Federal Budget disappoints dentists

Dental initiatives announced in this week’s Federal Budget have been met with almost universal disappointment, with the Australian Dental Association (ADA) saying it, “left a bad taste in the mouth for consumers and dentists alike”; the Australian Dental and Oral Health Therapists’ Association (ADOHTA) expressing “disappointment at the lack of commitment in addressing the fragmented dental health system”; the National Rural Health Alliance (NRHA) describing some measures as “misleading”; and the Opposition calling it a “cruel attack on dental patients”.

Last weekend, Minister for Health Sussan Ley announced the Abbott Government intended to add dental to its reform agenda for 2015/16, with “more-than $200 million in funding for state and territory services to be included in the Budget to allow for reform work to be undertaken over the next 12 months”.

Ms Ley said the Abbott Government would offer the states and territories a new 12 month National Partnership Agreement on Dental, worth a total of about $155 million in 2015/16.

Ms Ley said this would be coupled with continued access to the Commonwealth child dental benefit scheme for states and territories in 2015/16, which would increase the total support package to over $200 million to provide funding certainty while reform was worked on over the next 12 months.

However, the ADA pointed out that “the so called funding for public dental services under the National Partnerships Agreement is being sold as an investment when in reality it is a reduction in the funds that were promised last year by the amount of $45 million. The proposed $200 million will now cover both the Child Dental Benefits Schedule and funding for dental services.”

The balance of the Government’s promised funds were allocated to the Child Dental Benefit Schedule, for which there will be no increase in rebate levels for the next four years, despite many dentists charging at or below cost for the services—effectively asking dentists to subsidise the Government.

“Most of the claims made under the Child Dental Benefits Schedule are bulk-billed by dentists,” explains ADA President Dr Rick Olive AM. “By bulk- billing dentists are providing these services at or below cost because they know that many of the families eligible for services under the CDBS find it difficult to find the extra money required for regular dental check-ups normally. There is only so much subsidisation that dentists can accommodate and still provide affordable services to eligible populations. The pause in indexation of rebates for the CDBS comes on the back of a pause in indexation of rebates for veterans. Which group should dentists now say no to?”

Although Federal Health Minister Sussan Ley promised a new 12 month “National Partnership Agreement on Dental” (NPA) and access to the Commonwealth Child Dental Benefit Schedule (CDBS), the $200 million proposed funding will now cover both.

“The NPA was intended to deliver $1.3 billion over four years starting from 1 July last year. But so far the Coalition’s pledge has amounted to a 12 month delay, a nearly 25% cut to the 2015-16 allocation from $200 million to $155 million and the wiping of the remaining $1.15 billion from the forward estimates.” says Australian Healthcare and Hospitals Association (AHHA) Chief Executive, Alison Verhoeven.

“Public sector access to the Child Dental Benefits Schedule has been extended, but it comes with a four year freeze on indexation of both benefits payable and the benefits cap.  This has the potential to increase the copayments charged in the private sector which will drive additional patients to the public sector where bulk-billing is compulsory.

“The Government will also cease funding for the Voluntary Dental Graduate Year Program and the Voluntary Oral Health Therapist Program which target workforce shortages in rural and remote areas.  According to the Department of Health these programs have failed to deliver but no details of any evaluation of the programs have been made publically available.

ADOHTA were also dismayed to learn that the Oral Health Therapy Graduate Year Program (OHTGYP) and the Voluntary Dental Graduate Year Program (VDGYP) has been axed.

ADOHTA President, Ms Hellene Platell says, “We are concerned that funding for the Oral Health Therapy Graduate year Program (OHTGYP) has been withdrawn after this year. This program has not been evaluated and the perception that it failed to deliver is unfounded. It has been invaluable in attracting 100 oral health therapy graduates Australia wide to provide and deliver much needed dental services under the public system in many regional settings”.

“The Voluntary Dental Graduate Year Programme subsidised positions for 50 newly graduated dentists annually and in doing so provided the public sector with increased numbers of dentists to provide services under the public dental system and in regional areas. Cancellation of the programme will make it even more difficult for dentists to find jobs and deliver services in an environment where too many dentists are entering the workforce”, Dr Olive added.

To cap off the hits, the Dental Relocation and Infrastructure Support Scheme also took a blow, the extent of which is still to be determined as details available are not yet forthcoming.

“All in all an uninspiring Budget for dental care in Australia,” Dr Olive concluded.