It was a week where both sides of politics trashed each other’s dental policies. But if you are sick with bad teeth, only one thing mattered. The current Chronic Disease Dental Scheme (CDDS), having treated a million Australians, faced the chop from the federal government.


Thanks to a disallowance motion in the parliament by Coalition Health Shadow Peter Dutton, it may be saved and debate is underway.

Coalition MPs lined up for their suffering constituents. Independent Bob Katter also strongly backs this effort to ensure chronic disease sufferers can get the dental treatment they need. Rob Oakeshott and Tony Windsor are considering their positions.

Labor enjoyed initial support for its dental scheme but that is fast eroding. First, their alternative plan is delayed 19 months simply to help their hunt for a surplus. Worse, they tried to kill off the CDDS 19 months before starting their own, dumping millions of patients onto state dental hospitals, emergency departments and GPs.

The twisted logic means that Labor’s debt pains trump the nation’s dental pain.

The Coalition’s CDDS was pilloried for cost blow-outs, for dental rorting, treating the wealthy and for ignoring those who didn’t have chronic disease. 

Cost-blowouts mostly reflect the program’s success with around 40 per cent of the New South Wales public dental waiting lists getting treatment through the CDDS they would never get otherwise.

Average CDDS treatment costs per adult have fallen from $2400 to $1170 reflecting declines in untreated disease. Within two years, Associate Professor Hans Zoellner estimates the CDDS will fall back to a manageable $340 million per annum. Comparable to what Health Minister Tanya Plibersek is offering state governments - but massively more effective.

Simple refinements could have reduced the annual cost by $330 million a year, but Labor passed them up, preferring political point-scoring to practical improvements.

Minister Plibersek’s attacks on the integrity of dentists was also unfair. Only one in 1500 services showed irregularities. All professions have “cowboys” and we have audit sections in Medicare for that purpose. After traducing dentists, Labor’s new children’s schedule possesses all the same flaws, allowing dentists $1000 free rein every two years for the children of family tax benefit recipients.

“Treating millionaires” - it is now standard Labor fare for a waning government to turn to class warfare for a poll boost. Millionaires don’t dream of idyllic days in dental chairs. People with chronic disease and terrible teeth do. Over 80 per cent of all CDDS treatments were concession card holders. These are the real victims of the government’s cuts.

There are no GPs, specialists, dentists or even dental workers in Labor’s caucus, so Treasury designs Labor social programs and there is little informed debate prior to policy announcements. Their fixation with public dental provision is verging on the pathological, because Australia’s dentistry is 95 per cent private and without them, there is no solution.

Labor’s plan has two parts. The first is an injection of $1.5 billion into state dental hospitals. They tried the same thing in 1994 and waiting lists barely changed. That was because state dental services are mostly haphazard visiting programs run out of urban teaching centres, which are slow and assiduous but unable to reduce waiting times.

Public dental services are a disaster for regional Australians who need to visit major cities and only get treated if their disease is worse than the appalling oral pathology which queues up in major cities.

The $1.5 billion allocation is actually only $220 million annually, to be divided eight ways between states and territories. Victoria and New South Wales’ allocation still leaves them spending less than every other state and territory does right now. The boost to South Australia, WA and Queensland still leaves them spending less than the Northern Territory does now.

There are three types of dental patients and Labor risks mismanaging all three. Children mostly need early and preventive interventions, 90 per cent of which can be performed by supervised oral health workers, technicians and hygienists. But Labor now pays the private dentists to do this work, most of it minor. Meantime the oral health workers are sidelined and dental technician graduate rates are actually falling.

Private dentists are best deployed with the second groupm, the poor and chronically ill adults. But Labor wants to kill-off the CDDS - that very program. This will lead to an avalanche of work hitting GPs for scripts, emergency departments for pain relief and dental hospitals with one-to-three year waits.

The third group, severe disease requiring complex care is best done in dental hospitals. But those unfortunate souls are now battling everyone else for treatment, given that our 95 per cent private dental workforce is left on the sideline.

The other component of the government’s dental program is $2.5 billion for children to be treated privately. But the $1000 over two years is a cut-price version of the current CDDS which allows up to $4250 for severe disease. Labor’s plan excludes serious work like stainless steel bridges, crowns, orthodontics and root canal work. Aboriginal kids with severe caries are likely to have their teeth pulled instead of conserved.

The Gillard Government has replaced treating the sickest first, with huge subsidies for the poor, regardless of the disease severity. Ripping a billion dollars out of Medicare is now Minister Plibersek’s legacy.

On the surface, this week’s dental debate brought out the worst elements of our two-party system, with both major parties tearing away at each others’ schemes with barely an inch conceded.

More subtle but far more importantly, independents and key groups including the Dentists Association sided with the Coalition.

For patients with dental disease who only now realise the Labor plan included the death of the CDDS, waiting in pain for 19 months and a federal election will look less attractive every day.

Comments on this post close at 8pm AEST.

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21 comments

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    • acotrel says:

      07:14am | 24/09/12

      There are a couple of things which are certain - Labor will get the balance correct, however the LNP will try to bias the system to help their friends at the top end of town get richer !

    • JennyF says:

      09:08am | 24/09/12

      19 months (now reducing) without CDDS is not getting it right, it shows no knowledge of the problem that chronic illness patients have. That matters nothing to the Government who is only about point scoring with the majority.

    • Realist says:

      09:11am | 24/09/12

      My wife is an aged care worker. Took her client into the dentist for work that had been booked under the CDDS only to be told the work has been cancelled due to the fact it was booked, after the cut off date. The receptionist was apologetic and explained that they had been given only 3 days notice from the government to cease all work covered by the CDDS.  How is that for balance you ideological fool? Just an apologist for a sick and mean government.

    • Alfie says:

      09:42am | 24/09/12

      “....Labor will get the balance correct.”

      Ha, ha, ha…that will be a first.

    • JoniM says:

      11:53am | 24/09/12

      @ acotrel
      “Labor will get the balance correct,....”
      You are kidding !
      Labor only ever gets the focus group stats right !
      Nothing else !

    • Alfie says:

      01:33pm | 24/09/12

      Swan just announced a deficit of $43.7 billion for the 2011-2012 FY . They just keep on making stupid promises that they can’t afford.

    • Gratuitous Adviser says:

      07:15am | 24/09/12

      I listened to the debate last Thursday.  The opposition, repeating themselves, on and on and on and on (A good case for a three speaker limit or a high voltage shot in the goolies for any politician that repeats himself/‘herself more than 5 times).  That said, the ALP’s 19 month limbo is obviously more to do with the budget surplus and politics than good government. 

      “On the surface, this week’s dental debate brought out the worst elements of our two-party system, with both major parties tearing away at each others’ schemes with barely an inch conceded”.

      It can not get any worse.  Contemporary Australia is cursed with Governments and Oppositions that are more concerned with the politics, personal ambition and sometime profit (NSW pollies anyway) than the betterment of the people of Australia.  We are living through a dark period in Australian politics and it will be remembered in history, as such.

    • Joan says:

      07:17am | 24/09/12

      So the benign smile of Plibersek really hides a hard uncaring heart of stone. - dump the CDDS and let poor and sick suffer dental pain for 19 months.  Plibersek and Labor implemented CDDS policy so badly according to Plibersek that they have been funding millionaire dental treament.. Instead of better managent of exisiting CDDS, tweaking it to improve Plibersek takes as sledge hammer to it just like Labor did to Howard asylum seeker policy. now costing billion dollars to repair, money which could have been spent on dental, medical care.

    • acotrel says:

      08:49am | 24/09/12

      I am really glad you did not try to use the words ‘caring’ and ‘LNP’ in the one sentence. That would have been very hypocritical.

    • Bazza the oracle says:

      08:24am | 24/09/12

      And the biggest problem… where is the money coming from????????
      More taxes on the workers. When you tax them enough to distribute their money to the non workers they’ll eventually say’ why bother’. Then we’ll have all non workers.Communism is alive and well in this government.

    • MarkF says:

      11:36am | 24/09/12

      Not that many years ago I had two teeth that needed to be fixed.  Put up with toothache for a year trying to save the money up for the dentist (mortgage and kids didn’t leave enough in the kitty for that).  Went to the local (small) hospital and put my name on the waiting list.  A year later still waiting with one of the wife’s uncles whose whole family were dole bludgers/pensioners having a laugh because if they want anything done they get booked in straight away.

      Eventually talked to a large regional hospital and when I told them I was taking panadol with codeine + ibuprofen with codeine both washed down with aspirin at the same time three times a day just to take the edge off the pain they freaked and had me booked in next day.  It was pure pleasure getting those teeth finally ripped out (only option, root canal was out of the question because of the cost).

      The whole system from top to bottom sucks.

    • Sharon says:

      08:34am | 24/09/12

      A case of the 2 party political monopoly here in Australia more interested in political point scoring than achieving a fair workable solution to our dental problem!
      That just about sums up why nothing gets done whilst these 2 parties fight over who’s right and who’s wrong, basicaly something left over from the kindergaten days we thought were left behind.

    • Alfie says:

      08:35am | 24/09/12

      The Labor way - if it works, destroy it. Then come up a humongous multi-billion dollar plan that will sound good (eg. Revolution, Crusade), take a few decades to implement and deliver the same or less than the previous plan. The result will hopefully dumbfound the great unwashed who want their teeth fix for free, and will vote for Labor again.

    • JoniM says:

      11:42am | 24/09/12

      Alfie !
      You have discovered the ALP strategies that have served them so well for all these years ! Record debt and deficit is not an issue for the great unwashed as long as their lifestyle is not threatened tomorrow ! Buy them off and fear & smear the other mob ! Good enough !

    • Dash says:

      08:47am | 24/09/12

      Announced the NDIS but not where the funding is coming from.

      Announced the Schools wealth redistribution Gonski but not where the funding is coming from.

      Announced the dental scheme but not where the funding is coming from.

      Increased cost of setting up Nauru again. Where is that money coming from.

      If the ALP win the next election, taxes will be going up! Or they will plunge us fuirther into debt. Which will it be?

      When will someone ask the ALP to tell us the plan for repaying the record level of debt they have racked up in 4 short years? They got last years budget wrong to the tune of $22billion. And now want us to believe they will deliver $1.5b??? And there is no plan to pay off the debt they have racked up!

      This is either yet more bullshit policy announcement (like the 260 childcare centres, the cheaper groceries, the cheaper fuel and the East Timor solution). Or, the ALP are going to increase taxes!

    • Kika says:

      08:54am | 24/09/12

      The moral of the story = brush your teeth and hope to dear god your mother had a good calcium rich diet before she became pregnant with you.

    • nihonin says:

      09:50am | 24/09/12

      The other part of the story is: and hope Labor aren’t in government and trying to conjure up a surplus.

    • Yak says:

      08:54am | 24/09/12

      I believe that when Mr. Abbot introduced the CDDS scheme, it was going to cost $90m per year. At the moment it is costing $80m per month. What happened there?

    • Anjuli says:

      12:27pm | 24/09/12

      Within the national health in the UK when it was first started up every one could have free dental . People who had had no teeth for many years went to be fitted with same, on receiving there sparkling new dentures went home and put them into a drawer where they stayed,it was the same with spectacles . After many years the UK finally had had enough now the patient pay unless referred to a hospital if intensive treatment is warranted.  It is a fact people abuse all systems if given free.

    • UschiW says:

      01:01pm | 24/09/12

      So, the government is worried about treating “millionaires” under the CDDS ?  There is a very easy solution: RESTRICT the CDDS to Pensioners and Low income earners! Duh! That wasn’t so difficult, was it?

    • Mik says:

      01:34pm | 24/09/12

      War veterans have been using a system that has worked well for 50 or so years.

 

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