Dental Health: Federal Funding

Written on the 18 April 2012

I am pleased to rise and speak on Ms Hartland's motion:


That this house --
(1) notes the terrible state of dental health in Victoria;
(2) recognises that oral health should be an integrated part of the national health system; and
(3) calls on the federal government to --
(a) accept the recommendations of the National Advisory Council on Dental Health and make a significant investment in state dental programs in the 2012-13 budget; and
(b) make this the first step towards universal commonwealth-funded dental care for all Australians.


We have just heard Ms Hartland's views of the federal government and its interventions in this area, but I want to speak on what Victoria is undertaking. I acknowledge and agree with Ms Hartland on the importance of good dental and oral hygiene, especially for young people, to help prevent long-term gum disease and dental problems which, if they go untreated, can have an adverse effect for many people. I think we would all agree that early prevention and intervention in this area is very important.


There are areas of chronic disease that can be impacted and untreated dental caries can lead to things like autoimmune disease and joint pain; it can have long-term bacterial implications and a whole range of chronic disease health implications, so I agree that there is a need for as much prevention and intervention with young children as possible, and I encourage parents and schools to ensure that where possible they recommend that message.


I draw the main part of my contribution to what is happening in Victoria as it currently stands. I know there have been some improvements and, as Ms Hartland has acknowledged, there has been some improvement over recent times. I put on the record that public dental services are provided to all children up to 12 years of age. Young people aged 13 to 17 years and adults who have a pension concession and cardholders or dependants of concession cardholders will be entitled to that public dental health service.


Public dental services are also provided to all children and young people up to 18 years of age in residential care provided by the children, youth and families division of the Department of Human Services; all youth justice clients up to 18 years of age who are in custodial care; and all refugees and asylum seekers.


I think Ms Hartland made mention of those groups of people who have public dental services provided to them. Children, young people and specific population groups, including indigenous refugees and asylum seekers do in fact have priority access to general dental care. It is my understanding that when the need arises they are offered the next available appointment for that general care. It is important to note that those groups who are at risk or vulnerable in relation to provision of service are able to access general dental care.


In relation to the overall waiting times that Ms Hartland mentioned and the improvements, it is worth noting that the general statewide average waiting time is 11 per cent lower than under the Labor government. That shows the coalition is taking this issue seriously. In fact as at 30 June 2011 the average waiting time for both general and denture care was 17 months, This is a reduction of some months from what occurred under the previous government -- in fact, I think it was 19 months for general care and 20 months for denture care as at June 2010. I can also state that denture statewide average waiting times are 15 per cent lower now than under the previous government, so we are seeing a trend of a decreasing in waiting times in those two important areas. It is important that members understand that in relation to this motion.


In relation to denture care, as at June 2011 the average waiting time was 17 months, and that is a reduction from 20 months. They are not huge leaps and bounds in terms of overall months, but they are certainly improving.


I think that is encouraging for all Victorians, especially those groups I have mentioned.


I am also pleased to say that the Baillieu government has increased overall dental funding by more than $4 million compared with Labor's final budget when it was in power. The government is also investing in a range of dental programs to improve dental health capacity across Victoria, which was part of its election commitments. We have just debated Ms Pulford's motion about the Baillieu-Ryan government using the 2012-13 budget to deliver on its election promises.


We are undertaking our election and budget commitments, and we are delivering on those, as was highlighted in the previous debate. In relation to our election commitment in this particular area, it has included $3.3 million over four years to attract more public sector dentists.


It is important that we have more people on the ground to deliver these services. There is $4.8 million over four years to improve access to dental services in country Victoria. Often it is very hard for rural and regional patients to access dentists as there are not the same numbers of dentists in some parts of Victoria as there are in perhaps some of the metropolitan or larger regional areas. It is important that we have identified the need for improved services in those areas of country Victoria.


There is $2.8 million over four years to promote oral hygiene and early intervention in young children. As I have previously said, that is particularly important, because if we can get to children at a younger age, we can prevent a lot of issues arising and potentially prevent a range of chronic disease from occurring. That is a very important aspect to make mention of. The government has been very particular on early intervention and prevention for children and young adolescents in a range of areas.


I ask the house to recall that the Minister for Health has done this in a number of areas, as I said, in particular in childhood obesity, which has been a particular concern of this government. One of the things the minister did last year was put together a package for preventive health initiatives for children, which was an investment of around $40 million. That was really looking at the obesity issue that many children in communities right across Victoria are facing, and that all goes to an overall plan of looking at what the government is doing with early intervention and preventive measures for not only children but also adolescents, young adults and certainly those people who need to access public dental services and who come from a range of different areas.


In relation to what is occurring at a national level, there are a number of commonwealth dental programs, as Ms Hartland highlighted. She spoke about those commonwealth dental programs. The Medicare chronic disease dental scheme was introduced in November 2007.


Under that scheme eligible patients can receive up to $4250 in Medicare benefits for dental services over two consecutive calendar years. In 2010-11 there was $170.6 million in benefits paid to Victorians, and that shows that around 1.35 million services, or 23.6 per cent of the total services, were provided in Victoria. That is putting into context the number of services in relation to this issue. Certainly more could always be done, but it is important that we understand where Victoria sits in relation to the Medicare dental scheme and those statistics I have just highlighted.


There has been some discussion about the benefits paid to dentists and specialists, and I know there has been a debate in relation to some financial aspects in recent months. Dentists need to be supported like any other health professional in relation to their services and the care they are delivering to their patients, and equally those patients who have private health insurance should be supported in their ability to pay for good health and dental care.


I know that at a federal level, in relation to what is potentially going to occur in relation to the private health insurance rebate under a federal policy initiative, many Victorians and indeed many Australians have concerns about the impact that that might have on their ability to afford private health insurance. I would urge the federal colleagues of those opposite to ensure that private health insurance is an option and the rebate is not cut in any way.


We know the commonwealth government has flagged that there will be significant changes to the Medicare


safety net, and this will no doubt have an impact upon many people who suffer from chronic disease and many people who need to access dental health services. Members should be aware that the commonwealth has significant responsibility in this regard, and any reduction in funding to these programs will have an impact on access to those dental services here in Victoria. What would that do to many people in Victoria? It would put an additional cost onto many Victorian families and potentially result in poorer dental and general health outcomes. That should be noted, and we should be preventing that where possible. The commonwealth government needs to take that on board.


The commonwealth government has also made it less affordable for people to access private health insurance, as I have said. It is extremely important for anyone who has private health insurance that the dental aspect of that private health insurance is included as part of the individual's overall health cover because, as was rightly said, dental health care is part of a person's entirety and should be looked at in that respect in relation to private health insurance. I make note again of the private health insurance rebate and the commonwealth government's decision to remove, for the first time in memory, $2.4 billion of health resources over the next three years, which includes a $600 million removal of resources from Victoria. It is another hit on Victoria by the commonwealth government, and members should be aware of the implications of what is happening with dental health services at a federal level.


In relation to Ms Hartland's motion, in which she talks about dental health care being part of a national health system, I reiterate that there needs to be improvement here in Victoria.


I am pleased to say that there have been some improvements over time and, to reiterate those, there has been some impact on waiting times here in Victoria. In the Bentleigh Bayside Community Health service area in December 2007 there was a general waiting time of 14 months. That has now been reduced to 9 months. The denture waiting time in December 2007 was 25 months. That has now been reduced to 12 months. In both those instances the reduction was measured in June 2011. Improvements can be seen in some specific areas and in the overall areas I mentioned earlier in my contribution.


I reiterate to members that I am pleased the Baillieu government is taking preventive health measures seriously. It has undertaken a number of initiatives in relation to dental health care, improving facilities and providing extra funding which will go a long way to assisting many vulnerable Victorians in being able to access dental health care. We will not be supporting Ms Hartland's motion.

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