House debates

Monday, 20 October 2014

Bills

Dental Benefits Legislation Amendment Bill 2014; Second Reading

7:36 pm

Photo of Andrew NikolicAndrew Nikolic (Bass, Liberal Party) Share this | Hansard source

I welcome this opportunity to address the House on the Dental Benefits Legislation Amendment Bill 2014. In particular, I would like to highlight a trifecta of equally important issues that address some of the revisionist history that we have just heard from the member for Ballarat. Firstly, the omissions and even injustices of the previous government in relation to policy in this important area; secondly, to focus on the benefits of this amendment bill to the dental profession, the very same professional community which were so unnecessarily harried by our predecessors; and finally, but perhaps most importantly, the practical benefits of this amendment bill for many Australians. This is most especially the case for those who have not been able to access adequate dental care because the former government had so mismanaged, then abandoned altogether, the practically-functioning and effective dental architecture enshrined in the then Chronic Disease Dental Scheme.

Now to the first of these issues: egregious former government oversight, occasioning negligence. The previous government's policy, operations and management of the Chronic Disease Dental Scheme, prior to formally closing it in 2012, was manifestly inadequate and unjust. This included, most particularly, their vindictive pursuit of dentists under the thinly veiled guise of Labor's purported commitment to recovering overpayments. This vindictiveness was directed at dentists who had treated in excess of one million patients. Yet, in reality, these financial transfers were, in the main, the result of minor technical errors in paperwork and administration. In this more balanced context, Labor's vocal condemnation and sometimes McCarthyesque pursuit and condemnation of dentists was overwhelmingly without substance—and even bordered on being slanderous. It was in equal parts, cynical, shameful and wholly manipulative.

What then, might you ask, was the real motive that impelled Labor's duplicity? It was the removal of a scheme to which they were, and remain, ideologically opposed, and in which the then Prime Minister had an obvious close personal interest. In a nutshell, Labor chose to forsake the collective public good because it presented the opportunity to attack the work of former health minister and current Prime Minister. By their actions, Labor sought to undermine an altogether effective dental scheme which was doing much good for many Australians, particularly those who were economically disadvantaged.

That Labor's pretext of choice was related to minor clerical errors says much more about the nature and quality of the opposition than about the largely innocent targets of their fault finding—the hardworking dental community. Yet again, as has so often been the case with our opponents, this saga showed them to be more focused on parochial self-interest than on the broader and much more substantive issues of national strategic improvement and social wellbeing. This is a case of Labor not seeing the wood for the trees, of exaggerated attention to paper error rather than to the widespread alleviation of chronic dental disease and the pain and other health consequences that follow. Surely, in the interests of the very best social policy, all of us in this parliament must strive to elevate our thinking, well beyond the deadening hand of retrospective bookkeeping to a plane of higher, even enlightened, possibility to identify and seize ways in which the lives of our fellow Australians might be improved. During its period in office, from 2007 to 2013, over the issue of dental care, Labor fell very far short of this laudable standard.

I would like to add a very human dimension to the consequences of Labor's action. In early 2013 I was approached by a young women, in her 20s, from Launceston, who was suffering from a very serious chronic dental condition. It was a condition that was badly affecting her lifestyle in every way, including her confidence. This young woman was at risk of losing her teeth from this chronic condition. Remember, this is a woman in her 20s. She only worked part time and did not have private medical cover and was simply unable to pay up-front for the desperately needed treatment she required. So desperate were her circumstances that she had sought loans and even tried to get an early release of her very modest superannuation to get the treatment she needed.

The tragedy here is that, under the Liberal Party's Chronic Disease Dental Scheme, established under the former Howard government in 2007, her condition would have been covered because it was the only Medicare dental scheme that provided chronic dental treatment for adults. Under John Howard's dental scheme she could have accessed benefits of up to $4,250 over two calendar years.

It is instructive to note that 80 per cent of people who received treatment under the Howard government's Chronic Disease Dental Scheme were those who needed it most—namely, concession card holders. It was a scheme that provided more than 20 million services to over a million patients—that is, before the Labor government closed it down for political reasons at the end of November 2012. No new patients were allowed to access services after 7 September 2012. You can do the maths. This left a 13-month gap in services, meaning that the young lady who approached me in Launceston, sadly, fell through the cracks. She was not the only one. There were children in the midst of treatment who were unable to have their treatment completed by 30 November 2012, when Labor arbitrarily changed the goalposts.

The young lady I speak of was a victim—a real-life consequence of Labor's ill-considered, knee-jerk policy changes. We also saw ill-considered policy changes to border protection, pink batts, the live cattle trade, the NBN, overpriced school halls, with their never-ending appetite for borrowed money. It is a very long list and Australian taxpayers are bearing the consequences.

In relation to the young woman I mentioned, I managed to get her the help she needed by pleading her case to a local service club. They came up with the $3,000 needed to start her treatment. We got the money, paid the dentist and her future health is now looking much brighter today, but all of that stress and pain should not have been necessary. We should not have had to rely on the goodwill of a Lions Club in Launceston.

That is why I am particularly pleased to add my voice to a bill that amends the Health Insurance Act 1973 and the Dental Benefits Act 2008 in order to introduce critical changes for the efficient operation of the Child Dental Benefits Schedule. It will also bring about an improved process whereby those dentists who have unknowingly erred clerically and/or administratively—but certainly neither knowingly nor deliberately—as part of the former Medicare Chronic Disease Dental Scheme, will have these debts waived.

The detailed implementation of this effort will include two important things: a move to secure the appropriate waiver of these debts by the Minister for Finance, under section 34 of the Financial Management and Accountability Act 1997; and the requirement for the Chief Executive Officer of Medicare to waive the debts of those dentists concerned, thereby saving both them and others, including indirectly the wider Australian public, much time and angst in the process.

These intended steps by the government are only fair and reasonable, and are also in keeping with this government's strong desire to differentiate between genuine error and deliberate financial misappropriation. To do otherwise—as did Labor's bull-in-a-china-shop approach—would be to continue to waste time, energy and emotion, not least of which on the part of our valued dentists. Such a course would also be contrary to that most rare commodity on the other side of the chamber—a welcome outbreak of common sense.

Perhaps, most important of all for dentists is that these actions and initiatives will go a long way in matters which are other than financial in nature. By and through them, this essential and important professional body will be provided certainty of action, faith that their concerns have been patiently listened to and taken seriously, and some increased measure of professional esteem and self-respect by the constructive erasing of what many reasonably feel to be the former government's widespread tarnishing of their professional reputation, conduct and competence.

This bill also foreshadows additional improvements for the Australian community, including improved auditing and compliance mechanisms, the guaranteed independent examination of alleged or suspected future malpractice and enhanced efficiency measures. I will outline here how that will be achieved. Firstly, for auditing and compliance, in order to ensure that taxpayers' money is spent appropriately and that compliance audits are made as efficiently and effectively as possible, this bill introduces amendments which will more closely align the compliance frameworks of the Dental Benefits Act and Medicare. This will include the power to compel a provider to comply with a request to produce documents to substantiate the payment of future benefits.

Secondly, for guaranteed independent examination of alleged or suspected malpractice, the Professional Services Review, or PSR, is an independent authority which examines suspected cases of inappropriate practice referred by the Department of Human Services. The PSR protects patients and the community from the risks associated with inappropriate practice, and protects the Commonwealth from having to meet the cost of medical and health services provided as a result of inappropriate practice. The PSR can currently investigate cases of inappropriate practice under the Medicare program and the PBS, the Pharmaceutical Benefits Scheme. This bill will enable the PSR to also investigate cases of inappropriate practice under the Dental Benefits Act.

In conclusion, this bill establishes a provision requiring the chief executive of Medicare to waive debts raised against dentists in limited circumstances for services provided under the former Medicare Chronic Disease Dental Scheme. It will allow the Professional Services Review scheme to apply to dental services provided under the Dental Benefits Act 2008, consistent with other Medicare services. It will ensure powers under the act enable the chief executive of Medicare and relevant employees of the Department of Human Services to obtain documentation to substantiate the payment of dental benefits in a similar way to Medicare benefits. The bill also makes a number of technical amendments to the act, including to support the framework for the Child Dental Benefits Schedule.

Dental health care may appear rather prosaic to some—doubtless amongst this body are members of the former government whose collective efforts on it were so singularly unconstructive. Both their actions and their selective inaction in these areas impacted negatively on the provision of improved dental care for many Australians, including the distressed young woman about whom I raised the attention of this parliament. At the end of Labor's six years in office, the system was manifestly more inferior than it had been at the start. In no way were many Australians any better off—neither the highly qualified and dedicated professional dental community entrusted with providing this service nor many members of the long-suffering public, many of them whom should have been its fortunate beneficiaries.

By our efforts on this bill, the government has, just as it has been compelled to do on so many other policy fronts, confronted a mess inherited from Labor—and, in this particular case, a mess exacerbated by a financial witch-hunt against dentists for a cynical ulterior motive and purpose. The government's efforts on this issue will be to the longstanding benefit of many Australians, regardless of their social circumstances. I, therefore, have much pleasure in commending the Dental Benefits Legislation Amendment Bill 2014 to the House.

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