Dental Benefits Amendment Bill 2012
Mr McCORMACK (Riverina) (17:41): The most important role for this parliament—for members who sit in this chamber and for senators in the other chamber—is to build a better life for the people of Australia. It is a shame that the disallowance motion on the Health Insurance (Dental Services) Amendment Determination 2012 (No. 1) was lost 71-69 last night in what was a tumultuous evening in the life of this chaotic government.
We witnessed last night more of the slow and tortuous death struggles of this shambolic government; and this determination, while nothing to do with parliamentary procedures, processes and personalities, does say a lot about Labor and its approach to things.
Dental care is a major issue forming a big part of the overall health portfolio, which is of the utmost importance to this parliament and the people we as elected representatives serve. I say that because if you have good health everything else seems to follow; a good life is conditional on good health. That is why it is paramount that the government—whichever party sits on the treasury bench—places a priority on health. People must come first. Labor knows that and the coalition certainly knows that. The coalition is committed to investing in the dental health of Australians. The Gillard government's closure of the Chronic Disease Dental Scheme is abrupt and short-sighted but hardly surprising. With Labor's debts spiralling out of control the Treasurer has shown he will do anything to avoid a fifth straight budget deficit, which would be an appalling legacy given that he inherited an economy in such strong shape after such sound fiscal management during the Howard years. If Labor can scrimp some measure of savings from dumping a policy—no matter that it has worked and provided good health outcomes—then it will pursue it ruthlessly, relentlessly, recklessly. This is all in the name of penny-pinching, certainly not in the name of good government and certainly not in the name of sound health delivery. Cost-cutting and the Treasurer's wafer thin budget surplus are it seems more crucial for Labor than the oral health of many Australians who rely on the Medicare Chronic Disease Dental Scheme.
This determination ends the scheme on 30 November 2012. No new services have been permitted since 7 September—three days before the determination was tabled in the House and the Senate. The government announced a replacement program on 29 August and the new measures will cost $4.1 billion. But—and it is a big 'but'—the new scheme will not begin until 2014. Further, the new program is unfunded. That should not come as a shock to many, for Labor has recently racked up $120 billion worth of unfunded promises. There is a $120 billion black hole in the government's forward spending. It is pledging things it will never, if voters have any sense, roll out.
A toothache is one of the worst pains a person can suffer. I am sure everyone in this chamber has at some stage in their life suffered a toothache. The essence of this debate on the Dental Benefits Amendment Bill 2012 is precisely what this federal government is doing to dental care in Australia over the coming months. This government, which is responsible for continuity of care, has ditched it with this new program, a program celebrated and lauded at its launch but which, as I said, is completely and utterly unfunded. That is sadly the Labor way. No financial arrangements have been made for the dental package announced not that long ago. How can this be so?
This is a manipulative government which has run out of dollars but not ideas to savage key areas to save costs. This government borrows every dollar it needs from overseas because this nation is now $246 billion in gross debt and we, our children and our children's children will have to pay that off, and it will take years, decades. Our interest bill is $1 million an hour and increasing. Our gross debt went up by another $2 billion during the past week. Despite all this, Labor will keep making billion-dollar promises until the polls improve.
State funded public dental care has long waiting queues. As many as 750,000 people are waiting for care. With state funded dental care, unless you have a significant dental emergency, you simply do not get seen. Seniors who have chronic dental disease never get a chance—they have to access private services. Fortunately, Australia has a private dental model. Almost all of the nation's 10,800 dentists practise in the private sector. Why would a dentist want to work in the public sector when he/she can make so much more money in the private sector?
In Australia 600 dentists and 300 hygienists and oral health specialists and therapists are graduating each year. Those entering the profession are not enough to meet the demand and there has not been any effort on that side of the House to look at what jobs can be done by the people who work with dentists. As was pointed out recently by the member for Bowman, Dr Andrew Laming, the shadow parliamentary secretary for regional health services and Indigenous health:
If that work were done by allied health professionals, it would free up dentists to do the work which can only be done by them. This is a government which has abandoned that frontier.
This is also a government that has to its great discredit and shame shelved the chronic dental disease scheme. That scheme was introduced by the current Leader of the Opposition on 1 November 2007 when he was the Minister for Health and Ageing. It was his contention that, if people were genuinely sick and dental issues were part of that chronic disease, they deserved treatment. That is too true. It is about placing the needs of the sick first. But this Labor government, by dismantling the Chronic Disease Dental Scheme, is arguing that it does not matter how bad your teeth are if you are poor you go to the front of the queue.
In a developed country such as ours the reality is that dental disease is relatively evenly spread throughout the community. As Dr Laming so succinctly put it:
Having a concession card does not suddenly make your teeth bad. Earning a salary or getting a job does not suddenly make your teeth good. This is a government which has replaced a system designed to meet the needs of the sick with a system designed for the poor. The reality is that you have to look after both.
Well said, member for Bowman. Unfortunately, for adults who were previously protected, until their cover resumes in 2014 Labor's political pain will be put before their dental pain. Labor needs a surplus—as if that is going to happen!—so people will just have to wait. New South Wales and Victoria are the poorest investors in state dental care. Those are the states where you wait the longest. In fact, you do not wait because you never get the care. That is because the Labor state governments which set up those systems underfunded public dental care and have done so for years.
I listened to the member for Eden-Monaro talk about the fact that the coalition governments in New South Wales and Victoria were to blame. That is not so, member for Eden-Monaro. In 16 years we had very hard Labor. We had it under Bob Carr, Morris Iemma, Nathan Rees and then Kristina Keneally, who did not fund dental care the way it needed to be funded. Yes, there are cutbacks and they are hurting many communities. They have been brought about because of the need to make ends meet after those 16 years of terrible government by state Labor governments under Carr, Iemma, Rees and Keneally.
The answer is that federal Labor says it will find $1½ billion dollars two elections from now and hand it to the state governments and hope that the states spend it on dental care.
What did the opposition leader's scheme, when he was the health minister, do? Sure, the member for Eden-Monaro pointed out that it was brought in in the last days of the Howard government—a very good government, might I add, who were very fiscally responsible over 12 long years and who put many billions of dollars in the bank which have now been lost by the Rudd-Gillard governments.
What did the opposition leader's scheme do? A patient went to a general practitioner who established that they had a chronic disease and their teeth were fixed through Australia's 95 per cent private dental system immediately. It cost around $2,220 on average. For children with chronic disease, it cost $2,125 on average. What did the opposition leader's scheme do? His dental plan slowly worked its way through the sickest Australians, fixing their teeth. For mental health patients, the scheme put them at the front of the queue. They had their teeth done. They had their gingivitis fixed. They had their crowns and their bridges all fixed up. It enabled people with severe chronic dental disease to have a healthy mouth—and for some of these mental health patients for the first time in their lives.
Were there a few cosmetic procedures in the scheme conceived and introduced by Tony Abbott? Yes, there were. Was there a health justification for them? Yes, there was. Those on that side of the chamber have gone to great pains to talk about the rorting in the scheme which they have dismantled—one in 1,500 cases. Does it happen any less with doctors than with dentists? Surely it happens with Medicare and doctors. Of course it does; probably in roughly the same proportions. Doctors are no different from dentists in that respect. It is part of the trust built into a universal system.
When I last spoke on this bill, I spoke about the terrible healthcare system that they have in America, and we are so very fortunate here in Australia to have safety nets for people who get chronically ill—safety nets put in place by coalition governments, safety nets put in place by Labor governments. We on both sides of the House recognise how important health is and that we should be doing everything we can to ensure that we continue to have one of the best health systems in the world. Let me tell you: if you are in America and you get sick, if you are in the United States and you get a toothache, unless you have health insurance with dental health insurance built in, then it is just too bad. You put up with the pain.
The state public dental waiting lists were reduced by Tony Abbott's scheme. The waiting times in New South Wales were cut by 40 per cent, thanks to the now opposition leader's scheme. We have a GP centred health system. We allow the GPs to work out who is the sickest and who needs dental care the most. That was the justification for that particular scheme.
Getting your teeth fixed through the Chronic Disease Dental Scheme cost $2,220 per patient. But what was it this year? It had fallen to $1,117. Why is that so? Because all the serious work had been done. We were finally seeing the scheme drop to the level of performing the role of surveillance: monitoring the long-term care of Australians' teeth—those Australians who most needed it. The hard work had been done, and that had been done thanks to that scheme put in place by Tony Abbott and continued under Labor.
I know that Labor members opposite, the member for Parramatta and the member for Canberra, know how important oral health care is. I know the member for New England, who sits in the chair, knows how important it is, particularly in rural and regional Australia and those areas where we do not have as many dentists as in the metropolitan areas, the big cities. It is so much more important perhaps in regional areas that we have a system in place, because a lot of the patients there have to drive a lot further to get their oral health fixed up.
But that all stops now. That all stopped in early September, when a government with no money left evoked an image of dental care 19 months hence—because that is how long it is going to take now for those adults to actually get the proper care they need. This government criticises dentists for overcharging but then comes up with a scheme that gives $1,000 every two years to young people. Do you think that will not be open to abuse? Labor's scheme is precisely the same as the opposition leader's scheme, except that it is treating kids instead of the chronically ill seniors who most need it.
As I said, this is a scheme that needs to be continued. The funding will not commence until July 2014. The government has not said how it will pay for the measure. Many patients on the Chronic Disease Dental Scheme who lose access to treatment on 30 November will have to wait 19 long months to see if the government delivers on its promise and starts to provide more funding to state governments—state governments that have been bled dry by Labor governments for far too long. There is no detail on how much funding will be provided, with the possibility that the bulk of the money might not be provided until the end of the six-year period, and that is in 2018.
There are already 650,000 people on public dental waiting lists. We need to look after the people on those waiting lists who are in most need of dental care and most in pain. We need to continue to be able to provide good oral health care for those people because, as I said, health should be the number one priority for the government; it certainly is for the opposition. Therefore, I urge the government to reconsider this ill-thought-out idea.