Budget cuts will worsen oral health, says DHAA Inc.

Dr Melanie Hayes of the DHAA
Dr Melanie Hayes of the DHAA

The Dental Hygienists’ Association of Australia (DHAA) Inc. today expressed its frustration with the cuts to dental funding in the Federal Budget and argued that updating the scope of practice of dental hygienists and oral health therapists is now more necessary than ever since the Abbott government proposes no other way to address high levels of unmet need.

The government has deferred the National Partnership Agreement for adult public dental services until July 2015, ceased reward funding to States and Territories under the National Partnership Agreement on Improving Public Hospital Services, and axed the National Partnership Agreement on Preventive Health.

Dr Melanie Hayes, DHAA Inc.’s National President, said, “We are disappointed that the government has abandoned continued investment in preventive oral health, demonstrating contempt for those Australians who rely on public dental services. Oral health is strongly linked to socio-economic status. Funding cuts to public dental services will further widen this disparity.”

According to data from the Australian Institute of Health and Welfare, Australia’s lowest income-earners are more likely to experience complete tooth loss, live with toothache, or avoid food due to pain. This pain usually worsens, until sufferers with preventable dental disease ultimately visit their GP or local hospital – where they will now be charged a co-payment.

Reduced uptake of much-needed preventive services by marginalised groups leads to costlier interventions at a later date. It is estimated that 750,000 consumers visited general practitioners with dental related issues in 2010 and the cost in hospital admissions was $84m; approximately nine per cent of total admissions were classified as preventable dental disease. In addition, expenditure in hospital outpatient clinics was $10m for preventable dental disease.

“There are already high levels of unmet need for oral health care. Since the government is intent on abolishing various initiatives, it needs to make more rapid progress in reforming workforce models to reduce bottlenecks and improve access to services,” said Dr Hayes.

“At present, there is no direct access to dental hygiene services in Australia. Patients must see a dentist, which incurs delays and costs, and wait for a referral to a dental hygienist or oral health therapist, in order to receive preventive services. Yet we can all make our own appointments to see physiotherapists, optometrists, podiatrists, and a range of other health care professionals. The government needs to follow the lead of other jurisdictions such as Canada, the United Kingdom, the Netherlands, New Zealand, Sweden, Norway, and many states in America in allowing direct access to the services of dental hygienists and oral health therapists—a reform DHAA Inc. has advocated for in several rounds of consultations. This change is long-overdue but has been made more necessary than ever by the latest round of funding cuts to desperately needed oral health programs.”

The DHAA Inc. supports and advocates for preventive models of health care delivery. The Federal Budget has significantly reduced opportunities for access to oral health care, which is necessary to maintain general health and reduce overall health care costs. Allowing direct access to preventive care professionals such as dental hygienists and oral health therapists would assist in ameliorating the impact of these budgetary initiatives.

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  1. There seems some flaws in the assumptions and logic in this article:

    1. Much of the article gives a summary of the potential demand for preventive services. Now, if the Federal Government had funded the State Governments to expand their services and the new jobs were with the State Governments, would the DHAA still want the right to independent private practice? If the answer is “yes”, then Federal/State funding isn’t relevant to the scope of practice debate.

    So the discussion is how best to deliver Hygiene services.

    2. The article assumes certain behavior of dental practices, implying that seeing a dentist is a barrier to having preventive services. Are we sure of that? Is that how practices are actually working! I thought there was good two-way referral within these progressive practices. On the other hand, if a hygienic service was on another independent site, yes, there would be a delay in two way referrals which is the opposite of what the article suggests.

    3.How would setting up separate practices for hygienic services reduce the cost to patients? The capital expense and on going overheads of a “squat” are not cheap and would be far greater than reorganizing an existing clinic’s appointment book to hotbed a work station or if needed adding another surgery!

  2. The DHAA support a team approach to preventive oral health care. One of the issues with not having direct access is that some private health insurers do not recognise the services of a dental hygienist or oral health therapist, which therefore leads to an increased cost for patients who can’t claim a rebate for these services. It is an assumption that direct access results in hygienists and OHTs setting up their own practices. Also, the current scope of practice lacks clarity, which means that dentists, oral health therapists and dental hygienists alike struggle to understand and interpret it, and how to make best use of the entire dental team. The DHAA look forward to a clarified scope being released in due course.

  3. I’m sorry to be a pest but the response (above) to my first comments on scope of practice debate has introduced a new point of justification, which was not even in the original article, namely Health Fund rebates.

    Health Fund behaviour has nothing to do with Federal/State funding arrangements for ‘Australia’s lowest income earners’.

    Besides, not too many of the ‘lowest income earners’ affected in the article would have Top Benefits Cover (where dental benefits reside), if they have private health insurance at all!

    The ADA is doing it’s best to get the government and the various private health insurance funds to standardise the use of item numbers.

    Is the DHAA is now arguing that direct access is required to help the rich people with top cover benefits? That’s a long way from the tone of the article above.

  4. My apologies. Private health insurers was just an example. Medicare is probably a better example given the original media release. And yes, while Medicare doesn’t fund Dental care generally, there are specific programs targeted at those who require access to care.


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