Amanda Rishworth (Kingston, Australian Labor Party, Shadow Parliamentary Secretary for Health) Share this | Link to this | Hansard source

I move:

That this House:

(1) notes:

(a) the importance of a well-resourced dental system in improving the oral health of our most vulnerable citizens; and

(b) that well trained and well supported dental graduates are critical to improving the oral health of our nation;

(2) shows extreme concern at the Government's announcement to cut $40 million from the Voluntary Dental Graduate Program (VDGP); and

(3) calls on the Government to reverse this decision and ensure that the 36 public dental services that were set to host the VDGP in 2014 are able to do so.

It is a very important motion that I move today. Oral health is often overlooked when we talk about health care, but it is vitally important to one's overall health and wellbeing. Poor health of one's teeth and gums can cause or exacerbate a wide range of other diseases and health conditions. There are also the psychological effects that occur. People who have poor dental health can feel very embarrassed if they are missing teeth or have other issues around oral health, and they can withdraw from society. That is why it is very important that, in addition to a private dental healthcare system, we have a strong public dental healthcare system. Importantly, that system must deliver to those most vulnerable citizens, those citizens most at risk, who do not have the means to ensure that they get good oral healthcare treatment. That is why the Voluntary Dental Graduate Year Program is a very important program that ensures that there is encouragement for new dentists, graduating dentists, to go into the public dental system. It is also great for dentists. It ensures that graduate dentists gain extra professional experience and support through a structured program and have important access to and experience in the public dental sector.

That is why I am very concerned that this government have axed this program—a cut of close to $40 million to the Voluntary Dental Graduate Year Program. It is a real problem. I do not understand this sort of tradition of the Liberal Party of cutting the public dental system. The Howard government cut close to a billion dollars from the public dental service—actually it was quite a lot more than that in real terms today. It took Labor to commit $4.6 billion back into our public dental system, including money for children to get their checks.

This $40 million of funding was designated to increase the number of places to 100 for graduate dentists who want to get some experience voluntarily. The program also placed dentists in public dental facilities across the nation, thereby ensuring that health workforce shortages that often occur in the public system were provided for. The impact of these cuts are going too deep. Young, graduate dentists who want to get this experience will not be able to access this scheme. I think it is time that the government reversed this decision. This $40 million cut is ill thought out.

We have seen the mess that the Liberal Party have made when it comes to the dental system.

Mr Ewen Jones interjecting—

If you have a question, you might want to ask one instead of interjecting, member for Herbert. It is no wonder you are embarrassed about this cut.

The government need to explain a number of questions. Once again, there are issues with the transparency of this cut. The government website still says that there are 100 positions. It has not been updated to reflect this cut. This is very concerning for people applying for these positions. Also, the government need to explain which of the 36 dental services that were set to host this program in 2014 will have their funding cut. The government have not been transparent about who will receive cuts.

They need to explain to the Australian community what the coalition's plan is for public dental health care. Under Labor, we saw a huge investment that improved waiting times and access to services right across Australia. Of course, there is more work to be done and more work to ensure that those on waiting lists can get access to public dental services. One of the big issues in this regard is ensuring that the workforce is in place. Unfortunately, and not surprisingly, we have seen the public dental system earmarked by the coalition for cuts.

I think it also very concerning that the coalition are failing to support graduate dentists. This program was not only about ensuring there is the workforce in the public dental system but also about providing extra support for graduates to receiving training. Unfortunately, the coalition have shown that they refuse to support graduate dentists—and this is from a government that said there would be no cuts to health. Of course this is just the start of many more cuts. I hope the coalition will release their proposed cuts, because the Australian people have had enough of their secrecy. (Time expired)

Ian Goodenough (Moore, Liberal Party) Share this | Link to this | Hansard source

Is there a seconder for the motion?

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

I second the motion.

Jane Prentice (Ryan, Liberal Party) Share this | Link to this | Hansard source

I rise today to speak in support of (1) and (b) of the motion on dental services. It is indeed of great importance to have a well-resourced dental system, which will improve the oral health of not just our most vulnerable citizens but all Australians. As part of that system, we need well-trained and well-supported dental graduates, who will play a crucial role in improving the oral health of our nation. However, with respect to (2) and (3) of the motion, I note that in 2012 the then Labor government withdrew government support and funding for some of our most vulnerable citizens—those with chronic dental problems.

The previous Labor government dismantled the Medicare Chronic Disease Dental Scheme after Prime Minister Abbott introduced the scheme during his time as health minister of the Howard government. The coalition was concerned to see that the many patients receiving treatment under the CDDS were left in the lurch. Labor at the time promised to effectively replace the CDDS with their Child Dental Benefits Schedule and a program for adults that was not intended to start until July 2014—some 19 months and one election later.

What the then Labor government simply did not seem to understand was that chronic dental problems are just that: continuing and ongoing problems. Chronic dental problems do not disappear simply because the funding disappears. Australians suffering from a chronic dental disease cannot simply wake up one morning and say: 'Well, the government has cut a program that greatly improved my quality of life. My problems will suddenly go away too, and I will be better.' No, these poor victims of chronic dental disease were made victims of Labor's chaos and mismanagement. They were left out in the cold for almost two whole years.

The news was little better for sick children using the scheme. They would have to wait 13 months until January 2014 and would have their benefit cut from $4,250 to $1,000 over two years. I understand that more than 60,000 services have been provided to children through the CDDS. These were children—children who were not able to have their treatment completed. The then Labor government, with their Greens partners in support, were asked to explain why these children were left to suffer for 13 months with unfinished treatment and no certainty of the schedule of services that were to be provided under Labor's new scheme well over a year later.

With many unable to afford the full cost of private treatment, this had serious health, economic and social ramifications for those suffering from chronic dental disease. This was a shameful decision that coalition members opposed and tried to stop in the parliament. Eighty per cent of patients under the chronic disease dental scheme were concession card holders, and they were being shoved out into the cold by Labor's decision. The Labor government had promised it would replace the scheme with a more limited program, but for adults that was not scheduled to start until July 2014, a 19-month wait. If you have ever had a toothache, Mr Deputy Speaker, you know that 19 hours is like an eternity, let alone 19 months. And, if you already have cancer, a heart condition, diabetes or another major health issue, a failure to treat your teeth can cause further health implications.

Labor simply did not have their priorities straight in the health portfolio. The failed former health minister, the member for Sydney, has no credibility. Under her tenure, Labor cut $1.6 billion from state hospitals in the 2012 Mid-Year Economic and Fiscal Outlook. Labor holds up the great $650 million GP Super Clinics Program as a huge success, yet, seven years after they were promised and announced, many are not even open. Many remain just vacant blocks of land.

Labor spent a lot of money in health, but it was wasted on a new supersized bureaucracy and program cuts like the failed superclinic program. Labor failed to deliver any extra benefits for patients. Only the coalition government is working towards a stronger, more efficient, health portfolio where the focus is put back on the patients rather than the bureaucrats.

I commend the member for Kingston for drawing the House's attention to the importance of dental health. But I must question why she supported the last Labor government in dismantling the chronic disease dental scheme, leaving our most vulnerable citizens stranded without support. Hypocrisy, thy name is Labor.

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

I must say that the member for Ryan usually researches her speeches well, but unfortunately on this occasion she is quite confused about the Medicare Chronic Disease Dental Scheme. It was not a scheme that dealt with chronic dental disease, as she constantly stated throughout her contribution; rather, it was open to people who suffered from a chronic disease to access that program. Yes, it did help some people, but, then again, I felt that a scheme that would enable somebody with an ingrown toenail to access the chronic disease dental scheme shows that it was a very poorly targeted program.

That was the problem with that scheme: it was poorly targeted. It had no means test whatsoever. People who were millionaires were accessing that scheme. Dentists who I have spoken to about it were really frustrated about the types of people who were coming along and accessing the scheme. All they needed was a doctor who would sign off on it and they would be able to go along and get over $4,000 worth of dental treatment. It was poorly, poorly targeted! It was a scheme that helped some people but did not help others.

The other point I wanted to make was that the member for Ryan was talking about Grow Up Smiling—how that would not be accessible and that families could not access it until 1 January this year. It is in place and it is working. Thousands of children throughout Australia are actually accessing this scheme. Let us look at what you are axing here. A program—

Government Member:

A government member interjecting—

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

I would have thought that National Party members in particular from your side of this House would be up here speaking about this axing of the voluntary dental graduate program because those areas that are likely to benefit most from it are those areas that are further out from the cities, where they have trouble attracting people to work as dentists. This gives those dental graduates the opportunity to improve their skills enormously and it provides services to those areas that really lack dental health services.

That was only part of what Labor did when they were in power. We moved from the Chronic Disease Dental Scheme, which was very poorly targeted—and was one that I am sure the minister will not reintroduce—to a much better and fairer system, where those people who actually needed dental treatment could access it. A partnership agreement was reached—an interim partnership agreement came into being in the middle of last year, and the full-blown partnership comes in later this year.

This allowed those people who could not afford to attend a dentist to actually visit a dentist to get the treatment that they needed—those people who had need of a dental scheme, rather than people who were millionaires and who really should have private health insurance to access dental health care. The partnership agreement will provide $345.9 million over three years to address public dental help waiting lists, something that I am sure those on the other side would want to see happen. I know that when we looked at this issue in the House of Representatives Standing Committee on Health, all members were committed to improving dental health for everybody.

It is $1.3 billion over four years—that was the interim amount that I just gave you—$2.7 billion over six years for Grow Up Smiling, and $225 million over four years for the flexible grants program that will put in place infrastructure in outer metropolitan areas. Labor was committed to dental health reform for all students while this government— (Time expired)

Ewen Jones (Herbert, Liberal Party) Share this | Link to this | Hansard source

Like the member for Ryan, I would like to speak to the motion, and to parts 1(a) and 1(b). I do believe that we have to look after our dental health in this country. I was in a meeting in the last sitting week, and Peter Dutton, the Minister for Health, was there. We were going over all the problems in the health portfolio—all the issues around funding and where we were going to find all this money. There are problems with overpayments, the GP Superclinics and all these other things—the money taken out of the state hospital systems and things like that. I asked him, 'Have we got any good stories about health?' He stopped for a minute and said, 'We always have good stories about the health industry. We have one of the truly great health systems in the world in this country.' That is the message that I would like to get across here. Dental health just forms part of it.

What we have to do is make sure that we have a system which operates inside its budget. What we have to do is understand that currently the health spend in this country is $140 billion per year of which the federal government pays about $62 billion. We must look for efficiencies at every turn. When you are, as Joe Hockey has always said, looking down at accumulated deficits of $123 billion and when you are looking at gross debt if left unchecked at $667 billion, we are not doing anyone any favours by cutting programs and we are not doing anyone any favours by not addressing the issue of debt. Part of that will always be contentious matters where people say it is their pet project.

The member for Shortland said that you could get referred to a dentist because you had an ingrown toenail on the Chronic Disease Dental Scheme. I cannot speak for too many members, I can only speak for the phone calls that came through to me but I had parents, I had elderly, I had people coming to me—

Ms Hall interjecting—

This is the thing: why was it cut? Was it cut because it was not a good program? It was cut because Labor wanted to get to a budget surplus. That was the only reason for cutting it. You can sit there, holier than thou, and ask: are you going to bring it back? You guys cut it. We had to find the room to run the system. I would like to quote TheAustralian from 10 March 2014, where Townsville dentist Daryl Holmes who runs 23 practices in Queensland, New South Wales and Adelaide—1300SMILES—said:

… the abrupt closure of the CDDS spurred an outbreak of 'dental rage', with 14,000 patients demanding treatment ahead of the cut off.

He said:

Our girls were getting harassed at the front desk. It was a massive problem.

The hypocrisy of this motion and asking whether we are going to bring this back is just writ so large. I did not think I would see anything worse than the MPI last Thursday. The members from Western Australia were jumping up and down about having a plan for Western Australia. The member for Pearce got up and sliced and diced about the rhetoric around what they were trying to do there and what this motion actually stands for.

We have a health budget of $62 billion per year. It is incredibly right that we have to go through and look to make sure that every dollar is accounted for and that every dollar is spent wisely. Through the GP Super Clinics Program, we got one superclinic promised in 2007. I could go on for a day and a half about this. It is still not open. It is built; it has a big sign out the front saying Townsville GP superclinic; it has got the darkened glass; it has got everything there but it is still not open. It was promised in 2007. It was also promised that it would open 24 hours a day, seven days a week and take pressure off the emergency department. This will be open from seven in the morning until 11 in the evening, so it fails on the first thing. The GP superclinic model was supposed to be on a bulk-bill basis and everyone would be bulk-billed. These people will only bulk-bill concession holders, gold card holders, minors and pension holders, so it fails on every count. As soon as that was done, there was $6 million back in the kitty because the Townsville City Council would not let it open the hours it had planned to anyway. A responsible government would have done this correctly. This sort of motion for a $40-million program, which may be a fantastic program, says that you guys just do not get it. Now $123 billion worth of debt has to be addressed.

Gai Brodtmann (Canberra, Australian Labor Party, Shadow Parliamentary Secretary for Defence) Share this | Link to this | Hansard source

I would like to thank the member for Kingston for moving this motion on a subject that is very close to my heart. I know it is a subject that is close to her heart as well. Both of us understand that dental health and hygiene is in a way the great socioeconomic indicator in this nation. I am very proud of the work that Labor did while in government on improving dental health right across the nation, right across all socioeconomic levels. It is interesting that the member for Herbert focused on a range of issues and talked about cuts in the past. I remind the member for Herbert that what we are talking about today is the cut that is currently planned. Your policy is to cut $40 million from the voluntary dental graduate program.

I also remind the member for Herbert, with the greatest respect, of his leader's comments just prior to the election, where he said that there would be no cuts to education, no cuts to pensions, no cuts to the ABC and SBS and, most importantly, no cuts to health. The fact that you now have plans to cut $40 million from this vitally important program flies in the face of that.

I know from speaking to my constituents that they are very, very concerned about what the budget could bring for them. Despite these promises of no cuts to education, no cuts to pensions, no cuts to the ABC and SBS and no cuts to health, you have already abolished the Alcohol and Other Drugs Council of Australia, which is based in my electorate. There is $1.5 million in funding required for that organisation. That organisation has been around for nearly 50 years, providing world-class, invaluable advice on alcohol and other issues. It is a respected organisation, with a library that is one of a kind. It is a library that is coveted throughout the world for its expertise and its holdings. At the moment, the future of that library looks like it could be the shredder and the Mugga Lane tip. That is my great concern.

Despite the fact that your leader said prior to the election that there would be no cuts to health, already ADCA has been abolished—with 14 jobs lost, with this world-class library potentially gone—and now we have this plan for a $40 million cut to the Voluntary Dental Graduate Year Program. This program for dental graduates is a structured, one-year program that is designed to integrate practice and professional development opportunities, enhance workforce and service delivery capacity and support young dentists as they enter the profession. The program is specifically designed for graduates working in the public sector. It supports the best dental graduates in the country to work in the public sector, where their skills are most needed.

We have a scheme here in the ACT that is run by the Salvos—which a dear friend of mine, Liz Dawson, is actively involved in—that supports people from very disadvantaged backgrounds and who have no teeth. Through the trauma of time and their socioeconomic background, they have no teeth and, as a result, they have poor diets—as you cannot eat a carrot without any teeth! Also as a result of not having teeth, they cannot go out and get jobs because their self-esteem is at rock bottom. This scheme—and I have funded a number of these programs—is to provide these people with dentures and opportunities not just to eat a healthy diet and get fit and healthy again but also to get back into the workforce by boosting their self-esteem.

Good dental care is incredibly important. It enables good nutrition, as I have mentioned, and it prevents serious infection. It is important not only for our physical health but also for our mental health. A good set of teeth can provide the self-esteem required to find work, to access training, to actively engage in the community, to feel proud of yourself and to feel as though you can contribute to the community. Poor dental health can be a real barrier to social inclusion—and that is something that I have witnessed firsthand in my electorate.

We have a proud record of investing in dental health, to ensure all Australians have access to decent, quality dental care. We are incredibly proud of these investments. They show our commitment to ensuring that every Australian has access to dental care. I urge those opposite to show their commitment to a well-resourced dental system by reversing the decision to axe the Voluntary Dental Graduate Year Program. Let's support our best dental graduates to help Australia's most vulnerable people access the dental care that they deserve. (Time expired)

Craig Kelly (Hughes, Liberal Party) Share this | Link to this | Hansard source

I rise with great pleasure to speak on this motion. I have been sitting here in the chamber listening to the contributions of the members for Kingston, Shortland and Canberra with the utmost interest, and their contributions have convinced me more than ever that they simply do not get it. Let us go back a little bit in history on our dental disease scheme and what we on this side have done in government here in Canberra over the years to help people with dental diseases. We do need to assist the most needy in our community to offset some of the high costs of accessing dental care. But we have to do that on a sustainable basis.

I would like to correct some of the revisionism, especially from the member for Shortland. If you go back to 1996, this federal government was $96 billion in debt. So, every year, the government the Howard-Costello government had to run a surplus to pay that debt down. They did that year after year, after year, after year. That meant putting money aside that otherwise could have been used for dental schemes to improve the dental health of Australians. Instead it had to go into retiring that debt and paying off that interest. By 2005, they had finally paid it off; $96 billion of debt had had been retired. Plus, what often gets overlooked is another $54 billion worth of interest payments made along the way. So, once we got that debt out of the way, once we got those interest payments cleared, we were able to still run surpluses. That allowed the previous coalition government to then invest more money in dental health, and that is exactly what the previous coalition government did. When the former health minister, the now Prime Minister Tony Abbott, in 2007 introduced a chronic dental disease scheme.

While this scheme was running it gave one million Australians access to dental care that they had never had before and that they would never have been able to afford. In fact of those one million people, 80 per cent—800,000 Australians—were able to get treatment under that scheme to address their dental needs. That is the social benefit of good government. That is the social benefit when you do not waste money; that is the social benefit of growing the economy.

Then what happened during the reign of the previous Labor government? We saw waste; we saw mismanagement; we saw increases in red tape and green tape. During the last parliament, in 2012, they cut the chronic dental disease scheme. They cut it overnight. In September, they even backdated the cutting so no new participants could access that scheme. And they had a cut-off for treatment of 30 November. This left thousands and thousands of people half-way through their treatment. And Labor said: 'Don't worry. We're bringing in a new scheme on 1 July 2014.' So they told citizens of this country with chronic dental disease—who needed treatment who were getting it under a previous coalition government scheme—to go away, take an Aspro, put up with pain and come back in 18 months. That is what this previous government did. And they come in here today with this motion. The word 'hypocrisy' does not come close to covering what we are seeing today.

They are arguing about a voluntary dental graduate program. Let's get a few facts before we hear this hysterical whingeing and whining about cuts. This scheme in 2013 provided 50 placements with the aim of assisting young dentists who are doing their training—to address the geographical distribution of our dental workforce; making sure those areas of public service in our remote regions are actually getting new dentists in. So we had 50 new placements in 2013. That was due to increase to 75 placements and 100 placements. We are simply making sure this scheme is working correctly before it is extended any further.

Debate adjourned.