Andrew Southcott (Boothby, Liberal Party) Share this | Hansard source

The most authoritative survey of Australia’s oral health is the Australian Institute of Health and Welfare’s national adult oral health survey, which looked at the health of our teeth from 2004 to 2006 and reported in March 2007. It found that 30 per cent of Australians were avoiding dental care due to cost, that 20 per cent of people identified cost as preventing them from seeking a recommended treatment and 18 per cent reported that they would have difficulty paying a $100 dental bill. This is not something that is in dispute; this is something that is agreed. It is based on the best information that we have from the Australian Institute of Health and Welfare.

Where we differ is how we should approach this to do the best for Australia. It is worth recognising that in the contributions from the shadow minister for health and from the previous speaker, also from the Labor Party, we heard a lot about the state of Australia’s oral health but we did not hear a lot about the state and territory governments. It is a matter of fact that our public dental services are run by the state and territory governments and always have been. What we see now when we look around Australia is lengthening waiting lists for public dental services.

The Australian government does have a role to play in dental health but it is important to recognise that, for most people, something like 85 per cent of dental services are run through the private sector. It would be a big mistake to put all of your eggs in one basket, to focus exclusively on the public dental services because on this side we believe that people, where possible, should be able to visit a dentist of their choice. We have done a number of things to make that option more accessible to people. We introduced in 1998 the private health insurance rebate, a subsidy of 30 per cent for people who have private health insurance. That subsidy is greater for people over 65 and 70 years of age—it is 35 per cent for people over 65 and 40 per cent for people over 70. The direct contribution we make just in the private health insurance rebate is approximately $400 million a year for dental services.

We also make a contribution for the university training of dentists. Most recently we have announced a new school of dentistry and oral health at Charles Sturt University in Bathurst to address some of the workforce issues in dentistry. We announced a new measure for Medicare in this year’s budget which should help 200,000 people with chronic health conditions over the next four years. It should help to reduce the numbers of people who are on the state government dental waiting lists.

What the measure in this year’s budget provided for was that, for people with chronic and complex conditions like diabetes, heart disease or cancer, where oral health is having or could have an impact on the person’s general health, there would be a Medicare item for them to visit a dentist. They must be under a GP management plan, but there are something like 700,000 people on GP management plans. They must be part of a team care arrangement. Residents of aged-care facilities are eligible for this measure if they are managed by a GP under a multidisciplinary care plan. But what it requires is for the patient to be referred to a dentist by a GP.

This is a very significant measure. It allows for up to $4,250 worth of Medicare funded dental treatment over two consecutive calendar years. It covers 450 items on the Medicare Benefits Schedule. It allows for things like restorative dental work and dentures, which federal Labor’s scheme does not allow for. When we look at this scheme I think it is true to say that the scheme that we first introduced has not met our expectations. But what we do find is that a similar scheme to this works very well with the veterans. What we have done is mirror those arrangements.

So when we look at the differences between Labor and the government, their scheme is just the old Keating scheme. What it involves is giving $295 million directly to the states. It is a bureaucratic solution. I guess the only thing we have to be thankful for is that the Leader of the Opposition has not announced another committee or another review, but this is a bureaucratic solution. It is the sort of solution you would expect a bureaucrat to come up with. The problem is that our scheme, which is $385 million over four years, would be axed and replaced by one which is $90 million less and which just involves giving the money directly to the state and territory governments.

When we look at how the state and territory governments have performed, we find that in the public dental services the infrastructure is run down and they have tremendous problems attracting people to work in that sector. I think it is crazy to ignore the role that the private sector can play in delivering these services. The Labor Party have announced that state governments would be required to meet new standards and that there would be: priority services for individuals with chronic diseases affected by poor oral health, timely service for preventative and emergency services, maintaining current effort.

That is basically meaningless. The state governments would argue that they already do that. In fact, when you look at the guidelines that the state governments set for their own schemes, you find out that they are meaningless within their own systems. For example, in New South Wales it is required that someone with no false teeth and no teeth of their own should be seen within three months, and yet the waiting list is more like 2½ years.

The debating point raised by the member for Gellibrand and shadow minister for health was that our current scheme has not been utilised by any child in South Australia and a number of states. Speaking from the perspective of my own state, there is a very simple reason for this. The South Australia Dental Service has, as part of it, the school dental service, which offers comprehensive dental care to all South Australian children from birth to 18 years of age. The service is free for preschool, primary and high school students with a school card or who are dependants or holders of a Centrelink concession card. So this is one of the dangers of having someone inexperienced look at a whole bunch of statistics and say: ‘Eureka! I’ve found it. Children aren’t using this in South Australia.’ There is a very simple reason: we have a school dental service available for all children.

One of the problems with Labor’s scheme is that it relies on having more people to work as public sector dentists and it completely ignores the role that the private sector could play in providing these services.

In conclusion, there is a very clear choice here. We recognise that people should be able to go to the dentist of their choice and we have found a way to do this through Medicare. That will allow people to have up to $4,250 of Medicare funded services with their dentist and will include things like dentures or restorative dental work as well as all of the preventative dental health that is so important for people with the chronic conditions like cancer, heart disease and diabetes.

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