COMMONWEALTH OF AUSTRALIA SENATE Official Committee Hansard COMMUNITY AFFAIRS REFERENCES COMMITTEE Reference: Public dental services FRIDAY, 6 MARCH 1998 CANBERRA BY AUTHORITY OF THE SENATE CANBERRA 1997 INTERNET The Proof and Official Hansard transcripts of Senate committee hearings, some House of Representatives committee hearings and some joint committee hearings are available on the Internet. Some House of Representatives committees and some joint committees make available only Official Hansard transcripts. The Internet address is: http://www.aph.gov.au/hansard SENATE Friday, 6 March 1998 COMMUNITY AFFAIRS REFERENCES COMMITTEE Members: Senator Bishop (Chair), Senator Knowles (Deputy Chair), Senators Forshaw, Bartlett, Neal, O’Brien, Payne and Synon Participating members: Senators Abetz, Brown, Bob Collins, Colston, Faulkner, Gibbs, Margetts and West Senators attending the hearing: Senators Bishop, Bartlett, Forshaw, Knowles, Neal and Payne Matter referred by the Senate for inquiry into and report on: Current arrangements for the provision of public dental services in Australia, with particular reference to: (a) the current and future dental care needs of low income earners and other disadvantaged groups of Australians and the capacity of both private and public dental services to meet those needs; (b) the effect of the abolition of the Commonwealth Dental Health Program; (c) the nature of the Commonwealth’s responsibility to make laws for the provision of dental services pursuant to section 51(xxiiiA) of the Australian Constitution and the extent to which the Commonwealth is currently fulfilling that responsibility; (d) the Commonwealth’s role and responsibility in setting and monitoring national goals for oral health in Australia; and (e) options for reform in the delivery of public dental services, including an exploration of the efficiency and effectiveness of a range of options for delivering dental services to low income earners. WITNESSES BELL, Ms Kathryn Harrington, Policy Officer, National Aboriginal Community Controlled Health Organisation, PO Box 168, Deakin West, Australian Capital Territory 2600 ................................................. 65 BLUNDEN, Mr Stephen Vincent, Chief Executive Officer, National Aboriginal Community Controlled Health Organisation, PO Box 168, Deakin West, Australian Capital Territory 2600 ................................... 65 BROWN, Ms Margaret Irene, Chairperson, Health Consumers of Rural and Remote Australia, PO Box 280, Deakin West, Australian Capital Territory 2600 ...... 55 BUTLER, Dr Robert John Francis, Executive Director, Australian Dental Association, 75 Lithgow Street, St Leonards, New South Wales 2065 ......... 18 DAVIS, Ms Jill Rosemary, Director, Dental Health Program, ACT Community Care, GPO Box 825, Canberra, Australian Capital Territory 2601 ............... 78 FLEETWOOD, Dr Michael, Principal Dental Officer, Dental Health Program, ACT Community Care, GPO Box 825, Canberra, Australian Capital Territory 2601 . 78 FOLEY, Ms Michele Anne, Project Officer, Health Consumers of Rural and Remote Australia, PO Box 280, Deakin West, Australian Capital Territory 2600 ...... 55 FOLTYN, Dr Peter, Consultant Dentist, St Vincent’s Hospital, Victoria Street, Darlinghurst, New South Wales 2010 ................................ 34 GILMOUR, Ms Jonine Carol, Dental Program Coordinator, Durri Aboriginal Corporation Medical Service, 51 Smith Street, Kempsey, New South Wales 2440 65 GREGORY, Mr Gordon, Executive Director, National Rural Health Alliance, PO Box 280, Deakin West, Australian Capital Territory 2600 ................. 55 HARRIS, Mrs Susan Elizabeth, Dental Program Coordinator, Durri Aboriginal Medical Service, 51 Smith Street, Kempsey, New South Wales 2440 .......... 65 KINGSFORD SMITH, Dr Elisabeth Dell, Clinical Research Coordinator, Central Sydney and South Eastern Area Health Service, United Dental Hospital, 2 Chalmers Street, Surry Hills, New South Wales 2010 .................... 39 KLINEBERG, Professor Iven, Dean, Faculty of Dentistry, University of Sydney, 2 Chalmers Street, Surry Hills, New South Wales 2010 .................... 27 LOY, Dr John, First Assistant Secretary, Health Services Development Division, Department of Health and Family Services, PO Box 9848, Canberra, Australian Capital Territory 2601 ............................................ 1 MARRIS, Mr Frank, Senior General Counsel, Office of General Counsel, Attorney-General’s Department, 50 Blackall Street, Barton, Australian Capital Territory 2600 .................................................. 1 MOSSOP, Mr Michael, Director, Special Access Programs Section, Health Services Development Division, Department of Health and Family Services, Furzer Street, Phillip, Australian Capital Territory 2606 .............................. 1 SHORT, Ms Leonie Marjorie, Convenor, Oral Health Special Interest Group, Public Health Association of Australia, PO Box 319, Curtin, Australian Capital Territory 2605 ........................................................ 48 WILKINSON, Dr Ernest John, Director of Dental Services, Central Sydney and South Eastern Area Health Service, United Dental Hospital, 2 Chalmers Street, Surry Hills, New South Wales 2010 .................................. 39 Friday, 6 March 1998 SENATE—References CA 1 Committee met at 9.01 a.m. LOY, Dr John, First Assistant Secretary, Health Services Development Division, Department of Health and Family Services, PO Box 9848, Canberra, Australian Capital Territory 2601 MOSSOP, Mr Michael, Director, Special Access Programs Section, Health Services Development Division, Department of Health and Family Services, Furzer Street, Phillip, Australian Capital Territory 2606 MARRIS, Mr Frank, Senior General Counsel, Office of General Counsel, Attorney- General’s Department, 50 Blackall Street, Barton, Australian Capital Territory 2600 CHAIR—I declare open this public hearing of the Senate Community Affairs References Committee. The committee is taking evidence into matters relating to the provision of public dental services, which was referred to the committee for inquiry and report by 30 April 1998. All non-confidential submissions to the inquiry have been publicly released and are available from the secretariat. I welcome officers from the Department of Health and Family Services and from the Attorney-General’s Department. You will not be required to answer questions on the advice you may have given in the formulation of policy, or to express a personal opinion on matters of policy. The committee has before it the submission from the Department of Health and Family Services. Dr Loy, do you wish to make any alterations to that submission? Dr Loy—No. CHAIR—I now invite you to make a short opening statement and at the conclusion of your remarks I will invite members of the committee to put questions to you. Dr Loy—Thank you, Mr Chairman. The department’s submission focuses principally on an account of the former Commonwealth dental health program, from its inception to the decision to cease it. Given the government’s decision for the Commonwealth not to have a direct involvement in the funding of dental services, we felt that some of the other terms of reference for the inquiry were more properly the province of other parties. We have also offered you a brief bush lawyer’s view on the constitutional issues in the terms of reference, but we are very glad that an officer from the Attorney-General’s Department is here to be more authoritative on that. We touch on the developments of the National Public Health Partnership and the potential that may have for the Commonwealth and the states to take an approach to monitoring an examination of oral health as a popula- tion issue. CHAIR—Thank you, Dr Loy. Mr Marris—I am here to provide you with any assistance on constitutional or legal issues that might arise. COMMUNITY AFFAIRS CA 2 SENATE—References Friday, 6 March 1998 CHAIR—I have a number of questions going down that path and we might come to you in due course. Dr Loy, what do you understand to be the government’s current role in the provision of public dental services in this country? Dr Loy—The government decided in the 1996 budget to cease the only role the Commonwealth then had in the funding of public dental services. In that sense, the Commonwealth has no role in the funding of public dental services. The overall issue of oral health, as a health issue, is one in which we maintain an interest, but we have no direct role in the funding of public dental services. CHAIR—Do you have any indirect role? Dr Loy—In so far as the Commonwealth and states have arrangements for financial assistance generally, you could claim that to be a very indirect role. I think that is the same role we have in any kind of service and it is not one that involves us in the provision of the service or in the direct decision making in relation to priorities. CHAIR—Do any obligations derive from Commonwealth involvement of the COAG process in respect of public dental health? Dr Loy—No. CHAIR—Does that impose no obligations at all? Dr Loy—No. CHAIR—Does the Commonwealth have any influence in relation to public dental services provided by the states and territories? Dr Loy—I would think our influence is very limited. The reality is you buy influence with money. CHAIR—How much money is provided by the Commonwealth currently? Dr Loy—None directly for public dental services. CHAIR—None. Is there no influence at all? Dr Loy—That is a fair assumption. As I said, the Commonwealth and the states