Filling the dental gap: meeting unmet oral health needs – Melbourne

Two million Australians delay or miss out on dental care each year because of cost. Although people on low incomes fare worst, even people on higher incomes miss out on care. The existing public response is uncoordinated, unplanned, and inadequate. State public dental schemes are so overwhelmed that many people wait more than a year for care.

What should be done?

Part of the answer is improving the value of existing public dental services. But part of the answer is that the Commonwealth should expand its role and establish a universal dental scheme paralleling Medicare. The universal scheme should cover primary care dental services, including preventive dental care, such as scaling, fixing cavities and gum disease, and undertaking extractions. The first step should be the Commonwealth assume responsibility for the most needy – pensioners and healthcare cardholders. This will cost about $1 billion a year, taking into account what states already spend. This Policy Pitch heard about both of these approaches.


Stephen Duckett, is Director of the Health Program at the Melbourne-based think tank, Grattan Institute. He has held top operational and policy leadership positions in health care in Australia and Canada including as Secretary of what is now the Commonwealth Department of Health. He has a reputation for creativity, evidence-based innovation and reform in areas ranging from the introduction of activity-based funding for hospitals, to new systems of accountability for the safety of hospital care. An economist, he is a Fellow of the Academy of Social Sciences in Australia and of the Australian Academy of Health and Medical Science.

Zoe Wainer, is Chair of the Board of Dental Health Services Victoria, and has recently completed a secondment to the Department of Prime Minister and Cabinet. She has a clinical background in cardiothoracic surgery and surgical oncology as well has public health and health administration.  She has been actively engaged with and implanting the principles of value-based healthcare throughout her various roles, in particular in her role as Chair of the Board of DHSV, which, as a statewide public oral health service, is in the process of implementing Value-based Healthcare as a new clinical and operating model.