Adam Bandt (Melbourne, Australian Greens) Share this | Link to this | Hansard source

After the last election, of which everyone knows the result, the voters of Melbourne put me in the fortunate position of being able to sit down with the now Prime Minister to negotiate the formation of government. On behalf of the people of Melbourne I said that we would support the Labor government on a number of conditions.

We have stood by this government and provided our rock solid and stable support. I am very happy that we are now seeing one of these conditions being met by the introduction of the Dental Benefits Amendment Bill 2012. We said when we sat down and negotiated the formation of government that we wanted to see action on climate change, we wanted to see the study into high-speed rail completed and we wanted significant reform in the area of dental health. As a result of that agreement struck back in 2010, we now have the Dental Benefits Amendment Bill 2012. I am very happy indeed to rise to speak in support of it.

This bill is a big step forward for Australian health care. It heralds a massive investment in the dental health of Australia's children. That is a smart investment and it will be handsomely rewarded in the future. It is also an achievement that the Australian Greens are proud of. By working with the government on this dental reform package, we have delivered for Australians. We have demonstrated what can be achieved by a minority government when different sides of politics work together. It is not a moment too soon that we in this chamber have turned our attention to dental health. Australians are lucky to have an excellent health system. It is a system that, with few exceptions, is there for us when we need it. We have a universal system. Anybody can access it, whether or not they have insurance and whether they are rich or poor. There is room for improvement in our health system, but we can say that no Australian who is sick needs to suffer alone or fear the financial consequences. That is surely something to be proud of.

That is all true unless you are suffering from a certain type of medical problem. If you have a broken toe or damaged spleen, we will look after you. But if the problem is in your mouth you are out of luck. When it comes to teeth, getting help can be out of the reach of many people. This has terrible consequence for the health of the nation. That dental care was left out of Medicare is a historical accident. Today, the vast majority of dentists work in private practice. Spending on dental health mostly comes straight from the hip pocket, either directly or through health insurance. Dentists set up shop where people can afford to see them—generally in big cities and in more affluent areas. Dental care is expensive. That comes as no surprise to any Australian.

That means that for certain segments of the population, going to the dentist is a luxury that they cannot afford. Unfortunately, when you do not get the health treatment that you need your health gets worse. Simple dental decay can become an infected abscess. A cheap filling can become a hospitalisation. Life can become a misery for some people. Because so many struggle to find the money to get to the dentist, dental visiting patterns in Australia are poor. About a third of people do not go as much as they need to for good oral health. About the same number report delaying visits or delaying the treatment that they need due to cost. The data shows that this trend is worsening over time.

If you do not go to the dentist regularly, you lose teeth. You are four times as likely to end up with an extraction as somebody who goes as often as they should. You have four times the decay. You end up with fewer working teeth in your mouth. And unfortunately income is an excellent predictor of oral health: the lower your income bracket, the worse your indicators are. As someone who represents the electorate that of all electorates in the country has the largest number of public housing dwellings, I speak from firsthand knowledge when I say that it is incredibly important for the people of Melbourne that this reform is made. I know that the number of decayed, missing or filled teeth doubles as you go from the highest income bracket to the lowest.

If you are Indigenous, the situation is worse. Indigenous Australians in their late teens have eight times the decay and 11 times the incidence of periodontal disease than those in their late teens in the non-Indigenous population. Older Australians also suffer. One in five people in aged care are suffering pain or discomfort due to dental issues at any time. In regional and rural Australia, services are even more difficult to access, so country Australians fare worse than those of us who live in big cities. All of this adds up to massive inequity.

And the problem is only getting worse. The oral health of our kids was once among the best in the OECD. But it has been steadily slipping. It is high time to act to address this growing health crisis. I am pleased to be speaking to a bill that begins to do precisely that.

The Australian Greens have been campaigning for dental healthcare reform for a long time. Nothing is more important than the nation's health. We recognise this and have made getting dental care into Medicare one of our top priorities for reform. Our vision is for comprehensive dental health care that is universally accessible. We have not been shy about saying that. It is a vision that we continue to strive for and one that Australians share. People know that getting access to adequate dental care can be a challenge. I have spoken to many constituents and others around Australia about it. When you point out that it does not have to be this way—that the country could afford to bring dental care into Medicare—you have an instant policy convert. Why can't it be covered? There is no good answer.

When the Greens signed the agreement with the Labor Party to form government, we made dental health a part of that understanding. We know that reform will be an incremental process, but it has to start somewhere and it started with the Greens. We have consistently defended the role of Medicare. We know that a single-payer model is the most efficient. Australia must avoid going down the road of treating public health care as a safety net, only available for those who cannot afford top quality health care. We do not want a two-tier US-style health system here. It is less efficient and it is less equitable. We should not only not chip away at Medicare but we should expand it. Dental health is the obvious omission.

To advance this cause, we worked with the government to get the National Advisory Council on Dental Health established. They were an independent panel of dental experts tasked with assessing the reform options for Australia. The options that they came up with are consistent with a long-term universal access scheme. This is a goal that many in the health sector share. But this is not just a health issue. It is as much an issue of social justice as a health issue. The pain of poor dental health affects the poor. It affects migrants and those of diverse backgrounds. It affects Indigenous people worst of all. In a practical sense, it can affect your chances of finding meaningful work able to sustain you and your family. If you front up for a job interview with your teeth missing, you are less likely to get that job.

These statistics translate into real consequences for people, such as constant pain, loss of sleep, malnutrition and sometimes even a life-threatening infection. Sometimes the consequence is social exclusions. As I said, getting a job or even getting a rental property is all the more difficult if your health is bad, let alone if you have missing teeth. Imagine being too afraid to smile lest somebody see the gaps and judges you for them. The Greens care for people. Dental health reform is for the people who are falling through the cracks and suffering as a result.

I am pleased to say that we are making progress. By making dental health a priority, we saw over half-a-billion dollars in the last budget put into dental health initiatives as a down-payment on a bigger reform. Now, by working with the government, we have achieved the next phase of reform. In August, a $4 billion dental reform package was announced. This includes $1.3 billion in new money for the nation's public dental services so that they can hire more dentists, build new infrastructure and stay open longer. We also achieved $225 million for grants so that nobody will miss out. Rural and remote communities and other areas that are missing out will be able to access this money to ensure that every Australian has access to services when they need them.

But the biggest reform of all is a new Medicare entitlement for kids, with $2.7 billion to be spent over four years to give all kids in families receiving family tax benefit A access to essential preventative and restorative dental care. That is 3.4 million kids who will be able to go to the dentist of their choice, hand over their Medicare card and get seen. This is the biggest dental reform in Australia's history. It is a big injection of funds and it means millions of Australians will get better care sooner. It is also a better investment. By investing in the dental health of our children, we ensure that there will be a generation of adults who have better dental health than many of us could boast today.

This bill implements the first stage of this reform. It alters the Dental Benefits Act to enable all children in family tax benefit A families to access a schedule of services that will enable them to get good dental care. This entitlement can be used in public or private clinics. You can take the kids to the dentist that you prefer, from the family dentist to the dentist in the school dental van. The entitlement will be for $1,000 in services every two years.

Unfortunately, part of this reform involves the closure of the Chronic Disease Dental Scheme. This scheme had many inefficiencies. It was also inequitable, as it was not means-tested. Some people could get thousands of dollars in treatment while others who did not qualify under the uncertain definition of 'chronic disease' could get nothing. Still, it was publicly funded dental care and we do not deny that many people got treatment. That is why the Greens kept it open for an extra four years while we negotiated something for the future. It is regrettable that some people will lose an entitlement, but as part of this package we have ensured that the public system will have as many extra resources as possible so that those in dire need will have somewhere to go. In the end, the new reform will lead to greater equity. More people will get the services that they need to stay healthy.

The Greens believe that everybody deserves access to the best in dental care. Nobody should miss out. We will continue to build on this reform until we have achieved that vision and nobody is excluded. This bill is consistent with that goal. By establishing the Child Dental Benefits Schedule we have taken a big step towards universal dental care, giving 3.4 million young Australians access to Medicare funded dental care. But it is only a first step. One day, going to the dentist will be like going to the doctor. We are a rich nation and we can afford to do it. We should strive to lead the world in health care. There can be no better way to spend the dividends of our prosperity than on better health care. There can be no more equitable way to spend than to share that care with those who presently cannot afford it.

Yes, we are not there yet. If we had our way, the Greens would get us there much faster. This bill and this reform involved many compromises. But they serve as an excellent example of what a minority government can do when people from different sides of politics get together to work in good faith. I congratulate the government on this reform and I am proud of the role that the Greens and the people of Melbourne have played in it. It will make a difference in the lives of many people, and not a moment too soon. I commend the bill to the House.

Jamie Briggs (Mayo, Liberal Party, Chairman of the Scrutiny of Government Waste Committee) Share this | Link to this | Hansard source

I rise to speak on the Dental Benefits Amendment Bill 2012 and the disallowance motion moved by the shadow minister for health. It will not surprise people to learn that I will be taking a different approach to the one the member for Melbourne took in his remarks in this respect. In fairness to the member for Melbourne, what he said was true to his heart and true to his ideological view of the world. Paraphrasing, he said that the Greens and their coalition partner, the government, are happy to announce a dental scheme without allocating the funding for it and without thinking through the consequences and how much this will cost. That is a position that the Greens take very regularly. They do not have a particular view about economic responsibility. They believe that government should be there at every step of people's lives and to hell with the consequences. The Greens are not renowned for fiscal responsibility.

However, it is shameful for the Labor Party—who claim that they are trying to build a surplus, and this current government has never delivered one—to have stood alongside the Greens when this was announced. The health minister, representing the Labor Party, announced this policy without announcing how it would be funded. It is one of the policies which add to the $120 billion black hole of commitments that the government has made in the last few months, as reported by the Australian Financial Review. These are commitments that the government is announcing without thinking through the consequences and without allocating the appropriate appropriation from the budget to pay for these big new policies into the future. We know that adding dental care to Medicare would be hugely expensive. In fact, it was a former Labor finance minister, Peter Walsh, who commented some time ago that the quickest way to bankrupt the Commonwealth would be to add dental care to Medicare.

This is an issue that needs to be thought through carefully, and that is the approach the coalition has announced it will take. In January this year the Leader of the Opposition made a very good speech in respect of managing Australia's economy and managing Australia's budget in an appropriate manner. In that speech he said that we have an aspiration to ensure that the dental needs of Australians are looked after better than they are now but that we need to do it in a well-thought-through and budgeted way so that we are not just adding additional cost to the Australian budget without thinking about the impact on Australian taxpayers, because ultimately it is taxpayers' money that we are about here.

Much is said about the benefits to children who will be covered by the scheme from 2014, which we heard the member for Melbourne talking about. But little is ever thought about the consequences for those same children when they get older and have to deal with increasing debt and deficits because of commitments made by previous generations, and that should always be one of the considerations that we give in this place. All the needs of society need to be tempered by the fact that there is a limited resource in the federal budget. Already we have a government that is spending more than it earns each year and that is why we have a record debt. The government will boast that it is a low debt compared with the rest of the world, but of course you do not compare your mortgage to that of your next door neighbour; you look at the way you can address your mortgage yourself within your means. What we are seeing now increasingly is that the Australian budget is becoming more and more difficult to manage because the government continues to make inappropriate and badly-thought-through decisions in relation to expenditure. We have seen that on a range of policy issues. Most famously is the pink batts scheme—

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

Order! The member for Mayo will return to the bill before the chair.

Jamie Briggs (Mayo, Liberal Party, Chairman of the Scrutiny of Government Waste Committee) Share this | Link to this | Hansard source

I am, Madam Deputy Speaker Burke. I am talking about the cost of the dental scheme. I think that is a very important point that we need to think about. Time after time we have seen examples of the government making announcements about policies, as the Minister for Health did in this respect, standing next to the Greens spokesperson on this—in coalition with the Greens—without thinking through the consequences of the bill. She made an announcement without saying where the money is coming from. We have seen this time and time again with this government: disaster after disaster. Whether it be the pink batts scheme or whether it be the overpriced school hall scheme, there have been a litany of examples of the government not having thought through the consequences.

In addition to that, what I thought was disappointing about the member for Melbourne was that he just walked away from those people who are currently receiving the support of the Chronic Disease Dental Scheme. Time after time we and the shadow minister for health have said that, if there are problems with this scheme, we will work with the government to fix those inefficiencies and problems—of course we will—but what we would not do, and what we do not support, is just hanging people out to dry who are currently getting the benefits of these schemes. We have example after example in our electorates of people who are currently getting the benefit of this scheme who are now going to be left without the assistance that they expected—and in some cases in very poor circumstances.

At the Port Elliot Show in my electorate on the weekend numerous people raised with me the fact that they are midway through treatment and it is going to be cut off. On the attitude of the government, a constituent of mine, Sharon from Strathalbyn, told me that the Minister for Health's office advised her that there is nothing that could be done about it. That was the response from the Minister for Health's office when she contacted the Minister for Health to say that it was a real problem for them. Sharon said that she had some serious dental work that needed to be done, and still needed to have her bottom teeth removed. On her dentist's advice she has to wait until her gums recede properly before having the dental work completed. But come the 30 November scheme cut-off, which will happen before she can have the work completed, she will miss out on having it done under the scheme even though she is midway through the treatment. Labor members of parliament come in here time after time to tell us how they stand up for people in society who need their support, but they stand by the policy that the Minister for Health and their coalition partners, the Greens, are advocating: to get rid of the scheme midstream. It is a disgrace.

There is not only one example—another is Diane from Victor Harbour, whose 20-year-old daughter has an eating disorder. She had an appointment arranged for 17 September; however, the appointment, which had planned for dental work, has been cancelled because the practice is trying to deal with the backlog of people. She will not get into the chronic support scheme.

What does the Labor Party say to these people? What is its answer? The answer according to the minister's office is that there is just nothing you can do about it. We have a policy where we see that the details have not been thought through as to how this is to be paid for in the future. It is the aspiration of doing good things without thinking through the consequences for those people you are trying to do good things for—in order words, the increased tax they will have to pay in the future and the increased debt that it will build up—and without thinking through properly how to put this policy in place. We are also seeing a litany of examples in each of our electorates—as well as, I am sure, in the electorates of Labor members—where this scheme that is being cut short mid-stream for many people receiving this treatment is causing great difficulty and great damage. We know the details of this dental scheme have not been thought through, just like so many other Labor Party messes that have been inflicted upon our country in the last five years. This adds to that mess.

The people in my electorate who have been affected by this have been shocked at the lack of regard that the health minister, her office and the government have had for the concerns that people have raised in this respect. It seems to be a further example of the way the Labor Party operates in government, in this case in coalition with the Greens. I support very strongly the move by the shadow health minister to have the Chronic Disease Dental Scheme continued and to disallow this move by the government because it will make a genuine difference for people who are mid-stream with their treatment. It is shameful that they are to be left hanging and waiting without any possible way to fix issues which, on advice, they have not been able to fix prior to the scheme closing at the end of November.

In summing up my view on this bill, improving Australia's coverage for people's dental care is an important policy to pursue, and the Leader of the Opposition made it very clear in January that this would be something we would aspire to do in a proper, well-thought-through way. Labor is doing it in this manner, without thinking through the consequences. When the minister for health stood with her coalition partner, the Greens, at the media conference announcing this, she was asked how she was to pay for it. She said, 'Don't worry, we'll tell you about that later.' That summed up exactly the Labor Party's attitude to the federal budget: 'Don't worry about it, we'll tell you later.' The $120 billion black hole: 'Don't worry about it, we'll tell you later.' These are people who purport to represent the people who have to pay for this excess, this lack of foresight, these badly thought through plans and, indeed, this lack of planning for how these schemes will work.

What we see all too often with this government is that it is about the politics of the day, about trying to ensure that the Prime Minister survives until Christmas and gets through the crisis developing within the party's leadership. This morning we saw the resignation of the caucus chairman, which no doubt adds to that pressure. That is what this bill represents: politics. It does not represent good policy. As Peter Walsh, a former Labor finance minister of much renown, said: without thinking through putting dental in Medicare you will bankrupt the Commonwealth. This is what the Labor Party is seeking to do not just through this action and this announcement but also through a series of actions and announcements. It is shameful the way the party has gone about it; hanging people out to dry mid-treatment, not thinking through the consequences for future generations and the impact on their budgets and their decisions that they will get to make with their money. The shadow minister for health's motion is worthy of support, and a better-thought-through dental scheme will be announced by the coalition leading up to the next election.

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

I am very pleased to speak out on the Dental Benefits Amendment Bill 2012. I think this side of the House and certainly I have always been very focused on how we better provide dental care to those who need it most. Having good quality of teeth and having good dental care does make a huge impact on various aspects of our lives. First and foremost is the impact on our general health and wellbeing. If we do not address this issue in a preventative way then it will put strain on our health and hospital system. Living with poor dental health can be a painful exercise, affecting speech, sleep and eating, with certain foods even triggering off nerve endings. For some people, chewing anything can hurt because of rotten teeth and decay. If we do not look after our teeth and we lose the ability to chew then it is really a nightmare for many, many people and a severe impact on their quality of life.

Having poor dental care and poor teeth and oral health can also have very severe adverse interpersonal social impacts on a person's poor health, which can drive a person to withdraw from their life. People can suffer from the embarrassment of the appearance of their teeth, which can lead them to avoiding eating in public or having meals with friends, and even being afraid to smile and show their teeth in photos. Unhealthy-looking teeth can also cause people to miss out on job opportunities due to their outward appearance not meeting the employer's expectation. I think it is important to note that if people are not able in childhood to have good oral health then this poor oral health can follow them into adulthood. That is why I have been an advocate for a long time about supporting preventative care and preventative treatment to ensure that small problems in childhood are addressed and these issues are not carried on and do not get worse into adult life.

I think it can be said that the overall dental health of children has been improving over the decades, but this trend is not necessarily improving over the last two decades. It is shocking to look at some of the statistics from the Australian Institute of Health and Welfare report, which shows that almost 20,000 children under the age of 10 are hospitalised each year due to avoidable dental issues. It is also shocking that more than half of young people have tooth decay by the age of 15, with 45.1 per cent of 12-year-olds reported to have decay in their permanent teeth. Perhaps more alarming is that just under half of children who have just started school had a history of decay in their baby teeth. This is of concern and something that we on this side of the House are very, very driven to address.

I think it is important to look at the effect that income has. For so long, we have treated dental health as separate to physical health—separate to our normal health for which we can go to the doctor. Our dental health has been set very separately. It is not as easy for those that have a more modest income to afford to go to the dentist, unlike going to the local GP with the universal health care that we have. It is not as easy for people to be able to go and visit a dentist, especially if they are on a modest income. Many families cannot really afford the prospect of going to the dentist just to do preventative work. I think that is so important.

I am so pleased that this bill is going a long way to actually saying that, for those families that suffer from cost-of-living pressures and need assistance with their children's health care, we are going to provide that assistance. We are going to provide it for those to ensure that their children are able to access the health care that they need and ensure that the issues that they may experience in their childhood get addressed and do not continue on and plague them in their adult life. So I think this is incredibly important.

I also hear many cases in my electorate of adults who are in pain, putting up with poor dental health. I have seen firsthand the devastating impact that it can have on their lives. For many of these people the necessary treatment with a private dentist is too out of reach for their budgets, so they go on putting up with poor teeth.

We have heard a lot from the opposition today about their great plan for dental care, which they have not announced; there are no details. They say they will have a plan but there are no details. When they were in government, when the Howard government was elected, they ripped millions upon millions of dollars out of public dental care. In my electorate, at Noarlunga, as it was around the rest of the country, that led to huge waiting lists being accumulated. So many people could not access dental care because of the funding withdrawal by the coalition. Today we are seeing some crocodile tears when it comes to dental care. Their record while in government showed they ripped money out of the public dental system. Of course, those on a low income, who cannot afford a private dentist, use the public dental system and rely on the public dental system. In government, the opposition ripped money out of that.

We have not been doing that. We have been ensuring that we are putting money back into the public dental system and we have already made significant dental care investments. The government has provided, in its most recent budget, $515 million to have a blitz on public dental waiting lists. This is a quite shocking statistic: those who earn more than $60,000 a year have seven more teeth, on average, than Australia's poorest people. That shows quite clearly the income gap that causes the difference between those with good oral health and those without. We need to ensure that the public dental care system is accessible. We need to ensure that those on the lowest income who cannot afford to go to a private dentist can actually access the care they need. While the Liberal Party in government pulled out money, we are putting money back in.

I see the member for Boothby here, who has been very critical about the GP superclinic at Noarlunga. It is very disappointing that he has not recognised the important services that are available there. At the Noarlunga complex we have been able, with a partnership between the state and federal government, to triple the number of dental chairs. We have seen a rise from six dental chairs to 24 dental chairs.

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

You closed the school clinics. Good one!

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

If the member for Boothby would look at the bill, maybe he would see the massive support we are providing for children in this bill, and then he might actually consider the bill and vote for it. It is disappointing that he will not vote for helping children get appropriate dental care. He seems to be opposed to this in Noarlunga, and I am sure the residents of Noarlunga would be very upset if he is opposed to increasing the number of dental chairs from six to 24, which is expected to provide 32,000 appointments for adults and children each year. This is an important boost. Importantly, we will provide the services to those who need it the most: those on a modest income.

We have heard a lot today about the Chronic Disease Dental Scheme, which the Liberal Party is so proud of. The now Leader of the Opposition introduced that scheme while he was health minister. As I have tried to illustrate, income plays an important role in whether or not you can get access to health care. When armed with these facts, you would think that when the Leader of the Opposition was looking at the Chronic Disease Dental Scheme he might look at the equity in dental care. That equity being: perhaps means test this? Perhaps means test this to ensure that the public money is being directed to those who need it most.

Of course, the now Leader of the Opposition—the then health minister—did not means test this program, and this provided another important inequity. That was that if people had a chronic disease then they could access a significant amount of money to get dental treatment. If you were poor or on a modest income, and did not have a chronic health condition, you could not access any money from it. It was poorly targeted and not means tested, so public money was going and, indeed, as the program continued there seemed to be increasing problems with the program.

Of course, first there was the cost blow-out; a complete cost blow-out that the then Leader of Opposition said would cost around $90 million each year. It ended up costing $1 billion each year. And there were still so many people who did not have a chronic disease waiting on the public dental waiting list because they ignored the public dental waiting list, and ignored the people that need it the most. So first of all there was the poor targeting: $1 billion targeted very poorly, not means tested and available to people on a very high income.

The scheme was also poorly managed, receiving 1,000 complaints and with reports and evidence of wide misuse of the scheme. This includes some practitioners ordering dentures that did not fit, unnecessary crowns or other work and charging up to $4,250 for doing very little work. We often hear the opposition talk in this place about using taxpayers' money responsibly. Unfortunately, they do not have a very good track record on this. They might talk a lot in this place about using taxpayers' money very wisely but, unfortunately, while in government they failed to deliver this, and the Chronic Disease Dental Scheme was one of those.

Unfortunately, it has been left to this government to fix it up and actually to ensure that the money that is spent by taxpayers on public dentistry is done in a way that ensures that those who need it most do get access to it. We announced a policy of shutting this scheme down. We believed straight away that this money was poorly targeted and that it was being, quite frankly, rorted in a lot of cases—therefore, we felt very strongly about it. To those on the opposition benches who say that this is such a surprise: this has been our policy for a long time and we are now delivering on that policy to ensure that that money is used responsibly, that that money is not wasted and that that money is actually directed, as I said, to those who need it the most.

The bill before the House today is the first step in our dental reform package, which really seeks to bridge accessibility issues. These reforms build on the work that the government has done so far to turn around the impact of the coalition government's cuts to the public dental scheme when they were in government. Quite frankly, there is the fact that the coalition ignored the dental health of children when they were in office. It provides $2.7 billion for around 3.5 million Australian children, who will be eligible for subsidised dental care under the children's dental scheme, Grow Up Smiling. That will commence on 1 January 2014. As well, we are providing $1.3 billion for the states and territories on 1 July 2014 to expand the services for millions and millions of adults in the public system who are low income earners, to ensure that they do have access to better oral health care. I was speaking also to the dental service at Noarlunga, and they are now embarking on being able, with the injection of money from the Commonwealth, to engage in preventative check-ups to ensure that they do not let problems just go into emergencies—go into chronic problems—but are actually having preventative check-ups to stop the problems from occurring.

This does build on the work that we have— (Time expired)

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

I rise to speak on the Dental Benefits Amendment Bill 2012. The coalition do support an investment in dental health; however, we have real concerns about the way the government is going to administer this bill should it pass the parliament and also about the fact that it has already announced that it is going to close the Medicare Chronic Disease Dental Scheme, the CDDS, effective on 30 November this year while the replacement scheme is not due to commence until 2014. It appears that this government is trying to yet again find a savings measure during this financial year to deliver some fictitious or thinly veiled surplus next year.

The closure of the Medicare Chronic Disease Dental Scheme really does concern me. The scheme was introduced by the coalition—in fact, by the now Leader of the Opposition when he was the health minister. I know from discussions with my constituency that many people on low incomes and means will not be able to afford any other dental services without the scheme we introduced when we were in government. They have very real concerns, and I will outline a few of those in my contribution.

We do support investment in dental health, but the problem we have is the intent of this bill and the fact it is going to leave a gap between November this year and 2014 in any scheme that will support families and people, particularly those with chronic diseases, who have already received and need dental services. The other aspect of it is that children will lose access to treatment on 30 November this year with the closure of the CDDS. This is a real concern. Not only people with chronic health issues but also many children will lose access to it.

I want to outline for the benefit of the House a couple of examples that have come to my notice in my constituency. I have had many people very alarmed about the closure of this scheme. They have already been advised by their dental service that they will no longer be able to access the Medicare Chronic Disease Dental Scheme. A constituent in Nanango needs major dental work. He is a 49-year-old disability pensioner who has been on the disability pension for some 16 years. He is currently suffering from abscesses and bleeding of the gums and is in serious pain. On 14 September this year he made an appointment to see his general practitioner. His local GP told him that the dental scheme was cancelled in early September this year and nothing would be available to him until 2014, notwithstanding the condition he is in and the very important reason why he needs access to dental services—he is a disability pensioner. My constituent is investigating other options for financing the dental work himself. I can assure you—and I hope members on both sides of this House would understand—that the ability for anyone on a disability pension to access dental services and pay for them is very limited. This constituent has accessed the Medicare Chronic Disease Dental Scheme because of his need for dental work, and without continuing dental work his whole health will deteriorate.

Another couple who live in Tara in my constituency have received a letter from their dentist to say that the dental benefits scheme is being scrapped. The wife has a litany of dental problems and is also legally blind and hearing impaired and needs both her knees operated on. She is not in good health: she is legally blind and hearing impaired. The couple relied on this dental scheme for their dental services for the benefit of their health, because—as the scheme that was introduced by the Howard government, when Tony Abbott was health minister, says—it is Medicare funded for a chronic disease dental scheme, for people who need this for a chronic health reason to be able to access the service to get that dental work done, because not having that work done is going to be very detrimental to their overall health. There is nothing—nothing—to replace access to a dental service for this couple who live in Tara, particularly the lady, who is legally blind and hearing impaired.

I have received another email from a Gordonbrook constituent on 3 October, only a few days ago. These are quotes, and these are constituents who write to me, email me or phone me and let me know their situation. They are not examples that I am making up. These are actual examples of constituents who have very real concerns. They have been accessing the Medicare Chronic Disease Dental Scheme but are going to lose that access as a result of what this government is doing in its approach to try and identify, through a savings measure, a scheme that has worked well. The government has no plans to put in another one until 2014. I quote from this email:

I am 65 years of age, and was diagnosed with diabetes 15 years ago, with complications of tooth decay and gum disease. During recent years, with the support of my doctor and dentist, I have received considerable help under the Medicare Chronic Disease Dental Scheme—

the scheme introduced by the coalition when Tony Abbott, now the Leader of the Opposition—was health minister. I go on:

The recent decision by the government to end the Scheme came as a shock. Would you please support the retention of the Medicare Dental Scheme after 30 November this year?

He ends his email by saying, 'Thank you for listening.' I can assure the House that I am listening to my constituents. The coalition is listening to the broad range of people out there who have gained considerable health benefits by being able to access the Medicare-funded Chronic Disease Dental Scheme that this government wants to scrap, with no plans to put anything in place until 2014. It is time that the government listened to emails such as this one from this constituent from Gordonbrook or the couple from Tara or the man from the Nanango who is on a disability pension—all within my constituency. I know members of this side of the House have examples—numerous examples—from their own constituents. I am sure the government members would be hearing from their own constituents who have examples like that with these people who have chronic health issues to deal with, who do need dental work and who—as it has been up until it was announced that it would be scrapped in September this year—have been able to access that dental work through the Medicare-funded Chronic Disease Dental Scheme.

One of the other concerns that are related to dental health is the access to rural health services for health and wellbeing of people living in rural and remote Australia. Recently, Humphreys and Wakerman from Monash University and the Centre for Remote Health in Alice Springs, a joint centre of Flinders University and Charles Darwin University, published a discussion paper entitled 'Primary health care in rural and remote Australia: achieving equity of access and outcomes through national reform'. What they found in that report is alarming. This is a university study. It is not a political party; it is a university study by credible universities and professors. They found that rural and remote Australians have a life expectancy of up to seven years less than their city cousins. The population that they described in rural and remote—as described in the discussion paper—is one-third of the total population of Australia. That is about seven million people, covering something like 7.5 million square kilometres of the land mass of Australia. They have poorer health outcomes due merely to their geographic location.

Recently on the ABC there was a report which should also send alarm bells through the halls of this parliament. It concerned the outback treatment of oral health—the TOOTH trial program that the Royal Flying Doctor Service is conducting in rural New South Wales. A dentist who is part of that program is looking at the dental health of people in north-western New South Wales and what he said should sound alarm bells every hour of every day in this place. He said the dental health that he had seen in rural Australia, where he was operating, was worse than he had seen in third world countries.

Using the examples of three constituents in my electorate using the Chronic Disease Dental Scheme, which was introduced by the Howard government, that is why the coalition has introduced a disallowance motion to ensure that we can see the continuation of access to a dental scheme. We would like to work with the government to refine the dental health scheme; it is not as though we oppose it. We support access to a dental health service for those who can least afford it where, without that dental work, it will have a detrimental effect on their health.

The work done by Monash University, the Centre for Remote Health in Alice Springs and at Flinders University, or The Outback Oral Treatment and Health Program by the Royal Flying Doctor Service and work they have done with dentists in that program, demonstrates to me—and it should demonstrate adequately to this government—that it is wrong to end a scheme that is still bringing benefits, particularly better health outcomes, for those who cannot afford access to dental services. Without that access there will be detrimental effects to their health. It means they will most likely end up on the health budget through Medicare because their health will deteriorate without access to the Chronic Disease Dental Scheme for their teeth.

For too long, in many ways, we have looked through the prism of Medicare to address the health needs of people. I acknowledge, too, that for too long dental services were not included in Medicare. I know that state governments have a public scheme. The problem for those constituents of mine who I have just described is that there is a 650,000-long waiting list to gain access to the public scheme, which I understand some doctors have suggested to my constituents they should try to do. Are they going to join a queue of 650,000 people because the government cancels this very successful scheme without any plans to introduce a new one until 2014?

I say to the government: listen to the examples that I have brought to the attention of the chamber. Listen to the people out there who desperately need dental health to be addressed through a Medicare-funded program. We will work with you to make sure we can refine the current scheme. We are committed to that. But please, do not leave people out on a limb without any access for the next 15 to 18 months, probably closer to two years, which appears to be the government's approach. What this will mean is that we will move a disallowance for the closure of the Chronic Disease Dental Scheme to protect those patients who otherwise would have to go without treatment for at least 19 months for adults and 13 months for children until Labor's proposed alternatives are due to commence.

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

I rise to speak on the Dental Benefits Amendment Bill 2012, which amends the Dental Benefits Act 2008 to set up the legislative framework for the Child Dental Benefits Schedule that will commence operation in January 2014. I noted with interest the comments from the member for Maranoa, particularly about his constituents in Tara. For his benefit, I will point out that last night, I was at an event in Brisbane for the Republic of China—Taiwan—and met some constituents of mine who run a charity called the Tzu Chi Foundation. They were out in Tara on the weekend. They are a charity, but they take dental chairs out to Tara. I might send him the information, because I think that he would like to send them a letter congratulating them on the charity work that they do. I met them last night at this event and the Minister for Health, the Hon. Lawrence Springborg, was there as well. This is a charity that did great work in the flood. They gave out almost $1 million to people in my electorate. On the weekend, they were out helping the member for Maranoa's constituents in Tara. I just mention that in passing. It does show—as the member for Maranoa pointed out, with that waiting list in Queensland of 650,000 people—how important it is that we get dental care right. It is a big issue. I would acknowledge that, as stated by the member for Maranoa.

The Child Dental Benefits Schedule form part of the Gillard Labor government's $4.1 billion dental reform package, which was announced by Health Minister Plibersek on 29 August 2012. The Commonwealth's power to legislate on the provision of dental services was added to the Constitution following a referendum in 1946 which authorised the insertion of the whole amendment as it stands today. As anyone who knows the history of referendums in Australia knows, we have had only eight out of 44 actually get up, so it was significant when section 51(xxiiiA) was initially introduced by the Chifley Labor government in order to pass the Commonwealth's Pharmaceutical Benefits Act 1944.

The then Leader of the Opposition, a bloke whose last name was Menzies—perhaps some of those opposite might have heard of him; he went on to other things—actually supported the extension of the Commonwealth government's power to legislate for the provision of maternity allowances, widows' pensions, child endowment and unemployment, pharmaceutical, sickness and hospital benefits, but he was opposed to the extension of the power over medical and dental services. The Parliamentary Library gave me some information showing that the opposition claimed that the proposed amendment would give the Commonwealth constitutional power to nationalise the medical and dental professions and make them members of one government service, which they argued undermined the right to professional independence held by medical and dental practitioners and the right to personal autonomy in a doctor-patient relationship. Although Dr Evatt, the then Labor Attorney-General, was less than clear about the issue of nationalisation, it became clear during the course of the parliamentary debates that some members of the Chifley government were in favour of introducing a similar scheme to the National Health Service trust in Britain. To prevent this possibility, Mr Menzies then proposed an amendment that extended Commonwealth powers to the provision of medical and dental services but not so as to authorise any form of civil conscription. This was accepted by the Chifley Labor government and was put to the people in September 1946 and was carried both nationally and in all six states. So you have there Ben Chifley, Bob Menzies and Doc Evatt all on the same page on this issue in terms of clarifying to the Australian people how important it is that we get our dental services right and bring them into the Constitution.

If it had not been for a good Labor government like Ben Chifley's and also the Gillard Labor government of today, we would not be in the position we are in today to introduce programs like dental for kids which will help over 3.4 million children have access to better oral health care. The child benefit schedule will replace the Medicare Teen Dental Plan. The legislation means that, for over three million children, going to the dentist will be just like seeing their GP. I am sure the member for Mayo—and I take note of his position sitting at the dispatch box and congratulate him on his promotion—would be in favour of this, in terms of giving dental care to young children.

It means that 3.4 million children whose families receive family tax benefit part A, Abstudy, carer payment, disability support pension, parenting payment, special benefit, youth allowance, double orphan pension, the veteran's children education scheme or some military rehabilitation and compensation act education and training scheme will qualify for this new scheme, the dental scheme for kids. Families will be entitled to $1,000 per child every two years over the life of the package. Importantly, parents will be able to take their children to either private or public dental services to access this program. Whether it be the QEII dental clinic, which is in my electorate, or the school dental clinic at Yeronga, also in my electorate, working families in my electorate will receive more assistance when they go to the dentist.

In addition to the dental scheme for kids, the dental reform package will provide extra funding for 1.4 million additional services for adults on low incomes, including pensioners, concession cardholders and those with special needs, to have better access to dental health care in the public system. The program will also mean more services and more dentists in areas of most need, particularly outside capital cities and large regional centres. As I mentioned in the discussion with the member for Maranoa, when you have a charity from my electorate who have connections to Taiwan going out to Tara—a town I used to play football against when I was growing up in St George—to offer dental work, you know that we do need to do more work. The package comes on top of the $515 million allocated in the last budget, which included a blitz on public dental waiting lists, and, taking the member for Maranoa's figures for Queensland, a waiting list of 650,000 people. That is obviously no comfort whatsoever if you have a toothache.

Now, I have had a lot to do with QEII hospital. In particular, I have been to the waiting area of the dental hospital a lot. I particularly remember the lead-up to the election of 2004, which was held eight years ago today. One of the members opposite was elected on that day, eight years ago; I congratulate the member for Cunningham on that anniversary. That election was not as good for me; there was no second prize in 2004. But I spent a lot of time at the QEII hospital, because it was obviously a big issue in that election. We were trying to bring in more dental services. I remember the former member for Werriwa talking about dental care at the time, because it is important that we get it right. I remember that election well in terms of looking at providing the appropriate support. I remember the Medicare safety scheme put forward by the Minister for Health at the time, the member for Warringah. He gave a rock-solid, ironclad guarantee on Four Corners that that was going to be the policy. So on 9 October that was the policy but, by March the next year—only four or five months later—they rolled over.

Now, in that Westminster tradition, did he resign and say, ' I gave my guarantee.' It was like a blood oath without blood. It meant absolutely nothing; he rolled absolutely rolled over. His word, whether written, signed or whatever, was shown to be worth absolutely nothing.

Mr Briggs interjecting—

So you are saying it is exactly the same as that, member for Mayo? He is saying it is exactly the same as that.

Andrew Leigh (Fraser, Australian Labor Party) Share this | Link to this | Hansard source

Order! The member will direct his comments through the chair.

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

I am sorry, Deputy Speaker. So oral health has been declining since the mid-1990s, as the former health minister—now Leader of the Opposition—would know, with almost 20,000 kids under the age of 10 hospitalised every year due to avoidable dental issues. With two boys under 10, I know how difficult it can be to get children to brush their teeth twice a day, let alone getting them to brush their teeth for longer than 20 seconds. Oral health is not only important to your appearance and your sense of wellbeing but also to your overall health. Studies have found that cavities and gum disease can contribute to many other serious conditions, even leading to things such as diabetes and respiratory diseases. Untreated cavities can also be painful and lead to serious infections and other health complications.

Now, I have been in this parliament for only five years, but for much of that time I slipped into a habit that I had never had in my life of occasionally, during question time when it got a little dull, having a lolly. My dentist pointed out to me the other day that it is a classic case of someone taking up sweets later in life. I have had to stop that. I now have had to pay attention to everything that goes on in question time without any treats.

There have also been studies that have found correlations between poor oral health and heart disease and even between poor oral health and women delivering pre-term babies. Poor oral health certainly affects your appearance, your self esteem and your quality of life. There is nothing worse as a male, in terms of the things that affect you, than having bad teeth or a toothache. It can also be linked to sleeping problems as well as behavioural and developmental problems in children. By age 15 three out of five kids in Australia have tooth decay—60 per cent of them. Untreated, decay and fillings are similar across income ranges, but if you earn more than $60,000 a year you have, on average, seven more teeth than Australia's poorest people, those earning under $20,000.

Sadly, in Queensland, I am embarrassed to say that this has traditionally been worse because for many years in Queensland there was a culture that did not have people put fluoride in the water. Thankfully, the Beattie and Bligh governments changed this, and started to put fluoride into the water. I remember hearing a story from someone I know in the RAF who talked about her job as a forensic pathologist. She said they were able to identify the Bali victims from Queensland by their teeth. That is a horrible statistic, but it is just a reality because, unless they were from Townsville, no-one in Queensland had fluoride in their water and so their teeth were not the same as the rest of Australia's people. I saw a retrograde step by the Liberal National Party government, which took the onus off communities to have fluoride in the water, and that is a sad backwards step.

Mr Tudge interjecting—

With respect, I suggest that talking about fluoride is an important correlation in terms of dental health. Good oral health is about much more than having those pearly whites; it is about preventing other major health issues and diseases over the course of your life. That is why the government is getting in early through the introduction of the Dental for Kids program. Good habits and intervention early head off a world of troubles and costs later in life. The Dental for Kids program is an investment in prevention because we know that our oral health as children is the best predictor of our oral health as adults.

It was Queensland Labor that introduced fluoride into our water supplies, as it is the Gillard Labor government that recognised that prevention is far better and far cheaper than cure. We all know this of health but it is equally true for cost-effectiveness, as preventative oral health means fewer trips to the dentist, less waiting time and lower costs for families. In stark contrast we have the Liberal National Party Premier of Queensland, Mr Newman, saying that he would consider allowing some Queensland communities to opt out of having fluoride added to their regional water supplies but would not reverse fluoride in those communities that already have it. This is short-term populism of the worst kind, and very short-sighted.

As usual, the Liberal National Party is having an each-way bet on the outcome and is not focused on the long-term oral health prevention strategy for our children. This is, of course, while Premier Newman cuts over 4,100 staff from Queensland Health and cuts important central agencies like BreastScreen Queensland. Undoubtedly, some of the 4,100 are those who provide oral health services to Queenslanders. In fact, I read a few weeks ago that some Public Service dentists were sacked. Hopefully, I misheard this, because Public Service dentists are our real health heroes. They forgo significant money for that special place in heaven that comes with looking after public patients. Anyone in the dental services knows that public health dentists could make two, three, four or five times as much if they were in private practice; instead, they like the challenge of looking after the poorest in our community. Hopefully, we will not have to rely on charities like the Tzu Chi Foundation in my electorate to provide dental services in the bush.

This side of the House is committed to the best environment for our children's future, whether it is in education, health or the environment itself. That is why I am a strong advocate for the Dental for Kids program in my electorate and why I proudly commend the bill to the House.

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

We have sat here for 15 minutes listening to the member for Moreton, but he barely, if at all, discussed any reason as to why the government are cutting the Chronic Disease Dental Scheme, which is the central focus of this bill, the Dental Benefits Amendment Bill 2012. I think the reason that he did not want to discuss that is that he is embarrassed by it. He knows that by cutting this scheme there will be hundreds of thousands of people who will no longer be able to get the dental care they so desperately need. That is why he does not want to discuss it.

I spoke on the disallowance motion concerning this package, so I do not want to go over all of the arguments which I presented in that debate. What I would like to do in the time I have available is to quickly summarise some of the points which I made in relation to this legislation and add some additional new material and particularly some comments constituents of mine have brought to my attention in the intervening period.

Mr Deputy Speaker, as you would be aware, the effects of this government's dental package is threefold. Firstly, it abolishes the Chronic Disease Dental Scheme almost immediately. Secondly, it ensures that there is absolutely no coverage for the people who were benefiting from that scheme until, at the very earliest, July 2014. Thirdly, it holds up hope—and hope only—that there will be a replacement scheme from July 2014. I say 'hope only' because there is in fact no money allocated towards that scheme and there are no details in relation to it. So, really, it is just an election commitment. So they are abolishing a scheme immediately and putting up what is really just an election commitment which does not have any money attached to it as yet.

The Chronic Disease Dental Scheme has been a tremendously successful scheme. It has treated 1.5 million Australians who have had chronic problems with their mouths. There have been over 20 million consultations since the beginning of this scheme, which Tony Abbott introduced when he was health minister. Importantly, it treated the mouth for the first time in the same way that we treat the rest of the body from a public policy perspective—that is, that there is a universal healthcare system for your mouth as there is for the rest of your body.

So why do the government want to close this scheme down given that it has been successful and it has benefited so many Australians over the course of the last few years? The government have given us three reasons for closing down this scheme. Firstly, they say that the costs have overblown for the scheme. It is true that it has become more expensive than what was initially envisaged, but the reason that it has become more expensive is not that it has been managed ineffectively—as we saw with the school hall program, for example, where school halls were built for twice the cost for which they should have been built. This scheme has become more expensive than forecast because the program is a demand-driven program and more people have sought assistance through this program than we initially anticipated. That is the reason that costs are greater than what was initially anticipated. The cost per consultation has in fact come down quite considerably, so over time this program has become more efficient rather than less efficient. The cost has gone down from $2,225 per patient to $1,117 per patient. So it has actually been a successful program. More people have benefited from it than we had anticipated, and the cost per patient had been coming down. So the argument that the government put forward that 'the costs have blown out and therefore we are shutting it down' does not stack up. If that were the real reason—that the government are concerned about the overall cost to the budget—then why not put on the table some amendments to the program to maybe limit the type of procedures that would be covered by the Chronic Disease Dental Scheme? That would be consistent with a concern about the cost blowing out and we would have sat down with the government to try to work through that.

The second reason the government has stated as to why they want to close down the Chronic Disease Dental Scheme is that the program is untargeted—that is, that millionaires are getting access to this particular program. But the figures do not demonstrate this. In fact, 80 per cent of all the people who have benefited from this scheme are concession cardholders. Indeed, this evidence is backed up by Associate Professor Hans Zoellner, who is Chairman of the Association for the Promotion of Oral Health at the University of Sydney. He says:

Government claims that the system is used extensively by millionaires and that it is greatly rorted, are not supported by the available evidence. All statistical evidence is that the scheme has been used primarily by people on low incomes, and that patients have received the type of treatment expected after a prolonged period of without service.

That is what one of the health experts from the University of Sydney says: it has not been used extensively by millionaires, as the government claims, but largely low-income people have benefited from this scheme. Indeed, even if some wealthier people have accessed this scheme over the years, that is perfectly consistent with the universal health system that we have for Medicare. Under Medicare it does not matter how much money you earn, you can go to a public hospital and get treatment.

If the government is saying that we have to scrap the program because millionaires can access the Chronic Disease Dental Scheme, the logical implication is that the government is also looking at the Medicare scheme and is either going to means-test it or somehow scrap it. That would be the logically consistent argument if you were to follow that through. That is not the right reason for them to do this.

The final reason the government has put forward for closing the Chronic Disease Dental Scheme is that they say the program has been rorted. Yes, there have been some irregularities in the operation of the program, just like there probably is in every entitlement program across the country; but no amount of red tape or oversight of bureaucracies can ever eliminate people being fraudulent. In this particular program the number of irregularities was only one in 1,500, which is actually quite a low figure and again is consistent with my understanding of the irregularities with the general Medicare program. This argument does not stack up.

What are the government proposing through this package to replace the Chronic Disease Dental Scheme? They are proposing the promise, as I mentioned before, that by July 2014 there will be more money given to public dentists in order to treat patients who have previously benefited from the Chronic Disease Dental Scheme. That is the promise. What they are offering for certain is nothing in the short term—absolutely nothing until at least July 2014. Then there is a promise that something might be offered from July 2014 if they find the money for it, and currently there is no money allocated towards that scheme. Even if the government did find the money they are promising to put towards reducing the waiting lists for public dentists, it would still not have the same sort of impact. It would not be sufficient.

I go back to Associate Professor Hans Zoellner from the University of Sydney, who said:

Government intends only a 30% increased public dental spending, which is very much less than would be needed to satisfy even current demand, so people with chronic disease will not receive timely or comprehensive care needed.

Again the verdict from the expert is that if the government are re-elected at the next election and if they do find the money to invest towards the scheme which they are promising the Australian people then it will still not be sufficient to cover even the existing waiting list, let alone all the new people who will be on the waiting list after the abolition of the Chronic Disease Dental Scheme.

Since we have been debating this in the parliament, I have had many constituents come up to me concerned about the axing of the Chronic Disease Dental Scheme. I would like to just read out a few of those comments from constituents of mine. First of all, we had Anya Filek of Wantirna South. She is a young person, a disabled pensioner, who relies on the scheme to help her with dental problems relating to her chronic illness. She says:

I must visit my dentist every 4 months and now that the scheme is gone I will no longer be able to afford it. It's so hard being a young person on a pension and being unwell. They can't leave us out in the cold like this.

Also, I refer to Adriana and Joe Rapisarda, who are both pensioners living in Bayswater. Adriana has lupus and as a result must have regular dental work to prevent gum disease. She has been a recipient of the Medicare Chronic Disease Dental Scheme for the past two years and has to get vital work done every three or four months. Similarly, her husband, also a pensioner, uses the scheme, as he has had a stroke and heart attack. He needs dental work to limit the harmful effects of medication on his gums. He is therefore utilising the Chronic Disease Dental Scheme. That is going to be axed now. He is a pensioner. You have voted for this, Mr Deputy Speaker, to restrict the access to these two—

Andrew Leigh (Fraser, Australian Labor Party) Share this | Link to this | Hansard source

Order! The member for Aston is reminded of the independence of the chair. He is welcome to refer to actions of the member for Fraser, but will not reflect on the chair.

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

I withdraw that comment. The member for Fraser is supporting this, Mr Deputy Speaker, so that these two pensioners will no longer be able to get the type of dental care which they so desperately need. Kevin McMurrugh of Ferntree Gully, another constituent of mine, he also will suffer as a result of these cuts. He says:

I cannot believe the Government would have reached this decision suddenly or without due consideration.

We are going to have many thousands of people who will no longer be able to afford dental care, me included.

A Rowville man, who did not want to be named, said that the cuts to the scheme would be a devastating blow to him financially. He had already battled Paget's disease and bowel cancer and was undergoing treatment for prostate cancer. He said he will be unable to afford the vital dental work he requires on an ongoing basis as a part of his recovery. He says: 'I am thoroughly disgusted with the way we are currently being treated by this government,' which I think is a very accurate summation.

I think that every member of the government should reflect on some of those people I have read out, who will be affected by the cuts to the Chronic Disease Dental Scheme—people like Mr and Mrs Rapisarda. They are pensioners, they have been ill and they have had heart attacks, and because of their medication they get gum problems or teeth problems. So the Chronic Disease Dental Scheme can help them out. They will no longer be able to afford to get the vitally needed dental work they require.

I also call on the Independents, who will have the casting vote in relation to whether or not this scheme survives. I ask them to consider people like Mr and Mrs Rapisarda, like Ms Filek and like Mr McMurrugh, from my electorate, who will no longer be able to afford the dental work they so desperately need.

I think that the real reason that the government are cutting this scheme and why they are not putting any money towards any new scheme is that they have so categorically blown the budget with so many wasted programs that they are now desperately cutting absolutely every possible thing they can find in order to try to get a budget surplus. There have been many lows for this government over the last five years, but the cutting of this scheme I think will go down as one of the lowest of them all.

Mike Symon (Deakin, Australian Labor Party) Share this | Link to this | Hansard source

I speak in support of the Dental Benefits Amendment Bill 2012. This bill will amend the Dental Benefits Act of 2008 by setting up the legislative framework for the Child Dental Benefits Schedule to start in January 2014, and it is a component of the $4 billion six-year package announced by the Minister for Health on 29 August this year. In addition to this measure, there was an announcement of $345 million in this year's federal budget to alleviate pressure on public dental waiting lists, a program that commences from January 2013. This package will replace the Chronic Disease Dental Scheme and the Medicare Teen Dental Plan.

On commencement of the scheme there will be around 3.4 million Australian children who will qualify for the Grow Up Smiling dental scheme. This scheme will see the federal government assume the primary responsibility to fund basic dental services for children from their second birthday through to the time of their 18th birthday in families that receive family tax benefit part A, which is a particularly good way to judge where the need should be. The current income cut-off threshold for families with two children for family tax benefit part A is around $112,000. The recent 2011 census figures have come out recently and, for my electorate of Deakin, they show a median family income of $1,601 per week as an annual figure. That works out to be about $83,252. On that measure most families in Deakin with children will have access to the Grow Up Smiling scheme as the median family income is well below the cut-off threshold for family tax benefit part A. It is estimated that 7,147 families with 12,451 children will be covered within the electorate of Deakin.

Up to $1,000 of dental services will be funded over two years for each child in families—not only in my electorate of Deakin of course, but right across the country—that qualify for family tax benefit part A, and this continues for the life of the package. Importantly, because it is hard to access public dental services in my area, it will be the parents' choice as to whether to have these services done in public or private dental services. Services covered by the scheme also include those performed by para-dental professionals such as oral health therapists and dental hygienists, as already covered by the existing Medicare Teen Dental Plan. One of the key aims of the bill is to make a visit to the dentist to be no more difficult than a visit to the doctor for the 3.4 million children that will be covered.

The benefits of preventative health of the population in the future are not always easily quantified in today's dollars because there are so many unknowns. However, I think we can look at statistics and trends to form a good idea of where this record federal government funding in dental services will lead. A great resource that I often look at in terms of health debates is the Australian Institute of Health and Welfare and the reports that they produce on a regular basis, which I know many members in this place do read large sections of. In particular the report titled Oral health and dental care in Australia, key facts and figures 2011makes some very interesting reading. The report goes over a number of years and lists in detail reports of various surveys from 2004 to 2010, so it is not just a flash in the pan or a snapshot.

In 2006, from a survey of children attending a school dental service, the percentage of children with decayed, missing or filled baby teeth increased from around 40 per cent in the four- to five-year-old group up to around 60 per cent in the six- to eight-year old group. I found that to be quite a disturbing figure, but the report brought further concern when it came to the number of children with decayed, missing or filled permanent teeth. That figure rose from 1.4 per cent for children at five years of age up to 29.8 per cent for children at 10 years of age and 58 per cent for children at 15 years of age. That is not baby teeth; that is permanent teeth.

The National Survey of Adult Oral Health from 2004 to 2006 reported that, for adults, the overall average of decayed, missing or filled teeth for a person aged 45 to 64 was 19.8 teeth per person. Of those 19.8 affected teeth, 0.5 were decayed, 7.2 were missing and there were around 12.1 fillings per adult person between the ages of 45 and 64. People without dental insurance had a higher number of teeth missing due to decay and untreated decay, but a lower number of filled teeth. Obviously that is coming from the fact that they would not be able to afford as many visits to the dentist in some cases.

The highest proportion of untreated decay was seen in persons earning less than $12,000 per year, while the lowest prevalence was seen in people who lived in households with an income of more than $100,000 per year. These numbers are just small samples taken from the AIHW report. The report contains many more tables and surveys, including the national dental telephone interview survey of 2010. One particular finding was that the average number of missing teeth was inversely related to household income. That pretty much follows the previous report.

Australia should not be a country where only those on higher incomes have access to proper dental treatment. I believe that Australia should be a country where all children have access to dental services so that the average number of decayed, missing and filled teeth drops as a result of preventative and restorative dental work that is done early in life before many of these conditions become more severe.

I mentioned the Chronic Disease Dental Scheme earlier, a scheme that was introduced in 2007 by the now opposition leader and then health minister Tony Abbott. Over the four years that that scheme ran, the forecast expenditure was $384.6 million. But by May 2010 the benefits paid out by the scheme had already added up to $916 million and the amount of claims and payments have increased at a massive rate since then. The Chronic Disease Dental Scheme is now costing the Australian taxpayer around $80 million a month. A quick calculation is in order here. At $80 million a month, that works out to be around 10 times the amount that the scheme was costed at back in 2007: $8 million a month versus $80 million a month. That is a huge increase. Many times in debates in this place we argue over dollars, but rarely is there such a huge differential between what was forecast and what the outcome was: $80 million a month. With that sort of addition, it is no wonder that, when it comes to election and policy costings, the Liberals have a $70 billion black hole.

But there is not only the direct cost to consider here; there is also the cost of opportunities along the way. The Chronic Disease Dental Scheme is not means tested, and therefore we have seen huge amounts of public money being paid to the well off—the very group that the figures I talked about before show are least in genuine need of welfare or assistance from the government. The rorting of the Chronic Disease Dental Scheme has reached huge proportions and has been reported on consistently over the years. A stream of media reports has come out ever since the federal Labor government tried to shut this scheme in 2008 and again in 2010. In both cases, the Senate disallowed the motion to shut the scheme.

Some of the media reports speak for themselves. Mark Metherell, writing in the Sydney Morning Herald on 14 March 2009, said:

The Senate has twice blocked Government moves to abandon dental Medicare, which costs about $250 million a year and rising.

If you look at the figure, it was $250 million in 2009. It has risen way beyond that. In another article Mark Metherell, this time in the Age on 5 November, said:

Medical leaders have told The Age that dentists are advising patients who are not eligible to seek doctors' referrals, which can authorise Medicare coverage of up to $4250 in dental work, including dentures and crowns. The scheme is meant to be restricted to patients with chronic medical diseases linked to their dental conditions.

In the Australian on 11 March 2010, in an article titled 'Senate block "letting dental rorts thrive"' by Adam Cresswell, the figures had changed. The article said:

Latest figures show the scheme has cost taxpayers $732 million between its relaunch with increased benefits in November 2007 and last December.

The December referred to was December 2009.

The Sunday Herald Sun of 21 March 2010 had an article by Clair Weaver and Sharon Labi which said:

… investigators have uncovered systemic fraud in two programs that allow doctors and dentists to claim generous rebates for writing plans and treating the chronically ill.

Whistleblowers warn the system is being abused, with medicos getting rich and patients who shouldn't even qualify being given thousands of dollars worth of taxpayer-funded treatments.

The dental costs have blown out by 325 per cent to more than $800 million, while GPs who wrote chronic disease management plans have earned $914 million since they were introduced in July 2005. That budget has blown out by 200 per cent …

They are just some examples, and they are actually not recent ones because there has been some work by the department in this area to go after some of the most egregious examples—and that needs to be done in any program—but they are indicative of why the figure keeps rising. As with any scheme where there is no actual budgeted amount, while it may not appear in the budget figures it still has to be paid for. Obviously part of the change from the Chronic Disease Dental Scheme to the dental package we are now going to is that it is going to be something that can be quantified and measured over the years.

In terms of the announcement and the bill we are now talking about, the Consumers Health Forum of Australia puts out a large amount of information on both medical and dental issues. Sometimes it makes very good reading and sometimes it is critical of the government too. Carol Bennett, the CEO of the Consumers Health Forum of Australia, on 29 August put out a press release, which said in part:

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.

She went on to say:

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.

I agree with that statement. We have always found in relation to what the government funds that prevention is far better than attempting to cure. The Dental Benefits Amendment Bill 2012 is a great step along the path to getting prevention to be a natural first step rather than having to get people into the dentist many months or years later to fix problems that have taken a long time to develop. It has always made sense to me that our efforts be directed at prevention so that down the track hopefully we as a nation end up with a far smaller health bill in that area than we do at the moment. I commend the bill to the House.

Teresa Gambaro (Brisbane, Liberal Party, Shadow Parliamentary Secretary for Citizenship and Settlement) Share this | Link to this | Hansard source

I rise to speak on the government's latest unfunded policy farce—the Dental Benefits Amendment Bill 2012—and its astonishing political decision to axe the Howard government's Medicare Chronic Disease Dental Scheme. This farce began on 29 August this year when the Minister for Health, Tanya Plibersek, and the Greens health spokesman, Senator Di Natale, announced an unfunded $4.1 billion dental program that is not even due to commence until 2014, right after the next election. Sadly, policy announcements based on phantom funding to be delivered on the never-never timetable are becoming par for the course under the Gillard government. What is more disappointing is that, despite knowing 'Wasteful' Wayne has delivered a $120 billion budget black hole that is rising by the day, the Gillard government continues in its deceit of the Australian people in making promises that it cannot possibly keep.

The situation keeps getting worse. When the government attempts to explain where this $4.1 billion is coming from, it cannot quite give us the answers. The Prime Minister and the health minister clearly were not reading from the same song sheet on 29 August this year. They had a press conference where they sent out mixed messages as to where the money was coming from. The Prime Minister said:

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

But then the Minister for Health claimed that the scheme would be new money. Apart from contradicting the Prime Minister, the health minister contradicted her own response when asked where the funding was coming from. Yes, where is the funding coming from? The minister's response was that the government will find the savings in the budget which will be outlined in the Mid-Year Economic and Fiscal Outlook later this year. That fiscal outlook is going to show just how badly the Labor government continues to drag the country into debt.

So, after first saying it was going to be new money, which was then contradicted by the Prime Minister, who said it was a savings, the minister then said:

We have a very good record of finding savings in the budget … We found $30 billion of savings in the last one.

The government must come clean; is it a saving or is it a spend? The government's inability to explain where the money is coming from is very disappointing, especially when we remember what Prime Minister Julia Gillard told Australians in a press conference on 11 February last year. She said:

Every time we announce something we properly account for it …

It seems she forgot about that promise. Then again, this is the same Prime Minister who told the Australian people that 'there will be no carbon tax under a government I lead', and we all know how that worked out.

There is a rather unfortunate pattern emerging here of Labor and the Prime Minister promising they will do one thing and then doing completely the opposite. This is their status quo. It would appear from recent media reports that even the Labor caucus is worried. A number of caucus members asked at a meeting a few weeks ago, 'Where's the money coming from?' They are very worried about where the money is coming from. The fact that the government has no money to fund this proposed dental scheme will inevitably lead to higher taxes. We recently heard the government's own Treasury official commenting that there is only one place where money can come from; he outlined a number of areas, and higher taxes were included in that.

The Dental Benefits Amendment Bill does not commence until 1 January 2014. The bill makes some minor amendments to the Dental Benefits Act 2008, changing only 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 for a change from the Medicare Teen Dental Plan to the Child Dental Benefits Schedule. A schedule of services, fees and details of how the scheme will be funded is still not available, but this government is always very poor on the detail.

Apart from the fact that there is no money to fund this scheme, the government is rushing the bill through parliament without the detail I have just mentioned, and it does not commence for well over a year; that is, a year after the next election. The government's actions suggest this is all about the politics of the issue rather than some really good policy decisions. The minister has acknowledged that services for most children will cost less than the proposed $1,000 cap. There will be children on the Medicare Chronic Disease Dental Scheme who will require more services but, alarmingly, there is no provision to ensure they will continue to receive adequate treatment, especially in the period before the bill commences.

Available data suggests that well over 60,000 services have been provided to children under the CDDS thanks to the policies of the Howard government introduced by the Minister for Health at the time, Tony Abbott. It seems that whatever the coalition giveth the Labor Party is intent on taking away. Thanks to Labor and the Greens, the closure of the scheme on 30 November will leave a gap of 13 months for many children currently receiving treatment. There are children in the midst of treatment who will not be able to have their treatment covered or completed by 30 November. Those families will have nowhere to turn. This is how Labor cares for Australian families—false promises of future programs with phantom funding. The minister and the Greens should explain why Australian children must suffer for 13 months with incomplete treatment and no certainty of the schedule of services that are to be provided—assuming, of course, that the government actually delivers on its unfunded promise in July 2014.

As I said, the CDDS was introduced by the coalition when we were in government and it has been an enormous success. It is the only Medicare dental scheme that provides treatment for adults. It has provided 4,250 Medicare dental benefits over two years for eligible patients with a chronic health condition, and approximately 20 million services were provided to more than one million patients since 2007. Labor has repeatedly tried to close the scheme for political reasons—simply because it was established by Tony Abbott as health minister and it has been a success in improving access to treatment. Despite Labor's claims of expenditure blow-outs, the average claim per patient, according to the Department of Health and Ageing, is $1,716—well below the allowable $4,250—and some recent estimates suggest the average cost per patient has fallen to below $1,200. The coalition offered to work with the previous health minister to refine and improve the scheme, including working through a process to provide high-cost items such as crowns and bridges, but all offers were rejected.

It was quite amusing to listen to the member for Deakin when he said earlier on that this was a scheme for the rich. Well, it has been reported that 80 per cent of services under the CDDS were provided to concession card holders or low-income earners. It should be noted that Medicare is a universal scheme that all Australians pay for through the Medicare levy and the taxation system. But this evidence suggests that the dental services have been predominantly utilised by low-income Australians. Many of these people would otherwise have been forced to go without treatment or they would have added to the 650,000 people who are already on public dental waiting lists.

Thanks to Labor and the Greens, as from 30 November this year patients will be left without access to treatment and many will be unable to afford the full cost of private treatment. The government's vague promise to provide funding to the states and territories for public services is not due to commence until mid-2014—and we know what a great success that has been in the past when services were not provided to people or there was a go-slow and the states took the money but the delivery of services was very dubious.

Some patients in the midst of complex treatment will not be able to complete their treatment by 30 November. This will have serious health, economic and social ramifications for these people. Under this bill Labor is proposing to provide funding of $1.3 billion to state and territory governments for public dental services, but this funding will not commence until July 2014. It seems as if Labor is hoping it might win the lotto in the meantime to pay for it, because that is the only place it is going to get this money. That is why the government is not saying where the money is coming from. So, from 30 November this year many patients on the CDDS will lose access to treatment and will have to wait 19 months to see if the government delivers on its promise and provides more funding to state governments. Again, not surprisingly there is no detail on how much funding will be provided by the end of the year, with the possibility that the bulk of the money might not be provided until the end of the six-year period, in 2018, if at all. There are already 650,000 people—400,000 adults, according to the government—on public dental waiting lists. The minister has said Labor's plan will only provide 1.4 million additional services over six years. The CDDS has provided approximately 20 million services, including seven million in the last financial year alone.

In 2008 Labor promised the Commonwealth Dental Health Program, which it never delivered. The program promised one million services by providing funding to the states and territories. It was revealed in Senate estimates that the Commonwealth did not assess the capacity of the public dental workforce to provide projected services and the number delivered may have been significantly less than was promised. The number of services to be provided over the full six years under Labor's recent proposals is only 20 per cent of what the CDDS provided last year alone. What is worse is that there are no guarantees that there is any capacity to deliver the proposed services through the public system in terms of workforce or infrastructure. A lack of infrastructure, particularly in the public system, will impede capacity to deliver the projected number of services.

The $225 million measure under the government's proposal to develop infrastructure will not be available prior to the commencement of the new initiative. An invitation to apply for funding under the Flexible Grants Program for dental infrastructure, both capital and workforce, will not commence until 2014 so projects are unlikely to be completed or provide tangible benefits until years later. All in all, this bill does not set out a properly funded dental scheme that inspires any confidence whatsoever.

There is hope, however, for Australian families that the coalition supports investment in dental health. The coalition is very concerned that many patients receiving treatment under the CDDS will miss out on the treatment during the gap period between the closure of the CDDS and the proposed commencement of the government's measure. The coalition renews its commitment to work with the government to refine the CDDS in the meantime, including reviewing the process to provide in certain high-cost items such as bridges and crowns. I call on the minister and all Labor backbenchers and the Independents to put aside their political churlishness and to act in the best interests of Australian families and in the best interests of their dental health.

Nick Champion (Wakefield, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on the Dental Benefits Amendment Bill 2012 and it is good to be talking about dental care. It is a particularly important thing in my electorate. I have often noticed constituents who have had significant tooth decay and how that has affected their lives, their job prospects, their social prospects and just their everyday quality of life. It is obviously an important issue to both sides of this House.

One should not forget the history of this. Dental care is a state responsibility in the main and the first intervention by a federal government into this area was by the Keating government. In the last few years of the Keating government a significant package was announced to reduce state waiting lists, which were blowing out at the time as the state governments reduced funding for dental care in the community. Traditionally it was one of their responsibilities but, sadly, it is one that state governments have neglected over time.

Increasingly it has needed the intervention of federal governments, and the Keating government was the first to announce a significant investment in trying to reduce those waiting lists. That has been the traditional way of dealing with this issue. It is an unfortunate fact of life that that scheme was cancelled by the Howard government in its first year of office, along with a lot of other promises that were important to my electorate like the expansion of the main north road and a few other things in South Australia which were important at the time. What then followed was a decade of neglect when state governments across the board often did not spend enough money on public dental health care. The federal government was less than interested as well, until former Prime Minister Howard hit the twilight years of his time in office and the boom started to roll in with all the money.

Jamie Briggs (Mayo, Liberal Party, Chairman of the Scrutiny of Government Waste Committee) Share this | Link to this | Hansard source

Are we getting a history lesson or a debate on the bill?

Nick Champion (Wakefield, Australian Labor Party) Share this | Link to this | Hansard source

He could not stop himself spending. I know the member for Mayo was there at that time. It must have been a glorious period announcing those sorts of schemes. What we got was the Chronic Disease Dental Scheme, which when it was announced was speculated to cost $90 million a year. It now costs the Commonwealth $1 billion a year. We know those last few years in office for Mr Howard were—

Mr Briggs interjecting—

The scheme was supposed to cost $90 million a year and it ended up costing the Commonwealth taxpayer $1 billion. That is hardly good accountancy; it is hardly good book keeping. It was a prime example of John Howard's spending abilities in his final years. There was a lot of wishful thinking of what things would cost versus what they ended up costing the budget. It started out supposedly costing the Commonwealth taxpayer $90 million and ended up costing the taxpayer $1 billion—not unlike the subsidy for private health care which, of course, had similar calls on the Commonwealth budget.

Of course, the reason why that scheme has not served the taxpayer well is that, first of all, it is not means-tested. It is an open-ended scheme, and it can provide up to $4,250 to people of any income. So presumably, if a millionaire goes to his doctor and gets a care plan, he qualifies for taxpayer-subsidised dental care. This happens at the same time as many of my constituents—who live in the poorest suburbs of Australia and often do not have a good relationship with their general practitioner, or else have a sporadic relationship with their general practitioner because of the nature of general practice these days and the nature of their socioeconomic situation—often cannot get a cent at all, or they find it very hard to access the health system to be able to get dental health care. Many of them wind up on the public waiting list after some time. So what we have here is a very long period where the Commonwealth has been involved in dental care but, perhaps because of state governments not doing their jobs and secondly because of the spending that was associated with the first mining boom, there were some schemes that perhaps were not the best use of taxpayer's money.

We know dental waiting lists are very high around the country. I am pleased to say that my state has had some success in reducing the waiting lists. In 2002, under the previous Olsen-Brown government, there were some 93,000 people on the waiting list for dental care. That has been reduced by a quarter, down to 70,287. That is still too high and obviously we want to reduce that waiting list, but we can see from that situation that, when the South Australian state government put resources in and spent more money, what happened is that those waiting lists came down. There were fewer people on them. Of course, what also happened is that the waiting times—that is, the times that people waited to get to see the dentist to get the work done—also reduced, and they reduced dramatically. In 2002, the waiting time in South Australia was some four years. Obviously, during that time people's problems got worse and worse and worse, and obviously that ended up costing the taxpayer more in the long run because there was not prevention factored into this scheme. With dental care, a little bit of money and care at the start often prevents chronic problems later on. This year the waiting time is just 16 months, so the waiting time has dramatically reduced. That shows that, when you put public money in, you can reduce dental waiting lists and dental waiting times. That system works well; it is just that the state governments have not been putting the resources in up until now. They should be ashamed about that. It really is a shocking abuse of the public interest in my opinion.

That said, the South Australian government has been allocating resources and doing a better job than most other states, and we have seen it put some resources into my local area. The GP Plus clinic in the Elizabeth city centre has dental beds, and I have met many of my constituents who have been fortunate enough to receive care there. They are, as I said before, some of the poorest people. That, I guess, is the difference between Labor priorities and the priorities of the coalition. The coalition do not mind if people on very high incomes get $4,250 of taxpayers' money to fix their teeth. They do not mind if cosmetic work is being done. That is not to denounce cosmetic work as unimportant. It is important, but it is not as important as fixing people with really desperate problems who are really without the means to fix them. It is very important that we put resources in where they can yield the greatest benefit for the taxpayer. Most importantly, it is important that we reduce those public waiting lists, which are the product of state government neglect.

This bill is focused on children and, as I said before, a little bit of money at the start of a person's life can set the patterns of care. Being taken to the dentist as a child is not an enjoyable thing to do. I still have vivid memories of being taken in primary school to the government dental service. I did not enjoy it that much but it set in place a bit of a standard. I would not say I have the best teeth in the world but I had some experience with the dentist. That is why focusing this bill on children, making sure that parents are able to take children to the dentist, and making sure they can get up to $1,000 per child, public or private, in order to set those patterns of a lifetime, is a particularly important thing. It speaks to Labor's priorities for preventative health.

The reason the Howard government scheme blew out by such a degree—it was meant to cost $90 million and ended up costing taxpayers $1 billion a year—is that it was preceded by a decade of neglect in this area by the Howard government. That government reaped the whirlwind and did not take into account preventative health. We hear people decrying politicians all the time for not looking at the long term, but the health system is all long term. Preventative health—that is, setting people's lifestyle habits early, encouraging them to see a dentist, encouraging them to be mindful of diabetes and other chronic diseases—is all about setting good lifestyle patterns early on by, for example, making sure kids go to the dentist and making sure people's diets and lifestyles are not going to cause problems down the track.

The Labor government has done its very best to make sure that preventative health is the way we want to go. We know that in the long term that is the only way to reduce the burden on the health budget and to safely protect the taxpayers' interests. If we go around simply putting bandaids on everything, we will end up with the Howard government experience of a chronic disease scheme blowing out by vast amounts of money. Of course, this was not the only Howard government scheme to blow out; it went on a bit of a spending spree in the last few years of office, placing a great deal of pressure and leaving a lot of time bombs on the federal Commonwealth budget, and these were revealed when the global financial crisis wrecked revenues across the world.

Dental care is particularly important. It is important, firstly, for us to have a blitz on public dental waiting lists, working with the states to make sure that their systems work. State governments have a responsibility to make sure they work. It is not good enough for state governments to simply withdraw from this field. More and more over the last decade or so we have seen state governments neglecting their responsibilities while the Commonwealth government, of whatever persuasion, becomes responsible for it by dint of public pressure and because we are the people who collect the taxes. That is not the way the Federation is supposed to work. State governments are supposed to take responsibility for their responsibilities. The alternative will be that we eventually end up with universal coverage of dental care. That is a possibility, but it will require state governments to play their role by either handing over the power and resources to do that or pulling their weight.

The second thing we need to do is to, like I said, focus on preventative health. This bill is focused on children and on making sure that it sets habits of a lifetime, not just for parents in making sure that they do not leave dental care until the last moment, but that they have the resources, the help, the assistance and the nudge. The Commonwealth resources will put the idea into a parent's head that they should be going to the dentist regularly. They will probably spend more than $1,000 but, of course, every dollar spent in the first years of life from ages two to 18 will help set the patterns of a lifetime because generally people do not want bad teeth. It is only when it sneaks up on them that they end up with great difficulties.

On that note I commend the bill to the House. I urge the House to adopt it.

John Cobb (Calare, National Party, Shadow Minister for Agriculture and Food Security) Share this | Link to this | Hansard source

Today I rise to speak on the Dental Benefits Amendment Bill. There is an old saying, which those opposite would do very well to learn and to obey: 'If it ain't broke, don't fix it.' For some reason the government seem to have an obsession with taking a good scheme or successful policy—usually one introduced by this side of the House when in government—and dumping it for no apparent reason and to the detriment of the Australian public. One has to suspect in this case that it is something to do with money and with trouble in getting the books in order, which I think the Treasurer might have a lot of problems doing at the moment. The Labor government take good schemes, especially those introduced by our side when in government, and trashes them for no good reason. There are a couple we can think of—off-shore processing and temporary protection visas—which would be a couple of good ones to bring back in, and now it is dental care they are doing it to.

Last month I used an adjournment speech to detail just how devastating the Labor government's changes will be for dental patients, particularly in my electorate of Calare. I referred to the case of local pensioner, Ted, of Raglan, near Bathurst, who contacted me to express his outrage, and that of neighbours in his street, at the government's decision to scrap the highly successful Medicare Chronic Disease Dental Scheme. They are not only to scrap it now but have no alternative for care until Labor's new, untried, untested and unfunded dental health care scheme is introduced sometime in 2014. The government are scrapping a scheme introduced by the opposition leader when he was Minister for Health. As we heard mentioned earlier, it is a scheme that has provided more than $4,000 in Medicare dental benefits over two years for eligible patients, like Ted, with a chronic dental health condition. It is a scheme that has helped approximately one million patients with more than 17 million services since 2007.

Since my adjournment speech last month I have had quite a number of constituents contact me to express their fears, their concerns and, to be quite honest, their fury at Labor's changes to a highly successful and efficient dental healthcare scheme. I would like to share with the House and with the parliament a couple of these constituents' thoughts. I received a letter from Marion, a pensioner in Bathurst, regarding the scrapping of the Medicare Chronic Disease Dental Scheme. She wrote:

I am writing to complain about the government … the way it closed it so soon. I am a diabetic and widower. I went to the doctor on 5 September and he wrote me out a referral to the dentist. I went on Monday morning 10 September, only to be told it closed on Saturday the 8th. The receptionist said I would probably be out of pocket. I thought we were entitled to $4,250. Now I cannot get my teeth fixed. It is unfair. I have paid taxes all my life, now to be left without any help.

This is part of a letter I received from self-confessed 'desperate aged pensioner' Geoff, from Forbes, regarding dental health work he needs:

With the Prime Minister's latest decision concerning dental health, does this mean I will be put on hold? All of this is affecting my health, dignity and self-esteem. I am an aged pensioner. I am afraid to appear in the public eye. I don't feel comfortable mixing with people in social outings. To make things worse, I suffer from depression.

And this is part of an email I received from David, in Oberon, which was aptly titled 'Things that worry me':

I have Diabetes. Part of the management of the disease is having closely managed good dental health. It is well known that Diabetes can turn fatal if a diabetic doesn't maintain good dental health. I know this because my doctor told me and when he put me on the Medicare Chronic Disease Dental Scheme.

He also told me that this was part of the medical management for which he was being paid by the government to manage my disease. Will the scrapping of the scheme now mean that the government isn't really serious about looking after senior people in ill health? I am able to pay for the ongoing management of my dental health within reason but it could mean that the crown I am in the process of getting or the regular maintenance of my teeth may now be delayed if the cost is too great.

In turn that may mean that infection could enter my body by way of my mouth that could exacerbate my Diabetes and in turn cause me to seek other medical treatment possibly in hospital that would be far more expensive to the government via Medicare than the cost of prevention.

Has the government thought this aspect through or don't they care about people with chronic diseases who look after themselves and are good Australian citizens?

Now to the specifics of today's amendment. The coalition's greatest concerns about Labor's plans to change the dental care scheme are that there is no alternative plan between the end of November and 2014 and that their plan appears to be entirely unfunded. It is a little hard to have a plan for dental care that has no money attached to it. You might be going to wish people well, but that will not solve many problems for them.

This bill makes very minor amendments to the Dental Benefits Act 2008, only changing the eligibility age of the current Medicare Teen Dental Plan from 12 to 17 years to 2 to 17 years. We understand that more than 60,000 services have been provided to children under the Chronic Disease Dental Scheme. The closure of the scheme next month, 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 30 November. Those families will have nowhere to turn. 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, unexplained promise, in 2014. We in the coalition support investment in dental health and do not oppose the intent of the bill, but our concerns must be addressed.

I have no doubt the main reason for dumping this is the fact that the Treasurer has the country, the government and himself in one heck of a mess in his budget. Heaven only knows what kind of a deficit we are really looking at in the 2012-13 budget. In a desperate attempt to mitigate it, the Treasurer and the Gillard government are willing to play with the medical and dental health of people who cannot afford it. The previous speaker talked about it not being subject to only those who cannot afford it. We are talking about people who really have serious problems and really cannot afford it. If you were serious, then, instead of scrapping it, why don't you amend it? But you are not. This government is scrapping it irrespective of what financial situation people are in. As we have said before, they have no alternative. They have a vague promise for 2014. It is a disgrace. The people of Calare are not alone in wondering what sort of a government walks out on them on a program that has done a lot for a lot of people.

Stephen Jones (Throsby, Australian Labor Party) Share this | Link to this | Hansard source

For over a decade now members of the Illawarra Dental Health Action Group have been campaigning for reform in dental care. The action group is chaired ably by Ms Alice Scott, a constituent of mine, who is a very active member of the community, not only in dental care but in a whole raft of other areas of community life. This group has been agitating not only for an improvement in existing services but in pointing out where local dental providers are not doing the right thing under existing government schemes, advocating on behalf of local community members, particularly members on low incomes who are attempting to get access to the public dental scheme, and, lobbying government, having come here to Canberra on several occasions with a bigger than life-size pair of teeth to draw attention to their cause.

So they have been working for over 10 years to see some reform in the way dental health is delivered in this country. Their objective, quite simply, is to ensure that the mouth is treated no differently to any other part of the body when a person seeks medical or health treatment. That is, if somebody has a problem with their oral health then they are able to deal with it through a Medicare provided service in the same way that they could have an ailment in any other part of their body treated through a primary health care provider and paid for by the Medicare system.

So I am not surprised that when the Minister for Health announced the government's $4.1 billion Dental Health Reform Package on 29 August this year it was welcomed by the Dental Health Action Group. It was a guarded welcome, I have to say, because their long-term objective, as I have said, is the full Medicare-isation of dental health care, but they could see that this was a first and significant step.

What we are doing through this $4.1 billion dental reform package is ensuring that, for about three million children, going to the dentist will be just like seeing a GP—3.4 million children whose parents get family tax benefit part A or are receiving a range of other government income support benefits will be able to have access to the government's dental care package for kids. Families will be entitled to $1,000 per child every two years through the package to provide for dental care for their kids. Parents will be able to take their children to either a private or a public dental service to access the program. In addition to the dental care for kids arrangements, the reform package will provide additional services for 1.4 million adults on low incomes, including pensioners and concession card holders and those with special needs, to give them better access to dental health care in the public system.

We must remember that this does not stand alone. It builds on the nearly half a billion dollars that was set aside in the Labor government's last budget to fund a state government blitz on public dental care waiting lists. As you would know, Madam Deputy Speaker O'Neill—because you represent a similar electorate to mine—many people who are currently on public dental waiting lists are seeking access to free or significantly subsidised dental care simply because they cannot afford it themselves. This package goes a long way towards ensuring that those people have that much-needed dental care.

The issue of dental care for children is particularly important. We know that the oral health of children in our community has been declining since the mid-1990s. Almost 20,000 kids under the age of 10 years are hospitalised every year because of avoidable dental issues. By the age of 15, six out of every 10 kids have tooth decay. We know that if we nip this in the bud early we can ensure not only that we are improving the oral health of these kids but that we are saving both them and the public system a hell of a lot of money down the track. If tooth decay is prevented or treated early then a child's problems can be treated by way of a filling instead of removal of a tooth or several teeth and instead of long-term gum disease. It is a significant investment—and I say it is an investment because we are investing in the oral health of our children to ensure that we do not need to pay significantly more down the track when significant dental disease occurs.

So this has been very much welcomed by the dental health advocates within my electorate, and it will mean a lot to kids within my electorate. There are about 52,000 kids—about 28,000 families—in the region who will be able to gain access to the government's subsidised dental care. That is indeed a significant benefit for people in the Illawarra and Southern Highlands. In my own electorate around 19,000 kids, coming from around 10,000 families, will have direct access to the scheme. They will see a benefit, straight up, that they do not currently enjoy. It will enable us to tackle, head on, that decline in oral health standards that has been occurring since the 1990s, particularly in kids from low- and middle-income families.

A number of comments have been made within the course of this debate, including by the last speaker, about why we were closing the chronic diseases scheme. I think he used the words, 'If it ain't broke, why fix it?' Nothing could be further from the truth. In my own electorate I have received numerous complaints from constituents who have accessed the scheme only to find that they have been treated for ailments that they did not believe they had and that, on second opinion, they found they did not have; that the cost of the treatment they received was wildly inflated so as to access the entirety of the Chronic Disease Dental Scheme budget for their individual allocation; and that shoddy work was performed on more than one occasion.

I had somebody come into my office and seek my assistance because they had been provided with a dental plate that did not fit. They were unable to eat in the normal way that you and I would expect somebody who has just undergone significant dental treatment and had a new plate fitted to be able to do. They could not even chew on a sausage, such was the poor quality of the work. So somebody saying, 'The scheme isn't broke, so why fix it?' shows that they are clearly out of step with the community and out of touch with reality—and that is before we get to the cost of the scheme.

The scheme that was introduced by, I believe, the current Leader of the Opposition, who was the then Health Minister. He brought in the legislation to bring about the Chronic Disease Dental Scheme. We were told it was going to cost $90 million a year. It is currently costing over $1 billion a year, so no more evidence is needed as to why something is wrong. We have heard numerous examples of how the scheme has been rorted. It is not means tested. It is poorly targeted. So it was a poorly designed scheme from the get-go. Its aims, I will say, were absolutely laudable. I think the aim of ensuring that people with chronic dental diseases have a mechanism by which they can have those diseases treated, and treated in an affordable way—and treated quickly—is laudable and would enjoy the support of all members in this place. But to have a scheme that is aimed at ensuring that extended from everyone on a pension to those on multimillion-dollar salaries, and to have a scheme which is so poorly designed as to allow the sorts of rorting that has gone on, is not in the public interest. That is why we are moving, through this legislation, to reform the scheme and replace it with one that is means tested, that is targeted and that I hope will become the Medicare-isation of dental health care in this country—and it matters a lot.

This is aimed at children and aimed at improving the public health dental waiting list. But there is another group of people we should be focused on. On more than one occasion I have had employers talk to me about this issue and the importance of dental health to improving somebody's employability. If they have two job applicants come through the door and sit down for a job interview, and one starts to talk and they have are poor, decayed and gapped teeth, and the second person, sitting alongside them, has all the same aptitudes but does not suffer the same diseases and the same problem, the second person is more likely to be employed. I do not endorse that approach, but it is a reality. I have had job seekers say the same thing to me as well. So it is not just a cosmetic thing, and it is not just a health thing; it actually impacts on somebody's capacity to look for work and to be successful in job applications. I think the bill before the House is a first and important step in overhauling this scheme and will provide real benefits to people who live in electorates like mine.

I will conclude by once again congratulating the tireless work of the Illawarra Dental Health Action Group, its chairperson, Alan Scott, and the many people who have campaigned for over a decade to provide support to local constituents and advocated on behalf of public dental health patients. It has been an important organisation in ensuring that we get the sort of change that we are debating in this chamber today. I commend the legislation to the House.

Nola Marino (Forrest, Liberal Party) Share this | Link to this | Hansard source

The Labor government is cutting $1.5 billion from the health budget through the Dental Benefits Amendment Bill. The minister has confirmed the cuts, saying that this is a direct savings measure—and we know why that is necessary, don't we? It is necessary because of the combination of Labor's absolute addiction to wasting billions and billions of taxpayers' funds and as a result of what we now know is $120 billion worth of unfunded spending promises: whether it is the NDIS, whether it is the Gonski review changes, whether it is the unfunded submarines or whether it is border protection—the list is almost endless. And we do know that this particular bill is part of that government-unfunded $120 billion worth of promises. It is $4.1 billion worth of a dental program that will not actually commence until 2014—well after the next election, interestingly.

The bill before the House is not really about a broad policy debate on dental health, and it certainly does not go to any of the questions of the longer-term issues about dental health management in this nation. I do know that Sydney University oral pathologist Professor Hans Zoellner has said that approximately 1.5 million people have accessed this program, 80 per cent of whom were actually healthcare card holders. They are the people who have accessed this program, who need this sort of support. He also said that this Medicare scheme is actually well targeted. In spite of the comments that have been come from the other side, it is targeted, because it is delivering, generally, to people on low incomes. And, as I said, Professor Zoellner's comments were that 80 per cent of those who have received this level of care were healthcare card holders.

But if the government are looking at longer-term dental health care in this country, why have they refused the coalition's bipartisan offer to work to basically refine the Chronic Disease Dental Scheme, the existing scheme? Instead, they have just closed the program—because they are really chasing that budget 'surplus' and have to find the money from somewhere—and are proposing that some time in the future, an alternative program, the source of funding for which, as I said, is yet to be announced, will be in place. It is another never-never plan, and well out beyond the next election. This is a pattern for Labor. It is also a pattern for Labor to take funding from one group of Australians and simply redistribute it to another.

We are talking here about people who are midway through treatment. Since 2007 we do know that people with chronic diseases, whether it is diabetes, whether they are in remission from cancer or having treatment for leukaemia, or whether it is heart disease—people who have depended, and do depend, on dental services to protect their health. It is not a cosmetic issue for people with these types of diseases. This is a very serious issue, and they have relied on this scheme to assist them through probably the toughest times in their lives, some of the toughest health challenges they are facing. This CDD Scheme is the one that has supported them during their time of most need.

But from December this year, Australians with chronic diseases who need dental treatment will have their funding cut by this government. Instead, the government will fund a dental scheme for children, maybe in a year's time. Typical of Labor, it is taking with one hand and—after having pocketed the money—in the run to the next budget it may at some time give some of that money back with the other hand. It reminds me very much of the whole debate over youth allowance. We had the government taking with one hand and eventually being forced to give it back with the other, but only partly. Now we have the same thing with dental care.

As we know, the Chronic Disease Dental Scheme involves Medicare payments for the services provided by dentists, dental specialists, and dental prosthetists in their surgeries. Patients admitted to hospitals are not covered because they come under a state management system. Eligible public patients can receive up to $4,250 in Medicare benefits for dental services over two consecutive calendar years. That is, and has been, available to patients who have a chronic medical condition with complex care needs that must be managed by a GP under a specific Medicare care plan. It is aimed at patients whose oral care is also impacting on their general health. The patient must be referred by their GP to the dentist.

We also need to consider what impact the sudden closure of this program is going to have in a broader sense in relation to the states. Members of this House would certainly be aware that the majority of dental care is funded by state governments, not the Commonwealth government. This bill does nothing to address the impact this decision will have on dental waiting lists in each of those states. This issue that the government has deliberately created—not only a funding gap but a time lag for services—is going to add to the waiting lists.

In my electorate in Western Australia, the dental services that are provided are provided by the Public Community Dental Services and the Country Patients Dental Subsidy Scheme. The Public Community Dental Services operates a 10-chair public dental service in Bunbury in my electorate, and that is funded by the WA government. The Country Patients Dental Subsidy Scheme is also a state government scheme that provides payments to eligible people in country locations where there are participating private dental practices and no public dental clinics.

The Chronic Disease Dental Scheme takes some of the pressure off each of these public dental schemes. The closure of this scheme will add to waiting times. I would really like to know just what consultation the minister and the government have had with the states and with the state ministers on the inevitable impact these changes will have on them and the services they are providing. Given the history of this Labor government, I will not be making an assumption that this discussion has taken place.

The coalition has raised other concerns in relation to the dental issues. In particular, there are children who will lose access to treatment on 30 November with the closure of the CDDS, including children whose current treatment will not be completed by 30 November. What about those children? There is the unfunded $2.7 billion cost of the measure the government is proposing. The schedule of services and fees is not available, as the bill, as we know, is just being rushed through the parliament—which is another habit of this government. Of course, the government is working overtime on that budget surplus issue.

There are real and valid concerns that I have mentioned, and they reflect the lack of a long-term plan for dental care and what is probably the arrogance of the government in failing to work with service providers and the states. We have proposed an inquiry that would consider all of these issues and seek to provide an integrated and inclusive approach—that is what is needed, given the role of the states. The Labor scheme announced last month proposed to provide $1.3 billion to state and territory governments for public dental services. What it failed to announce was where this proposed money was going to come from. It has to be funded. Again, this fits the Labor pattern.

The provision of government funded dental care in Australia has a long and varied history. Of course, the government is not willing to engage in a broader plan. We have made that offer; that has been refused by this government. And, of course, we are once again debating a small component of dental care. The broader issue here is exactly where the funding is going to come from: the length of the lag time between the end of one program and the start of another, which is at least 14 months, during which people will be unable to access services.

Those are the concerns I have with the bill before the House.

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

I rise to speak on Dental Benefits Amendment Bill 2012. I guess one of the important things in communication is the ability to relate. So I will relate the words of a famed communist back to Labor. It was Nikita Khrushchev who said: 'Politicians are the same all over. They promise to build bridges even when there are no rivers.' And so it is with this Dental Benefits Amendment Bill. The facts, as stubborn as they are, are that, under the current scheme—a coalition scheme—20 million services have been provided 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 in 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 not a man who plays politics with people's lives or with their children's lives. He is a firm and considered servant who does not make empty promises, for a promise made is a debt unpaid.

This is the kernel of the coalition problem with this bill: it is not costed, it is not funded and it is not fair. The coalition are crystal clear in our unwavering commitment to the health of all Australians. I cannot support any bill that will burden the hardworking families of Tangney with another unnecessary government debt. But this is what we have seen time and time again from this tired and troubled Labor government. They promise now and we have to pay later. One thing is for certain: the promises of yesterday are the taxes of today. And we know Labor hate accountability.

What we have, then, is a $4.1 billion commitment that is unfunded. Where will the money come from? The money will come from you and me. Increasing borrowing is Labor's answer to everything. In fairness, Labor should make this their fall-back, because it is the only thing they deliver on. They have borrowed and borrowed. In fact, they have got better at borrowing other people's money the older they have got. Just by way of example, Labor has turned net government interest payments from $1.02 billion in earnings into $6.5 billion in payments. That is more than enough to implement every single one of the Gonski education recommendations for the next four years.

These are the facts. Labor over promises and under delivers. It is said that we promise according to our hopes, and perform according to our fears. Labor has a lot to fear, because when the people of Willetton, Bull Creek, Applecross and Attadale find out that they will be left with nothing for 19 months they will be angry. The Dental Benefits Amendment Bill will stop the successful CDDS on 30 November and leave nothing in its wake—nothing. There is no outline of what will fill the gap between November 2012 and July 2014, when the proposed measures are to come into place.

And look more closely at the proposed measures. Under the current scheme, the successful coalition CDDS, up to $4,250 is available over a two-year period. Contrast this with the proposed bill and we see that Labor and the Greens have reduced the maximum amount by $3,250 or 77 per cent of that currently available. Reducing the amount available by 77 per cent and leaving the people of Tangney in the lurch for 19 months is, quite frankly, a disgrace.

The real anger of the silent majority demand and deserve answers. Labor's most noble intention with this bill was to give a little to a lot, rather than a lot to a little. But what we find is that they will actually stop giving to everyone for 19 months. Conveniently, 19 months from now is July 2014. By then we will have passed the next election. It is hubristic to assume that Labor will still be in power by then. Government is not the gift of the unions and back-room boys but of the people.

Labor thinks it is better and more clever than Australians. This government is more interested in playing politics than discussing policy, and concerned about putting political profit before its duty to our nation. The political profit here is, of course, the much-vaunted budget surplus. And if it means that the parents of Riverton and Rossmoyne will be left scratching their heads, left in the dark and concerned about how they will fund their children's dental bills, then so be it! The Prime Minister and Treasurer are unconcerned. They do not care, because they will be able to point to fact that they apparently delivered a budget surplus—a budget surplus at all costs.

We cannot pass this bill—a bill that will leave Australians worse off. We know that 30 November—less than 10 Mondays away; less than 60 days away—marks the end of a good, decent and effective policy. That is the day when the CDDS stops, and when spin over substance starts. If you are in treatment make sure it finishes by 30 November, and by God make sure you do not need dental services again until 2014.

How much of a cop out is it that the maximum provided for under this proposed scheme is only $1,000, when the Department of Health and Ageing's own figure for the average cost of treatment is $1,716? This is in a country where the five-year average rate of inflation is three per cent, and the rate of rate increase in inflation is increasing. What a rort!

How can anyone in Tangney or anywhere in Australia ever consider this bill to be 'fair dinkum'? The coalition CDDS provides up to $4,250. Promise after promise, time after time, Labor are letting the people down. What happened to the Labor promise to their partners the Greens? What happened to the Commonwealth Dental Health Program? It is time to focus on facts. This bill is unfair, unfunded and unnecessary. If Labor do not and cannot value health, why should they be trusted on anything else? In measure, then, the government must know the rightful anger of the people when they are attacked. The consequences for the young and the sick are grave and urgent. It is time we return hope, reward and opportunity to all Australians.

Honourable members: Keep going! You still have six minutes.

Six minutes? I thought you had someone on your side that was going to do it. Anyway, what does it say about people? Imagine you had painful and unsightly dental work that required treatment and you were told: 'Tough, you'll have to wait 19 months'? The people undergoing treatment right now are in grave danger of not having that treatment completed. They have to have that treatment completed by 30 November. What happens then? Say someone is halfway through a root canal treatment—they have had the hole drilled and a little bit of a plug put in. That is it; sorry, the rest of your filling will have to wait 19 months. Do you think there would not be any further degradation to that tooth? Do you think you would not get further rotting into maybe another part of the root system or further pain? This is a very real problem that this government refused to acknowledge. Clearly the government is completely embarrassed about the situation. Look at the plethora of speakers lining up on the other side to support this bill, which they vaunt.

The government says that the CDDS is in fact an unfair scheme and that it is going to replace it with a better scheme. Where are the government members to support it? Look, there is a row of empty benches opposite with no one supporting the bill. What does that say about the government's commitment to dental health? What it says is that this government has got a huge problem with its so-called budget surplus. It is a budget surplus which it is vaunting but which it finessed so much to such a great extent that it is doing everything it possibly can to pretend that it is going to be a real surplus.

There is $47-odd billion in NBN funding for the budget surplus, but guess what? It is not in the budget papers. It is off budget. It is like having a car and deciding you want to buy some mag wheels. You tell yourself, 'It's not coming out of my budget. I will not take it out of the household budget. I will pretend it does not come from that because when I sell that car it might even earn a profit due to the fact that it has mag wheels.' Is that a realistic assessment? Do you really think that the NBN is going to be able to make money on that $47 billion that is being spent? If that was the case, where is the cost-benefit analysis? We are still looking for that one. It has disappeared.

Here is a government that is looking at a mirage of a budget surplus that is never going to eventuate. It is doing everything it can to keep things off budget or otherwise hide things away. It will just get rid of the CDDS and what are we going to replace it with? I am pleased to see that the health minister has finally turned up. I am surprised that she has not been vociferous here in supporting this bill. There is a 19-month gap between when the CDDS ends and your scheme supposedly gets introduced.

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

No there isn't. You made that up.

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

Not true? Have a look at your own bill. You are going to leave people in the lurch. For people who are on treatment now, that treatment ends at the end of November. What happens to them, Minister?

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

It is not true.

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

There will be nothing until April 2014. You can wait, folks. That is okay; that is the Labor way: 'We make promises we cannot deliver on and we have borrowed so much money that we cannot really borrow any more. What sort of promises do we make? We are now promising to spend the states' money. We are not even spending money that the federal government is borrowing anymore'. They are making promises that they cannot deliver and so they are relying on the states to fund those promises. What a disgrace.

I notice the Treasurer is here. This is supposed to be responsible budgeting. It is a joke and it is getting worse. I almost do not know where to go—

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

We can tell.

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

with where the government has got us. It is an absolute disgrace, member for Windsor. The government is so desperate in pushing a budget bottom line that it is prepared to leave people in the lurch for 19 months when they have chronic oral health problems. The government says it has got a great scheme but guess what? You have to wait 19 months. Your treatment will have to end by 30 November because otherwise there is a gap. (Time expired)

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 legislation because we do have a government that proposes to leave some of the most vulnerable Australians in the lurch. We do have a government that is being absolutely callous in the way it is treating these people. We do have a government that cannot manage its own budget and, because it cannot manage its own budget, Australian people will suffer. The government is so eager to wind up the scheme. It has been chasing the scheme on the basis of ideology. It shows that this government does not care for the neediest Australians. It shows that it does not care for those Australians in the very worst of health. It shows that this government is absolutely out of touch with the health needs of many Australians. This scheme provided much needed dental assistance payable under Medicare for Australians who would otherwise be totally unable to afford this treatment.

What has the minister said to these people? She said, on 30 November, 'Your treatment must stop; you have to go on the state waiting list; you may wait for two years; and I don't care.' This minister says, 'I don't care about sick Australians. I only care about my own political future. I only care about Labor ideology.' This minister is leaving Australians in the lurch at a time when their health is most in need.

Debate interrupted.