Preliminary Pages
Foreword
While advances in
clinical practice and fluoridation of water have seen significant improvements,
it is still the case that almost all Australians will experience an oral or
dental health problem at some time in their lives. Currently, over 90 per cent
of adults show signs of treated or untreated dental decay.
And yet, for many
Australians the costs of accessing private dental services are prohibitive.
Furthermore, with an estimated 400,000 adults on dental waiting lists across
Australia, even those who qualify for public dental services frequently have to
wait weeks or even months for treatment. What this points to, is a dental
health system that is in need of significant reform.
In 2012 the Australian Government committed to a $4.1
billion Dental Reform Package. Within the package, $1.3 billion has been
earmarked for the National Partnership Agreement (NPA) on Adult Dental
Services, which is the focus of this inquiry. The NPA, to be delivered from 1
July 2014, will provide additional dental services in each of the states and
territories to those adults who need it most.
During the inquiry the Committee considered how the NPA
might be framed to optimise delivery of these additional public dental
services. Importantly, with a history of dental health policy that is
characterised by changing priorities and sporadic short-term funding, the
Committee has also looked to the future. The Committee has recommended that the
Australian Government continue to work with state and territory governments to
achieve a coordinated, sustainable and strategic approach to dental policy.
Ultimately, the Committee would like to see a system that
enables all Australians to access dental and oral health services – whoever
they are, where ever they live and whenever they need them. I believe that
implementation of the Dental Reform Package, including the Adult Dental
Services NPA, represents significant progress toward achieving this worthy goal.
On behalf of the Committee, I would like to thank all those
who participated in the inquiry by providing written submissions or attending
the public hearings and roundtable discussions held in Canberra and Dubbo. I
also thank Charles Sturt University for hosting the Committee’s public hearing
in Dubbo.
Ms Jill Hall MP
Chair
Membership of the Committee
|
Chair |
Ms Jill Hall MP |
|
|
Deputy
Chair |
Mr Steve Irons MP |
|
|
Members |
Mr Mark Coulton MP |
Ms Deborah O’Neill MP |
|
|
Mr Steve Georganas MP |
Mr Ken Wyatt MP |
|
|
Mr Geoff Lyons MP |
|
Committee Secretariat
|
Secretary |
Dr Alison Clegg |
|
Inquiry
Secretary |
Ms Renee Toy |
|
Research
Officers |
Ms Siobhán Leyne
Ms Emma White
Ms Belynda Zolotto |
|
Administrative
Officers |
Ms Fiona McCann |
|
|
Ms Kathleen Blunden |
Terms of reference
The National Partnership Agreement (NPA) for adult public
dental services is a significant component of the Australian Government’s
Dental Care Reform Package. Under the NPA, from 1 July 2014, the Australian
Government will provide funding to state and territory governments to expand
services for adults in the public dental system.
To identify priorities and inform the NPA such that it can
be framed to meet the particular and localised needs of each state and
territory, the House of Representatives Standing Committee on Health and Ageing
will inquire into and report on the provision of adult dental services.
Specifically, the Committee will consider:
n demand for dental
services across Australia and issues associated with waiting lists;
n the mix and coverage
of dental services supported by state and territory governments, and the
Australian Government;
n availability and
affordability of dental services for people with special dental health needs;
n availability and
affordability of dental services for people living in metropolitan, regional,
rural and remote locations;
n the coordination of
dental services between the two tiers of government and with privately funded
dental services; and
n workforce issues
relevant to the provision of dental services.
List of recommendations
3 Priority areas for adult dental services
Recommendation 1
The Australian Government include principles in the Adult
Dental Services National Partnership Agreement which require state and
territory governments to develop improved linkages with private providers of
dental services and not-for-profit organisations to help deliver dental
services to patients in need.
Recommendation 2
The Department of Health and Ageing and Health Workforce
Australia work with the Dental Board of Australia to amend the professional
scope of practice registration standards to allow dental hygienists, dental
therapists and oral health therapists to practice independently.
Recommendation 3
The Department of Health and Ageing investigate enabling
dental hygienists, dental therapists and oral health therapists to hold
Medicare provider numbers so that they can practice independently as solo
practitioners within the scope of practice parameters stipulated by their
professional practice registration standards.
The provision of Medicare provider numbers to these
practitioners could be piloted.
Recommendation 4
The Australian Government include principles in the Adult
Dental Services National Partnership Agreement which require state and
territory governments to develop improved linkages with private providers of
dental services and not-for-profit organisations so that patients living in
areas where public dental services are not available or are oversubscribed have
better access to care.
Recommendation 5
The Australian Government include incentives in the Adult
Dental Services National Partnership Agreement to encourage state and territory
governments to improve the focus on preventive dental services as a component
of addressing overall dental and oral health.
4 Adult Dental Services National Partnership Agreement
framework
Recommendation 6
The Australian Government, in negotiation with state and
territory governments, develop a formula for the allocation of funding to state
and territory governments under the Adult Dental Services National Partnership
Agreement based on the size and distribution of priority population groups,
including:
concession
card holder population;
geographic
spread of the population;
the
Indigenous population; and
other
priority population groups such as people with disabilities, people with
chronic diseases, people on low incomes or people who are homeless.
Recommendation 7
The Australian Government include a ‘maintenance of effort’
clause in the Adult Dental Services National Partnership Agreement, similar to
that included in the Dental Waiting List National Partnership Agreement. This
clause should specify that state and territory governments must maintain public
dental clinical activity for adults, so that additional funding provided under
the Adult Dental Services National Partnership Agreement is used to increase
current effort.
Recommendation 8
The Australian Government develop a performance and reporting
framework for the Adult Dental Services National Partnership Agreement that
will accurately and objectively assess progress towards achieving agreed
benchmarks for service delivery and clinical outcomes.
In consultation with state and territory governments, and with
private providers of dental services, consideration should be given to a range
of key performance indicators that will allow for monitoring of:
changes
to the levels of clinical activity;
preventive
services as a proportion of all services delivered; and
targeting
of services to specific population groups.
In developing the performance and reporting framework,
consideration must be given to making use of existing data collection and
reporting systems to maximise administrative efficiency and minimise reporting
burden.
Recommendation 9
The Australian Government include provision in the Adult
Dental Services National Partnership Agreement that requires all signatories to
commence negotiations for a new National Partnership Agreement (or alternative
funding model) at least 12 months prior to its expiration.
Recommendation 10
The Department of Health and Ageing, in consultation with
state and territory governments and other key stakeholders, examine the case to
appoint a Commonwealth Chief Dental Officer or establish an independent
advisory body to:
improve
coordination between the Australian Government, and state and territory
governments;
increase
engagement with the private sector, particularly private providers of dental
services; and
provide
independent policy advice on dental and oral health.
Recommendation 11
The Australian Government commit to a robust dental policy
framework that guarantees the long-term sustainability of the public dental
sector as a provider of dental services through ongoing funding support.
Recommendation 12
The Australian Government, in consultation with state and
territory governments and other key stakeholders, establish and commit to an
implementation strategy for the National Oral Health Plan 2014-2023.
Recommendation 13
The Australian Government adopt a strategic policy approach
which supports deliberate and phased progress toward a universal access to
dental services scheme for Australia.