Sunday 1 May 2016

Australian Federal Election 2016: Turnbull's federal plan for your pearly whites


Excerpt from Australian Dept. of Health statement, 23 April 2016:

Through the 2016–17 Budget, the Government is introducing the new national Child and Adult Public Dental Scheme from 1 July 2016. This Scheme will replace the Child Dental Benefits Schedule and the National Partnership Agreement on Adult Dental Services.

Under the Child and Adult Public Dental Scheme, over 10 million Australians will have access to Federal Government subsidised public dental care. We expect that an extra 600,000 public dental patients will be treated each year through this Scheme.

The Government will spend $2.1 billion in the five year National Partnership Agreement for the new Scheme. This represents the largest-ever Commonwealth investment in public dental coverage –– which, for the first time, will be enshrined in legislation to provide long-term certainty.

Overall, we will spend a total of about $5 billion over the next four years in improving dental outcomes, including through the Child and Adult Public Dental Scheme, private health insurance rebate, the Commonwealth's contribution to in-hospital dental services, and dental infrastructure in rural and remote Australia.

Public dental services will be improved with better funding. Over time, people's dental health issues will be tackled earlier, with the focus shifting from restorative to preventive dental care, avoiding tooth decay, and alleviating more significant health problems and expense.

The new Child and Adult Public Dental Scheme lays the foundations for a fair and equitable national scheme for children and adults that Australia can afford now and into the future. This reflects the Government's broader integrated approach to health reform, improving oral health, and contributing to better overall health.

Sky News, 23 April 2016:

As part of the $5 billion plan, $2.1 billion will go to the states and territories, who can use the money to pay for private dentists "where service gaps arise" Ms Ley said.

The Australian Dental Association (ADA) has described the new scheme as "smoke and mirrors".

Axing the children's dental scheme is the wrong approach to a serious problem, and money is being taken out of dental care, dentists say.

"Let's see this for what it is. This is a 'budget saving' that results in a reduction of about $200m per annum for dental care," ADA president Rick Olive said in a statement.

"Let's not be fooled. This is a measure that just won't deliver."

The Turnbull Government announcement reveals that the new dental health scheme is directly funding public dental health to the tune of $2.9 million over five years, with approx. $415 million available in 2016-17 or an average of around $51.8 million for each state and territory.

In its 2014-15 Budget the Abbott Government deferred the National Partnership Agreement for adult public dental services and ceased the Dental Flexible Grants Programme – saving $609 million over four years. In that budget government also expected to achieve savings of up to $35.7 million over four years by deferring indexation of Department of Veterans' Affairs (DVA) dental and allied health provider payments to 1 July 2016.

In its 2015-16 Budget the Abbott Government expected to save $125.6 million over four years from 2015‑16 by broadly aligning indexation arrangements for both the benefits payable and the benefits cap under the Child Dental Benefits Schedule with indexation arrangements for other health benefits programmes. In that budget government stated it would provide $155.0 million in 2015-16 for a one year agreement to replace the existing National Partnership Agreement on Adult Public Dental Services and that the agreement would support the provision of dental health services to adults who rely on the public dental system.

Public dental health schemes across the country have been under intense strain since at least July 2014 even when eligibility for these schemes was targeting low-income households. Now the Turnbull Government has decided to open the floodgates by removing means-tested eligibility.

There is a subsidy cap per eligible individual of $1,000 every two years in the existing federal scheme and I presume that this cap will remain in the new scheme.

With the $2.1 billion divided between eight states and territories over a five year period only 1.74% of the Australian population, or a total of est. 52,500 people in each state/territory, will potentially be able to access this scheme every two years via a participating private dentist before the money runs out.

The remaining 40% of adults and children the Turnbull Government calculates may wish to access this national public dental scheme will be obliged to seek treatment from the public dental heath schemes in their respective states or territories.

However, if the Turnbull Government subsidises dental treatment at a lower rate that the existing scheme then the number of individuals who receive adequate treatment by way of state and territory public dental health schemes may drop dramatically.

All those accessing state public dental schemes will be faced with waiting lists.

At the end of December 2015 there were 9,203 children and 104,156 adults who were waiting for public general dental care in NSW – 11% of the children and 32% of adults had been waiting for periods exceeding clinically acceptable benchmark times.

An est. 15,507 individuals on the waiting list were in the Mid-North Coast and Northern NSW regions.

Given past reports of waiting times, it is not outside the realms of possibility that approximately 25% of those who have been waiting for public general dental care in NSW have been waiting for up to one to two years.

In September 2015 the population of NSW was 7.64 million people. All of these people are now potentially eligible for public general dental care under the Turnbull Government's Child and Adult Public Dental Scheme once they reach two years of age and over.

Does Prime Minister Turnbull seriously believe that his est. $5 billion cut eight ways will stretch that far?

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