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

On behalf of the House of Representatives Standing Committee on Health and Ageing I present the committee's report entitled Bridging the dental gap: report on the inquiry into adult dental services, together with minutes of the proceedings.

The matter was referred to the committee by the Minister for Health on 11 August this year. It is well known that almost everyone will experience an oral health problem at some time in their lives. In Australia today over 90 per cent of adults show signs of treated or untreated dental decay. Those with the capacity to pay can assess treatments through private dental services. However, for those most needy, private dental treatment is simply unaffordable. Across Australia over 400,000 adults are on public dental waiting lists. Some people have to wait months for an appointment. For others, waiting lists are not the problem because public dental services are not available where they live.

To address the issues regarding the public dental system the government has committed to a $4.1 billion Dental Reform program. This includes $1.3 billion towards the National Partnership Agreement for Adult Dental Services, from July 2014. Funding under the NPA will help provide additional public dental services for eligible adults across Australia. It should be noted that there is an intergovernmental agreement in place.

In its inquiry, the committee considered how the states and territories might use the new funding arrangements to address the most pressing dental needs. This included how to reach people living in rural, regional and remote areas and how to address the long-term dental health needs of many Australian adults.

The committee considered how to meet the dental health needs of particular population groups with special needs, including Indigenous Australians, older Australians, people with chronic illness and people with disabilities.

The committee heard a wide range of views and experiences regarding the public dental system. The committee heard that Steve, a physically disabled man, had never had his teeth brushed, let alone received a dental check-up. The committee heard that others had to wait 40 months to access dental treatment.

Dental practitioners, oral therapists and hygienists explained how they could best provide services for public patients. The committee also heard from not-for-profit organisations which had partnered with state government service providers or with private dental practitioners to improve access to public services.

The committee has made a number of practical suggestions for consideration during the implementation of the NPA—for example, the need to improve interactions between public and private providers of dental services, to address workforce shortages and to improve access to services.

The committee was told that in the past, dental policy has been characterised by sporadic, short-term and ever-changing priorities. The future of dental services in Australia needs to provide certainty and sustainability—and I emphasise those two things—for public dental patients.

To do this, an ongoing commitment to funding of public dental services is necessary so that gains made are not lost. The committee heard that the ultimate goal for dental services in Australia should be a universal access scheme. With a long-term, sustainable and strategic approach, the suite of dental reforms, including the NPA, will be an important step towards a universal scheme.

On behalf of the committee, I would like to thank those who participated in the inquiry by providing submissions or attending public hearings and roundtables. Their input and insight assisted in shaping the recommendations contained in the report.

I would also like to thank the wonderful secretariat and Emma, from the department, who has been with the committee and assisted with the inquiry, because without their work and without their contribution we would not have such a fantastic report, looking at the sustainability of dental services in Australia—something that is very close to all of our hearts and something that every member of parliament has been confronted with in their office when people come to see them about this very important issue.

Finally, I would like to thank my colleagues on the committee for their participation and contribution to the inquiry. I commend this report to the House.

In accordance with standing order 39(f) the report was made a parliamentary paper.

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

I rise to join with the House of Representatives Standing Committee chair on the tabling of the report Bridging the dental gap: report on the inquiry into adult dental services. I also note that some of the secretariat are here and congratulate them for the work and effort they put into the report as well.

The terms of reference for the inquiry were to identify priorities and inform the NPA such that it can be framed to meet the particular and localised needs of each state and territory, specifically: demand for dental services across Australia and issues associated with waiting lists; the mix in coverage of dental services supported by state and territory governments and the Australian government; availability and affordability of dental services for people with special dental health needs; availability and affordability of dental services for people living in metropolitan, regional, rural and remote locations; the coordination of dental services between the two tiers of government and privately funded dental services; and workforce issues relevant to the provision of dental services.

The report states that although there have been substantial improvements in dental and oral health in Australia over the last century, the Australian Institute of Health and Welfare's publication, Australia's health 2012, reports that almost everyone will experience an oral health problem at some time in their lives and that over 90 per cent of adults show signs of treated or untreated dental decay.

There are many factors that contribute to poor dental and oral health, and the interaction of factors associated with this is complex. The report states that as well as individual factors there is a complex interplay of structural, social and economic factors. Some of these factors associated with poor dental and oral health in adults include possession of a concession card. Concession card holders are more likely to have poorer oral health compared to non-cardholders. This is linked to unfavourable dental-visiting patterns, which include not visiting the same dentist, not visiting yearly and seeking treatment for a problem rather than getting a check-up.

Access to public sector dental services' limited funding and workforce shortages within the public sector have been identified as contributing to poorer oral health status of eligible patients. Remote, rural and regional residents have a higher rate of unfavourable visiting patterns at 38 per cent, which increases the risk of poor oral health as compared to urban residents at 27 per cent.

Also, individual behaviour, and diet and oral health behaviours contribute to oral health—for example, the consumption of sugary and acidic foods can lead to an increased risk of dental decay. The discipline of brushing your teeth at least daily is a personal responsibility that parents need to encourage.

I want to touch on the closure of the Chronic Disease Dental Scheme, which was raised as an issue by some submitters who were concerned about the provision of dental services to people with special needs. The CDDS was closed to new patients on 8 September 2012 and to all patients on 30 November 2012. The Commonwealth Department of Health and Ageing noted that 76.7 per cent of CDDS patients are also eligible for public dental services and so are expected to be able to receive treatment by state and territory services. The Department of Health and Ageing advised the committee that those not eligible for public dental services are expected to access services in the private system.

The Dental Hygienists' Association of Australia would like to see a replacement for the recently abandoned CDDS. The Australian government has not outlined any viable replacement for this scheme. As a result, many chronically ill patients are without a scheme focused on their needs.

The committee visited Charles Sturt University at Dubbo and saw a fantastic clinic that would be a good model for regional areas, and this report goes into many facets of what a good system could be and how it should be structured. As with all health issues, the remote, rural and regional areas have fewer resources, and so we see more long-term problems with health in those areas. In finishing, the report states that the AHHA also expressed concern about the inefficiencies and the potential for duplication observing. After many years of minimal involvement by the Australian government in the funding of dental programs, there are now myriad of programs being administered by a range of departments and agencies. There is a significant risk of inefficiency, duplication and waste as a result of an uncoordinated approach to the planning and implementation of new initiatives and integration with existing programs.

This report, hopefully, goes some way to assisting the government of the day to achieve better dental and oral health outcomes for all Australians. I also thank my colleagues who attended all the hearings and the committee get-togethers to go through the report. The recommendations are noncontroversial, except maybe for recommendation 3, about which I am sure we will hear back from the industry sometime once the report has been tabled. Again, thanks to the secretariat and also, I commend this report to the House.

Bruce Scott (Maranoa, Deputy-Speaker) Share this | Link to this | Hansard source

The time allotted for statements on this report has expired. Does the honourable member for Shortland wish to move a motion in connection with the report to enable it to be debated on a later occasion?

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

I move:

That the House take note of the report.

Bruce Scott (Maranoa, Deputy-Speaker) Share this | Link to this | Hansard source

In accordance with standing order 39, the debate is adjourned. The resumption of the debate will be made an order of the day for the next sitting. Does the honourable member for Shortland wish to move a motion to refer the matter to the Federation Chamber?