Senate debates

Wednesday, 31 October 2012


Dental Benefits Amendment Bill 2012; Second Reading

6:36 pm

Photo of Concetta Fierravanti-WellsConcetta Fierravanti-Wells (NSW, Liberal Party, Shadow Minister for Ageing) Share this | | Hansard source

I would like to start my contribution to the debate on the Dental Benefits Amendment Bill 2012 by saying that the coalition supports investment in dental health and it has been a tenet of our policy for a long, long time. The government is now closing the Medicare Chronic Disease Dental Scheme, effective from 30 November, and the replacement schemes are not due to commence until 2014. We on the coalition side are very concerned about the many patients who are currently receiving treatment under the CDDS and who will be forced to forgo that treatment during this gap period.

On 29 August, Minister Plibersek and Greens spokesperson Senator Di Natale announced an unfunded $4.1 billion dental program, which has the touch of the never-never about it because, of course, it is not due to commence until 2014—way after the next federal election. The government have also announced the closure of the Medicare Chronic Disease Dental Scheme, effective from 30 November this year, so no new patients were able to access the services after 7 September. How typical of this government. They do it all the time. They make a decision to shut things down with very little notice and very little consideration as to the effect that these sorts of things have on patients. We saw it with the Better Access changes, when Minister Butler made a decision to change Better Access with very little to no consultation whatsoever with the sector and no regard whatsoever for the impact on patients.

What does the closure of the scheme mean? It means that the means-tested family tax benefit part A or other specified payments entitlement for children aged two to 17 years will not commence until 14 January—13 months after some children will lose access to the existing scheme. This proposal is supposedly to provide a $1,000 capped benefit over two years to eligible children, with the government claiming some 3.4 million children will be eligible, again, at an unfunded cost of $2.7 billion. The proposal for the adults will not commence until 1 July 2014—19 months after the current scheme closes. Funding will apparently be provided to state governments for public dental services, and services will no longer be available for adults through private dentists under Medicare. The unfunded cost of this is $1.3 billion. Then, of course, there is the flexible grants program for dental infrastructure, the capital and the workforce component, which will not commence until 2014. The invitation to apply for funding under that grants program will not commence until 2014, again, at an unfunded cost of $225 million.

The bill before us does not commence operation until 1 January 2014. Whilst it makes very minor amendments to the Dental Benefits Act 2008, only changing the eligibility age of the current Medicare Teen Dental Plan from 12 to 17 years to two to 17 years, it also makes other minor terminology changes. A schedule of services, fees and details of how the scheme will be funded is still not available. This is not surprising; it is a common practice with this government. This government is rushing the bill through the parliament without having this very important detail, even though it does not commence for well over a year—well after the next federal election. What does this suggest? It suggests that it has absolutely nothing to do with helping people with issues pertaining to dental care and everything to do with politics. This is not about good dental policy. It is more about politics and spin over substance.

The Minister for Health has acknowledged that services for most children will cost less than the proposed $1,000 cap, but there will be children on the Medicare Chronic Disease Dental Scheme who will require more services, and there is no provision to ensure that they will receive this adequate treatment, especially in the period before the bill is due to commence. The available data suggests that well over 60,000 services have been provided to children under the current scheme. The closure of the scheme on 30 November will leave a 13-month gap for many children currently receiving treatment. There are children in the middle of treatment at the moment who will not be able to have their treatment completed by 30 November. Those families have nowhere to turn. There has been no consideration whatsoever of the impact that this will have on those children. The minister and the Greens need to explain why these children must suffer for 13 months with incomplete treatment and absolutely no certainty whatsoever on the provision of the schedule of services that are going to be provided. This is, of course, on the proviso that the government actually delivers on its unfunded promise in 2014.

The coalition support investment in dental care and do not oppose the intent of the bill, but we do have legitimate concerns about the children who will lose access to treatment on 30 November with the closure of the current scheme. We have concerns about the children who will not be able to complete their treatment. We have concerns about the unfunded $2.7 billion cost of the measure and we have concerns about the schedule of services and fees and the other essential details that are not available as this bill is being rushed through the parliament. Accordingly, we propose that an inquiry be conducted with respect to these issues. We reserve the right to consider the findings and provide our response in future.

I now turn to the Medicare Chronic Disease Dental Scheme. As I said, it will close on 30 November, with no new services to be provided after 7 September. The scheme was introduced by the coalition when in government and has been an absolutely enormous success. It is the only Medicare dental scheme that has provided treatment for adults. It has provided $4,250 in Medicare dental benefits over two years for eligible patients with a chronic health condition and approximately 20 million services have been provided to over one million patients since 2007. We know that Labor has repeatedly tried to shut down the scheme for its own political reasons and has gone to absolutely extraordinary lengths simply because it was established by Tony Abbott as health minister and has been a success in access to treatment. We have seen this repeatedly from former Minister Roxon; if Tony Abbott introduced it, she wanted to shut it down. Included in this obsessive pursuit to shut down the scheme has been the pursuit of dentists for minor and inadvertent paperwork mistakes. Despite claims of expenditure blowouts, the average claim per patient according to the Department of Health and Ageing is $1,716, which is well below the allowable $4,250. Indeed, recent estimates suggest that the average cost per patient has fallen below $1,200.

We offered to work with the previous health minister to refine and improve the scheme, including through a process for providing high-cost items such as crowns and bridges, but of course that was rejected. It is reported that 80 per cent of services under the current scheme have been provided to concession card holders. It should be noted that Medicare is a universal scheme that all Australians pay for through the Medicare levy and the taxation system, but this evidence suggests that dental services have been predominantly utilised by low-income Australians.

At this point in time I would like to, if I may, look at some of those Australians—particularly older Australians—who have benefited from this scheme. I would like to quote from correspondence that I have received from an organisation called Australian Aged Dental Care, which provides mobile dental services to aged care facilities. This company has been operating since 2011 and has treated over 5,000 residents in aged care facilities during this time. They will continue to do so until 30 November, when they will be effectively shut down. What, then, will happen to those older Australians who are receiving these services in aged care facilities? Clearly they will not have anywhere to go. This company has a fleet of three mobile clinics, each with three surgeries and specialised dental chairs to assist in the treatment of immobile patients. I had the opportunity to see how their operations worked by visiting an aged care facility in north-western Sydney when they were operating and to see firsthand the great job they were doing in assisting older patients to come to their facility where they provide these services.

What is going to happen to these people? Many of these people, who would otherwise have got service, will now be forced to go without treatment or be added to the 650,000 people already on the public dental waiting list. After 30 November, many will be left without access to treatment. Many will be unable to afford the full cost of private treatment. The government's vague promise of providing money to the states and territories for public dental services is not due to commence until mid-2014. Many of these patients in aged care facilities, where the services straddle a period of time, may be in the midst of complex treatment. They will not be able to complete that treatment after 30 November. Many of these older Australians and concession card holders have serious health issues; that is why the scheme is helping them. After 30 November, when the service is shut down, there will be potentially serious health, economic and social ramifications for these people.

Labor proposes to provide funding of $1.3 billion to state and territory governments for public dental services. Funding will not commence until July 2014—but of course they have not said how they are going to pay for it. Many patients, as I have said, will need the bulk of the detail about the changes— (Time expired)