Steve Irons (Swan, Liberal Party) Share this | Hansard source

I rise to contribute to the debate on the Dental Benefits Legislation Amendment Bill 2014, in which we have heard various speakers from both sides of the House getting quite passionate and giving their version of the facts as they have gone along the way. It just amazed me listening to the member for Blair talking about $80 million a month, when the previous government foisted on the current government $1 billion a month in interest payments. His crocodile tears in worrying about $80 million a month, after they foisted on the Australian people $1 billion a month in interest payments, just amazes me. Then he talked about the CDDS system, which was scrapped, and which he had started getting complaints about in 2007. If it was such a bad system, why did the Labor Party wait until 2012 to scrap it? The reason they scrapped it was, as the member for Bowman said, to try to achieve that impossible and elusive surplus, which they still have not managed to deliver since 1989.

Let me get back to my contribution on the bill. Mr Deputy Speaker, as you know, we on this side of the chamber have a long history of supporting and implementing healthcare policy initiatives that benefit all Australians. Where the coalition have worked to develop various policy structures that reflect the areas where Australians have indicated service delivery and support is needed the most, those opposite have taken schemes that were established or extended by the coalition and have shut them down or reduced their level of support, despite their high success rate. This is not because the schemes were ineffective or were not meeting their objectives, unlike many policy initiatives implemented by those opposite; it is because the Labor Party needed to find ways to pay for all their other policy failings and the enormous debt that seems to follow every Labor government throughout the history of Australia.

I cannot mention Labor failings without highlighting some of the worst policy catastrophes in our recent history, like the pink batts scheme, their attempt to roll out the Building the Education Revolution and, of course, the fiscally unstable mining tax that generated barely any revenue. Now, apparently, the concept of learning from your mistakes still has not been caught onto by those opposite either, since, within days of the government scrapping the mining tax, the Leader of the Opposition announced that, if elected, the Labor Party plan to bring it back. These are of course just a couple of Labor's policy failings, which those in this place could simply unify under one umbrella and entitle: 'How not to run government'.

Those opposite have criticised this government's budget measures to put Australia's healthcare system and other policy portfolios back on a sustainable path, yet what we saw under the former government were a series of broken promises on health and the removal of fully funded initiatives that benefited the chronically ill. Those in this place would know that the Howard government introduced Lifetime Health Cover in 2000 as part of reforms that significantly increased private health insurance coverage in Australia. Yet what we saw under the former government was a series of changes to private health insurance that made it more expensive for the almost 11 million people that hold some form of private health insurance. Despite repeated promises that they would not change the private health insurance rebate, Labor means-tested it in 2009 and 2011, made changes to the indexation arrangements last year and removed the 30 per cent rebate on Lifetime Health Cover in 2012.

In six years of Labor being in government, household health costs increased by 35 per cent, and hospital waiting times for elective surgery grew from 34 days to 36 days. Let us also not forget Labor's attempt to roll out their $650 million GP Super Clinics Program, where 64 clinics were promised in 2007 but only 33 had been delivered when this government was elected last year to fix the mess of those opposite. Most recently, the true extent of Labor's hypocrisy was also highlighted in the government-commissioned Australian Institute of Health and Welfare report which clearly identifies a slowdown in health funding in 2012-13 under those opposite, despite their claims that they were spending more on health and their criticisms of this government's plan to put spending measures back on a sustainable path.

Of course, if this were not enough turmoil for our healthcare system, those opposite sought then to discredit and shut down a scheme that delivered much-needed treatments for those who were already suffering from other serious health conditions. The scheme I am of course referring to is the Chronic Disease Dental Scheme, a scheme that was set up in 2004 and expanded in 2007 by the current Prime Minister as then health minister to provide capped Medicare benefits for dental services for people with chronic medical conditions and complex care needs and whose oral health was impacting on or exacerbating their condition. Benefits of up to $4,250 over two years were available to all Australians on a referral from a GP.

Despite the high level of support this scheme provided the chronically ill, those opposite sought not only to discredit its delivery but shut it down in 2012 and left patients with no Medicare benefits for dental services for dental services for 18 months, from 30 November 2012 to 1 January this year. The coalition fought hard to keep this scheme, with the now Minister for Health, Peter Dutton, moving a disallowance motion in September 2012 to disallow the closure of the scheme. I supported the motion in this place on the need to retain a scheme that had great success by the standards of any government, with more than 20 million dental treatments provided during the life of the scheme to more than one million patients, 80 per cent of whom were concession card holders.

I have a relationship with the Forgotten Australians, and during that period after the Chronic Dental Disease Scheme was down I met with quite a few of them. Many of them who had been under that treatment from the CDDS were extremely disappointed with the Labor government for having shut that scheme down, as many of them were in the middle of treatment and it was chopped off with them unable to get their chronic oral health problems fixed. Many of them were totally disappointed with the efforts and implementation of the destruction of the CDDS.

Although the chronic diseases under this scheme were not prescriptive, chronic conditions are generally deemed as those of at least six months duration and include such conditions as asthma, cancer, cardiovascular disease, diabetes, arthritis, mental illness, musculoskeletal conditions and stroke. I highlight this because the three most common chronic conditions typically managed by GPs are arthritis, diabetes and depression, according to the Australian Institute of Health and Welfare. Yet, instead of those opposite working to fix the issues raised in this scheme and assist sufferers with their condition, their answer was to put it in the too-hard basket and shut it down. They shut it down despite arthritis and other musculoskeletal conditions affecting an estimated 6.1 Australians and diabetes affecting about one million Australians in 2011-12.

Not only did the scheme have a high take-up by patients; it was also universally accessible, just like other Medicare schemes, and was appropriately funded under the policy framework—just another thing those opposite never seemed to manage. It is also peculiar that those opposite continue to say they are a party that supports universal health care; when they shut down the Chronic Dental Disease Scheme they claimed it should only be available to concession card holders, which does not really make it universal. I agree that supporting our most vulnerable should be the priority of any government; but, last time I checked, universal health care includes everyone who seeks to access it. I guess we can just put that down to yet another policy contradiction by those opposite.

Despite their inability to appropriately fund or manage policy initiatives, those opposite also attempted to discredit this dental scheme by claiming that there were massive cost blow-outs and the scheme was flawed. Considering the scheme was always funded appropriately under a coalition government and the average claim was $1,760, well under the $4,250 cap, I think we can also safely say that any blow-outs were once again the result of those opposite mismanaging—mismanagement that resulted in household health costs increasing by 35 per cent, education costs increasing by 39 per cent, gas prices increasing by 71 per cent, water and sewerage prices increasing by 79 per cent and electricity prices increasing by a massive 101 per cent in the six years those opposite attempted to govern. If we want to talk about blow-outs, perhaps those opposite need to remind themselves of the $91 billion of deficits between 2008-09 and 2012-13 that they left as their legacy to the Australian people.

Unfortunately, despite the coalition's best efforts to retain the scheme, it was shut down on 30 November 2012, with one of the reasons cited by those opposite being alleged rorting by dentists. The reality, however, was once again very different from what those opposite claimed. This alleged rorting stemmed from the scheme's requirement that dentists provide a written treatment plan and quotation to a patient before commencing treatment for the services to be eligible for Medicare benefits. A copy of the plan was also required to be given to the referring GP. A compliance audit did, however, reveal that dentists were not meeting these administrative requirements, which prompted the Department of Human Services to pursue repayment of the full amount of benefits paid by Medicare to these dentists. This non-compliance was, however, far from the rorting those opposite claimed, with the majority of these cases simply being due to minor paperwork errors.

It was the view of this government while in opposition and remains our view today that to pursue the recovery of the full amount of the paid Medicare benefits was an excessively severe punishment. Thankfully, following the hard work of our colleague Senator Bushby, who introduced a private member's bill in the Senate to have this recovery action dropped for those dentists who were deemed to have only made administrative errors, common sense eventually prevailed. The private member's bill prompted a Senate committee inquiry which resulted in those opposite acknowledging what those on this side of the chamber already knew: a harsh and unfair line had been taken with this matter, and these actions needed to be resolved. The former minister for human services subsequently sought to have these debts waived under section 34 of the Financial Management and Accountability Act 1997, which leads us to the purpose of the bill before the House today.

A statement by the former minister was issued on 12 October 2012 outlining how debts would be waived. This stated that debts would be waived for:

The late or non-provision of treatment plans and quotes for audited dental practitioners' claims made before April 2010; and in cases after this time where an audited practitioner has shown their intent to meet the Scheme's requirements.

In these instances the Department of Human Services and the Department of Finance were required to assess these cases and make a determination. This has resulted in a lengthy and time-consuming process for both departments and has left dentists waiting two years for an adequate resolution.

The bill before the House today seeks to finally lay this matter to rest. It will waive debts for those dentists who made minor paperwork errors while providing a much-needed service to chronically ill patients and remove the unwarranted stigma that has for too long been attached to this scheme. It will achieve this by amending the Health Insurance Act 1973 to allow the Chief Executive Medicare, or CEM, to waive debts raised against dentists, as per the former minister's determination, rather than requiring the departments to assess all individual cases. In the majority of cases this will have no financial impact on dentists or the Commonwealth, as most dentists who incurred a debt due to noncompliance are yet to make this payment.

The bill does, however, include a provision that repayment be made to the small amount of dentists who have already paid their debt to the Commonwealth. I acknowledge that there were a small amount of cases where evidence supported claims that dentists had committed fraud. This bill will not excuse those dentists from repaying their debt; it will only serve to waive the debt of those who acted in good faith and provided this much-needed service, but did not adequately fulfil the scheme's administrative requirements.

I now turn to another key aspect of this bill which seeks to amend the Dental Benefits Act 2008 and the Health Insurance Act to bring the operational procedures of the Child Dental Benefits Schedule in line with other Medicare programs. By way of background, the Child Dental Benefits Schedule commenced on 1 January and is an extension of the former Medicare Teen Dental Plan. It provides eligible children aged two to 17 with access to up to $1,000 in benefits over two years to cover the cost of basic treatment. The scheme is means tested, requiring a child's family to receive family tax benefit part A or a relevant Australian government payment to be eligible. Currently, compliance powers for dental services are different to other Medicare schemes and investigative processes for inappropriate practice are not cohesive.

The amendments proposed in this bill seek to rectify this by aligning the two acts' compliance powers to ensure appropriate Medicare claiming is occurring. The changes will provide the CEM with the power to obtain documents from dentists to confirm that amounts paid under the schedule are accurate. Additional amendments will also provide the CEM with the power to enforce compliance and to impose civil penalties or recover any imposed debts on behalf of the Commonwealth in the event of noncompliance. Civil penalties would be imposed in those instances where the requirements detailed in written notices are not complied with. For an individual the civil penalty is 20 penalty units, and for a body corporate it is 100 penalty units.

I commend the bill to the House.

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