech pathology, physiotherapy and all sorts of ancillary health services, and I think this model is the way to go.

There are currently 650,000 Australians on public dental health waiting lists. This is purely because there are not enough dentists. While I am encouraged by the government’s commitment in this bill, I do not think it goes far enough. If we do not tackle the shortage of medical professionals, particularly dentists, in regional areas, it will not matter how much money you are given to see a dentist if there is not one available. The tragedy is that anywhere you go in my electorate you can see children in the street—children that I know, from families that I know—who are of the age of five and six who have rotten stumps instead of teeth. I think in this day and age that is an absolute indictment of our society. If we do not do something innovative and show a greater commitment from this place, as the leaders of this country, we will not overcome this problem.

Laurie Ferguson (Reid, Australian Labor Party, Parliamentary Secretary for Multicultural Affairs and Settlement Services) Share this | Link to this | Hansard source

I thank the previous speaker and the member for New England for articulating some of the concerns of rural areas that I guess in national and international trends of urbanisation we perhaps do not focus on as much and for the issues they raised about the ageing of the workforce and the need to make sure through training initiatives that people do actually go to those areas.

In a broader sense and legends apart, there are still great areas of social inequity in this country, and certainly the question of health care is one of them. If we look at the realities, we find a very close correlation between many health problems and socioeconomic deprivation, and the dental area is one of them. I cite the Australian Dental Association’s National dental update of November 2004. It noted:

A number of factors contribute to this abysmal record—

and it was referring to the dental situation—

and it is essential that they be properly identified and dealt with to return Australia to a much improved position on the OECD table. The percentage of adults rating their oral health as average, poor or very poor decreases markedly in households with a pre-tax income of more than $50,000 when compared to households with a pre-tax income of less than $20,000.

Lower oral health is clearly associated with social and economic disadvantage.

I would very strongly reiterate the view of some earlier speakers that one of the worst decisions of the previous government, very shortly after coming to power, was to rid this country of a very worthwhile dental scheme. It was unfortunate that the disastrous decision to force the by-election in the seat of Lindsay distracted the Australian population at that time from what was very much a class based decision which denied working-class people, in particular, access to very necessary oral health care. For the opposition to come in here tonight and say that what is provided here is not good enough is absolute gross hypocrisy because they abolished the dental scheme with great glee soon after being elected to government.

I also note complaints about the state governments. Quite frankly, not all of those state governments have been in for a decade or two, and if there is any build-up of problems, one would have to say that the other side of politics at a state level also must have some involvement if that is the case. Also, this particular bill puts it on the state governments very clearly not to reduce services. They are matters that we really need to understand in this legislation.

The matter is serious. It has been a long time coming. It has been commented upon on many occasions. The ABC’s Health & Wellbeing website said:

What’s the most common health condition in Australia? Heart disease? Cancer? Few people realise it’s actually tooth decay, with advanced periodontal (gum) disease the fifth most common, and rates of edentulism (loss of teeth) also high, according to the Public Health Association of Australia. As a nation, we’re facing a crisis in oral health, with half a million people unable to access a dentist for even basic care.

We all know that other figures have indicated that large numbers of people do not have proper health care because they cannot afford it. Basically, they do not go ahead with it if it is determined that they should, because of the cost. There is also a clear correlation between dental problems and other diseases. The previous government brought in a scheme where there had to be a chronic condition before people were assisted. I gather that the total figure of those helped during that period was in the area of 7,000 people—that is the number of people who were assisted under a scheme those opposite now laud, now praise here—and they have the temerity to attack this government’s initiatives.

We are now seeing that over one million young people will have the option of having a check-up. We now hear complaints that this will not necessarily provide for all of the dental care that should eventuate if there are problems. Quite clearly, the check-up is an indication to a family that something should be done. Obviously we appreciate that in some cases they will not be able to afford to act on it, but quite frankly many of them would not be able to even afford the test in the first place without this government initiative. What we are seeing is a clear commitment being fulfilled by this legislation. It will provide far wider access to dental care. It will obviously do something about waiting lists via the $290 million being devoted in that area.

In an era when inflationary pressures are here, when transport costs are going up, there is real pressure being placed on parts of my electorate such as Rydalmere and Dundas, which clearly do not have public transport available. This gesture by the government in making sure that something is done in an area that really affects people’s wellbeing, which as I said earlier relates to other health problems, is a measure that should be supported and praised rather than denigrated. We have a clear devotion of a sizeable amount of money over the next few years for annual preventive dental checks, providing an oral examination and, where required, X-rays, scaling and cleaning and other preventive measures for teenagers. I do not want to go over areas that other members have covered. Quite clearly this is a situation that is often raised with members of parliament. If you look around the electorate, if you run into people, they do often raise the question of dental care. In an electorate like mine, which is below national socioeconomic indicators, where people are experiencing really hard economic circumstances, this is important legislation and I have pleasure in supporting it.

Bob Baldwin (Paterson, Liberal Party, Shadow Minister Assisting the Shadow Minister for Defence) Share this | Link to this | Hansard source

Today I rise to speak to the Dental Benefits Bill 2008 and the Dental Benefits (Consequential Amendments) Bill 2008. I look at this program that is being put forward by the government and I see disappointment. I see disappointment because it was the Prime Minister who, during the election campaign, said, ‘The buck stops with me,’ and ‘It’s time to end the blame game.’ What we have seen introduced with this bill is a change in program priorities. What we see with the introduction of this bill is a reduction in benefit to the individual and provided to the state governments. The money that is being provided to the state governments under the Commonwealth Dental Health Program, some $290 million, is going to be consumed in the consolidated revenue of health. The state governments in the public system have only 10 per cent of dentists. And in the public system already, they cannot keep up with the work.

One of the interesting statistics provided to me by the Association for the Promotion of Oral Health is a table that shows what state expenditure is on dental health. I will quote New South Wales: it has a dental expenditure of $138 million and a population of 6.828 million, so the per capita spend is $20.21. The previous speaker talked much about his disappointment and the fact that more needed to be done. What the coalition has said all the way along is that the state governments are not delivering on their responsibilities. In fact, it is so dire that people have complained long and hard. In a release from the Australian Dental Association, Dr John E Matthews, the federal president, claims that this program being proposed by the government is too little for too few. He said:

For far too long, the States and Territories of Australia have failed to meet their obligations to ensure proper delivery of dental care to poor and disadvantaged Australians. This Government had the opportunity to rectify some of the specific deficiencies that existed by introducing some coordinated plans that are able to be built upon or modified to meet future needs …

He goes on to say:

Instead it has provided the State/Territory Health Services with additional funding [less than provided more than 10 years ago] to prop up schemes that have not delivered to date. It’s a Band-Aid solution at best.

I will continue to quote him when he says:

The ADA had advised Government that the previous Commonwealth Dental Health Plan was deficient in that it failed to seek accountability from the States as to their contributions to the provision of dental health. Despite the ADA’s calls for the creation of an improved CDHP seeking such accountability from the States as a prerequisite for funding, such calls for responsible Government have been ignored.

Again, in per capita expenditure, New South Wales ranks the lowest. Its expenditure is nearly half of what is spent by the Northern Territory government per capita, which spends $39.99 per person. In Tasmania, it is $34.36, in Queensland it is $33.97, and the list goes on until we get to New South Wales at $20.21 per person. This is an absolute disgrace. It is what we echoed as a government: that the state governments were denying adequate dental health to our constituents. They were ignoring the need and, as we have heard in the quotes from those two gentlemen, the reduction in funding has had a dire effect.

But we did listen to people. We listened to people and we introduced a plan that spread the spend over the 90 per cent of dentists not in the Public Service. We provided funding on a Medicare rebate scheme for dental services. That Medicare rebate was provided after a GP had referred an individual with chronic dental care requirements to a dentist. That was capped at $4,250 over two years. It was a massive improvement. It was $4,250 over two years for one person with chronic dental issues.

What we are seeing is a replication of programs under this government’s Teen Dental Plan. It is $150, provided you meet the means test requirements for the Teen Dental Plan. The New South Wales government provides the school dental plan, which picks up most of the teen dental issues. So what we are seeing here is a replication of expenditure for no direct benefit for those who are chronically suffering with dental conditions.

If you talk to someone who has such infected teeth in their mouth that they are just stumps protruding through their gums, who cannot eat, who cannot afford to get their dentures fixed and who has gone on a waiting list to wait forever, you will see that it is not a pleasant sight at all. That is why the coalition’s program was so strong. It was so strong that in the nearly five months that it was operational it provided 311,943 services. This government has sought to slash that program. It has sought to slash a program that was directly funding the individual with dentists in the private scheme through a Medicare rebate. Now individuals will go back on to the underfunded state government waiting lists.

It will be an interesting turn of events to hear colleagues on the government side talking up a program that has already let the people down. State governments, as you have heard in the addresses from the Australian Dental Association, have responsibility for dental health. This program, the same as the Howard government’s program, was to have provided additional support. But when I look at those funding figures, which are absolutely atrocious as a spend for the individual, I am embarrassed to be coming from New South Wales when it is providing the least amount of per capita support. I think that it is absolutely fraught with danger. I also note that the 311,943 services that I quoted is a figure that was provided at Senate estimates by Ms Gay Santiago, the Acting Assistant Secretary of the Primary Care Financing Branch of the Department of Health and Ageing.

The reality is that this government will go out on the front foot and say: ‘This is a wonderful funding program. We have provided to the state governments additional funds to address the dental problem.’ There are a couple of key concerns with this. There are not enough dentists in Australia, just as there are not enough doctors. There needs to be more provision, more training and more education. All governments of all persuasions can do more about that. But there is nothing being set aside to attract more dentists into the public health system. The provision of this $290 million will do very little to attract people into the system.

Going back to the Teen Dental Plan, a $150 voucher might sound wonderful because somebody can turn up and have a dental check-up, but what if they need an X-ray? What if they need an extraction? What if they need root canal therapy? What if they need a crown? There is no support for that. There are many young people who have chronic dental issues through poor diet and health, failure to look after their teeth, and breaking their teeth and failing to get them repaired, so they have infections in their gums that affect their diets and their lifestyle. These people will now be put onto the waiting list whereas, if it were a chronic condition, they would be able to seek a reference from their GP to the private provider of dental services and have that problem remedied.

I just do not think that this program has been well thought out. What we saw during the election campaign was nothing more than something to grab a headline. Now, by hell or high water, the Rudd government is determined to deliver its program regardless of the consequences to our constituents. I have spoken to many of my constituents who have accessed the Howard government dental plan and been able to get their teeth fixed, get their jaws fixed or have their teeth repaired and finally eat an apple. Something that many of us take for granted is being able to bite into an apple. If your teeth are in such bad condition that you have stumps, if your false teeth are broken or if you otherwise have an inability to eat, you cannot eat basic foods like apples. I think that is atrocious. Associate Professor Hans Zoellner, from the Association for the Promotion of Oral Health, said:

The states can’t provide more service without more public dentists, and the CDHP doesn’t even replace the now axed dental Medicare scheme for people with chronic diseases of $340M (2007-8 Budget papers), so it can’t possibly achieve even more in the public system with less.

And:

Since some states spend about half per capita than others on dentistry, wouldn’t it be more sensible for the Federal government to insist under-funding states increase dental spending to a minimum level, rather than encourage them to just maintain existing funding? – This smacks of a Federal Labor Government going easy on Labor State governments.

It is not about ending the blame game. It is about holding states accountable for their responsibilities. Whilst it is tremendous to be able to provide additional funds for programs, regardless of whether they are from the federal government or the states, I think the taxpayers demand that federal governments hold state governments to account on the way they spend their money and the way they appropriate it into various sectors. As we have seen in New South Wales, at $20.21 per person, they have not spent much on dental health. The bill is flawed, and it is flawed for a number of reasons. It will not address the situation of 30 per cent of Australians having reported avoiding dental care due to the cost of services. It will not address the 650,000 people currently on public dental waiting lists. It will not address the 50,000 people who are admitted to hospital each year with preventable dental conditions, putting further pressure on public hospitals. It is no good just pumping money into a state government that has no intention at all of addressing the need for more dentists and no intention at all of spending more per capita of its individual budget.

In conclusion, I am very disappointed with this bill. I would have thought that, after the years of sitting and listening to members of the Labor Party, more would have been done—that is, more than just handing cheques to state governments, more on personal intervention in dental work and more on direct outcomes. As I said, 311,934 services have been provided. In any man’s or any woman’s language—provided they can speak, with their teeth, of course—that is a significant contribution. How do they expect people to be able to pay for X-rays, at $25 to $48? A scaling and cleaning can cost $51 to $116. Root canal work can cost from $222 to $598. Crowns cost on average $1,100, and prices range from $787 to $1,600. These are unaffordable for many people, but they were affordable under the coalition dental plan with a reference from a GP. The Labor Party will go forward and sell their policy to the people. When we come to the next election and there are still a lot of people who have been denied access to dental services because the state governments have not spent, have not planned and have not provided the benefits they need, they will be held accountable. I would like to see the coalition continue with their policy to provide funding directly through Medicare for the provision of such services, as we did as a responsible Howard government.

Sid Sidebottom (Braddon, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on the Dental Benefits Bill 2008 and related bill. Teeth, chompers, pearly whites, fangs or pegs: whatever you choose to call them, teeth and oral health in general play a crucial, basic and sometimes painful role in the health and wellbeing of all Australians. Our teeth are a lifetime investment. They are essential for the most fundamental—and let us not forget delicious—element of being human, eating. Despite their essentialness, though, Australians have come to consider dental health and routine dental checks as secondary or less important than the rest of our health needs. We consider a check-up at the dentist a luxury or an elective item. We do not acknowledge the importance of our teeth to our overall health. We put off going to the dentist, we ignore that toothache and we disregard the health of our teeth as too expensive to deal with. I suspect there are a variety of reasons: comparatively, and unfortunately, the history or culture of pain formerly associated with a visit to the dentist persists; services are not eligible for or part of the Medicare system; the relatively high costs of treatment; and the need by many to take out private health insurance extras to pay for the treatments.

But one of the major contributors has been the inactive role of the former Howard government in relation to supporting the provision of dental health care in Australia, whether this be in a lack of funding directly into a national dental health scheme or in its reluctance to offer national and financial leadership in the training and provision of dental health experts. To blame the states in relation to these matters reflects mostly on the Howard government’s lack of leadership on a vital national health matter. Contrary to attempts by members opposite—and we just heard the member for Paterson repeat himself 20 times in a 10-minute speech that went to 20 minutes—to justify the Howard government’s wilful neglect of dental health under the constitutional guise of arguing it to be a state rather than a federal responsibility, 12 years of neglect by the Howard government followed and it is now simply too tough for too many to get in to the dentist. Many people instead allow the pain to become excruciating before they do anything about it and then, if and when they can manage to get themselves in to see a private dentist, the cost is comparatively high. Many have given up; they have learnt to cope with aching teeth and ignore their poor oral health. Our health as a nation has suffered no end because of this.

Let us take a minute, if we may, to consider the legacy the Howard government left behind in their post-1996 abandonment—and that is what it was—and neglect of national dental health. In 1996 the Howard government scrapped Labor’s Commonwealth dental health scheme, effectively ripping $100 million per annum out of the public dental services. As a result of this, as the second reading speech of the Minister for Health and Ageing, Ms Roxon, on the bill graphically points out, more than 650,000 Australians are now trapped on public dental waiting lists. In addition, some one in three Australians report avoiding going to the dentist due to the cost. A staggering 50,000 people are hospitalised each year in Australia suffering from preventable dental conditions. This puts added pressure on an already bursting public hospital system, particularly in my home state of Tasmania. One in six Australians report avoiding certain foods because of problems with their teeth. Tooth decay is currently Australia’s most prevalent health problem. Gum disease is ranked the fifth most common disease in the nation. More than one-quarter of adult Australians, I understand, are currently suffering from untreated dental decay.

In my home state of Tasmania, the figures are very worrying, but I acknowledge the Bartlett-Giddings Labor government is working hard to tackle the issue. Unfortunately, adult Tasmanians have the worst dental health in Australia. We have the highest rate of tooth loss—14.3 per cent compared to a national average of 8.3 per cent. We have the greatest number of dentures—19 per cent compared to a national average of 15.8 per cent. We have the highest average number of missing teeth and the largest number of people who have not seen a dentist in the past five years—15.4 per cent compared to the national average of 10 per cent. In February 2007, Tasmania’s dental waiting list stood at more than 9,000 people. Of these, 800 people on the north-west coast were on the long-term list.

We must stop and consider for a moment that these statistics represent real people, not just numbers. That is 9,000 people struggling to eat, being kept awake at night and, more often than not, in agony. In Tasmania it can take up to five years just to get into the dentist for a routine check-up. Admittedly things have begun to change, but that is a historical statistic. In 2005 there was one dentist for every 4,000 people in Tasmania. The national average was one dentist for every 2,000 people. Here is another statistic I would like to share with you: nationally, in 2005 there was only one dentist for every 11,500 people eligible to use public services. The Howard government spent the past 12 years refusing to acknowledge these statistics, choosing instead to blame the states—we heard a rendition of the blame game just a moment ago—dismantling the former Keating Labor government’s Commonwealth dental scheme and ripping millions of dollars from the nation’s health system.

What are the implications of this forced neglect of our teeth? Oral health holds the key to our overall health and wellbeing. For 12 years Australians with poor oral health have been sleep deprived, and this has led to all sorts of other health complaints. Poor oral health can trigger all sorts of other medical conditions, as other members have pointed out to the House, including pneumonia, cardiovascular disease and diabetes. Poor oral health is a killer—it kills people. It is linked to premature, low birth-weight babies. Persistent pain has a devastatingly debilitating effect which impacts on every facet of our daily lives. It causes social isolation and poor mental health, puts pressure on personal relationships and can trigger low self-esteem. Indeed, we could spend a whole evening discussing the ramifications of just that last point alone. All of these ailments put significant additional pressure on public health services.

Stop and think for a moment how difficult it might be for someone to get themselves a job or to be approved for a rental property when they have missing or damaged teeth. These problems have increased reliance on welfare payments and public housing. It is serious stuff. It is something you do not think of, but imagine trying to impress someone personally when you have massive problems with oral health or your teeth.

What are we going to do about it, apart from talk about the past? The Dental Benefits Bill, which we are discussing, will allow the Rudd government to deliver on its election promise to provide improved dental services for Australian families and help turn some of these dire statistics around. I regard this as a down payment. This is not enough—nowhere near enough. It is a down payment. It will improve services in two ways: firstly, through the Teen Dental Plan; and, secondly, through the new Commonwealth Dental Health Program. The Rudd government will provide $780 million over five years for these two programs—some $490.7 million over five years to the Teen Dental Plan and $290 million over three years to the Commonwealth Dental Health Program. These commitments will help ease the country’s current dental crisis—I say ‘help ease’; we still have a long way to go—by ending the blame game and working hand in hand with the state governments, for heaven’s sake, not ignoring state needs and gutting health funding like the former Howard government did.

As I have just said, the Rudd government will provide an additional $290 million over three years to improve access to public dental services. Discussions with the states and territories about the introduction of this program are well underway. This money is all targeted at public dental services, to provide additional services to those who need it most: the vulnerable and the needy.

The first task of the new program is to reduce waiting lists by funding an additional one million dental consultations and treatments over the next three years. Strict conditions will be put on the states and territories to ensure the Commonwealth funding goes where it is most needed—to those suffering chronic conditions, to preschool children and the elderly, and to those living in regional areas. This is great news to my electorate of Braddon and, I know, to my colleague the member for Moreton.

I must acknowledge at this point the Rudd government’s decision to discontinue the former government’s Enhanced Primary Care Program, as mentioned by those on the other side. This program introduced by the Howard government allowed GPs to refer people with chronic or complex health conditions to dental and allied health specialists for up to five Medicare rebated treatments in a calendar year. Whilst assisting needy clients—and there is no doubt it did that—the major problem with this scheme was that the Howard government had grossly overestimated the moneys needed to be set aside for these services. So this money was locked up and the majority was not used. And I note the former speaker talked about 300,000 services. That does not mean 300,000 people; it means services. Let us be honest about this stuff. It did help people, and we appreciate that. However, we have to make priority decisions to help more. So, while a small number of people were receiving the service, the unspent moneys, which could have been used for any number of other dental services, were being wasted.

The philosophy behind this government’s decision to discontinue that program is to instead put all available funding into the Commonwealth Dental Health Program. We believe this new system will provide targeted assistance to many more needy clients and those who need it the most.

I would like to now refer to the Medicare Teen Dental Plan. In the last decade, there has been a fourfold increase in tooth decay amongst Australian children. It may in fact shock members and those who may be listening to this debate to learn that currently only about 58 per cent of school-age children have ever seen a dentist—and that is not for positive reasons, let me assure you. This is not acceptable. The Rudd Labor government are committed to fixing it, despite the fact that we come from some considerable way behind—and let us not forget that. So, from 1 July 2008, the government will provide up to $150 per eligible teenager aged 12 to17 years towards an annual preventive dental check-up.

This scheme will have two significant outcomes, we believe. Firstly, it will provide financial assistance to parents to ensure their children keep their teeth in good shape; and, secondly, it will encourage teenagers themselves to continue to look after their teeth once they become independent. The flow-on effect of this objective cannot be underestimated. If we can encourage and educate the next generation about the importance of good dental health then the chronic dental issues we face today will be greatly reduced in the future, which is what any good preventive health program should do.

The Medicare Teen Dental Plan will operate as part of the broad Medicare arrangements, through a new dental benefits schedule. The dental benefits schedule will be administered by Medicare Australia and will operate in a similar manner to the existing Medicare arrangements. However, unlike the Medicare Benefits Schedule, the DBS will be targeted to specific age groups and working families receiving family tax benefit part A.

In closing, the Rudd Labor government will deliver $780 million to Australia’s dental health through the Commonwealth Dental Health Program and Medicare Teen Dental Plan. This will set us up for a whole new level of dental care in Australia and a whole new belief system when it comes to our teeth. But it is a down payment; it is a beginning. It is a re-involvement of the Commonwealth in dental health. It will bring dental health care and access to dental care back to the forefront of Australians’ minds. Our children will be educated and encouraged from a young age to value their teeth as a lifetime investment. Most importantly, it will ease the burden on the public health system well into the future. Unlike those opposite, I welcome this bill.

John Cobb (Calare, National Party, Shadow Minister for Regional Development) Share this | Link to this | Hansard source

I rise to speak on the Dental Benefits Bill 2008 and the Dental Benefits (Consequential Amendments) Bill 2008. The issue of dental services in regional Australia, certainly in western New South Wales—and I am sure, Deputy Speaker Scott, in your own electorate in south-western Queensland—is a huge one. Anything that helps the people of our regions with their dental health has got to be a good thing. However, the program that we initiated in November 2007—where patients who were assessed by GPs as having complex medical conditions which required dental services could go and see private dentists or whoever and receive over $4,000 worth of treatment over two years—was a break in the nexus. It allowed people who would have otherwise been unable to get treatment to do so. An earlier speaker today talked about dental health becoming part of normal health, and I think there is a case for that. Certainly, the people described by our scheme had health issues requiring dental surgery and other services, and they were able to get those under that scheme; otherwise, they might not have been able to.

Other members have talked about the extent to which that service was used. People were able to line up for it up until March of this year. A lady in my electorate of Calare, from Orange, had gone through the step-by-step process to be assessed to be able to use that scheme. She came to see me and said that the scheme had been cut without warning, as it were, and, even though she had met all the requirements, the current government had said that she could not take advantage of it. That was a lady who had done a lot of work to go through the process, and she had every reason to be upset about it—as a lot of people were, obviously, right around Australia but particularly in regional areas such as western New South Wales.

I am thankful for anything that my constituents can get to ease their path into dentistry. The Labor Party—the current government—is introducing a scheme as part of this bill whereby young people can get $150 for a check-up; but, as the member for North Sydney, the shadow minister for health, said earlier, given that the Labor Party itself has said in the past that the cost of a check-up is well over $200, I am not quite sure what it is going to do except perhaps tell someone they have a problem. They will still have to pay a bill for the value of that check-up. Then what the heck do they do? They have not got any money to have the procedure done. I am not quite sure where this is leading.

I would like to get back to the regional issues. Without doubt, an enormous problem in the regions, whether it be Kalgoorlie, south-western Queensland, Calare or Parkes—wherever these electorates are—in the provision of dental services is having dentists available to do the work. We have a big problem especially in some of our smaller towns, our regional areas, where people do not have great access to public transport or any other form of transport.

I think one of the big things that we as a government did was to make it easier for our regional kids to get into medicine or nursing without necessarily having to go to Sydney, Melbourne, Brisbane or Perth to do their training. Dubbo used to be in my electorate and Orange is now in my electorate. We are setting up a dental school in Orange with outreaches in Dubbo and Bathurst. Wagga has another part of that dental school. Last year we set aside $65 million to set up that dental school. That will make it much easier for kids from country regions in particular to do their training to become dentists. It is a known fact that if you get kids from regional areas into dentistry they are far more likely to practise in those regions. This is what we did with medicine. We created in places like Orange and Dubbo rural clinical schools which took kids from the University of Sydney. I think the same thing happened in Western Australia. They have been a huge success. We have to continue to train our young people from regional areas. Over 10 years our initiatives took the percentage of regional kids entering medicine from around eight per cent up to about 26 per cent today. That is a huge thing. Last year we set up projects to enable the same thing to happen in dentistry. I think that is enormously important. As I think about it, Mr Sidebottom, the member from Tasmania—I forget his seat—

Barry Haase (Kalgoorlie, Liberal Party, Shadow Parliamentary Secretary for Infrastructure, Roads and Transport) Share this | Link to this | Hansard source

The member for Braddon.

John Cobb (Calare, National Party, Shadow Minister for Regional Development) Share this | Link to this | Hansard source

Thank you very much.

Simon Crean (Hotham, Australian Labor Party, Minister for Trade) Share this | Link to this | Hansard source

He is a very good member too!

John Cobb (Calare, National Party, Shadow Minister for Regional Development) Share this | Link to this | Hansard source

I am sure he is. The member for Braddon said that we did not do anything. The Regional Partnerships program is something the Labor Party likes to chuck rocks at because it was so popular, but I remember that last year we gave $125,000 to put a dental chair in Narromine, where they are besieged with people looking for dental treatment without their having to go to major cities such as Sydney. Obviously it is a terrible thing to make dental services available to people in the bush! It is obviously one of the bad things that Regional Partnerships did!

Simon Crean (Hotham, Australian Labor Party, Minister for Trade) Share this | Link to this | Hansard source

They did some good things.

John Cobb (Calare, National Party, Shadow Minister for Regional Development) Share this | Link to this | Hansard source

That is wonderful to hear. Let me just point out a few of the other things that are coming to fruition which are so important to regional dental services. We put $12.5 million into the six major universities that teach dentistry in Australia. I am very, very pleased to find out that, finally, Griffith University have come to an arrangement with the bureaucracy as to how they will spend their $1.8 million. They are going to set up in the town of Brewarrina, which is a town in my electorate with a very high Indigenous population. My electorate has one of the higher percentages of Indigenous Australians, and we are very proud that we have well over eight per cent of the descendants of the original Australians in our electorate. Brewarrina does have a real issue with dental health, as do Bourke and the far west. I am just delighted that Griffith University are going to be spending part of their allocation in Brewarrina in western New South Wales. Every two months they will be taking eight students there for three weeks as part of their training to do dental work, and that is fantastic. I implore Greater Western Area Health to do their bit in the recurrent funding for that. It is all very well for the Commonwealth to fund this and for Griffith University to provide the transport, but I call upon Ms Roxon, the Minister for Health and Ageing, to fulfil the $250,000 promise our government made to Brewarrina to make this a permanent situation. I am just delighted that Griffith University are leading the way and are going out to western New South Wales—in this case to Brewarrina—to make that happen. If the Labor government want to put money towards young people’s health, that is fine. I think it is ridiculous to fund what is in the order of half the cost of a dental check. It still does not leave them with any money to pay for the other half or to actually get the necessary work done. To say that we wiped out a program for which there was an obvious need, as the member for—what was it again?

Simon Crean (Hotham, Australian Labor Party, Minister for Trade) Share this | Link to this | Hansard source

The member for Braddon.

John Cobb (Calare, National Party, Shadow Minister for Regional Development) Share this | Link to this | Hansard source

Thank you. For the member for Braddon to say that it was—

Simon Crean (Hotham, Australian Labor Party, Minister for Trade) Share this | Link to this | Hansard source

There is something wrong with your memory.

John Cobb (Calare, National Party, Shadow Minister for Regional Development) Share this | Link to this | Hansard source

Yes, I know. It is a problem, isn’t it? For the member for Braddon to say that we did nothing on this is ridiculous. There were 300,000 services. Of course, it is not 300,000 people, but people who needed genuine work were able to get it done. As I said earlier, people in my electorate are coming to me wanting to know why it is, when they have done all that work, that suddenly they have been cut dead on a program which was obviously so necessary, simply going on the number of people who have taken advantage of it. I think it is shocking that that program is being cut. If the government want to bring in a new one, I think they should fund it rather than throw people half the cost of a dental check-up and then give them nothing to follow it up afterwards. Mr Deputy Speaker Scott, regional health is a huge issue—as you, I and the member for Kalgoorlie are well aware—and we will pursue it and do our level best to keep the government on their toes on it.

Greg Combet (Charlton, Australian Labor Party, Parliamentary Secretary for Defence Procurement) Share this | Link to this | Hansard source

The issue of dental care, of course, is an issue that is of great interest to many of my constituents as well, and a number of the members who have spoken previously have drawn attention to the circumstances in their own electorates. But it is relevant right across the country for many working families who are struggling with the financial costs that are associated with dental care. Indeed, as we have heard from some of the other speakers, a number of Australians are struggling with these costs, and the numbers are growing quite considerably. The 2007 Australian Institute of Health and Welfare report concluded the following: 30 per cent of Australians reported avoiding dental care due to the cost, 20.6 per cent said that the cost had prevented them from having recommended dental treatment and 18.2 per cent reported that they would have had a lot of difficulty paying a $100 dental bill—and, of course, $100 does not take you too far once you are in the dentist’s chair. At the last election Labor promised to implement a teen dental health plan, and with the passage of the Dental Benefits Bill 2008 and the cognate bill the government will have met that commitment.

Before I get to the substantive aspects of the bills I just want to outline some of the other statistics I think relevant to Australian dental health. At the same time that we have seen the pressure of dental health care costs rising for working families, we have seen a worsening of some of the dental health of many Australians. It is a sad fact that tooth decay ranks as one of Australia’s most prevalent health problems. Some of the statistics relating to this problem are really quite alarming, and I think it is important to emphasise them. It is estimated that 25.5 per cent of the Australian adult population have untreated tooth decay. One in six Australians aged 15 have avoided certain foods because of problems with teeth during the last 12 months. As we have heard the member for Braddon note, 50,000 Australians a year are hospitalised for preventable dental conditions. Between 1996 and 1999, five-year-olds experienced a 21.7 per cent increase in deciduous tooth decay. Hospitalisation rates for children under five for dental conditions increased by 91 per cent between 1994-95 and 2004-05, a shocking statistic over a 10-year period. There was also a 42 per cent increase in children being treated in private hospitals for dental cavities between 2000 and 2005.

For a country which is relatively affluent by world standards, this is an unacceptable situation. It is statistics like these that have led the Rudd Labor government into action in the area of dental care. As a government, we are determined to turn around a decade of neglect under the previous government. It can never be forgotten, of course, that the previous government abolished the Commonwealth dental health care program in 1996, taking out $100 million per year from public dental health services. I think there is no doubt that that decision in 1996—which, surprisingly, I have heard some of the members opposite attempt to defend during the course of this debate—has contributed to a number of the statistics that I have referred to worsening over the past decade.

I turn to the bills before the House, and firstly the teen dental health plan. The bills implement Labor’s teen dental health plan, which was announced before the election. This will mean that, from 1 July 2008, the government will provide up to $150 per eligible teenager towards an annual preventive check for all teenagers aged between 12 and 17 years in families that receive family tax benefit part A, and also teenagers in the same age group who receive the youth allowance or Abstudy. The annual preventive check within the scheme will include an oral examination and, where clinically required, X-rays, a scale and clean and other preventive services, which are extremely important for teenagers. This plan will provide relief for a large number of families who are struggling with the rising cost of dental health. I am pleased to say that this initiative alone, it is estimated, will benefit over 1.1 million eligible teenagers across the country. I am pleased to say that we believe that, in my electorate of Charlton, it will potentially assist approximately 14,000 of the family members of my constituents.

Funding for this initiative was included in the government’s recent budget, with a total of $490.7 million being provided over the next five years, an extremely substantial commitment by the government to try and improve teenage dental health. We have been advised that the Department of Health and Ageing is currently working with the Australian Dental Association and other stakeholders to provide information about the Teen Dental Plan to dentists to ensure that the scheme runs smoothly and that people are able to access it in an appropriate manner.

The other element of the legislation before the House is that, to facilitate the teen dental health plan, the bills will establish a new dental benefits scheme. This scheme will provide the necessary framework to allow for dental benefits to be targeted to specific groups of patients. It allows for the targeting of the measures in these bills towards teenagers and gives the government the opportunity of exploring further schemes to target dental health care assistance to those most in need.

It is important to emphasise that the teen dental health plan is only the first part of the government’s plan for improving dental services in Australia, but of course it is not the only part. In the recent budget the government also provided $290 million over three years to state and territory governments to help fund up to one million additional consultations and treatments for Australians needing dental treatments. This is all about implementing a new Commonwealth Dental Health Program.

Funding arrangements to support this program are being developed between the Commonwealth and states and territories. States and territories will be required to maintain their own level of funding for dental services but will be able to use this additional funding to supplement their existing public dental services. It is extremely important, of course, that the Commonwealth’s contribution will make a net addition of $290 million worth of dental services They will also be able to access the funding to purchase services from the private sector in areas where public dental services are not able to be accessed.

All of this is indicative of the fact that the Rudd Labor government—unlike the previous government—is taking leadership in the area of dental health rather than relying on the tired example of the previous government, who resorted to the argument that this is all the responsibility of the states. I have noted that speaker after speaker amongst those opposite has emphasised, as a justification for the previous government’s policies in this area, the argument that this is all the responsibility of the states and that that is why we have the problems we have. The fact of the matter is that there is a responsibility on the part of national leadership as well to address serious problems of this nature.

Within the budget the government also committed $49.5 million to the James Cook University proposal for the Cairns School of Tropical Dentistry. This project will deliver capital infrastructure aiding in the delivery of 60 dentistry places a year. So that is an important addition to the capacity within northern Australia.

The initiatives that I have outlined have all occurred in the first six months of the Rudd Labor government. This stands in contrast—and, having listened to some of the contributions from those opposite, it is important to emphasise this—to the record of the Howard government in the area of dental health over 12 years. As I indicated earlier, it is a well-known fact that the Howard government scrapped Labor’s Commonwealth Dental Health Program in 1996, ripping out at the time $100 million a year in contributions to public dental health services.

Barry Haase (Kalgoorlie, Liberal Party, Shadow Parliamentary Secretary for Infrastructure, Roads and Transport) Share this | Link to this | Hansard source

It ran out.

Greg Combet (Charlton, Australian Labor Party, Parliamentary Secretary for Defence Procurement) Share this | Link to this | Hansard source

The effects of this become obvious when you look back at the period since that cessation of that program. From the other side of the table I hear the interjection that it ran out. There was an obligation to make sure that these important health effects in the dental area were addressed by government, and that was the failure. In the circumstances of the decisions of the previous Howard government, it is important to note that over the last decade state and territory governments have more than doubled their investment in public dental care. Yet over the same period public dental waiting lists blew out to 650,000 people after the Howard government’s decision to axe the Commonwealth Dental Health Program.

Barry Haase (Kalgoorlie, Liberal Party, Shadow Parliamentary Secretary for Infrastructure, Roads and Transport) Share this | Link to this | Hansard source

Mr Haase interjecting

Greg Combet (Charlton, Australian Labor Party, Parliamentary Secretary for Defence Procurement) Share this | Link to this | Hansard source

The states doubled their funding, in fact. In 2004 the Howard government belatedly attempted to address their failure in this area by making dental care available through Medicare, but only to people with chronic illnesses and complex care needs. However, I think it is now well recognised that the scheme introduced in 2004 was riddled with problems—including complex and restrictive eligibility criteria, high out-of-pocket costs and somewhat complex referral processes from GPs for people to be able to access the entitlement under the scheme.

As a result the scheme only assisted about 7,000 people over a three-year period, in a context where we have 650,000 on a waiting list. I do not think that can be characterised as a success in public policy terms. So the Rudd Labor government has made an important start in trying to address this important area of public health, where I think, as a nation, we have been failing people in the community. For these reasons I commend the bills to the House.

Graham Perrett (Moreton, Australian Labor Party) Share this | Link to this | Hansard source

If you go up to level 1 of Parliament House, you will find a couple of acts up there that precede the Federation of Australia. They are dated July 1900. There are two original copies of them on display up there. Schoolkids look at them. It might be interesting for some of the people opposite to go and have a look at them, because it is a copy of our Constitution as an act passed by the British parliament.

Barry Haase (Kalgoorlie, Liberal Party, Shadow Parliamentary Secretary for Infrastructure, Roads and Transport) Share this | Link to this | Hansard source

Mr Haase interjecting

Graham Perrett (Moreton, Australian Labor Party) Share this | Link to this | Hansard source

There are two copies up there at the moment, actually, if you go and have a look.

Barry Haase (Kalgoorlie, Liberal Party, Shadow Parliamentary Secretary for Infrastructure, Roads and Transport) Share this | Link to this | Hansard source

Person, not people. There is only one here.

Graham Perrett (Moreton, Australian Labor Party) Share this | Link to this | Hansard source

Sorry, I should have said ‘person’. The opposition should go and have a look at these acts, because the copies of the Constitution do not have any blood on them. There are no great tear stains on them, because obviously Australia was born out of an act of the British parliament, not the revolutions of some of the other places around the world—even democratic countries around the world.

The Constitution is obviously a difficult document to amend. I have my copy of the Constitution here. Section 51 says:

The Parliament shall, subject to this Constitution, have power to make laws for the peace, order, and good government of the Commonwealth with respect to:

…            …            …

(xxiiiA.) The provision of maternity allowances, widows' pensions, child endowment, unemployment, pharmaceutical, sickness and hospital benefits, medical and dental services ...

Section xxiiiA was obviously an amendment. It came in after a referendum on 28 September 1946. Actually three referendum questions were put. Two of them were rejected. The one that got up was this one that amended the Constitution, which is not an easy thing to do—only eight out of 44 referenda have actually passed. It is a very difficult document to change, but this question did get up, even though the two alongside were rejected. Just for the benefit of the member for Kalgoorlie I will point out that 62.26 per cent of Western Australians actually voted for that amendment. That was the highest percentage in all of Australia. I know that Western Australians have a strange history when it comes to voting on referenda, but on this occasion 62.26 per cent of Western Australians said, ‘We want that amendment. We’re in favour of that amendment for the Commonwealth to look after dental services.’

It is my understanding that there was actually a joint ticket sponsorship of that amendment to the Constitution by Ben Chifley and Bob Menzies. The proposal that was put to the Australian people has been sitting there since 28 September 1946. The Constitution is very difficult to change. Unfortunately, one of the Howard government’s first acts when it came to power was to rip the funding out of public dental services. I am sure Bob Menzies would turn in his grave at such an act. It was one of the first things that the Howard government did.

In 1996 the coalition axed $100 million of dental funding to the states. In my home state of Queensland—which, Mr Deputy Speaker Scott, is something you hold close to your heart—our share was $20 million a year, which would relieve a lot of people’s misery. In today’s dollars the funding shortfall is more than double that. Mr Deputy Speaker, as you know, I grew up in a town in the bush, St George. The dentist where I grew up in St George was Steve Logan, who was a great dentist. He did a lot of great things for the community—I could certainly tell you a few tales about him because I am good friends with his sons—but now in St George they cannot recruit a dentist. Why is that so? Not surprisingly, when a federal government rips $100 million out of public dental services, there are fewer dentists and fewer dental services. It is not hard to see the results of removing $100 million from a public scheme. This was the trigger that set off the decay of the public dental system throughout Australia, and unfortunately Australians have since then had to reap the benefits of that horrendous decision.

On top of that, the coalition government failed to train enough dentists through our universities. The previous speaker, the member for Charlton, mentioned the new dental school in Cairns and the speaker before that mentioned the dental school in Orange, but obviously these measures are too little, too late in terms of addressing the problem. Those dentists will not be opening mouths to provide relief for years to come—until 2014, 2015 or 2016—and that does not help the people who are suffering from a toothache now.

In Queensland we have just 0.58 dentists for every 1,000 people, and I know other states are in a similar situation. In fact, I can relate to that. After eating a bit of Cadbury fruit and nut chocolate on Sunday I lost a filling, so I had to call my dentist this morning. I am in an inner-city electorate, which is well serviced in terms of dentists, but I cannot see a dentist before the end of July, and that is for someone who is on a decent wage and has private health cover. So obviously there are a lot of other places around Queensland, and I am sure it is the same in Western Australia, where the dental queues are growing longer and longer. It has got to the point in some areas around the country where public dental patients have no realistic expectation of receiving non-emergency dental treatment, and this has occurred within a decade.

The reality is that some people simply cannot afford private dental treatment. Their only option is to wait for their condition to get so bad that they need emergency treatment. I have seen those queues. The electorate of Moreton has a couple of facilities—including QEII hospital. If you go there in the morning, you will see the queue of people lined up in the order in which they arrived at the door of QEII hospital. It is staggering to see the pain that people are in, and people let them move further up the row in the hope that they do not have to go home untreated at the end of the day. This is a shameful legacy for the opposition to have to their name.

It is simply not sustainable to have dental queues increasing out of control. It is also unthinkable that some people are forced to suffer pain because they cannot get access to a public dentist. That is why the Rudd government made a commitment to restore funding for public dental services. The Dental Benefits Bill 2008 and the Dental Benefits (Consequential Amendments) Bill 2008 offer a two-pronged approach to improving dental services around the country. They include $490 million for the Teen Dental Plan and $290 million for the Commonwealth Dental Health Program. In all, it is a massive investment in improving the oral health of all Australians, providing $780 million over five years.

The Teen Dental Plan is about ensuring our young people enter adulthood with healthy teeth. Certainly, having been a schoolteacher in a former life, I know how sensitive young people are about their teeth and how it can affect for life if they have problems with their teeth, both socially and obviously health wise, which earlier speakers have addressed. The Teen Dental Plan provides $150 a year towards an annual preventive dental check-up for eligible teenagers aged 12 to 17 years, so that they start a relationship with their dentists. The dental benefit will be available to families receiving family tax benefit part A. In other words, this measure is about helping those who need it most.

I have certainly had dealings with Mike Foley, former President of the  ADAQ, the dental authority. He has talked about the horrible situation in the mouths he has had to look into, and you realise how dental care is a social justice issue, certainly in Queensland, a non-fluoridated state. This is about to change and I commend the health minister and the Premier on that initiative. The Teen Dental Plan will include an oral examination and, where required, X-rays, scale and clean, and other preventive services. This is a program that will benefit more than one million teenagers every year. This bill will also set up an appropriate framework for payment of dental benefits under a new dental benefits schedule. It is similar to the MBS, but it is means-tested and specifically targeted to teenagers. As part of the framework, Centrelink and Medicare will be able to exchange information so that vouchers can be distributed to eligible families and teenagers.

This bill also establishes the Commonwealth Dental Health Program to restore funding to the states and territories to reduce public dental waiting lists. I am thankful that it will avert a lot of misery. Through this program, state and territory governments will be able to provide up to one million additional dental consultations and treatments to help clear public dental waiting lists around the country. As I stated earlier, the $100 million ripped out in 1996 is a significant amount of money. Combined with the attacks on universities, obviously no-one opposite should be surprised that there are fewer dentists, which means longer waiting lists. So let us make Ben Chifley proud and let us make Bob Menzies proud. I commend the bill to the House.

Tony Zappia (Makin, Australian Labor Party) Share this | Link to this | Hansard source

I too rise to speak in support of the Dental Benefits Bill 2008 and theDental Benefits (Consequential Amendments) Bill 2008. These bills are further examples of the Rudd government delivering on yet another election commitment, and doing so very quickly in this term of government. This substantial commitment of $780 million is made up of $290 million towards the Commonwealth Dental Health Program and $490 million for the Teen Dental Plan. The need for this expenditure is urgent, and it is important that this policy be delivered as quickly as possible because, as we have heard from speakers on both sides of this House, the number of people on waiting lists for dental treatment, and the compounding financial and health costs and the deteriorating quality of life of those people, continues to rise. The quality of their lives continues to suffer.

I can speak firsthand about this because I have met a number of the people that fall very much into that category and I have seen the impact it has on their lives. People who have problems with their teeth cannot eat certain foods and that, in turn, has compounding effects on their general health and, quite often, other health complications arise. As has been proved time and time again by the medical profession, poor eating habits are frequently the cause of other medical problems. I have also seen the social impacts on people. One pensioner was telling me in the lead-up to the election campaign about how the fact that he could not get a new set of dentures—he could not afford them—meant that he had to start cutting out part of his social life. He felt entirely uncomfortable in going out and doing the sorts of things that he had been doing, firstly, because he could not enjoy the food and, secondly, because he did not like the way his teeth looked. It caused him to lose a lot of self-confidence.

In the second reading speech, the Minister for Health and Ageing highlighted how some 650,000 Australians are on public dental waiting lists and how 30 per cent of Australians are reported to avoid dental care because of the cost of those services. On almost a daily basis we hear concerns raised by families, by people on low incomes and by pensioners about how difficult it is to face cost-of-living pressures. There is no question that that is happening, and we know that there are a lot of people out there doing it tough—so you can very easily understand how 30 per cent of Australians are actually avoiding dental health care because they simply cannot afford to go to the dentist. It becomes one of the low priorities of their expenditure when it perhaps ought to be one of the high priorities. But, because it is something that they can make do with and learn to live with in the short term, they keep putting off the expenditure. Sadly, the fact that they do so means that, ultimately, the expenditure that they incur further down the track is much, much higher as a result of the consequent health issues that arise. So, whilst they might think at the time that they are putting their money into something that is more urgent, perhaps they are actually making the wrong choice about that.

We also heard from the minister how 50,000 people end up in hospital each year because of preventable dental conditions. Every time this happens it means that someone else has to wait in line for services that they also need. These people would not have to wait in line if the dental care were there and the 50,000 people had not been forced into hospital through neglect of their dental health needs. The minister also talked about how tooth decay is Australia’s most prevalent health problem. I am not surprised to hear that, given the withdrawal of funding from the Commonwealth Dental Health Program by the previous Howard government. Clearly, if you are going to withdraw $100 million a year from a service, someone is going to suffer. Ultimately, the people that are going to suffer are the people that are in need of that service. When you consider that $100 million in funding was withdrawn over a 10-year period and when you consider that dental health is the second biggest health expenditure of Australians—in the latest figures that I was able to obtain some $3½ billion was spent on dental health in one year alone; I think it was 2005-06—you can understand how dental health is one of those areas where people do spend a lot of money. The withdrawal of a billion dollars, or thereabouts, over a 10-year period can make a huge dent in the services that are provided to people that need those services.

The minister also talked about how, between 1996 and 1999, five-year-olds experienced a 21.7 per cent increase in deciduous decay. That is effectively a 21.7 per cent increase over a four-year period. Isn’t it interesting how that increase coincides with the withdrawal of the Commonwealth dental service? I might come back to that a bit later on because I want to say something about some of the remarks that I have heard from speakers on the other side of the House about who is responsible for dental health services in this country. Those statistics that the minister referred to are appalling statistics and they highlight both the urgency of this legislation and the rightful, widespread condemnation of the Howard government for axing the Commonwealth Dental Health Program and in doing so, as I said a moment ago, ripping $100 million per year from the public dental health system. The overwhelming numbers of people who make up the statistics that I referred to earlier are the people who are already the most disadvantaged in our society. They are the pensioners, those on low incomes and the children of parents on low incomes. Those children end up being the victims of all of this because, unlike even their parents, they have had no say in this matter whatsoever. They are the most vulnerable that you could refer to.

Quite understandably, it is those people who miss out because, quite frankly, if you are better off you are likely to be able to afford the dental services that you need and, as you need them, you access them from the public system or the private system. But if you cannot afford them you are the one who is going to go without, just as you have to go without in so many other areas. It begins a downward spiral in your life, because if you do not access the services you need when you need them, as I said earlier on in my remarks, it starts to create other health issues and on it goes. The importance of this bill is that not only does it deliver the $780 million I referred to to the dental needs of Australia but it delivers to those people who most need the money and the support and who would most likely go without if the federal government were not providing this level of support.

I want to talk about another matter, though. I hear speakers from the other side say time and time again that when it comes to the provision of dental services the responsibility lies with the states—as if dental health is not part of overall good health. I was pleased that the member for Moreton reminded me about the Constitution and that section 51, part xxiiiA specifically refers to dental health being an obligation of the federal government. But putting that to one side for a moment, I think that every Australian would quite rightly believe that the federal government has some responsibility when it comes to the provision of health services, and to suggest that dental health is not health but something totally different is totally mind-boggling. The extraordinary absence of logic in suggesting that one part of your body does not come under the broad scope of health because it is dealt with by a specialist who is referred to as a dentist totally baffles me. I have to say that I cannot understand the logic in using the line that it is a state responsibility because dentists are, for some reason, a special category, and I suspect that no-one else in Australia can either.

Roger Price (Chifley, Australian Labor Party) Share this | Link to this | Hansard source

Certainly the pensioners.

Tony Zappia (Makin, Australian Labor Party) Share this | Link to this | Hansard source

Exactly—the pensioners. I have to say that it would not only be the pensioners. I wonder how the dentists and the other dental health professionals feel about that when they hear it. Are they too not referred to as health professionals? Is dentistry not a health service in their eyes? I suggest that they would not be terribly impressed when members opposite suggest that people who study dentistry or nursing in the dentistry field are not considered equal to those who study other forms of medicine. I know a number of dentists. They study dentistry—therefore a medical field—and they do so for a number of years. It is one of those areas in which you have to specialise. The dentists with whom I have had experience I fully commend as absolute health professionals in their field.

There is another element to this business of where the states should be responsible for a service and where they should not. Again, it is interesting that the opposition members continually blame them for the state we are in when it comes to the number of people who are on waiting lists and that they supposedly are to blame for all the woes we face when we talk about dentistry. In my state of South Australia between 1996 and 2002, when some of the statistics escalated the most, we had a Liberal government in power. So I wonder whether the members opposite also direct their criticism at the Liberal government of the day when they throw that criticism at the state governments. I doubt very much that they do. They are simply using that excuse to try to blame the state Labor governments. As we have said time and time again, they play the blame game on a matter on which they themselves were extraordinarily negligent.

What we did see, though, is that in 2004 the Howard government started to panic on this issue because public opinion went against the government of the day. The opinion was that the federal government was not doing enough to assist people with dental needs. In particular, it was the pensioners who were raising the matter the most. So we saw the Howard government bring in some of its own legislation, referred to as the Commonwealth dental scheme, in 2004. But, as other speakers have said time and time again in this debate, the referral process and eligibility criteria were so complex and so restrictive that in my own state, over the four years that the Howard government scheme was in place, I understand that no services at all—and I stand to be corrected if members on the other side can prove me wrong on this—had been provided to children up to the age of 14; that is, absolutely zero. That was the take-up rate of that scheme for children under 14 in the four years that the scheme was in place. It shows how poor the scheme was and how miserably it failed. And because it failed—again, not surprisingly—come the 2007 election, dental health became a major issue which I well recall campaigning and doorknocking and speaking to community groups about on a regular basis. No-one has to convince me that dental health was a major election issue, because I was confronted with it on a regular basis by people I spoke with who were demanding that the federal government reinstate the Commonwealth dental plan and do more than what was being done. As a result of that, and as a result of a government that was beginning to panic because it could sense the mood of the people out there—and with an election looming in 2007—we saw the federal government amend its own scheme and make further changes to it in order to try to establish some credibility on this issue with the voters. It was too little and it was too late. By that stage, voters had had enough. By that stage there were too many people out there who had been waiting too long for assistance. They were not prepared to wait any longer, and they were not prepared to give the Howard government another three years to see what kind of additional scheme it was going to implement. They were not prepared to give the Howard government another three years of bringing in a scheme which, again, would probably not suit their needs. Not surprisingly, they voted with their feet in 2007.

I said earlier that I had met a number of people in the course of my campaign who drew my attention to their need for dental health services. Not surprisingly, when I was elected as the member for Makin the very first constituent who came into my office was a constituent who wanted assistance with respect to his dental needs. I am pleased to say that I was able to assist him and he was able to get the kind of support that he deserved, needed and had been waiting for for some time. That was the very first constituent I had come into my office. Since that time, I have had a number of others come in with similar problems, again, having been on waiting lists for too long and literally in dire need of dental assistance. Again, I did whatever I could for them. But what I can say to them now is that, as a result of this $780 million committed by this government, the waiting lists will be reduced and the services will be out there for them to access when they were not there in the past.

A number of the matters that I would have otherwise spoken on in this debate have already been addressed by other members. I am not going to repeat all of the issues that were raised by members, particularly on this side, in support of this bill, but I do want to respond to some of the issues that were raised by members opposite. One of the criticisms has been that we do not have enough dental professionals in the public system and therefore, regardless of how much money you throw at the system, people will not be able to access the services. Why don’t we have enough dental professionals in the system?

Amanda Rishworth (Kingston, Australian Labor Party) Share this | Link to this | Hansard source

Because they kept ignoring it.

Tony Zappia (Makin, Australian Labor Party) Share this | Link to this | Hansard source

Absolutely. For 10 years the Howard government did absolutely nothing about ensuring that the future needs of the dental profession were being met by our universities. That is why we have a shortage. But there is another reason why we have a shortage, and that is that when you pull $100 million a year out of a service then of course the waiting lists are going to grow. Had we invested that money over the last 10 years into the service, the waiting list today would not be so long and therefore the professionals who are out there today would be able to cope with the demands that are being placed on them. It is quite simple. You do not have to use an extraordinary amount of logic to work out that, if you had been servicing people for the last 10 years, you would not have had the accumulation of people on the waiting lists that we now know we do have.

But it goes further than that, and I am pleased that other members, including the member for Moreton and the member for Charlton, have referred to the James Cook University and the establishment of a dentistry school there. This government is aware that there is a shortage of dental professionals in the field. We are very much aware of that, and that is why there has been this investment in the James Cook University—again, to try to increase the number of professionals that are required throughout the communities wherever you go in Australia.

I guess the other matter is that, when it comes to the health checks, there is no reason why those health checks cannot be done by private practitioners. It does not have to be a dentist in the public system. They can in fact be done by private dentists, and I am sure that many of them will be. Whilst I am speaking on the Medicare Teen Dental Plan, can I say this: as a parent of children who are now in their 20s, I can well recall when my kids were in their teenage years. I can recall that it is in those years that young people tend to neglect their health needs the most when they should in fact do quite the opposite. Not surprisingly, the statistics show that between the ages of 18 and 21 is when young people generally have the worst and most dental problems. Why? Because at the time when preventive measures should be taken they are being ignored—for a whole range of reasons. I am sure that anyone in this House who is a father or a mother would understand how kids grow up and how they tend to commit their time to other things and neglect the things that perhaps they should not be neglecting. The reality is that that is when they ought to be looked at, and so the Medicare Teen Dental Plan is not simply a $150 payment that is going to create a check-up. What it is going to do is create the preventive action that will save those families money later on and ensure that those kids have much better health as a result of it.

Quite frankly, this legislation goes a long way to doing a lot for a lot of people. I commend it to the House, and I am pleased to see that, as I said earlier, this government has introduced it so early in its period of government.

Roger Price (Chifley, Australian Labor Party) Share this | Link to this | Hansard source

I want to support the remarks of my colleague the honourable member for Makin and the contribution he made to the Dental Benefits Bill 2008 and Dental Benefits (Consequential Amendments) Bill 2008, pointing out that of course dentistry is part of the health system. It was an absolute disgrace when, 12 years ago, one of the first actions of the Howard government was to abandon the field. Every year and every month during that 12-year period they said it was a state responsibility. The truth is that during that period the states doubled the funding that they were spending on the public dental health system. And what was the Commonwealth doing? Absolutely nothing. And, of course, waiting lists were blowing out. I am very proud to be here in this House seeing that we have made a commitment to dentistry. I have two public dental health clinics in my electorate, one of them named after the late May Cowpe, a great Trojan of the ladies auxiliary at Mount Druitt Hospital and, I suspect, a Liberal Party voter. With this money, that clinic is going to be able to really deliver a service and cut the waiting lists. We all know that in its last year of operation the pensioner dental health program helped 600,000 of our fellow Australians, and what did the Howard government do? They chopped it and said it was a state responsibility. As far as dental health was concerned, the Howard government did not want to know, and, of course, we have picked up the pieces, as the honourable member for Makin said.

I have a lot of constituents coming to see me legitimately who are concerned about their dental health program and getting their teeth fixed. Regrettably, the neglect of oral health can lead to the hospitalisation of people; it can lead to death. It is a very serious matter, and the greatest crime is when parents cannot afford it for their children or pensioners and those on welfare are unable to access the service. I have seen some horrendous cases where people have had to wait two and three years and have had to ingest liquid food because they could not eat solids. This was a situation where those opposite would constantly say, ‘This is a state responsibility.’ In fact, you would not think they are federal members because every problem in Australia is usually a state responsibility or a state problem or a state caused problem. But, on this side of the House, we are prepared to work constructively with the states to get solutions, to provide help, and we will not turn our backs on pensioners and others in need.

Janelle Saffin (Page, Australian Labor Party) Share this | Link to this | Hansard source

The debate is interrupted in accordance with standing order 34. The debate is adjourned and the resumption of the debate will be made an order of the day for the next sitting. The member will have leave to continue speaking when the debate is resumed.