In 2019, Grattan Institute published a report called Filling the gap: A universal dental scheme for Australia. The report outlined the problems plaguing dental care in Australia: primarily that the cost of dental care comes straight out of patients’ pockets, causing those who can’t afford it to miss out. The result is skipped care, and poor oral health, especially for poorer people.
This submission shows that little has changed since Filling the gap was published in 2019. In fact, on many measures, Australians’ oral health has declined.
The main problem with dental care in Australia – that cost is a big barrier to care – remains the same. Millions of Australians still skip or delay needed dental care because of the cost, and poorer Australians still see the dentist less often than wealthier Australians. Where people are eligible for state dental schemes, waiting times are too long, and getting longer, with many patients waiting more than a year for the care they need.
Because the problems remain the same, the policies proposed in Filling the gap are still the best solutions.
The federal government should declare its intention to introduce a universal primary dental care scheme. The National Health Reform Agreement (NHRA), due to be updated in 2025, should be the mechanism used to negotiate a deal between the federal government and the states.
Because the jump from the current incoherent patchwork of inadequate schemes to a national, systematic approach is significant, it would be impractical to move to a universal scheme overnight. The cost would be large – about $5.6 billion in extra spending per year – and the oral health workforce would need to grow. So, the federal government should announce a roadmap to a universal scheme, including plans to expand the workforce, followed by incremental steps towards a universal scheme. The recently commissioned review of health practitioner regulatory settings should encompass dental care, to make sure dental clinicians are not restricted in delivering care they are trained to provide.
The first step is for the federal government to takeover funding of existing public dental schemes, fund them properly, and enable private-sector providers to deliver publicly-funded care. Coverage should then be expanded – first to people on Centrelink payments, then all children. After that, the federal government should take the final step to a universal scheme, ideally within a decade.
Removing financial barriers to dental care would improve Australians’ oral health. This submission and Filling the gap explain why this change is needed, and details how the transition should be staged.
Peter Breadon
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