Dental health funding a kick in the teeth

29 April 2016 | The federal government's new dental health program boasts $2.1 billion dollars, but where is that money coming from?

The Tooth Fairy plays a trick

The Federal Government is hoping to do more with less with its new dental health plan, announced by Health Minister Sussan Ley at the weekend.

Commonwealth spending on dental health will be $248 million less than expected next year under the new scheme, while access to subsidised treatment will be expanded to more people on low incomes.

Unveiled as a pre-Budget health announcement, the Child and Adult Public Dental Scheme (CAPDS) will fund public dental services for all children, as well as adults with concession cards. The government estimates an additional 600,000 Australians will get dental treatment a year, with 10.3 million people eligible for subsidised dental care.

Six in ten adults on low incomes have untreated tooth decay, twice the rate of the general population. On average, a person on a low income has 20 decayed, filled or missing teeth. The government hopes that its plan will deliver better outcomes for preventative care, reducing costs for ongoing treatment.

Now you see it…

The scheme will cost $2.1 billion over five years, with legislation ensuring longer term financial commitments from the Commonwealth.

Despite government claims that this "represents the largest-ever Commonwealth investment in public health coverage", the announcement conspicuously avoided mention of the $1.3 billion of unspent money that will be axed from dental programs introduced by the Gillard Government, nor the $1.5 billion the Coalition has removed from dental funding since it took office.

In 2012 Labor announced a suite of programs aimed at improving dental health outcomes for children and low income adults:

  • The Child Dental Benefits Schedule (CDBS) provided $2.9 billion over six years. The plan provided up to $1000 per child over two years for families receiving Family Tax Benefit Part A or certain other benefits. $125.5 million was cut from the program in last year's Budget, and it will now be entirely replaced with the Coalition's CAPDS.
  • The National Partnership Agreement on adult public dental services (NPA) allocated $1.3 billion over four years for the states to support their public dental health systems. Due to commence in 2014-15, it was postponed by one year in the Coalition's first Budget, and last year it was scrapped in favour of a one-year agreement worth $155 million. Its functions will also be replaced by the CAPDS.
  • The flexible grants program would have seen $227 million spent on dental equipment and infrastructure, and initiatives to support the dental profession. In the 2014 Budget this money was reallocated to the Medical Research Future Fund.

…now you don't!

Of the $4.4 billion originally budgeted for the lives of these programs in the 2012 budget, only $1.6 billion has since been spent on dental health. There is $1.3 billion still left in the CDBS piggy bank, which will now be folded into the new scheme.

Over the last two budgets the government has cut $1.5 billion from dental heath. What this boils down to is an $800 million increase to the budget today, offset by almost twice as much in cuts.

And the money that is there will be spread out over a longer period of time. About $415 million will be spent on the Coalition's scheme in 2016-17. This is a reduction on the already truncated $663 million the CDBS had been set to receive.

The Health Minister said the Coalition's scheme would be more efficient than the system under Labor. The new funding model "fits in with our commitment to tackling waste and duplication in the health system to ensure funding is targeted where it is needed most, which we are not seeing from current dental arrangements", Ms Ley said.

But the Australian Dental Association has slammed the government's dental plan, accusing it of a "smoke and mirrors" accounting trick that will do nothing to alleviate pressure on waiting lists.

"The State and Territory public sector dental services are already over extended with waiting lists of between nine months to three years depending which state you consider," said ADA President Dr Rick Olive. "What is happening is the government is promising delivery but it is doing it in such a way that the services will not, in fact, be accessible."

The Budget will be delivered on May 3.

* As the Federal Government entered caretaker mode on May 9, pending the election on July 2, these changes have yet to be enacted. The Child Dental Benefits Schedule remains open for the time being.

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