Andrew Laming (Bowman, Liberal Party, Shadow Parliamentary Secretary for Regional Health Services and Indigenous Health) Share this | Link to this | Hansard source

This is an opportunity for me, which I appreciate, to put on record some more context around the dental scheme that is being proposed by this government and to provide a better understanding, I think, than we have seen so far in much of this debate on exactly how the economics of dental care in Australia work.

I already pointed out in my first contribution that dentistry in Australia is a predominantly private enterprise and that any solution will always rest privately with dentists. It was something that was respected by this side when in government, that devised the Chronic Disease Dental Scheme. The great myth that is being perpetrated by the other side about the coalition's scheme is that it blew out in cost. I think you need to remember some basic facts about public dentistry in this country, which has been perennially underfunded. On average there are up to three-quarters of a million Australians who, at any one time, are seeking out dental care which they cannot afford privately. That cohort are predominantly older and, more frequently than the rest of the population, have chronic disease. What is most important of all is that they find it virtually impossible to afford private dental care.

The scheme proposed by the coalition increased in its initial estimates from around $100 million to close to $1 billion a year. Let us step back and see whether that is a failure or in fact a success. The first piece of evidence in favour of this scheme is that dental waiting lists in the public dental facilities decreased by 40 per cent during this period of Commonwealth investment in dental care. Secondly, if you have three-quarters of a million people, each needing between $1,000 and $2,500 worth of dental care which they cannot afford, then you know what? That adds up to over a billion dollars. If anything, the success of the Chronic Disease Dental Scheme is that it reached out to the most vulnerable cohort.

I pointed out in my earlier contribution that the one thing that this program focused on was looking after the sick. And what we are seeing over here is, on the one hand, a Labor government criticising us for that and instead devising a system that looks after concession card holders; but, on the other hand, they are actually devising a children's dental scheme which runs almost identically to the Chronic Disease Dental Scheme in its functionality, as far as a dentist is concerned. So what we have is a 'mini-me' dental scheme, starting of course not tomorrow or next year, because the budget pain felt by this government is simply greater than the dental pain felt by Australians—no, it is a program that starts in nearly two years time. When it starts, it will be exactly the same: a cap of $1,000 every two years for dentists to look after young people's teeth. So the criteria in that scheme make us just as at risk of the rorts that have been criticised in the previous scheme, except that they will be treating a person with a birth certificate that has a smaller number on it than the coalition scheme did.

The complaints about rorts and irregularities in the CDDS were around one per 1,500 patients. That is quite consistent with a lot of our MBS data. Did the government act to fix the problem? No, they did not. They have had four to five years to fix the problem and they have elected not to. In fact, offers have been made by other parts of this chamber, and they have been passed up. This government preferred to see this program run up to close to $1 billion a year, when simple changes and modifications to it as it was rolled out could have saved $330 million a year.

The second very important piece of evidence is that the use of the scheme was in decline as the burden of disease was being treated—and we know that from the per-case figures: $2,225 for adults; $2,125 for children. But this had fallen to $1,174 by this year. And the whole program itself, within two years, was likely to fall to $374 million a year; quite affordable, and not that far away from the estimates when this scheme was set up. The fault of the CDDS, if there is one, is that it simply mopped up the public waiting list of dental disease, and it did it very effectively.

I know, over there, they were talking about all those millionaires getting their dental treatment. Well, I will remind you of one thing: millionaires pay their taxes, and they have paid their way handsomely. Once you start denying Australians basic universal health care, I dare you to do the same to Medicare. Go on: cut them out of Medicare. But you will not do that, will you? No, these millionaires paid their way. What percentage of the CDDS were people on concession cards? Eighty per cent. So, 80 per cent of the CDDS clients were not millionaires; they were concession card holders getting the dental care they needed.

The government listened to some unusual sources of information. One of them was a doctor by the name of David Rivett, who said just recently, in an AMA publication:

… a loud Hooray for the termination of the—

CDDS—and:

This program has been a real burden for GPs, with patients often supported by family members, aggressively demanding dental funding …

How outrageous! How frustrating for those poor doctors having patients coming in saying, 'We want dental care, and we know there's a scheme that can look after us.' His second criticism is that an 'elderly diabetic' was 'referred for dental care under the scheme to improve her nutrition' and she came back 'two weeks later' with a $4,000 bill, including 'fillings and some descaling work.' I don't know if Mr David Rivett can even read a receipt on dental work—I don't think he's got any dental training—but I am glad that diabetics in this country were getting the dental care they could never get in the public system.

I have one minute left, and I will take you through a very important journey. If you are a sick kid, you were getting care under the coalition's program—$2,125 a year. That sick kid will wait for two years and, when they finally get the care, it will be cut to $1,000 every two years. That will be cut-price dental for that kid. Those sick kids are worse off. Now, children who are not sick have always had to go to private dentistry or public hospitals—and they will still have to do exactly the same thing until 2014. The sick adults that have been getting care under the coalition scheme now have to wait; they miss out—and they will miss out because, if they are not concession card holders, there will be nothing for them, and the paltry $212 million a year transferred to the states will simply be soaked up, but will not make much difference to those dreadful year-after-year waiting lists in public dental. This is a bad move. And the most vulgar part of it is the 15 to 19 months where there will be nothing for Australians in dental care. That is a great shame and that is why we will be opposing the bill.

Shayne Neumann (Blair, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak in support of the Dental Benefits Amendment Bill 2012. I saw a couple of headlines, one entitled, 'Dental care is failing the needy', from the Sydney Morning Herald of 19 March 2007; and 'Country aching over dental crisis', from the Sydney Morning Herald of 26 January 2007. On this side of the House we are very proud of the long history and record of Labor governments contributing to the oral health needs of our country. Those opposite have no plan. You will hear one speaker after another criticising us and standing up on that side of the chamber for millionaires, again and again and again.

The particulars of this legislation are that it amends the Dental Benefits Act 2008. It sets in place a legislative framework for the Child Dental Benefits Schedule to commence operation in January 2014 and it extends the age range of people eligible to receive the dental services to include children of at least two years of age but under 18 years of age. Currently the legislation provides for children aged 12 to 18 years, under the Medicare Teen Dental Plan.

The bill before the chamber results in an easy operation for mums and dads across Australia. The Medicare Teen Dental Plan is effectively being replaced by a better and more comprehensive arrangement called the Child Dental Benefits Schedule, which will provide far more children with the kind of access to the good dental care they need. This legislation forms part of the package of the $4.1 billion reform announced in August 2012.

I found a reference a while ago to something that former finance minister Lindsay Tanner said. It was in reference to arguments that took place after the budget in 2008, where the coalition steadfastly opposed our reforms with respect to oral health care in this country. Those opposite are very keen to spend the money, but they oppose the taxes this government has imposed to provide good health care, good road infrastructure, good assistance in education, assistance with superannuation increases, and flood recovery and the like. They are very happy to take the credit, to spend the money, but to oppose, irresponsibly, the bills necessary for the funding of those outcomes.

Their irresponsible attitude in relation to legislation we brought in in 2008 resulted in $284 million being wasted by those opposite in relation to this, because they blocked it in the Senate. One of the first acts of the previous coalition government, in 1996, was to cut $100 million in funding and leave Australia with an ever-burgeoning public dental health crisis, to the point where about 650,000 Australians were on the dental waiting lists. I saw that and experienced it when I was the chair of the Esk Health Reference Committee, as part of the West Moreton Health Community Council. At that stage, Esk, which is located in the Brisbane Valley, was in the electorate of the member for Dickson, who happens to be the shadow minister for health. It is interesting that year after year not a word was said by him in relation to those issues in his own electorate as the waiting lists became worse and worse in his area. We did not see a press release. We did not see a statement. I saw no correspondence, no overtures to the health council and no offers of funding to assist oral health care in his own electorate.

In 1994 the then Keating Labor government introduced state funding for dental services, targeting those on low incomes, who are the most in need. And, as I said, one of the first acts of the Howard government was to take that away, just as they ripped $1 billion out of the childcare sector not long after they were elected, in 1996. Earlier on I read from headlines in the Sydney Morning Herald dating back to March and January 2007, and they just say it all about the legacy of those opposite. I will read them again: 'Dental care is failing the needy'; and, 'Country aching over dental crisis'. That is the legacy of nearly 12 years of coalition government in this country.

In 2008 we introduced a means tested plan funding annual check-ups for teenagers. It took a Labor government to do that. One-third of Australians at that time could not afford dental care, with people on waiting lists for up to five years. One of the things I am most proud of with this government is the fact that we have doubled health funding in this country—it is in partnership with the states, but we are the ones putting up the money, to 2019-20. This is in stark contrast to those opposite, who adopt the attitude of slash and burn. We will see that if they ever sit on this side of the chamber. We know that because the now Leader of the Opposition was the health minister in the Howard coalition government when they de-funded public health and hospital systems in this country by $1 billion. What an impact that had on public health.

Perhaps we are now not expecting him to copy Campbell Newman in Queensland. Perhaps Campbell Newman was copying him, when he was health minister. In places like Townsville we have seen 45 front-line nurses go. In my electorate, too, front-line services have been slashed as jobs have gone. This has real consequences for many areas around the country.

Today we have heard all the jeremiads from those opposite about our policy. We have seen them one after another get up here and talk about the Chronic Disease Dental Scheme. They never talk about the fact that a scheme that had previously been costed at $90 million to taxpayers was, and is, costing $80 million a month. They have the temerity to criticise us about waste and mismanagement when it is their policy that has caused this. Former finance minister Lindsay Tanner belled the cat back in June 2008 saying that we were going to save $248 million by getting rid of the scheme we are proposing to get rid of with this legislation. Their scheme means that if you are a millionaire you are not means tested. It means that if you are a kid with bad teeth, in a regional or rural area, you really are disadvantaged compared with someone who might live in a salubrious suburb in Sydney or Melbourne. The scheme is not means tested and not targeted at all. It is open to significant abuse, and has been abused. That is the reality of the scheme we are getting rid of today.

The legislation that we are bringing forward today is part of a package. I was also most proud of the fact that this government in the budget put forward $515.3 million as an investment in oral health for those who can least afford it, for a blitz on the waiting lists. The 400,000 people waiting for care on public dental waiting lists will receive the benefits of those measures that we introduced in the budget: new spending to boost the dental workforce and improve facilities in those regional and rural areas I am talking about—front-line services being provided to build the health service; front-line services that are required, particularly in regional and rural Queensland, and were so nastily and meanly slashed by the LNP at a state level in my home state of Queensland: more than 4,000 health workers, pathology services, dental services, breast screening, nursing, TB—the lot. Services are being downsized and people are being thrown out of jobs across the length and breadth of Queensland.

So, while we are here today, bringing forward assistance to about 3.4 million Australian children who are eligible for funding for dental care, I wonder what those people opposite from Queensland will say? I wonder what they are saying to their communities in places like Gladstone, Hervey Bay, Townsville, Mount Isa and all those areas where there is downsizing and where jobs are being outsourced? I wonder what they say to them?

I know what the CEO of the West Moreton-Oxley Medicare Local had to say about the package that is before the chamber today. Vicki Poxon said that the announcement was particularly vital for the residents of the Ipswich and Somerset regions, which hold a comparatively large number of low-income households. Ms Poxon said:

An announcement like this will go directly towards improving the all-round health and wellbeing of our residents, in particular, children and pensioners who need it the most.

Considering roughly 20 per cent of the West Moreton-Oxley region is made up of children under 14 years, this is an announcement that will be very well received by households in our area …

Of particular importance to us is ensuring our rural areas are given much-needed assistance in the more isolated locations, so we welcome this announcement as a step forward for those residents.

It’s an unfortunate reality that for many families proper dental care is simply not a financial possibility, and as a Medicare Local, this package brings us closer to our goal of seeing Australians access proper care so that they can live healthier, happier lives.

I think that is an outstanding statement and absolutely accurate. The package does strike a balance between improving services for low-income cardholders and a new investment in prevention. One thousand dollars in two years for children for check-ups and diagnoses—that is the kind of thing that is important.

We believe that preventative health care is really critical. On the other side of the chamber, they are the people who opposed the National Preventive Health Agency. On this side of the chamber we believe in preventive health, and we believe that we need to spend more to prevent ill-health. It is a good investment in the long term.

Investment in children's dental care is an investment in the future for those children. When I was a practising lawyer in the jurisdiction of family law, I saw many people in very difficult circumstances in what we used to call child custody cases. There were some terrible, terrible cases of children whose dental health had been neglected by their parents, sadly—it was abuse, neglect and, almost, family violence, what had happened in those cases. Those parents, and sometimes grandparents, brought applications in the Family Court or the Federal Magistrates Court seeking parenting orders. I recall specifically one case that I dealt with in Bundaberg in relation to this where the child's teeth had to be entirely taken out. It was awful because of that. I was acting, actually, for the grandparents. The parents were suffering and had very little access to money and very few parenting skills, but it was a horrible case, and I saw many of those types of cases in my time as a lawyer.

We need to do more to help parents to care for their children. But we also need to fund these services better. Better oral health care for children results not just in a good outcome for their physical wellbeing but also a good outcome for the general community and the economy, because children who care for their teeth are less likely to have serious health problems later on in life, are more likely to have greater confidence in themselves and higher self-esteem, and are more likely to get good educational outcomes and good jobs and to contribute to community life.

This is an investment in the future. It is a good package that will have good outcomes. And for Queensland this is a fantastic outcome. We have seen the dental waiting-list money from the budget: $67.3 million in additional funding and for public clinics now for low-income adults, $249.4 million. We are seeing great outcomes from this government in terms of the health of our country—opposed, always, by those opposite. (Time expired)

Ewen Jones (Herbert, Liberal Party) Share this | Link to this | Hansard source

I like the member for Blair, but he came in here and did not say one word about the sick and the poor and what they are going to do until 2014. He did not say one word about their chronic dental problems and what is going to happen to them until this scheme kicks in. I would be willing to wager $20 on the fact that that kid who had all his teeth pulled out probably had them pulled out under the Chronic Disease Dental Scheme. The member for Blair comes in here every day and rails at the Queensland government about the cuts and job losses and everything like that, but I ask the member for Blair: where was he when the Queensland government was not paying their health workers? Where are the speeches in the Hansard about how badly treated the Queensland health workers were by Bligh's Labor government? The member just mentioned tuberculosis. Let us not forget that it was ex-Premier Bligh who pulled the funding from tuberculosis in the Torres Strait. And it is this health minister that continues to do so and who will not do anything about it. We have got drug-resistant tuberculosis and all sorts of problems up there. We did not hear him talk on anything. He is very selective about it and should be very careful.

I rise to speak on the Dental Benefits Amendment Bill 2012. This bill seeks to amend the Dental Benefits Act 2008 to allow the establishment of the Child Dental Benefits Schedule, revising the Medicare Teen Dental Plan to extend the age range of children currently covered by the public dental system. Notably, this bill comes with a price tag of $2.7 billion, a little more than half of the government's recently announced changes to the dental system. What this creates is the 12th new bureaucracy loaded onto the health system since this Labor-Greens government came to power. It is something you all should be very proud of.

This bill needs to be considered in the context of Labor's wider changes to dental health, announced recently by the Minister for Health. The introduction of the Child Dental Benefits Schedule is one component of this plan. The first part of these changes involves the scrapping of the Medicare Chronic Disease Dental Scheme, or CDDS, which will come into effect on 30 November this year. There are nearly 650,000 people on the waiting list for this scheme, the waiting list for which can reach five years. But the new scheme will not start on 1 December this year; this new scheme will start in 2014!

Straight up I have to question the minister's motives over this change. The CDDS was introduced by the coalition. It was created by the member for Warringah. The Labor Party has been against this program for a while and I cannot help but ask whether it is just because it is the Leader of the Opposition's program. Those opposite talk about budget blow-outs and rorts of the system and they have aggressively pursued dentists over largely inadvertent mistakes in paperwork. But the data shows the average claim per patient has been only $1,716, well below half the maximum $4,250 allowable under the scheme. This has been a good program. Those opposite complain that the CDDS costs $1 billion per year and that that is excessive. Yet the minister says that her scheme will cost $1 billion per year—that is, $4 billion.

This bill is about expanding coverage to children, but over 60,000 services were provided to children under the CDDS. Could it just be that dental patients have to suffer for this government to take a swing at the Leader of the opposition? Geez, that would be a cynical outlook. The CDDS is about serious dental problems; it is about chronic conditions. We on this side of the House do understand that dental issues are the second biggest cause of admission to Townsville Hospital, behind only diabetes. What we are talking about is not only a big health issue in itself; if we do not treat it as soon as we are aware of it, it will be an even bigger problem in hospital emergency rooms.

The CDDS will end on 30 November. In fact, services under the CDDS have already finished—nobody who applied after 7 September this year will even get on the list. Its replacement will not begin until 1 July 2014, yet the member for Blair stood there and rail against the Campbell Newman government, saying that he is leaving people high and dry. It beggars belief. That is almost two years that people with chronic dental problems and who cannot afford to fix it themselves will have to wait to get anything done about them. Remember, over 80 per cent who claim this thing are in fact card holders. They are the poorest and weakest in our community. That is almost two years from today for dental concerns to become major and far more expensive problems; and that is even if there is a plan for 2014. As I said, there are currently around 650,000 people on the waiting list for the CDDS. This government expects that, come 1 July 2014, it will have a plan for those who have been waiting another 17 months to get to the front of the queue. It beggars belief. I have had constituents in Townsville who need work done under this program call me. They have told me that they have received notice from their dentist that they need to schedule their surgery as soon as possible, or else they will be waiting at least another two years—if it is delivered at all. That is not right and it is not fair.

It also needs to be noted that there is a 13-month period during which the children that this bill supposedly helps will have to wait before the new program starts at the beginning of 2014. One of the core fundamentals of the ethical code in the health fields is 'first do no harm'. That is the catchcry of the Leader of the Opposition. It should be one of the fundamentals of government. Instead, this government is doing the exact opposite by hanging out to dry for another two years the thousands of patients in urgent need of this dental program. It is outrageous that the Prime Minister and the health minister can get out there spruiking their investment in dental services while stripping everything away from those in most desperate need for at least those two years.

This bill represents more of the same in Labor's ad hoc approach to allied health. A governmental approach to the health system needs to be about the bigger picture. As I said, dental issues are the second biggest cause of admission to Townsville Hospital: if you can treat them you do not save just the patient, you save health spending as well. It is typical of this government's inconsistency that it can pour money into the dental field—money it does not have or even plan to provide—right after it has stripped back private health insurance rebates. It gives with one hand and takes with the other.

The attack on allied health by this government through means-testing private health insurance increases the withdrawal by people from their private health cover. People look at the range of their cover and say, 'Okay, it's going to cost us more. What can we go without?' We will see a dropping of allied health services such as dentists, physiotherapists, optometrists, occupational therapists and the like. We will eventually see these allied health professionals leaving places like Ayr, Ingham, Charters Towers, Innisfail and Tully. They will close their doors and move to the bigger cities, because there will not be the critical mass of people they need to keep their doors open. This will have a domino effect on all health services and will create the conditions for chronic dental problems. There are people on this scheme who should be accessing the CDDS, who need to go to a dentist but cannot afford to. They cannot afford to come to Townsville to get it done, much less go to Brisbane. We are just making it even harder for these people all the way through. That is especially the case for people in rural towns and communities.

By bringing in these changes, the government are delivering to these people the fate they are expressly trying to avoid. The member for Blair spoke about the trial in Hervey Bay. It was a distressing story. Some poor kid had to have every tooth in his head pulled out. I guarantee that kid was not going to a dentist from the beginning. That is not anything to do with a dental scheme; that is parent neglect and they should be charged for it. These are the people we need to get to. These are the children who will eventually be noticed by the teacher and who will get into the Chronic Disease Dental Scheme. This is not going to be picked up with a bit of a scrape and plaque removal. They will get $1,000 every year to be fixed up.

The question waiting to be answered on the dental bills to come is: where is the money coming from? These changes are supposed to be ready to go in 2014. That is inside the forward estimates, but where exactly is it detailed in the budget? It is not in there. This is yet another example of this government making the grandiose announcements that they do so very well. They make it sound good. They throw around the big money. Then they walk away, leaving the job half-finished behind them. Where is the detail of these plans? Where is the detail of where the money is coming from? Where is the detail about what will happen to patients who will need dental care between now and 2014? Where is the detail of how much this will actually cost each year? You cannot do half the job and then pat yourself on the back. Yet that is what we see from this government time and time again. Whether it is about education, charities regulation, the NDIS, increased refugee intake; the list goes on and it's got dental health at the top.

This government is like the workers who turn up at starting time and put the billy on, have a cuppa until it is time to go to smoko, then go to the toilet until lunch. Eventually they might get an hour or so of work in in the afternoon. They go home and say they are putting in. That is what this government does—it does not deliver. I can only assume at this point that the Treasurer has entirely given up any hope of achieving the surplus he has promised so many times.

The coalition supports investment in dental health. We have an established scheme. We have form on this. We deliver. The government cannot just announce policy on the run that has a huge price tag and no plan. There are some 650,000 people on public dental waiting lists already. Are the dental patients who need work before these schemes begin in 2014 just expected to shuffle up to the back of that queue, pop a Panadol, have a lie down, put some ice in their mouth, that sort of thing? It is time this government put some thought into delivery, instead of trying to wedge the member for Griffiths or vilify the member for Warringah.

My good friend Senator Ian Macdonald says that good policy will always lead to great results. This is bad policy formation with no consultation with anyone apart from Labor's lords and masters, the Greens. You always have to worry when a Labor minister turns up at a press conference to make an announcement and you see the Greens spokesperson at their shoulder. You know it is going to cost. You know it is going to be expensive. You know it has not been thought through. You know it has been done for any reason other than that it is good policy. It does not make sense.

This is bad legislation, uncosted, and it will hurt the most vulnerable people. This will not lead us to great results; this will lead us to nowhere but inequity, especially in rural and regional Australia. This scheme will hurt the people most in need and it should be opposed because this is bad government. You people are hurting the very people you seek to help. It is not on. You should drop this legislation and continue with what is a great scheme. I thank the House.

Geoff Lyons (Bass, Australian Labor Party) Share this | Link to this | Hansard source

I am proud to stand here today to support the Dental Benefits Amendment Bill 2012. In fact, it is one of the most important bills to be introduced in this place this year as it is going to improve the lives of many Australians by assisting them with dental care. The bill, once enacted, will commence on 1 July 2014. The bill amends the Dental Benefits Act 2008 to set up the legislative framework for a child dental benefits schedule, which forms part of the government's $4.1 billion dental reform package which Minister Plibersek—and what a fine minister for health she is—announced on 29 August 2012. The Child Dental Benefits Schedule will replace the Medicare Teen Dental Plan from 1 July 2014. This bill will mean that, for three million children, going to the dentist will be just like seeing a GP. This is a landmark achievement for this government.

Going to the dentist is something many families cannot afford. We, the Gillard Labor government, are doing something about that. Unlike those sitting opposite, we are in tune with the community. We have listened to concerns of parents around the country and we are making it more affordable to access good dental care. Some 3.4 million children whose families get family tax benefit part A, Abstudy, carer payment, disability support pension, parenting payment, special benefits, youth allowance, double orphan pension, the Veterans' Children's Education Scheme payment or the Military Rehabilitation and Compensation Act Education and Training Scheme payment will qualify for the new scheme Dental for Kids.

Families will be entitled to $1,000 per child every two years over the life of the package. I note that parents will be able to take their children to either private or public dental services to access this program, which is fantastic. This is an investment in prevention because we know that our oral health as children is the best predicator of oral health as adults. As I have said in this place many times, the only way to save money in health is to do things right and to do them early. This scheme is a great example of this. In addition to dental for kids, the dental reform package will provide extra funding for 1.4 million additional services for adults on low incomes, including pensioners and concession card holders and those with special needs, to have better access to dental health care in the public system. These measures will be very welcome in my electorate of Bass, I am sure.

Importantly, it will mean more services and more dentists in areas of most need outside capital cities and large regional centres like my electorate of Bass. The package comes on top of $515 million in the last budget, which included a blitz on public dental waiting lists. This package is badly needed. The oral health of children has been declining since the mid-1990s and we know that almost 20,000 kids under the age of 10 are hospitalised each year due to avoidable dental issues. That figure is truly shocking. By age 15, six out of 10 kids have tooth decay.

Untreated decay and fillings are similar across income ranges but, if you earn more than $60,000 a year, you have on average seven more teeth than Australia's poorest—45.1 per cent of 12-year-olds had decay in their permanent teeth. Recent studies show that children in the poorest areas of the country experience 1½ times the amount of tooth decay and cavities experienced by those in the wealthiest areas. We know that the number of family members with untreated tooth decay in low-income households is more than double the number in high-income households. Let us hope that soon these statistics are a thing of the past.

Around 400,000 languish on public dental waiting lists. Millions of people go without adequate dental care. We have listened and we are acting. This plan will kick off at the end of next year, just 15 months away. The measures announced in the 2012-13 budget are already underway, which is great. Labor believe we have a responsibility to ensure that all Australians are at least able to afford to go to a dentist and, in particular, that children should be given access to government subsidised oral health care. States and territories provide dental care for children and adults. However, eligibility for these services is not the same in every state.

Dental for kids will provide access to dental services for many who are not currently entitled to access public dental services. Dental for kids also means parents can decide whether they want to take their kids to public dental clinics or to their own local dentist. It is important to note that this $4 billion package is contingent on the states and territories continuing to fund dental care at or above their current level of spending. State and territory services will continue to operate as they do now. However, the federal government will now pay for many of these services. Public dental services will not be able to charge any copayment for services funded by the Commonwealth. This in turn will allow states and territories to direct more spending to services for low-income adults, which is an area of great need. What is important to note is that this package strikes a balance between improved services for low-income cardholders and new investment in preventive dental work. The investment in children's dental care is an investment in their dental needs as adults and will ensure that the oral health of each generation is better than the last generation's.

The government has a proven track record in finding savings in budgets to deliver on our priorities and still return the budget to surplus. We found $33 billion of savings in the last budget and over $100 billion in the budgets before that. That has allowed us to deliver on our priorities in public health, paid parental leave, aged-care reform, mental health reform and the biggest pension increase in our nation's history. We have got one of the strongest economies in the developed world, with stronger growth and lower interest rates under this government's stronger economic management. But we are also managing the economy in the interests of working Australians by keeping people in jobs and delivering important reforms like this dental reform.

The Liberals said no to Medicare, they said no to national health reforms and they said no to public hospital funding, slashing billions from basic hospital care. As John Howard's health minister, the member for Warringah, the Hon. Tony Abbott, increased out-of-pocket expenses by 50 per cent, put in place a poorly targeted dental scheme that now costs Australia's $1 billion each year and froze GP training places, leaving six in 10 Australians living in suburbs and towns without enough doctors. What I want to say to those opposite is that saying no has real consequences. It risks the health of millions of Australians by increasing medical costs and closing hospitals and community health centres.

The opposition continued to support the rorted Chronic Disease Dental Scheme instead of backing fair and sensible reform of dental policy, including almost $2 billion for low-income adults and a blitz on public dental waiting lists. The Minister for Health yesterday released a statement regarding our dental plans. She pointed out that the member for Warringah's rorted dental scheme was supposed to cost $90 million a year but ended up costing $80 million a month. He introduced the scheme in the final days of the Howard government. The scheme handed millionaires more than $4,000 each but ignored children of low-income Australians who simply had bad teeth. More than 1,000 complaints were made about the scheme, including complaints about dentures that did not fit; amalgam fillings being swapped for porcelain fillings; unnecessary cosmetic work being done; and charging for work that never happened.

Labor's new investment in dental care began with a budget allocation of $515.3 million and was followed by a commitment of $4.1 billion in August. This is in stark contrast to the Liberals' track record on dental care policy. The Liberals have said no to every major health reform. But they said yes to tobacco donations, collecting more than $1.9 million in donations from big tobacco companies since 2004 and benefiting from $16 million of anti-Labor tobacco ads and political lobbying.

Only Labor has a plan to help families with the cost of living and build a stronger economy by spreading the benefits of the mining boom. Working families are worried about the cost of living—electricity, rents, school uniforms and groceries. Even a simple family outing feels like it is beyond the reach of some. That is why Labor has put in place a package of measures to help people make ends meet. This dental package is a great example of that. We have an outstanding record of significant achievement secured in the most closely divided parliament in decades. Our economy is healthy and growing; it is the envy of the world's advanced economies. We are bringing the budget into surplus. We are working with business to drive gains in productivity. We have cut taxes, delivered pension benefits, increased super, started a massive skills program, initiated new programs for disabled Australians and developed sweeping aged-care reforms. We are bringing 21st century broadband to all households and we are tackling global warming and moving to a clean energy future.

In other words, the Gillard Labor government is getting important things done, and it will continue to do so. As a government we have made choices. We stand for supporting working Australians with a package of policies that helps them get through, giving working people a fair share of the resources boom and making the hard decisions that will build a new Australian economy and get us ready for the future.

The Liberals always put vested interests ahead of the needs of the community or ahead of working Australians—on the mining tax, on increasing superannuation for workers and on making big polluters pay for their carbon emissions. They put headlines before hard work, politics before principle.

We are repairing the 10 years of waste and neglect of our health and dental system inherited from the Howard government. This is a building block that will improve the lives of many. Improving the living standards of this generation and future generations means that we are making the right decisions now. I urge all members of the House to support this legislation.

Craig Kelly (Hughes, Liberal Party) Share this | Link to this | Hansard source

I rise to speak on the Dental Benefits Amendment Bill 2012. Sadly, this bill simply sums up the Labor government. In fact, this bill could be a metaphor for this government. Firstly, this bill is just another broken Labor promise. Secondly, this bill is nothing more than a hoodwink, a con, a deception, a pea-and-thimble trick. Thirdly, this is a bill that will cause undue pain and suffering and hardship to hundreds of thousands of Australians. This bill is just another example of why the Labor government will go down in history as the worst in our nation.

This bill just adds to the long list of broken promises by this government. It is just another example of why the Australian public simply cannot believe a single word that this government says. In a press conference back on 11 February 2011, the current Prime Minister said:

Every time we announce something we properly account for it and properly fund it.

Those are her words; the transcript is available on the Prime Minister's website. So how is the government properly funding the spending in this bill—$4 billion? Where is the money coming from? That is more than a fair question, given that we have a Prime Minister who has promised:

Every time we announce something we properly account for it and properly fund it.

In this government's haste and confusion when making an announcement on this bill—that haste and confusion that we have seen time and time again, which has been the hallmark of this government—the Minister for Health simply let the cat out of the bag. She was reported in the Age on 30 August as saying:

There is not billions of dollars in the budget for this … we need to find a new $4 billion …

So there we have, in the minister's own words, confirmation that the government are making announcements, without a clue of how they are going to properly fund them. The admission that they need to find a new $4 billion is confirmation that this bill is just another broken promise and a further erosion of trust of the Australian public.

As the minister has confirmed, we need to find a new $4 billion for this bill. There is a call going out around the nation tonight: where is the money coming from? It is not only this bill on dental health. The government needs to explain where the money is coming from for the new asylum seeker policy. Where is the money coming from to fund a National Disability Insurance Scheme? Where is the money coming from to fund the Gonski education reforms? Where is the money coming from to fund our new submarines? So far these unfunded promises add up to a massive $120 billion black hole.

If that is not bad enough, we wake up this morning and we hear another unfunded promise from the government—this time $1.4 billion a year for taxpayers to fund private childcare workers. This is simply yet another government commitment without them having a clue where the money is going to come from. This is against a background of falling commodity prices, a likely downturn in revenue and the Prime Minister hanging on to the delusion that the budget is still in surplus. No wonder even members of Labor's caucus yesterday were joining in the chorus with the other 22 million Australians: where is the money coming from?

Are the government going to raise taxes to pay for this bill? Are they going to slash more jobs in the Public Service? If they fail to do so, given their unprecedented track record of broken promises, the Australian public will see these unfunded promises, such as those in this bill, for what they are—nothing more than a hoodwink, a deception, mere empty promises, all designed for short-term political gain to fool people in the run-up to the next election. But, I suppose if this government thinks it can get away with the promise before the last election, 'There will be no carbon tax under a government I lead,' it could probably get away with anything.

As I said, this bill is nothing more than a hoodwink, a con, a deception, a pea-and-thimble trick. In peddling their nonsense about this bill, one thing the speakers on the other side conveniently have forgotten to mention—the inconvenient truth about this bill—is that this unfunded dental health program will not begin until 2014, well after the next federal election. Under this bill, the means-test entitlement for children aged 12 to 17 will not commence until January 2014 and the proposal for adults does not commence until July 2014. So what we have is nothing other than an unfunded promise on the never-never, something that will not even happen, at the very best, until after the next election.

What is even more shameful is the other inconvenient truth about this bill. This government is, at the same time, announcing the closure of the existing Medicare Chronic Disease Dental Scheme. Under the government's proposals, no new patients can access this scheme after 7 September—which has already gone—and no new treatments will be done at all under the existing scheme until 30 November. So the question is: what happens between now, when the scheme is closed, and 2014? What happens to someone suffering chronic dental disease during that period? The answer is: nothing. Absolutely nothing. There is nothing that this government is putting into place between now and 2013.

We have a bill here that is really about the federal Labor government stripping away money from dental health and replacing it with nothing more than a promise, something that might happen in the future. A classic pea-and-thimble trick. We have this government coming into the parliament and creating the illusion of being concerned for dental health, when the reality is that this bill rips away the existing Chronic Disease Dental Scheme to offset the government's reckless spending and wasteful management. Why is the government ripping away this existing scheme? This was a scheme established by the Howard government to provide patients who have chronic dental disease with rebates of up to $4,250, every two years, for private dental treatment. This is an existing scheme that has provided, since 2007, approximately 20 million services to over one million Australians who have suffered from chronic dental disease.

There are two reasons this scheme is being closed down, and neither of them is legitimate. The first reason is purely political. It is based on the ideology that everything the Howard government did was wrong. This is the same ideology that has seen the disaster on border protection. The second reason, and perhaps the real reason, is to simply try to shore up a dodgy budget surplus. We have seen claims from the other side that this scheme has been widely rorted. Let us look at these numbers. The minister says that there have been 1,000 complaints of so-called rorting. Let us put that into context. This is a scheme that has provided two million courses of care. So this wide rorting is 0.05 per cent. That should be a record of success, not failure. That 0.05 per cent of supposedly wide rorting includes pursuing dentists for the most minor and inadvertent paperwork mistakes.

These cuts to our dental health, that will occur over the balance of the life of this Labor government, will cause enormous pain and suffering for thousands, perhaps tens of thousands, of Australians. And the message this government gives to them is: 'Sorry, there's no money left. We've wasted it all. Simply take an Aspro, put up with the pain and wait for a year or two until this new scheme starts.' That is the message this government is telling tens of thousands of Australians today. Those Australians suffering with chronic dental disease are now paying the price. They are paying the price of this government's wasteful and reckless spending and failed policies. Those Australians suffering with chronic dental disease and those Australians who will suffer with chronic dental disease for the next year and a half are being forced to pay the price. They are being forced to suffer and endure pain for the disastrous schemes like the pink batts, the farcically named education revolution, the green loans debacle, the $5 billion cost of the denial and the refusal to admit the costly mistakes on border protection.

Those voting for this bill should stand up and admit that what they are voting for is going to cause pain and suffering for those with chronic dental pain and gum disease. There is also the issue of the urgent cut-off. Why the urgency to cut off the existing scheme? Twelve weeks from the announcement, the scheme was cut off altogether. The minister should explain why to the many children who must suffer and wait for another 13 months—with incomplete treatment and no certainty of what schedules are provided—or until this government gets around to supposedly coming up with some funding for this unfunded promise in 2014.

The executive officer of the Australian Dental Association drew attention to this problem. He said: 'There are a significant number of treatments that simply cannot be completed in 12 weeks.' They are 'anything from ongoing gum disease treatment, orthodontics and dentures where we have to wait for the extraction wound to heal before fitting'. The 12-week cut-off simply shows that those in government do not know what they are doing. They are either wilfully going out to cause pain and suffering or they do not know what they are doing. These people who are halfway through their treatments, and who are now left in limbo, are the ones paying for this government's waste.

I could go on and compare the two dental schemes, but what is the point? We are talking about a scheme in 2014. How can this government be trusted to deliver it when it is completely unfunded? Hans Zoellner, chairman of the Association for the Promotion of Oral Health, has pointed out one of the great weaknesses of the scheme. He said that few children needed enough dental treatment to get near the $500-a-year cap. On the one hand, it might cost a child $100 or $200 to go to a dental surgery. They do not need the $500 cap. But on the other hand, children with more serious problems are disadvantaged by this cut. Under the existing scheme they are able to go to a $4,250 limit.

And what about people with mobility issues? How will this scheme affect the disabled or nursing home patients and others with mobility issues? Under the current scheme, the one the government is getting rid of and replacing with nothing for 14 months, they are able to go to a local dentist. Now under the new scheme, which will start sometime in the never-never, they cannot go to their local dentist. They have to go to a public dentist and they will be forced to travel significant distances. So what happens to those people who have those mobility issues?

What about the capacity of our existing dental workforce? All of a sudden we will have a big reduction in demand through the cutting of this scheme. Then, when the new scheme starts, we will have an explosion in demand. We will have a built-up demand for 14 or 16 months, 19 months for adults, with no chronic dental schemes available. We will have an explosion of demand in 19 months. Simply, again, it is the government not understanding the basics of supply and demand.

This legislation deserves to be treated with complete contempt for the pain and suffering it will cause many Australians. The coalition's position is that we will be moving a disallowance motion against the closure of the Chronic Disease Dental Scheme, to protect those patients who will otherwise go without treatment for 19 months for adults and 13 months for children. That is at least; it will probably be longer than that. Those on the other side have a decision to make. You should stand up and support that disallowance motion. If you do not, you will be responsible for causing pain and suffering to tens of thousands of Australians.

Sid Sidebottom (Braddon, Australian Labor Party, Parliamentary Secretary for Agriculture, Fisheries and Forestry) Share this | Link to this | Hansard source

For the benefit of the member for Hughes, I notice that he, like the member for Dickson, is either deliberately misrepresenting Labor's dental policy or is just proving that he really does not know what was in, and what is in, the 2012 May budget.

Mr Buchholz interjecting—

John Murphy (Reid, Australian Labor Party) Share this | Link to this | Hansard source

Order! The member for Wright will cease interrupting.

Sid Sidebottom (Braddon, Australian Labor Party, Parliamentary Secretary for Agriculture, Fisheries and Forestry) Share this | Link to this | Hansard source

If you listen, you might get the information instead of just trotting ideas out that popped out in a templated answer by the member for Dickson. In the budget, we committed $515.3 million to dental spending, including $345 million specifically for taking care of adults on public dental waiting lists.

Craig Kelly (Hughes, Liberal Party) Share this | Link to this | Hansard source

The waiting list is 400,000.

John Murphy (Reid, Australian Labor Party) Share this | Link to this | Hansard source

Order! The member for Hughes.

Sid Sidebottom (Braddon, Australian Labor Party, Parliamentary Secretary for Agriculture, Fisheries and Forestry) Share this | Link to this | Hansard source

I sat and listened to you, thank you—manners. This money will be available to state and territory public dental systems from January 2013, just one month after closure of the Chronic Disease Dental Scheme. So contrary to your comments and to the member for Dickson's comments, the money is there and is available.

Mr Craig Kelly interjecting—

Thank you, but they are the facts. Read about it, cogitate, ruminate and let it sink in. Australians on a low income should be very happy about the Gillard Labor government's $4 billion dental package. I know I am, even if the member for Hughes is not. This six-year package is great for the country and great news for my electorate of Braddon—an electorate with lower than average incomes and greater difficulty in accessing affordable dental care.

Nationwide, this bill means there will be around 3.4 million Australian children who will be eligible for subsidised dental care just like they are eligible for Medicare funded visits to their GP. This will come in at a cost of around $2.7 billion. This is a lot of money but it is a much needed investment in the dental health care of our younger people. It is also a targeted and much better use of taxpayer funds than previous schemes, which tended to be uncapped and far too open-ended in terms of capacity to pay.

Under this package, our federal Labor government will also provide dental services to more than one million low-income adults and Australians in rural and remote areas, focusing especially on pensioners. Again, this will advantage my region in particular, which is rural and contains remote communities. It also has a comparatively aged population and a proportion of older citizens who rely on the pension for their main source of income. This component will cost around $1.3 billion, and the funding will be provided to the states and territories under a national partnership agreement to expand public dental services for low-income adults. This funding will depend on the states and territories to at least maintain their current level of dental care services. It is, after all, a partnership and it is, after all, an agreement. We do not want to see money skimmed or diverted by states into other areas, which is a practice all too often more the case than not.

In addition to the two components mentioned above, there is $225 million for dental capital and workforce to be provided to support expanded services for people living in outer metropolitan, regional, rural and remote areas. So, Mr Deputy Speaker, if I may, I will take you through the design of the package and its rationale.

The design of this package is based on addressing increasingly poor oral health amongst Australians, particularly people from low- and middle-income families. The need is apparent, which is why this government is acting to tackle it as a priority. Needless to say, those opposite will do as they have done over the life of this parliament—and reinforced by the member for Hughes; surprise, surprise—and vote against it or stymie it. Investment in dental infrastructure will play a key role in supporting the new dental reform package.

Unfortunately millions of Australians do not visit the dentist because they just cannot afford to. We have heard this in our electorates, like Braddon, one after another. Members time and again have raised this matter in and out of caucus. As a government collective we have recognised the problem and we are funding solutions. We know low-income households have more than double the number of family members with untreated tooth decay compared with high-income households. I believe we have a responsibility to ensure the people who are least able to afford to go the dentist should have access to government subsidised dental care, particularly children. Indeed, prevention is the best measure to tackle potential dental health issues.

The kids' dental health package will provide access to dental services to many children who are not currently entitled to access public dental services. There is a distinct, measured need for this. Recent studies showed that children in the poorest areas of the country experience 1½ times the amount of tooth decay and cavities, unfortunately, compared to those in the wealthiest parts. Early intervention can significantly reduce the costs of treatment, limit early extractions and reduce chronic dental disease. The latter is a result of poor dental health care over time, and this aspect of the package is designed to mitigate such an eventuality. Emphasis on child dental care is the most effective use of funding rather than on poorly targeted later-term remediation treatments.

The dental scheme for kids means that parents can decide whether they want to take their kids to the public dental clinics or to their own local dentist. Importantly, it means actually accessing dental specialist care when it is needed by families who struggle to afford such services or are totally unable to.

Children aged two to 17 in family tax benefit part A-eligible families will be entitled to subsidised basic dental treatment. This is capped at $1,000 per child over a two-year period and it aims to address dental decay in children, which unfortunately has been increasing since the 1990s. In my electorate of Braddon, this package applies to around 8,300 families or 15,800 kids—that is nearly 16,000 eligible kids in my region.

Those opposite question why are we funding a range of new dental programs for low-income earners. Why should we change from the current Chronic Disease Dental Scheme introduced by the Howard government? First of all, a fact: one in five of our lowest income earners have not been to the dentist in over five years, if ever. Poor dental health has wide-ranging impacts on speech, sleep, eating and general health and wellbeing—not to mention, in extreme cases, social isolation and depression.

Around 400,000 Australians languish on public dental waiting lists, and millions of people go without adequate dental care. Improving dental health will help relieve the pressure on hospitals and the broader health system. Indeed, I think it is often forgotten just how integral dental health is in the holistic framework of an individual's health and wellbeing. I have often questioned—I am sure some of you have as well—why dental health has managed to be somehow separated from other health related issues covered under Medicare. It is as if our teeth and gums are different from other parts of our anatomy in terms of affecting health and wellbeing and being affected by 'unwellness'—if there is such a term.

I mentioned the current Chronic Disease Dental Scheme before. Why are we acting to dismantle this now? Since being elected in 2007, the government has been trying to shut down the Chronic Disease Dental Scheme and replace it with more effective policies. The Chronic Disease Dental Scheme is not means-tested, which means people with high and very high incomes can get $4,250 free dental care—not subsidised but free dental care—if they are eligible via the medical criteria applied, and this does not include the ability to pay. That is a fact. How can this be equitable or fair or in fact efficiently targeted when there is so much competition for the healthcare dollar in Australia?

It is not targeted, which means patients can get caps, crowns and other, often cosmetic, work at the taxpayers' expense. Now, nobody wishes chronic disease on anyone, but to not apply an income or ability-to-pay criterion on a treatment just does not stand the test of fairness. All the while, people who have bad oral health but no 'chronic disease' have trouble seeing a dentist at all. Added to the inequity I mentioned above, and exacerbating the issue further, is the fact that the cost of the scheme has completely and utterly blown out.

Tony Abbott, the Leader of the Opposition, when he was health minister, said it would cost around $90 million a year; instead, it is now costing almost $1 billion each year, and it still leaves people on public dental waiting lists. The coalition scheme is clearly another example where Tony Abbott did not pay attention to the details—either that or he is not good with numbers.

On top of the cost blow-out, more than 1,000 complaints—which the member for Hughes tried to dismiss statistically—have been lodged about the Chronic Disease Dental Scheme. There has also been widespread, documented misuse of the scheme. This includes some practitioners ordering dentures that did not fit, unnecessary crowns or other work and charging the full $4,250 while doing little or even no work. I note that the Minister for Human Services and his department are currently talking to the Australian Dental Association and the AMA in an effort to deal with anomalies in relation to incorrect claims made in relation to the CDDS.

In contrast to the CDDS, the federal Labor package will address the needs of the Australian community in a fiscally responsible way. We know that people in low-income households are more likely to have poorer oral health than those in high-income households. This package is targeted at people who are least able to pay to see a dentist themselves. At the same time, we will ensure spending on the scheme is sustainable and responsible.

As the new scheme gets closer, more information will be made available to parents, but in essence they will be able to make their claims through Medicare just like they currently do for GP visits. If the dentist bulk-bills for the services, parents will not be required to make any payments. For dentists that do not bulk-bill, a trip to Medicare will see the cost for the service partly reimbursed, along the previously mentioned formula.

So, what about phasing out the current Chronic Disease Dental Scheme? The Chronic Disease Dental Scheme will no longer operate after 30 November. Patients who currently have a GP management plan and team care arrangements or a multidisciplinary care plan which was put in place prior to 8 September 2012 have until 30 November to complete their treatment. Thereafter, the patient will need to pay for the treatment.

The Gillard government, like Labor governments before us, are delivering on our priorities in areas like public health, paid parental leave, aged care and so forth. As I said before, the money that we have set aside in the budget will be available to the state and territory public dental systems from January 2013.

I note that members opposite—certainly the member for Hughes and member for Dickson—continue to support the CDDS instead of backing our fair and sensible reforms of dental policy, which include almost $2 billion for low-income adults and a blitz on public dental waiting lists.

The misused, abused and blown-out CDDS was supposed to cost, as I mentioned earlier, $90 million a year but ended up costing $80 million a month. Let me repeat: $80 million a month, for a scheme that was estimated to cost $90 million a year. I believe the opposition are too proud and too stubborn to admit this has been a policy blunder, so they just ignore the evidence.

Tony Abbott introduced the scheme in the final days of the Howard government and has supported it ever since—the member for Hughes reflects that. Unfortunately, it is poorly targeted, and more than 1,000 complaints were made about the scheme. Those included complaints about dentures that did not fit and so on.

Labor's new investment in dental care began with a $515.3 million budget allocation followed by a $4.1 billion commitment in August. We will deliver on our scheme. It is funded, and it will certainly be eagerly welcomed and appreciated in my electorate.

Andrew Southcott (Boothby, Liberal Party, Shadow Parliamentary Secretary for Primary Healthcare) Share this | Link to this | Hansard source

I rise to speak on the Dental Benefits Amendment Bill 2012. What this bill does is implement part of the government's $4.1 billion unfunded dental commitment. Last month, on 29 August, the Minister for Health together with the Greens health spokesperson announced this $4.1 billion unfunded dental program. It involves the closure of the extremely successful Chronic Disease Dental Scheme now and a program commencing not this year or next year but in 2014—well after the next election.

I would like to speak firstly about the Chronic Disease Dental Scheme, which is being closed. The Chronic Disease Dental Scheme was one of a number of measures introduced by the Howard government which showed how flexible Medicare could be and how you could expand access to Medicare. We expanded access to Medicare in the area of mental health. With a referral from a GP, people could access, on Medicare, psychologists and other allied health professionals. We did it in the area of GP care plans. Where a GP decided it was appropriate, there could be up to five allied health visits on Medicare.

And we did it, most importantly, in the area of dental health. This was very much the passion of the Leader of the Opposition. He also recognised that the important thing in dental health was not the checks but the access to restorative treatment. When you consider dental health, one of the problems with past Commonwealth schemes has been a heavy reliance on state dental services. That really ignores the significant capacity of the private sector to deliver outcomes. That is why we did it through Medicare. Many of the government speakers have said that this scheme was poorly targeted and mentioned that there were no income or assets tests. That is the Medicare system. The system is based on universal access. It is a social health insurance scheme based on universal access.

The government have announced that Chronic Disease Dental Scheme will close on 30 November. People who did not already have treatment underway by Friday, 7 September are not eligible for the Chronic Disease Dental Scheme, new services stopped being provided after 7 September, and all treatments must be completed by 30 November. On 30 November, patients will have no access to treatment, and many will be unable to pay for it privately. It is extraordinary that it is the Labor Party who is ripping almost $1 billion a year out of Medicare. They often have a lot to say about the Liberal Party and Medicare, but it was no idle boast that the Liberal Party in government were the best friend Medicare had ever had.

Patients in the middle of complex treatment will be left high and dry, with semi-completed work, when the Chronic Disease Dental Scheme closes. I have already been contacted by a number of constituents who are concerned that they will be unable to complete their treatments by 30 November. This will potentially have serious health consequences for these people, who will be left to languish in the lengthy queues of the state public dental systems.

The Medicare Chronic Disease Dental Scheme was introduced by the coalition government in 2007. It provided for $4,250 in Medicare dental benefits over two years for eligible patients with a chronic health condition who were referred by their GP. Since it was introduced, it has provided treatment to over one million patients and provided around 20 million individual services.

Since coming to power, Labor have continually undermined the Chronic Disease Dental Scheme for their own political reasons. They have attacked it because it was started by the Leader of the Opposition when he was the Minister for Health and Ageing. They have attacked it because it has been successful. They have persecuted dentists for minor and inadvertent paperwork mistakes. They have claimed it has been rorted. Despite the government's cries of expenditure blow-outs, the Department of Health and Ageing has stated that the average claim per patient has been $1,716—well below the maximum limit. More recent estimates claim that this has dropped even further, to below $1,200.

The coalition has offered to work with the government to refine and improve the scheme, to look at things like caps, but these offers have been rejected and the Chronic Disease Dental Scheme has been scrapped. Eighty per cent of services under the CDDS were provided to concession card holders. These people from now on will be forced to go without treatment or to join the 650,000 people on public dental waiting lists.

The coalition supports investment in dental health and we do not oppose the intent of this bill. But we do have some legitimate concerns with the government's proposal. One of the major concerns is where the money is coming from. They made this announcement but with no idea of where they are going to find the money to actually pay for it in 2014. It has been described as a budget saving dressed up as a dental announcement because the government know their budget is in trouble.

The government's announcement leaves patients high and dry for up to 19 months while the government pockets the savings from closing the Chronic Disease Dental Scheme. The government's scheme will provide for a $1,000 capped benefit over two years for eligible children. The scheme will be a means tested entitlement for children aged two to 17 years who are the children of someone receiving family tax benefit A, and it will not commence until January 2015. The adult scheme will not begin until mid-2014. A part of this, $4.1 billion, is for the state governments to receive direct funding for public dental services.

The question I have got is: how does this scheme address the very real workforce issues in the public dental schemes? It is possible you could give more money to the state dental schemes but unless you have got the dentists working in the public sector you will not see those waiting lists, 650,000 people and 400,000 adults, start to come down. Very significantly, as a result of this bill and as a result of the government's determination to close the Chronic Disease Dental Scheme, adults will no longer be able to access services through private dentists under Medicare. The government has removed the access for adults to receive dental services under Medicare.

The bill also does make some minor amendments to the Dental Benefits Act, changing the eligibility age for the current Medicare Teen Dental Plan from 12 to 17 years to two to 17 years of age. The schedule of services, fees and details is not yet available. The government have been very quick to introduce this bill but not so quick to tell us where the money is coming from. They are rushing this legislation through without allowing the parliament the opportunity to properly scrutinise this scheme. The question is: why the rush? The scheme does not commence for well over a year, and after the next election.

The government have acknowledged that many children will not use the $1,000 cap under this announcement. What they have not acknowledged is there will be children who are currently eligible for the Medicare Chronic Disease Dental Scheme who will require more work than the new $1,000-cap. What happens to these children? Over 60,000 services have been provided to children under the Chronic Disease Dental Scheme. Many of these children will be left mid-treatment when the scheme closes on 30 November. These children will then face a 13-month gap until they will be eligible for the new scheme. What do the minister and the government say to these children who will suffer 13 months with incomplete treatment between the closure of the Chronic Disease Dental Scheme and the new scheme in 2014?

What is not clear from the announcements made by the government is how this new scheme sits with the school dental service component of the state dental schemes. There is some variability between what each state does in this area. To what extent is the Medicare scheme replicating what is already happening in the school dental services? Is this intended as a top-up scheme? In many of the areas of joint responsibility, the Commonwealth has introduced a requirement that the state governments maintain their effort. Is there any requirement for state governments to maintain their effort in the school dental services? The question is: to what extent does this replicate what is already going on? Are we going to have duplication or are we going to see state governments actually pulling back in the area of the school dental services?

The coalition is worried that patients receiving treatment under the Chronic Disease Dental Scheme will now miss out on treatment during the gap between the scrapping of the CDDS this year and the 2014 commencement of the government's new dental scheme. The coalition will be moving to disallow the closure of the Chronic Disease Dental Scheme. We will do this to protect those patients who will miss out in the 19 months until Labor's scheme starts in 2014. We are committed to working with the government to refine the Chronic Disease Dental Scheme, including a review of the process for providing high-cost items.

The coalition has been a great supporter of investment in dental health. But closing the Chronic Disease Dental Scheme and removing access for adults from Medicare for dental items is a retrograde decision and will have a serious impact on many Australians with chronic disease.

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

I rise to support the Dental Benefits Amendment Bill 2012. I believe it is good legislation that will deliver a more equitable service throughout Australia. I will pick up on one of the points the previous speaker made about the school dental service. The states and territories will be encouraged to continue to operate as they do now. However, the federal government will now be paying for these services. So it will not be a duplication; it will be building and making sure the scheme that is in operation at the moment operates more efficiently, effectively and as a uniform scheme. I know that in my state of New South Wales the school dental scheme is all but non-existent.

The bill will extend the age range of people eligible to receive the dental service to children aged between two and 18 years. This will be replacing the Medicare Teen Dental Plan, which is for 12- to 18-year-olds and at the same time it will be rolling back and closing the Chronic Disease Dental Scheme. Under the Child Dental Benefits Schedule, children will be entitled to $1,000 in treatment over a two-year period.

If I could say at the outset: this scheme is a very targeted scheme. It is targeted towards addressing the issue of dental health when it really counts—at the beginning, from the age of two, developing good dental health practices and making it affordable for families that are unable to afford dental health.

The Chronic Disease Dental Scheme has helped some people who needed help, but it has helped a lot of people who did not need help. I was talking to my own dentist recently. He was telling me how one of his patients had been referred to him for assistance under the Chronic Disease Dental Scheme because they had an ingrown toenail. To my way of thinking, somebody who has an ingrown toenail is not in as great a need of dental health care as a young person whose parents cannot afford to access dental treatment. If they have poor dental hygiene, it will impact on their overall health for the whole of their life. So this is a scheme that is targeted to address dental health at its core, the time when people are developing the dental hygiene practices that will stay with them for life and ensuring that people, children, have good dental health.

In the electorate of Shortland, this change will help 16,794 children. That is 981 families that will benefit from this change. And it will be directing the services to those people who need it as opposed to some people who can actually afford to pay for their own dental health, because, currently, if you are a millionaire, and your doctor will complete the form saying you have a chronic health problem, then you can access a scheme that will deliver $4,250 worth of dental care to you over a two-year period.

This is part of the government's $4.1 billion dental reform package that was announced on 29 August this year. With the replacement of the Medicare Teen Dental Plan, that will take place on 1 January 2014. So, up until that time, we will still be targeting that teenage group. We know that the Chronic Disease Dental Scheme concludes at the end of November. As I mentioned earlier, it is poorly targeted. People were being assessed as being eligible for it when they probably should not have. I know of another case where an elderly woman of 90 was unable to access the Chronic Disease Dental Scheme, even though she had a chronic illness—she had a serious heart condition and was very ill—because her doctor was reluctant to complete the forms. Finally, after a lot of advice and a lot of help from me, she managed to be deemed eligible for the program—a pensioner, somebody who needed it—to address her dental health issues. She got to see the dentist two weeks before she died.

So it is a program that was designed to help people with chronic illness, and it did help some people that should be targeted for these types of programs, but it also did help a lot of people who could afford to provide for their own dental health. It did help a lot of people who did not have chronic illnesses and it also did not help people who needed to access the service, because there was not a proper understanding of the way the system works. So it was a poorly thought-out program. When it was introduced it was deemed that it would cost $90 million per year and now it is running at $1 billion a year. So, obviously, it was not costed properly—and we know that members of the opposition do have problems with costing their documents and budgeting, because they do have a $70 billion black hole where they cannot explain where the money will be coming from. I sit here and think it is quite ludicrous when I hear questions and rhetoric coming from the other side of the House. Their financial record, ability to cost policies, lay out their programs and prove to the Australian people that they are fiscally responsible are abysmal.

This program, and this legislation we have before us, is really quality legislation—legislation that is going to help so many young people and legislation that, when combined with the other initiatives that the government has in place, will really do something about providing access to dental health services to people who cannot afford them, who are disadvantaged at the moment and who are unable to deal with their dental health issues.

I am sure most members of this House know how important it is to have good dental health, because if you do not it can affect your overall health. If you get a serious infection it can lead to hospitalisation and to problems with your heart and other organs of the body. So it is vitally important not only that people who are financially able can access dental treatment but also that people on low to middle incomes are able to see a dentist in a timely fashion.

This initiative is combined with the $5.15 million announced in the last budget that will be directed towards a blitz on the public dental health list. It is to enable people who cannot afford to go to a dentist and who do not have private health insurance, simply because they cannot afford it, to access the treatment they need. This is what the government is all about. It is about providing access to dental health services to all Australians, not just select groups.

Targeting your funding and assistance so that the most people can benefit from it is exactly what this government is doing with its dental health program. It does not surprise me to hear those on the other side are saying no and standing up for millionaires to continue receiving benefits under the Chronic Disease Dental Scheme. When that program was introduced it would have been much better if there had been a means testing component placed on it, but that did not happen, because those on the other side of this parliament are not the friends of people such as the pensioners and those people who look to government for assistance.

The government has been trying to shut down the Chronic Disease Dental Scheme since 2007, because we want to replace it with a more effective scheme. What we think we have here is a suite of schemes and proposals, a way of attacking dental health across the board, that will benefit everyone.

We want to tackle poor oral health head-on. Kids, particularly, in families that have lower incomes, and even some people in lower-middle-income families, do not have access to the dental treatment that they should. One of the most disturbing facts is that decay amongst children has been on the rise since 1990. There was a point, when I was younger, when most children accepted the fact that they would have to visit the dentist, and that would mean fillings and extractions. If you look at many of our older Australians you will find that dentures are commonplace, and that is just the way it was. But then we turned the corner and dental health, our children's health, started to improve. For my own children a visit to the dentist involved being told, 'You are doing a really good job with your teeth. They are perfect.' That is the change from my day and from back further. There has been a generational change. When you hear that dental decay amongst children has been rising since 1990 it says to me that we are not attacking the problem properly. So, the government has developed policies that will address the issue and ensure that those one in five children in our lowest income households, who have not been to a dentist in over five years, will be able to afford to go to the dentist.

I implore the opposition to look at this in a more holistic way. Look at it in a way where you can see the benefits it will deliver to the majority of Australians, not just a select group. The children of Australia need the opposition to support this legislation. They need them to adopt a responsible approach to dental care, and they need to acknowledge the fact that the government has put a lot more money into addressing dental health waiting lists. Those who come from states where there are coalition governments need to go back and make sure that those coalition governments do not rip money out of the dental health schemes, just as they have ripped it out of education and health.

Sophie Mirabella (Indi, Liberal Party, Shadow Minister for Innovation, Industry and Science) Share this | Link to this | Hansard source

One is almost left without words after that truly sad, pathetic, unpassionate display of class warfare. We heard the member for Shortland talk about the fact that the current scheme is there for millionaires. I think I will go back to my electorate and tell my constituents, who are upset that the treatment they are getting under the current scheme is going to be axed leaving them in the lurch, that the Labor Party in Canberra is saying they are millionaires and do not deserve any help. In fact, I think I might even make sure that the constituents in the member for Shortland's electorate know that, because I think it is only fair that they know what their member of parliament says in this place instead of going back home and pretending to empathise with her constituents who are receiving treatment under the current scheme.

What we have seen from the Labor Party with this bill, the Dental Benefits Amendment Bill 2012, is exactly what they are doing across the board: pretending, faking concern and compassion in order to try and save this government from the most laughable claim it has made, which is that it will deliver a budget surplus. This is just a budget cut masked in the clothing of compassion. And this bill does come at a very interesting time. It comes during a week in which the Labor Party has spent its collective efforts on demonising state Liberal governments for making budget savings—those Liberal governments that took over basket-case economies from embarrassingly corrupt, morally bankrupt, long-term Labor governments, swept out of office with record results in some electorates because people had had enough. During the last two weeks, Labor members have lined up like lemmings at the doors of parliament to take cheap political pot shots at state Liberal governments. And it truly is pathetic.

What I would have liked to have seen was these same members going out on the doors when there were still Labor governments in the states in which they reside and defending the indefensible. Australians right across this nation will suffer for a long time from the wanton waste and negligence and debt that Labor governments at the state and federal levels have incurred. It is a crime: it is a crime against future generations, and it is a crime against the truly needy people in our society who are suffering because this government is being tricky with the truth and slippery with its funding of programs and its freezing of this program and that program and putting off funding beyond the next election. How stupid do they really think journalists are, not to pick this up? How stupid do they really think the Australian public is, not to see through this slippery, slimy, record spin-doctoring from the Labor Party?

Before going into detail, let us look at what this bill is fundamentally about. To borrow a phrase from the minister for families, this bill represents a $1.5 billion claw-back from Australia's health budget. Let us be very clear about that because, according to the minister, this bill is a savings measure; there is no doubt or ambiguity about that. And it is not just the health minister who claims that this policy is a savings measure; indeed, the Prime Minister herself boasts about it being a cutback as well. When asked at a recent press conference whether it was irresponsible to make a large promise without yet identifying where the funds will come from, the Prime Minister said this:

Well the announcement today is about a large saving. That is through the closure of a scheme designed by the former Government, by the Howard Government.

'The announcement today is about a large saving'—those were the words of the Prime Minister. No amount of weaselling and squirming and tricky double-speak will hide the fact that there is a cut in funding and services to the Australian people in terms of dental care.

We all recall the previous health minister, the member for Gellibrand, screeching untruths about the Leader of the Opposition cutting health funding during his tenure as health minister. Obviously her statements were untrue, but her central argument was that cutting money from the health system was morally wrong. So I do look forward to hearing the member for Gellibrand's contribution to this debate. I wonder whether she still holds the same hardline views about budget cuts in the health portfolio? I suspect not, because it is her own party that is engaging in this behaviour—and far be it from the member for Gellibrand to be consistent and apply consistent standards to both sides of the parliament! We know there is great hypocrisy and there are double standards when it comes to these issues from the member for Gellibrand and so many on the other side.

I also wonder whether those same Labor members who have made cheap political attacks on state Liberal governments in recent days will come out with the same spirited attacks on these cutbacks. I suspect that they will not, because, as far as those opposite are concerned, it is all very simple: Liberal cuts are bad; Labor cuts are good. It is like something out of George Orwell's 1984. And, according to those opposite, Liberal savings are 'savage cutbacks', but Labor cutbacks are 'responsible savings'. Well, let us be clear about one thing. The only reason Labor is pursuing cutbacks across portfolios, across dental care, is that it has wasted tens of billions of taxpayers' dollars and borrowed funds—poured them down the drain—to fund its ill-conceived, poorly executed policies. Whether it is free fluff in roofs, the outrageously expensive school halls, the redundant computers in schools—

Bruce Scott (Maranoa, National Party) Share this | Link to this | Hansard source

Order! Before the member for Indi sits down, I require her to withdraw her reference to 'corrupt' state governments in the body of her speech. I did not pull her up at the time—she was in full flight—but I do ask her now to withdraw the allegation of corrupt state governments.

Sophie Mirabella (Indi, Liberal Party, Shadow Minister for Innovation, Industry and Science) Share this | Link to this | Hansard source

I will withdraw what everyone knows was—

Bruce Scott (Maranoa, National Party) Share this | Link to this | Hansard source

No, you will do it unreservedly.

Sophie Mirabella (Indi, Liberal Party, Shadow Minister for Innovation, Industry and Science) Share this | Link to this | Hansard source

I withdraw.

Debate interrupted.