Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Link to this | Hansard source

I move:

That the Health Insurance (Dental services) Amendment Determination 2012 (No. 1), dated third of September 2012, made under subsection 3C (1) of the Health Insurance Act 1973, be disallowed.

The coalition is committed to extra investment into dental services. Tony Abbott and I have taken the decision to move this disallowance motion because we want to stand up for people with chronic disease in this country who are in need of dental services but are being stopped by this government from receiving those dental services.

By way of background, the Chronic Disease Dental Scheme was authored by Tony Abbott, who was then health minister in 2007, because he sold a desperate need for Australian is living in pain to receive services that the states were not providing. The success of the scheme has resulted in 20 million services being provided since that time to over one million Australians. The program has cost about $1 billion a year but that money has gone to help people who are in desperate circumstances. These are people who are living in significant pain, and they are not just adults; there are children as well. The government, by closing this scheme down and not commencing their own scheme until 2014, creates a gap of 19 months for people, where no services will be provided.

The minister will say to the Australian people that they have put extra money into public dental waiting lists administered by the state and territory governments around the country. But we know that 650,000 people languish on those lists as of today. And the suggestion that somehow people who have a chronic disease and are in need of dental services—people who can access services under the Abbott scheme today—could somehow turn up to the public hospital and receive equivalent services in the same time is a nonsense.

We have started to receive a flood of emails from people around the country who are captured by this government's mean spirited decision. These people include cancer patients who are part-way through dental treatment plans and have been told by their dentist that because of this change by the government their procedures will not continue, that their treatment plans are no longer funded and that they will live in abeyance and in pain until July 2014, when the government's own scheme commences.

It is important, also, to make the point that even when the government scheme commences it does not commence with the same generosity of the Abbott scheme. The Abbott scheme provided $4,250 to those eligible patients who had been referred by a GP to a dentist. Over a two-year period they could have that work performed up to that amount of money. For people who have contacted us this has been a life changer. I say, today, to the Prime Minister, the health minister and, most importantly, to the Independents, that they need to reassess their support of this crazy arrangement.

The government will say that the Chronic Disease Dental Scheme was somehow the playground of the rich because it was a universally accessible scheme—exactly the same way that Medicare operates. If somebody goes into a public hospital today with a heart attack, asthma or a broken leg, regardless of their earning capacity or their wealth they can receive treatment. The equivalent was provided under the Chronic Disease Dental Scheme. But when you break down the number of people who accessed the Chronic Disease Dental Scheme it becomes very apparent that this was not a scheme accessed to a large extent by people of means, in any case. In fact, 80 per cent of people who accessed the Chronic Disease Dental Scheme were on concession cards. It would have cost the government more to try and exclude the 20 per cent of people who did not hold concession cards than it would have been to provide the services for them under the scheme. So the government fails on that argument.

People will say, 'Well, why on earth would the government close a scheme down that is targeted at assisting those most in need: people with chronic disease—the most severely ill in many cases; people who are suffering severe dental pain?' There can only be one conclusion, because the government has resisted changes to this scheme over the course of the last five years despite saying that there were problems with the way in which some claims were being made. They refused to modify it. They refused to try and strengthen the system to try and exclude difficulties that they claimed were taking place, and now they seek to close it down altogether. I believe it is simply based on political motive.

It is based on political motive because this scheme was set up by Tony Abbott and they want to be able to trash the scheme and go to the Australian people claiming that they have a fantastic new scheme in 2014. But as is always the case with this government, their scheme, firstly, is poorly designed and, secondly, is unfunded. That is the hallmark of this Rudd-Gillard period of government: they cannot get the basics right. This government may have good intent in this space but they have not been able to deliver for those Australians who are most in need. I ask people who are suffering in significant pain, and parents who have children suffering in significant pain, please, to contact not just us—because we will continue the fight—but your local Labor member of parliament and Mr Windsor and Mr Oakeshott, who are facilitating this change today. Say to them that closing the scheme down and having nothing in its place for 19 months is bad policy. It is bad policy, and it is bad in terms of health outcomes. As part of the coalition's position, we do not hold the numbers in the lower house, so we have made approaches to the Independents, to Mr Wilkie, Mr Oakeshott, Mr Windsor and Mr Katter, to ask for their support for what we think is a reasonable position. We want to make sure that the 19-month gap is closed. That is all we are asking. If the government has an idea of wanting to restrict the Chronic Disease Dental Scheme but provide some support through it over the next 19 months, we would very happily to support that position. If the government has a reasonable compromise to put so that people would not live in pain over the next 19 months, put it on the table so that we can arrive at an arrangement that is in the nation's best interests.

But that is not what this government is proposing—and not for health reasons but for their own crass political purposes. When we contacted Mr Wilkie, he had the decency to say he had already made up his mind, that he was going to support the government. He was happy for people suffering from a chronic disease to go without those dental services during that 19-month gap. That is a decision for him. Mr Katter also had the decency to advise me that he intended to support the coalition's position because he did not want to see people suffering in pain over the course of that 19 months.

That of course leaves us with Mr Oakeshott, the member for Lyne, and Mr Windsor, the member for New England. Despite my office making contact with both Independents, they refused to get back to us, even to discuss a compromise position. If the Australian public wanted any demonstration of the way in which Mr Windsor and Mr Oakeshott slavishly follow every twist and turn and deviation of this government they need look no further than this bill before the House today.

This is bill is trying to address an anomaly created by bad government, and the Independents have the capacity to stop it. The Independents have the capacity to say to this government, 'Put in place some sort of interim measure which would allow dental services to continue for people most in need.' That is what we are asking for in this disallowance today. We want to make sure that this parliament provides some sort of relief for those who are most in need. Yet this government and the Independents complicit with them have a tin ear for those constituents, who no doubt are contacting them saying that they are partway through a treatment plan with their dentist and the work is now going to stop, or that because of chemotherapy they have had to delay the dental services that they are desperately in need of but now will not be entitled to because this government is closing the scheme.

Why will Mr Windsor and Mr Oakeshott not even entertain some sort of a compromise deal to provide relief to these people? It is because they are essentially tied to this government like no Independent has been to a government in our nation's history. I call on the two Independents to come into this House and explain. Explain, Member for Lyne and Member for New England, why you are facilitating this bad policy by this bad government? Why are you resisting those calls from needy people who are suffering from a chronic disease, and from parents who are in despair because they cannot afford services for their children unless they are provided under the Chronic Disease Dental Scheme or some iteration of that scheme?

This minister says those people can have some relief on the public dental waiting list. That is a nonsense, Minister. There are 650,000 people on that waiting list, and some people are waiting five years under that scheme. It shows how dreadful the Labor governments have been at a state level over the last decade, ramping those numbers up because they waste money, as this government does, on health bureaucrats instead of on front-line services. That is the hallmark of Labor governments in the health space. They spend money on bureaucracies and on bureaucrats and not on doctors, nurses and patients.

Why does this minister say that over the next 19 months chronically diseased patients needing dental services can get relief on public waiting lists when they cannot? Why, Minister, are you offering that false hope and that false promise—

Tanya Plibersek (Sydney, Australian Labor Party, Minister for Health) Share this | Link to this | Hansard source

You are lying.

Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Link to this | Hansard source

to these people who are most desperate in our country? I would ask the minister to withdraw her unparliamentary language.

Kirsten Livermore (Capricornia, Australian Labor Party) Share this | Link to this | Hansard source

I call on the minister the withdraw that remark.

Tanya Plibersek (Sydney, Australian Labor Party, Minister for Health) Share this | Link to this | Hansard source

I withdraw the remark, but he should correct the record.

Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Link to this | Hansard source

This minister will go down as one of the most incompetent—

Patrick Secker (Barker, Liberal Party) Share this | Link to this | Hansard source

Madam Deputy Speaker, the minister should withdraw without exception—which she did not do then.

Kirsten Livermore (Capricornia, Australian Labor Party) Share this | Link to this | Hansard source

The minister will withdraw.

Tanya Plibersek (Sydney, Australian Labor Party, Minister for Health) Share this | Link to this | Hansard source

For your benefit, Deputy Speaker, I certainly do.

Patrick Secker (Barker, Liberal Party) Share this | Link to this | Hansard source

Not for anyone's benefit; for—

Kirsten Livermore (Capricornia, Australian Labor Party) Share this | Link to this | Hansard source

I am satisfied with that. The member for Barker will resume his seat and I give the call to the shadow minister.

Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Link to this | Hansard source

Let me put on the record that—and this is certainly the department's and the public's view of this minister—incompetence reigns supreme in this minister's office. This minister may claim to sit around in Canberra cafes for most of her time when she is here in the ACT. But, Minister, I can tell you that when you talk to stakeholders, to dentists and to these cancer patients, you are condemned as incompetent. You are condemned because you will never preside over a scheme that provides support to patients, and to sick children whose parents are living in despair at the moment. You are condemned because these people have looked to you for support and in their hour of need you have surrendered them, as have Mr Windsor and Mr Oakeshott, who are complicit in this dreadful policy.

I say to the parliament and to the Australian people, if you want a demonstration of the government's incompetence, if you want to look at the way this government operates, you need look no further than their operation in the area of health. It is not just restricted to the area of pink batts, where they cannot get a policy right and they waste money; to school halls, where they have wasted billions of dollars; to the solar panels; or to the management of the carbon tax implementation. This is a government that cannot get the basic requirements right. The government's basic charge is to take care of its people. The government's basic charge is to protect its people. This government is hanging out to dry, for a period of 19 months, the most vulnerable people in our country. Cancer patients and people suffering from chronic diseases are being told by their GPs that, yes, under Tony Abbot's scheme for the last five years they had support and relief from the most severe pain that could be imagined but now, for crass political purposes, this government seeks to destroy the scheme, to hang these people out to dry for an extended period of time—not because their scheme is about to start tomorrow but because they want to drive Tony Abbott's scheme into the ground and discredit it, on unreliable grounds.

I ask this minister: what future is there for the 800,000 people who use this scheme? What future is there for people who have accessed this scheme, 80 per cent of whom have been on concession cards, and the most of the remainder of whom have been on relatively low incomes? What future is there for those people and people in like situations over the next 19 months?

If the minister refuses to answer, let me provide this understanding. The fact is that those people will not access services going forward. Even from 1 July 2014—in 19 months time—they will not be accessing $4,250 worth of dental services, as they have received under Tony Abbott's scheme. They will be receiving a maximum of $1,000—that is what is provided under the government's scheme. And they say that somehow that is superior to what the Abbott scheme provided.

This is a government dominated by spin, and drowning in its own spin. This is a government that does not have the capacity to look those people in the eye. The member for New England, who has come into the chamber now, needs to look his constituents in the eye and tell them why it was that he signed up to this plan, that he would not enter into negotiations, not enter into discussions, about some sort of compromise arrangement. It is incumbent on this minister, and these Independents, to say why they are supporting what is a failed process.

The minister can go over there and jest and laugh with the member for New England, but the member for New England should know that his constituents—those people who are suffering from chronic diseases in his electorate right now—are watching and listening to this debate and saying to the member for New England, 'Why are you not, Mr Windsor, standing up for us as your most worthy constituents?' The member for New England and the member for Lyne, why are you not prepared for your constituents?

The capacity now for this disallowance to proceed rests in the hands of Mr Windsor and Mr Oakeshott. If they want to do something for people who are going to be left high and dry for 19 months, they should come to some compromise, talk to us about a position whereby we could provide support to those most in need over the 19 months. If you want to provide support to the government's scheme for a start date of 1 July, that is an issue for you. If you are happy with the design and you think it is going to be an appropriate and efficient spend of money, then that is an issue for you, and I am happy for you to make that decision.

But what about these people over the next 19 months who will not have the same access that they are getting under the Chronic Disease Dental Scheme? And don't stand up here and say that they will receive assistance under the public scheme, because they will not; that is a falsehood. Those people who are able to receive treatment today, to turn up and go in and see their GP, would, under Tony Abbott's scheme, have been referred immediately to a dentist and received that $4,000 worth of treatment over a two-year period. That is not going to happen into the future under what the government is proposing and what the Independents are supporting in this arrangement, and that needs to be put on the record. And it needs to be addressed, because if these people are just going to blindly follow a bad government, then people are going to suffer in their constituencies.

This is an explanation that must be made by the Independents and by the government. They must say to those people who can get access under the Chronic Disease Dental Scheme that they are not going to get access over the next 19 months—look them in the eye and say that. That is the failure that is before the House today, and it is up to the Independents to support this motion to stop bad policy. (Time expired)

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

I second the motion. I am very pleased to speak on this motion that is seeking to retain the Chronic Disease Dental Scheme on Medicare. The Chronic Disease Dental Scheme was introduced by the Leader of the Opposition when he was health minister in 2007. It involved several critical insights. The Leader of the Opposition, as health minister, understood, firstly, that it was access to restorative treatment, not cheques, that people needed, and, secondly, that you needed to unlock the very significant capacity of the private sector in dentistry. And he did that through Medicare.

It was no idle boast when the coalition used to say that we were the best friends Medicare ever had. While the Labor Party introduced Medicare in 1983—and it came into being in 1984—by the time we came to government in 1996 we were strong supporters of Medicare, and we improved on Medicare while in government. We introduced access to dental on Medicare. We introduced access to psychologists through better outcomes and better access to mental health. And we expanded the access for allied health professionals on to Medicare, going through their GPs, with team care arrangements or care plans.

The Labor Party, in the last election, made the spurious claim that the Leader of the Opposition had taken a billion dollars out of the health system. Well, this health minister has, with the stroke of a pen, ripped out $1 billion from Medicare. I find it extraordinary that a Labor minister for health is the first minister for health we have had since Medicare was introduced who had actually removed a whole class of people from Medicare for dental. We all wonder what our legacies might be when we leave this place, but this minister's legacy will be this: health minister; ripped a billion dollars a year out of Medicare.

The Labor Party and the Greens propose to close the Chronic Disease Dental Scheme on 30 November. Also, as a result of their announcement, no new treatments will begin after 7 September. Let us look at the impact of this. I have had one resident of South Australia contact me who had radiotherapy for throat cancer and was referred by the public hospital to a GP to a get access to the Chronic Disease Dental Scheme. He is not eligible to go on the Chronic Disease Dental Scheme as a result of this government's decision. He was referred instead back to the state dental service and was originally told that it would be a 14- to 18-month wait. That is the impact, on a personal level, of what you have done.

Ms Plibersek interjecting—

Minister, there is now a 19-month gap for people with chronic disease, during which they will not have access to treatment. They have to fall on the state dental services, which we know have massive waiting lists. What the Chronic Disease Dental Scheme provided was $4,250 in Medicare dental benefits over two years for patients with a chronic health condition. They had to go through their GP and they had to be on a GP management plan or a multidisciplinary care plan—the same way we expanded access to allied health, the same way we provided improved pathways for people with mental health conditions. A chronic condition is one that has been or is likely to be present for at least six months or is terminal. This applies to patients with diabetes; who have had cancer and radiotherapy; who have suffered strokes; who have heart disease, especially valvular heart disease; who have chronic kidney disease; with osteoporosis; with asthma or chronic obstructive pulmonary disease; and with arthritis. Those are the most common conditions suffered by people accessing this scheme. The scheme allowed for dental assessments, preventative services, the removal of teeth, and fillings and dentures.

If we take a step back and look at the dental situation in Australia. Essentially, half the population are covered by private health insurance and are able to access a private dentist using their insurance. The rest either have to pay to go and see a dentist or they fall on the state dental services. And, what has been very obvious, is that there is a gap in treatment in Australia, and it is largely because the state dental services have massive waiting lists. The waiting lists vary from 18 months to over two years, depending on the state. So, by using Medicare, we were able to come up with a scheme that saw over one million patients treated and over 20 million services provided.

We often hear that this scheme was 'not well targeted'. Well, it is like Medicare—the same principle applies: universal access. That is a fundamental principle of Medicare. While people can say anyone could receive treatment under the Chronic Disease Dental Scheme, 80 per cent of the people receiving the treatment were concession card holders. So what the Labor Party need to do is to explain to people who are on the aged-pension, who are receiving Newstart, who are on the disability support pension, who are receiving any sort of concessional card, why they have removed for them—and why the minister has removed for them, at the stroke of a pen—choice of dentist. Because, under our scheme, they had choice of dentist. Under the government's proposed scheme, which begins in 19 months time—there is a gap of 19 months—they will fall on the states' dental services and it is just a matter of 'join the queue; take what you get.'

Hans Zoellner, from the Centre for Oral Public Health, has described this scheme as 'fantastically successful'—in fact, he suggested that the government could have expanded the scheme to include people on low incomes; that instead of abolishing the scheme, and ripping it from Medicare, it could have been used as the foundation for an expansion of dental services.

As I have said already, 80 per cent of the services under the Chronic Disease Dental Scheme were for concession card holders. As a result of this government's decision, they will be forced to join the queues and waiting lists in the public system—and there are more than 650,000 on these public waiting lists; 400,000 of whom are adults. Whereas, under the Liberal's scheme, using Medicare and using private dentists, they had a choice of dentist; now, it is just take what you get, and you will have to wait as well.

The government have claimed that there have been massive cost blowouts. One point I would make is that the Chronic Disease Dental Scheme was always funded by the previous government. Department of Health and Ageing figures show that the average claim is only $1,716—so it is well short of the cap. Some estimates suggest that this has dropped further, to below $1,200. The coalition has reached across the table to the government and offered to work with them to improve the scheme, to refine the scheme; and this offer has been rejected.

One thing I would like to say to the Independents—to the member for Denison, the member for Lyne, the member for New England and the member for Kennedy: think very seriously about what you are doing here. What you are doing is, for the first time, removing access to Medicare for a whole class of people. What you need to do is be prepared to tell people with cancer, with diabetes, with heart disease, with arthritis, who have had a stroke or with osteoporosis, why you have decided to rip them from Medicare for their dental services and just leave them lost in the waiting lists of the state dental services—and you have to be prepared to look them in the face and explain why you are prepared to do that. What you have to do to those people, 80 per cent of whom are concession card holders, is explain to the aged-pensioners, to the people on disability support, to the people on Newstart why they will no longer be treated on Medicare for dental services but will have to rock up to their local dental hospital.

The shadow minister for health mentioned that there will now be a 19-month gap. This will be 19 months of pain for Australians with chronic disease. And for the children in our children's hospitals around Australia, who previously would have had access to Medicare under the Chronic Disease Dental Scheme, that access has now been closed. They will not have to wait 19 months—that is the good news; they will only have to wait 13 months. That scheme starts on 1 January 2014. After that 19 month freeze, when adults can go on the state public dental services, there is still a further waiting list of, depending on the state, 14 to 18 months to as long as 2½ years. So this involves pain for Australians, pain over the next 19 months, while their dental pain has been forgotten by this government. I find it extraordinary that the party of Neal Blewett, the party of Bob Hawke, the party that introduced Medicare and regarded it as one of its proudest social reforms has now decided to rip pensioners and concession card holders off Medicare for dental. It is an extraordinary thing. This minister is the first Minister for Health to take a whole group of people off Medicare for dental. How does it feel, Minister, to be the first Minister for Health to take concession card holders off Medicare—concession card holders who, for the last five years, have enjoyed a choice of dentists and access, the two things that they never had under the state dental schemes. You, as minister, with the stroke of a pen, by regulation, have now closed this scheme and ripped $1 billion from Medicare.

I urge the Independents to think very carefully about this motion. It is a serious motion. We think that the chronic disease dental scheme is a good scheme. We think it should be preserved. We think it is meeting a need for both adults and children with chronic disease, those who are the sickest in our society, 80 per cent of whom have a concession card.

Ms Plibersek interjecting—

Are you making fun of people with asthma? Are you saying people with asthma should not be getting access to Medicare on dental? That is a disgrace.

Mr Dutton interjecting—

Kirsten Livermore (Capricornia, Australian Labor Party) Share this | Link to this | Hansard source

Order! The member for Dickson.

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

Asthma is a chronic disease, Minister, for your information. Dear oh dear!

Tanya Plibersek (Sydney, Australian Labor Party, Minister for Health) Share this | Link to this | Hansard source

The member for Dickson claims that I said they are not sick. That is absolutely not true.

Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Link to this | Hansard source

What did you say?

Tanya Plibersek (Sydney, Australian Labor Party, Minister for Health) Share this | Link to this | Hansard source

I said there is a difference between asthma and cancer.

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

She did not say that.

Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Link to this | Hansard source

You did not say that.

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

Anyway, here we have exhibit A—

Kirsten Livermore (Capricornia, Australian Labor Party) Share this | Link to this | Hansard source

Order! The minister has the call.

Tanya Plibersek (Sydney, Australian Labor Party, Minister for Health) Share this | Link to this | Hansard source

I ask that the member for Dickson withdraw that comment.

Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Link to this | Hansard source

I withdraw.

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

Tanya Plibersek, Minister for Health, ripped $1 billion from Medicare for dental—a proud achievement. It is an extraordinary day: a Labor Party minister, a minister from the party of Neal Blewett and Bob Hawke has been the first Minister for Health, since Medicare was introduced in 1983, to have actually slashed Medicare and removed a whole class of patients from Medicare. These are the sickest people in our society. They are the people who had been forgotten by the state dental services. They are the people who had new hope of being treated with a choice of dentist and through Medicare. It has now been lost. I encourage all members of the House, and the Independents, to support this disallowance motion.

Tony Windsor (New England, Independent) Share this | Link to this | Hansard source

I would like to make a contribution to this. I did not interrupt the shadow minister when he was on his rather excited diatribe, but I appreciate the member for Boothby's calmer approach to this issue. Maybe there are some messages in terms of that and in terms of prosecuting a case.

The member for Dickson seemed to make an assumption on a number of things. One was that he knew how I was going to vote. The minister does not know how I am going to vote. I have been engaged in discussions on this issue with the minister.

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

What about the shadow minister?

Tony Windsor (New England, Independent) Share this | Link to this | Hansard source

Hang on a bit. You will hear a bit about the shadow minister in a minute. It brings into question what the motives are of the shadow minister in coming in to this place, carrying on the way he has in relation to this issue, making statements that my office had not taken the time to contact his office.

Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Link to this | Hansard source

Exactly right.

Tony Windsor (New England, Independent) Share this | Link to this | Hansard source

That is not right. You know that Peter.

Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Link to this | Hansard source

I have logs of all the attempted contacts, Tony.

Kirsten Livermore (Capricornia, Australian Labor Party) Share this | Link to this | Hansard source

Order! The member for Dickson has had his opportunity and will sit there in silence.

Tony Windsor (New England, Independent) Share this | Link to this | Hansard source

You know that is not right. I have always had great respect for you. You also know, as has occurred on previous occasions, that my door has always been open to you—always—if in fact you have ever wanted to speak to me about various issues. I am involved as we all are in an extraordinary number of meetings on a whole range of issues, and I am not saying this is the first time that you have mentioned it, but the first time I have heard that the shadow minister has an arrangement he would like to speak to the Independents about was when he was speaking this morning.

I have been in negotiations for some time with the minister and the minister's office about these issues, because they are substantive issues and there are some very real questions that a number of people have been trying to find answers to. But for the shadow minister to suddenly raise the compromise, knowing full well—as all members of the opposition would know, and many of them walked through that door—that if he was really interested in a compromise he could have come and discussed it with me. Given the respect I have had for him—and I still do—one has to question the motives. What is the point of raising these issues in a vitriolic fashion if you are trying to convince someone who has not made up their mind on this particular issue to support you? The reaction that I think most people would have is that you are more interested in the issue than the solution to it. If you were interested in the solution to it and there were a compromise, I would have thought that the shadow minister—and you have not been a precious person in the past, where position puts you on a pedestal where everybody has to come and bow down in front of you; you are not like that. What is the point of raising these issues in such a vitriolic fashion when you know full well that you do not know how I am going to vote? The minister has no idea how I am going to vote. But your contribution—

Kirsten Livermore (Capricornia, Australian Labor Party) Share this | Link to this | Hansard source

Order! The member for New England needs to address his remarks through the chair.

Tony Windsor (New England, Independent) Share this | Link to this | Hansard source

The member for Dickson's contribution was almost an encouragement to vote against his disallowance motion, which leads me to think that the motive for this is to maintain this as an issue rather than solve it.

I have been more than happy to talk about compromises on this issue, and the minister would be aware of that. Meetings have been held as recently as this morning with various people about what this actually means, particularly to regional people, in terms of the changes that are contemplated. The member for Boothby, in his much more reasoned debate, raised some of those issues about the transitional arrangements, and those issues are still in discussion.

I think there is an issue there. If this particular arrangement is concluded there is an issue—not of the 19-month extent that is talked about—where the two schemes intersect. That is something that does need to be addressed. If the opposition truly have a compromise position that addresses that, I am more than happy to talk to them about that, because we have all expressed some degree of concern in relation to that particular point of intersection. But for the member for Dickson to come in here and make this—I do not know whether you think that that will gain leverage in the electorate of New England or whatever. I think the people of New England are a little bit smarter than that. Irrespective of that, I think it is disappointing that a shadow minister who has genuinely prosecuted a case in terms of the policy that they believe in has prosecuted it very poorly when it comes down to the absolute debate and what sorts of amendments or compromises may be obtained.

My staff were in touch with his office, I think as recently as yesterday afternoon, asking for more information about the disallowance.

Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Link to this | Hansard source

It's not true, mate.

Tony Windsor (New England, Independent) Share this | Link to this | Hansard source

One of your staff did ring back—

Mr Dutton interjecting—

Kirsten Livermore (Capricornia, Australian Labor Party) Share this | Link to this | Hansard source

Order! This is not a conversation between the member for Dickson and the member for New England; the member for New England has the call.

Tony Windsor (New England, Independent) Share this | Link to this | Hansard source

I am disappointed about the member for Dickson's rather vitriolic attack both on me and on my office, but I say again to the member for Dickson: if there is some sort of compromise arrangement, I would have thought it might have been sent to my office. I would have thought that the member for Dickson might well, as he has in the past, have walked through the door and said, as many members of the opposition have done over the years: 'Listen, have you got five minutes? I need to talk to you.' I am more than happy to initiate discussions with them. I leave that where it is. If there is something that I need to know in terms of a compromise, the door is open. Please come and see me.

Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Link to this | Hansard source

Can I say at the outset how delighted I am that we are actually debating dental care. I say that because this is a very important issue for pensioners, for children and for people on low incomes, who have been struggling with this for many, many years. It is great to hear the opposition talking about dental care, because I can recall the times that they spoke about dental care when they were in government. I recall two times. The first was in 1996, when the first act of the Howard government was to get rid of the Commonwealth Dental Scheme. They spoke about it then. The second time it was ever raised was at a minute to midnight before the 2007 election, when they cobbled together a botched up policy for the Chronic Disease Dental Scheme.

In the period in between, it was raised on a number of occasions. Many of us on this side campaigned on it. I did, very strongly, in my 2004 campaign and in 2007 and 2010. I constantly saw constituents of mine who had been waiting for years to get dentures, people who were on a pension, who were on low incomes, people waiting to get their teeth fixed, waiting for fillings—a whole range of things. Every single time it was raised either as a question in question time or a private member's motion or as a debate on radio or in the media, the answer always came back exactly the same, and that was: 'It has nothing to do with the Commonwealth government.' Look up Hansard. I urge people to look up the Hansards, look at the questions and look at the debates, and you will see the same answer over and over: 'It has nothing to do with the Commonwealth government. Go to your state Labor mates and get it fixed.' Those are the responses that we were getting.

So I am really pleased—I am delighted—that the opposition is actually talking about dental care, because we have a plan in place that will look after low-income earners, pensioners, children and also people with chronic diseases.

Dr Southcott interjecting—

Kirsten Livermore (Capricornia, Australian Labor Party) Share this | Link to this | Hansard source

Order! The member for Boothby has had his opportunity.

Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Link to this | Hansard source

Madam Deputy Speaker, I sat here from nine o'clock in silence. I did not intervene or interject at all, and I expect the same while I am speaking.

I am sure that the members opposite have a keen interest in dental care, but we have seen the package that was botched together at a minute to midnight just before the 2007 election. We were told that it would cost around $90 million each year. You might think that $90 million per year is a fairly reasonable amount. It is actually costing us $1 billion each year, and it still leaves people waiting on the list. There are still pensioners who are waiting to get dentures. There are still children who are not getting the services.

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

Half as many!

Kirsten Livermore (Capricornia, Australian Labor Party) Share this | Link to this | Hansard source

Order! The member for Bowman will sit in silence.

Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Link to this | Hansard source

There are still people waiting on the list to get their teeth fixed. There are people who cannot afford private health insurance, who perhaps do not have a chronic illness but have worked all their lives, paid their taxes all their lives and are now on a low income or a pension and are still waiting on that list. The scheme that Abbott put up in 1997 does nothing for those people. Our scheme will ensure that they get the services that are required.

We raised this issue continually, over and over again, when we were in opposition and when I was a candidate, and the answers were always the same. It was always: 'No, no, no. We are not interested in dental care. It has nothing to do with us. It's a state issue.' I am very interested to see where this interest in dental care has come from all of a sudden.

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

Because you're ripping a billion dollars out!

Kirsten Livermore (Capricornia, Australian Labor Party) Share this | Link to this | Hansard source

The member for Bowman persists in interjecting and he is warned! The member for Hindmarsh will be heard in silence.

Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Link to this | Hansard source

We heard the shadow minister for health say earlier that, in the last decade, we have seen state governments drive down dental care. That is because the coalition cut the Commonwealth dental scheme, and waiting lists went up to 750,000 people. People were waiting up to four years to get their teeth fixed.

As I said yesterday, I am always happy to take advice from anyone, but I am not sure whether any advice from the opposition should be taken seriously, with their record. Now they come into this House and talk to us about dental care and what should be done for people who have illnesses who are on low incomes et cetera. Where was this passion about dental care when they were in government and we would raise this constantly? There was a brick wall when we would raise it, for a whole decade. We all remember that. Every single one of us on this side remembers. I urge you to look at the Hansard, at the questions I asked and the questions that the member for Richmond and the member for Shortland asked. They were passionate about dental care. In opposition, there were lots of debates and lots of talk but there was constantly a brick wall put up, with the government saying: 'It has absolutely nothing to do with us. Go to your mates in the state Labor governments. It's their responsibility. We wipe our hands of it.' In 2007, as the clock was ticking over towards the federal election, the coalition came up with a scheme that was cobbled together and was meant to cost $90 million a year. We see it now costing $1 billion a year, approximately $80 million per month, with people still on that waiting list. It is doing nothing for those people.

On this side of the House, we are very proud of this bill. This is something that we have all campaigned on. It was an election promise in 2007 and 2010, and it is now coming to fruition. It is very important that those opposite support it. We were elected on this platform in 2007 and 2010. We have a mandate. It is very clear. On two occasions when we have tried to progress dental reform in this House, it has been blocked by those opposite—not once but twice. As I said, we have a clear mandate. It cannot be any clearer. We have the electoral authority to deliver this reform of the provision of dental services in this land. If you look at the Hansard from when we were in opposition, and from since we have been in government, you will see the commitments that we have made. We are delivering on those commitments. We want to deliver a dental scheme that is equitable for all in this nation. That is what this bill does.

I do not believe the opposition will support this bill, because that is all we have heard from them—a constant no, no, no, on every bit of reform that we try to put into this place. By opposing this bill, they are opposing the most vulnerable in our community—pensioners, children and low-income earners who have no other way of getting their teeth fixed and maintained. We have another fear campaign from those opposite, saying that we are cutting the Chronic Disease Dental Scheme and there will be no services for the people on that scheme. We are offering a service to people with chronic diseases and to people on low incomes. People on low incomes who have no other means to pay for dental care will get the services that they require. This is an Abbott scare campaign, just as we have seen with the carbon tax and a whole range of other things. It is a scare campaign trying to convince people that we are going to deprive them of dental services—when we have campaigned continually for 10 years on the fact that we believe in a dental system that assists pensioners and people on low incomes to receive the services that they require.

They are preaching now to us about dental care, but when they came in and axed the Commonwealth dental scheme people were required to wait up to two and three years. At one stage, the lists of people waiting to have their teeth fixed ballooned out to 750,000. Labor have promised, and we have been pursuing, something very different to those opposite, and that is to increase the availability of dental services. The poorly designed coalition scheme, which we have sought for years to replace, subsidised treatment of millionaires. Gina Rinehart could get access to that scheme, yet a pensioner in my electorate, in Plympton, who did not have a chronic disease but had worked all her life, paid her taxes and was now on an age pension, could not access it. You tell me where the equity and fairness is in that.

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

That's a lie!

Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Link to this | Hansard source

Madam Deputy Speaker, I ask that the member withdraw that remark.

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

I withdraw.

Kirsten Livermore (Capricornia, Australian Labor Party) Share this | Link to this | Hansard source

Thank you.

Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Link to this | Hansard source

As I said, it was a scheme that was poorly designed and that led to waste and dissatisfaction. I have seen many constituents who accessed the service only to find out that the money was gone within a couple of visits, they had not got what they wanted and they had not got the services they were paying for. I have seen many, many people. In fact, a couple of dentists have come to me to tell me that this is happening quite widely. Last year, we saw Medicare recover money—I cannot remember how much, but it was in the millions—where dental treatment had not been done properly but the money had been paid. That is taxpayers' money. I have heard many stories of treatments that have been of low value and poorly performed or that have remained inaccessible to those who need them the most. That is what our scheme is about: providing the services to those that need them the most. The system needs to improve, but improvement is anathema to those opposite. They would prefer a culture of fear, to scare people, to say we are taking something away when in fact we are actually giving back bigger and better dental services. Those opposite have been crying out with false alarm this morning, saying that Labor plans to deprive people of dental services. That is not correct. As I said, the only people who have deprived the Australian public dental care are those opposite—they cut the Commonwealth dental scheme in 1996. That was their very first act, and the fear I have is that an Abbott led government would do the same thing again. They would repeat what they did in 1996; it would be history repeating.

This is one example of a continual string of ironies where the coalition says positive change is negative change; where an increase in services means a decrease in availability—we are increasing services; that is the reality. The Abbott coalition strive to convince the people to fear the very changes that will benefit them most. They are trying to put the fear into people that these changes are going to benefit the Australian public, particularly low income earners, pensioners and children. I am proud to speak in favour of this bill. We have a record of campaigning for and promising that we will deliver a dental scheme, and that is what this is.

As a result of this package, which was announced by the Minister for Health in late August, 3.4 million Australian children will be eligible for funded dental care through the expansion of the government's current child focused dental scheme. That means that we are putting preventative measures in place. When these children grow up to become teenagers and adults, they will have much healthier teeth and that means they will not have to access these services, costing us less in the long run.

Currently, under the bill children aged 12 to 18 will be able to access dental care. Almost 3½ million children aged two and over will be able to access the care they need. That will be a good start in dental hygiene, and will set the path for fewer problems in the future, costing governments less money. That is why this is a good bill—it also covers the preventative side of things. Funding will be provided to the states for around 1.4 million additional dental services for adults on low incomes such as age pensioners, concession card holders and people with disabilities and special needs.

When the Howard government cut the Commonwealth dental scheme in 1996, the waiting list went up to 750,000 people, with an average waiting time of 2.4 years. We are delivering 1.4 million services, which will wipe out the bulk of the waiting list. If those opposite were to form government at the next election—shock, horror!—one of the first things they would do is revisit what they did in 1996. We know that deep down in their hearts they do not believe in the dental scheme. We asked those questions and they were honest enough to tell us when they were in government that these services had nothing to do with a federal government. Further, outer metropolitan, rural and remote areas will receive additional capital and workforce to provide the services where they are needed.

This package relies on federal funding complementing state funding. Many things have to be negotiated between the Commonwealth and the states, and I envisage, for example, New South Wales and Queensland may try to sabotage the process, as we have seen with other negotiations that have taken place, and the poor people of Queensland and New South Wales will be the worse off for that. (Time expired)

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

I support the motion by the shadow minister of health, the member for Dickson, that the Health Insurance (Dental services) Amendment Determination 2012 (No. 1), dated 3 September 2012, made under subsection 3C(1) of the Health Insurance Act 1973, be disallowed. I support the shadow minister because I support those in my community. Yesterday in this House I highlighted but three of the cases brought to me by my constituents.

What I find most appalling in this argument by the Minister for Health is that she claims that the services are there to be driven for and supported by the millionaires in our community. I have to tell the minister that there are not too many millionaires living in my electorate. My electorate is made up largely of aged people, with 21 per cent of my population being over 65. I have a very high demographic of low-income earners throughout my electorate. That is reflected in the government's own figures, which show that 80 per cent of the people who have accessed the Medicare Chronic Disease Dental Scheme are concession card holders.

In discussions this morning with one of my GPs—people who obviously you do not trust to make informed decisions about chronic disease—he said to me that the cost of providing this service, as against doing nothing and the hospitalisation of those people because of their chronic condition, is a cheap fix. In fact, while there is $4,250 allowed over two years to address the dental condition of those suffering from these chronic diseases, the average cost claim is less than $1,800 over the two years. In fact, the around one million people that have been treated have had 20 million services. Today, Minister, in an article reporting your response to my story in the Maitland Mercury yesterday, you said—

Kirsten Livermore (Capricornia, Australian Labor Party) Share this | Link to this | Hansard source

I ask the member for Paterson not to refer to 'you'.

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

I am sorry; in the article the minister said:

The MCDDS has been massively rorted with more than 1000 complaints from patients ripped off with dentures that didn't fit; work charged for that was never done and cosmetic and unnecessary dental work.

Minister, I put it to you this way. One thousand out of one million patients is 0.1 per cent. If you applied your argument to those receiving social security benefits who have rorted the system, you would be arguing to abolish social security because the fraud rate on that is far higher. I say to the minister, this is—to quote the old analogy— a very mean, tricky approach to dental care. This scheme takes care of those most urgently in need of dental repair work. It takes care of those predominantly who can least afford it. Your solution, Minister, is to put people on the queue, with 650,000 already waiting, who will take five years to process. These people will go to the back end of that queue and suffer all the time. I would like to point out comments from Mark Foster, Chief Executive, Hunter Urban Medicare Local, who is also a very well-respected GP. In responding to the arguments put forward on the abolition of this scheme, he said that chronic dental conditions:

… can affect nutrition, which is particularly important for patients with chronic disease;

chronic infections have a deleterious effect on general well-being and can … have a significant impact on patients already unwell due to a chronic disease;

dental infections can spread throughout the bloodstream infecting … which can have a significant impact on patients already unwell due to a chronic disease; and

surgery to have a prosthesis inserted will normally be delayed until a dental infection is resolved to avoid these complications. There can be significant delays in accessing this care through public clinics. Patients may suffer from severe joint pain and incapacity or face the risks associated with delays in cardiovascular surgery.

The reason I oppose this government and want to maintain this scheme is that I am standing up for my constituents in Paterson. I am standing up for those who cannot afford to get dental care. I am standing up for people like Josh, about whom you said:

I read the story in the Mercury about Josh Oran, and concerned for him, as I would be for anyone suffering or recovering from cancer.

How can your concern be for someone who has had bone cancer in the jaw and whose dental work, if not completed by 30 November, will have to go on the back end of the public waiting list to get it addressed? What about his nutrition? What about his quality of life? You come in here, Minister, as a great champion of social causes, yet you are prepared to put those who require urgent treatment to have quality of life on the backburner.

I say to the member of the Lyne, the member for New England, the member for Denison and the member for Kennedy, when you vote on this motion, you need to consider your constituents' needs. As it was pointed out, 80 per cent of the people who have accessed this scheme are on concession cards. I know because the member for Lyne represents the seat to the north of me and the member for New England represents a seat relative to the north-west of me. I have been to Kennedy a number of times and I have also been down to Hobart. I do not see the streets there lined with many millionaires, with people so able to afford urgent dental treatment. I say to you, if you vote to remove this scheme, I want to see you go back to your electorates tomorrow morning, to get into the media and say, 'I proudly voted down this scheme. I want to put all of those suffering from a chronic condition on the back end of the 650,000 waiting list. I want to deny you this treatment all because this minister's justification is 0.1 per cent of all treatments, which led to a complaint.' In saying that, this minister is saying in essence that she does not trust the GPs to make the informed decision of a referral for private dental treatment covered by this Medicare scheme.

I disagree quite often with GPs on a range of issues but I would have thought that, when it comes to the health and wellbeing of our community, they understand more about the medical system and the treatment of their patients than any politician or any bureaucrat because they treat them on a daily basis. They take care of their patients 'general health and wellbeing and Minister Plibersek wants to deny them access. Minister, I am going to go into my community and make sure they understand that you personally want to deny them access to urgent dental work.

Kirsten Livermore (Capricornia, Australian Labor Party) Share this | Link to this | Hansard source

The member has to stop referring to 'you'. He should address his remarks through the chair.

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

The minister constantly refers to care and concern for those disadvantaged in our community but the minister, in pushing this motion to abolish this scheme—

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

With the stroke of a pen.

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

with the stroke of a pen, says, 'You can get on the back of the queue.' The member for Hindmarsh talked about an equitable approach. There is urgent and high-priority work which should go to those who need it most. Imagine someone who has had a coronary occlusion being caught on the back end of a waiting list at a hospital. There is urgent work that needs to be addressed immediately and it is the same with chronic dental conditions. If that work is not done because, as the minister has made out in some of the media statements, people are seeking cosmetic work—for someone with cancer in the jaw bone who has no way of eating unless their dental condition is controlled—

Tanya Plibersek (Sydney, Australian Labor Party, Minister for Health) Share this | Link to this | Hansard source

They will be seen as a priority patient.

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

Oh rubbish! They will be seen as a priority patient and be put on the back end of the 650,000, and you know it.

Kirsten Livermore (Capricornia, Australian Labor Party) Share this | Link to this | Hansard source

The member for Paterson will not respond to interjections.

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

Well tell her to stop interjecting, Deputy Speaker. That is your role in this House.

Peter Garrett (Kingsford Smith, Australian Labor Party, Minister for School Education, Early Childhood and Youth) Share this | Link to this | Hansard source

Madam Deputy Speaker, I rise on a point of order. On a number of occasions, you have cautioned the member for Paterson for his use of the term 'you', which he knows is unparliamentary and contradictory to the standing orders. I ask you to bring him to order or he should sit down.

Kirsten Livermore (Capricornia, Australian Labor Party) Share this | Link to this | Hansard source

I thank the minister and remind the member for Paterson once again that he has to refrain from using the word 'you'.

Tanya Plibersek (Sydney, Australian Labor Party, Minister for Health) Share this | Link to this | Hansard source

Madam Deputy Speaker, I rise on a point of order. The member for Paterson was just extremely disrespectful to you in telling you your job and I think he should apologise to you for that.

Kirsten Livermore (Capricornia, Australian Labor Party) Share this | Link to this | Hansard source

I appreciate the minister's concerned but we will return to the debate. The member for Paterson will be heard in silence for the remainder of his time.

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

The Minister for Health does not want to hear or understand the concerns of constituents. I look forward to tomorrow when the member for Newcastle, the member for Hunter, the member for Shortland and the member for Charlton will all go to the media in the Hunter and say, 'I proudly supported taking away access to the Chronic Disease Dental Scheme. I was proud to stand up and vote to make sure it was got rid of.' Through the whole spectrum of the Hunter we have a high number of people on concession cards, people who normally do not have access to public dental hospitals. People in rural and regional areas who do not have access to public dental hospitals were able to be referred by their GP to their local dentist to get work done. This minister is now saying, 'Go on the back end of the queue. Drive yourself from Forster to the dental hospital in Sydney and sit there and wait.' Minister, this is totally unacceptable and cannot be supported.

The other thing the Labor Party keeps pushing is that the Howard government abolished the Commonwealth Dental Scheme. Well, that scheme was set up for four years, and it was the previous Labor government that made no allowance for it in the forward estimates. What we get from this government is rhetoric and very little action. What concerns me most about their proposal, as I said in my speech yesterday, is that this package is unfunded. I want people to clearly understand that they are abolishing this scheme to put the money in the bank to offset the $120 billion black hole. Those who are suffering from a chronic dental condition are now personally going to pay with their health for the financial mismanagement of this government because they are ripping this scheme down.

I have just been informed that the member for Kennedy will not be supporting the government on this, and for that I commend him. Obviously the member for Kennedy has been out and about among his community and understands the importance of this. He and I, like the majority of members in this place, represent rural and regional electorates and we do not have a public dental health hospital in our community. That means long distances to travel and those in regional areas incurring further cost to get down to the public dental hospitals in the capital cities.

This is poorly designed. All the minister is trying to do is rip money out of the system to prop up a failed financial package—and it is the people of Australia and, in particular, my constituents in Paterson who are going to suffer. Minister, you failed in your response in an article today in the Maitland Mercury. It was an appalling response. On one hand you said you care for people who suffer from these conditions and then you accused them of being millionaires who do not deserve the treatment. I say that is wrong.

I seek leave to table two documents. The first is page 1 of yesterday's Maitland Mercury, which contains an article that highlights the concerns of my constituents in relation to the abolition of the Medicare Chronic Disease Dental Scheme. The second is page 4 of today's Maitland Mercury, which contains the minister's responses to that article.

Leave not granted.

Tanya Plibersek (Sydney, Australian Labor Party, Minister for Health) Share this | Link to this | Hansard source

Listening to this debate you would think there is no choice to be made. But, in fact, we have a very important choice to be made. We have a choice between keeping open the rorted wasteful Chronic Disease Dental Scheme or opening a scheme that will look after the dental health of low-income Australians and 3.4 million Australian children. We have had very strong third-party endorsement for the path that we are taking as a government. Steve Hambleton, from the AMA, says:

This is a huge improvement on the existing dental scheme. There is less bureaucracy and red tape, and the program is better targeted at those with the greatest need.

Gordon Gregory, from the National Rural Health Alliance, says:

Being relieved of the financial responsibility for the oral health of 3.4 million children, the States and Territories will be able to reduce their public dental waiting lists rapidly and to a significant extent.

Shane Fryer, of the Australian Dental Association, might know what he is talking about, don't you think? He said:

The re-direction of federal funding to Australia's children and adults on low incomes or in rural areas will prove to be a sound investment. We know that if dental care can be provided to children then their long-term dental health will be significantly improved. Early intervention and preventive treatments are a proven and well-established method to prevent poor dental health in later life.

He goes on to say:

Currently around 65 per cent of Australians receive regular dental care. The ADA believes the new program will provide assistance to many Australian families previously unable to access regular care, as a sure way of helping them avoid a path where their dental health will deteriorate.

The ADA accepts that the CDDS funding model was flawed but the chronically ill have special needs and those who have not been able to access care through financial or geographic disadvantage must continue to receive assistance. Increasing the capacity of the public dental system will help meet this need.

So says the Australian Dental Association.

The CDDS is a poorly designed scheme. It treats millionaires the same as battlers. It treats cosmetic dental work the same as the vital work needed by patients suffering from disease. The CDDS has been massively rorted, with more than 1,000 complaints from patients being ripped off with dentures that did not fit, work being charged for that was never done or cosmetic and unnecessary dental work. The government was billed for work on patients who did not exist. Some dentists charge twice for the same procedure and routinely overserviced. They swapped amalgam fillings for porcelain, inserted expensive crowns and performed unnecessary cosmetic work. In all, there were more than 1,000 complaints made.

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

Out of one million treatments!

Tanya Plibersek (Sydney, Australian Labor Party, Minister for Health) Share this | Link to this | Hansard source

The member for Bowman says it does not matter—1,000 complaints do not matter. In one case that was recently canvassed in the media a dentist has been ordered to repay more than $700,000. After an initial assessment of a sample of 20 patients, the dentist admitted billing for services that were never provided. After a subsequent audit began, the dentist admitted incorrectly billing patients 293 times. The dentist also said she had no record of 122 services provided to patients that she had billed to Medicare. After the audit began, the dentist voluntarily paid back $25,000 before being asked for a cent. In another case, in 2009, Medicare visited a dentist who was not providing treatment plans and quotes to patients.

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

So what!

Tanya Plibersek (Sydney, Australian Labor Party, Minister for Health) Share this | Link to this | Hansard source

The member at the table interjected again: 'So what!'

Mr Laming interjecting—

Yvette D'Ath (Petrie, Australian Labor Party) Share this | Link to this | Hansard source

The member for Bowman is reminded that he already has a warning.

Tanya Plibersek (Sydney, Australian Labor Party, Minister for Health) Share this | Link to this | Hansard source

Medicare visited a dentist in 2009 who was not providing treatment plans and quotes to patients nor copies of treatment plans to referring general practitioners. On a return visit in 2010 Medicare found the dentist had not rectified the issues. The dentist incorrectly claimed $1.9 million of taxpayers' money and the member for Bowman thinks that does not matter.

In another case, an audit of a dentist found he had incorrectly claimed $1.8 million. During the audit it was revealed that the dentist had repeatedly failed to inform referring GPs of the course of treatment he intended to carry out on their patients. The dental practitioner said it was because he did not use computers. That was $1.8 million of taxpayers' money ripped off under the scheme that Tony Abbott designed while health minister.

We have a choice: to keep this flawed wasteful scheme open or to provide dental services through the public system.

Luke Hartsuyker (Cowper, National Party, Deputy Manager of Opposition Business in the House) Share this | Link to this | Hansard source

You're providing nothing for two years!

Tanya Plibersek (Sydney, Australian Labor Party, Minister for Health) Share this | Link to this | Hansard source

The member interjects: 'nothing for two years.' The money starts to flow from 1 January next year. As soon as the states and territories sign-on they will have half a billion dollars on the table.

Mr Hartsuyker interjecting—

Yvette D'Ath (Petrie, Australian Labor Party) Share this | Link to this | Hansard source

The member for Cowper is warned.

Tanya Plibersek (Sydney, Australian Labor Party, Minister for Health) Share this | Link to this | Hansard source

The CDDS is flawed. It is not means tested. It has no restrictions on the type of work that can be performed. It has been complained about at an unbelievable rate. The amounts that have been overcharged are unbelievable. Why are those opposite defending such a flawed scheme? Because Tony Abbott introduced it when he was health minister. They need to defend the Abbott record. If they came into parliament and saw a scheme that was as badly abused as this they would never defend it. A scheme that was supposed to cost $90 million a year now costs $80 million a month. That is the design that Tony Abbott left us with.

Our scheme is going to be available from 1 January. We made available $515.3 million in the May budget for the states and territories from January. What do they need to do to get that money? All they need to do is agree to maintain their existing effort and show us what they are doing with the money. We are not even asking them to increase their own effort. We are just making sure that they at least maintain their existing effort. That effort is not clear in states like Queensland that are actually cutting dental services at the moment. The latest news out of Queensland is that dentists have been sacked at Brisbane hospital, dental services have been downsized at the Royal Children's Hospital and $1.4 million has been cut from the Metro North oral health budget. The member for Dickson, the shadow minister for health, has congratulated the Queensland health minister on that, saying that they are getting Queensland Health back on its feet and have done what Liberal National governments do. Yes, that is right, they have done what Liberal national governments do: they have cut services. Of course, we need to make sure that the states and territories at least maintain their current effort, but that money is available from 1 January, January this year, as soon as the states and territories sign up.

Those opposite have raised the issue of waiting lists. They talk about 650,000 people being on waiting lists. That is an exaggeration; there are around 400,000 people on waiting lists. But that proves that the Chronic Disease Dental Scheme is a flawed scheme. How can you be spending $1 billion a year and still have 400,000 people on waiting lists for public dental care? Is this some sort of alternative universe where people can think it is okay to spend $1 billion a year and still have 400,000 people around Australia on dental waiting lists? By their own admission this is a flawed scheme.

I will return to the history. The Liberals closed down the Commonwealth Dental Health Program. For 10 years they did nothing on dental care until at two minutes to midnight they introduced the flawed Chronic Disease Dental Scheme. The Liberals and Nationals are in here defending the Chronic Disease Dental Scheme, saying they will not close it down. They have also said that they want to support our children's dental scheme. I am glad they do. It is a massively popular move. We know that. The same people who come in here day after day saying: 'Where's the money coming from?', want to spend the $2.7 billion on kids and presumably on the other measures—the workforce measures and the public health measures—as well. So that is the $4.1 billion we announced in August plus, presumably, the half a billion dollars we announced in the May budget—that is a $4.6 billion investment by this government in dental health. I presume they are going to support the whole package. And they want to spend another $1 billion a year on the Chronic Disease Dental Scheme. These are the same people who come in here all the time saying, 'Where's the money coming from?' Where is the money coming from to allow you to add $1 billion a year to the bill? Where is the money coming from? Is this a firm commitment? Will you take this commitment to the next election? How will you pay for it on top of your $70 billion black hole?

There is no question that the CDDS is a flawed scheme, but I remind the House once again that this is not just about closing the Chronic Disease Dental Scheme; this is about what we replace it with. We are replacing it with a better scheme. We replaced it with half a billion dollars in the May budget: $345.9 million over three years for a waiting-list blitz, $10½ million dollars for oral health promotion, $35.7 million for expanding the voluntary dental year graduate program, $45.2 million for funding a graduate year program for oral health therapists, and rural and remote infrastructure and relocation grants for dentists. Those members who have rural and regional electorates should really think about this, because there are many places where you cannot see a dentist, even if you have money in your pocket, because there aren't dental services in those communities. We are proposing to do something about that. The Chronic Disease Dental Scheme does nothing about those workforce and infrastructure measures. And there will be $450,000 in the budget over three years for supporting the pro bono work that dentists do so well. What about what we announced in August? We announced $2.7 billion for 3.4 million Australian children who will be eligible for subsidised dental care. The member for Paterson said he is going to go back to his electorate and talk about the competing plans. He should tell the 18,060 children in his electorate and the member for Dickson should tell the 18,304 children in his electorate, who will be eligible for this free dental work, for whom it will be as easy to see a dentist as it is to see a GP now, how he is going to find the money to support both the rorted, wasteful Chronic Disease Dental Scheme and this new proposal that supports them, that gives them a firm basis for better oral health of their whole life. He should tell them what he is going to do to find that money.

What about the $1.3 billion extra for extra services for adults on low incomes including pensioners, concession card holders and those with special needs? All of them will have better access to public dental. We announced in August $225 million for dental capital and workforce measures that will make it easier to see a dentist in areas right across Australia where currently it is impossible or difficult to see a dentist.

The member for Dickson made a range of completely unsubstantiated comments including this idea that there is a 19-month gap. In the budget measures we announced in May, the spending can start in January. Every single person in this place understands that there are people, like the cancer patients mentioned, that have a desperate need for care. And those people who have income eligibility and who have that need for care will be seen in the public system. These issues and concern for the transition have been raised with me by my Labor colleagues and have been raised with me by the Independents Tony Windsor, Rob Oakeshott and Andrew Wilkie. I have been able to reassure them that the objectives and the outcomes of our agreement with the states will provide additional services for approximately 400,000 patients on public dental waiting lists, with a particular focus on Indigenous patients, patients at high risk of major health problems and those in rural areas, and expand the capacity of the public dental system to provide those increased services.

There was no concern from the Liberals when there was a 10-year gap caused by Peter Costello's closing of the Commonwealth Dental Scheme. There was no concern from them at all when that happened. There was no concern from the member for Dickson when services in his own state, in Brisbane were cut so viciously by the Campbell Newman government.

I conclude by saying this is not just about the closure of the CDDS. This is a choice of two alternate visions. Do you keep open a rorted, untargeted, overblown scheme or do you focus on kids, generations of oral health and public patients who need this support the most?

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

I rise to support the disallowance motion moved by the shadow minister for health and also to support the comments of the members for Boothby and Paterson. For those here in the gallery today, you might be confused about what this disallowance motion and this debate is actually about. It is not about two different schemes. It is about what happens in the transitional period between them.

Two weeks ago, if any of you sitting up there in the gallery, your son or daughter or your elderly parents came down with the chronic dental disease, you could go to your GP and get a referral to a private dentist through Medicare. Medicare would fund $4,250 worth of treatment spread over two years. That was open to every Australian two weeks ago. That scheme is now shut, closed. It has been replaced with nothing for 18 months. Your children will not be able to access Labor's new scheme until 1 January 2014. For adults it does not start until 1 July 2014—over a year and a half away, after the next election. And this new scheme is completely unfunded.

What this disallowance motion is all about is what happens in that transitional period. What the government is saying is that in the transitional period, after the scheme is cut, you will longer have that access. Put simply, if you are suffering dental pain, if you have an abscess on your tooth, if you have chronic dental disease then take an aspirin, go to a queue that is 650,000 people long at the public dental hospital, and wait in pain for a year and a half. This disallowance motion is about making sure that does not happen and to make sure that the Chronic Dental Disease Scheme continues until the start of this new scheme.

We heard from the minister about how great her new scheme is. If it is so great, why do you not start it straight away? Why are you waiting a year and a half until it starts—after the next election? If this new scheme is so great why does it not start today?

There is another issue with cutting off the scheme. We have to remember that many people are halfway through treatments on the existing scheme. That scheme closes down at the end of November, within 12 weeks. This shows a fundamental failure of understanding of how dental treatment works on behalf of this government. Many patients need treatment under the Chronic Dental Disease Scheme that goes on for many months. What this does is cut patients off in the middle of their treatment and they will be a unable to continue or to finish that badly needed treatment. They will be left stranded, up the creek without a paddle. The minister goes on about the rorts that need to be cut out, and says that that is why the scheme must finish almost immediately. That is fair enough. If there are rorts they should be wound down, but we need to put this 1,000 in context. The minister talks about 1,000 complaints but she fails to mention that the scheme has provided two million services of care—the 1,000 complaints represent less than one per cent. So for less than one per cent this minister is throwing the baby out with the bathwater and making 100,000, 200,000 or maybe 300,000 Australians suffer in pain for up to 18 months.

If the government say that it would cost $1 billion for this scheme to continue surely the government can find the savings. They come into this House and we ask them, 'Where is the money coming from for the $120 billion-worth of promises you have made over the last several months?' They give us the answer, 'It will come from savings.' Surely they could find savings of $1 billion to keep this scheme open so that Australians do not have to put up with pain and suffering for the next 18 months.

It is also important to note that the current dental scheme, which the government finds so objectionable, provides 80 per cent of its funding to those on concession cards. Those concession card holders are now being asked to wait—to go to the back of a queue of a public dental scheme and wait for 18 months. I do not think, in my short time in parliament, I have seen a disallowance motion of such importance, that can save such pain and suffering for so many hundreds of thousands of Australians.

I would like to think about the effect that the psychology of cutting the scheme will have on the economy. As we know, if any Australian came down with a chronic dental disease two weeks ago they could go to a GP, get a referral and go to a private dentist to have that fixed. For the next 18 months people cannot. They are left on their own. What is that going to do to the economy? Think of the millions of Australians who will now live in fear that if they suffer chronic dental disease they will not be covered by existing arrangements, because this government has taken it away.

We saw with the carbon tax and increasing electricity prices that people are frightened to spend money out in the retail shops because they do not know what their electricity bill will be. The same thing will happen with this, because consumers will be concerned that if they come down with chronic dental disease in the next 18 months this government will shaft them—they will take the existing Medicare benefits away from them and leave them with nothing. So this will have another detrimental effect on the economy: people will be frightened to spend because they do not know how they will be able to afford that dental care in the next 18 months if this government is ripping the existing scheme away from them.

This is an opportunity for those on the other side of the House to make a stand within their caucus. Those opposite should stand up in caucus even if they agree that their new dental scheme is great. I am sure all of those opposite do think it is great—and it is a legitimate debate to have about the two schemes—but they cannot leave hundreds of thousands of needy Australians shafted. Needy Australians will be posted up the creek without a paddle for a period of 18 months. Surely there are at least a few people on the other side of the chamber who are not prepared to see this happen to their constituents.

The Independents have a decision to make here. Hopefully they will realise that we need to do something in this transitional period and support this motion. We cannot allow a situation where hundreds of thousands of Australians will suffer acute dental pain for 18 months—where this government can say, 'Take an Aspro and go and wait at the back of a queue of over half a million people.'

If this government can find any savings let them find the savings to keep the existing Chronic Dental Disease Scheme going. Or they could just tweak it a little bit. Modify it, but do not take one scheme away and then leave a gap of 18 months until the next scheme starts. That is what this debate is about, and we hope that at least some on the other side, or the Independents, will support this motion that will stand up for the needy people in our community who will need dental treatment over the next 18 months.

Luke Hartsuyker (Cowper, National Party, Deputy Manager of Opposition Business in the House) Share this | Link to this | Hansard source

I welcome the opportunity to speak on this disallowance motion because it is a very important issue for the people of my electorate. It is a very important issue because it affects those people who can afford dental treatment the least. It is a very important issue because it is going to deprive many people of services that are vital to their health and will leave them with little or no alternative.

Yesterday, in the debate on the Dental Benefits Amendment Bill, coalition speakers outlined the history of the Medicare Chronic Disease Dental Scheme—a scheme which provided for the first time access for people who could least afford it to a Medicare funded dental scheme in Australia. The coalition supports good dental outcomes and assistance for those who need help to get those outcomes, but the coalition is concerned about the gap that this new bill will introduce. It is particularly of concern for low income earners and those most in need. There is a gap because the new scheme does not commence until January 2014 for children, a 13-month gap; and July 2014 for adults, a 19-month gap.

It is a gap that concerns constituents in my electorate. I have been receiving in my electorate office numerous phone calls from people concerned about what is going to happen to them in this intervening period, where the minister's legislation says there will be no treatment and there will be no alternative. The minister came into this place and said, 'Trust me; there'll be a few scraps on the table to look after you.' The reality is that my constituents know that they cannot trust this minister. They know that their own health is at risk. They know that they are going to be going to the end of a 650,000-person waiting list. They will wait 19 months for the new scheme to kick in. Then what will happen?—they will earn the right to go to the end of a waiting list that is 650,000-people long. That is hardly good policy. No wonder they are so concerned.

Children must wait 13 months to access the new scheme, and the cap has been reduced, from $4,250 over two years to $1,000 over two years. Whilst this will assist some children, for those with chronic dental problems, $1,000 over two years will simply not be enough. As I said, in my electorate there are a range of people who rely on the current scheme, and the removal of this scheme will put further pressure on the costs of living that they are currently experiencing.

I would like to recount two phone calls in particular that were received at my office. One person who called my office has Sjogren's syndrome, which attacks the glands that produce tears and saliva. This person requires ongoing preventative dental treatment. For them, the gap of 19 months is unconscionable. What is going to happen to them during that 19-month period? Are they going to take an Aspro, go home and do nothing, and see their health deteriorate? I was also contacted by a 68-year-old pensioner who was eligible under the current scheme. He requires continuous dental check-ups and denture upgrades. With no assistance, on his fixed income what is he going to do? This shows gross disregard by this government for people most in need. They claim to be the champion of the battlers. Unfortunately, they have proven by their conduct to be otherwise.

The minister also says the current scheme has been rorted and has to be closed down because of that. I say the minister should take action under the legislation to recover money from any people who have rorted the scheme. I would also say that there is rorting of other benefits in Medicare—is the minister proposing to close those down? There is rorting of the social security system—is the minister proposing to close down the social security system? Rorting is always an issue, and every member of this House abhors it. Having said that, it is not an excuse to close down a scheme that is providing much needed assistance with health to those most in need and is vital to improve health outcomes. Placing someone on a 650,000-person waiting list after 19 months is no solution to improve dental health outcomes.

The Independents should consider in their deliberations the impact that this gap in service is going to have for their constituents. I know the member for Lyne's electorate has a very similar demographic to mine—many people on low incomes, many people on social security benefits, and many other people who are unable to afford the sorts of dental care that the current scheme provides. I would say to the member for Lyne that he should think carefully about the issue of the 19-month gap. He should think carefully about the fact that, after that prolonged waiting period of 19 months, those people will still be faced with a waiting list of 650,000. The same goes for the member for New England. He would have many low-income earners and many people dependent on benefits in his electorate. He should also think carefully about the impact of withdrawing services from those people most in need. It is vital that the crossbenchers consider carefully their actions in this bill, because this is a very important disallowance motion before the House.

I commend the previous scheme as implemented by the coalition government. I certainly do not accept that rorting is a reason for taking away benefits from people most in need. As I have said, rorting is, unfortunately, a practice that occurs across a whole range of government benefits. It should be stamped out, absolutely. But the minister cannot use that as an excuse to close down a very important scheme. The crossbenchers should think carefully about maintaining the current level of services for their own people.

If the government were serious about improved dental outcomes it would be introducing a new scheme that moved seamlessly from the previous scheme rather than introducing a massive gap that is going to cause major problems to those people most in need and those who are benefiting from the current scheme.

Yvette D'Ath (Petrie, Australian Labor Party) Share this | Link to this | Hansard source

Before I give to call to the member for Blair, I apologise to the member; he was on his feet seeking the call before.

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

I oppose the disallowance motion. In our scheme, 5.2 million will be covered; on the CDDS, 650,000 are covered. That is the reality. I would have more respect for those opposite if they had a strong, good, caring history when it comes to dental care in this country. But what they have done is consistently and continually opposed dental reform in this country.

The Keating government brought in, in 1994, assistance at a federal government level for low-income earners, people on pensions and the like—$100 million of federal government funding to assist them on the waiting lists. We brought it in. That was hailed as a great initiative, with the Commonwealth government taking up what the federal Labor government did with Medibank and then Medicare. The federal government was taking responsibility, in part if not wholly, for oral health in this country.

What the Howard coalition government did in 1996 was come in, rip that $100 million or more out of the system and then leave about 750,000 people on waiting lists. They said, 'It's all the states' fault; it's not our fault.' That is what they said from 1996 until 2007—'It's not our fault; it's their fault.' Now they say it is not the states' fault. When their mates in New South Wales, Queensland and Victoria are in power, it is our fault. Where is the consistency?

When we have Campbell Newman in Queensland sacking dentists, closing down breast screening, taking pathology services and dental services out of the Royal Children's Hospital and sacking people everywhere—over 4,000 front-line services in health and hospitals across the whole of Queensland, including hundreds of workers in my area, across the western corridor between Brisbane and Ipswich and beyond—what do they say about that?

Where was the member for Dickson, who came in here with such feigned outrage, when it came to protecting the oral health of people across the country? Where was he? He did not say a word about that—not a word. Their scheme, which they brought in on the eve of the 20007 election, which was going to cost the taxpayers of this country $90 million, by June 2008 had cost them—according to Lindsay Tanner, the then finance minister—$248 million. Having consistently, in this chamber and elsewhere, opposed reform to bring in a system that would help low-income earners and children in this country, those opposite wasted hundreds of millions of dollars—if not billions—in dental health reform in this country. And they have the temerity and the gall to say that we waste money. They wasted it by their opposition. It was money for those needy millionaires, who need the $4,250!

They are always opposing reform. We heard the outrage from those opposite when it came to the private health insurance rebate. We are seeing similar arguments today in relation to this. And guess what? I had a bit of a look at the figures on the private health insurance rebate. A record 132,366 people took out private health insurance in the June quarter—a 0.4 per cent increase on March and the largest quarterly increase since 2007. But that was all going to collapse—no-one would ever take out private health insurance; they would all go to the public system.

I wonder where those opposite were in May this year; maybe there were holograms opposite. But they were there when the Treasurer talked about the $515 million in funding—and we saw the minister for health talk about this in subsequent legislation—that we are providing to make an impact on the waiting lists and other health reform in terms of people's oral health around the country. There is no gap; that is a nonsense. They must not have been here and heard those speeches. They must not have voted on those appropriation bills. I do not know what happened. Maybe it is all an illusion—they are in some sort of twilight zone. I do not know what happened with them.

This is what we are doing, and this is what we did in the budget, and this is what is being rolled out across the country. We are currently seeing 400,000 people on waiting lists getting access to public dental care in public hospitals across the country. There is new spending to boost the dental workforce and improve facilities in regional and rural areas.

I wonder if those people opposite actually get around to their electorates and have a look at what is happening? Of course, those opposite—who were not here, ostensibly, for the budget and the bills that related to them—did not make all those appropriation speeches up in the Federation Chamber or down here. Those opposite, not here physically, are now mute when the governments of their persuasion—and now the states—start taking the axe to health services in New South Wales or in Queensland.

What we are doing here will make a big difference across electorates. In my electorate there are nearly 25,000 children who will benefit from the reforms we are bringing in. There are 12,600 families who will benefit. The shadow minister talked about 'crazy arrangements'. In relation to those opposite, the crazy arrangement is the fact that they would support the non-means-testing of this dental assistance, which would waste billions of dollars—and they claim they are the champions of financial rectitude and prudence! What is their attitude going to be when the Dental Benefits Amendment Bill comes before this chamber? Are they going to vote for it? If you listen to the speeches from those opposite last night—and today as well, I guarantee—you will not be sure. I will be very interested in how they will cast their vote. Will they cast their vote for the 3.4 million children who will be eligible for funded dental care? Will they cast their vote for additional services for the 1.4 million adults on low incomes, including pensioners and concession card holders? Or will they vote for those needy millionaires? Is that their attitude?

Always, we have to do the heavy lifting when it comes to means testing. Always, those opposite support subsidies for the rich, the powerful and their vested-interest friends. Always, we have to do the hard yakka on this stuff. But if they come in, I guarantee you that they will never bring back the private health insurance rebate. And I would be very interested to see, if an Abbott-led government ever came on to this side of the chamber, whether they would bring back a Chronic Disease Dental Scheme. I tell you: they will not do it, because it is not good public policy, and they know it very well. They know it is not working for the hundreds of thousands of people on the waiting list.

With the Chronic Disease Dental Scheme, not one person has actually been in a position where they can say, 'I'm off the waiting list.' Where are the examples on that today? Where were the examples last night? Where are the examples of people who got off the waiting list and used this scheme? They have not compromised for five years. They said they would compromise. We saw the shadow minister saying, 'Come to us!' There was this sort of conversion experience, and now they want to compromise. For five years we have seen nothing but truculence and obstinacy in this area. For five years we have seen financial profligacy from those opposite. For five years we have seen crazy arrangements in their mind and in their policy development on this issue, and all because they want to look after their precious Leader of the Opposition, because this was his baby. This was the little scheme he came up with in they dying days of the Howard government. This is the man who ripped a billion dollars out of the health system and came up with this scheme. This is the scheme they want to protect.

Stuart Robert (Fadden, Liberal Party, Shadow Minister for Defence Science, Technology and Personnel) Share this | Link to this | Hansard source

Madam Deputy Speaker, on a point of order: Under section 90, it is inappropriate for the member to impute any motive upon any member of the House, let alone a Leader of the Opposition, and I ask that you ask him to withdraw that imputed motive.

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

There was no imputation in there.

Yvette D'Ath (Petrie, Australian Labor Party) Share this | Link to this | Hansard source

The member for Blair has the call.

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

How many times have we seen those opposite defend this and talk about it in the context of the fact that it was the Leader of the Opposition's scheme when he was the health minister. By their own words I this chamber they are actually admitting what I said.

This scheme will have a big impact. Apart from the fact that we are introducing a scheme that will help 3.4 million Australian children, and provide 1.4 million additional services, we will see another $225 million allocated for dental services—in capital and workforce—not just in the capital cities of Sydney, Melbourne and Brisbane but out in regional, rural and remote area.

In my area, the West Moreton-Oxley Medicare Local area, about 20 per cent of the population is under 14 years of age. As I said last night, Vicki Poxon, the CEO of the West Moreton-Oxley Medicare Local, supported what we say, supported this reform. She described it as being of 'the utmost importance to us', as '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.

But it is not just Vicki Poxon who have backed what we are doing. Carol Bennett, of the Consumer Health Forum of Australia, in a press release dated 19 August, said:

Cost is the big barrier preventing a large section of the community from accessing preventative dental services, which in turn contributes to development of chronic conditions that place major demands on our health resources …

The statement went on to quote Ms Bennett further:

"By driving change through prevention in younger generations, there is increased likelihood that a whole generation will not need emergency treatment or hospital admission for chronic and preventable disease.

“By addressing the dental needs of seniors and pensioners before they develop other chronic conditions, it frees health resources for other areas of high need.

“This is a big win for the whole community. If you improve the health of those who can’t afford a decent standard of dental care, you raise the general health of the entire community.

She is absolutely right. And we saw Dr Cassandra Goldie, from ACOSS, in a press release on 29 August, saying similar things, welcoming 'the commitment to meet the oral health needs of adults experiencing poverty and inequality who have gone without dental care for too long'. She further makes the point:

By ensuring affordable appropriate and timely dental care for people on the aged or disability pension and all those with a health care card, this reform establishes the policies and funding mechanisms to reduce a major area of health inequality in Australia …

People like Dr Goldie and Carol Bennett would certainly know, from their work in these areas.

I think this package strikes a very important balance between improved health services for those on low incomes and it will make a big impact in terms of prevention. We have seen the Australian Institute of Health and Welfare give some pretty damning assessments of where we are in terms of the oral health needs of children. I did make this point when I spoke on the bill last night. The oral health of children has declined since the 1990s. Almost 20,000 kids under the age of 10 are hospitalised each year due to avoidable dental issues and, by age 15, six out of 10 kids have tooth decay. Over 45 per cent of 12-year-olds have decay in their permanent teeth. In 2007, the Australian Institute of Health and Welfare's child dental health survey discovered that just under half of children aged six years attending school dental services had a history of decay in their baby teeth. So there is much need for reform in this area, and we are seeing funding rolled out accordingly.

I made the point that the waiting-list budget money that we are getting across will make a big difference in terms of the waiting list in Queensland. We will see $67.3 million received by Queensland for public dental clinics from the budget and additional funding for public clinics for low-income adults of the sum of $249.4 million in Queensland under this new package.

These are important reforms. We should pursue them. The disallowance motion should be opposed and the feigned outrage from those opposite should be shown for what it is: simply another scare campaign from those who can say nothing positive about public policy in this country.

Dan Tehan (Wannon, Liberal Party) Share this | Link to this | Hansard source

The member for Blair was spinning so much—spinning, spinning, spinning—that I thought he was, sadly, going to fall over with dizziness there for a moment. But I can understand why he is spinning: because he knows that what this government is doing is not right. He knows that what this government is doing is going to leave the most vulnerable without access to dental services for 15 months for children and for 21 months for adults. This is a crime. Why is it happening?

When the member for Blair says, 'Let's have a look at motives', the reason why this is happening is that this government cannot manage its budget. This is the direct result of sending cheques to dead people. This is the result of putting Pink Batts in roofs and then having to remove them. This is the direct result of having a Building the Education Revolution in schools which provides schools with canteens which you cannot fit a pie-warmer in. This is what this bill, sadly, is all about—because, when you cannot manage the books, in the end you have to find ways to try and save money.

So what is this government doing? Well, the Minister for Health has decided that she will put a halt on the provision of publicly provided dental services to the most needy for a period of 15 to 21 months. I must commend the shadow minister for health for the press release he put out on this. It was titled 'Let them eat cake'. I thought the headline hit it beautifully, although I did think he could maybe modernise it a little bit and use 'Let them sip lattes.' Perhaps that would have been a better headline, because that is what this is all about. It is about the fact that it will not matter if the poor and most needy in our society suffer as a result of this—this is the attitude of the Minister for Health towards these people, as epitomised by what they are trying to do by removing the Medicare Chronic Disease Dental Scheme. It is a shame.

The Minister for Health was in here a little bit earlier saying, 'No, we can bring the scheme on a little bit earlier. We just need the states to come on board.' The hypocrisy. She will be in here today in question time, as she has in previous question times, criticising the state governments for taking money out of health. Yet, what is this disallowance motion about? It is calling on the federal government to account for taking money out of dental health services.

I ask the Minister for Health: why don't you concentrate on what you are responsible for? Why don't you concentrate on the federal government rather than criticising the Queensland and New South Wales state governments, and whoever else you want to criticise? Why don't you focus on doing your job, because if you did your job properly we would not be in this situation here? We would not be taking from the most vulnerable and needy public dental services. We could be here saying 'Let this scheme continue.'

The Minister for Health has also raised the point that there has been some rorting of the scheme. Just because there has been some rorting does not mean that you close down a whole scheme and leave nothing in its place for 15 months. You could come in and say, 'Well, maybe we need to tighten the scheme in certain places,' and I am sure that we on this side would look at those proposals, because no-one wants to see any scheme rorted. But what we will not stand by and allow to happen is for you to close a scheme that is providing much needed services.

Let us look at the statistics on that. The Chronic Disease Dental Scheme has provided approximately 20 million services, including seven million last financial year alone. It is reported that 80 per cent of services under the Chronic Disease Dental Scheme have been provided to concession card holders. So, those on the other side can mock the 'dental scheme for millionaires' and so on, and try to gloss over the facts, but nothing will hide the fact that 80 per cent of services under this scheme have been provided to concession card holders.

What I would like to see is the minister come in and tell us, 'Okay, so there might have been a little bit of rorting,' but what, Minister, do you have in place for the next 15 months for the 80 per cent of services that were provided to concession card holders? What now happens to those concession card holders? What is your plan? And, please, don't come in and say, 'Well, if the states sign up we will be able to provide services next year.' Come here and say, 'Well, I have agreement from the states because we have negotiated with them and we can get a program up and running on 1 January this year.' Instead, what I am sure we will hear is, 'Well, if the states did this and the states did that maybe we could ….' Enough is enough. You cannot come in here in question time day after day and criticise the states for supposedly reducing their health services when you are just using that to try to disguise the fact that you are actually doing it.

It is going to be very interesting to see how the Labor Party back bench responds to this. It is going to be particularly interesting to see whether the member for Griffith has anything to say in this area. I think if the member for Griffith does have something to say in this area. Given the nervousness on the Labor Party back bench about closing this scheme and leaving nothing in its place, I think we might see the government react. That is a point that the Independents should take into account, because they could be left high and dry if they are not careful. They could be left as the ones holding the can for having supported the cutting of dental services to zilch for the next 15 months. The nervousness and the ability to react to anything that the member for Griffith might say could see a change come upon this place very quickly.

So, I call on the Independents to judge this disapproval motion on its merits. Look at the facts and the evidence and judge it on its merits. Look at the fact that if they do not support this disallowance motion people in rural and regional Australia will be left with minimal health provisions from the public purse, or perhaps none at all. That is very important, especially for constituents in rural and regional Australia. Those of us who live in rural and regional Australia know that getting access to a dentist is even harder than getting access to one in city areas. So the impact of the closure of this scheme, with it being replaced by nothing, will be harder in regional and rural areas. I ask the Independents to think long and hard about that fact before they decide which way they are going to vote on this measure.

This disallowance motion should be supported. What we are saying to the government is: stop, think and consider the consequences of your actions here. We understand that you have a budget black hole. We understand that it is $120 billion. We have seen it on the front page of the Australian Financial Review: a $120 billion black hole. The Australian public are fully aware of that black hole and the size of it. But why, when you want to tighten the belt, are you hitting the most needy and the most vulnerable? Why would you hit the Chronic Disease Dental Scheme, when you know that 80 per cent of the people who use it are on concession cards? Let them eat cake! Let them sip lattes! No, let us actually provide something for them that they need. This is a health service that is fundamental to the community. You should stop, think and ask yourselves: is this really the action of a government which professes to care about the most needy in society? It is not. We have offered a way forward for you, but you will not accept that way forward, and that is wrong.

That is why the shadow minister has moved this disallowance motion. I commend the shadow minister for health on the way he has gone about prosecuting this issue, because this has been an issue that the government have tried to slip through. This has been an issue where they have used the guise of attacking the Queensland, New South Wales and Victorian state governments for their supposed cutting of services. They have used that attack to try to disguise and hide what they are doing with this Chronic Disease Dental Scheme and the fact that they are replacing it with nothing for 15 months. But the shadow minister for health has not let this happen. He has prosecuted the case loud and clear. He has held the government to account. That is what this disallowance motion is all about. It is about holding the government to account, saying to the Minister for Health: we will not listen to you in question time go on about the states supposedly cutting services, when that is what you are doing here, and you are doing it because you have a $120 billion black hole.

In conclusion, Mr Deputy Speaker, I thank you for the opportunity to speak on this disallowance motion. It is a disallowance motion which should be supported. It is a disallowance motion which will enable services to those most needy in our community to continue, and therefore it is one which I would hope all members would support. But, if all members do not, I dearly hope that the Independent members in this place will support the opposition in making sure that this disallowance motion gets through.

Mrs Bronwyn Bishop (Mackellar, Liberal Party, Shadow Minister for Seniors) Share this | Link to this | Hansard source

I rise to speak to this disallowance motion. I think that in listening to the debate you can see quite clearly what a cruel manoeuvre the government is engaged in. This disallowance motion would restore the ability of those people who are in desperate need of dental attention because they have a health need to have that attention for the next 13 months in the case of children or 19 months in the case of adults. Well we might ask: why the gap? The gap was very well described by the previous speaker, the member for Wannon, when he said that this is a cost-saving measure in order to find savings to find a way out of the $120 billion black hole in the government's current budgeting procedures.

If we look at exactly what this scheme, which the disallowance motion would allow to continue, has done, I think the statistics are very impressive indeed. One billion dollars a year has gone to people in desperate need of dental services because of a health problem. You might ask: what sort of problem? When you note that 60,000 treatments have been for children, you see that they could be children who have heart disease. They cannot have an operation to cure that heart disease or that heart impediment until such time as they have dental treatment, because of the risk of infection. For those children who have already begun a process of treatment, it has now ceased. They may be part way through it, and they are obliged to wait another 13 months before it can be resumed. Is that fair? Is that cruel? Is that putting the life of the child at risk?

One of the things that I always find fascinating about the way that the Labor Party present an argument—particularly the Minister for Health, because she is the one responsible—is that they do not like to deal in specifics: what impact it might have on the individual person. It is always the collectivist ideal. It is always: 'This is a big picture; never mind the individuals and how it impacts on them.' On this side of the House, we think about those individuals and what it means. Twenty million services have been provided, to over a million Australians, in the course of this program that was introduced by the current Leader of the Opposition, who was then the Minister for Health and Ageing. The Leader of the Opposition, as minister for health, was compassionate about the need for this program. To hear it denigrated by speakers on the other side saying that we support it because somehow, if we did not, it would reflect on the Leader of the Opposition is pathetic. The fact of the matter is that he introduced the program, got it through the cabinet process and had it enacted because he cared about the outcomes for individuals in need of assistance.

I listened to speakers on the other side again using the lines of class warfare. 'This is a program for millionaires,' said one member from Queensland. I would remind him that the whole of the Medicare system is based on universal access. There are no means tests in Medicare. It is a universal system which is available for all to use. That is how it was planned. That is how it remains. That is how it is implemented. And yet we had the member for Blair saying that this was a scheme for millionaires and it was up to the Labor Party to put in the hard work of having means testing for access to schemes. Is he telling us that the whole of Medicare is now going to be subject to means testing? Is that what he is suggesting? Is that the plan that is secretly behind the beginning of the cuts? Certainly that was the implication that he was leading to in his speech.

The average claim under the Chronic Disease Dental Scheme, according to the department, is not $4,250, which is the maximum amount available over a two-year period, but $1,716. Recent estimates suggest that this figure has fallen to $1,200. It is not a scheme that is being rorted. It is not a scheme that is being cancelled by the government because it is being rorted. It is a scheme that is being cancelled because they want savings, and there will be no replacement of it until 2014. Eighty per cent of people using the Chronic Disease Dental Scheme have a concession card, but we do not means-test it because it is part of Medicare and Medicare is not means-tested; it is universal. All this talk about having schemes for millionaires is nothing but classic class warfare, unless it is proposed by the Labor Party that they intend to means-test all of Medicare. We would be very interested to hear some rebuttal on that point. Perhaps the minister may have to speak to the member for Blair and tell him that he is right or wrong in his flagging of the intention to means-test Medicare.

Had the Chronic Disease Dental Scheme not been in place, 800,000 people who have accessed support under the scheme would have joined the 650,000 people who languish on waiting lists every day. Again and again I have heard complaints about and heard criticism of state governments, particularly Queensland, because of action that they have taken with regard to health. And yet, in this very action that the government are taking in scrapping this scheme, they are placing undue hardship on the state schemes, which were not coping in the first place, and taking $1 billion a year out of dental care. The number of services to be provided over the full six years under Labor's recent proposal is only 20 per cent of what the Chronic Disease Dental Scheme provided last year alone. In other words, it is doing what it was set up to do. The 19 months with no treatment for adults and the 13 months with no treatment for children is harsh and it is cruel.

Just to outline it again: Labor and the Greens will close the scheme on 30 November, with no new services to be provided after 7 September. It is the only Medicare dental scheme that provides treatment for adults. It has provided $4,250 in Medicare dental benefits over two years for eligible patients with a chronic and ongoing health condition. I have spoken about the need for children who are waiting for heart surgery, perhaps, to have dental treatment, but of course a lot of the users of the Chronic Disease Dental Scheme, particularly adults, are people who have a cancer and it has resulted in a chronic health condition and they require dental treatment in order for that treatment to continue.

Labor has continually tried to close down the Chronic Disease Dental Scheme, for political reasons as well as financial ones, but it has already booked the savings. The Prime Minister says that this will save money, but the savings have already been booked. So the problem arises for the government that its new scheme is unfunded and it has to find several billions of dollars for the scheme that it proposes, which will not start—with everybody included—for 19 months. The gap period is part of the savings, but the money still has to be found to provide for the scheme that the government is putting in place, even though it will curtail more serious dental treatment for those who have greater need. We do not have details of what the fee structure will be, we do not have details of how it will operate and we certainly have no details of where the money is coming from. We are particularly concerned that many of the patients receiving treatment under the current scheme will be forced to forgo their treatment, and that includes people who have already commenced it. The treatment will have to be discontinued for the period of the gap.

Let us go back to the 60,000 children who have received treatments under the chronic disease dental scheme. All the rhetoric from the other side seems to be that they are introducing a scheme that will provide services to children. They deny, by not mentioning those children who have benefited from the existing scheme, that our scheme covered children at all. Yet, for those 60,000 children who have had the benefit, it has been of enormously important—in many cases life-saving—significance.

I have asked how many individuals have come forward to members and said what the proposed changes will mean to them individually—and they are coming forward. Because of the personal nature of the disease that they have, they do not really want it to be made public. They are happy to talk about their condition in general but, as an individual being put under the spotlight in the media, the nature of their condition means that they do not really want to say 'this is what they are doing to me.' Who can blame them? These are people who are ill, who have a Medicare item which is now going to be withdrawn, together with, as I said earlier, $1 billion in funding.

The Labor Party has been keen to mislead the general public by saying that when Tony Abbott was health minister he withdrew money from the healthcare system. He did not. It does not matter how many times he puts forward the evidence, that allegation is repeated by the Labor Party. But here in black and white, here in budget documents, here in legislation, here in a regulation we have the Minister for Health herself, personally, with the stroke of a pen, taking $1 billion out of the health system.

Alan Tudge (Aston, Liberal Party) Share this | Link to this | Hansard source

Shame!

Mrs Bronwyn Bishop (Mackellar, Liberal Party, Shadow Minister for Seniors) Share this | Link to this | Hansard source

It is shameful for her to do that, and she is one who very much likes to preach that she is morally superior to others because she is caring and compassionate. Her action today belies her portrayal of herself. Care and compassion are not two words that go together with the withdrawing of services from people who desperately need them. In many ways politics can be very harsh, but in an area such as this, when we are continually hearing from the Labor Party that their scheme is going to cover X thousands of people or is going to do something or other for someone unknown, when it comes to the nitty-gritty of supporting an individual who has a desperate need they are always found wanting.

This disallowance motion now lies in the hands of Mr Oakeshott and Mr Windsor. Whether or not children and others can continue treatment they have begun, whether those in desperate need of a heart operation or have disease from cancer treatment can have access to the scheme for the next period of 13 to 19 months, according to whether you are a child or an adult, rests in the hands of Mr Windsor and Mr Oakeshott. We will see, when it comes to a vote, whether or not Mr Windsor's words in the chamber that he wished to be consulted and he was not unmoved by the arguments being put forth, ring true. I sincerely hope that they do; I certainly hope that Mr Oakeshott and Mr Windsor are as compassionate as they say they are and that they will vote with the opposition and disallow this regulation.

Alan Tudge (Aston, Liberal Party) Share this | Link to this | Hansard source

I also support the motion that Health Insurance (Dental services) Amendment Determination 2012 (No. 1), dated 3 September 2012, made under subsection 3C(1) of the Health Insurance Act 1973, be disallowed. If this disallowance motion does not pass today and if the government's Dental Benefits Amendment Bill does pass today, three things are going to happen. The first is that the Medicare Chronic Disease Dental Scheme will end on 30 November, and no new patients will be able to access it. Second, it will ensure that people have no coverage at all until at least 14 July. Thirdly, it holds up hope that a replacement scheme might be put in place in 2014.

The first two things that I mentioned are certainties—they are facts. If this disallowance motion is not passed and if the government's package is passed, then those first two things will definitely occur. The chronic disease dental scheme will be scrapped and there will be nothing in its place until at least 2014. The third thing is just a hope, just an election promise, because there is no detail, it would be implemented after the next election and, most importantly and quite astoundingly, no money has been allocated to it.

So, together, the package the government has put forward is not a good one and we cannot support it. Worse, thousands of people will be left in the lurch over the next 19 months. For this reason we ask that the House support our disallowance motion today, which will at least have the effect of not cancelling the chronic disease dental scheme, and we ask members to seriously consider how they vote on the government's package which will be put forward after we have voted on this disallowance motion.

What is the Medicare Chronic Disease Dental Scheme? This scheme was implemented in 2007 when Tony Abbott was health minister. It provides up to $4,250 in Medicare benefits over two years for eligible patients with chronic health conditions. The intent of the scheme—and the intent has been delivered—was really to recognise that under the universal Medicare scheme we have public assistance for people to get their body fixed, but that Medicare never covered the teeth and the mouth. There is an inconsistency there because there is no great difference between a chronic health problem in one's mouth versus a health problem elsewhere. So Tony Abbott, as health minister, introduced this scheme to address that inconsistency. What it meant in practice was that, if you had a chronic teeth problem, you could go to your GP and, if the GP established that indeed you fitted the criteria, that you did have a chronic condition, you could immediately go to one of the 10,000 dentists in Australia and get your condition fixed.

Over the course of the scheme, this cost on average $2,220 per patient and for kids it cost on average $1,125. The chronic disease dental scheme slowly worked its way through Australia's sickest patients and treated an enormous number of them, fixing their teeth. So people who had never had good teeth, people who had chronic conditions but could not afford to see a dentist, all of a sudden had their teeth fixed and for the first time in their life had teeth they could be proud of. One million Australians benefitted from this scheme over the last few years, with 20 million consultations in total.

Why, given the success of this scheme, does the government want to close it down? The government has put forward three reasons to close down the scheme. Firstly, it says the costs are overblown. Indeed, it is the case that the scheme is more expensive than initially forecast, but the reason is that more patients access the scheme. It is a demand-driven program. So the more patients who are eligible to access the scheme, the more expensive it becomes. In this way, it is very different from most of the programs which the current government has introduced and managed which have been budget blowouts because the government have not managed the programs properly. The Medicare Chronic Disease Dental Scheme is not at all like that. We have seen the cost per patient drop over time from an average of $2,225 per patient to this year being an average of $1,117 per patient—per patient, it is becoming less costly. As I said, I distinguish this dental program—a demand-driven program where the cost per patient is becoming less over time but the overall cost to the taxpayer is growing purely because more patients are accessing it—from many of the government's programs, which have had true cost blowouts purely because of administrative incompetence.

You do not have to think for very long to recognise those programs. The pink batts program is the classic one. It cost $1 billion to put pink batts into people's roofs and then a further billion dollars to removed the pink batts from people's roofs. The NBN is another. Initially the NBN was going to cost $4.5 billion and now we are looking at $50 billion and growing, yet still only 50,000 residences have been covered. With school halls, we know from audited accounts that school halls were built for almost twice as much as they should have cost. That is a legitimate cost blowout. With the chronic disease dental scheme, the additional expenses are due to more patients receiving coverage.

The second reason the government argue the program should be closed down is that they said the program is 'untargeted'—that is, that wealthy people are accessing the program. Let us look at the figures. The figures show that 80 per cent of the one million people who accessed this program were concession card holders. More importantly, as the member for Mackellar pointed out, the fact that our dental scheme is not a means tested program is perfectly consistent with the universally accessed Medicare scheme. Every person in Australia is able to go to a doctor and be covered by Medicare. Every person in Australia is able to go to a public hospital and get free treatment through the Medicare scheme.

Medicare is a universal scheme and until at least this point Medicare has been supported on both sides of the House. As the member for Mackellar pointed out, what is the implication of the government's argument if, all of a sudden, they say that, if you are a wealthy person, you should not be able to access health care for your mouth through a dental scheme? Are the government also indicating today that they plan to means test the Medicare scheme, because that would be the logical conclusion? I think the Minister for Health should clarify this point because most Australians would be shocked if, indeed, the government were to make the Medicare system no longer a universal scheme. It seems that could be one of their plans and the Minister for Health should clarify that point.

The third argument for why the government plans to close the chronic disease dental scheme is that they say it has been rorted. About one in 1,500 cases have had some irregularities. In any large-scale government scheme you will never be able to ensure that there are no irregularities. That is just the nature of things. Some people are going to be completely and utterly dishonest, and no amount of red tape, accounting or oversight is going to ensure that every single irregularity can be removed from the system. One in 1,500 is a similar figure to what we understand occurs through GPs and in the public health system. But the government have not been in here complaining about the Medicare system and saying we should be shutting down Medicare because there is an irregularity in one in 1,500 cases. So the three arguments they have put do not stack up.

The real reason they are planning to close this program down—and it will be closed down if this disallowance motion does not get up—is that Tony Abbott started it. Because Tony Abbott started it when he was health minister, the government does not want to continue it. And the second reason is that the government are desperate to find savings in the budget. They are willing to cut people's access to dental care in order to find savings because they have wasted so much money elsewhere.

The second certainty which arises from the government's package, and which will occur if this disallowance motion goes down, is that no scheme will replace it until July 2014 at the very earliest. What this means for the 650,000 people on the dental waiting lists is that the waiting lists will simply get longer. I would like to read out comments from Anya Filek, from Wantirna South in my electorate, a recipient of services under the Chronic Disease Dental Scheme. She says:

I suffer dental problems related to my chronic illness and must visit my dentist every 4 months and now that the dental scheme is gone I will no longer be able to afford it. I have rung my local public health centre and have been placed on a minimum 2 year waiting list but what do I do in 4 months time when my teeth begin to break and crumble as they will do? …

How does the Minister propose to 'extend' the public dental scheme by 2014 as promised? Will she magically triple the amount of dental chairs in all community health centres?

I would like the Minister for Health to come in here and address Anya's concerns and tell us what she is going to do about patients like Anya—and there are thousands of other patients in a similar condition.

I will summarise where we are at at the moment. We know for certain that, if this disallowance motion is not passed, the Chronic Disease Dental Scheme will disappear. We know for certain that, if this disallowance motion is not passed, nothing will be put in its place until at least July 2014. The third thing is that the government hopes—and it is just a hope—that it will be able to replace this scheme with something in the distant future, in 19 months time. But, as I pointed out earlier, this is a false promise because their proposal for this dental scheme's replacement, remarkably, does not begin until 2014—after the next election—and there is no money attached to the bill. So we should consider this as merely an election promise. That is all it is, and we would like to know where the money is coming from.

I plead with the Independents—Mr Oakeshott, Mr Windsor and Mr Katter—and the Greens to support this disallowance motion and keep the Chronic Disease Dental Scheme in place for another 19 months at the very least so that Anya in my electorate and thousands of others like her across Australia can continue to receive the dental treatment they so desperately need.

Paul Fletcher (Bradfield, Liberal Party) Share this | Link to this | Hansard source

I am pleased to rise to speak on this disallowance motion in relation to the Health Insurance (Dental Services) Amendment Determination 2012 (No. 1). Let us start by reminding ourselves what the effect of this motion is. The starting point is that in 2007, when the current Leader of the Opposition was the Minister for Health, the coalition introduced the Chronic Disease Dental Scheme. The instrument which gave effect to that decision was the Health Insurance (Dental Services) Determination 2007.

If we then fast forward to August this year, we observed a phenomenon which we see quite frequently under the present government—a dual Labor-Greens press conference. At that press conference there was an announcement in relation to a new dental package. Buried deep in the press release was a statement that the new package would replace the Chronic Disease Dental Scheme. You need to read the entirety of the media release if you want to satisfy yourself that it is silent as to the question of when the current government intended to bring the Chronic Disease Dental Scheme to an end. You will also find that the media release is entirely silent on when the new arrangements will be in place.

In any event, we had that announcement and subsequently, on 3 September 2012, the present Minister for Health made a determination the effect of which was that, if it took effect, the previous determination, the 2007 determination, would cease as at midnight on 30 November 2004. In other words, if the minister's determination takes effect then the Chronic Disease Dental Scheme will cease operation with effect from 30 November 2012. If you read the details of the determination, it also becomes evident that, if you were not already receiving treatment under the Chronic Disease Dental Scheme as at 7 September 2012—that is, some days ago—it was no longer open to you to commence treatment under the scheme.

What we are therefore debating is the motion moved by this side of the House to disallow the minister's determination of 3 September. If the disallowance motion is successful then the Chronic Disease Dental Scheme will continue to operate in accordance with the 2007 determination. That brings us to the question: what is the thinking behind the coalition moving this disallowance motion?

As we have analysed this issue, it has been very difficult to avoid the conclusion that this is yet another example of the Gillard Labor government saying one thing and doing another. It says that it is introducing a new service. It says that it is introducing new arrangements for dental care involving $4 billion of dental spend on children, low-income adults and the bush. What it is actually doing is quite different from what it says it is doing. What it is actually doing is suspending, with immediate effect, the existing Chronic Disease Dental Scheme. And there will be no new scheme in place until 1 July 2014 at the earliest.

The rationale for the decision to bring the Chronic Disease Dental Scheme to an end is stated to be, amongst other things, that there is a cost blow-out. Of course, the question of the cost of any social program is one that the coalition will always take seriously. We have indicated in the past, and our shadow minister and others have repeated, our willingness to engage with the government on the details of how the Chronic Disease Dental Scheme operates and some of the cost drivers. Our willingness to engage has so far been rebuffed, and we find ourselves in the position where the minister has moved ahead to bring to an immediate end the Chronic Disease Dental Scheme and, therefore, in many ways, the only practical alternative now available to the coalition is to move this motion.

In the time available to me, I want to make essentially three points about our thinking behind doing so. The first is that this is, once again, an example of the way in which the Gillard Labor government always seems to mess up the transition from one set of arrangements to another. Whenever there is a new package introduced, whenever there is new law introduced, whenever new arrangements need to be implemented, it always seems to be done in an extraordinarily messy and clumsy way, with very little thought given to the mechanics of transition and very little thought given to how citizens are expected to adapt themselves to the change. The second point I want to make is that what is driving this messy transition, a transition which leaves many of our least privileged citizens facing some very difficult choices, is a desperate desire to engage in some political window-dressing and to get a good announcement, and, of course, to shore up relations between the Labor Party and the Greens party. The third point I want to make is to acknowledge that, of course, there will always be opportunities to examine and refine the operations of any scheme of public administration—the Chronic Disease Dental Scheme is no different—and that we are, of course, open to working with the government on that.

Let me start with the first point: the way that this Gillard Labor government always seems to mess up transitions. We have seen with the Chronic Disease Dental Scheme, as with so many other policy announcements by this government, something which is rushed in with very little notice and very little time for citizens to adapt themselves to the change and very little consideration of how a change might be introduced in a way which is least disruptive and difficult to manage. As many of my colleagues have pointed out, the way that this particular transition has been managed means that, amongst other things, those who are presently in the middle of dental treatment will have to cease it as at 30 November. It is hard to imagine a more disruptive and ill-thought-through way to implement a change of arrangements. These people include those who are suffering some very serious diseases indeed—diseases that, on any view, amply meet the description 'chronic diseases', including cancer, HIV and hepatitis; these are all diseases which are known to have, as a side effect, the causing of significant dental problems.

Unfortunately, the way the government has handled this issue is not very different from the chaotic mismanagement of the transition when the Home Insulation Program was suddenly announced to be terminated at very short notice, or the way the government introduced changes to the aged care funding arrangements earlier this year—and I have had many representations from aged care facility operators in my electorate about how difficult it is to adapt their operations to a change being announced at very short notice—or, indeed, from the introduction of the carbon tax, and, again, I and my colleagues have had many representations from industries which, even weeks before 1 July, were still uncertain as to how that particular legislative package was to operate. I am sorry to say that there is a pattern of this government messing up transitions, and that pattern is repeated in the case of the particular determination the disallowance of which the House is presently debating.

The second point I want to make is that good policy and good transition management has come a distant second to the government's political agenda, driven by two principal motivations: firstly, to keep the Greens party happy, and, secondly, to keep those aspiring to return to the position of prime minister at bay. It might be said, and often is said, as a general principle that an apple a day keeps the doctor and indeed the dentist away. It also it might also be said as an explanatory principle of what is going on here that an unfunded policy announcement a day keeps Kevin away. Because that is, frankly, one of the principal motivations behind what is going on in this shambolic policy process, the disallowance of which the House is now debating.

Amongst other things, this new package announced by Minister Plibersek together with a Greens party senator is completely unfunded. It forms part of the $120-billion black hole of unfunded policy announcements from this government in recent months. That, amongst other things, is the reason why one of the truly significant components of what is happening here is to cut off the Chronic Disease Dental Scheme with almost immediate effect. That is driven by a desperate desire to try and claw back some money in an attempt to fund at least a small part of this massive, yawning and ever-expanding gap.

I cannot help noting that in the media release from the minister and in the transcript of her joint press conference with a senator from the Greens party, there was a very amusing spectacle of a journalist asking the questions as follows: 'what sort of time frame are you looking at for the scaling up?' and, 'how would you pay for it?' That produced, remarkably, a response from the Greens party senator. We all know the Greens are completely indifferent to the question of how anything is to be funded but I do think this is a particularly delicious example of the genre. The relevant Greens party senator had this to say, 'I think, like the minister, today is a day to celebrate the fact that people right across the country are now going to be able to access dental care in a way that they had previously not been able to. The cost is not going to be a barrier anymore for many people.' That was all the relevant Greens party senator had to say in answer to the questions: how would you pay for it? Where is the money coming from?

I cannot help reminding the chamber that responsible political parties keep a careful eye on how promises are to be funded. We have the extraordinary spectacle of the present government building up a roster of unfunded promises amounting to some $120 billion in an unfunded policy black hole, egged on by their good friends in the Greens party to whom the whole question of how policy might be paid for is one that is so theoretical and irrelevant that they do not even deign to give it any consideration.

Let me turn briefly to the third point I want to address, which is the question of whether there are opportunities to review the way in which the Chronic Disease Dental Scheme works. We have heard from the minister at some length her bitter dislike of the Chronic Disease Dental Scheme, which, she argues, is poorly targeted. It is refreshing to see a minister in this government expressing even lip service to the question of careful targeting of government expenditure. On all the evidence, this is merely a convenient excuse for the government's political objective of getting a new announcement out there and desperately looking for some areas where it can find some funding to back up that announcement. Let us be clear. No scheme of public administration is ever perfect. There will always be opportunities for improvement. There will always be opportunities to look for efficiencies. The coalition has consistently signalled that we stand ready to work with the government on the question of whether there are refinements necessary to the Chronic Disease Dental Scheme. There may well be areas where we could work constructively together. Our shadow minister and others have repeatedly made that point.

It is very difficult to avoid the conclusion that the government is simply looking for a convenient excuse to axe a particular policy which it does not like for a whole range of reasons. Let me conclude by saying this disallowance motion was moved because this is very bad policy to manage a transition in such a chaotic way. This is driven, as is so often by this government, by political considerations and not by good policy management.

Steve Irons (Swan, Liberal Party) Share this | Link to this | Hansard source

I rise to speak on the disallowance motion put by the member for Dickson, the shadow minister for health. It is always a pleasure to follow the member for Bradfield and also the member for Aston and the member for Wannon who put such salient arguments before. I also heard the member for Blair speak and I will raise some of the issues he brought forward in his contribution. I think the contribution he made was based a lot on politics of envy. I heard him talking about the millionaire's scheme for a lot of his speech. As we know, 80 per cent of the users of the previous scheme were concession card holders.

The Dental Benefits Amendment Bill 2012 has been presented as part of the recent dental announcement by the health minister and the Greens. This is the first opportunity for the House to consider the government's announcement on 29 August. The number of speakers we have heard so far just on this disallowance motion reflects the many controversial elements of that package. Everyone in this chamber supports investment in dental health. Going to a dentist is a relatively expensive trip for most Australians and it is important that we do what we can in this place to make dental care accessible to the general public.

Earlier in the week in this chamber we saw what happens when the government has good intentions but fails on the drafting and on the implementation process. The Charities and Not-for-profits Commission Bill 2012, which had the express goal of easing regulation and making life easier for charities and not-for-profit's, a goal that was written into the preamble and announced by Minister Shorten in 2009 as the reason for being for the legislation, morphed into the most burdensome piece of legislation that the not-for-profit sector has seen in this country. The bill created uproar in the charitable sector and the government made nine amendments to its own legislation. So the charities were not happy nor should they be. This demonstrates that you can have the best intentions but if you cannot implement your ideas in a practical way then you can end up doing more harm than good. It is in this respect that we in the coalition have two main issues with this legislation before the House today. The first issue is the provision to close the Medicare Chronic Dental Disease Scheme on 30 November. The second issue is if the government has the money to be able to deliver this package. The closure of the Chronic Dental Disease Scheme to be replaced by a scheme that does not start until 2014 seems to be bad policy that lacks rhyme and logical reasoning. The existing scheme has been a good scheme. We have heard that it has had its faults. We know that no schemes implemented by governments work perfectly, but instead of canning schemes we can adjust them as we go along.

The present scheme has worked well and efficiently for the benefit of Australians. Over the last five years some 20 million services have been provided to over a million patients. It has not been rorted as some government schemes are. The average claim under the scheme was $1,716—well under the cap of $4,250. It is also worth noting that the scheme has been utilised by those who need it the most. As I said before, it is reported that 80 per cent of services under the CDDS have been provided to concession card holders.

I know, through my connection with the forgotten Australians that many of them are coming up to that age where a lot affected by chronic disease and they have taken advantage of this scheme implemented by the Leader of the Opposition when he was in government. I know those people will be disappointed. I have seen some of the forgotten Australians and I have seen the benefits they have had from sourcing this scheme. I am sure that many of the forgotten Australians who have chronic disease will be disappointed by the fact that this government has canned the scheme and that there will be nothing available for them until 2014. While the scheme was successfully implemented by the coalition this government has chosen to close the Medicare Chronic Dental Disease Scheme on 30 November.

The closure of the Chronic Dental Disease Scheme, to be replaced by a scheme that does not start until January 2014 seems to lack logical reasoning, as I said before. The existing scheme has been a good scheme. As I said, it delivered for some 20 million services. So, while Medicare is a universal scheme that all Australians pay for through the Medicare levy and the taxation system, the CDDS is a system that has been predominantly utilised by low income Australians. This is a key point: it is accessible to all.

Given that the scheme has been an enormous success by the standards of any government health program it is worth posing the question: why would any government in their right mind be proposing to end a program that has done so much good for Australia? The answer, as usual, has nothing to do with policy or principle. With the Labor Party it is all to do with personal and petty politics and achieving their desire—the sacred budget surplus.

Of course such a successful scheme could not have been implemented by this government. It was a scheme implemented by the coalition. As I said before, is was implemented by the Leader of the Opposition Tony Abbott, when he was the health minister.

Labor are trying to close the scheme for political reasons, as we heard from the member for Bradfield. We know that Labor has gone to great lengths to undermine the scheme because it is a coalition policy and had been such a success in improving access to treatment. The mechanics of what the government is doing here is to close the scheme altogether at the end of November with no new services to be provided after 7 September—a date which has now passed. There is then to be a 19-month gap before people will be able to access a scheme. This is a long period for Australians not to have access to a chronic disease dental scheme, and the coalition has legitimate concerns about the children who will lose access to treatment on 30 November with the closure of the CDDS and also about the children will not be able to complete current treatment by 30 November. Where are they going to go and what are they going to do? They will have to wait until January 2014.

The Dental Benefits Amendment Bill refers to children's dental care or, more specifically, dental care for children between the ages of two and 17. So it is worth considering in particular the potential implications of the closure of the CDDS on children. The bill does not commence until 1 January 2014 and makes very minor amendments to the Dental Benefits Act 2008, changing the eligibility age of the current Medicare Teen Dental Plan from 12 to 17 years to two to 17 years. It makes other minor terminology changes to provide essentially for a change from the Medicare Teen Dental Plan to the Child Dental Benefits Schedule, although I would also note that the schedule of services and fees and their essential details are not yet available. As with most of the programs and schemes implemented by the Labor Party, we are still waiting on detail and clarity so that we can see was is actually going to be implemented.

As the shadow minister said, the minister has acknowledged that services for most children will cost less than the proposed $1,000 cap but there will be children on the Medicare Chronic Disease Scheme who will require more services and there is no provision to ensure they continue to receive adequate treatment, especially in the period before the bill commences.

We know from previous speakers that 60,000 services have been provided to children under the Chronic Disease Dental Scheme, and cutting off the scheme will provide a great degree of discontinuity to children in the middle of treatment, who will not be able to have their treatment completed any time soon. A 16-month gap in care is not an acceptable outcome and is a clear failure of the bill we are debating today.

So why the rush? Why the rush towards 30 November, when the replacement is not due to come into effect until 2014? One could be cynical and say it was about manufacturing the paper surplus for 2012-13, but we know that any surplus for this financial year is looking extremely unlikely. Also, it is legislation that will not even be implemented until after the next election. Instead, it looks as if the reason is more likely to be and attempt to satisfy the Greens and to fend off a challenge from the member for Griffith in the short term.

Madam Deputy Speaker, aside from the specific provisions in the package, we in the coalition are also concerned about its unfunded burden on the taxpayer. This program, which the government is estimating at $4.1 billion, is completely unfunded. And it is just one of a host of high-cost announcements over recent weeks that have created a black hole of up to $120 billion. I think I hear an interjection repeating that: $120 billion!

Do you remember Mr Deputy Speaker Mitchell, what was being discussed in this place in May? The government was announcing years of surpluses to come—a promise they had been repeating for years—starting in this financial year, 2012-13. They promised fiscal discipline. Just four months later, they have delivered $120 billion worth of unfunded promises. So, barring new taxes, there are going to be continued deficits under the Labor Party—no great surprise, as the last surplus they delivered was before the member for Longman was born, whom I am fortunate enough to sit next to in this place.

So what prompted the government to break a promise that they repeated time and again in the lead-up to the election? What has prompted them to turn their backs on fiscal discipline and break the very clear promise they were making before the last election? You have guessed it: the Greens. It was the Greens that forced the Prime Minister to introduce a carbon tax and it is the Greens that have again forced the Prime Minister and the Treasurer's hand here. No promise is so sacred, no commitment to the Australian people worthy enough, that it would prevent this government from breaking a pre-election promise to satisfy the Greens. But, as with all policies that the Greens design, there are problems.

The National Disability Insurance Scheme was announced as costing $10.6 billion a year when fully operational. As Joe Hockey said, there is no crueller hoax on people with disabilities than announcing a program that they cannot deliver. It is the same with this bill. This is a program that is unfunded, and I would be surprised if they can deliver it. There is also $2.1 billion for reopening Nauru and Manus Island. The increase in the refugee intake to 20,000 is going to cost $1.4 billion. The government has committed to 12 new submarines at $35 billion. There is $6½ billion for the Gonski review. This is all in the space of no more than a couple of weeks.

Furthermore, this spending spree is taking place in the most difficult of environments: there is global uncertainty in iron ore prices, a driver of our economy; there is slow growth and recession around the world; and industry in Australia is reeling from the carbon tax, the mining tax and other taxes. The resources minister has already declared the mining boom over, the budget is at an all-time high in terms of debt and we have had the four biggest deficits on record delivered by this Treasurer. Now is not the time to be going on a massive spending spree to satisfy the Greens. Before the spending spree, the Prime Minister stood up and said, 'Every time we announce something, we properly account for it and properly fund it.' Well, that is not what is happening with this bill. What is more disturbing is that the newspapers are reporting the spending binge as being about the Prime Minister warding off a Rudd challenge—$120 billion of unfunded spending designed only to keep the Prime Minister in her job. This is not what a dental scheme should be about. It should be about caring for those who need it.

So it is because of those two main concerns—firstly, the closure of the chronic disease dental scheme and its implications for Australians and children in particular; and, secondly, the unfunded nature of this commitment and the rushed way in which it is proceeding through the House—that we in the coalition have moved the disallowance motion, to disallow the closure of the chronic disease dental scheme. We will continue to fight against the closure of the scheme for the 18-month period in which people will not be able to access chronic disease dental assistance. Thank you.

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

In the final hours of this debate, it is fairly obvious that there is not going to be a reconciliation between the two sides of politics. As an opposition we have made it exceptionally clear now that there is a significant service gap for Australians who are trying to get dental care with the implementation of the government's plan to start funding dental care in 2013-14, leaving a 15- to 19-month gap in between. What you are seeing if you are witnessing or listening to this debate today is the age-old divide between Labor and the coalition. There is the current Labor government with its almost unshakeable faith in the public provision of services, and the coalition with its belief in a blended model—the belief that, by working a private and public health system together, we can have the best of both worlds.

The government's approach simply collapses when it comes to dental care, and it is probably because there are no dentists, doctors or medical specialists on that side. I do not think there is even anyone who has worked in the dental profession on the other side—but I am happy to be corrected. The problem with such a paucity of real experience in the dental sector is that you are then utterly reliant on advisers and bureaucrats to send up recommendations about how to save money, rather than actually knowing what happens in dental care as a service. The government does not understand how this sector works. Australia is a 95 per cent private dental system, and that means our public dental system, run by state governments as an mostly in dental hospitals, is extremely constrained in its supply of dentists. So the pure injection of some money by the other side does not fix the problem.

There are three typologies of people who need dental care. There are the young, who often need surveillance and early and quick intervention for usually small cavities; there are older people who have chronic disease and dental problems that can be either aggravated by or a part of it; and then there are extremely sick people for whom dental disease is extremely severe and who can really only be fully cared for as a hospital in-patient. So we have the young, the everyday adult disease and the severely sick.

What you need to understand is where this government is going. Saying, 'Here's a little bit more cash for state dental hospitals,' is to fundamentally misunderstand how those hospitals work. If anyone from this government had ever walked into a dental hospital, they would understand that a bit more money going into a system that does not have enough dentists does not achieve a great deal. It is quite correct—whether the waiting lists in state hospitals for dental care have been three-quarters of a million or half a million, the reality is that in those hospitals they are mostly dental students under supervision, getting final dental training before they go and work in the private sector. They are predominantly learning, working slowly and carefully under supervision. That is not the way to reduce a waiting list of half a million people. In a private dental system, the way to decrease the waiting list is to empower GPs and dentists in the private sector to fix the problem.

The very architects of Medicare do not understand the power of the system that they designed. But the evidence is there in front of them. Tony Abbott's chronic disease dental scheme, in addition to helping the sickest in the community—giving them the dental care they never could get from state dental hospitals—actually reduced those waiting lists. In New South Wales, the wait for a public dental appointment through their dental hospitals has decreased by 40 per cent, because for the first time people can go to their GP and say, 'Look, as part of my chronic disease and the linked dental ailments, send me off to a private dentist and let me get the job done.'

This morning we saw one of the most disappointing displays by a health minister that I have seen in a decade. It was the current health minister first of all choosing in this debate to traduce dentists and imply that they were dishonest, unreliable and rorting the system; and then, in a fit of rage, suggesting that asthma is not a chronic disease. When the list of chronic diseases for which dental care is eligible was read out by the shadow parliamentary secretary for health, she scoffed at him and said, 'Asthma—you call that a chronic disease?' On the very day that this parliament is promoting a bipartisan event on 'When you can't breathe, not much else matters' and the importance of understanding lung disease, Australia's Minister for Health and Ageing was scoffing at asthmatics, suggesting that asthma is not a serious disease and does not deserve its place as a chronic disease. You would not have found her predecessor saying something so ill considered, nor the health minister before that, nor the one before that—all ministers I knew personally. But this narky, nasty aspect of the health minister's personality is very undesirable and very unsuited to the job.

For 10 years now we have been hearing the accusation from this government that we ripped a billion dollars out of the health system. But in one fell swoop, with this new policy, this government—because they need to try to get a surplus by July next year—are ripping a billion dollars out of Medicare. So they are guilty of exactly what they have been accusing us of for the last decade.

This health minister's argument against the Medicare Chronic Dental Disease Scheme set up by Tony Abbott has been that dentists abuse the system. But any public official can, potentially, abuse a system. That is why we have an audit process—to identify them and get them to pay the money back. That is how the law works. That is why we have an audit team in Medicare Australia. They should be allowed to do that job to get back any money falsely claimed. Dentists agree, the coalition agrees and the government agrees.

How disappointing it was today to hear the health minister—not a backbencher reading from notes carefully prepared by a staffer but the health minister—read out a list of all the violations committed by dentists under the chronic disease scheme. On average, only one out of every 1,500 cases led to a complaint which was investigated. Are you telling me that the character of dentists is not as good as that of doctors or nurses, that they are fundamentally different and more dishonest people, that they cannot be trusted with the dental health of Australians? That is patently ridiculous.

Medicare Australia's audit system should be respected and supported. Instead, this government chose—for political reasons—to let this wound fester, to let the program roll on, to not modify, correct or improve it. They did so simply because they wanted to be able to attack the opposition. Given every opportunity to tailor and refine that program, they passed them all up. There was every opportunity to save $330 million a year on this program by more appropriately targeting it as it became more popular. All of these opportunities were passed up just to make a political point.

I think it is worthwhile—because it is quite complex shifting from one chronic disease dental program to the government's alternative—to follow the path of some different patient types. I will talk about sick kids with a chronic disease, about well kids coming from families which are wealthy or which have a concession card, and then about adults—adults with a chronic disease and adults who do not. Up until 9 September, if you were a sick child with dental problems, you would be covered through a GP and a private dentist. Now the sickest children in Australia are being told, 'Complete your treatment by 30 November or pay for it out of your own pocket.' These are young people with complex conditions, often unable to reliably get to a dentist. They may be disabled or have mobility problems. They may be mental health patients with anxiety disorders. For every possible permutation of health condition, you cannot be sure that all the needed treatment can be completed within this very short time frame. But the government will not budge by one day. This is dental treatment which just has to be done—there are no two ways about it.

This idea that you could simply turn up at a state funded dental hospital is bunkum. It is bunkum because state dental hospitals are there to train dentists. If they can reduce waiting lists a bit, that is well and good. But in effect they are there as a service—to train the dental profession. This is a government which has not trained more dental therapists. Dental therapy graduates have fallen by six per cent under this government. I concede there are more hygienists, but it is oral health graduates, technicians and therapists we need—they can treat the majority of disease in the young. The government's decision to cut young, sick Australians off from the current chronic disease program simply shifts them across to state dental hospitals. But the only people who can get treated in a state dental hospital are people whose dental disease is literally dripping out of their mouth. The most urgent cases get pushed up the list to get treated at the dental hospitals. Everyone else simply sits on a waiting list and never gets to the top.

In South Australia, the waiting list is 18 months to two years. In Queensland, it is two to 3½ years. Realistically, no-one with dental disease and a hope of having it cured would sit for that long on a waiting list. It is not a waiting list; it as a list you simply sit on until you go and get it done privately or you pass away. The people who get treated in dental hospitals are primarily the urgent cases—where they have an abscess or something requiring immediate treatment. That is predominantly what gets done in these hospitals.

The government's proposition—that, as of next year, they will start investing in these hospitals—is inadequate. The $212 million per year which has been committed is, when spread around the eight jurisdictions, only a negligible increase in what is already being spent. The Northern Territory and the ACT spend the most per capita. Then we have Queensland and South Australia. The lowest spending per capita is in Victoria and New South Wales. Even with all of the investment which has been promised by this government—we know of course that it is unfunded and simply adding to the debt and that, even as we have this debate, they do not know where this money will come from—the money provided to Victoria and New South Wales does not even get those states to the current level of South Australian or Queensland spending per capita. So if people in New South Wales want to know how they will be treated under this government's program, they should try to get an appointment in Queensland or South Australia—a two-year wait. That is what you will have after the government's program is implemented.

If you live in Queensland and South Australia and this additional money is added, the per capita spend will still be less than it is in the Northern Territory or the ACT. So go out right now and make a phone call to Darwin and see how long it takes to get your chronic disease treated in Darwin's publicly funded system—over 12 months. We can use the states which already spend more to see exactly what the situation will be like, after you add the federal top-up, in the more poorly funded states. The problem with adding money to state dental services is that you never remove the waiting list—you can only ever hope to treat the most urgent cases on the waiting list.

The fundamental flaw in what this government is doing arises from their failure to understand how dentistry works in this country. The program for the young consumes $2.5 billion in treating children under the age of 18 through a cut-price dental program of up to $1,000; many of those children need far more. Try treating an Aboriginal child with a large hole who needs a stainless steel crown; you cannot even do that for a thousand dollars. The Child Dental Benefits Schedule proposed by this government explicitly excludes crowns, bridges and root canal work. We are getting this cut-price dental arrangement that actually does not serve the children who need it most. What is the point of having a universal dental scheme when you say to Aboriginal children with severe caries, 'Sorry, Julia Gillard bans a crown and a bridge—

Ms Anna Burke (Chisholm, Deputy-Speaker) Share this | Link to this | Hansard source

The member will refer to individuals by their appropriate title.

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

'The Prime Minister bans that personally, so all you can have is an extraction. We'll just pull the tooth, because that is all that this government's plan will allow us to do.'

As I have said before, the fundamental flaw is that, predominantly, teen dental disease can be managed by therapists; it can be managed by oral health graduates. Don't tie up the dental profession in public health. They are the most highly trained specialists in the area. They should be dealing with complex and chronic disease. This is a government that has not activated the oral health routes yet, and therapist numbers are falling. That $2.5 billion spend, which has a capped amount of $1,000, is at risk of overspends and rorts; our chronic disease program was rorted by a very, very small number of people. So, in effect, the government's protestations about the former program will be the same ones that will vex the new program. There are DVA dental officials and advisers who can verify which chronic disease patients need further care and which do not. The government has the opportunity to continue the care for the people who need it most but it is electing not to.

This is a simple situation where it has been decided that the political pain of this federal government to find a surplus will trump the dental pain of our nation. Those opposite are more worried about their political future than about the dental future of Australians. This government is insistent on injecting more money into public dental systems which are not overly efficient and, at the same time, it is hobbling the 95 per cent of private dentists in this country who hold the key to reducing waiting lists. By doing what it is doing today, you will see more people going to their GP and being refused dental care, more GPs giving out antibiotics and trying to buy time, and more expenses to Medicare. All of those half a million people will be turning up to public hospitals and emergency waiting rooms seeking antibiotics and quick solutions. That was the old way and that is what Labor are bringing us back to. They should swallow some pride, understand how the dental sector works, agree to continue the Chronic Disease Dental Program and look after Australians' dental care.

Michael McCormack (Riverina, National Party) Share this | Link to this | Hansard source

There is nothing worse than a toothache. I am sure the minister at the table, the member for Lindsay, and the member for Wakefield would agree with me. When you have got a toothache it just takes over your whole system: it pains, it aches; it is debilitating.

We have just heard the shadow parliamentary secretary for regional health services and Indigenous health give a very impassioned speech about why this disallowance motion is so important. He would know; he is a doctor. He has actually practised at Gundagai in my Riverina electorate. As his portfolio includes Indigenous health, he knows how important oral health is to people of a low socioeconomic status and to people in regional areas.

I support this motion for disallowance of the Health Insurance (Dental services) Amendment Determination 2012 (No. 1), made under the Health Insurance Act 1973, which has been brought to this parliament by the shadow minister for health, the member for Dickson. From the speakers list, government members would have noticed the number of members from this side of the House who were keen to speak on the Dental Benefits Amendment Bill 2012. That is because members on this side of the House are very in tune with their electorates and what they are saying, certainly when it comes to the provision of health.

The minister for health, and her predecessor, would know that I have been praiseworthy of the government for its investment in health in the Riverina. Indeed, there has been money for the Wagga Wagga Base Hospital: $55.1 million. There has been money for the private-public partnership at Griffith, to the tune of $11.388 million, as well as $6 million to the Hillston multipurpose service redevelopment. They were all good contributions. Mind you, it was money being spent by a federal government after years of inaction by the state Labor government.

Whenever anything goes wrong nowadays with the federal government, their default position is to blame the state coalition governments. The immediate option is to press the button to blame, in New South Wales, Barry O'Farrell; in Queensland, Campbell Newman; and in Victoria, Ted Baillieu is getting the blame for anything and everything. Mind you, those three premiers are doing their utmost to repair their states as a result of the huge debt and deficit left to them—the legacy of too many years of Labor governments to remember.

With this government, the ripping away of oral health services has been brought about because we have got $246 billion worth of national debt and now we find we have $120 billion of black holes in Labor's spending. Labor is allocating money which it knows it will never have to roll out; hopefully, after the next election, there will be a coalition government in place.

Luke Hartsuyker (Cowper, National Party, Deputy Manager of Opposition Business in the House) Share this | Link to this | Hansard source

Hear, hear!

Natasha Griggs (Solomon, Country Liberal Party) Share this | Link to this | Hansard source

Hear, hear!

Michael McCormack (Riverina, National Party) Share this | Link to this | Hansard source

I hear the member for Cowper and the member for Solomon say, 'Hear, hear!' because they know how important it is for rural and regional areas to get a coalition government in place. As I say, the federal Labor government is promising money almost cruelly, raising the expectations and hopes of people with a disability with the National Disability Insurance Scheme—money that the Productivity Commission says is a minuscule amount considering what is actually needed to properly fund such a scheme. And with the Gonski education overhaul, we see the minister for education promising all sorts of things, but the government is very low on funding delivery.

There is nothing worse than a toothache—we all know that; we have all had one. In America at the moment—and this is relevant to this particular disallowance motion before the House, because at the moment we have a presidential election in America—one of the biggest stories going around is about a fellow by the name of Kyle Willis, a 24-year-old father who died from a condition which started as a toothache. I downloaded a story from the web which is very relevant to this motion. It speaks of the fact that Mr Willis is dead because he did not have health insurance; he is dead because he could not afford a simple antibiotic to kill the infection in his mouth. Yet there are still people in America who think the health-care issue is something that President Barack Obama made up to steal money from hardworking Americans' pay cheques.

The difference between America and Australia in many ways is that we have safeguards in place. We have safety nets in place. We are so privileged, we are so lucky, to have systems in place to help those who most need it. We now have a very good disallowance motion, which I support, before the House. The bill before the House is going to strip away people's dental health services, and we cannot afford that.

Poor Mr Willis was unemployed and he could not afford a visit to the dentist. He could not pay to have a wisdom tooth removed, which in the United States costs $400, based on national averages for extraction costs, because he did not have insurance. He was just another American guy. One in four Americans under the age of 65 do not have dental insurance, and that includes people who have regular health insurance. That bothersome wisdom tooth went beyond dentistry when his lack of money kept him from getting it taken care of. He went to the emergency room but he did not have health insurance. That is an average American story, and we do not want that to be an average Australian story. We do not want to have cruel stories, disastrous stories, of people saying that their friends and relatives suffered so greatly because this mean-spirited government took away money in a vital dental services system.

This is not about preserving rorts. This is about oral health in this country, particularly in regional areas such as Cowper, Port Macquarie and New England. I certainly trust that the regional Independents, who say they care about regional people and the constituents they serve, will come in and support us on this disallowance motion, because it is important. The coalition supports investment in dental health. The government has announced the closure of the Medicare Chronic Disease Dental Scheme, effective 30 November, and the replacement schemes are not due to commence until 2014. To anyone out there needing this assistance—and I hope they are listening to the audio from parliament—and to the people in the gallery, I say: 'If you've got a toothache, get it fixed now because after 30 November you will have to pay for it out of your own pocket because of this mean-spirited—

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

Appalling!

Michael McCormack (Riverina, National Party) Share this | Link to this | Hansard source

It is appalling—'bill before the House.' We have a disallowance motion, which I support, and I know that Dr Andrew Laming beside me also supports it, as does the member for Cowper, the member for Solomon and the member for Gilmore behind me. They all support it because they know how important it is. The coalition is extremely concerned that many patients receiving treatment under the Medicare Chronic Disease Dental Scheme will be forced to forgo treatment during the gap period. The coalition will announce its dental health priorities prior to the next election, and they will be good policies. They will be policies which will provide a safety net for people most in need of good oral health.

On 29 August, the Minister for Health, with the Greens health spokesperson, announced an unfunded $4.1 billion dental program, which is not due to commence until 2014. There we have the rub again: Labor being dragged to the table, kicking and screaming, by the party to which they are beholden, the Greens. The government announced the closure of the Medicare Chronic Disease Dental Scheme, effective 30 November 2012, and no new patients were able to access services after 7 September. This means that the means-tested Family Tax Benefit Part A, or other specified government payment, entitlement for children aged two to 17 years—the young kids who obviously cannot afford it themselves, and many of their families cannot either; kids do not get a say, they just have to put up with a toothache—will not commence until January 2014. That is, 13 months after some children will lose access to the CDDS.

The proposal is to provide a $1,000 cap benefit over two years to eligible children. The government claims 3.4 million children will be eligible, but the unfunded cost is $2.7 billion. The proposal for adults will not commence until 1 July 2014—that is, 19 long months after the Medicare scheme closes. You would not want to get a toothache during that time. Funding will be provided to state governments for public dental services. Services will no longer be available for adults through private dentists under Medicare. The unfunded cost is $1.3 billion. That is a disgrace. Labor and the Greens are again co-opting, coercing and coordinating their activities to hurt the Australians who are most vulnerable, particularly in regional areas. As I said, you really would not want to get a toothache in that time.

As part of the Labor government's changes to its dental policy, its bill will seek to amend the legislation of the Medicare Teen Dental Plan. It was a plan established by Labor in 2008. The government announced that it plans to change the existing Medicare Teen Dental Plan to the Child Dental Benefits Schedule, commencing a long time away, in January 2014. Under the current legislation, a $163.05 voucher is provided for eligible teenagers to receive an annual preventative dental check. We all know—Dr Laming beside me knows—how important it is to have preventative medicine and how important it is for kids to be able to go and get a check-up to make sure that their teeth and their oral health is good. The proposed legislation will change the age of eligibility to cover children from the age of two years old to less than 18 years old from the current bracket of 12 years old to 18 years old. The coalition supports investment in dental health because we know how important it is. If you have your oral health right, it makes such a difference to your overall health.

The government has not released a schedule of services fees and details on how the scheme will be funded and, despite the commencement date being more than 12 months away, is trying to push this through the parliament without these details which would allow the new scheme to be fully scrutinised. Haven't we heard that before? We heard it in the electronic health records debate earlier this year. We heard it on the Murray-Darling Basin Plan. We have heard it in so many other areas. But it is just a cover because this government is in serious financial strife. It is just a cover because this government is in serious leadership strife.

Here is a government which is doing everything it can to cut areas which are of vital importance to the nation. It has underfunded our boat people security measures. It has stripped $5.5 billion from our Defence budget. That is a disgrace. It has pushed our Defence spending as a proportion of gross domestic product to—wait for it—1938 levels. Here we have a government which says that it is prioritising Defence and yet we have a Defence budget which is at its lowest level since 1938. And everybody knows what happened in 1939.

Back to the dental legislation, the schedule of items to be covered under the cap of $1,000 over two calendar years will be made by future changes to the Dental Benefits Rules, and the government claims 3.4 million children will be eligible under this proposal. That is fine. However, for those kids and adults who are going to have to wait—in the adults' case, 19 months—it is far too long a gap period, particularly if they have a toothache. The Minister for Health has acknowledged that most services for children will cost less than the proposed $1,000 cap. However, there will be children on the Medicare Chronic Disease Dental Scheme who will require more services and there is no provision to ensure they will continue to receive adequate treatment, especially prior to the commencement date.

This disallowance motion needs support. It needs the support of the House. It certainly needs the support of the regional Independents, who say they care about regional people and say they stick up for their electorates. Here is the test. Come into this House and support the shadow health minister's disallowance motion because, as I say, oral health is so important to the people of this nation and particularly those in regional areas.

Natasha Griggs (Solomon, Country Liberal Party) Share this | Link to this | Hansard source

I rise today to speak on the Health Insurance (Dental services) Amendment Determination 2012 (No. 1). Like the other members of the coalition, I am a strong supporter of investment into dental health and I support this disallowance motion that is before the chair.

While I am always an avid advocate of investment into dental health, I am very concerned about the Labor government's decision to close the Medicare Chronic Disease Dental Scheme as of 30 November this year. Why is it that this Labor government is closing down this highly successful scheme? It appears to me that perhaps it is playing politics with the dental health of Australians. Could it be because it was the then health minister and now Leader of the Opposition, Tony Abbott, who introduced the scheme that provided Medicare funded dental support to Australians?

Since its introduction in 2007, we have seen over $1.7 million in benefits spent in the Northern Territory, breaking down to over 15,000 services provided. That is a lot of services and it is a lot of money that Territorians have had invested in them, and I am very concerned that that is going to be taken away from them.

Across Australia, over one million Australians have benefited from the scheme—60,000 of these being children. I am very proud to be a part of that legacy. For me, this shows that this is a program that is working, and it is highly disappointing that it appears that this government has decided to take away the Medicare dental help for Australians purely because it was an initiative of the then health minister, Tony Abbott. I could understand if the scheme had not been a success, but it has been. Over one million Australians have benefited from this scheme. Now, under Labor's six-year proposal, the predicted number of services is equivalent to 20 per cent of what the health minister's Chronic Disease Dental Scheme provided in the last year alone. It is really quite distressing that Labor and the Greens are stopping the only dental scheme available to adults across the country just so they can shut down this program that was introduced, as I said, by the now Leader of the Opposition.

The dental health of those in my electorate and across the country should not be used to the Labor government's political advantage. As of 7 September, the new services provided under the Chronic Disease Dental Scheme have been stopped. From 30 November, the scheme will be closed altogether. The new scheme will not be introduced until 2014, which is after the next federal election. Can we trust this government to keep a promise after it has broken so many? It was this government that said at the last election that there would be no carbon tax under their government. But here we are in 2012 and we have a carbon tax under a Labor government.

I ask this Labor government to explain to Territorians why they will have a window of 19 months where there will be no Medicare dental scheme to provide dental treatment for adults in the Northern Territory. Not only does this bill not commence until 2014; it has not been funded. The government has announced a $4.1 billion scheme with no plans as to how it is going to pay for it. Quite frankly, this is not good enough. The people of the Territory and across Australia deserve better. This program has been demonstrated to have worked and it is really, really important for electorates like mine and that of the member for Riverina, who spoke earlier. Regional Australia needs programs like this.

I ask again: how can we trust this government to fund its program? Where will it get the money from? I call on the government to explain to the people of the Territory the $120 billion black hole. This Labor government has not delivered for the people of the Territory. How can we believe that it will fund this scheme? Territorians have lost their faith in Labor, and that is why after the last Territory election we now have a Country Liberal government. People know they can trust a conservative government. Life is always better under a conservative government.

Between these schemes, education reforms, additional aged care funding and border protection cost blow-outs, where is this Labor government going to get the money to fund this new scheme? The Australian people are not an endless credit card that this government can keep spending against. They do deserve better. It is only further proof for the Australian people that this Labor government has lost its way and is heading for a huge budget blow-out.

I am proud to stand here today, standing up for chronic disease sufferers. I am ashamed that this Labor government and the Greens are taking away access to dental treatment that is urgently needed. The people of Australia and throughout my electorate will be worse off, as they always are under a Labor government. Labor has stripped many Australians of dental health treatment. These people will simply not be able to afford dental care anymore. Labor should be hanging their heads in shame. As the member for Riverina said a few minutes ago, anyone who has a toothache had better go and get it fixed now, before the government shuts down this program altogether, leaving them waiting for another 19 months before they can get anything done, and that is if the program is actually implemented.

I am sickened by the thought that the government and the Greens will now force children to wait 13 months until they can once again receive dental care. We know that preventative care is so important, but here we are having a system shut down, taking away the opportunity to have preventative care. The Labor government has claimed that 3.4 million children ranging from two to 18 years will be eligible for $1,000 worth of services, capped over two years, under the new scheme. Under the current scheme adults and children receive $4,250 over two years. While the scheme is capped at $4,250, according to the department the average claim for the scheme has been around $1,700, although recent estimates suggest that the figure may have fallen as low as $1,200 per patient.

As a mother myself, I find it offensive to see children suffering. As I said, it is important to have preventative care. I think that by closing down this program you are taking away that opportunity. We know that Labor has lied to parents. Those opposite have promised dental services to—

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

Madam Deputy Speaker, on a point of order: I find that term offensive and I would ask that the member withdraw it.

Deborah O'Neill (Robertson, Australian Labor Party) Share this | Link to this | Hansard source

It would assist the House if the member would withdraw.

Natasha Griggs (Solomon, Country Liberal Party) Share this | Link to this | Hansard source

I withdraw. Those opposite have misled parents. Those opposite have promised dental services to 3.4 million children, but this is to be paid by $2.7 billion worth of unfunded promises. As I said earlier, the Labor government has a $120 billion black hole and it is getting bigger.

Under this new scheme adults will be forced to suffer from untreated dental problems for an additional six months. My constituents are going to have to wait 19 months for a Medicare dental scheme. This is again to be paid for by an unfunded $1.3 billion program to be given to the state and territory governments to be spent through public dental services. No longer will adults be able to obtain dental services through private providers. The Labor government just does not understand. There are over 650,000 Australians on the public dental waiting list. It cannot handle this bad Labor policy.

Earlier in the week Minister Plibersek claimed that the new scheme would crack down on millionaires who benefit from the current Chronic Disease Dental Scheme. I am here to inform the minister that the National Advisory Council on Dental Health has reported that 80 per cent—yes, 80 per cent—of all services provided under the Chronic Disease Dental Scheme have gone to those on concession cards, so hardly millionaires. It just goes to show how out of touch and ill thought out the minister's scheme is.

While Medicare is a universal scheme funded by all Australians through the Medicare levy, it is evident that the dental schemes have mostly been embraced by those on low incomes. These people on low incomes already struggle with huge cost-of-living pressures through the government's waste and mismanagement, its overspending and of course its carbon tax. Now they will have to forgo treatment or go onto the already exhaustive public dental waiting list. As I have already mentioned, with over 650,000 other Australians, it is a huge waiting list. I understand that currently in Darwin people on the public dental waiting list are generally waiting around 13 months for just a basic check-up—13 months.

The Labor government should be held accountable for their actions. The scrapping of the successful Chronic Disease Dental Scheme is going to put even further pressure on the public dental waiting list. I ask that the Labor government and the Greens to explain to the people of my electorate of Solomon why they will be forced to wait even longer now for dental care. Those currently on the Chronic Disease Dental Scheme will be forced onto public dental waiting lists. I ask again: what are the real motives of this Labor government?

I am saddened to say that this reminds me of what I spoke about in the House earlier this week, how the Rudd and Gillard Labor governments had played politics with the lives of dementia patients and their families. They are doing exactly the same now with the dental health of thousands of Territorians and thousands of Australians. I understand this government has had many failures, like the Gillard government's Building the Education Revolution scheme and revoking highly successful policies like our border protection policies, but this has gone too far.

This government, these people opposite, are now playing with the health of the people of my electorate and, as I said, people all across Australia. Playing politics with the dental health of Australians, forcing Territorians to suffer for almost two years while they wait for this bill to commence, is reaching a new low, even for this government. This is only further proof that the government have completely lost their way. Not only are they unfairly forcing Australians to wait 19 months for Medicare funded dental treatment; there is no assurance that at that time there will be adequate infrastructure or an adequate workforce to support the dental treatment Territorians and other Australians need.

Why is the Labor government shutting down a successful scheme that provides real dental assistance to Australians and replacing it with an unfunded and inadequately supported program? The government does have a lot to answer for. The lack of support Labor will provide to this scheme is another clear example of how completely out of touch they are with Territorians and the wider community. They have made another promise of money, $225 million, to develop infrastructure to support this unfunded scheme. Where is this money coming from?

I support the disallowance motion and I think that the government has done the wrong thing. We are calling on the Independents who represent regional areas to support this disallowance motion to make sure regional Australia has the appropriate dental services and to continue with a program that has proven to work.

Warren Entsch (Leichhardt, Liberal Party) Share this | Link to this | Hansard source

I welcome this opportunity to speak today on this motion for disallowance on the Health Insurance (Dental Services) Amendment Determination 2012 (No. 1). While I am sure I am not alone in dreading a trip to the dentist, I am fully aware of the importance of good oral health. Being a neglecter of my teeth in my younger years, I have certainly learned to live to regret it.

You realise that good oral care not only means a person can eat, speak and socialise without pain or embarrassment but also contributes to their general wellbeing. At the other end of the scale, poor oral health not only results in infections, tooth loss, minor and major surgery but also contributes to cardiovascular diseases, diabetes, strokes and low birth weight.

It seriously concerns me that this government is proposing to shut down what has been a very effective program, the Chronic Disease Dental Scheme. It has been incredibly successful up in my region. They are closing down the scheme, known as the CDDS, on 30 November this year. The cut-off date for any new services was 7 September, which, as we all know, has already passed.

The government claims that an additional 3.4 million children will become eligible for subsidised dental care under their proposed bill, and I certainly welcome any investment in dental health for young people. But there is very serious need for these services not only in our metropolitan areas but further out, in our regional areas and our Indigenous and remote communities—where there is an absolutely chronic need for these services. In Leichhardt, a high number of my constituents live in regional and very remote areas, where there are a range of barriers to achieving good dental health.

First of all, in regional areas it is very difficult to access regular dental treatment. There are fewer dental professionals in those areas, resulting in delays in receiving treatment and much higher consultation fees. Of course, if you do not drive and there is no public transport—as there is not in the overwhelming majority of my region—logistically it is very difficult to get to a clinic. Also, living far away from metropolitan centres, people find it difficult—and this is a real issue in remote communities—to find affordable fresh fruit and vegetables, and other healthy food options.

Transport costs boost prices by up to 30 per cent, and the length of time it takes to get the food to the stores means its quality is often be compromised. This means it is much easier and cheaper to buy processed and sugary foods. Many remote communities do not have access to fluoridated water. I know it is controversial, but it is a cost-effective way to reduce the rate of cavities in whole communities. Lastly, information about good oral health is harder to access. It is not just about the importance of brushing your teeth regularly but also about knowing which foods are bad for your teeth, and why it is so important to have regular check-ups and catch problems early. Many people of Aboriginal or Torres Strait Islander heritage live in my electorate. While they are subject to exactly the same barriers, they also have additional issues that they have to contend with. For a start, they may avoid going in to the dentist, because often dentists' clinics are not culturally sensitive, particularly when there is strict emphasis on appointment times and fees can be charged if people do not turn up. For people travelling down from remote communities, it really is a whole new experience, and sometimes very challenging. In addition, Indigenous Australians are more likely to smoke, have diabetes and sit lower on the socioeconomic scale, all of which contribute to them having much poorer oral health than other Australians.

Some of the statistics are quite sobering: 51 per cent of Indigenous children under the age of five have been hospitalised for dental treatment, compared with 34 per cent of non-Indigenous children; Indigenous people aged between 17 and 20 are 8.2 times more likely to have decayed teeth; and 49 per cent of Indigenous adults between the age of 35 and 54 avoid certain foods because of their oral health problems, compared with 17 per cent of other Australians.

It does not matter what your background is; delays in getting treatment mean that the condition worsens, and at the end of the day that means major surgery. Figures for 2009 show that in the Cairns and Hinterland health district, dental conditions were second only to diabetes complications as the most common cause of potentially avoidable hospitalisations. With a rate of 353 hospitalisations per 100,000 people, the Cairns and Hinterland rate is significantly higher than the wider Queensland rate of 267 incidents per 100,000 people.

This leads on to a number of concerns I have in relation to how the new proposal that has been put up by the government is going to be funded and implemented. For a start, age is no barrier to dental health issues. Good oral health for young people is vital, but it is no less important that people of all ages have access to effective dental care. The Chronic Disease Dental Scheme in its current form was established by the coalition in 2007. It allowed eligible patients of all ages with chronic health conditions to receive up to $4,250 in Medicare benefits over two years, and it was very successful. Despite that, we are well aware of Labor's attempt to shut down this scheme, and I am very glad that up until now they have failed, because the last thing anyone with an ongoing serious health condition needs is additional pressure on their finances. As I mentioned earlier, Labor's 29 August announcement outlined the closure of the Chronic Disease Dental Scheme, effective as of 30 November this year. Unfortunately, given that the new child dental scheme does not commence until 1 January 2014, this means that there will be a gap of some 13 months in treating the young people. It is certainly not rocket science to work out the impact this will have on families who struggle to afford dental treatment for their children. I fear for those children who may remain untreated and what impact that will have on their overall health.

In addition, Labor's proposal for adults will not commence until 1 July 2014, which is 19 months after the Medicare scheme closes. Until then, more than one million patients who have been eligible for the Chronic Disease Dental Scheme will lose access to timely dental treatment. Quite frankly, that is just not good enough.

Today I received an email from a lady in my electorate, who really puts a human face on this crisis. Lyn Blyth lives in Palm Cove. She is in her late fifties. I will read her email verbatim:

At age 58 in 2010 I was diagnosed with breast cancer. On advice pre chemotherapy I had a full dental health check up as the teeth could particularly be affected by the type of extremely toxic chemotherapy I required. My teeth and gums passed with flying colours and during the six rounds of chemotherapy I was ever vigilant with dental hygiene as well as rinsing my mouth at least six times a day with salt water.

However at the end of the sixth round and the day before I was to travel to Townsville to live for six weeks daily radiotherapy I developed a painful problem with a tooth. Unable to resolve the problem with my dentist I was referred to one specialist in Townsville and then to another. I endured much pain and many expensive treatments at nearly $1000 dollars each while having radiotherapy each day before another cancer patient told me about the dental scheme. I contacted my GP who authorised my Enhanced Primary Care form to help with these crippling costs.

I am still not finished my treatment for this exact problem due to slow healing times due to chemotherapy drugs. I would not have been able to have a reasonable outcome if not for the dental scheme and would not have undertaken the treatment which hopefully is almost at an end. Many patients could be in this situation and I think there should at least be a reasonable phase out time for people in this situation. I have just lost another tooth due to this ongoing problem and will lose more if it is not resolved satisfactorily compromising my nutritional intake and overall health.

Please ensure you give voice to my and other patients' legitimate concerns to government during your time in Canberra representing your constituents!

Yours faithfully, Lynette Blyth

Unfortunately, there are a lot of Lyn Blyths out there in the community. I think Lyn's voice should be heard in this place when we are giving consideration to the changes that are being promoted by this government. With regard to the adult scheme, Labor plans to give funding to the states and territories for public dental services. Commonwealth funded services will no longer be available for adults through private dentists under Medicare. There are a number of shortcomings with this plan. Firstly, cost-of-living pressures are already hitting residents of my electorate hard. The last thing they need is additional financial and personal stress in the form of not being able to afford to take themselves or their children to the dentist.

Secondly, around the country there are already some 650,000 people on public dental waiting lists. Labor has not provided any indication that the public system can actually provide for these extra patients. Waiting lists often make newspaper headlines, and Far North Queensland is no different. As an example of the desperate need in my electorate, I refer to an article in the Cairns Post of 17 February this year. The article is about the opening of a new $25 million student dental clinic at James Cook University. This facility, the only one of its kind in Australia, opened with a waiting list of more than 2,000 people. The 112 people who were lucky enough to score an appointment on the opening day for discounted treatment had waited four months for the privilege. One Clifton Beach resident, a mother of three, said she would not be able to afford dental care for her family if she did not have a Queensland health card that makes her children eligible for free examinations and treatment at the clinic.

I have to say, with a great deal of pride, that myself and a former colleague, the member for Herbert Peter Lindsay, and Senator Macdonald from the other place, were instrumental in getting the funding to establish this state-of-the-art facility, and it has certainly made a hell of a difference to the oral health of people living within our region. But that in itself does not solve the problem, which is the critical need to continue to maintain the Chronic Disease Dental Scheme. It allows people to receive up to $4,250 over two years towards treatment, and I think that is very important.

The other concern I have here is in relation to how the government are going to pay for all of these changes they are making. They are closing down this very successful Chronic Disease Dental Scheme. Under the new one they will have, they say the proposed dental entitlement for children is going to cost $2.7 billion; for adults, another $1.3 billion; and the third entitlement, or Flexible Grants Program for Dental Infrastructure, is another $225 million. That is $4.225 billion dollars, totally unfunded. If you add that to the $120-odd billion that is out there for a whole range of other promises—only the other day $1.4 billion was announced for private childcare workers, and there is the $6.5 billion for the Gonski review—none are funded, I think it is even crazy to suggest that we continue to run up this bill when we have a perfectly functional scheme. If we shut it down today, there are going to be a lot of people, like Mrs Lyn Blyth and others, who are going to suffer very badly from the closure of this scheme.

For those reasons, I very strongly support this disallowance motion and I hope that we can get the support in this place to make sure that the Chronic Disease Dental Scheme remains in place. (Time expired)

Joanna Gash (Gilmore, Liberal Party) Share this | Link to this | Hansard source

I rise to speak for the disallowance motion. The reason I do so is that I vividly remember why I welcomed an earlier bill, introduced some years ago by the former coalition government. In speaking for the disallowance motion, let me relate a story.

Some years ago, prior to the introduction of the Medicare Chronic Diseases Dental Scheme by the former coalition government, which the government now wants to terminate, I well remember talking to a constituent of mine from Kings Point, just outside Ulladulla. He was middle-aged and in great pain—physically, emotionally and mentally. He had no teeth, he could not eat properly, he was unemployed and he had lost his girlfriend. He effectively had no life, and readily admitted he was feeling suicidal. He grunted at me that he hated politicians, because they did nothing for him. I explained to him that the public dental services were provided by the states and that I had very limited influence over a state Labor government. He knew the waiting lists were horrendous and, even then, after a prolonged wait of many years, the treatment was rudimentary.

In rural and regional areas like Gilmore the situation was even worse, so I really felt for him and was concerned that he was entertaining the thought of suicide to end his torment. Anyway, I made a few phone calls, wrote a few letters and bent a few arms. I had no idea what may have transpired, or whether my efforts were effective, until about nine months later, when he came back and saw me at one of my village visits. He asked, 'Do you remember me? I honestly could not. I did not recognise him. His face was beaming, his cheeks had colour and there was certainly a spring in his step. He opened his mouth and showed me his teeth. He explained that, since he had had his teeth done, under our Medicare Chronic Disease Dental Scheme, he had gotten a job, now had another girlfriend and was basically enjoying life. Fundamentally, he had been given back the will to live. If nothing else, it is that man alone who showed me the importance and value of having a comprehensive public dental health scheme. And, I might add, it is one achievement I will never forget.

Yet here we are, taking away the scheme that was a lifeline to people in my electorate, an electorate with an above-average demographic of disadvantaged persons. The absence of things that many take for granted every day can have severe implications. The man I met on that day encapsulated the depths of despair many people faced each and every day. In a country as wealthy and privileged as Australia, it just should not be allowed to happen—and that is why I welcomed the introduction of the Coalition's Medicare Chronic Disease Dental Scheme, which this government now wants to close down. And that is why I am supporting this disallowance motion.

But not only will it be closed down in just a couple of months; there is nothing in the wings to replace it—except a concept for 2014, well after the next election. Who can say that this goal will not be pushed further and further back, beyond 2014, if this government cannot balance its books? And it is just a goal, a statement of intent, not backed up with anything and certainly without any guarantees, nor any details as to how it would work.

So what are people going to do in the meantime? Are we going to go back in time with many more cases like the man from Kings Point, thinking life was no longer worth living because he just could not stand the pain and isolation? If I said this government wants to put into place an inferior and cheap substitute, a superficial dental scheme, I would not be entirely correct in my description—because it pre-supposes that Labor will stick to their promise, and we all know their track record on promises. No, this is all about cutting costs and, because the coalition's scheme was so successful, the demand and therefore for costs of the scheme have gone up. In fact, on radio just this morning the minister herself admitted as much, so its not about delivering a better product to the public, it is all about cutting costs. She also said that some dentists were rorting the system, but she failed to say the extent to which it justified the thrusting of 600,000 people into dental health limbo. Many of those will come from rural and regional areas, like Gilmore. I wonder whether the alleged rorting by dentists is as extensive as Labor's pink batts fiasco or their school building rorts, which cost the Australian taxpayer billions of dollars.

The reality is that Labor does not care about people in my electorate like my Kings Point man. They will cut costs to save themselves and put in a scheme that is just a tarted up smoke screen, hoping people are gullible enough to swallow their spin. It will only be a matter of time before the chorus of voices demanding urgent dental treatment will grow in pitch. What will Labor do then, assuming they are still around?

Their program will not start until 19 months after this scheme has closed down—maybe, and that is a big maybe. It is proposed that funding will be provided to state governments for public dental services. Commonwealth funded services will no longer be available for adults through Medicare. Those people are going to have to find money to pay for urgent dental treatment out of their own pockets. And how many will be able to do that? There are still 600,000 people on the public dental waiting lists, while many thousands have already been treated under our former scheme. How many of those will have their lives shortened as a result of this government's policy? Labor has not provided any assessment or guarantees that the public dental workforce is even able to meet the demand. They just do not know and clearly they do not care, so desperate are they to cut costs. The means tested Family Tax Benefit Part A, or other specified government payments, entitlement for children aged two to 17 years will not commence until January 2014, 13 months after some children will lose access to the Chronic Disease Dental Scheme.

The proposal is to provide a $1,000 capped benefit over two years to eligible children. The government claims that 3.4 million children will be eligible. The minister has acknowledged that services for most children will cost less than the proposed $1,000 cap. But there will be children on the Medicare Chronic Disease Dental Scheme who will require more services, and there is no provision to ensure they continue to receive adequate treatment, especially in the period before the bill commences. That is another reason I support this disallowance motion.

Available data suggests that well over 60,000 services have been provided to children under the Chronic Disease Dental Scheme. The closure of the scheme on 30 November will leave a 13-month gap for many children currently receiving treatment. There are children in the midst of treatment who will not be able to have their treatment completed by November 30. Those families will have nowhere to turn. That is why this disallowance motion is important. The minister and the Greens should explain why these children must suffer for 13 months with incomplete treatment and no certainty of the schedule of services that are to be provided, assuming the government actually delivers on its unfunded promise, in 2014.

We support investment in dental health. We know that the 600,000 people on the public waiting list deserve better. There has to be a better way. Again, that is why this disallowance motion must succeed. We have legitimate concerns about those who will lose access to treatment on 30 November with the closure of the Chronic Disease Dental Scheme. We do not know what will happen to those who are unfortunate enough to be caught up in this period and are not able to complete current treatment by the final date. Nor do we know how the unfunded $2.7 billion cost of the measure will be met. Details are also missing from the schedule of services and fees, and other essential details, that this government wants to rush through the parliament. These are all vital and legitimate questions that the government has refused or failed to provide answers to.

We want to see this motion passed and I ask the Independents to support ongoing treatment for residents of my electorate of Gilmore. We are really concerned about the many patients who will be thrown on the waiting list scrap heap and held at the mercy of this government, a government with a well deserved reputation for waste, inefficiency and broken promises.

We also will move to disallow the closure of our Chronic Disease Dental Scheme in order to protect those in need. We are happy to work with the government for a productive outcome by refining what has proven to be a very successful and popular scheme. We want to review the process for providing certain high-cost items such as bridges and crowns. We understand that. But if the government thinks that the $50 billion spent on their NBN scheme is worthwhile, what does cutting back on dental spending say? It says that the government does not think there are any votes in improving the quality of life for our pensioners or senior citizens. Maybe they think the distraction of the NBN will do that.

I have been down this road before, and it looks like it is unfolding as a case of back to the future. The sad thing is that there is every likelihood that the authors of this plan may not be around to take the blame. Then the process will have to start all over again.

I urge all in the House to support the disallowance motion. I certainly do not want to see once again stories in my local newspaper showing photos of people using superglue to put their teeth back in place, because they could not afford the dental scheme, or pulling out their own teeth. This is Australia. This is not a Third World country. Having meals through straws is absolutely incomprehensible. It is difficult to justify no service for dental when this government has so many failed projects and can afford to waste so many millions of dollars.

Dennis Jensen (Tangney, Liberal Party) Share this | Link to this | Hansard source

I rise to speak on this motion of disallowance. Perhaps I have softened, because I wish to quote a famed Communist back to Labor, but this is the first rule of effective communications: relate. It was Nikita Khrushchev who said:

Politicians are the same all over. They promise to build a bridge even where there is no river.

And so it is with the dental benefits amendments bill to which we have moved this disallowance motion.

The facts, as stubborn as they are, are that under the current scheme, the coalition's scheme, 20 million services have provided cover to over one million patients since 2007. And 80 per cent of services under the Chronic Disease Dental Scheme have been provided to concession card holders. The people of my electorate are indignant that Labor is playing politics with their health. The reality is that Labor has gone to great lengths to undermine the CDDS because it was established by Tony Abbott as Minister for Health and Ageing and has been a success in improving access to treatment. The alternative Prime Minister is a man tackling our roughest challenges with fidelity and diligence. Tony Abbott is a man who does not play politics with people's lives or their children's lives. He is a firm and considered servant who does not make empty promises.

Kelvin Thomson (Wills, Australian Labor Party) Share this | Link to this | Hansard source

Order! The debate is interrupted in accordance with standing order 43. The debate may be resumed at a later hour, and the member for Tangney will have leave to continue when the debate is resumed.