The Australian Dental Association (ADA) believes the Australian Competition and Consumer Commission (ACCC), in focusing its annual review on scope-of-practice questions, has missed an opportunity to investigate anti-competitive behaviour by health funds.
The ADA was prompted to criticise the ACCC following that body’s annual request for stakeholders’ views on private health insurers’ (PHI) anticompetitive behaviour. The request for views is part of the ACCC’s annual report on private health insurers (PHIs) that it provides to the Senate.
This year, according to the ADA’s National Dental Update, the ACCC sought specific comment on:
Issues that reduce the extent of health cover and increase consumers’ out-of-pocket expenses … In particular, the ACCC will enquire into a perceived lack of recognition of certain allied health providers by health funds.
“The ACCC referred to circumstances where certain providers of health care are said not to be recognised by PHIs while others providing the same or similar services, with different qualifications, are recognised,” the ADA news update said.
“Unfortunately, with respect to dental care in Australia, the ACCC’s concerns are misplaced and misinformed. This misplaced focus has resulted in a missed opportunity for the ACCC to consider the healthcare sector’s views about how PHIs’ broader anticompetitive behaviour impacts on consumer choice.”
The ADA said it knew of no circumstances where PHIs did not recognise either dentists or allied dental professionals, and that PHIs and other dental professionals worked within clear guidelines set down by the Dental Board.
The update does express concern that “The ACCC makes reference to the services provided by ADPs as being of the same quality as those similar services provided by dentists and this therefore justifies some change in practice adopted by PHIs. This interpretation is selective and incorrect. The ADA’s submission outlined how the education and training of the ADPs is not comparable to that of a dentist. The level of training provided to dentists far exceeds that provided to ADPs. The dentist is the team leader and is trained in all aspects of dentistry. The ADP is trained to perform limited services.”
However, the ADA was more concerned with lack of transparency, procedural fairness and natural justice when dealing with PHIs; issues around being a “preferred provider”, rebate levels and PHI interference between the dentist/patient relationship. The ADA expressed concern that these issues are the real concerns the ACCC should be dealing with, rather than dealing with scope of practice issues.
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