Mrs Bronwyn Bishop (Speaker) Share this | Link to this | Hansard source

The original question was 'That this bill be now read a second time'. To this the honourable member for Ballarat has moved as an amendment 'That all words after "That" be omitted with a view with a view to substituting other words'. If it suits the House I will state the question in the form that the amendment be agreed to. The question now is:

That the amendment be agreed to.

Warren Snowdon (Lingiari, Australian Labor Party, Shadow Parliamentary Secretary for External Territories) Share this | Link to this | Hansard source

I am pleased today to be to speak on this piece of legislation, the Dental Benefits Legislation Amendment Bill 2014, which, as the Bills Digest reminds us, has as its purpose to:

I want to speak to the Child Dental Benefits Schedule. You would know, Madam Speaker, that this program was a Labor initiative under the previous government and commenced on 1 January 2014. It provides access to benefits for basic services to children aged two to 17 years. The total benefit entitlement is capped at $1,000 per child over a two-year calendar period. The CDBS has a means test which requires receipt of family tax benefit part A or a relevant Australian government payment. The bill introduces amendments which will bring the compliance framework for the CDBS into greater alignment with Medicare's compliance framework. The bill also amends the Health Insurance Act 1973 and the Dental Benefits Act 2008 so that the provisions of the Professional Services Review scheme can be applied to any dental services provided under the Child Dental Benefits Schedule. The Professional Services Review is an independent authority that examines expected cases of inappropriate practice referred to it by the Department of Human Services. The PSR can currently investigate cases of inappropriate practice under the Medicare program and PBS. And as the Minister for Health has pointed out, these critical amendments to the Child Dental Benefits Schedule will make the scheme more efficient, ensure that Commonwealth funding is being used appropriately and promote a more consistent compliance structure for both Medicare and dental programs.

We have over recent decades seen an improvement in some areas of dental health, but oral health of children has been declining since the mid 1990s. Almost 20,000 kids under the age of 10 are hospitalised each year due to avoidable dental issues. By age 15, six out of 10 kids have tooth decay—this information comes from an AIHW report—and 45.1 per cent of 12 year olds had decay in their permanent teeth. In 2007 just under half, or 46 per cent, of children under six attending school dental services had a history of decay in their baby teeth. Untreated decay and fillings are similar across income ranges, but if you earn more than $60,000 a year you have, on average, seven more teeth than the poorest Australians. This information has come from the Institute of Health and Welfare; some of it was from 2007, some of it was from 2011. But oral disease is predominantly a preventable condition and there remains a great opportunity for further improvement. This Child Dental Benefits Schedule is but one measure.

It is evident that treatment alone cannot significantly reduce the enormous personal, social and financial costs associated with oral health problems—and I welcome the Deputy Leader of the Labor Party to the chamber; she was the engineer of the Child Dental Benefits Schedule. A population approach focusing on promotion and prevention is what is required. Oral disease, like other preventable infections in chronic disease, is experienced at much higher rates by disadvantaged groups. In a moment I will refer particularly to Aboriginal and Torres Strait Islander Australians, as they have significantly poorer oral health outcomes than their non-Aboriginal or Torres Strait Islander counterparts. Other groups at risk of poor oral health in our population are very young children aged nought to four, people with chronic illness, the aged, people with special needs, those on low incomes and people living in remote locations.

My electorate of Lingiari covers all of the Northern Territory and Christmas and the Cocos Islands—Darwin and Palmerston excluded—and so it fits the bill for people with poor oral health outcomes. In my case, I represent a large Aboriginal population: around 40 per cent of my constituents are Aboriginal people who mostly live in very remote communities, although some live in urban centres such as Darwin, Katherine, Tennant Creek and Gove. I want to now point out what this means, and I am indebted to the Australian Indigenous health review, which in 2011 provided a review of Indigenous oral health. What that makes very clear to all of us is that Aboriginal and Torres Strait Islander Australians have poorer oral health than other Australians. It is very clear that oral disease can cause substantial infection and tooth loss. For those of us who have ever had a toothache or issues with our teeth, we would know that, obviously, it can commonly result in very severe pain and make everyday activities, such as just eating and speaking, very difficult.

But more importantly in a way, oral diseases affect not only the mouth but have also been associated with cardiovascular disease, diabetes, stroke and pre-term low birth weight. Two of the most common diseases that affect oral health are dental caries and periodontal. Dental caries are what we commonly know as cavities or tooth decay, and, referring now to this review of Indigenous oral health:

… are caused by acid-producing bacteria living in the oral environment that proliferate in the presence of sweet and sticky foods

In the early stages dental caries can be completely reversed. If they go untreated they will cause irreversible damage. I will come to the prevention side of that in a moment. Again referring directly to the review of Indigenous oral health:

Periodontal diseases are associated with bacterial infection of the periodontal tissues causing inflammation. Unlike caries, they are specifically attributed to poor oral hygiene as opposed to a poor diet. Like caries, periodontal diseases are preventable and treatable. Periodontal diseases range in severity from gingivitis (a mild and completely reversible form) to periodontitis (a severe destruction of the tissues that support the teeth).

Periodontitis is modified by systemic factors—these are important; smoking, diabetes, hormonal imbalances, stress and poor diet can greatly exacerbate this illness.

What we now know is that the oral health of Aboriginal and Torres Strait Islander Australians was once better than the oral health of non-Aboriginal and Torres Strait Islander Australians. Dental caries and periodontal disease were uncommon in rural and remote parts of this country up until the late 20th century. And then things changed. Dental decay, a disease of affluence that emerged in the 19th and 20th centuries, was not common in Aboriginal and Torres Strait Islander communities. It is now, and it is a real issue of great concern.

I was recently in the community of Ngukurr, which is on the Roper River about 700 or 800 kilometres south-east of Darwin; it might not be quite that far. It is a reasonably large community with a competent health service—the Sunrise Health Service, an Aboriginal community controlled health organisation run out of Katherine which looks after the clinic and other services in and around Ngukurr. I have a very old friend there, a person I have known almost all the time I have been in the Northern Territory, which is now a long time—close to 35 or 36 years. I call this lady old, but she is probably my age, so I guess I am calling myself aged. I certainly do not look it.

Warren Snowdon (Lingiari, Australian Labor Party, Shadow Parliamentary Secretary for External Territories) Share this | Link to this | Hansard source

Close!

An honourable member: Not a day over 90.

That is right! This wonderful woman, who has been a community leader for many years and very active in the community, has enormous problems with her teeth. She has had these problems for some time. Sadly she apparently will not go to Katherine, which is some distance away, to have it treated because there is no real treatment available in her community. This is one of the key issues which confronts people who live in rural and regional Australia, specifically Aboriginal and Torres Strait Islander people—the lack of availability of accessible dental services.

That leads to a whole lot of issues which I am sure the deputy leader may refer to; if not, I will at least passingly refer to them. There are huge issues with the dental workforce and with attracting people to work in the bush. I know there are some dentists—some of whom come from Canberra—who volunteer their time working in remote communities. They do a marvellous job, but they are not full time. There is an issue here about how we make sure we have the available workforce to look after this populations.

Sadly, what we have seen from this government so far is cuts to health, and they have not missed the oral health sector. Again, this has direct implications for the health workforce, with $40 million cut from the Voluntary Dental Graduate Year Program, a program that was increasing access to dental services for people in regional areas through workforce support. So the very people who need the greatest input from the dental workforce are those who are now suffering directly as a result of the cuts to this particular program. That is something which is quite shameful, and I am wondering why members of the National Party in particular—and those Liberals who represent regional seats—are not up in arms about this issue, because it directly impacts all Australians who live in rural and regional Australia.

I was also recently with the member for Blair in Pukatja, or Ernabella, in South Australia. There is a story here because one of the issues around prevention is, of course, trying to get people to stop drinking high-sugar-content drinks. They have a program there called Mai Wiru which is about healthy food. What they have now done in some stores in the Bush is take the high-sugar-content drinks off the shelves, or put them at the very back of the shelves so they are not in the line of sight of people when they come in. This is a real issue. I spoke to a dentist who runs a mobile dental van for Nganampa Health Council; I launched the van some 18 months ago. I asked him what the situation was like in terms of the background fluoride levels in the water. He said, 'There is nothing wrong with the fluoride levels in the water; they are very good. The problem is the kids do not drink water or, if they do drink water, they drink bottled water from the store which hasn't got fluoride in it.' There are some real issues here about how we make sure people do the right thing, and that requires leadership not only from the communities but from the people who run the stores.

I would say to those big companies who flog these high-sugar-content drinks to the community: you need to understand the health implications, particularly the dental health implications, of people consuming these products. I also make the point that, while we can change this behaviour, we also have to get people to eat properly. If they eat properly and they are healthy they will not have all these diseases. I commend the bill and support the amendment moved by the shadow minister for health.

Tanya Plibersek (Sydney, Australian Labor Party, Deputy Leader of the Opposition) Share this | Link to this | Hansard source

Today I am rising to speak to the Dental Benefits Legislation Amendment Bill and the amendments moved by the shadow minister for health, who is doing such an excellent job of informing the Australian community about the importance of dental health and of government investment in it. Not long after I was elected I had a man come to me about a friend and neighbour of his—a woman he had known for some years who had had a very difficult life. She was living in public housing. She had left a violent relationship. She had two children she was doing her very best to look after; she was a beautiful, dedicated mother struggling to bring her kids up right. She was so proud of the fact that her son had won a scholarship to go to a quite prestigious school. She had worked hard to give him a secure background, despite her own difficulties, and her great sadness was that she could not go to school with him on his first day of high school because she had no teeth. Her teeth were so bad she thought, 'If I turn up with this boy on his first day of school, he will be embarrassed by me. He will be ashamed of his mother and I don't want him to start school in that circumstance.' This neighbour of hers came to me and said, 'She's not going because she's got no teeth; can you help?' We were able to help. We had some very generous support and she was able to get dentures sooner than she had expected. She had had her teeth pulled out at the dental hospital because they were completely decayed. The dental hospital was able to speed up the replacement of her teeth with dentures, and she was able to go with him. That story has stayed with me for many years because it is such an important illustration of not only the health consequences of an inadequate dental health system but also the social consequences. It is pretty hard to get a job if you do not have teeth. I have met many people over the years who have said that they are embarrassed and that they cannot smile in public. They have no confidence and when they go into a job interview they do not want to speak. It is impossible to overstate how important it is to have decent dental care, particularly for very low-income Australians who have missed out along the way.

This is one of the reasons we introduced our health package when we were in government, and one of the things I am proudest of, as the former health minister, is the work that we did in dental care. When I was the health minister we introduced a $4.1 billion dental health reform package that followed previous substantial investment of $515 million. This dental health reform package focused on helping low- and middle-income families, children and those in outer metropolitan, regional, rural and remote areas. The member for Lingiari was speaking earlier about the communities that he represents and how important the investment has been in those communities. The package had a number of key measures, ensuring dental health for young Australians, ensuring dental health for low-income Australians and investing in the dental workforce and infrastructure. Unfortunately, so many of those measures that we implemented are today at risk and under threat—in some cases, already reversed.

The Child Dental Benefits Schedule is a fantastic investment in the future dental health of our children. You will not grow up to have good oral health if you do not start as a kid. It reminds me of another story. One of our previous members of parliament was once a social worker. There was a girl who was about 15-years-old who used to get $2 dollars a day for her lunch; one day she would buy hot chips and the next day she would buy a two-litre bucket of ice-cream. As a social-worker teacher, my colleague said to her—I think her name was Tammy—'Tammy, you really need to look after your health better. Have you been brushing your teeth?' 'No, I haven't been brushing my teeth,' came the reply. My colleague said, 'Well you'd better start brushing your teeth or you're going to lose them.' Tammy replied, 'It doesn't matter if I lose them. I lost the first lot and they just grew back.' So there was not even the most basic level of education in that young woman's home about good oral health. If you do not start life with good teeth then you do not get them as an adult.

We decided to invest in the teeth of our young people from families on middle and lower incomes so that going to the dentist for this generation of young Australians would be as easy as going to the doctor. I am proud of that. So three million kids between the ages of two and 17 would get access to a benefit of about $1,000 over two years so that they could get a check-up, get fluoride treatment and get fillings and a whole range of basic dental work. We hope that that investment at this early age means that they will develop life-long good oral health. We also hope that the number of young people who are hospitalised every year because of avoidable dental issues—20,000—will continue to reduce. There are kids who have a general anaesthetic because they are too young to have explained to them that it is important to sit still and have dental work done. They are under a general anaesthetic having all of their teeth pulled because their teeth are so rotten. You can imagine not only the health effect of that but also the distress that it causes those children and their families.

According to the Australian Institute of Health and Welfare, 58 per cent of 14-year-olds experienced decay in their permanent teeth in 2009. And I will tell you what: there is a big difference between kids in the poorest areas and kids in the wealthiest areas. Low- and middle-income families have 1½ times the amount of tooth decay and cavities of those in the wealthiest areas.

In the first five months of the Child Dental Benefits Schedule operating around the country, we have seen 1,522,393 services, including 15,000 in remote and very remote areas—the kids that my friend the member for Lingiari was talking about earlier. It is a wonderful scheme, and the thing that worries me is that we have a health minister who is saying now that he has concerns and that he is deeply troubled by the Child Dental Benefits Schedule. In his second reading speech, the minister said:

I put on the record some early concerns about the way in which the Child Dental Benefits Schedule was structured.

Seriously, he is the minister. He has been the minister for more than a year. If he has concerns, maybe he should put some effort into fixing them rather than just flagging what he is planning, which is a future cut to this wonderful scheme.

We also invested $1.3 billion in this same package for around 1.4 million additional services for adults on low incomes, including pensioners and concession-card holders and those with special needs, to grant them better access to dental care in the public system. That is on top of our initial $515 million dental package, which was the original public dental blitz. Around 205,000 additional public dental patients received treatment in 2013 because of that blitz. But, of course, this government has cut funding to this scheme and other dental programs in the 2014 budget. There has been $400 million cut from public dental schemes that were helping so many Australians. The member for Lingiari talked about the importance of workforce measures, particularly in communities like his—remote communities where it has been particularly hard to get a dental workforce. We provided $225 million for dental capital and workforce to support expanded services for people living in outer metro, regional, rural and remote areas. We wanted to ensure that Australians had the same access to dental care no matter where they lived.

This government has cut that program, as well, in the 2014 budget. They cut $229 million from the dental infrastructure scheme, which was helping build vital services in rural, regional and outer metro areas. They cut $15 million from Charles Sturt University's program to establish dental clinics on the Central Coast. They cut $40 million from the Voluntary Dental Graduate Year Program, as the member for Lingiari pointed out. How distressing for people who have been waiting so long for some decent dental care to have this government come in—despite saying, 'No cuts to health'—and cut hundreds of millions of dollars from dental care! We undertook these reforms because the previous—

Mr Ewen Jones interjecting—

So you support these cuts, do you? Yes, he supports the $400 million cuts.

Mr Ewen Jones interjecting—

Ian Goodenough (Moore, Liberal Party) Share this | Link to this | Hansard source

Order!

Tanya Plibersek (Sydney, Australian Labor Party, Deputy Leader of the Opposition) Share this | Link to this | Hansard source

I will be telling your electorate that you support these $400 million cuts. I will be telling them; don't you worry. You support these cuts, and I will tell everyone that you do. The Chronic Disease Dental Scheme treated millionaires the same way as those—

Mr Ewen Jones interjecting—

Ian Goodenough (Moore, Liberal Party) Share this | Link to this | Hansard source

Order!

Tanya Plibersek (Sydney, Australian Labor Party, Deputy Leader of the Opposition) Share this | Link to this | Hansard source

Designed, introduced and defended by the now Prime Minister, the then health minister, the scheme that was supposed to cost $90 million a year ended up costing $80 million a month. And it did not matter if you were a millionaire; you could have access to that scheme. It did not matter if the work was cosmetic; you could have access to that scheme. Billions of dollars spent on a scheme that was so poorly designed and so—

Mr Ewen Jones interjecting—

Ian Goodenough (Moore, Liberal Party) Share this | Link to this | Hansard source

Order! The member for Herbert.

Tanya Plibersek (Sydney, Australian Labor Party, Deputy Leader of the Opposition) Share this | Link to this | Hansard source

Throw him out if he does not shut up.

The explanatory memorandum says that this legislation is also allowing debts incurred during the design of the Chronic Disease Dental Scheme to be waived. Some of those mistakes were genuine mistakes. They were genuine mistakes because this scheme was so poorly designed by the now Prime Minister, the former Minister for Health. As I said, it was supposed to cost $90 million a year and ended up costing $80 million a month because of, in some cases, work being done that did not need to be done. There were over 1,000 complaints about dentures that did not fit and about work that was done that was not necessary. Compare that—a scheme costing $80 million a month and so poorly designed—to our targeted scheme investing in public dental services so people on low incomes could get the care and the treatment that they need.

But, of course, this is all part of a pattern. This is a government that said before the last election that it would not cut health—and what has it done? It has cut more than $400 million from dental care—much-needed dental care around the country. The minister is now softening us up for further cuts to the children's dental scheme—a scheme that has, for more than three million Australian children, made it as easy to go to the dentist as it is to go to the doctor.

We have seen these cuts come on top of $50 billion cut from public hospitals. These cuts have come on top of the $7 GP co-payment. They have come on top of up-front costs that used not to exist for diagnostic imaging—costs that the Prime Minister obviously had no idea that his own budget contained, when he was speaking about them in question time yesterday. We have seen it come on top an increased cost of medicines.

The most vulnerable Australians and ordinary mums and dads right across the board know that if their kids need dental care they should get it now before this minister cuts this program. They know, if they are waiting for public dental care, to forget about it. They know, that if they need to go to the GP, it is going to cost them to go to the GP to get a blood test or to get a diagnostic image. When they go to the pharmacy they are going to be paying more for their medicine. But if they turn up at casualty because they cannot afford to go to the doctor anymore, they will be waiting longer because of the cuts to the public health system.

I want to finish on this note, Mr Deputy Speaker: I see in the advisers' box a number of people from the Department of Health who worked extraordinarily diligently on the dental reform package that we took to the people in our time in government. I want to congratulate them for their dedication over many years, the fine work they did and their commitment to the people of Australia to ensure that every Australian can have decent dental health.

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

It is a privilege to follow the member for Sydney in this debate. I know that, as minister, she was totally committed to ensuring that all Australians had access to quality dental care. She was totally committed to ensuring that, in Australia, we had proper preventative dental health. It is really sad to see that the reforms that she brought in are being slowly whittled away by a health minister who has absolutely no commitment to dental health for all Australians. This legislation is abrogating responsibility for dentists who did not abide by the regulations at the time. It is not reintroducing the Chronic Dental Health Scheme, because those on the other side of this parliament know that it was a poorly targeted and highly costly scheme. Twenty per cent of the recipients—those who went along and accessed the Chronic Dental Health Scheme—could well and truly afford to pay for the work that they had done.

It was a scheme that was fraught with problems. There were pensioners on low incomes that actually had problems being able to access the scheme. It was very bureaucratic, and, to some extent, I do understand how dentists could have inadvertently breached the guidelines. When you are looking at dental health and the major dental health initiative being introduced by this Minister for Health, you find it is a measure that will allow those who breached the guidelines of the Chronic Disease Dental Scheme to be absolved from having to pay back the money that they obtained from the government by not correctly following the guidelines.

I want to place on record the need for the government to recognise the importance of dental health to a person's overall health. It has been a traditional approach by those on the other side of this House that wherever they can they abrogate any Commonwealth responsibility for dental health. Dental health is part of a person's overall health and the government needs to learn this, the minister needs to learn this. It really worries me when each and every day we come into this place and we hear about another cut and another attack on our health system.

I strongly argue that the best dental health programs are those that prevent dental health problems, programs like the Child Dental Benefits Scheme, a program that this minister has put on notice, a program that will prevent dental health problems for children into the future. When they are adults, it will reduce the cost to the health system into the future. But this minister does not get it. He does not understand the importance of the Child Dental Benefits Scheme. It shows that he does not understand the issue, unlike the previous Minister for Health, the member for Sydney, who spoke before me in this debate.

When the member for Sydney was the health minister, I was chair of the Committee on Health and Ageing. She asked the committee to do an inquiry into dental health services and the committee brought down a unanimous report, Bridging the dental health gap. When we spoke to the Department of Health during that inquiry, they acknowledged that the Chronic Disease Dental Scheme provided worthy dental services to some persons. It did. I can identify some people in my electorate who were definitely helped by the Chronic Disease Dental Scheme, but it was poorly targeted and had a range of problems with its implementation and administrative requirements. That can be seen partially by the fact that we are here today debating legislation about dental health that will abrogate the responsibility of those dentists who breached the guidelines.

The Chronic Disease Dental Scheme failed the people of Australia and now we have a government that has already ripped $400 million out of dental health and I believe is set to rip more out, instead of making a commitment to the long-term reforms that were put in place under the previous government when the member for Sydney, the Deputy Leader of the Opposition, was the Minister for Health. I might go through some of the things that were included in that package: $2.7 billion over six years in the Child Dental Benefits Scheme. That is under threat. The minister signalled it is under threat.

I would like the minister in his summing up to guarantee this House that he will not touch the Child Dental Benefits Scheme, acknowledge in his speech the importance of preventative dental health. I do not think you could have a better targeted program than the Child Dental Benefits Scheme.

There will be $1.3 billion over four years from the national dental partnership. One of the first acts of the Howard government was to rip money out of dental health. Here we are again in this House with a minister that is hell-bent on ensuring that he rips money out of dental health—$400 million already and I am sure that is only a signal of things to come. Previously, the Howard government put money into private health insurance as opposed to putting money into delivering direct dental health services to Australian people.

There will be $225 million over four years from the flexible grants for dental infrastructure in outer metropolitan, rural and regional areas. That was designed to reduce barriers to accessing dental services for people living in those areas. The Committee on Heath and Ageing that I chaired went out to many areas, to rural New South Wales to the electorate of Parkes. When we went to that electorate, we saw how important it is to make sure that those communities had access to dental health services, that those communities had access to dentists. There were $77.7 million for the Dental Relocation and Infrastructure Support Scheme to help doctors relocate into regional and remote areas. The fact that the government is walking away from these initiatives shows their total lack of commitment to dental health.

In relation to the report, I would like to note the assistance and the advice that the committee had from the Department of Health. I know that they were very instrumental in helping the previous minister develop much of that scheme. It is really very sad that we are going to be in a situation in future where things like money to alleviate pressure on public dental health waiting lists will be gone, watered down or reduced, that the capacity to expand the workforce will be gone, watered down or made totally ineffective, that oral health protection activities and the pro bono dental service provision money—all these things are under threat because of this government's actions.

The bill creates a waiver provision for the Medicare Chronic Disease Dental Scheme. It makes a number of amendments to the operation of the child dental benefits scheme. It really demonstrates just how poorly targeted that scheme was, how it failed to address problems in the dental scheme, how public waiting lists, infrastructure, workforce distribution and child dental health suffered. These were issues that the then Minister for Health, the now Prime Minister ignored. These were issues that he failed to address. This Minister for Health is moving to where the Prime Minister was when he was the health minister, ignoring the needs of all Australians, ignoring the need to put in place strong, preventive programs. As I said earlier, I am waiting to hear his reply in which I hope he will give a rolled gold, iron clad commitment that he will, under no circumstance, do anything to whittle away the child dental benefits scheme.

It is so different from the vision that Labor had for dental health when we were in government. We had a vision to implement a better and fairer dental care system for Australians, one that is affordable and focuses on prevention in order to deliver future improvement to Australians' oral health. It is about cutting dental healthcare costs in the future. That is the vision we had when we were in government. This minister and this government have a vision to allow those dentists who were trapped by the unworkable bureaucratic scheme—the child dental benefits scheme, which was put in place when the Prime Minister was the Minister for Health—to abrogate the responsibility to pay their debts.

In the calendar year 2013, over 200,000 public dental patients received treatment because Labor funded public dental health waiting lists. We had a blitz on those dental health waiting lists. I can see that under this government we are returning to the same old approach to dental health—ignore it. There is a failure to acknowledge that dental health is important for the overall health of the person. I call on the minister to make a commitment that dental health will be adequately funded in Australia.

Peter Dutton (Dickson, Liberal Party, Minister for Health) Share this | Link to this | Hansard source

I thank the members for their contributions to the debate on the Dental Benefits Legislation Amendment Bill 2014. The bill amends the Health Insurance Act 1973 and the Dental Benefits Act 2008 to allow for better process for waiving debts for dentists under the former Medicare Chronic Disease Dental Scheme. The bill also allows for critical changes for the efficient operation of the Child Dental Benefit Schedule.

The Chronic Disease Dental Scheme was introduced in 2007 by the former coalition government. The scheme provided more than 20 million services to more than one million patients, 80 per cent of whom were concession card holders. It was the most significant dental investment since Federation. It was shut down the former Labor government because it was established by Tony Abbott who was health minister—nothing more and nothing less. The scheme was shut down by the Gillard government for political reasons, not through any other reason that those opposite have been trying to mislead themselves and others into believing. In fact, the arguments proffered by those opposite would seem quite contradictory. On the one hand, they talk about the link between oral health and chronic disease, yet on the other hand they slam a scheme which was established to address that very issue. To make things worse, the incompetent Gillard administration, in their political pursuit of Tony Abbott getting credit for the investment into these dental services vilified dentists across the country. It was a shameful act but one of many by the Gillard government.

The Chronic Disease Dental Scheme included technical reporting requirements which necessitated dentists providing treatment plans to general practitioners, along with a quote and treatment plan to patients before starting treatment. Dentists who did not meet these technical reporting requirements have been pursued for repayment of the full amount of the Medicare benefits paid under this scheme, although in most cases these dentists met all the other requirements of the scheme and provided much-needed services to over one million patients suffering from chronic diseases. These dentists did nothing more than make minor paperwork errors. I made it very clear on several occasions in the House and publicly that recovery of the full benefit was an excessive punishment for a minor technical issue of overlooking a paperwork requirement and, worse still, it was politically motivated.

But, rather than seek to redress this paperwork issue through design changes to the scheme—a proposal for which I offered my full support whilst we were in opposition to the then Labor government—the then Labor government chose to use dentists' technical oversight as a means of discrediting the scheme, shutting it down and leaving thousands of patients without access to dental treatment; again, all in pursuit of a political outcome.

The Department of Human Services sought to redress the debt issue by applying the Minister for Finance to waive these debts under section 34 of the Financial Management and Accountability Act of 1997. This process has so far been extremely time consuming and resource intensive. It has also created anxiety and uncertainty for dentists who have been waiting for long periods of time to find out if their debts have been waived.

This bill will relieve the uncertainty for dentists by allowing for faster processing of the waivers. It also does this by allowing the Chief Executive Medicare to waive the debts of those dentists who provided services in good faith but did not meet the paperwork requirements.

As I have clearly stated previously, this amendment will not excuse the very small number of dentists who did not comply with other legal requirements of the scheme or who committed fraud. Fraud happens in every large government program, and we have a zero tolerance for such acts, including in relation to these. Only those dentists who provided services in good faith will be eligible to have their debt waived and, as I have said before, we know that these dentists are in the vast majority.

This bill also amends the Health Insurance Act of 1973 and the Dental Benefits Act of 2008 to introduce crucial changes for the operation of the Child Dental Benefits Schedule. To ensure that compliance audits of the Child Dental Benefits Schedule are more effective and efficient, this bill introduces amendments which will bring the compliance framework for the Child Dental Benefit Schedule into greater alignment with Medicare's compliance framework. It does so by including the power to compel the provider to comply with a request to produce documents to substantiate the payment of benefits.

This bill also includes a power that will enable the Chief Executive Medicare, or a relevant officer of the Department of Human Services, to give a notice to a provider requiring them to produce documents to a practitioner or another relevant person to confirm appropriate Medicare claiming is occurring.

The bill also amends the Health Insurance Act of 1973 and the Dental Benefits Act 2008 so that the provisions of the Professional Services Review scheme, which can investigate cases of inappropriate practice, can be applied to any dental services provided under the Child Dental Benefits Schedule. These critical amendments to the child dental benefits scheme will make the schedule more efficient and help to ensure that Commonwealth funding is being used appropriately, assisting to promote a more consistent compliance structure for both Medicare and dental programs operating under the Dental Benefits Act 2008.

This government is committed to improving the health outcomes for Australians and ensuring efficient and effective delivery of services. These amendments are in keeping with our commitments and, in commending this bill to the House, I indicate for the benefit of the House that the government will not be supporting the amendment put forward by the honourable member for Ballarat, but I commend this bill to the House.

Question negatived.

Original question agreed to.

Bill read a second time.