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

I am pleased to speak in continuation on the Dental Benefits Amendment Bill. I was disappointed to see the member for Lyne vote yet again with the government against the disallowance proposed by the coalition which would have protected those in the community who so desperately need dental services. In outlining the reasons for his decision, he said:

… I have had several discussions with the Minister for Health and have received several important assurances. The most important of these is that there will be no gap between the closure of the CDDS and the flow of funds from the government reforms.

I must say that is a very important point, but what does this assurance mean? I would hope that the member for Lyne would spell out how this assurance protects the people of the North Coast of New South Wales from the withdrawal of services. Is the member saying that all patients currently on the CDDS will be transferred seamlessly into a new system but utilising a proportion of state services and their treatment continued? Is that what that statement means? Or is he saying that patients will be transferred to the state dental scheme with its waiting lists? We all know that there are waiting lists in the state system of up to five years.

This is important, as we are debating legislation that defines the care that people will receive rather than a nod and a wink from a minister. The legislation as it is currently drafted says that for children new arrangements commence on 1 January 2014 and for adults the new arrangements commence on 1 July 2014. That begs the question: why is the member for Lyne supporting the closure of the CDDS in 2012 with arrangements for children not starting for 13 months and arrangements for adults not starting for 19 months? Surely, in the interests of better health outcomes, in the interests of serving the people of the North Coast, these arrangements should be continuous. There is an important question mark over the services which may be available under the new scheme. Can the member for Lyne guarantee that the people of the North Coast will be eligible for the same types of treatments that are available under the CDDS?

It may be that a range of treatments are unavailable under the new provisions.

Another important issue is where will the services be delivered. There is a serious question about where people will be able to access services. It may be that North Coast residents are required to travel to Sydney, for example, to access services. This is unclear. Will there be a choice of dentist under the new arrangements, as there is under the CDDS?

What do we say to a cancer sufferer enduring chemotherapy who needs ongoing dental treatment, which is currently being provided under the CDDS? What does the member for Lyne say to such a patient? How are the interests of such a patient safeguarded; how can we be sure that that person's treatment will continue. Will that person just fall into a void? Will that person just be transferred to a state waiting list? Will that person just be denied treatment? Will that person, perhaps in their darkest hour, facing huge challenges, potentially be denied treatment beyond November this year? I believe that this is an unacceptable situation and I think it is incumbent on the member for Lyne to tell the people of the North Coast of New South Wales what are the safeguards, what are the provisions that the minister has offered, that are going to ensure that all of those patients currently undergoing treatment can have that treatment continue? Will he be able to reassure those patients that not one patient will miss out, not one patient will end up suffering, as a result of these changes.

It does seem rather strange that this legislation would say that the new payments that will be flowing to the states will flow in 2014—not in November 2012—not until November 2014. What do we say to those people already in the queue, who perhaps have been waiting years for services? What is going to be their fate? Will they be pushed further down the queue to make provision for those who are currently receiving treatment? That is unclear also. There are many people on North Coast public dental queues who have been waiting years for services and who may be waiting even longer as a result of these changes. We just do not know.

Why would the member for Lyne vote against the disallowance when there are no clear transitional arrangements in place to protect the people that he represents and protect the people that I and other members represent on the North Coast? Why would he be voting against the disallowance of a measure that provided a very important protection only on the nod and the wink of a minister? I think it was incumbent upon the member to ensure that protections were in place before he voted for the disallowance. In the legislation before us, there are certainly grave doubts about the future of dental care for people suffering chronic disease and for those people urgently in need of ongoing treatment. So I hope the member for Lyne will advise the people of the North Coast of the details of the assurances he has received on how individual cases will be dealt with, how people such as cancer sufferers will be protected, how measures will be put in place to ensure that those currently receiving treatment will not be dropped into some void of bureaucracy, just waiting to get onto a waiting list, and how measures will be put in place to ensure that those people currently on dental waiting lists will not be further disadvantaged by the changes to the scheme. These are important questions.

We know that the coalition scheme, the Chronic Disease Dental Scheme, has been disliked intensely by the Labor Party. They have been attacking the scheme at every turn. They have been attempting to get rid of the scheme at every opportunity. They have been victimising dentists for alleged fraud under the scheme. The coalition agrees that where there is fraud dentists should be duly dealt with under the law but, where dentists have been providing services to patients in good faith and there are only minor administrative errors or omissions, that should not be subject of major actions by the government. This government reviles and detests this scheme, implemented by the current Leader of the Opposition when he was health minister, and yet it is a superior scheme because it allows people to access Medicare benefits for dental services—up to $4,250. That is a significant contrast to the benefits that are currently offered and the caps on the new scheme, which provides only $1,000 over two years for children and requires that adults be dealt with through the public system.

The government is implementing a scheme that is a substantial backward step in ensuring good health outcomes for the people of the North Coast, and in putting that legislation forward they have garnered the support of the member for Lyne, from the North Coast, and he says he has assurances from the minister. We really do need to know what those assurances mean in practical terms for the people of the North Coast—for people who cannot afford to access dental care through private practices; for those who cannot afford unnecessary trips to Sydney, if that is what the changes mean; for those who cannot afford to wait longer for services, if that is what they mean; and for people who are suffering greatly from chronic disease such as cancer, who cannot afford to be without the treatment they cannot afford to buy. It seems incredible that the member for Lyne would vote against disallowance.

The coalition will be opposing this legislation proposed by the government, for good reason. It is going to result in adverse health outcomes for the people that we represent. It is bad legislation. The coalition offered to work with the government to improve facets of the scheme, but such is their hatred of the scheme that those offers came to nothing. We will be opposing this legislation because we are about providing better health outcomes, not worse health outcomes. We are about supporting people in rural and regional Australia, giving them the best possible health outcomes that they can have. I certainly think that this is a backward step in health care in Australia.

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

The member for Cowper and his colleagues on that side might be happy to vote against a measure which will see 3.4 million Australian children receiving dental care, but I, for one, will be supporting the Dental Benefits Amendment Bill 2012 and supporting it wholeheartedly. I am pleased that I am able to join so many of my colleagues on this side of the House in doing so. From, for example, the approach taken by the member for Lyne on the disallowance motion yesterday, I know that there is support for this bill from other parts of the chamber as well. Adequate Commonwealth government funding for dental health in Australia is something Labor have been arguing for since the earliest days of the Howard government, when Peter Costello axed the Commonwealth dental scheme in his first budget.

I will come to the specifics of this bill in a moment. First, however, I want to make the point I have made at the start of my contributions on all of the health related bills introduced in recent years—the establishment of the Australian National Preventive Health Agency, plain packaging of cigarettes, workforce measures funded through Health Workforce Australia and the creation of Medicare Locals and hospital boards. All those measures have been component parts of the overarching health reform agenda of this government. When we came to government, we wanted to get past the blame game and the cost-shifting between the federal and state governments which had come to characterise the health portfolio under the Howard government. That was no better illustrated than in the debates we had about the Commonwealth government's responsibility—or, in the case of the Howard government, denial of responsibility—for dental care. That same approach saw the Howard government cut funding for public hospitals and then criticise Labor state governments for the consequences of those cuts.

We came to government prepared to take responsibility for the delivery of health services. To do that properly we needed to understand the demands on our healthcare system, the barriers to meeting those demands and the best design for removing gaps and inefficiencies from the current system. The National Health and Hospitals Reform Commission did that work for us and all the measures we have legislated and implemented have been consistent with the commission's recommendations for achieving an integrated and efficient healthcare system capable of meeting the needs of the Australian community both now and into the future.

This bill is no different from those other measures and is a significant part of the broader reform framework. The report of the Health and Hospitals Reform Commission identified three reform goals to guide our restructuring of the health system. One of those goals is tackling access and equity issues which affect health outcomes for people. Following on from that, one of the five priority access and equity issues singled out for attention by the commission was improved access to dental health care. I point out that this report came out after the Chronic Disease Dental Scheme, which the other side is so supportive of, had been in operation for some years. So clearly very large gaps remained despite that scheme.

The report sets out the challenge very clearly and makes the following points: that Australia is in the bottom third of OECD countries for rates of dental decay; that nearly one-third of Australian adults avoid or delay visiting the dentist due to cost; that, at the time of the report in 2009, nearly a quarter of a million people were on public dental waiting lists; that there has been a 20 per cent increase in tooth decay among children since the 1990s; and that poor dental health is detrimental to people's general health and wellbeing. So better access to dental care has always been a priority for the government within our broader health reform agenda. Access to dental care is a matter of equity and is key to achieving the health outcomes we need if Australia is to be a healthy and productive nation.

The Dental Benefits Amendment Bill puts in place the first step towards the comprehensive dental health reform package announced by the Minister for Health on 29 August 2012. That reform package has a number of elements, which I note the opposition continue to ignore in this debate—focusing instead on the one fig leaf of dental care they came up with in their 12 years in government. Our comprehensive scheme includes the national partnership arrangements with the states for the expansion of services to adults in the public dental system. Those national partnership arrangements will mean $1.3 billion to fund around 1.4 million additional services for adults on low incomes, including pensioners, concession card holders and those with special needs—greatly improving access to dental care in the public system. Our comprehensive scheme also includes a flexible grants program to provide additional dental infrastructure in support of improved services and workforce development. It also includes the Child Dental Benefits Schedule, known as 'dental for kids', which is the subject of this bill.

This bill amends the Dental Benefits Act, which has been in place since 2008. It fulfilled Labor's promise at the 2007 election to help families with the cost of accessing dental health check-ups for their teenage children. The existing act supports that through the Medicare Teen Dental Plan by providing for the issuing of vouchers to eligible teenagers between the ages of 12 and 17. The government has, however, responded to the advice of the National Advisory Council on Dental Health to expand on that scheme by extending the potential support for a greater range of dental services to a much larger group, including children from the age of two. This bill gives effect to that commitment and amends the Dental Benefits Act by expanding the age range of eligible children. Currently the Medicare Teen Dental Plan covers eligible young people from the ages of 12 to 17. Following the passage of this bill, vouchers for dental care will be issued to eligible children and teenagers from ages two to 17—a very significant expansion of the program. The Child Dental Benefits Schedule this bill provides for will replace the existing Medicare Teen Dental Plan from 1 January 2014.

These amendments are just the first step in setting up the new 'dental for kids' scheme, which will see millions of kids getting better access to dental care. Those families who qualify will be entitled to $1,000 per child every two years. The eligibility test remains the same as the one for the Medicare Teen Dental Plan, which basically means it is targeted at low- to middle-income families. It is for children in households receiving the family tax benefit part A, Abstudy, the carer payment, the parenting payment, the disability support pension or a number of similar payments.

With that $1,000 every two years, those families will be able to take their children to either public or private dental clinics for services ranging from preventative check-ups to basic treatments such as fillings and extractions—another important improvement on the Medicare Teen Dental Plan. It is expected that this scheme will subsidise dental care for over three million children.

The precise range of services and benefit level under the Child Dental Benefits Schedule will be established at a later date under the Dental Benefit Rules. As the minister made clear in her second reading speech, she intends to consult with oral health professionals to design the fee schedule under the Child Dental Benefits Schedule. We understand that the schedule needs to contain an appropriate mix of dental services and fees that encourage participation by the dental professions and the right level of servicing. That will take time and the cooperation of the dental and oral health professions, but it is a very important part of making sure that this scheme gives children the care they need and the oral health practices that will carry them through into adulthood and old age.

We also need to ensure that families and the government are getting good value for the money that is subsidising particular dental services and treatments. That question of value for money is a good one and highly relevant to this debate, because a large part of the funding for the government's new dental health initiatives comes from the closure of the Chronic Disease Dental Scheme. We all know now, from the debate that has gone on in the House for the last week or so, that the Chronic Disease Dental Scheme was introduced by the Leader of the Opposition when he was health minister in the Howard government, and the opposition have been defending it ever since, including in this debate. They defended it, even as it became obvious that it was poorly targeted, subject to rorting and the costs were blowing out, while leaving so many other areas or dental care underfunded and neglected.

The Chronic Disease Dental Scheme, which entitled patients to receive over $4,000 of dental treatments every two years, was supposed to cost $90 million per year but is now costing $80 million a month because, as I said, it is not means-tested and it has been used in many cases for treatments that go way beyond what was needed to address people's basic dental problems and it left so many other areas of dental services unaddressed and left to the states to deal with. While that money was being shovelled out the door with the blessing of the opposition, thousands of low-income Australians sat on public dental waiting lists and our population fell further behind on comparative measures of our oral health. It was a shameful situation and one that we cannot stand by and ignore to the same degree as opposition members will continue to defend it.

We need our health dollars to go as far as they can towards improving the health of all Australians. The way to do that is to target spending on programs that have the biggest impact and reach those who we know are the most disadvantaged when it comes to accessing dental health services. With that in mind, last year the government sought expert advice on what needs to be done to lift the standard of dental health and access to dental care.

The National Advisory Council on Dental Health reported to the government in February this year and made it clear that, among its other recommendations, the No. 1 priority had to be providing subsidised dental services to children. Once again, we have seen the opposition accusing the government of some kind of arbitrary, knee-jerk reaction and a vendetta against the Chronic Disease Dental Scheme. That argument cannot be sustained when you look at the genesis of this measure and the other measures within our dental health scheme. These are things that have been recommended to us by experts, at the same time as we were receiving advice over and over again about the inadequacy of and the rorting that was going on within the Chronic Disease Dental Scheme.

As I was saying, the National Advisory Council on Dental Health told us that dental health for children was the top priority for funding. One of the reasons for that is the deterioration in the state of children's teeth right across the population—rural and urban, high and low income. After decades of improvement, since the 1990s we have seen children's dental health decline. In that time, the prevalence of dental disease has increased. The advisory council report quotes the Child Dental Health Survey Australia from 2003-04, which showed that nearly 50 per cent of children aged five to six years experienced dental caries in their baby teeth and 41 per cent had untreated decay. An Australian Institute of Health and Welfare survey found that 45 per cent of 12-year-olds had decay in their permanent teeth and 25 per cent of that age group had untreated decay. An important point is that the prevalence, severity and level of untreated decay is higher in low-socioeconomic groups in the community. We can see from those statistics that children's teeth are getting worse, which highlights the lack of preventative care, and that a significant number of children are obviously not getting the treatment they need when decay sets in.

So 'dental for kids', which this bill supports, will allow children from families where the cost of going to a dentist is a barrier to regular visits to start having yearly check-ups and follow-up treatment where necessary. This will make a big difference to the rates of childhood dental disease that I just quoted and, very importantly, will reduce the burden of dental disease on those kids, our community and the health budget when they grow up. We know that those high rates of decay and dental disease that we are seeing in primary school children are not going to improve without treatment and, unless we make preventative dental care a regular part of their lives, we face the prospect of having to provide much more expensive and much less effective remedies further down the track.

The fact is that poor childhood oral health is a strong predictor of poor adult oral health, so of course it makes sense for the government to invest in better dental care for our children from the age of two and through their teenage years. Regular visiting patterns and good dental care will mean that they have the best chance of going through their life with healthy teeth and without the terrible medical and social detriments of dental disease. It is the best result for those children and their families, and the best use of government money to realise our health goals.

As I said, this is part of a much larger package, a $4 billion package, of dental health measures, which itself comes on top of half a billion dollars in the budget going towards addressing public dental health waiting lists. So we are making big inroads into addressing those access and equity issues for people when they need dental health care.

Another important investment in oral health, in my electorate, was money that came from Health Workforce Australia for the Central Queensland University's new allied health clinic, which includes 12 dental chairs which will be available for members of the public to come in and receive treatment from new Bachelor of Oral Health students, who have commenced their studies at CQU this year. We have seen 30 students enrol in this first year. They will, in effect, be doing their clinical placements at this facility built on the grounds of the university. So we are training our future oral health workforce at the same time as greatly increasing the dental health care that is available to people in Rockhampton and in Central Queensland more broadly. That is just another example of the government looking for very practical and cost-effective ways to address the issue of access to dental care.

I fully support the dental for kids measure as an important step towards better access to dental services in this country.

Greg Hunt (Flinders, Liberal Party, Shadow Minister for Climate Action, Environment and Heritage) Share this | Link to this | Hansard source

Let me begin by putting the Dental Benefits Amendment Bill 2012 in context. This bill is part of a broader issue facing the government. The government is desperately trying to put its budget back into surplus. We are the great supporters and advocates of that goal because there is a huge pressure on public borrowing, but there is a question of wisdom as to the way in which we do things. What we see here, in my view and in our view, is that this bill and this process abolishes a successful scheme and replaces it with one where the architecture, the design and the human impacts are under deep question. We will not stand in the way because we do not believe that there should be no coverage, but we are about to face a major human impact where real people will suffer real consequences as a result of what is effectively the creation of an 18-month gap for many Australians who suffered deep, chronic pain and from deep, chronic dental issues.

I really want to deal with this bill in two steps: firstly, the human consequences to people within my own electorate of this bill, if it is passed in its current form, and that is why we saw the coalition move a disallowance in terms of the suspension of the current dental scheme and why we believe that it is important to have a bridge, if not a complete continuation, of what we are proposing; and, secondly, I want to deal with the bill itself.

Let me focus on an approach from two parents in my electorate. Corinella residents Richard and Carol Casbolt have written to me. Their view was very simply and eloquently expressed. They set out that their daughter Danielle has a real risk of further health deterioration as a consequence of the closure of the current Chronic Disease Dental Scheme, which is part and parcel of this package. I cannot believe that the government would intend these consequences but, having lived through the Home Insulation Program, I know there is an issue of wilful or constructive blindness where people simply turn a blind eye to consequences which, while they would not want them to happen, they certainly will not stand in the way of them occurring. The letter from Mr and Mrs Casbolt proceeds in this way. Speaking of Danielle, they say:

Our daughter who suffers from Schizophrenia has to take a number of tablets that affect her bones and teeth requiring a number of visits to the dentist for fillings and teeth removal. At times the visits have cost her over $500 per time. Where to now?

That is the end of the quote but, sadly, not the end of the story. The story of Danielle, the story of Richard and Carol Casbolt, her parents, is the human face of what this package of measures will lead to as an unintended but, sadly, inevitable consequence. It is a form of constructive policy negligence. That is why we sought, through the member for Dickson's motion, to ensure that the Chronic Disease Dental Scheme was not closed down, that at the very least there was a bridge until the opening of the government's own scheme in 2014. So this is a genuine concern.

Let me similarly talk about the fact that Richard Casbolt has spoken to my office and said that the family knows of many other Bass Coast residents are likely to be similarly affected by the closure of the Chronic Disease Dental Scheme. So there are real human consequences as a result of this bill.

We can argue about the final design but I think it is unarguable that there is likely to be a major gap, which is upon us, until 2014 for people who have genuine, chronic pain and suffering. It amazes me that this parliament is about to embark upon a process that will lead to people with genuine suffering having their situations compounded. That is not who we are; that is not what we intend to be, but it is the inevitable consequence if the Chronic Disease Dental Scheme is pulled away at the same time as a replacement scheme is deferred until 2014.

Let me go further into the current situation. The Medicare Chronic Disease Dental Scheme was introduced by the former coalition government. The current Leader of the Opposition was its effective architect, overseer and introducer. It provides up to $4,250 in Medicare dental benefits over two years for eligible patients with a chronic health condition. The government has said it will replace this scheme with its own dental scheme but its proposal for adults does not begin until 1 July 2014. So what does Danielle Casbolt do in the meantime? These questions are being faced by families not just in the seat of Flinders, not just in the Bass Coast Shire, but around the country, and the many people who are most ill-equipped to deal with the problem are going to face issues relating to the withdrawal of this scheme. I do not think what is occurring here is right. We, of course, will not stand in the way of a replacement scheme and that is why we will not oppose this bill, but we did our best to preserve the current scheme so as there was no gap.

The scheme here will cost about $4.1 billion. If that money goes into the dental health space, it may serve some useful purposes. We do not believe that this scheme is the optimal design, but we also know it is unfunded, so it is a promise made without an ability to pay. In the meantime, tearing away the current support mechanisms will mean real failures for families, pensioners, seniors and young people. It is simply not good enough to deny local residents access to genuinely needed, vital dental treatment. The details of either scheme can be quibbled about, but the gap is completely unacceptable.

Whilst we will not oppose this bill, because to have something is better than to have nothing, we bitterly oppose the creation of a gap in terms of chronic dental health management for those who suffer disease or disability, many of whom are afflicted by mental health conditions or other issues. It seems that the government has inadvertently abandoned many of the neediest in our society. A good scheme is a positive step. Some form of scheme is better than nothing, but the government's actions in taking away the Chronic Disease Dental Scheme are simply unacceptable.

Melissa Parke (Fremantle, Australian Labor Party) Share this | Link to this | Hansard source

I welcome the Dental Benefits Amendment Bill 2012, a further instalment of the Labor government's health reform program, a policy reform effort that has undertaken the difficult work of rethinking, planning and funding in relation to a number of blind spots in Australia's health system. Of course, the cornerstone of our health system is Medicare, one of the great and defining features of Australia's fundamentally egalitarian approach when it comes to ensuring the provision of high-quality universal public goods in the areas of health, education and the environment. These are the things we all share. These are the things that underwrite social equality and social cohesion in Australia and are the core features of our egalitarian ethos.

But how do we measure the enormous social and economic value of Medicare? Just consider that in Australia we all—each and every one of us—have access to free, comprehensive public hospital care through a system that costs our public purse half as much, as a proportion of GDP, as the United States pays for a health system in which one in six uninsured Americans does not have straightforward access to health and hospital care. But our public health system can be better still, and making those improvements is a distinctively Labor project. It started with Medicare. It continues today. That is why this Labor government has increased the federal contribution to public hospitals by 50 per cent. That is why this government's $4.1 billion dental healthcare package is now introduced to address one of the shortcomings of our system—namely the fact that the public funding and availability of dental health care has not matched the level and function of public funding for primary and hospital health care. The inconsistency of that situation is something Labor has sought to address for some time, and that is why these reforms are particularly welcome.

In addition to the compelling equity arguments for improving the publicly funded provision of dental health care, there are compelling preventative and health cost arguments. We know that children who reach adulthood with healthy teeth are more likely to keep and maintain good oral health as they get older, and we know that good oral health is in turn strongly correlated with better general health. For older Australians, poor oral health can contribute directly to a number of serious health complications—and indeed bad teeth almost always lead to bad nutrition, which again compromises one's health. By ensuring that younger and older Australians, especially those from lower income households, have the ability to receive essential dental treatment, we are not only improving the health of millions of people; we are also implementing a profound preventative health measure, one that will protect individuals from the sometimes terrible consequences of bad dental health and that will create significant health savings in doing so.

The government's proposed six-year dental health reform package that we debate here today includes $2.7 million to support dental care for around 3.4 million Australian children under the dental care for kids program; $1.3 billion for around 1.4 million additional services for adults on low incomes, including pensioners and concession card holders and those with special health needs; and $225 million to be allocated to improving dental services, both in terms of infrastructure and workforce, in outer metropolitan, regional, rural and remote areas. And of course it has to be remembered that this package builds upon, and is in addition to, the $515 million investment made in the 2012-13 budget to fund a blitz on public dental waiting lists from 1 January 2013.

The new dental health care for kids program, called, appropriately, Grow Up Smiling, stands to benefit up to 13,700 children in my electorate of Fremantle. It means that, from 2014, eligible families will be able to receive dental treatment to the value of $1,000 per child over a two-year period from the time they turn two and until they turn 18. They will be able to visit a dentist and use their Medicare card to do so. I know that, at a time when cost of living in WA is a concern for many families, there is an understandable risk that parents might delay regular dental checks or basic dental maintenance as a result of pressures on the household budget. This reform will mean that parents are not put in that situation and their children can get the basic dental health care they should have when they are young, which will go a long way to setting them up for strong teeth and gums into adulthood.

In conclusion, I want to commend the Minister for Health, her department and her staff for the development of this well-targeted and carefully funded dental healthcare reform package. It represents a change that brings the public funding and accessibility of dental care into much better alignment with the principles on which Australia's general healthcare system, Medicare, operates, and it will mean greater quality of life for younger and older Australians, and both fewer health problems and lower health costs as a result of the problems that poor dental health can create.

Darren Chester (Gippsland, National Party, Shadow Parliamentary Secretary for Roads and Regional Transport) Share this | Link to this | Hansard source

I would like to take this opportunity to congratulate the new Speaker's panel on their election over the past 24 hours. In particular, I congratulate the member for Chisholm on her promotion to the position of Speaker. It is unfortunate for the members of the House of Representatives Standing Committee on Petitions because we will miss the member for Chisholm, who has been a valued member of our committee. But she will move on to higher duties. I also congratulate the member for Maranoa on his elevation to the position of Deputy Speaker and the member for Hindmarsh on his elevation to the Second Deputy Speaker role. To all the members of the Speaker's panel, I wish you well in your work.

In rising this afternoon to speak on the Dental Benefits Amendment Bill 2012, I will be speaking in support of my colleagues in the Liberal and National parties who have raised concerns about the direction this government is taking in relation to dental health care in the nation. I wish we could be in a position where we would support this government's position, because there is a desperate need to support the dental healthcare needs of the Australian people, but—as has become, I think, symptomatic of this government and its approach to a vast range of public policy areas—it has simply failed to do its homework, and it has failed to get the details right.

I have had the opportunity to follow this debate quite closely, and I recall the speech of the member for Aston, who perhaps summed up the situation quite succinctly when he said that basically this is just an election promise. It has all the credibility of an election promise when this government talks about its reforms in relation to dental health care, because so much of what this government announces is not funded. Unfortunately, this government has a long history of making promises and then not keeping them. The most obvious one that has had a direct impact on my community is the Prime Minister's announcement only days before the last election, where she specifically ruled out introducing a carbon tax, and we all know what happened to that promise. So I believe that the health minister's announcement—

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

Excuse me. Is the member for Kennedy seeking the call?

Bob Katter (Kennedy, Independent) Share this | Link to this | Hansard source

No, he is already talking, isn't he?

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

I am sorry. I saw you standing there; I just thought I would check. I beg your pardon; the member for Gippsland has the call.

Darren Chester (Gippsland, National Party, Shadow Parliamentary Secretary for Roads and Regional Transport) Share this | Link to this | Hansard source

Thank you, Deputy Speaker. There may have been some confusion. I understood that the member for Kennedy was arriving late, so I am sorry if there has been some confusion there, but I thank him for giving way.

As I was saying, the health minister's announcement in relation to the government's reforms on dental health is as shambolic as some of those other public policy areas that I am going to touch on in a few moments time, in the sense that it was openly contradicted by the Prime Minister within 24 hours. We had on one hand a minister saying that this was an announcement that the government would need to find money to pay for in the future, and on the other hand we had the Prime Minister saying that it was a savings initiative. It has been quite confusing for the Australian people to listen and to watch the government in relation to its management of this and many other issues.

Unfortunately, I am concerned that this is a pattern of behaviour within the government, where, in its desperation and its need to try and generate positive news cycles, it is making a lot of unfunded promises and feelgood announcements to try and engender some level of support within the community but then failing to do the homework and explain to the Australian people how it is going to deliver some of these programs.

We have seen that, unfortunately, with issues like the National Disability Insurance Scheme. I am one member who, like many others on both sides of this House, has been strongly supportive of the need for a National Disability Insurance Scheme, but the government has not been honest with the Australian people on how it is actually going to fund the National Disability Insurance Scheme. It has made grand announcements, and it parades itself around the country as being the only side of politics committed to the NDIS, but the simple fact of the matter is that the government has not explained how it is going to fund it.

It is the same with the grand announcements the government made in relation to Gonski and its education plans. Again, there is no explanation from this government about how it is going to meet its financial commitments into the future.

We have seen that with the aged-care package of reforms. The government has not explained how it is going to pay for it. And its mental health package has ended up being more smoke and mirrors than anything else. Unfortunately for the Australian people, they have had some very significant promises made to them but are yet to have an explanation from this government about how it is going to pay for them.

I am afraid that the dental plan fits into the same category. Any government can come out and make an announcement, but how are they actually going to pay for all this? How are they going to pay for all of the commitments that the government have promised?

If it assists the member for Kennedy, I will not be long, and I will give him every opportunity to make his contribution.

The coalition strongly supports investment in dental health. We are concerned about the government's announcements in relation to the Medicare Chronic Disease Dental Scheme. It announced the closure of the scheme effective from 30 November but failed to provide assurances to the Australian community that there would be a replacement scheme in place until 2014. We are very concerned that many patients throughout Australia, particularly in regional communities, will miss out on treatment under the CDDS during this gap period.

We have seen this government's announcement of the $4.1 billion dental program, which was made on 29 August by the Minister for Health and the Greens health spokesperson, Senator Di Natale. Again, as I referred to earlier, it was unfunded. It just reinforced within the community the view that this government almost inevitably has to do the Greens' bidding. But I would caution members opposite about continuing down the path of responding to concerns, issues or policy positions from the Greens, who have proven themselves to be economically illiterate when it comes to managing the major issues facing our nation, and this is a classic case in point.

It is beyond me to try and understand why any cabinet minister, let alone the Prime Minister, would ever stand beside a member of the Australian Greens and do joint press conferences, when you consider that at the last election less than 10 per cent of the Australian population voted for the Greens. It strikes me as more than passing strange that the Prime Minister was prepared to do a joint press conference announcing this fantastic power-sharing agreement, supposedly in the aftermath of the last election, with the leader of a party which 90 per cent of the Australian people had voted against. I am not sure who within the strategy department of the Australian Labor Party thought it was a great idea to have the Prime Minister with the Leader of the Greens playing happy families in the courtyard at the Prime Minister's office, but the pattern continues. We see once again this time the health minister doing a joint announcement with the Greens health spokesperson on this program, which I believe is a folly.

I recognise Deputy Speaker Scott in the chair. You missed me moments ago, Member for Maranoa, as I passed on my congratulations to you on your elevation to this important role. I know that the way the parliament works is something that you have taken very seriously during your career in parliament, and I am sure that you will do a great job in the role of Deputy Speaker and be an enormous support to the Speaker herself. I congratulate you in your presence and wish you all the best in your new role.

The opposition has spoken at length in relation to this issue, and I am not going to delay the House any longer. I recognise that the member for Kennedy has arrived in the chamber and is ready to make his contribution as well. May I simply say that the opposition, the coalition, are very concerned that we have a government which makes decisions and takes actions which are more about the politics of the day than good public policy.

We have, as the member for Bradfield described it, a half-baked plan before us. It is designed more to keep at bay Kevin—the member for Griffith—and to discredit the Leader of the Opposition, Tony Abbott, and his scheme than it is to deliver good public health outcomes. I predict that the pressure will be on this government, that there will be another Twitter campaign or another email campaign like we saw with Margiris, that there will be a backflip on the dental plan and that the government will be forced to accommodate the thousands of Australians who face the unfortunate situation of putting up with a gap of at least 13 months before receiving treatment under its dental plan.

I appreciate the opportunity to raise my concerns about the government's position on dental health. It concerns me that the government is making an enormous number of completely unfunded promises. It is committing future governments to extraordinary expense for schemes such as the dental plan, the NDIS, the response to the Gonski review, the aged-care reform package and the mental health package. All these commitments are being made on a wing and a prayer, and unfortunately it is going to be left to future governments of this nation to clean up the mess left by the Rudd and Gillard governments. I thank the House.

Bob Katter (Kennedy, Independent) Share this | Link to this | Hansard source

In my electorate we call public meetings, and at every single meeting in the previous round, which was held two years ago or more, dental health was raised as an issue. The latest round of six meetings—to which 200 or 300 people turned up—was held last week, and, to my memory, the issue of dental health was again raised at every meeting. We were quite surprised that, in the previous round of meetings, two people turned up who had reached a point of such desperation that they had extracted their own teeth—one of them did it on Channel 9 for the whole of Australia to see so that he could let the incompetence of the government be known.

We live in an extremely rich nation. If a government cannot fix teeth and instead leaves people in pain, you must wonder whether it is really a government at all. You can cut back on education or you can cut back on the arts—you can cut back on a whole range of services—but I would have thought that one service that you cannot cut back on is dental health. What has prompted the government to do such a remarkably stupid thing? In my 39 years as a member of parliament I have watched governments; when they start making mistakes it is like in football: they catch dropsy and just keep making mistakes. I remember that, in the Whitlam era, every time I would turn on the radio I would think that it was too good to be true—I really did not like Mr Whitlam—each day a new disaster befell the government. It seems that this government—just like the Queensland government—cannot be told. Even though you may say to the government, 'Please don't do this; it's a terrible thing to do,' it will transpire that every aged person in Australia sooner or later will get the message through their dentist—if they get to a dentist—or through their doctor that the dental scheme is gone.

I give the Leader of the Opposition considerable praise for his position on the government's revised dental scheme, because, let's face it, the revision is a bit sneaky. It looked pretty harmless—it looked like there was no money involved, and it got past Treasury—but in the end it was found that there is one hell of a lot of money involved in the revision. As far as I can see, the current government has owned up to the fact that there will be a fall from $1.2 thousand million a year in outlays for a dental scheme to about $600 million a year. They are switching a chronic aged-persons' scheme to a young persons' scheme, and that is immediately a diminution—a cutting in half—of the current outlays. Clearly this is being done under pressure from Treasury, but would you cut out fixing people's teeth when they are in pain? I think that everybody would have had toothache at some stage, and really it is the most dreadful pain. If you had to cut, you would cut everything before you cut medical and dental health care, yet the revised scheme involves a very sizeable cut. Why replace a chronic aged-persons' scheme with a young persons' scheme? Young people, by their very nature, do not have old enough teeth for decay to be a serious problem for them. If you say, 'We're going to look after young people rather than old people,' you are looking after people who do not have a problem. You will look after people who do not have a problem, whereas you will not look after people who have very serious problems indeed.

Professor Hans Zoellner had a lot to do with putting the original dental scheme together under the previous government, and I praise him. I also praise the now Leader of the Opposition for his role in the scheme when he was health minister. But I most certainly cannot praise the present government. The new minister, who seems a very capable and able and intelligent person, has been hit with a real big coathanger right at the start of her tenure, and all I can say to the minister is: you have taken a very wrong turn in your first real initiative—they have pulled the wool well and truly over your eyes.

To reiterate, what is being proposed here is very, very simple. Instead of looking after old people, we are going to look after younger people. Quite frankly, if you want to do something for younger people, give them all a toothbrush and toothpaste at school and have them brush their teeth every lunch time. That would cost you about a million dollars a year, and you would halve tooth decay in that cohort of the population, when you are supposed to be giving them some sort of assistance. The assistance that you are going to provide here will be very minimal indeed. I think most of money for the scheme will go towards administration costs—to a lot of people running around the countryside—not to a dentist sitting beside someone in a dental chair and fixing their teeth. I hope I am wrong in foreseeing that.

What is being proposed is that we look after people who do not need looking after and that we not look after people who need looking after. One of the great benefits of that for the government is that they can spend a hell of a lot less money. If you are going to make cutbacks, make them everywhere else in your budget but do not make them on Medicare, on the health and welfare of people, and do not cut back on dental health.

In the first round of meetings we had in the electorate I represent, we met two people—one in Richmond, a western town a long way from anywhere and one in Babinda, on the outskirts of Cairns, a suburb of Cairns, if you like—who had to pull their own teeth out. Everyone in Australia could watch one of them do that, because it was done on Channel 9. The person had been told, 'You have to wait for three months,' and when the wait finished they were told, 'We have had to put you to the back of the list because you are not a very important patient; your problem is not a very serious one.' So he was put back another three months, then another three months. He was in continuous pain and eventually realised that he was never going to get in, so he pulled his tooth out himself. In the recent round of our meetings, a lady got up and said, 'There is a four-year wait to have a tooth fixed in North Queensland.' She was told, 'When you do get in you will get one tooth fixed each year.' So, after you wait four years, you can only get one tooth fixed in the next year. The magnitude of the problem is huge and some serious money has to be put into it.

In my political career I have never proposed that we should put extra money somewhere without suggesting where that money can come from. In the Queensland health department I fought tenaciously against the upgrading of nurses because I could see that a massive blowout in costs was going to occur. We had nurses doing on-the-job training who were suddenly lifted up to university training, and of course all the work they had done in their traditional roles was pushed down to another rung of nurses. A whole layer of employment was created in the state of Queensland under the Ahern government, which I regret to say I was part of. It most certainly did not occur up until the election of Mike Ahern. Under the Bjelke-Petersen government, we steadfastly resisted the push to put that extra structure in. That extra structure has come at an absolutely colossal cost to the people of Australia in terms of both services, because there was not enough money to do the job anymore, and benefit. And maybe the horse has bolted there.

The second area of savings is in agency nurses and agency doctors. I am reliably informed that there are agency nurses getting $1,500 a day. They watch their poor old colleagues earn much less pay than that—they are flat out getting $1,500 a week. The doctors are on a considerably higher amount. Even if that figure is exaggerated, there is no doubt, no question in anyone's mind, that it is close to the action. Agency nurses and doctors are costing 10 times more than ordinary nurses and doctors working in the system. What sort of incompetent government in Queensland would get to a stage where something like one in 10 nurses is an agency nurse? What level of incompetence is this? Clearly that is a problem that could be solved in the space of three or four months by anyone with intelligence and ability. You simply employ a cadre of nurses that agree to be transferred around—a lot of nurses are young people who like being transferred around; it is exciting to go from place to place. Of course, they get paid a hell of a lot more than existing nurses. But they do not get paid the absolutely outrageous agency fees that are being paid presently.

In respect of the other area of savings, I am simply quoting the AMA. I went to 12 doctors that I knew very well that had been practising for over 15 years. I put it to them that the AMA was saying that, in Queensland Health, there are now three non-touch people for every person who actually has patient contact. I asked them whether that was the other way around 15 years ago and all 12 of them said, 'Yes, I would say that is pretty much the way it was 15 years ago.' So we have three people who do not have anything to do with patients for every one person who has patient contact, whereas 15 years ago it was the other way around. So clearly there are supernumeraries on a colossal scale inside this department that need to be wiped out. There are two huge areas of wastage in the public service.

Finally, in the time that I have left, my home country is North Queensland's mid-west, those little towns between Townsville and Mount Isa. I can never remember a period—until 17 or 18 years ago—when we did not have four dentists servicing those four towns: Cloncurry, Richmond, Julia Creek and Hughenden. It seems to me that, when I ring up, most of the time they have no dentists at all. So some 10,000 people— (Time expired)

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

Order! The debate is interrupted in accordance with standing order 43. The debate may be resumed at a later hour. The member for Kennedy has leave to continue speaking when the debate is resumed.