Glenn Sterle (WA, Australian Labor Party) Share this | Hansard source

The incorporated speech read as follows—

Health Insurance Amendment (Medicare Dental Services) Bill 2007

Mr President I rise to speak on the Health Insurance Amendment (Medicare Dental Services) Bill 2007.

I wish to speak on this Bill for a number of reasons, mostly because it’s important that the appalling record of the Howard Government in regard to health and dental care is not forgotten.

Mr President, the measures in this Bill are a weak and pathetic attempt to paper over the catastrophic damage that the Howard Government has done to the tradition of Government supported dental care since coming to office 11 long years ago.

One of this Government’s first actions was to abolish the Commonwealth Dental Health Program.

This was nothing less than an act of political bastardry. It had nothing to do with health care. It was intended as a kick in the head of the Labor Party. It was about belting up the States and to hell with the consequences for people on low incomes. To hell with people with disabilities. To hell with the elderly of this country.

This action in 1996 was the first step in Mr Howard’s long held dream to dismantle Australia’s public health system.

If things had gone as planned, the abolition of the Medicare would have been the next step.

In 1996 the Howard Government had the dismantling of Medicare in its sights and let’s not beat about the bush, it is still on their agenda.

I have no doubt that the Prime Minister would enjoy striking at the heart of Medicare if given half the chance.

Remember that prior to the last election the Prime Minister and all that lot in the Cabinet gave no inkling that they were going to wreak havoc on Australia’s industrial relations system. On past form it is hardly likely that he would telegraph his intentions to dismantle the Medicare scheme at the first real opportunity.

Mr President, the measure contained in this Bill is nothing more than a con.

The Howard Government’s way is to cause problems and then make a huge noise about how it fixes the very problems it created.

But it now looks like the trusted old strategy is going off like a bucket of prawns in the sun.

Let’s look at their current leadership chaos. As the story goes the member for Mayo was given the task to sound out the Cabinet for support of the Prime Minister’s leadership.

The alleged plan was to murky the waters around the leadership issue and then clear the waters by throwing in a chlorine bomb to fix a fungus that never actually existed.

But I’ve got news for you—the truth is its more like a toxic algal bloom.

What a farce. What a hopeless mob.

Mr President, as it has been said before, you can get away with fooling a few people all the time, you can even get away with fooling all of the people some of the time. But Mr President, you sure as hell can’t get away with fooling all of the people, all of the time.

The majority of Australians have had a gutful of this tricky and unfair Government.

One of the great contributions to dental care in this country has been the State Government School dental schemes that have been an important feature of dental care for decades.

Don’t just take my word for it, take the word of a recent President of the Australian Medical Association. This is what Dr Bill Glasson, the then AMA President, said when interviewed on radio in March 2004:

“preventative dentistry is what its all about, and we certainly practise that in our children and it’s a great success in this country.”

How’s that for a ringing endorsement of State Government school age dental care schemes?

Dr Glasson went on to say:

“I think a dollar spent on dental care saves us three dollars or more in the health system down the line.”

Dr Glasson further stated:

“What I would like to say is there is a certain percentage of our population out there who probably should have zero gap, in other words, there is probably five percent or ten percent of the population that need to be picked up, supported, full stop.”

Given that school age children make up approximately 20% of the population, in effect, what the President of the AMA was saying was that almost a third of Australia’s population require access to Government funded general and preventative dental care.

In 1996 we had such a system—with school children covered by State Government school dental services and adult Commonwealth concession card holders covered by the Commonwealth Dental Health Program (CDHP).

A Senate Inquiry into public dental services in May 1998 found that the CDHP was, and I quote:

“successful in meeting its aims, especially in terms of providing greater access to dental services for low income and disadvantaged groups in the community.”

The Senate Committee’s Report went on to say:

“since the cessation of the program access to dental care has been reduced with increasing public dental waiting lists. There are now over half a million on waiting lists for general dental care throughout Australia.”

Mr President, a recent count now puts the number of people on public dental waiting lists at approximately 650,000. Here we are, 9 years after the Senate’s Report and we have an even greater number of Australians unable to obtain affordable and timely dental care.

This year, the Federal Government funded Australian Research Centre for Population Oral Health at the University of Adelaide and part of the Australian Institute of Australian health and Welfare, published the Report of the National Survey of Adult Oral Health 2004–2006.

This survey interviewed over 14,000 people aged 15-97 of which five and a half thousand were dentally examined.

The survey found 1 quarter of Australian Adults had untreated tooth decay. The survey also found that this figure varied by no more than 5% among the generations. In other words the rate of tooth decay did not vary according to age.

This means that the Howard Government can’t simply blame past governments for this problem—it’s a problem owned and caused by the Howard Government front and centre.

It’s a problem that has been caused by those opposite and their accomplices in the other place.

The survey also found that the levels of untreated decay were more than twice as high among indigenous Australians.

In addition the survey found that approximately 20% of people had moderate or severe gum disease.

These findings point to a massive failure in Australia’s preventative dental services.

As a past President of the AMA, Dr Bill Glasson said in 2004:

‘Preventative dentistry is what it’s all about … money spent on dental care will save money.”

If the high level of untreated and oral health disease in the adult population is not addressed urgently, the result will be much greater health costs in the future.

Government health experts, health and medical academics, the AMA and the Australian Dental Association have been making this point for years, backed up by reputable research.

The Howard Government’s response, apart from tinkering around the edges of the problem, like the measure in this bill, has been to blame the States and Territories for the lack of needed publicly funded dental services.

The 2004-2006 National Survey of Adult Oral Health found that 30% of Australians reported avoiding dental care due to cost.

Approximately 20% of people said that cost had prevented them from having the recommended dental treatment.

In other words, the Howard Government has presided over the establishment of significant access barriers to needed dental care, including preventative dental care.

The Survey found that the financial barriers to dental care were greatest amongst uninsured people and indigenous Australians.

If you are an adult indigenous Australian or a person on a low income, who can’t afford private dental insurance, you might as well forget it. The chances that you will ever be able to afford preventative dental care are now almost zero.

The survey found that people without private health insurance were twice as likely to have difficulty in paying a $100 dental bill than people who had private health insurance.

In 1996 the Howard Government dumped uninsured people.

It’s been a hallmark of the Howard Government that if you are a low income person you are a loser and a whinger. Also anyone who stands up for a fair deal for low income people is accused of promoting the culture of envy.

Mr President, we on the Labor side of politics are proud of our tradition of promoting the cause of the less well off in the community and we are not going to be intimidated by the self-centred silver tails opposite.

We on the Labor side will always call it as it is.

The performance of the State and Territory Governments in the provision of public dental services has been exemplary despite bad mouthing by Howard Government Ministers.

In the period 1995/96 to 2004/05 Australian Institute of Health and Welfare figures show, State and Territory government expenditure on public dental services increased by approximately two and a half times.

Don’t tell me that the States haven’t been pulling their weight.

Australians know who the absconder from public dental care is—the mean and tricky Howard Government.

The Howard Government, by abolishing the CDHP effectively took federal dental care services money from the least well off in the community and handed it over to the better off members of the community.

In 1995-96 the Commonwealth was contributing through the CDHP approximately $100 million per annum to public dental services.

By 2005-06, having slashed and burnt commonwealth funded public dental services, the commonwealth were spending close to 4 times the cost of the CDHP on private health insurance dental premium rebates.

I would find it quite incredible to believe that even the most stone-hearted Tory would think this was justice, that this was a fair thing.

Why was it necessary to trade off Commonwealth support for public dental services for low income people for private health insurance premium rebates? It make absolutely no sense.

The fact is, this sort of caper has become par for the course for the Howard Government. This mean and tricky Government has made these types of tricky deals an art form.

Mr President, sadly this sordid story doesn’t end here. There are two other culprits in this merry tale of incompetence—first the private health funds.

In 1995-96 private health fund benefits for dental services were approximately 58% of total member cost of dental services. By 2005-06 the value of private health fund benefits for dental services had fallen to approximately 49% of total member cost of dental services.

However, when you look more closely you find that the real story is that fund own sourced benefits for dental services are now only approximately 33% of member dental costs compared to 58% in 1995/96 with the difference being picked up by the taxpayer.

On a fund member basis, per capita fund benefits for dental services, after taking account of the federal government private health insurance rebate, fell by 6% in the period 1995-96 to 2005-06.

On the other hand over the same period, fund member out of pocket costs for dental services increased by approximately 200%.

The stark reality is that neither the private health funds nor the Howard Government have eased the direct cost burden of dental services to fund members over the last decade.

This is a major policy failure by the Howard Government.

What the Federal Government’s private health insurance rebate policy has done has been to make life simpler and easier for the private health funds.

No wonder the private, for profit sector is lining up to get a piece of the action. Who could blame them for clambering to get into a high profit, no risk business subsidised by the Federal Government with a guarantee that you can increase private health insurance premium prices by at least the CPI every year.

You don’t have to worry about such a thing as a productivity dividend.

The other beneficiary of the Government’s largese has been the private dentists.

Again you can’t seriously blame them. If there’s enough room to shovel your snout in the trough then why wouldn’t they muscle in?

In the ten years to 2004-05 total private dental expenditure increased by 130% compared to an approximate 100% increase in private medical expenditure in the same period.

Obviously, private dentists have done very well out of the Commonwealth’s assault on public dental services even when compared with the almost perpetual winners in the income stakes, the medical profession.

The situation with dentistry in Australia is simply another example of inequality of access to health care being sponsored by the Howard Government.

Mr President, I was very encouraged to read that the current Federal President of the AMA who is from WA, Dr Rosanna Capolingua, in announcing the AMA’s health policy priorities for the 2007 federal election had this to say:

“Australia has a good health system by world standards, but it is not providing equal access to all Australians to high quality health care and services.”

I strongly agree with these comments.

Dr Capolingua is a person who does not hesitate to speak out robustly on problems with Australia’s health care system.

I must say, however, that I was more than a little surprised to read this statement from a President of an organisation that traditionally has been a natural supporter of conservative governments—particularly so close to a federal election.

This gives a measure of how seriously the Federal AMA views the failure of the Howard Government’s policy management of Australia’s health system.

Also I was a little disappointed that, unlike her predecessors, no mention was made of dental health in the AMA’s 2007 federal election health policy priorities.

I know dental services are not a front line responsibility of medical practitioners but, as we know, the lack of adequate preventative dental care and treatment almost inevitably flows on to more serious medical conditions.

As far back as seven years ago the AMA had this to say:

“The Australian Medical Association has commended the ALP for its commitment to re-establishing the Commonwealth Dental Health Program for the benefit of low-income Australians and pensioners who are suffering immeasurably since the scheme was scrapped 4 years ago and called on the Howard Government to match the commitment.”

Dr Kerryn Phelps, the then Federal President of the AMA stated:

“Dental care should not be treated as a privilege—it’s fundamental to health care overall ...

It is essential for the Commonwealth Government to share its responsibility for those Australians who cannot afford dental care.”

What has changed since these words were spoken by the Federal President of the AMA way back in August 2000?

Mr President, in fact things have got worse.

A few days ago the professional body of Australia’s Dentists, the Australian Dental Association (ADA) called upon the Howard Government to address the mal-distribution of the current dental workforce. Dr John Matthews, the Federal President of the ADA had this to say:

“A mal-distribution in the current supply of dentists make timely and affordable access to dental treatment a difficult proposition for a number of Australians.”

Dr Matthews went on to say:

“Australians living in rural and remote areas have comparatively poor oral health compared to their urban counterparts due to the lack of access to dental care. This is totally unacceptable. There are 650,000 people on waiting lists for public dental care with an average waiting time of 27 months.”

And then he said:

“Just allowing the market to solve the problem is not going to work. We need positive government action to solve this crisis. This is another case where the Federal Government must show leadership and work co-operatively with the States.”

Dr Matthews is absolutely correct. This is exactly what Labor has been saying for years.

Mr President, Labor is opposing this Bill because it simply continues the political fraud that the Howard Government has foisted on low income people who have been shut out from access to dental care.

In stark contrast to the current regime a Rudd Labor Government:

• Will re-establish a Commonwealth Dental Program;
• Will ease cost pressures on working families by contributing to the cost of dental care;
• Will keep people out of hospital for preventable dental conditions;
• Will end the Blame Game and work with the States and Territories to fix Australia’s dental care system.

Under Labor, State and Territory Governments in exchange for additional funding will be required to meet new standards of dental care. These will include:

• Providing priority services to individuals with chronic diseases affected by poor dental health; Providing timely service for preventative and emergency services; and
• Maintaining the current effort.

The facts are as clear as day—the Howard Government has made a complete shambles of its dental care policy and there is nothing in this Bill that changes that.