Oral health: whose responsibility?

Monday, 22 February 2016
Oral health - whose responsibility?
Oral health - whose responsibility?

The National Rural Health Alliance was part of a delegation from the National Oral Health Alliance (NOHA) that met with the Department of Health to discuss current strategic developments with the Australian Government's involvement with oral health. The issues of greatest importance are the future of the Child Dental Benefits Schedule (CDBS) and the amount of support to be provided to States/Territories for their public dental health services.

NOHA is in the curious situation which sees a small number of its members involved in and therefore aware of some parts of the government's strategic planning but restricted by a confidentiality agreement, with other members having to guess what is happening on the basis of Senate Estimates and opaque meetings such as the one attended by this NOHA delegation.

Unsurprisingly, the Department would not be drawn on the nature of the specific measures that would be announced in the May Budget, indicating that the Government was considering all options. It seems that there are discussions with the States/Territories about what will be in place after expiry of the 12-month 2015-16 National Partnership Agreement which made available $200 million for the delivery of dental services and continued access to the CDBS. This represented a reduction of what had been promised by the previous Government

Spending on the CDBS has been less than was budgeted but, given its perception of current fiscal circumstances, the Government has no interest in improving its uptake.

The NOHA delegation, which included the ADA and the RFDS, emphasised the high need among three population groups - Aboriginal and Torres Strait Islander people, those on low income, and people in more remote areas - but the Australian Government has no appetite for additional spending in the area or, specifically, for targeted programs. To the extent that it accepts responsibility for oral health programs at all, the Government wants to be a wholesaler, not a retailer. Unfortunately, uniformity can be the enemy of effectiveness.

This approach extends to programs for Aboriginal and Torres Strait Islander people, with the onus falling to States/Territories and with State affiliates of the AMSs.

Given the Australian Government's overall direction in oral health, it will be instructive to see how the reform of Federation activity - if it proceeds - deals with the matter. More will be revealed in the May Budget, but it is already clear that the investment in oral health - for that is how expenditure on prevention ought to be seen - will be less, not more. The NRHA and others are particularly concerned about the availability in rural and remote areas of infrastructure and clinicians for oral health, but that's another story.