House debates

Monday, 23 June 2008

Dental Benefits Bill 2008

Consideration of Senate Message

Consideration resumed from 19 June.

Senate’s amendment—

(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 five 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.

12:06 pm

Photo of Nicola RoxonNicola Roxon (Gellibrand, Australian Labor Party, Minister for Health and Ageing) Share this | | Hansard source

I move:

That the amendment be agreed to.

We have before us the Dental Benefits Bill 2008, which the opposition have amended in the Senate. I have to say that, after all their positioning on the dental issue, it has been quite hard to know what the opposition were going to do in the Senate on the dental bills. It looked for some time like they were going to be opposing them altogether. This is a bill which delivers significant benefits to families, particularly moderate-income families with teenagers, who should be encouraged to get the preventative dental check that this legislation, if passed, will allow them to get. So we are pleased that the opposition have finally agreed to support this bill, but their behaviour in the Senate on a range of matters related to dental care does demonstrate their very opportunistic and unprincipled approach to dental care. They claim that they care about dental health, after having spent 11 years doing absolutely nothing in dental care—ripping $100 million a year out of the Commonwealth Dental Health Program and seeing those waiting lists grow to 650,000 people. Similarly, they claim to be economically responsible but they commit economic vandalism by blocking the offsetting savings from discontinuing their badly targeted, failed dental program.

I need to make it clear that whilst we are prepared to agree to the Senate’s amendment to this bill which will provide for a review—we are not worried about reviewing programs that are introduced; it is obviously important to see how they work and if they can be improved—in doing so we see that the opposition wants to have their cake and eat it too. They want this new program. They now support this new program. They are now prepared to concede that it might help families with teenagers. But they want to continue their old program as well, with scant regard—absolutely no regard, I think—for the cost involved in doing this.

This government were elected after asking the community to make a choice on dental care. We outlined significant new programs. But we also made it clear that we would close the previous government’s failing chronic disease program. Now, after much toing and froing, we see that the opposition are prepared to support our election commitments and allow them to be implemented—but they want to keep their programs as well. Sooner or later this just does not add up. We will have many other occasions where we will be able to highlight this issue. We are providing $780 million over five years to our two new dental programs: the Medicare Teen Dental Plan, which is specifically the subject of this bill, and the Commonwealth Dental Health Program. They are both squarely targeted at the people who are the most in need of help, many of whom could not afford dental care without this assistance.

The Medicare Teen Dental Plan will provide up to $150 towards an annual preventative check for eligible teenagers aged between 12 and 17. It will help the terrible state of our teenagers’ health, their teeth and their oral health—where the rate of decay quadruples from the age of 12 to the age of 20. Over one million teenagers will be eligible. The Commonwealth Dental Health Program invests $290 million over three years to provide up to one million consultations and treatments. This, as I say, is targeted at those most in need, such as pensioners and Indigenous Australians, and it will help address the Howard government’s legacy of those 650,000 people still on public dental waiting lists around the country.

The opposition’s response on these major investments has been all over the place. We have seen confusion, contradiction and changed positions. We have seen spokespeople saying one thing and the leaders saying something else. The spokespeople have actually changed their position several times on this as well. The member for North Sydney, who is here in this House, has now said that he ‘certainly understands the burden of dental disease in our society’ but that was at the time when he was opposing the programs that we had planned to introduce. Now we know that they are prepared to accept them, but they are only prepared to accept them, it seems, at a very significant cost—that is, maintaining their program. It seems they think that governments do not have to make difficult choices and do not have to say that programs which may have helped some people but were poorly targeted, difficult to access and not helping the broadest range of people may have to be sacrificed in order to help a larger number of people and those most in need. This is something that we made absolutely clear that we were going to close during the election. We made it clear that we would discontinue the Liberals’ complex and poorly targeted scheme and that we would invest in our dental programs that were better targeted at those most in need.

Let me just briefly remind the House when we are talking about this program that is being discontinued that the opposition have sought to prevent it being discontinued in the Senate and flag that this is the exact program that was so poorly targeted and failed so dismally (Extension of time granted) that it did not help a single person aged under 24 in the Northern Territory for the whole time it was in existence and did not help anyone at all in South Australia up to the age of 14 in the same four years. So, not one single child born in South Australia or the Northern Territory during the life of the Howard government had any assistance from this program. Nevertheless it is one that the opposition want to continue—at great expense—without acknowledging that choices have to be made and acknowledging the mandate that was given to this government at the election.

As I have said, the opposition want to have their cake and eat it too. They are now supporting our better targeted investments in dental health but they want to cling to their failed and poorly targeted chronic disease scheme. It is irresponsible and would blow a significant hole in the budget. I think it shows their cheapness and politically opportunistic approach to these sorts of issues. It is confused, contradictory and economically irresponsible—not something that we would have expected, particularly from the member for North Sydney, who has prided himself on having an economically responsible approach to these sorts of issues.

We do not think the amendments that have been moved in the Senate particularly add any value to the bill. Of course Medicare Australia will publish plentiful information that will allow the assessment of the dental benefits schedule to be made, but we are happy to have this review if the opposition insist on having it built into the bill—although I might say again that this does show their inconsistency and confusion: they constantly criticise the government for having reviews but they add an amendment that means we will be having another review every three years in perpetuity on just this one change.

So the government are not prepared to oppose this amendment. It would be far worse for us to delay the introduction of the Medicare Teen Dental Plan because of the opposition’s point-scoring and we will not do that. We do not want to deny over one million teenagers access to the preventative dental health checks that they need. We do not want to stop our kids accessing dental care for months because of the opposition’s grandstanding politics. We think our kids’ dental health is too important to let this occur so we will vote in favour of this amended bill. We believe that we need to address the terrible state of teeth, particularly of teenagers, in this country. It is a legacy that the previous government’s inactivity has left us—quite a severe downturn in the status of and outcome for teenagers and their oral health. We know that we need to act now to turn this around. If this bill is passed, it will be an important step in doing just that.

12:14 pm

Photo of Joe HockeyJoe Hockey (North Sydney, Liberal Party, Manager of Opposition Business in the House) Share this | | Hansard source

One of the benefits of having young children is that you get to watch lots of Thomas the Tank Engine. Whilst I would not accuse the Minister for Health and Ageing of being the Fat Controller, she does sound like Miss Jenny uttering the words of the Fat Controller about ‘confusion and delay’. On the one hand, the minister said that it is a great idea to have a review—she is not afraid to have a review of any program—but, on the other hand, the minister criticised us for insisting in the Senate on having a review. On the one hand, the minister says that there is a dental waiting list crisis but, on the other hand, the minister and her colleagues in the Senate opposed our revocation of the proposed regulation by the government to abolish Medicare dental. On the one hand, the minister says that our Medicare dental program did not provide services for people in South Australia over four years, particularly young people in South Australia, but, on the other hand, it is the law in South Australia for the state Labor government to provide dental services for students and, if they are not receiving any dental services, to ring up the Premier of South Australia and ask him why he is not doing his job. On the one hand, the minister says that only 13,000 services have been provided, yet in Senate estimates the minister’s own department says 300,000 services have been provided in five months. The words ‘confusion and delay’, uttered by the Fat Controller in Thomas the Tank Engine, could find no better home than in the words of the Miss Jenny equivalent, the Minister for Health and Ageing, because the contradictions are rich.

We believe there are significant problems with the Teen Dental Plan put forward by the government. In providing a rebate of up to $150, the government’s own costings state that the analysis in X-rays will probably cost $240, so there is a $90-shortfall, even taking into account the fact that it is ‘up to $150’ that the government is proposing to give people who are in receipt of family tax benefit part A. There is, therefore, going to be a gap. The combined dental initiatives of the Labor government exceed the total cost of the continuation of Medicare dental, as estimated by the Labor government.

The coalition believes that dental services for chronically ill people should be available through Medicare. To quote the member for New England—and I hope he will understand me delivering this quote in a more sanitised version—you have Medicare to remove a boil in an inappropriate part of your anatomy but you do not get Medicare to remove a boil in your mouth. The truth of the matter is that we, the coalition, introduced dental services on Medicare and the Labor Party in government tried to remove them. The fact that you have received more than 300,000 services, with a value of up to $4,250 over a two-year period, as a result of the Howard government initiatives, is a great thing, and we stand by that. Let it be forever marked on the headstone of the Labor Party’s attitude towards dental care that the Labor Party tried to take dental care for chronically ill people off Medicare and that it was only the coalition that was able to stop them. We make no apologies for that whatsoever.

Finally, I would just say in relation to this specific amendment—

Photo of Nicola RoxonNicola Roxon (Gellibrand, Australian Labor Party, Minister for Health and Ageing) Share this | | Hansard source

What do you want to close to pay for it?

Photo of Joe HockeyJoe Hockey (North Sydney, Liberal Party, Manager of Opposition Business in the House) Share this | | Hansard source

That is a very interesting interjection by the minister. It is very helpful. ‘What would you like to close to pay for it?’ I will tell you what we would start with. We would start with the $35 million grant that was given to Toyota. Isn’t it amazing how the Labor Party takes $35 million off veterans and gives it to Toyota, a company that made a profit last year of $17 billion, which is nearly the entire Australian government surplus? Not even the member at the table would agree in his heart of hearts—

Photo of Greg CombetGreg Combet (Charlton, Australian Labor Party, Parliamentary Secretary for Defence Procurement) Share this | | Hansard source

Mr Combet interjecting

Photo of Joe HockeyJoe Hockey (North Sydney, Liberal Party, Manager of Opposition Business in the House) Share this | | Hansard source

I am digging deep here, son! I do not even think the member would agree with giving Toyota $35 million to develop a hybrid car in Australia when they are already developing the hybrid car. They are already going to build it, and the $35 million pig fat for the Prime Minister in Tokyo is a starting point.

Photo of Chris BowenChris Bowen (Prospect, Australian Labor Party, Assistant Treasurer) Share this | | Hansard source

Mr Bowen interjecting

Photo of Joe HockeyJoe Hockey (North Sydney, Liberal Party, Manager of Opposition Business in the House) Share this | | Hansard source

Okay, two months worth—the Assistant Treasurer very helpfully interjects. I say to the Assistant Treasurer: did you, sir, approve the $300 million investment by Medibank Private in a private health insurer? Did the Assistant Treasurer approve that? Three hundred dollars is being spent by a now nationalised-for-ever Medibank Private in buying AMH, which is a private—

Photo of Nicola RoxonNicola Roxon (Gellibrand, Australian Labor Party, Minister for Health and Ageing) Share this | | Hansard source

AHM!

Photo of Joe HockeyJoe Hockey (North Sydney, Liberal Party, Manager of Opposition Business in the House) Share this | | Hansard source

Sorry, AHM—I stand corrected—which is based in New South Wales, a private health insurer. So not only are the Labor Party opposed to private health insurance but they want to go out and buy some of the providers and spend $300 million of taxpayer’s money in doing so. The minister invited me to give suggestions on how you can save money from one area and put it into Medicare dental. I am making constructive suggestions here.

Photo of Harry JenkinsHarry Jenkins (Speaker) Share this | | Hansard source

Order! The honourable member will direct his remarks through the chair.

Photo of Joe HockeyJoe Hockey (North Sydney, Liberal Party, Manager of Opposition Business in the House) Share this | | Hansard source

I am an economic conservative in the Prime Minister’s mould! Being an economic conservative in the prime minister’s mould—

Photo of Michael KeenanMichael Keenan (Stirling, Liberal Party, Shadow Assistant Treasurer) Share this | | Hansard source

Mr Keenan interjecting

Photo of Joe HockeyJoe Hockey (North Sydney, Liberal Party, Manager of Opposition Business in the House) Share this | | Hansard source

It is a slightly larger mould with me. But, being an economic conservative, I say to you that there are savings to be made that can help to pay for better dental care. I just point out that I do not think the solution—

Photo of Chris BowenChris Bowen (Prospect, Australian Labor Party, Assistant Treasurer) Share this | | Hansard source

You didn’t make them.

Photo of Joe HockeyJoe Hockey (North Sydney, Liberal Party, Manager of Opposition Business in the House) Share this | | Hansard source

I would just say to the Assistant Treasurer that I have sat in the ERC, and I sat for a number of years in the ERC, and there are always savings to be made across government. He knows that and I know that. The question is where you save money if you make the hard decisions.

Government Members:

Government members interjecting

Photo of Joe HockeyJoe Hockey (North Sydney, Liberal Party, Manager of Opposition Business in the House) Share this | | Hansard source

I have got form! Now that I am being invited, I relish the opportunity to reflect on a glorious ministerial career!

Photo of Harry JenkinsHarry Jenkins (Speaker) Share this | | Hansard source

Order! The member should ignore the invitations. The interjectors should not offer the invitations.

Photo of Joe HockeyJoe Hockey (North Sydney, Liberal Party, Manager of Opposition Business in the House) Share this | | Hansard source

I sacked 500 people in Medicare, because Medicare never made a profit.

Photo of Nicola RoxonNicola Roxon (Gellibrand, Australian Labor Party, Minister for Health and Ageing) Share this | | Hansard source

And you are proud of it!

Photo of Joe HockeyJoe Hockey (North Sydney, Liberal Party, Manager of Opposition Business in the House) Share this | | Hansard source

Yes, I am proud of that, because it was the right thing to do. Service actually improved in Medicare offices, and 500 people out of head office here in Canberra was hardly missed by the general public. In fact, efficiency actually improved. But it was a hard decision that was made two years ago because we had to save some money. So you do actually make hard decisions without having an impact on the quality of health care for individual patients out there. We were able to introduce a dental service on Medicare for Australians with chronic dental problems because we had a budget surplus, because we paid off the Labor Party’s debt. We, when we came into government, got rid of not only the $90 billion of Labor Party debt but the ongoing $10 billion deficit that we inherited from the Keating government. When you have got the money you actually can deliver better services and you can deliver them efficiently.

I do not think giving more money to the state governments to provide dental services in their public hospitals is a solution when 90 per cent of the dentists are in fact in the private sector. So the only way you can address the backlog of demand for dental services in the public system is by moving dentists from the private system to the public system. Dentists are not going to do that, having just spent literally hundreds of thousands of dollars, if not millions of dollars, buying state-of-the-art equipment for dental surgeries that they have to pay off over a period of time. They are not going to close a dental surgery in which they have built up goodwill and simply move to a public hospital for less pay. Therefore, no matter how much money you put into public hospitals, unless you get the dentists into those public hospitals you are not going to be able to do anything about the backlog.

That is why we set up Medicare dental: so that the Medicare scheme—after first going to a doctor and laying down a plan of management for chronic dental disease—would provide people with the services that they needed as soon as possible from a dentist rather than waiting in a queue at a public hospital. We stand by our policies in relation to dental. We think the Labor Party have got it wrong. We respect the Labor Party’s mandate in a way they never respected our mandates on the privatisation of Telstra, a whole range of different tax reform measures and other things. They never respected our mandates; we will respect theirs in relation to dental care. On that basis we are glad they accept our amendment to the Dental Benefits Bill 2008. We stand by Medicare dental, and let it be forever said that the Labor Party wanted to walk away from dental care through Medicare.

Question agreed to.