David Gillespie (Lyne, National Party) Share this | Hansard source

This bill amends the Health Insurance Act 1973 and the Dental Benefits Act 2008. It allows the operation of the Child Dental Benefits Schedule to be overseen in a similar fashion to the Medicare oversight process. Not only will the professional service review process be able to be applied to the Child Dental Benefits Schedule but also the CEO of Medicare can request documents to substantiate Chronic Disease Dental Scheme billing is appropriate. These are sensible and appropriate measures that ensure compliance with the intent and design of the scheme.

I would just like to make some observations on this scheme and its history and some reflections on the previous government's dental policy and its development. The Child Dental Benefits Schedule commenced in January this year, but it is a leftover policy from the previous government. There has been a dental scheme absence, apart from state-based public dental schemes, since the Chronic Disease Dental Scheme was axed in August and September 2012.

The Chronic Disease Dental Scheme was a great scheme, with a good clinical basis and intent, but, like in any government scheme, there were instances where either patients or dental practitioners were pushing the boundaries to a stage where the envelope was broken. I am very loath to say 'abuse' or 'fraud' but in some cases the intent and the administration of it was not ideal, and the response was not appropriate to the problem. In classic ALP fashion, rather than instituting compliance and oversight, which you would think any sensible administration would bring into play if it had concerns, it appears to me that it gave them the excuse to get rid of a scheme or a coalition achievement that actually had some runs on the board.

There also appeared to be the opportunity to save the previous administration a heap of money, because there was no replacement for about 14 months. They also summarily demanded in retrospect refunds of thousands of dollars from dentists who had supplied services to patients. The justification of that, to me, seems to be a technicality—that the dentist had not filled out part of the paperwork. This also reflects badly on the previous administration because, surely, with most transactions in business you check that the work has been done before you pay the provider. That tells me that they were not checking on the processes that they should have had in place in the first instance.

For many people in my electorate this scheme was a godsend, because there are lots of elderly people, concession card holders and pensioners in the electorate of Lyne who unfortunately, because of the generation they grew up in, had bad dentistry. They also have serious kidney, vascular and heart conditions. The Chronic Disease Dental Scheme in many instances prevented further disease. Even though it was being done late in life for many of these recipients, it was very preventive. If you have kidney disease, gingivitis, rotten teeth or you cannot eat good nutrition because you have no teeth, this was a godsend. Twenty-five per cent of the electorate of Lyne either have a concession card or are in receipt of a pension, so this change had massive ramifications for the electorate. When the axe fell, many were left in limbo. In some cases, they were halfway through their treatment program. Others who had committed to it were left high and dry and struggled on in chronic discomfort or had to commit to multiple extractions and false teeth.

I think the previous administration were so desperate to save money anywhere that they just saw this as an excuse to blame the dentists and give them an account rather than institute what we are doing with this amendment. We are instituting proper oversight of a scheme which is targeted to a different cohort altogether. Paradoxically, the two-year-old to 17-year-old cohort probably have the best teeth in the country. We are also instituting means-testing so that it is applied to people who really need the help.

I am sure the spin doctors were consulted heavily in the development and rollout of this scheme, because it is hard to criticise anything that is targeted at children. Everyone knows that if children have good nutrition, have a toothbrush that is used, have fluoride in their toothpaste and are not fed sweet drinks all the time, most of them should be left with healthy teeth and gums by the age of 17. I hope this really is a dental program and not a spin doctor program that was punched out in the dying days of the previous government.

The coalition government will certainly be monitoring and observing this scheme to make sure it has the outcome that was intended. We still need to address the other problem: with the summary execution of the Chronic Disease Dental Scheme, many genuinely concerned and good practising dentists and dental practices were left with huge bills, in retrospect, months and years after they delivered good service. This is a classic case of using a fig-leaf response to cover up the deficiencies and inadequacies of the previous administration. The old saying 'Throwing out the baby with the bathwater' is applicable here. There were problems with the Chronic Disease Dental Scheme, but, rather than fixing them, they got rid of the whole scheme altogether.

The amendments to section 34 of the Financial Management and Accountability Act, with oversight and the CEO of Medicare able to inquire, and with professional services review processes, will simplify the process of garnering the debts that were levied. It will also give the department the ability to waive the debts. It will not excuse fraud; it will not excuse abuse. Currently, the investigation process whereby money is retrieved is so laborious and long that the amount of funds expended in getting funds back costs as much as the returns. Also, I find that it was an affront to bill retrospectively professional people who were doing a good job for patients with chronic disease.

I commend these amendments to the House. As I have said on so many occasions, when you are in government you have to have good administration. This is a good legislative response to a problem that is now going to be addressed and fixed. I commend the bill and the amendment to the House.

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