Stage one of dental health reform should focus on improving access for children and lower income adults, according to recommendations from the National Advisory Council on Dental Health.
The Council’s report says improving children’s oral health will reduce the overall burden of disease and improve long‐term oral health across the population, while low income adults are a priority because they are more vulnerable to dental disease.
It outlines two options for a universal children’s scheme based on current dental service delivery systems. The first would use an individual capped benefit entitlement and provide a basic suite of preventive and treatment services. The second would expand services and improve consistency across state and territory public dental services.
The report emphasises the importance of linking oral health reform to other health reform efforts, particularly Medicare Locals and Local Hospital Networks.
It suggests that Medicare Locals could identify service gaps, engage in oral health promotion, facilitate access to oral health services for special needs patients, act as an information gateway between the states and territories and local oral health providers, and include oral health education in training for health professionals.
But what role do Medicare Locals see for themselves?
Jason Trethowan, Chief Executive Officer of the Barwon Medicare Local in Geelong, suggests that Medicare Locals have a major role to play in improving oral health.
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What Medicare Locals can do for oral health
Jason Trethowan writes:
The release of an expert advisory committee’s report recommending options for a future dental health scheme in Australia raises questions regarding the role of Medicare Locals in improving oral health for local communities.
Coming off the back of earlier work in our area, it is widely recognised that the Geelong region has had an inadequate supply of dental services to meet the oral health care needs of our communities.
In our context, the Victorian government is the main player when it comes to funding and purchasing public dental health services for patients. The government also has plans to strengthen its oral health promotion and disease prevention network.
Despite the State’s investment, patients face lengthy waiting lists to access public dental care services, so when it comes to Barwon Medicare Local confirming local service gaps, I am confident oral health will be right up there.
Medicare Locals do not need to duplicate the work already being undertaken by the State government and the providers from whom they purchase services, however competing policy and funding arrangements not well co-ordinated at the local level could lead to unintended consequences in areas of workforce planning and disruption to what may already be working well.
What role then should a Medicare Local play in supporting future federal government investments in dental care?
Together with the State, Medicare Locals could:
- Undertake shared population health and primary care planning for oral health
- Use newly established consumer and community engagement mechanisms to drive change
- Partner at a regional level to ensure providers are supported to work in under-resourced communities
- Identify opportunities to ensure new services reach the patients that the new schemes are designed for
- Plan for a future workforce in dental care at the local level
- Ensure new government-funded capital developments are prioritised in locations where services are needed most
- Strengthen an integrated primary health care system by improving the working relationships and connections between general practice and dental services via the use of E-Health
- Develop web-based navigation tools for consumers and carers to identify how to access dental services, where they are provided, waiting lists and any potential out-of-pocket expenses
- Promote quality and best practice guidelines for dental care to local providers
- Promote public health messages, especially in under-resourced communities, on preventing oral health conditions
- Report back to the community on service use and effectiveness of how the dental schemes have worked at the local level
While the current discussion is on schemes and funding, governments should also consider how best to maximise the value of the policy intent with a carefully considered implementation approach at the local level.
I have just had a look at the tag line on the Medicare Local logo and it reads – “Connecting health to meet local needs”.
Sounds like a good place to start.
• Follow Jason Trethowan on Twitter: @barwonml
