Plibersek, Tanya, MP

Ms PLIBERSEK (Sydney—Minister for Health) (10:33): Listening to this debate you would think there is no choice to be made. But, in fact, we have a very important choice to be made. We have a choice between keeping open the rorted wasteful Chronic Disease Dental Scheme or opening a scheme that will look after the dental health of low-income Australians and 3.4 million Australian children. We have had very strong third-party endorsement for the path that we are taking as a government. Steve Hambleton, from the AMA, says: This is a huge improvement on the existing dental scheme. There is less bureaucracy and red tape, and the program is better targeted at those with the greatest need. Gordon Gregory, from the National Rural Health Alliance, says: Being relieved of the financial responsibility for the oral health of 3.4 million children, the States and Territories will be able to reduce their public dental waiting lists rapidly and to a significant extent. Shane Fryer, of the Australian Dental Association, might know what he is talking about, don't you think? He said: The re-direction of federal funding to Australia's children and adults on low incomes or in rural areas will prove to be a sound investment. We know that if dental care can be provided to children then their long-term dental health will be significantly improved. Early intervention and preventive treatments are a proven and well-established method to prevent poor dental health in later life. He goes on to say: Currently around 65 per cent of Australians receive regular dental care. The ADA believes the new program will provide assistance to many Australian families previously unable to access regular care, as a sure way of helping them avoid a path where their dental health will deteriorate. The ADA accepts that the CDDS funding model was flawed but the chronically ill have special needs and those who have not been able to access care through financial or geographic disadvantage must continue to receive assistance. Increasing the capacity of the public dental system will help meet this need. So says the Australian Dental Association. The CDDS is a poorly designed scheme. It treats millionaires the same as battlers. It treats cosmetic dental work the same as the vital work needed by patients suffering from disease. The CDDS has been massively rorted, with more than 1,000 complaints from patients being ripped off with dentures that did not fit, work being charged for that was never done or cosmetic and unnecessary dental work. The government was billed for work on patients who did not exist. Some dentists charge twice for the same procedure and routinely overserviced. They swapped amalgam fillings for porcelain, inserted expensive crowns and performed unnecessary cosmetic work. In all, there were more than 1,000 complaints made. Mr Laming: Out of one million treatments! Ms PLIBERSEK: The member for Bowman says it does not matter—1,000 complaints do not matter. In one case that was recently canvassed in the media a dentist has been ordered to repay more than $700,000. After an initial assessment of a sample of 20 patients, the dentist admitted billing for services that were never provided. After a subsequent audit began, the dentist admitted incorrectly billing patients 293 times. The dentist also said she had no record of 122 services provided to patients that she had billed to Medicare. After the audit began, the dentist voluntarily paid back $25,000 before being asked for a cent. In another case, in 2009, Medicare visited a dentist who was not providing treatment plans and quotes to patients. Mr Laming: So what! Ms PLIBERSEK: The member at the table interjected again: 'So what!' Mr Laming interjecting— The DEPUTY SPEAKER ( Mrs D'Ath ): The member for Bowman is reminded that he already has a warning. Ms PLIBERSEK: Medicare visited a dentist in 2009 who was not providing treatment plans and quotes to patients nor copies of treatment plans to referring general practitioners. On a return visit in 2010 Medicare found the dentist had not rectified the issues. The dentist incorrectly claimed $1.9 million of taxpayers' money and the member for Bowman thinks that does not matter. In another case, an audit of a dentist found he had incorrectly claimed $1.8 million. During the audit it was revealed that the dentist had repeatedly failed to inform referring GPs of the course of treatment he intended to carry out on their patients. The dental practitioner said it was because he did not use computers. That was $1.8 million of taxpayers' money ripped off under the scheme that Tony Abbott designed while health minister. We have a choice: to keep this flawed wasteful scheme open or to provide dental services through the public system. Mr Hartsuyker: You're providing nothing for two years! Ms PLIBERSEK: The member interjects: 'nothing for two years.' The money starts to flow from 1 January next year. As soon as the states and territories sign-on they will have half a billion dollars on the table. Mr Hartsuyker interjecting— The DEPUTY SPEAKER: The member for Cowper is warned. Ms PLIBERSEK: The CDDS is flawed. It is not means tested. It has no restrictions on the type of work that can be performed. It has been complained about at an unbelievable rate. The amounts that have been overcharged are unbelievable. Why are those opposite defending such a flawed scheme? Because Tony Abbott introduced it when he was health minister. They need to defend the Abbott record. If they came into parliament and saw a scheme that was as badly abused as this they would never defend it. A scheme that was supposed to cost $90 million a year now costs $80 million a month. That is the design that Tony Abbott left us with. Our scheme is going to be available from 1 January. We made available $515.3 million in the May budget for the states and territories from January. What do they need to do to get that money? All they need to do is agree to maintain their existing effort and show us what they are doing with the money. We are not even asking them to increase their own effort. We are just making sure that they at least maintain their existing effort. That effort is not clear in states like Queensland that are actually cutting dental services at the moment. The latest news out of Queensland is that dentists have been sacked at Brisbane hospital, dental services have been downsized at the Royal Children's Hospital and $1.4 million has been cut from the Metro North oral health budget. The member for Dickson, the shadow minister for health, has congratulated the Queensland health minister on that, saying that they are getting Queensland Health back on its feet and have done what Liberal National governments do. Yes, that is right, they have done what Liberal national governments do: they have cut services. Of course, we need to make sure that the states and territories at least maintain their current effort, but that money is available from 1 January, January this year, as soon as the states and territories sign up. Those opposite have raised the issue of waiting lists. They talk about 650,000 people being on waiting lists. That is an exaggeration; there are around 400,000 people on waiting lists. But that proves that the Chronic Disease Dental Scheme is a flawed scheme. How can you be spending $1 billion a year and still have 400,000 people on waiting lists for public dental care? Is this some sort of alternative universe where people can think it is okay to spend $1 billion a year and still have 400,000 people around Australia on dental waiting lists? By their own admission this is a flawed scheme. I will return to the history. The Liberals closed down the Commonwealth Dental Health Program. For 10 years they did nothing on dental care until at two minutes to midnight they introduced the flawed Chronic Disease Dental Scheme. The Liberals and Nationals are in here defending the Chronic Disease Dental Scheme, saying they will not close it down. They have also said that they want to support our children's dental scheme. I am glad they do. It is a massively popular move. We know that. The same people who come in here day after day saying: 'Where's the money coming from?', want to spend the $2.7 billion on kids and presumably on the other measures—the workforce measures and the public health measures—as well. So that is the $4.1 billion we announced in August plus, presumably, the half a billion dollars we announced in the May budget—that is a $4.6 billion investment by this government in dental health. I presume they are going to support the whole package. And they want to spend another $1 billion a year on the Chronic Disease Dental Scheme. These are the same people who come in here all the time saying, 'Where's the money coming from?' Where is the money coming from to allow you to add $1 billion a year to the bill? Where is the money coming from? Is this a firm commitment? Will you take this commitment to the next election? How will you pay for it on top of your $70 billion black hole? There is no question that the CDDS is a flawed scheme, but I remind the House once again that this is not just about closing the Chronic Disease Dental Scheme; this is about what we replace it with. We are replacing it with a better scheme. We replaced it with half a billion dollars in the May budget: $345.9 million over three years for a waiting-list blitz, $10½ million dollars for oral health promotion, $35.7 million for expanding the voluntary dental year graduate program, $45.2 million for funding a graduate year program for oral health therapists, and rural and remote infrastructure and relocation grants for dentists. Those members who have rural and regional electorates should really think about this, because there are many places where you cannot see a dentist, even if you have money in your pocket, because there aren't dental services in those communities. We are proposing to do something about that. The Chronic Disease Dental Scheme does nothing about those workforce and infrastructure measures. And there will be $450,000 in the budget over three years for supporting the pro bono work that dentists do so well. What about what we announced in August? We announced $2.7 billion for 3.4 million Australian children who will be eligible for subsidised dental care. The member for Paterson said he is going to go back to his electorate and talk about the competing plans. He should tell the 18,060 children in his electorate and the member for Dickson should tell the 18,304 children in his electorate, who will be eligible for this free dental work, for whom it will be as easy to see a dentist as it is to see a GP now, how he is going to find the money to support both the rorted, wasteful Chronic Disease Dental Scheme and this new proposal that supports them, that gives them a firm basis for better oral health of their whole life. He should tell them what he is going to do to find that money. What about the $1.3 billion extra for extra services for adults on low incomes including pensioners, concession card holders and those with special needs? All of them will have better access to public dental. We announced in August $225 million for dental capital and workforce measures that will make it easier to see a dentist in areas right across Australia where currently it is impossible or difficult to see a dentist. The member for Dickson made a range of completely unsubstantiated comments including this idea that there is a 19-month gap. In the budget measures we announced in May, the spending can start in January. Every single person in this place understands that there are people, like the cancer patients mentioned, that have a desperate need for care. And those people who have income eligibility and who have that need for care will be seen in the public system. These issues and concern for the transition have been raised with me by my Labor colleagues and have been raised with me by the Independents Tony Windsor, Rob Oakeshott and Andrew Wilkie. I have been able to reassure them that the objectives and the outcomes of our agreement with the states will provide additional services for approximately 400,000 patients on public dental waiting lists, with a particular focus on Indigenous patients, patients at high risk of major health problems and those in rural areas, and expand the capacity of the public dental system to provide those increased services. There was no concern from the Liberals when there was a 10-year gap caused by Peter Costello's closing of the Commonwealth Dental Scheme. There was no concern from them at all when that happened. There was no concern from the member for Dickson when services in his own state, in Brisbane were cut so viciously by the Campbell Newman government. I conclude by saying this is not just about the closure of the CDDS. This is a choice of two alternate visions. Do you keep open a rorted, untargeted, overblown scheme or do you focus on kids, generations of oral health and public patients who need this support the most?