Positive Life NSW

Lance Feeney updates Talkabout readers on where we're at advocating for your rights.

Dental scheme still in place – for now

The Commonwealth Dental Health Program will provide $290 million over three years to deliver public dental services to states and territories and help clear the backlog of people waiting for public dental visits. The program is still on hold, pending the withdrawal of the Medicare Enhanced Primary Care (EPC) scheme introduced in November 2007 by the Howard Government. You can read more about this at http://www.health.gov.au/internet/main/publishing.nsf/Content/dental-com...

The Minister for Health Nicola Roxon has indicated strongly in dealings with the Australian Dental Association (ADA), that the two systems will not coexist and that the government wants to wind-up the EPC scheme. The scheme is uncapped and facing a budget blow-out. Ms Roxon has said that $290 million over three years will have to be withdrawn from the Commonwealth Dental Health Program, if the Medicare EPC scheme continues. She said this would reduce spending on the federal program and would mean that NSW patients in the public system would lose 327,200 public dental services at a cost of $90 million.

Minister Roxon believes the scheme is poorly targeted because only people with chronic medical conditions qualify for the program. The Association for the Promotion of Oral Health (APOH), analysing data on the use of the scheme, refutes these claims. APOH Chairman, H Zoellner reported that: “Analysis of most recent Medicare statistics indicated a generally balanced use of Medicare funds (…) Most patients have three to four extractions, surgery or other treatment for pain – it’s not cosmetic or for fun (…) Patients average 2.7 preventative services, 0.14 root therapies, 0.76 dentures, and 2.26 routine fillings each”.

The Australian Dental Association (ADA) is concerned about the appropriate use of the scheme and has written to the NSW Director General of Health. In communications with Medicare, they have not shown a concern with providing greater guidelines, due to the intention to wind the program down. Although the ADA is supportive of auditing to ensure clinically appropriate outcomes, as the professional representative body, they are disappointed where some dentists may take advantage of the scheme. The ADA notes, however, that inappropriate use of the scheme is still small and that a lot of people are getting appropriate benefit.

While the Senate blocks the government’s attempts to dump the EPC dental scheme, it will continue - but for how long? The Senate is due to sit in early March 2009. There will have been much lobbying of independents (The Greens, Family First, Senator Xenophon), by a range of interest groups. There is (and will continue to be), growing pressure on senate members who opposed the government’s last attempt to dump the scheme, to vote with the government and end it.

We advise all people with HIV (who are either using the Medicare EPC Dental scheme or contemplating using the scheme) to progress treatment as quickly as possible.