Thursday, 30 November 2023
Provision of and Access to Dental Services in Australia Select Committee; Report
I present the final report of the Select Committee into the Provision of and Access to Dental Services in Australia, together with accompanying documents. I move:
That the Senate take note of the report.
It has been a privilege to be the chair of this landmark select committee inquiry into dental services in Australia.
I would like to begin by thanking the thousands of people who participated in this landmark inquiry. What we have heard, thanks to your advocacy, is that the oral healthcare system in Australia is undeniably a system in decay. Undeniably, colleagues, we have a system in decay.
Thousands of people took the time to share with us their experiences. There are some key themes that are undeniable: dental care in this country is too expensive; people are waiting too long to access public dental care, if they're eligible at all; and we must do more to support our oral healthcare workforce.
We, as a committee, conducted a survey: 17,000 people took the time to reply, the largest committee survey in the history of the Senate. It showed that 97 per cent of the community supports the Australian government making more dental services available for free.
This committee has held hearings across the country from Perth to Brisbane, Canberra and Launceston. I'd like to thank all those who submitted and appeared at the hearings. I would also like to thank the fabulous, dedicated secretariat team, who supported this inquiry to be as robust and collaborative as any Senate inquiry I have ever participated in. I would like to thank my fabulous team for their incredible work in supporting me to participate in and chair this inquiry. And I would like to extend my personal thanks to Senator Askew, Senator Marielle Smith, Senator Cadell and the Deputy Chair, Senator Payman, for their tireless work in creating this significant report.
The stories I have heard over the past eight months will stay with me forever. We have heard that people are choosing between their rent, eating three meals a day and getting access to oral health care.
We have heard stories—harrowing, moving, inspiring and distressing stories. They are of the type that truly moves you as somebody elected to represent their community to put all your effort and energy into making sure that this place genuinely provides solutions to the challenges and problems facing our community members.
I share with you now just one story. It's a story passed to us by Dr Stormon, who gave an electric toothbrush to a grade 2 kid. She shared in her evidence to the committee:
I gave it to him, and the next day I excitedly went to him and said, 'How did you go with your Spider-Man toothbrush?' And he said, 'I gave it to my younger brother, because my teeth are rotten but he has a chance.'
This system is failing children. It is failing disabled people. It is failing First Nations people. It is failing seniors. It is failing everyone—everyone. The number of people, including children, who are having all of their teeth removed in this country is unacceptable. The number of people living with chronic toothache out of fear of the price tag of having it addressed is unacceptable. The number of people who are ending up in our hospitals, including in ICU, with the consequences of untreated, entirely preventable diseases because they cannot access dental care in this country in 2023 is unacceptable.
It is beyond time that our governments get to work and bring the mouth back into the body.
This inquiry has shone a light on many incredible professionals who were going above and beyond to fill the gaps where the state and territory governments are failing people.
One of those organisations that I'd like to acknowledge the work of is the Kimberley Dental Team. They continue year in, year out to provide services to people across the Kimberley. It's a difficult challenge made even more difficult by the lack of secure funding provided by governments.
I am incredibly proud of this report. I am incredibly proud that it has a clear call to action:
The committee recommends that the Australian Government works with the states and territories to achieve universal access to dental and oral health care, which expands coverage under Medicare or a similar scheme for essential oral health care, over time, in stages.
Universal access to dental care, through Medicare or a similar scheme, we have to get this done.
The immediate question that confronts us now is: how do we get there?
Well, the inquiry charts a pathway for that too. Recommendation 13 is:
… that the Australian Government considers the establishment of a Seniors Dental Benefit Scheme.
It is beyond time for this recommendation to be implemented, as it was a key recommendation of the Royal Commission into Aged Care Quality and Safety. Recommendation 22 is:
… that the Australian Government develops a plan and timeline to expand access to the Child Dental Benefits Schedule to all children, over time, initially targeting better access for disadvantaged and vulnerable children.
Under the current arrangement, many children are not able to access the child dental benefits scheme or school based dental programs.
The single biggest cause of avoidable hospitalisation in the Northern Territory is children being admitted under the age of 17 to have a general anaesthetic. Why? Because they need to have all of their teeth removed. It's usually under the age of five years. That is the single biggest cause of hospitalisations which are preventable in the entire Northern Territory.
Disability and dental
One of the communities left behind by the profit-driven oral healthcare system is, of course, disabled people. There are only 26 specialist dentists in the entirety of Australia. The ACT, where we are now, does not have one single specialist dentist. That is not okay. Tasmania doesn't have a single specialist dentist. That is not okay.
Expanding scope of practice
Lastly, one of the things raised by this inquiry is the need for the government to better support our workforce. We need to improve remuneration and conditions for dentists and oral health practitioners practising in the public sector, and we need to increase the size and scope of oral health therapist workforces and ensure that all practitioners are supported to work to their full scope of practice. To get these reforms done, we need a chief dental and oral health officer and to establish a dental and oral health space within the Department of Health and Aged Care to coordinate these national reforms. I'm proud that this is a recommendation which the committee has made.
Beyond all else, we need to get the mouth back into the body and to get oral health care into Medicare and recognise it as the urgent cost-of-living issue that it is. As mortgages are on the up, as rents are on the up, as food prices are on the up, people cannot afford the average $230 charge for a dentist appointment in Perth. People simply don't have that kind of money.
I commend this report to the Senate for its detailed consideration. I seek leave to continue my remarks later.
Leave granted; debate adjourned.