Andrew Murray (WA, Australian Democrats) Share this | Hansard source

No, they have not said so publicly. Schedule 4 of this bill is an outstanding amendment to the medical expenses tax offset which excludes purely cosmetic procedures, both medical and dental, from the tax offset for medical expenses incurred over $1,500 in an income year. This is a just exclusion from a beneficial tax provision that operates under the premise of providing tax relief for health rather than image related medical procedures. It is shameful to think that some Australians have been able to claim beneficial tax treatment for expensive cosmetic surgery while at the same time there is an alarming number of Australians unable to access necessary medical treatment due to issues of affordability or waiting lists. This is yet another instance of a divide in this country between the rich and the poor.

No single issue so much defines the advantages that the haves have over the have-nots than the access to dental care that many of us take for granted. The government provides millions of dollars and subsidies to those on higher incomes to help with dental care costs, but Australians on lower incomes receive nothing. An immediate injection of leadership and money is needed for disastrously long waiting lists for basic dental services, for the relief of pain and the repair and replacement of defective teeth. Tooth decay is the most common health condition in Australia, and tooth loss and gum disease are amongst the top problems. Diet, particularly of poor people, is very material to the development of tooth decay.

It is true that Australian children are relatively lucky in their access to affordable dental care, primarily through state provided services, and this is reflected in figures of good rates of oral health in those states. But it is a very different story for adults. Australia now has the second worst adult oral health of all the OECD nations, which I think number 30 now. Yet the government continues to do nothing about it. Ninety per cent of dental services are provided through the private sector with the patient paying a fee—and often a considerable fee in my experience—for each visit. Dental services are expensive. Many people on lower incomes do not have private health insurance and cannot afford private dentist fees. Those people miss out.

The government is spending more than $320 million a year subsidising dental care for people with private health insurance, but all it has done for those who cannot afford private cover is to cut the Commonwealth dental health program established by Labor. I do hope restoring that is in Labor’s program when they campaign to be the next government. When the Howard government abolished the program in 1996 there were 380,000 Australians waiting for public dental care, according to the statistics. According to those statistics there are now more than 600,000. The longer people wait, the more damage is done to their oral and general health. Poor dental health impacts on other medical conditions, including heart disease, diabetes, arthritis, respiratory ailments and cancer.

Of course, the government is continuing to ignore the lack of a workforce program to provide oral health care. There are too few dentists to meet the potential demand. Estimates have suggested that increases in population and in demand will mean Australia will face a shortfall of 1,500 dentists. I have no way of knowing whether that is accurate but there is general consensus that there are too few dentists for the need. I assume that if there were more dentists available fees would fall, because there would be more competition. That is another thing to think about.

The lack of federal funding for public dental health services is creating an ever-increasing gap between those who can afford dental health care and those who cannot. There are no funds for emergency dental treatment, let alone the preventative dental treatment that saves money in the long run. There is not even a means test basis on which you can enter into the dental queue. The changes to Medicare that the government has put in place, while a small step in the right direction in this bill, only apply to patients with chronic health problems that are made worse by poor oral health, and they only cover limited procedures. Treatment relies on a doctor’s referral, if you can get in to see one, and only refunds up to $220—although that is not in this bill; it is already established as a government program. This is unlikely to cover the normal fees charged by dentists. It is time that we had a long-term national oral health strategy and the funding that went with it. We do need leadership as well as money to bring about real reform of the dental care system. Redirecting any savings that result from the removal of the tax offset for cosmetic procedures to public dental services will not solve the problem, but it will at least direct some money to where it is most needed. My second reading amendment seeks to draw attention to this issue, and I will formally move it before concluding my remarks.