Dental health

Budget Review 2015–16 Index

Amanda Biggs

The main dental health spending measure announced in the 2015–16 Budget is for a one year National Partnership Agreement (NPA) on dental services to replace the previously deferred National Partnership Agreement on adult public dental services. $155.0 million will be provided to the states and territories to support their provision of public dental services in 2015–16.[1] Medicare funding for the child dental benefit scheme (CDBS) will bring the total envelope of Australian Government funding for dental health this financial year to around $200 million.[2]

Under the deferred NPA, $1.3 billion over four years was promised to the states and territories for improving public dental services for low income adults.[3] Although the Coalition promised to honour the NPA in the lead-up to the 2013 election, commencement was delayed by one year in last year’s budget.[4] While funding is now partially restored for one year, future funding remains uncertain. The delayed start to the NPA has been blamed for lengthening queues for public dental services.[5]

The nation’s current dental arrangements, split between the Australian Government and the states and territories, have been described by the Health Minister, Sussan Ley, as ‘fragmented’ with funding models that increase risks of inefficiencies and service gaps.[6] In her view, the Reforming the Federation process provides a ‘once-in-a-generation opportunity for constructive reform’ to ‘ensure Australians get seamless access to the services they need’.[7] She has foreshadowed a series of reforms to dental funding arrangements to be pursued over the next 12 months.

The Budget also included a pause in indexation arrangements for the CDBS, with savings of $125.6 million over four years forecast.[8] Operating since 1 January 2014, the CDBS is a means-tested dental benefit for children aged 2 to 17 funded through Medicare. Benefits are capped at $1,000 over two years, indexed annually.[9] Pausing indexation will bring the CDBS indexation arrangements in line with the paused indexation arrangements for other Medicare Benefits Schedule items (announced in last year’s budget). Further, the previously announced pause on indexation for Dental and Allied Health Provider fees for veterans services will be extended to July 2018, with savings of $69.6 million over four years.[10] In addition, unspecified savings over five years are forecast from redesigning some dental workforce programmes, including incentives to encourage dentists to relocate to smaller rural centres.[11]

Poor oral health for some Australians continues to be observed with the latest data finding one in three adults have untreated dental decay, with higher rates for those on lower incomes.[12] Meanwhile, evidence of links between poor dental health and poor health status have prompted calls for greater action.[13] Generally, stakeholders have reacted to the dental measures in this budget with some concern and disappointment. In a joint statement , the Consumer’s Health Forum and the Australian Healthcare and Hospital Association point to the high unmet demand for dental services and the cost barriers many consumers face. They argue that agreement on a new NPA must be achieved urgently, as further delays in funding ‘will be extremely disruptive to service provision and will have a negative impact on patients and their health’.[14] The Australian Dental Association (ADA) warns that waiting times for public dental services and access difficulties will continue, but is also concerned about the pause in indexation for the CDBS and veterans’ dental services, as well as reduced support for the dental workforce. The ADA points out that many dentists already cross-subsidise the cost of dental care through their participation in bulk billing, but would find this harder to do under the indexation pause.[15]

This suggests that progress on dental reforms over the next 12 months will be keenly scrutinised. But whether this will resolve duplication issues and arguments over responsibility for funding dental health remains to be seen.



[1].          Australian Government, Budget measures: budget paper no. 2: 2015–16, p. 107.

[2].          S Ley (Minister for Health), Abbott govt to sink teeth into dental reform, media release, 10 May 2015.

[3].          The NPA was announced by the former Labor Government. W Swan (Treasurer) and P Wong (Minister for Finance and Deregulation), Mid-year economic and fiscal outlook 2012–13, p. 229.

[4].          Australian Government, Budget measures: budget paper no. 2:  2014–15, p. 137. The Coalition’s commitment to the NPA was outlined in The Coalition's policy to support Australia's health system, August 2013, p. 17.

[5].          G McArthur, ‘Public dental patients in limbo’, Herald Sun, 24 April 2015, p. 2.

[6].          S Ley, op. cit.

[7].          Ibid.

[8].          Budget measures: budget paper no. 2: 2015–16, op. cit., p. 100.

[9].          The CDBS is based on a calendar year, so the pause will cease in December 2018. Australian Government, Portfolio budget statements 2015–16: budget related paper no. 1.10: Health portfolio, p. 84.

[10].       Budget measures: budget paper no. 2: 2015–16, op. cit., p. 180. Providers who treat veterans claim these payments as reimbursement for services.

[11].       Ibid., p. 110. The budget measure Rationalising and streamlining Health programmes, is forecast to realise savings of $962.8 million over four years.

[12].       Australian Institute of Health and Welfare, Oral health and dental care in Australia: key facts and figures trends 2014, AIHW, 2014, p. 5.

[13].       M Laverty , ‘Bite on government to improve dental health’, Sydney Morning Herald, 16 March 2015, p. 16.

[14].       Australian Healthcare and Hospitals Association, Consumer’s Health Forum, Dental health funding a clawback on previous commitments, media release, 11 May 2015.

[15].       Australian Dental Association, 2015-16 Federal Budget leaves a bad taste in the mouth, media release, 12 May 2015.

 

All online articles accessed May 2015. 

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