Informed, engaged communities for health

Filter by Categories
Aged care
Budgets
Federal Budget 2024-25
Federal Budget 2023-2024
Federal Budget October 2022
Federal Budget 2022-23
Federal Budget 2021-22
Climate and health
Climate emergency
Healthcare sustainability
Heatwaves
National Health and Climate Strategy
#HealthyCOP28
#HealthyCOP27
#HealthyCOP26
#CoveringClimateNow
COVID collection
COVID-19
Long COVID
COVIDwrap
COVID SNAPS
#JusticeCOVID
Caring for the Frontline
COVIDglobalMHseries
Croakey Conference News Service
#WICC2024
Croakey Professional Services
NHLF series
#KidneyCareTogether
ACSQHC series
ACSQHC series 2022
ACSQHC series 2021
ACSQHC series 2020
ACSQHC series 2019
CATSINaM 25 Years
Croakey projects
@WePublicHealth 2024
Summer reading 2023-2024
The Zap
#CroakeyLIVE #DigitalNationBuilding
#CroakeyLIVE #VoiceForHealth
#PHAAThinkTank2023
The Health Wrap
ICYMI
@WePublicHealth
@WePublicHealth2023
#CroakeyVOICES
#SpeakingOurMinds
Croakey longreads
#CroakeyREAD
CroakeyEXPLORE
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
Determinants of health
Environmental determinants of health
Social determinants of health
Education
Discrimination
Housing
Internet access
Justice and policing
Justice Reinvestment
Newstart/JobSeeker
Poverty
Racism
Social policy
Commercial determinants of health
Alcohol
Arms industry
Digital platforms
Food and beverages
Fossil fuels
Gambling
Pharmaceutical industry
Plain packaging
Sugar tax
Tobacco
Vaping
Disasters and extreme weather events
Disasters
Extreme weather events
Bushfires
Bushfire-emergency 2019-2020
Floods 2023
Floods 2022
Floods 2021
Floods 2011
Donor-funded journalism
Donor-funded journalism – 2024
Donor-funded journalism – 2023
Donor-funded journalism – 2022
Donor-funded journalism – 2021
Donor-funded journalism – 2020
Elections
lutruwita/Tasmania 2024 election
#NSWvotesHealth2023
Victorian election 2022
Federal Election 2022
The Election Wrap 2022
#QldVotesHealth
SA election 2022
WA election 2021
Tasmanian election 2021
First Nations
Indigenous health
Community controlled sector
Cultural determinants of health
Cultural safety
Indigenous education
Social and emotional wellbeing
Uluru Statement
The Voice
Lowitja Institute
NT Intervention
WA community closures
Acknowledgement
#CTG10
#NTRC
#RCIADIC30Years
General health matters
Abortion
Cancer
Cardiovascular disease
Child health
Chronic conditions
Consumer health matters
Death and dying
Diabetes
Disabilities
Euthanasia
Fetal Alcohol Spectrum Disorders (FASD)
Genetics
HIV/AIDS
HRT
Infectious diseases
Influenza
LGBTQIA+
Medical marijuana
Men's health
Mental health
Mpox
Non communicable diseases
Oral health
Organ transplants
Pain
Pregnancy and childbirth
Sexual health
Suicide
Swine flu
Trauma
Women's health
Youth health
Global health matters
Asylum seeker and refugee health
Conflict and war
Global health
WHO
Ebola
NHS
#WorldInTurmoil
Health policy and systems
Co-design
Health financing and costs
Health reform
Health regulation
Medicare 40 Years
MyMedicare
National Health Performance Authority
Pharmaceutical Benefits Scheme
Private health insurance
Royal Commissions
TGA
Workforce matters
Strengthening Medicare Taskforce 2022
National Commission of Audit 2014
Healthcare
Adverse events
Allied healthcare
Australian Medical Association
Choosing Wisely
cohealth
Complementary medicines
Conflicts of interest
Co-payments
Digital technology
E-health
Emergency departments and care
Equally Well
General practice
Health Care Homes
Health ethics
Hospitals
International medical graduates
Medicare Locals
MyHospitals website
Naturopathy
NDIS
Nursing and midwifery
Out of pocket costs
Palliative care
Paramedics
Pathology
Pharmacy
Primary healthcare
Primary Health Networks
Rural and remote health
Safety and quality of healthcare and aged care
Screening
Social prescribing
Surgery
Telehealth
Tests
Media and health
Media-related issues
Health & medical marketing
Misinformation and disinformation
Public interest journalism
Social media and healthcare
The Conversation
Media Doctor Australia
News about Croakey
Public health and population health
Air pollution
Artificial intelligence
Australian Centre for Disease Control
Government 2.0
Gun control
Health communications
Health impact assessment
Health in All Policies
Health inequalities
Health literacy
Human rights
Illicit drugs
Injuries
Legal issues
Marriage equality
Nanny state
National Preventive Health Agency
Obesity
Occupational health
Physical activity
Prevention
Public health
Road safety
Sport
Transport
Vaccination
VicHealth
Violence
Web 2.0
Weight loss products
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
Research matters
Cochrane Collaboration
Evidence-based issues
Health and medical education
Health and medical research
NHMRC
#MRFFtransparency
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2023
2023 Conferences
#GreenHealthForum23
#hpsymposium2023
#NMS23
#HEAL2023
#ASMIRT2023
#NSPC23
Our Democracy Forum
#AskMSF
#Lowitja2023
2022 Conferences
#16nrhc
#GreenHealthForum22
#Heal2022
#ICEM22
#NAISA22
#NNF2022
#RANZCP2022
#RethinkAddiction
#RTP22
GiantSteps22
Equally Well 2022 Symposium
Choosing Wisely National Meeting 2022
2021 conferences
#21OPCC
#BackToTheFire
#FoodGovernance2021
#GiantSteps21
#GreenHealthForum21
#HealthClimateSolutions21
#HearMe21
#IndigenousClimateJustice21
#NNF2021
#RANZCP2021
#ShiftingGearsSummit
#ValueBasedCare
#WCepi2021
#YHFSummit
2020 conferences
#2020ResearchExcellence
#Govern4Health
#HealthReImagined
#SAHeapsUnfair
2019 Conferences
#ACEM19
#CPHCE19
#EquallyWellAust
#GiantSteps19
#HealthAdvocacyWIM
#KTthatWorks
#LowitjaConf2019
#MHAgeing
#NNF2019
#OKtoAsk2019
#RANZCOG19
#RANZCP2019
#ruralhealthconf
#VMIAC2019
#WHOcollabAHPRA
2018 conferences
#6rrhss
#ACEM18
#AHPA2018
#ATSISPC18
#CPHCE
#MHED18
#NDISMentalHealth
#Nurseforce
#OKToAsk2018
#RANZCOG18
#ResearchIntoPolicy
#VHAawards
#VMIACAwards18
#WISPC18
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu
#OTCC2017
#ResearchTranslation17
#TheMHS2017
#VMIACConf17
#WCPH2017
Australian Palliative Care Conference
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
Croakey Professional Services archive
#CommunityControl
#CommunityControl Twitter Festival
#COVIDthinktank21
Lowitja Indigenous knowledge translation series
Croakey projects archive
#PHAAThinkTank 2022
Summer reading 2022-2023
#CommunityMatters
#CroakeyFundingDrive 2022
#CroakeyLIVE #Budget2021Health
#CroakeyLIVE #USvotesHealth
#CroakeyLIVE Federal election 2022
#CroakeyYOUTH
#HousingJusticeAus
#IndigenousHealthSummit
#IndigenousNCDs
#JustClimate
#JustJustice
#LookingLocal
#OutOfPocket
#OutOfTheBox
#RuralHealthJustice
#TalkingTeeth
@WePublicHealth2022
@WePublicHealth2021
@WePublicHealth2020
AroundTheTraps
Croakey register of influence
Croakey Register of Influencers in Public Health
Croakey Register of Unreleased Documents
Gavin Mooney
Inside Story
Journal Watch
Naked Doctor
Poems of Public Health
Summer reading 2021-2022
Summer reading 2020-2021
Summer Reading 2019-2020
Summer Reading 2017-2018
Summer Reading 2016-2017
The Koori Woman
TOO MUCH of a Good Thing
Wonky Health
CroakeyGO archive 2017 – 2018
CroakeyGo 2018
#CroakeyGO #QuantumWords 2018
#CroakeyGO #VicVotes 2018
#CroakeyGO Albury 2018
#CroakeyGO Callan Park 2018
#CroakeyGO Carnarvon 2018
#CroakeyGO Marrickville 2018
#CroakeyGO Palm Island 2018
CroakeyGo 2017
#CroakeyGO Adelaide 2017
#CroakeyGO Melbourne 2017
#CroakeyGO Newcastle 2017
#CroakeyGO Sydney 2017
Elections and Budgets 2013 – 2021
Budget2020Health
Federal Budget 2020-21
Federal Budget 2019-20
#AusVotesHealth Twitter Festival 2019
#Health4NSW
Federal Election 2019
NSW Election 2019
Federal Budget 2018-19
Federal Budget 2017/18
NZ Election 2017
Federal Budget 2016-17
Federal Election 2016
#HealthElection16
NT Election 2016
Federal Budget 2015-16
Qld Election 2015
NSW Election 2015
Federal Budget 2014-15
Victorian Election 2014
Federal Budget 2013-14
Federal Election 2013
Federal Budget 2012-2013
Federal Budget 2011
Federal Budget 2010
Federal Election 2010
Federal Budget 2009-2010
Support non-profit public interest journalism
Filter by Categories
Aged care
Budgets
Federal Budget 2024-25
Federal Budget 2023-2024
Federal Budget October 2022
Federal Budget 2022-23
Federal Budget 2021-22
Climate and health
Climate emergency
Healthcare sustainability
Heatwaves
National Health and Climate Strategy
#HealthyCOP28
#HealthyCOP27
#HealthyCOP26
#CoveringClimateNow
COVID collection
COVID-19
Long COVID
COVIDwrap
COVID SNAPS
#JusticeCOVID
Caring for the Frontline
COVIDglobalMHseries
Croakey Conference News Service
#WICC2024
Croakey Professional Services
NHLF series
#KidneyCareTogether
ACSQHC series
ACSQHC series 2022
ACSQHC series 2021
ACSQHC series 2020
ACSQHC series 2019
CATSINaM 25 Years
Croakey projects
@WePublicHealth 2024
Summer reading 2023-2024
The Zap
#CroakeyLIVE #DigitalNationBuilding
#CroakeyLIVE #VoiceForHealth
#PHAAThinkTank2023
The Health Wrap
ICYMI
@WePublicHealth
@WePublicHealth2023
#CroakeyVOICES
#SpeakingOurMinds
Croakey longreads
#CroakeyREAD
CroakeyEXPLORE
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
Determinants of health
Environmental determinants of health
Social determinants of health
Education
Discrimination
Housing
Internet access
Justice and policing
Justice Reinvestment
Newstart/JobSeeker
Poverty
Racism
Social policy
Commercial determinants of health
Alcohol
Arms industry
Digital platforms
Food and beverages
Fossil fuels
Gambling
Pharmaceutical industry
Plain packaging
Sugar tax
Tobacco
Vaping
Disasters and extreme weather events
Disasters
Extreme weather events
Bushfires
Bushfire-emergency 2019-2020
Floods 2023
Floods 2022
Floods 2021
Floods 2011
Donor-funded journalism
Donor-funded journalism – 2024
Donor-funded journalism – 2023
Donor-funded journalism – 2022
Donor-funded journalism – 2021
Donor-funded journalism – 2020
Elections
lutruwita/Tasmania 2024 election
#NSWvotesHealth2023
Victorian election 2022
Federal Election 2022
The Election Wrap 2022
#QldVotesHealth
SA election 2022
WA election 2021
Tasmanian election 2021
First Nations
Indigenous health
Community controlled sector
Cultural determinants of health
Cultural safety
Indigenous education
Social and emotional wellbeing
Uluru Statement
The Voice
Lowitja Institute
NT Intervention
WA community closures
Acknowledgement
#CTG10
#NTRC
#RCIADIC30Years
General health matters
Abortion
Cancer
Cardiovascular disease
Child health
Chronic conditions
Consumer health matters
Death and dying
Diabetes
Disabilities
Euthanasia
Fetal Alcohol Spectrum Disorders (FASD)
Genetics
HIV/AIDS
HRT
Infectious diseases
Influenza
LGBTQIA+
Medical marijuana
Men's health
Mental health
Mpox
Non communicable diseases
Oral health
Organ transplants
Pain
Pregnancy and childbirth
Sexual health
Suicide
Swine flu
Trauma
Women's health
Youth health
Global health matters
Asylum seeker and refugee health
Conflict and war
Global health
WHO
Ebola
NHS
#WorldInTurmoil
Health policy and systems
Co-design
Health financing and costs
Health reform
Health regulation
Medicare 40 Years
MyMedicare
National Health Performance Authority
Pharmaceutical Benefits Scheme
Private health insurance
Royal Commissions
TGA
Workforce matters
Strengthening Medicare Taskforce 2022
National Commission of Audit 2014
Healthcare
Adverse events
Allied healthcare
Australian Medical Association
Choosing Wisely
cohealth
Complementary medicines
Conflicts of interest
Co-payments
Digital technology
E-health
Emergency departments and care
Equally Well
General practice
Health Care Homes
Health ethics
Hospitals
International medical graduates
Medicare Locals
MyHospitals website
Naturopathy
NDIS
Nursing and midwifery
Out of pocket costs
Palliative care
Paramedics
Pathology
Pharmacy
Primary healthcare
Primary Health Networks
Rural and remote health
Safety and quality of healthcare and aged care
Screening
Social prescribing
Surgery
Telehealth
Tests
Media and health
Media-related issues
Health & medical marketing
Misinformation and disinformation
Public interest journalism
Social media and healthcare
The Conversation
Media Doctor Australia
News about Croakey
Public health and population health
Air pollution
Artificial intelligence
Australian Centre for Disease Control
Government 2.0
Gun control
Health communications
Health impact assessment
Health in All Policies
Health inequalities
Health literacy
Human rights
Illicit drugs
Injuries
Legal issues
Marriage equality
Nanny state
National Preventive Health Agency
Obesity
Occupational health
Physical activity
Prevention
Public health
Road safety
Sport
Transport
Vaccination
VicHealth
Violence
Web 2.0
Weight loss products
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
Research matters
Cochrane Collaboration
Evidence-based issues
Health and medical education
Health and medical research
NHMRC
#MRFFtransparency
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2023
2023 Conferences
#GreenHealthForum23
#hpsymposium2023
#NMS23
#HEAL2023
#ASMIRT2023
#NSPC23
Our Democracy Forum
#AskMSF
#Lowitja2023
2022 Conferences
#16nrhc
#GreenHealthForum22
#Heal2022
#ICEM22
#NAISA22
#NNF2022
#RANZCP2022
#RethinkAddiction
#RTP22
GiantSteps22
Equally Well 2022 Symposium
Choosing Wisely National Meeting 2022
2021 conferences
#21OPCC
#BackToTheFire
#FoodGovernance2021
#GiantSteps21
#GreenHealthForum21
#HealthClimateSolutions21
#HearMe21
#IndigenousClimateJustice21
#NNF2021
#RANZCP2021
#ShiftingGearsSummit
#ValueBasedCare
#WCepi2021
#YHFSummit
2020 conferences
#2020ResearchExcellence
#Govern4Health
#HealthReImagined
#SAHeapsUnfair
2019 Conferences
#ACEM19
#CPHCE19
#EquallyWellAust
#GiantSteps19
#HealthAdvocacyWIM
#KTthatWorks
#LowitjaConf2019
#MHAgeing
#NNF2019
#OKtoAsk2019
#RANZCOG19
#RANZCP2019
#ruralhealthconf
#VMIAC2019
#WHOcollabAHPRA
2018 conferences
#6rrhss
#ACEM18
#AHPA2018
#ATSISPC18
#CPHCE
#MHED18
#NDISMentalHealth
#Nurseforce
#OKToAsk2018
#RANZCOG18
#ResearchIntoPolicy
#VHAawards
#VMIACAwards18
#WISPC18
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu
#OTCC2017
#ResearchTranslation17
#TheMHS2017
#VMIACConf17
#WCPH2017
Australian Palliative Care Conference
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
Croakey Professional Services archive
#CommunityControl
#CommunityControl Twitter Festival
#COVIDthinktank21
Lowitja Indigenous knowledge translation series
Croakey projects archive
#PHAAThinkTank 2022
Summer reading 2022-2023
#CommunityMatters
#CroakeyFundingDrive 2022
#CroakeyLIVE #Budget2021Health
#CroakeyLIVE #USvotesHealth
#CroakeyLIVE Federal election 2022
#CroakeyYOUTH
#HousingJusticeAus
#IndigenousHealthSummit
#IndigenousNCDs
#JustClimate
#JustJustice
#LookingLocal
#OutOfPocket
#OutOfTheBox
#RuralHealthJustice
#TalkingTeeth
@WePublicHealth2022
@WePublicHealth2021
@WePublicHealth2020
AroundTheTraps
Croakey register of influence
Croakey Register of Influencers in Public Health
Croakey Register of Unreleased Documents
Gavin Mooney
Inside Story
Journal Watch
Naked Doctor
Poems of Public Health
Summer reading 2021-2022
Summer reading 2020-2021
Summer Reading 2019-2020
Summer Reading 2017-2018
Summer Reading 2016-2017
The Koori Woman
TOO MUCH of a Good Thing
Wonky Health
CroakeyGO archive 2017 – 2018
CroakeyGo 2018
#CroakeyGO #QuantumWords 2018
#CroakeyGO #VicVotes 2018
#CroakeyGO Albury 2018
#CroakeyGO Callan Park 2018
#CroakeyGO Carnarvon 2018
#CroakeyGO Marrickville 2018
#CroakeyGO Palm Island 2018
CroakeyGo 2017
#CroakeyGO Adelaide 2017
#CroakeyGO Melbourne 2017
#CroakeyGO Newcastle 2017
#CroakeyGO Sydney 2017
Elections and Budgets 2013 – 2021
Budget2020Health
Federal Budget 2020-21
Federal Budget 2019-20
#AusVotesHealth Twitter Festival 2019
#Health4NSW
Federal Election 2019
NSW Election 2019
Federal Budget 2018-19
Federal Budget 2017/18
NZ Election 2017
Federal Budget 2016-17
Federal Election 2016
#HealthElection16
NT Election 2016
Federal Budget 2015-16
Qld Election 2015
NSW Election 2015
Federal Budget 2014-15
Victorian Election 2014
Federal Budget 2013-14
Federal Election 2013
Federal Budget 2012-2013
Federal Budget 2011
Federal Budget 2010
Federal Election 2010
Federal Budget 2009-2010

The history of efforts to improve access to dental care – “more twists and turns than an episode of Midsomer Murders”

Introduction by Croakey: In a recent analysis of why Medicare is not actually the “universal health insurance scheme” that it is claimed to be, health policy analyst and Croakey editor Jennifer Doggett said the lack of coverage for dental services was just one of many examples of how Medicare “fails the universality test”.

Amid growing momentum for Medicare reform at a time when waiting times for public dental services are blowing out to well over a year in many jurisdictions, it is timely to consider the history of efforts to improve access to dental care.

In the first of two in-depth articles on this topic, regular Croakey contributor Charles Maskell-Knight says there are many lessons for would-be reformers from an examination of the “dental policy turbulence of the last twenty years”.


Charles Maskell-Knight writes:

In a recent article I suggested that one of the three priorities for an incoming Federal Minister for Health should be expanding subsidised access to dental care. The Greens election policy included expanding Medicare to cover dental services, and leader Adam Bandt in his speech to the National Press Club on 3 August made it clear that this is a priority policy objective for the party.

If the Albanese Government is minded to consider new dental policies, it should be aware of the history of Commonwealth dental policy over the last twenty years, which has had more twists and turns than an episode of Midsomer Murders.

In this article I set out the history, and draw out what seem to me to be the main lessons for the future. A later article will set out a proposal for future dental policy which will avoid the pitfalls of some past schemes.

The initial dental program

Apart from the subsidy for privately insured dental services implicit in the private health insurance premium rebate, the Howard Government’s first foray into funding dental services began in 2004 when it introduced so-called Extended Primary Care (ECP) items under the MBS.

Under these arrangements a GP could develop an EPC plan for a patient. If the patient’s chronic diseases were exacerbated by dental problems the GP could refer them to a dentist, who could claim for three services a year with a maximum total rebate across all three services of $220. While these benefits were barely adequate to cover assessment, they were completely inadequate as a contribution to treatment costs, and patients paid large out of pocket costs.

Over the three years 2004-07, a total of only 16,000 services were provided, compared with an initial estimate of 70,000 services per annum.

In the lead-up to the 2007 (election) budget, the Government asked the Department of Health to model a range of options for a dental benefits program. Pages and pages of tables were produced showing the costs for different groups (concession card holders and FTB-A families, concession card holders, all aged pensioners, full aged pensioners) and different scope of services and benefit caps.

But no matter how the parameters were tweaked, the cost was deemed too high.

The Government decided instead to add a much wider range of diagnostic and treatment items to the EPC program and increase the benefits cap to $2,000 per annum. Following pressure from the dental profession the cap was increased in August 2007 to $4250 over two years, and benefits for dentures were included.

The new arrangements were known as the Chronic Disease Dental Scheme or CDDS and began on 1 November 2007, three weeks before the Howard Government lost office.

Although the Government expected that “gatekeeping” by GPs would limit access to the new items, this was not the case. While expenditure was originally estimated at $385 million over four years, by the time the program was finally abolished in 2012 the CDDS was costing that much every five months.

The arrangements were subject to considerable criticism by the Rudd/Gillard Governments, and the phrase “dental rorts” was often applied to them. This is not fair: while there were there were some examples of deliberate over-servicing of people in aged care – the most egregious of which led to criminal charges – these were uncommon.

The real problem was the disjunction between the scope of dental services available and the chronic disease related dental needs of patients. For example, patients with functional dentition and no active dental disease but missing teeth were being provided with implants or bridges, with minimal impact on dental function and no impact on their overall health.

Another valid criticism was the distributional inequity of the arrangements: millionaires with an EPC plan could receive immediate private sector dental treatment, while otherwise healthy pensioners with dental problems were added to public sector dental waiting lists.

The program that wouldn’t die

The Rudd Government was elected in November 2007 with a dental policy that included abolishing the CDDS, and using the funding to establish:

  • a Commonwealth Dental Program, and
  • a Medicare Teen Dental Plan.

The Medicare Teen Dental Plan was established under the Dental Benefits Act 2008, and began from 1 July 2008. It paid benefits of up to $150 per year for an annual dental check-up for children aged between 12 and 17 years in families eligible for Family Tax Benefit A (or children receiving ABSTUDY, Youth Allowance or various other income support payments in their own right).

While an estimated 1.1 million (out of a total two million) teenagers were eligible for the scheme, actual take-up was around 30 per cent.

The 2008-09 Budget also provided for “$290.0 million over three years to establish a Commonwealth Dental Health Program — funding will be provided to the States to supplement existing public services and/or purchase private dental services” and “bring relief for up to 650,000 people on public dental waiting lists around the country”.

However, the program did not proceed, and the 2009-10 Budget noted that:

The Commonwealth dental health program will provide funding to reduce public dental waiting lists. The commencement of the program is on-hold pending the outcome of the Government’s negotiations with the Senate [to close the CDDS].”

The 2010-11 and 2011-12 Budgets contained almost exactly the same language. The Green Senators were refusing to support closure of the CDDS until they were satisfied with the new dental programs.

In early 2012 the Government finally lost patience with the Senate, and the 2012-13 Budget stated that the Commonwealth would be making $345.9 million available over three years from 2012-13 to 2014-15 to provide treatment for those on public dental waiting lists in the States, including ensuring support for Indigenous Australians.

However, it went on to note that:

The Government will redirect currently unallocated Commonwealth Dental Health Program funding towards this Budget’s dental health package. This funding was intended to replace the Chronic Disease Dental Scheme (CDDS) but has been redirected to boost dental services before the CDDS is closed and any new scheme commences. It still remains Government policy to close the CDDS.”

The Budget allocated $69.2 million in 2012-13, $155.2 million in 2013-14, and $119.6 million in 2014‑15. Funding was provided to the states under the National Partnership Agreement on Treating More Public Dental Patients (NPA).

The NPA stated that it was to provide treatment for an additional 400,000 public dental patients. To ensure that the funding provided additional services (and did not replace state funding) and that the 400,000 additional patients were not simply low cost “scale and polish” treatments, the Commonwealth proposed (and the states accepted) measurement of throughput using Dental Weighted Activity Units (DWAUs). Commonwealth funding was only paid for activity additional to the states’ baseline activity.

While the additional funding was successful in increasing public dental output, AIHW data show it did not consistently reduce waiting times. This was due in part to the “honeypot effect” – as the client group became aware services were more accessible, more people joined the waiting list.

“Once in a generation” reform – version one

In mid-2012 the Gillard Government finally agreed with the Greens in the Senate on abolishing the CDDS in return for a dental package billed by then Minister Tanya Plibersek as “once in a generation dental reform”.

The main elements of the announcement were:

  • a Child Dental Benefits Scheme (CDBS), under which children aged 2-17 in FTB-A families (and other children eligible for the Medicare Teen Dental Plan) could access up to $1000 over a two-year period in dental benefits for a wide range of diagnostic, preventative, and treatment items; and
  • a further $1.3 billion in payments to the states to expand public dental programs over the four years starting in 2014-15.  Funding over the four years was planned to be $200 million in 2014-15, $295 million in 2015-16, and $390 million in both 2016-17 and 2017-18. It was to be provided under a new National Partnership Agreement for Adult Public Dental Services (NPA II).

The necessary amendments to the Dental Benefits Act 2008 to support the CDBS were passed by the end of 2012, and the scheme began on 1 January 2014 with an estimated annual expenditure of $600 million.

It should be noted that the decision to establish the CDBS was taken against advice from the dental health experts in the Department of Health. Even before the scheme was established, most children had good dental health visiting patterns, and combined with widespread access to fluoridated water since birth in most of Australia, this meant children generally had excellent dental health.

While over three million children at any one time are eligible for the CDBS, take-up has consistently run at around a third. This is partly because the Liberal Government, which took office by the time the scheme started on 1 January 2014, was not active in promoting it, and partly because many families are covered by private health insurance and use this rather than the scheme.

“Once in a generation” reform – version two

The Abbott Government came to power in September 2013. It was committed to “honour[ing] the arrangements under the National Partnership Agreement for Adult Public Dental Services” and “seek[ing] to transition respective adult dental services to be included under Medicare” once the NPA expired. Like many 2013 election commitments, these were not met.

The first decision the new Government took in relation to dental policy was to defer the introduction of NPA II by a year to 2015-16, to avoid the overlap with the last year of the first NPA. The next decision in the 2015-16 Budget was to move to a one-year agreement only to cover 2015-16, with reduced funding of $155 million rather than the $200 million originally announced. These decisions saved $1,130 million from the previous Labor Government allocation.

In the lead-up to the 2015-16 Budget the Health Minister announced that the Abbott Government was going to “sink its teeth into dental reform”, and that there was a need to “take hold of this once-in-a-generation opportunity for constructive reform”. This media release generated considerable hilarity at the time in dental policy circles, partly because it was less than two years since the previous once-in-a-generation reform, but mainly because the “once-in-a-generation” phrase was also used in a contemporaneous Utopia episode.

In the 2015-16 MYEFO the Government decided (but did not announce) that it would legislate to impose an annual cap on expenditure under the demand driven CDBS. (The ministerial adviser who came up with this cunning plan was unable to suggest how it could be implemented. Presumably as spending approached the cap, dentists would need to seek real time approval for individual patients to ensure that the scheme would cover the cost.) This bizarre decision was designed to generate “savings” that could be used to offset the costs of listing new Hepatitis C drugs.

The results of the dental reform process were announced in the 2016-17 Budget:

The Government will reform public dental services by providing $1.7 billion over four years from 2016-17 for a new Child and Adult Public Dental Scheme (the Scheme) to be delivered by the states and territories (the states) under a National Partnership Agreement (NPA).

All children and adult concession card holders will be eligible for the Scheme and the states will have the flexibility to provide funded services to other groups based on need. Service levels for an individual will not be capped.

The Government will provide 40 per cent of the national efficient price for all dental services provided under the Scheme, with the states providing the remaining 60 per cent. After an initial transition period, growth in Commonwealth Government funding from 2019-20 will be capped in line with growth in the Consumer Price Index and population.

The cost of the NPA will be offset by terminating the Child Dental Benefits Schedule and the NPA for Adult Public Dental Services from 2016-17. Some savings from these two programs have already been included in the forward estimates.”

Following the 2016 election it became clear that the legislation to implement the new Scheme would be defeated in the Senate, and it was withdrawn from consideration.

Current arrangements

The Child Dental Benefits Scheme continues in operation (although the biennial cap was reduced from $1,000 to $800 in early 2017, but then returned to $1,000). Take-up continues to be poor, at around one-third of eligible children, and annual spending is a little over