Janet Rice (Victoria, Australian Greens) Share this | Hansard source

I'm speaking today in place of Senator Steele-John, the Greens health spokesperson, who is unable to be with us in the Senate today. Every year in Australia around 400 babies are born with a cleft. So the Australian Greens welcome this bill, the Health Insurance Amendment (Prescribed Dental Patients and Other Measures) Bill 2023, today. It will enable those with a cleft lip or palate to have access to the surgery they require at any age. Under current legislation, Medicare eligibility for treatment under the Cleft Lip and Cleft Palate Scheme for prescribed dental patients requires a person to meet complex and problematic access restrictions, with some people being denied treatment on the basis of age alone rather than on the basis of clinical need. This bill will allow a small cohort of patients who are currently denied Medicare reimbursement for treatment based on age alone to access Medicare benefits for the treatment they need, so the Greens join with the community in support of this bill.

However, when this bill came before the parliament, Senator Steele-John was disappointed and frustrated to hear that the key community stakeholder in this space, CleftPALS, had not been consulted on this bill despite it amending a scheme which entirely affects them and their children. When Senator Steele-John first met with CleftPALS, the primary need was clear. For over a decade, these parents of children with a cleft lip and palate have been asking for speech pathology services to be covered under the Medicare cleft lip and palate scheme. These children are currently forced to go without vital speech pathology services because of a lack of government funding. Minister Butler would have had an opportunity to make sure this call was heard if his office had consulted with the community prior to the introduction of this bill.

Speech pathology services should have been included in this bill. To illustrate why this is so important, I want to share the story of Josh, whose father, Tim Devlin, is one of the parents in CleftPALS and has been driving this message of a need for speech pathology, alongside parents all over Australia. Tim joins us here in the Senate today. For two years, Tim and his wife have been fighting to get NDIS funding for speech pathology sessions for Josh. During that time, Tim estimates that his son's private speech pathology costs have added up to around $6,400. A specialist can cost over $190 per hour. Tim says there's an obvious need for speech pathology sessions to be subsidised for children with cleft lip and palate, which is not adequately met by either Medicare or the NDIS. Josh is now in preschool and has had two years of intense speech therapy, but his speech is still not understood by kids in the playground and he requires further speech pathology services.

The amendment that I'll be moving later, during the committee stage, at the request of Senator Steele-John, gives the government the opportunity to rectify their lack of consultation and to amend the cleft lip and palate scheme to include speech pathology services. The advocacy by parents like Tim on behalf of their children has been so important, but it should not have been necessary. It's a government responsibility to ensure that the public health system leaves nobody behind. It has taken far too long to get this right. The time to rectify this and to amend this scheme is now. I call on the government and the opposition to support this amendment and to ensure that all cleft-affected children and adults can receive the speech pathology services they need.

I hope the Senate will also support the Greens' second reading amendment, which summarises the need for speech pathology services and acknowledges and thanks CleftPALS. I think it's worth reading out some of the second reading amendment, which states that we note: 'the continued work of CleftPALS and Speech Pathology Australia in advocating for the services which will improve patient outcomes for those with cleft lip and palate; the Medicare Benefits Scheme's cleft lip and palate scheme does not currently extend to speech pathology services; that many children with cleft lip and palate would greatly benefit from speech pathology services which are not currently accessible under the cleft lip and palate scheme and are expensive for parents and cleft-affected adults; CleftPALS, the peak community body for people with cleft lip and palate, was not consulted in the writing of this bill; that children with clefts, requiring intensive speech therapy, can often attend weekly therapy sessions for blocks of six to 10 weeks, multiple times per year; that due to the surgery schedule that children with cleft lip and palate can experience, which can be 10 to 20 surgeries over 25 years, 20 speech pathology services in a patient's lifetime is often inadequate; and, in response to pressure from the community, the Medical Services Advisory Executive Committee is now reviewing relevant evidence on 18 August 2023 and will subsequently make recommendations'. It further states that we agree: 'to thank CleftPALS organisations across Australia and Speech Pathology Australia for their advocacy and support for the cleft-affected community; and funding for speech pathology services under the MBS cleft lip and palate scheme must be included in the next federal budget'.

At the request of Senator Steele-John, I move:

At the end of the motion, add ", but the Senate:

(a) notes:

(i) the continued work of CleftPals and Speech Pathology Australia in advocating for the services which will improve patient outcomes for those with cleft lip and palate,

(ii) the Medicare Benefits Scheme's Cleft Lip and Palate Scheme does not currently extend to speech pathology services,

(iii) that many children with cleft lip and palate would greatly benefit from speech pathology services which are not currently accessible under the Cleft Lip and Palate Scheme and are expensive for parents and cleft-affected adults,

(iv) CleftPals, the peak community body for people with cleft lip and palate, was not consulted in the writing of this bill,

(v) that children with clefts, requiring intensive speech therapy, can often attend weekly therapy sessions for blocks of 6 to 10 weeks, multiple times per year,

(vi) that due to the surgery schedule that children with cleft lip and palate can experience, which can be 10 to 20 surgeries over 25 years, 20 speech pathology services in a patient's lifetime is often inadequate, and

(vii) in response to pressure from the community, the Medical Services Advisory Executive Committee is now reviewing relevant evidence on 18 August 2023 and will subsequently make recommendations; and

(b) agrees:

(i) to thank CleftPals organisations across Australia and Speech Pathology Australia for their advocacy and support for the cleft-affected community, and

(ii) that funding for speech pathology services under the Medicare Benefits Scheme's Cleft Lip and Palate Scheme must be included in the next federal budget".

I look forward to the support, I hope, of the government and the opposition.