Federal budget a kick in the teeth

The Federal budget has failed to deliver anything to improve access to dental care at a time when cost of living pressures are starting to bite.

The Federal Budget delivered on 9 May 2023 has been hailed by many as a health budget, investing $3.5 billion in bulk billing incentives to make it ‘cheaper and easier’ to see a doctor, $50.2 million in scholarships for nurses and midwives and $31.6 million to improve training support for international medical graduates to work in rural areas as signature headline funding announcements. There were important announcements to tackle e-cigarettes and tobacco which will have important oral health benefits. Sadly though, there was no additional funding to deliver more much needed dental care.

This continues the ongoing neglect of dental health as an important part of overall health and fails to recognise the importance of investing in public dental health care to improve the wellbeing of Australians. The Commonwealth funds dental care through four main mechanisms – Department of Veterans Affairs (DVA), the Child Dental Benefits Schedule CDBS), a National Partnership Agreement (NPA) for Public Dental Services for Adults and private health insurance (PHI) premium rebates that fund dental care for patients with dental extras cover. In 2020/21, total Commonwealth expenditure for dental care was $1.35 billion – comprising $84 million (DVA), $107 million (NPA), $381 million (CDBS) and $775 million (PHI).

This 2023/24 budget has $107.8 million per year for Public Dental Services for Adults to 30 June 2025, providing much needed certainty to the public dental sector. Previous budgets had been allocating this funding on an annual basis, leaving state public dental services on edge each budget wondering if they would have this funding for the following year. There is also a commitment to progress work on much needed longer-term adult public dental reform and funding for a national dental care survey, which will provide important data to inform future policy directions.

One major concern is that the $107.8 million Public Dental Services for Adults funding has remained static since at least 2017/18, so this represents a cut to public dental care in real terms and continues the trend of underinvestment in dental health compared to the rest of the health sector over the past decade.

Since 2011/12, total Federal recurrent health expenditure has increased 66%, from $51.3 billion to $85.2 billion. The largest growth in funding to specific areas (excluding private health premium rebates) has been in public hospitals (84%), private hospitals (369%), referred medical services (66%), unreferred medical services (58%) and benefit paid pharmaceuticals (32%). Over that same period, funding for public dental care has declined 49% from $956 million to $488 million. Conversely, private health premium rebates attributable to dental care increased 28% from $607 million to $775 million.

The lack of additional funding in this budget is a kick in the teeth for millions of Australians who struggle to access necessary dental care, and whose health and wellbeing suffers as a result. The Aged Care Royal Commission recommended the implementation of a Senior Dental Benefits Scheme to provide much needed support for older Australians, and this would build on the successful Child Dental Benefits Schedule which is already used across the public and private dental sector. However, it would appear that this may be another Royal Commission recommendation that falls by the wayside.

There is a glimmer of hope though. The Senate recently established a Select Committee into the Provision of and Access to Dental Services in Australia. It has been tasked to investigate issues including access to dental care, the adequacy of public dental services (particularly in regional and rural areas), the interaction of Commonwealth and state/territory governments, the social and economic impact of improving dental health and oral health workforce issues. Perhaps this work will help to inform the next steps that will see future budgets deliver on all aspects of health, not just parts of it.