Belated government response to dental Senate inquiry lacks bite.
Better late than never, the government has finally handed down their response to the Senate inquiry into dental health. No new funding or policy initiatives, but some room for optimism.
Last year, a Senate inquiry into the Provision of and Access to Dental Services in Australia heard testimony from 84 witnesses and over 17,000 public submissions, and we now have (belatedly) the response from the Albanese government. The contributions made by everyday Australians were harrowing but have clearly fallen on deaf ears. “The pain in my mouth affects my general well-being,” one submitter shared, “and the lack of regular, basic dental care takes away dignity and self-respect as well as inability to enjoy food properly.” Tragically, stories like these aren’t new but they are growing in number and intensity.
Working age Australians are increasingly accessing their superannuation to fund dental treatment and cancelling or delaying dental check-ups and treatment as cost-of-living pressures continue to bite. With the latest inflation figures showing that the cost of visiting the dentist has increased 4.3% over the past 12 months, more Australians are going to find paying for a visit to the dentist to be an impossible financial burden.
Despite only offering support (or in-principle support) to 11 of the 35 recommendations (and simply noting the remaining 24), and very deliberately not making any funding or policy commitments, there is room for optimism, both in terms of the tone of the response and the acknowledgement of some of the work that is presently underway that may lead to the necessary reforms that the sector is desperately crying out for. The words are encouraging, but Australians need action too.
The link between disability and oral health was a strong theme throughout the Senate inquiry, so clarification that the National Disability Insurance Agency will develop new examples for dental and oral health supports (such as modified toothbrushes and flossing devices and other necessary oral health care consumables) and publish them to the NDIS website by mid-2014 was welcome. So to the note that the NDIS review which is presently underway would consider the recommendation to allow some form of clinical dental assessment and care to be provided under the NDIS. Measures to improve the maldistribution of the oral health workforce by incentivising dental practitioners to work in regional and rural areas and expanding support for rural dentistry and oral health students were also supported.
Several recommendations focus on funding support for oral health research to provide the evidence to support programs that will improve population oral health. For example, there is clearly a need for more frequent national oral health surveys and better use of existing data. However Australia has the lowest and most inequitable amount of government research funding for preventing the disease burden related to oral conditions, hampering efforts to influence oral health policy and improve access to care. Having an MRFF funding round that focusses on oral health would help to address this inequity.
But there are also gaps that represent a missed opportunity to stamp themselves as the government that cares about oral health. The Child Dental Benefits Schedule (CDBS) has been one of the most important reforms in recent times and provides the building blocks for the establishment of a Senior Dental Benefits Scheme. However, There have been three reviews of the Dental Benefits Act 2008 since the CDBS was implemented in 2014, with a number of recommendations designed to increase the utilization rate and improve the scheme remaining virtually unchanged across those three reviews. The CDBS continues to have a poor utilization rate, which has remained consistently below 40% over the past decade. So, whilst the government notes that the Department of Health and Aged Care is currently progressing implementation of these latest recommendations it is worth remembering that there is not a good track record to rely on.
One of the key recommendations that would have a meaningful impact and would shift the dial on public dental funding (and by extension in improving oral health) is the establishment of a Senior Dental Benefits Scheme. This was also a key recommendation of the Aged Care Royal Commission and is strongly supported by professional and consumer groups. Although the government response only noted this recommendation and made no commitment towards implementation, they pointed to the work of the National Dental Reform Oversight Group which is currently investigating ways to improve access to dental care for various priority groups. It is anticipated that they will present a range of options to Health Ministers for consideration later this year. This points to the need for strong engagement at the state and territory government level to ensure that their support drives the necessary action.
It is easy to see why the sector is disappointed with the government response, because we have been here before, with meaningful recommendations for action from a long list of reports lying dormant with inaction, including the National Hospitals and Health Reform Commission suggestion to establish a Denticare scheme in 2009; the National Advisory Council on Dental Health which recommended a means-tested dental benefits scheme for all concession card holders; and the Aged Care Royal Commission solution to addressing the widespread neglect of oral health in nursing homes with the establishment of a Senior Dental Benefits Scheme.
It is important to situate the government response in the context of the current political cycle – a federal budget has just recently been handed down and there will be an election within the next 12 months. Neither of these should be seen as an excuse to let the government off the hook, but the upcoming election does present a golden opportunity to pivot election focus onto oral health. There is a risk that this is just another report that gathers dust on a growing pile. It is incumbent on everyone who has an interest in improving oral health to draw attention to the fact to poor oral health continues to be the biggest indicator of social disadvantage in Australia to ensure that we don’t let this government (or the next one) off the hook.
Associate Professor Matt Hopcraft and Dr Ankur Singh are dental public health experts at the Melbourne Dental School.
Call to action
Let the Health Minister Mark Butler know that it is time to tack action to improve oral health. Email him your concerns, and note the key recommendations from the Senate inquiry that you think need to be implemented. If you are a dental practitioner, include some examples of the issues that you are seeing. If you are a patient or advocate, include examples of the challenges that you are facing.
Email: minister.butler@health.gov.au
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