A return to free university education?
Since universities reintroduced fees in 1988, the cost of a degree has continued to grow, and student debt is contributing to the cost-of-living crisis.
The University of Melbourne Vice Chancellor Professor Duncan Maskell wrote this week about the need to reconsider free tertiary education in Australia. The central tenet of fee-for-service in the university sector is that education confers a benefit to the individual rather than society as a whole. This ignores the public benefit that higher education provides. University education was free in Australia from 1974 until 1988 with the introduction of the Higher Education Contribution Scheme (HECS). From modest beginnings with student contributions generally less than $2000 per year, many students are now graduating with tens of thousands of dollars of student debt.
Dentistry is one of the most expensive university courses in Australia (if not the most expensive), and this has important implications for access to dental services. There are nine universities in Australia that offer dentistry programs - University of Melbourne, University of Adelaide, University of Western Australia, Sydney University, University of Queensland, Griffith University, James Cook University, Charles Sturt University and La Trobe University. Six of these offer a traditional 5-year undergraduate program, and three offer a 4-year graduate entry program (which requires applicants to have already completed a minimum 3-year undergraduate degree). The student contribution for Commonwealth Supported Places is $11,800 per year, so the minimum cost of studying dentistry is now $59,000. Many of the 5-year programs have full-fee places or have a hybrid 3+2 model, with increased fees for the final 2 years. At the higher end of the spectrum, the course fees for the graduate entry Doctor of Dental Surgery at the University of Melbourne are $76,800, with an indicative total course fee of $331,017. These students must have completed an undergraduate degree (with the student contribution for a Commonwealth Supported Place in a Science degree totalling $24,900 over three years), so their total student fees to qualify as a dentists exceeds $355,000.
This high cost acts as a barrier or disincentive for students from disadvantaged backgrounds, which may be one of the limiting factors for some students from rural areas who have to move away from home to attend university. It then becomes one of the factors in graduates deciding whether to seek employment in the public sector, where remuneration is significantly less than in the private sector. There are also implications for the dental specialist workforce, with annual course fees for a 3-year Doctor of Clinical Dentistry post-graduate degree approximately $50,000. There is inequity across Australia, with specialists-in-training (qualified registered dentists undertaking specialist training) employed in NSW and South Australia to undertake the clinical training component where they are treating public dental patients in public dental hospitals (which helps to offset some of their student fees), but not in Victoria.
The cost of dental education will invariably flow through to increased costs to patients as graduates are forced to recoup the cost of their education, further impacting on the crisis in accessing dental care. There are also implications for the dental academic workforce, with the cost associated with attaining the necessary qualifications for an academic career not commensurate with academic remuneration.
Of course, one of the implications of a move back to free education is the likelihood of a decrease in the number of funded places, which would also have significant workforce implications. Nonetheless, it is definitely a debate worth having.