The dental care crisis and the Labor-Greens “reform” fraud

The federal election campaigns of both the Labor Party and the Greens have included bogus claims about the dental care “reforms” enacted by the Greens-backed minority Labor government.

The issue was raised by the Greens in their negotiations with then Prime Minister Julia Gillard for the formation of a government following the 2010 election. The de facto coalition agreement between the two parties included a joint statement that “Australia needs urgent further action on dental care and that proposals for improving the nation’s investments in dental care should be considered.”

Three years later, the Greens deputy leader Adam Bandt boasts that his election to the lower house of parliament in 2010 and subsequent deal with Gillard “secured the biggest dental health reform in Australia’s history.”

This is an outright lie—Labor and the Greens have in fact cut government funding and enacted an even more regressive dental care system.

With the support of the Greens, the Labor government shut down the Chronic Disease Dental Scheme (CCDS) last November. The scheme, introduced under the former Howard government, was extremely limited. It enabled patients with chronic medical conditions, such as asthma, cancer, cardiovascular illness, diabetes mellitus, arthritis, mental illness, musculoskeletal conditions and stroke—and whose oral health was impacting, or was likely to impact, their health—to access public Medicare subsidies of up to $4,250 over two years for private dental treatment.

The Labor government claimed that the cost of the CDDS had blown out as a result of millionaires and unscrupulous dentists rorting the system, though an official audit only found possible 623 cases to investigate out of the 1.5 million patients treated under the scheme.

The closure of the CDDS overwhelmingly affected poor people, leaving thousands suffering complex health issues without access to necessary dental treatment. More than 80 percent of patients treated under the scheme had a government concession card, issued to pensioners and some other welfare recipients. With the axing of the CDDS, waiting lists for the chronically under-resourced public dental services have further increased. Up to 650,000 people are on waiting lists. Public dental services struggle to meet demand for even the most acute and emergency care, while timely general and preventative care is virtually non-existent. In some states, patients can wait from 2 to 10 years for so-called non-urgent services such as dentures.

Dental care has never been covered under the Medicare health system. As a result, many working class people, who cannot afford private dental costs but are ineligible for public dental services, have no access to treatment. Nearly one in three Australians avoids dental treatment due to the expense. The situation for many is dire. Among people with serious oral health problems, nine out of ten experience pain or discomfort, as well as a limiting of their employment prospects. Many experience tissue infection as a result of dental disease, resulting in an estimated 60,000 preventable hospitalisations per year.

Having shut down the $1 billion-a-year CDDS, the Labor Party and the Greens boast about enacting new dental schemes, funded with $4.6 billion over six years.

In other words, the “biggest dental health reform in Australia’s history” involves a reduction of almost $1.5 billion in government funding. In devising its new schemes, the Labor government ignored the advice of its own National Advisory Council on Dental Health. In February 2012, the Council issued a report estimating that at least $10 billion in the next four years alone was required to improve oral health.

Moreover, almost all the nominally allocated funding, $4.1 billion out of the $4.6 billion, goes to a National Dental Reform Package that does not begin until January 2014. Under this scheme, the government claims that 3.4 million children under 17 will be eligible for up to $1,000 each over two years for basic services such as check-ups, cleaning and fillings delivered by private dentists. The scheme will also fund public dental clinics, supposedly expanding access to dental care for 1.4 million adult patients on low incomes. Another three-year $513 million fund is allocated to reduce public dental waiting lists—a drop in the bucket compared to what is required.

Consistent with the Labor government’s similarly regressive hospital funding system, the money directed to state governments for dental programs is tied to new benchmarks and “performance” targets based on delivering “efficiencies” and cutting costs. In the hospital sector, these mechanisms have created pressure on administrators and staff to cut corners and provide sub-optimal levels of care, leading to worse public hospital waiting times (see: “Australian hospital patients waiting longer under Labor’s ‘health reform’”).

The entire political establishment regards the provision of quality dental care for the working class and poor as an “unaffordable” luxury. Those who can afford to pay for expensive private dentists will continue to receive proper treatment, while everyone else can go without.

Far from delivering historic improvements, the Greens-backed Labor government has cut spending and further undermined the extremely inadequate public dental system. The next government in office will step up the austerity drive, with the National Dental Reform Package likely to be one of many promised government schemes axed or cut to deliver the budget surplus demanded by finance capital and the banks. The Greens’ record on dental care over the last three years underscores their full agreement with the major parties’ austerity agenda.

The Socialist Equality Party alone insists that high quality dental care must be recognised as a basic social right in a modern society. Billions of dollars must be immediately invested to create a proper public dental system that can make freely accessible the most advanced treatments and technologies to all who need them. Such measures can be achieved, however, only through the fight for a workers’ government to implement socialist policies and carry out the fundamental reorganisation of the economy in Australia and internationally to meet social needs instead of profit.

Authorised by Nick Beams, 113/55 Flemington Rd, North Melbourne VIC 3051