Andrew Laming (Bowman, Liberal Party) Share this | Hansard source

It takes a special contribution to debate dental care for 10 minutes and not to mention the private dental sector who represent 98 per cent of the dental profession, but after all we are dealing with the Labor Party tonight—that is right, with the massive scotoma they hold towards the private sector. They are just determined to funnel dental resources into an overstretched, under resourced public sector which cannot recruit dentists in the first place to do the work as the anathema for all dental challenges.

We need to go back to 2007 to start this story and I will be brief because a lot of water has gone under the bridge. We have had some technocrat Labor health ministers in that time making a mess of the dental system. They never found a sector of medicine where they could not stick their finger in the hive and upset the professionals. They managed to do it in eye surgery. I recall the then member for Gellibrand deciding that she would arbitrarily halve the rebates the cataract surgery and being airlifted out of the red zone by then Prime Minister Kevin Rudd when it all fell to pieces very early in 2010. The Labor government was determined to kick every part of the medical profession for the simple reason that they earn too much money. That is right—the fundamental sin of the medical profession in the eyes of this Labor opposition is how much money they ear. No matter how they try to couch the terms, that is really what they are trying to say to their voters. Of course, there is no problem with union reps earning enormous salaries; that is okay. In the six years they were at the helm the Labor Party were determined to chase those nasty doctors and dentists, those beleaguered professionals as far as they possible could and to make life a bloody misery for them. That was the intention. The Medicare Chronic Disease Dental Scheme was held above their heads as the Howard legacy with which they were intent to haul dentists over a barrel. That is right: line them up and make life a misery—for no greater sin than they failed to fill out the form correctly.

Let's just step back a bit. We have got chronic disease initiatives for doctors, and there was no problem there with poorly filled-out forms. But it was not so for the dentists. For the simple reason that they were carrying out a former coalition government policy, they were chased to the end of the earth on every indiscretion and every incomplete piece of paperwork. Make no mistake: this service was almost always performed; it was just that the forms were not filled out correctly in the majority of cases. What the previous Labor government did was sinful—in pursuing dentists who were just doing their job under the law of the day and treating the sickest Australians for their dental disease.

We just heard a Labor speaker tell you how the burden of dental disease is second only to one other cancer and that is responsible for a whole range of other diseases around the body. He was reading out the talking points from the Minister for Health's office. Isn't that chronic disease to which the dental program set up by the coalition was targeted—those with chronic disease? That is exactly how you reduce morbidity. There is no point filling a tooth that is not causing a problem; it is filling the tooth that is leading to the heart disease. That was the essence of John Howard's problem. Often the good that men do is interred and the evil lives on after them. But I come here to simply say: the CDDS did many good things.

When you remember that about 60 per cent of people have concession cards, and that program delivered 80 per cent of the services to high-need Australians, the only sin of that program is that some people who did not have a concession card had the hide to line up and get that service. They had the hide to line up and get their teeth fixed. Having paid a progressive tax rate, having contributed to the country because of your higher income and having not taken a welfare cut, how does that dare to disqualify you from dental care in this great country? Dental care should be provided on clinical need.

Here you have the division. Forget all of this Labor preoccupation with not filling in forms correctly. You have got a Labor Party that wants to treat the poor and you have got a coalition that was treating the sick. The last time I checked, you pay tax according to your ability and you should have access to services according to need. To hear the previous speaker lamenting that 20 per cent of people had the hide to go and access dental care without having a healthcare card is appalling.

To those Australians who pay their tax, who do not have a welfare care and do not collect a family tax benefit A, I say thank you and, if you are sick, you deserve to be cared for equally and on the basis of triage—on the basis of your health or the severity of your illness. But, of course, the Labor Party is utterly blind to that.

The second great hypocrisy in the Labor approach is that, having vilified the chronic disease scheme of the coalition and worked to close it down until they succeeded in late 2012, remember this: there was a coalition opposition then very willing to work with the Labor Party to reform the CDDS. Owing to how popular it was, we were quite willing to sit down with the Labor Party. So what did they do? They refused all advances. They refused all offers to reform the CDDS. Why? Because they wanted to hold it up above their heads unreformed, point to it and vilify it as a failed scheme. They spent five years doing just that without acknowledging that a few easy tweaks could have significantly improved it.

We could have looked at some forms of means testing. We could have looked at better targeting. We could have even carved some of those CDDS resources out and treated children. But, no, to make the political point they denied treatment for children for six years and instead allowed the money to pour into the CDDS and preferred to make the political point by blaming the coalition predecessors.

Let's go back a step and think about chronic disease for a moment. Doctors can treat it without being harassed by a Labor government using chronic disease schemes but, no, dentists are different purely because it was set up by John Howard in 2007—no other reason. You can be a billionaire and go and get a chronic disease assessment—team based arrangements and allied health care—under Medicare, but the minute you do it for your dental health, that was anathema to Labor.

What did they do? They set up a Child Dental Benefits Schedule—the CDBS—in which they have simply allowed $1,000 over two years for what? Exactly the same system that was under the Howard scheme still open to all forms of abuse, overtreatment and overcharging except you are treating a child instead of an adult. There is no difference, so they were quite happy to do that for kids and say it was a great reform but what have they done? Sure, they included the family tax benefit A eligibility criteria—I have no problem with that—but overcharging and overservicing still happens with the child scheme. The very reason they undermined the adult scheme lives on to this day thanks to the Greens and the Labor Party proposition for child benefit dental care. I have no problem: the scheme should have been around years ago, but the very criticism they held was never addressed in their own scheme, and that is hypocritical to say the least.

Second, in order to bring that $4,250 available for seniors and those with chronic disease down to $1,000, the Labor Party started to make certain dental care ineligible for their new scheme. So to get it to $1,000, the first thing that the Labor Party said—and we are talking about technocrat health ministers. We had a smart technocrat in the member for Gellibrand and then we had a not-so-smart technocrat in the current member for Sydney: the Latham without the loyalty. Under her and her predecessor's care, what we ended up with in that program was large amounts of money funnelled to state public dental systems that cannot recruit dentists and completely closing out private dentists from offering any form of public care, so you lose 98 per cent of your carers. Then last of all they said: You can't have bridges done. You can't have crowns done. They actually ruled out advanced and highly technical dental care from this child benefit dental scheme. That might be fine for my kids and yours but, if you go to an Aboriginal community where there is severe disease, that kind of treatment is absolutely necessary. But it has been obliterated from the Labor scheme.

This was a Labor government with no understanding about Indigenous dental care, because those children need significant dental work. The alternative to a bridge and a crown for those that actually have not spoken to a dentist before is extraction. That means losing teeth instead of conserving them. The last time I checked in the last 10 years the great push in children is to conserve teeth, but this is a Labor government that actually excluded crowns and bridges from that care, obviously to save money—and I can see that imperative—but that does not work in Indigenous care. We needed a voucher system that provided the dental care that would absolutely conserve teeth in this most serious of situations.

The final point to be made is the exclusion of private dentists from the scheme. What I have said here is simple: the Labor Party hated that private dentists could access these payments. They then hated that the paperwork wasn't filled out completely but had no problem with doctors who did not. This bill finally brings those indiscretions under the PSR, which is a way more commonsense approach to examining these areas. Where dentists delivered the dental care but did not fill in the form, why can't they get at least part payment? No, they had to pay the entire amount back and that was so ridiculous. We had dental bodies around the country basically queueing up to beg the Labor government of the day not to take this action against dentists. But, for the Labor Party, it was not about the dentists or the patients; it was just about making a political point and bagging the coalition.

I am not for a moment going to say to you that the Chronic Disease Dental Scheme hit the nail on the head and delivered a comprehensive and complete scheme. But it targeted the most expensive, the sickest and the most complex cases and ensured that you were treated, whether you were rich or poor—remember that. I thought the previous speaker from Tasmania gave an excellent example—that of a young working women, earning barely the basic minimum wage. This woman, in her late 20s, had decay through 20 of her teeth and was facing extraction of all of them and dentures. It was that Labor Party over there who said, 'Because you hold down a job, you can't have dental care. You shouldn't be eligible for it because you don't have a concession card.' That was their only concern—'You work; so you are not eligible to go to a state dental facility and we do not care about you.' Under the coalition's scheme she would have had her teeth fixed, based on clinical need. The problem is that those opposite have never had a clinician of any quality over there to help them with their policy. You are driven by technocrats who care only about cost-cutting and niggling the professions who deliver this valuable care. I say to the opposition, 'You have a chance to rethink this.' The opposition now have a chance to rethink it and to get it right.

We obviously support satisfactory arrangements for seniors, for those in need and for children. It should go down in the records that, while these are only minor amendments that take an enormous pressure off dentists, for six years it was the Labor Party who held up dental reform for no better reason than to have a target to shoot at in the form of the CDDS. They left us with no dental care for 13 months—in that almost fallacious fight to find a surplus that they could never deliver. People who were half treated with dental care were told, 'By the end of the month, there will be no more services that are public funded.' It was a disgrace at nearly every level. It is amazing to think that a party that pride themselves on social policy could get it so utterly wrong and, in the end, criticise us because a few rich people got their teeth fixed. That was apparently the sin of the CDDS—that a single dollar went to someone who did not have a concession card.

Let me say thank you to those Australians who pay their tax under a progressive system, who work hard and who are self-reliant. If tough times and poor health befall them, they deserve some care from the state—and that is a situation that has not been occurring in Labor state governments around the country. Under the CDDS they were denied that care. I look forward to a day when those people can get comprehensive dental care regardless of their age.

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