Richard Colbeck (Tasmania, Liberal Party, Shadow Parliamentary Secretary for Health) Share this | Link to this | Hansard source

As outlined in my speech during the second reading debate, I move opposition amendment (1) on sheet 5495 in respect of the Dental Benefits Bill 2008:

(1)    Page 47, after line 14, at the end of the bill add;

68 Review of Operation of Act

        (1)    The Minister must cause an independent review of the operation of this Act to be undertaken as soon as possible after the first anniversary of the commencement of this Act.

        (2)    Further independent reviews of the operation of this Act must be made as soon as practicable after the third anniversary of the commencement of this Act and at three yearly intervals thereafter.

        (3)    The Minister must cause a copy of the report of each review mentioned in subsection (1) and (2) to be tabled in each House of the Parliament within 15 sitting days of the day on which the report is given to the Minister.

        (4)    The review must be conducted by a panel which must comprise not less than 5 persons, including;

             (a)    a person occupying the position of Commonwealth Chief Medical Officer;

             (b)    a person nominated by the Australian Dental Association;

             (c)    a person nominated by the Consumers’ Health Forum of Australia;

             (d)    two other persons nominated by the Minister, at least one of whom must have qualifications in medicine or dentistry.

This amendment will require a review of the operation of the act after 12 months and at three-yearly intervals thereafter. The reviewer will be required to report to the minister who in turn must table a copy of the report in both the Senate and the House of Representatives. The amendment provides that the review shall be conducted by five persons: the Commonwealth Chief Medical Officer; a nominee of the Australian Dental Organisation, which is the peak organisation of the profession; a person nominated by the Consumers’ Health Forum of Australia, which is a highly respected independent consumers group and which is currently already represented on the Medical Services Advisory Committee; and two other persons appointed by the minister, at least one of whom must be a dentist or a medical practitioner.

I think this is an important amendment to this legislation, given what we have seen, particularly through our interrogation on this legislation at estimates over the last six months. When the proposal was first put by the government prior to the election, when they first made their election promise, the Teen Dental Plan was to be costed at some $510 million. At February estimates we found that the cost had been revised down to $325.8 million. We saw a subsequent press release from the Prime Minister and the Minister for Health and Ageing suggesting that it was $360 million. The budget papers we saw presented on budget night talk of $490.7 million over five years, which equates to somewhere in the order of $350 million. So there appears to be quite some confusion within the government as to the cost of this particular measure.

We know from estimates that there was no consultation with the states on this particular proposal prior to the election. We also know that there are school dental and teen dental programs that operate in every state in Australia—to varying degrees of success, I might add—and that this legislation provides a new program that potentially cuts across them. The government has not at this point in time conducted any discussions, that we have been advised of at any rate, on how this program will interact with those programs, what the impact on the state programs might be and whether or not this legislation will provide opportunities for the states to withdraw from them, although we have assurances from the government that it intends to ensure that the states do not start withdrawing their funding from their existing programs.

I think that, given the significant variance in information that we have had from the government on this program and given the fact that they still appear to be working out how the program will interact with existing dental programs and the dental community in the states, it is appropriate that we have some sort of review process put in place. This review process, as I said in my speech in the second reading debate, matches other instruments that have been attached in the past to other pieces of legislation. I think that the group that we have suggested as part of this process is one that allows the government some flexibility in its compilation and gives the minister some capacity for choice in the membership. I think it is important that the government have that flexibility. The review also covers some of the checks and balances that were not undertaken in the development of this scheme prior to the election and it does provide some capacity for the parliament to see how this new scheme will interact with existing schemes in the various states. It is quite obvious that, not having had the consultations that they needed to have, that understanding just does not exist at this point in time within the government.

This amendment also provides the government with the opportunity to follow the review process, to modify the scheme if necessary and to refine it so that it provides better dental outcomes—which, I think we all agree, is the intention of the legislation. That is why the opposition is supporting the legislation. But, if there is some need to refine the scheme to prevent the states from withdrawing from their existing programs and effectively cost-shifting to the Commonwealth, or if there is some need to refine it so that it actually interacts with the private sector or other schemes more effectively, I think that is a positive move and a positive contribution that the opposition can make to this particular scheme at this point in time, given the lack of consultation and the lack of discussion that has occurred to date. This amendment allows the government to put the scheme into operation from its proposed date of 1 July.

I do note that the government believe that the reporting through Medicare will be sufficient, but all that basically does is give them the raw numbers; it does not allow for discussion with the states and territories to understand what the interaction between this scheme and the other schemes is. I think that is an important addition to this particular program. Given the enormous range of costings that we have seen for this program from the government, since their initial promise through to the budget, and given some questions that exist within the industry as to what this program will really cost, I think it is appropriate that initially there is an investigation of the scheme after 12 months and then that there are further investigations at three-year intervals.

Jan McLucas (Queensland, Australian Labor Party, Parliamentary Secretary to the Minister for Health and Ageing) Share this | Link to this | Hansard source

The government sees no need for this amendment. I query why the opposition would move such a useless amendment if they are interested in knowing how these particular dental programs will roll out. These payments will be administered by Medicare Australia, and statistics on the operation of the program will be compiled by Medicare Australia and provided to the Department of Health and Ageing and other government agencies. The opposition spokesperson knows that as a government we are committed to making sure these programs that we introduce do in fact work. I think he acknowledged that in his contribution just before. We will be monitoring this program extremely closely and making amendments to the program if in fact we need to do so. But, more importantly than that, the statistics will be published every month on the Medicare Australia website so that everybody—dentists, doctors, families and even the opposition—will be able to review the progress of the program month by month.

The opposition amendment talks about a review after a whole year. You do not have to wait for a whole year; after the first month, at the end of July, you will be able to have a look at the website and see how we are travelling. I suggest that waiting for a whole year would be a waste of time. As well as that I am sure the dental profession will be extremely active in reviewing from its perspective the progress of the program and letting the government and the public know what they think.

An obvious question though—and Senator Colbeck might want to respond to this, but I hope I am not inviting a debate—is why the previous government did not see any need for a review of the dental benefits that it introduced as part of its extended primary care items. There was no formal review of that particular program. Indeed, there was no need for a review mechanism for everybody to realise what a total flop that particular program was. The Minister for Human Services, Senator Ludwig, said in his speech on the bill this morning that less than $50 million was spent on those items over four years. That was the commitment of the previous government. Compare that to the real commitment to Australia’s children and their dental health that we are undertaking through this and other programs.

There will be plenty of opportunities for review of the success of this program. Month by month statistics will be placed in the website and anyone, including the opposition, has the opportunity to review it. There is no need for regular formal reviews of this sort, outside of the usual accountability mechanisms.

With respect to the continual questioning—irrespective of the fact that we answer the questions—about the costings, Senator Colbeck knows, because we talked about this at length at estimates, that the costings for this particular program were available before the election. They were initially conservative but were then lowered by the process of the Charter of Budget Honesty. We canvassed this at estimates. We have provided answers to the opposition on this particular question, but it is not in the interests of the opposition to listen to the answers.

Furthermore, at estimates we reminded the opposition that this program is demand driven. The Teen Dental Plan will provide up to $150 for every eligible teenage towards an annual preventive dental check. That will target those who are aged between 12 and 17 in families that receive family tax benefit A. Teenagers in the same age group receiving youth allowance or Abstudy will also be eligible for the program. We think about 1.1 million teenagers every year will be eligible for the Medicare Teen Dental Plan. The Medicare Teen Dental Plan will operate as a part of the broad Medicare arrangements through the new dental benefits schedule.

This is a sensible program. We do appreciate the fact that it will start on 1 July with the support of the opposition, but we do think that this review mechanism will not work and is in fact an expensive waste of time.

Richard Colbeck (Tasmania, Liberal Party, Shadow Parliamentary Secretary for Health) Share this | Link to this | Hansard source

I could not let an opportunity go by—provoked as I was by Senator McLucas—to remind her that the government did promise to spend $800 million on dental care during the term of this parliament. I acknowledge that she has provided responses to me in respect of the value of this program but, as I indicated in my previous contribution, we have now had four numbers for this amount. My concern is to hold the government to its promise that it would spend $800 million on dental care during this term. It is nowhere near that at this point in time. Senator McLucas’s response was essentially as I predicted: check the website and you will see the statistics. But that does not deal with what the states might do in response to this program, which is a real concern to the opposition and I think it should be a concern to the government.

This has really got nothing to do with the colour of politics on either side. As we discussed at estimates, there is a pattern of behaviour by states—unfortunately on occasions with respect to the relationship between state and Commonwealth governments—and there are natural tendencies. The opposition is concerned to follow through with respect to the scrutiny of how this program interacts with state programs, and looking at statistics on the Medicare website will not necessarily do that. We did hear at question time today of programs where statistics were supposed to be placed on Medicare websites and they were not. So, scrutiny does not necessarily follow. We also know that, with respect to the reductions in hospital waiting lists, the first quarterly reports were due on 6 May and here we are well into June and we still have not seen the first reports on the websites.

As predicted, the government came up with the response: ‘Just check out the website and you will see what the numbers are.’ I do not necessarily want to get into a long debate over this because I do understand that the government wants to have its legislation passed, so I am quite happy to leave it at that after having made my point.

Question agreed to.

Bills, as amended, agreed to.

Dental Benefits Bill 2008 reported with amendment; Dental Benefits (Consequential Amendments) Bill 2008 reported without amendment; report adopted.