Richard Di Natale (Victoria, Australian Greens) Share this | Hansard source

I also wish to speak on the response to the resolution of the Senate by Senator Kim Carr. I think it is important to perhaps separate some of the issues that have been discussed here this evening. The first point is the question that relates to the audits of the Chronic Disease Dental Scheme. It is critical that we understand that the Greens and the coalition together both expressed concerns at the way that the CDDS was audited. In fact, we worked together on this issue through the Senate estimates process and in a range of other ways. We agree with the opposition. We felt that a number of dentists were targeted who had provided treatment in good faith, who had ensured that people who would otherwise not have been able to afford dental treatment were offered that treatment, but they were caught up in a tangled web of paperwork and bureaucratic requirements that were quite arduous and unlike any other Medicare process. We agree with the opposition that something should be done about it. In fact, we have worked with the government to ensure that there is a resolution to that issue and we remain confident that the government has acknowledged that there were problems in the way those audits were done and that many innocent dentists were caught up in that audit process. We hope that issue will be resolved.

The Chronic Disease Dental Scheme requires some explanation. On one hand the scheme was described by the Minister for Health as the worst example of public policy that she has ever seen; on the other hand, we hear that the opposition believe it was a perfect scheme. I have not heard any criticism of the scheme from the opposition in terms of the way the scheme operated, and they have had very little constructive to say on how it could be improved. I think the truth lies somewhere in between those points of view. The Chronic Disease Dental Scheme did provide treatment to some people who would otherwise not have been able to afford it. That is a good thing. It did, however, have some serious structural flaws. We had an issue where people were required to go to their GP, and that GP was then required to ensure that an appropriate referral was made to a dentist. Many of the dentists who were involved in the scheme were unaware of what was required from them in terms of responding to the GP in providing written quotes and so on, so there were some serious administrative problems with the scheme.

There was also an issue around equity. We had one scheme operating in dental care which was very generous, which provided over $4,000 worth of treatment over the course of two years, and we had a scheme that was not means-tested. What that meant was that there were people, many of whom would otherwise have been able to afford dental treatment, getting very expensive dental treatment and there were many others in the community who simply could not afford dental treatment who were missing out. Some people who were missing out could not afford to get a filling while people at the other end of the spectrum were able to get things like crowns, bridges and implants done. So that was a serious inequity, and we recognised that. We were willing to entertain a reform of the CDDS so that we modified it and put some restrictions around the scope of service to ensure that it was means-tested and to abolish the onerous referral requirements. The government was not keen on that change. It wanted to see the scheme scrapped, and in its place they wanted to see the foundations laid for genuine Medicare funded dentistry, beginning with children but also ensuring that people who are covered by the scheme were still able to access treatment through the public dental service. So the package that was negotiated was a package that essentially will lay the framework for Medicare funded dentistry, starting with children. That is a huge win. It is something we are very proud of. It means that we are going to see $2.7 billion invested in Medicare funded dentistry for kids. There are 3½ million kids who will now be able to go to the dentist in the same way as they go to the doctor.

We saw over $1 billion invested in state and public dental services. It is true that there is a gap between that funding stream and the abolition of the CDDS. That was a case of the Greens not getting everything we wanted and being forced to compromise, which we did. We compromised because we knew that what would be rolled out through the National Dental Scheme is something we can build on. It is something that means that, over time, all Australians will get access to Medicare funded dentistry. That is an important policy priority for the Greens. It is something that we think has to be pursued by both sides of politics.

We know that we are in a country that, while it does very well in terms of its overall health outcomes, when it comes to dental health does poorly. We do poorly because we have a situation where people who need dental care simply cannot afford it. By laying the platform for Medicare funded dentistry so that kids get access to care in the way that ensures that it is essentially funded through the Medicare system, we lay the foundations for what ultimately we hope will be Medicare funded dentistry for all Australians.

In the interim, those people who have a chronic disease and are a concession card holder will be able to access treatment through the state public dental system, although I do acknowledge that the increase of investment in the state public dental system will take some time to roll out. But, as I said, that was a question of compromise. The government was not willing to entertain the notion of any changes to the CDDS. They wanted to see its abolition and they wanted to see the start of a new scheme in its place. We came to that negotiation in good faith and ultimately that is the outcome that we have agreed on—an outcome that I think we can all be very, very proud of. What is important to note is that over time we would like to see all Australians being able to access dental care in a way that current patients of the CDDS can do—that is, through their dentist, and ensuring that there is an entitlement that allows at the very least important preventative dental treatment to occur.

Ultimately this scheme will be judged by what rolls out over the next few years. I am very, very confident that, once young children start going to the dentist—and let us not forget that we have got a situation where the oral health of young kids is declining—all health will improve. One of the real concerns is that we have seen a decline in the oral health of some young children, and that is something that will impose a huge costs on the health system down the track. So prioritising our kids is a good, sensible investment. It is the right place to start. I do acknowledge that the space between the new dental scheme operating and the abolition of the Chronic Disease Dental Scheme is one where we would have liked to have seen that gap narrowed. But in totality I am pleased with the outcome that we have managed to secure.

I know that some people will be disappointed—those people who are receiving treatment under the Chronic Disease Dental Scheme—but what has been interesting is that through all the correspondence that we have had with people, when we discuss what is actually going to start from 1 July 2014—Medicare funded dentistry for young kids; a huge boost to state public dental, over $1 billion; a quarter of a billion dollars for regional and rural dental services infrastructure and so on; an increase in training; relocation packages to move to regional and rural areas—people generally accept that what we have got is much better than the status quo. It is for that reason that the Greens were very happy to be able to announce that package with the government several weeks ago.