Mr ENTSCH (Leichhardt-Chief Opposition Whip) (13:18): I welcome this opportunity to speak today on this motion for disallowance on the Health Insurance (Dental Services) Amendment Determination 2012 (No. 1). While I am sure I am not alone in dreading a trip to the dentist, I am fully aware of the importance of good oral health. Being a neglecter of my teeth in my younger years, I have certainly learned to live to regret it.
You realise that good oral care not only means a person can eat, speak and socialise without pain or embarrassment but also contributes to their general wellbeing. At the other end of the scale, poor oral health not only results in infections, tooth loss, minor and major surgery but also contributes to cardiovascular diseases, diabetes, strokes and low birth weight.
It seriously concerns me that this government is proposing to shut down what has been a very effective program, the Chronic Disease Dental Scheme. It has been incredibly successful up in my region. They are closing down the scheme, known as the CDDS, on 30 November this year. The cut-off date for any new services was 7 September, which, as we all know, has already passed.
The government claims that an additional 3.4 million children will become eligible for subsidised dental care under their proposed bill, and I certainly welcome any investment in dental health for young people. But there is very serious need for these services not only in our metropolitan areas but further out, in our regional areas and our Indigenous and remote communities-where there is an absolutely chronic need for these services. In Leichhardt, a high number of my constituents live in regional and very remote areas, where there are a range of barriers to achieving good dental health.
- First of all, in regional areas it is very difficult to access regular dental treatment. There are fewer dental professionals in those areas, resulting in delays in receiving treatment and much higher consultation fees. Of course, if you do not drive and there is no public transport-as there is not in the overwhelming majority of my region-logistically it is very difficult to get to a clinic.
- Also, living far away from metropolitan centres, people find it difficult-and this is a real issue in remote communities-to find affordable fresh fruit and vegetables, and other healthy food options. Transport costs boost prices by up to 30 per cent, and the length of time it takes to get the food to the stores means its quality is often be compromised. This means it is much easier and cheaper to buy processed and sugary foods.
- Many remote communities do not have access to fluoridated water. I know it is controversial, but it is a cost-effective way to reduce the rate of cavities in whole communities.
- Lastly, information about good oral health is harder to access. It is not just about the importance of brushing your teeth regularly but also about knowing which foods are bad for your teeth, and why it is so important to have regular check-ups and catch problems early.
Many people of Aboriginal or Torres Strait Islander heritage live in my electorate. While they are subject to exactly the same barriers, they also have additional issues that they have to contend with.
For a start, they may avoid going in to the dentist, because often dentists’ clinics are not culturally sensitive, particularly when there is strict emphasis on appointment times and fees can be charged if people do not turn up. For people travelling down from remote communities, it really is a whole new experience, and sometimes very challenging. In addition, Indigenous Australians are more likely to smoke, have diabetes and sit lower on the socioeconomic scale, all of which contribute to them having much poorer oral health than other Australians.
Some of the statistics are quite sobering: 51 per cent of Indigenous children under the age of five have been hospitalised for dental treatment, compared with 34 per cent of non-Indigenous children; Indigenous people aged between 17 and 20 are 8.2 times more likely to have decayed teeth; and 49 per cent of Indigenous adults between the age of 35 and 54 avoid certain foods because of their oral health problems, compared with 17 per cent of other Australians.
It does not matter what your background is; delays in getting treatment mean that the condition worsens, and at the end of the day that means major surgery. Figures for 2009 show that in the Cairns and Hinterland health district, dental conditions were second only to diabetes complications as the most common cause of potentially avoidable hospitalisations. With a rate of 353 hospitalisations per 100,000 people, the Cairns and Hinterland rate is significantly higher than the wider Queensland rate of 267 incidents per 100,000 people.
This leads on to a number of concerns I have in relation to how the new proposal that has been put up by the government is going to be funded and implemented. For a start, age is no barrier to dental health issues. Good oral health for young people is vital, but it is no less important that people of all ages have access to effective dental care.
The Chronic Disease Dental Scheme in its current form was established by the Coalition in 2007. It allowed eligible patients of all ages with chronic health conditions to receive up to $4,250 in Medicare benefits over two years, and it was very successful. Despite that, we are well aware of Labor’s attempt to shut down this scheme, and I am very glad that up until now they have failed, because the last thing anyone with an ongoing serious health condition needs is additional pressure on their finances.
As I mentioned earlier, Labor’s 29 August announcement outlined the closure of the Chronic Disease Dental Scheme, effective as of 30 November this year. Unfortunately, given that the new child dental scheme does not commence until 1 January 2014, this means that there will be a gap of some 13 months in treating the young people. It is certainly not rocket science to work out the impact this will have on families who struggle to afford dental treatment for their children. I fear for those children who may remain untreated and what impact that will have on their overall health.
In addition, Labor’s proposal for adults will not commence until 1 July 2014, which is 19 months after the Medicare scheme closes. Until then, more than one million patients who have been eligible for the Chronic Disease Dental Scheme will lose access to timely dental treatment. Quite frankly, that is just not good enough.
Today I received an email from a lady in my electorate, who really puts a human face on this crisis. Lyn Blyth lives in Palm Cove. She is in her late fifties. I will read her email verbatim:
“At age 58, in 2010, I was diagnosed with breast cancer. On advice pre- chemotherapy I had a full dental health check up, as the teeth could particularly be affected by the type of extremely toxic chemotherapy I required. My teeth and gums passed with flying colours and during the six rounds of chemotherapy I was ever vigilant with dental hygiene as well as rinsing my mouth at least six times a day with salt water.
“However at the end of the sixth round – and the day before I was to travel to Townsville to live for six weeks daily radiotherapy – I developed a painful problem with a tooth. Unable to resolve the problem with my dentist I was referred to one specialist in Townsville and then to another. I endured much pain and many expensive treatments at nearly $1000 dollars each while having radiotherapy each day before another cancer patient told me about the dental scheme. I contacted my GP who authorised my Enhanced Primary Care form to help with these crippling costs.
“I am still not finished my treatment for this exact problem due to slow healing times due to chemotherapy drugs. I would not have been able to have a reasonable outcome if not for the dental scheme and would not have undertaken the treatment which hopefully is almost at an end. Many patients could be in this situation and I think there should at least be a reasonable phase out time for people in this situation. I have just lost another tooth due to this ongoing problem and will lose more if it is not resolved satisfactorily compromising my nutritional intake and overall health.
“Please ensure you give voice to my and other patients’ legitimate concerns to government during your time in Canberra representing your constituents!
“Yours faithfully, Lynette Blyth.”
Unfortunately, there are a lot of Lyn Blyths out there in the community. I think Lyn’s voice should be heard in this place when we are giving consideration to the changes that are being promoted by this government.
With regard to the adult scheme, Labor plans to give funding to the states and territories for public dental services. Commonwealth funded services will no longer be available for adults through private dentists under Medicare. There are a number of shortcomings with this plan. Firstly, cost-of-living pressures are already hitting residents of my electorate hard. The last thing they need is additional financial and personal stress in the form of not being able to afford to take themselves or their children to the dentist.
Secondly, around the country there are already some 650,000 people on public dental waiting lists. Labor has not provided any indication that the public system can actually provide for these extra patients. Waiting lists often make newspaper headlines, and Far North Queensland is no different. As an example of the desperate need in my electorate, I refer to an article in the Cairns Post of 17 February this year. The article is about the opening of a new $25 million student dental clinic at James Cook University.
This facility, the only one of its kind in Australia, opened with a waiting list of more than 2,000 people. The 112 people who were lucky enough to score an appointment on the opening day for discounted treatment had waited four months for the privilege. One Clifton Beach resident, a mother of three, said she would not be able to afford dental care for her family if she did not have a Queensland health card that makes her children eligible for free examinations and treatment at the clinic.
I have to say, with a great deal of pride, that myself and a former colleague, the member for Herbert Peter Lindsay, and Senator Macdonald from the other place, were instrumental in getting the funding to establish this state-of-the-art facility, and it has certainly made a hell of a difference to the oral health of people living within our region. But that in itself does not solve the problem, which is the critical need to continue to maintain the Chronic Disease Dental Scheme. It allows people to receive up to $4,250 over two years towards treatment, and I think that is very important.
The other concern I have here is in relation to how the government are going to pay for all of these changes they are making. They are closing down this very successful Chronic Disease Dental Scheme. Under the new one they will have, they say the proposed dental entitlement for children is going to cost $2.7 billion; for adults, another $1.3 billion; and the third entitlement, or Flexible Grants Program for Dental Infrastructure, is another $225 million. That is $4.225 billion dollars, totally unfunded. If you add that to the $120-odd billion that is out there for a whole range of other promises-only the other day $1.4 billion was announced for private childcare workers, and there is the $6.5 billion for the Gonski review-none are funded, I think it is even crazy to suggest that we continue to run up this bill when we have a perfectly functional scheme. If we shut it down today, there are going to be a lot of people, like Mrs Lyn Blyth and others, who are going to suffer very badly from the closure of this scheme.
For those reasons, I very strongly support this disallowance motion and I hope that we can get the support in this place to make sure that the Chronic Disease Dental Scheme remains in place.
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