The Australian Government’s latest report into dental services was tabled in Parliament at the beginning of this week. The report (which is available online here) by the House of Representatives Health Committee called for innovative modes of service delivery, and a long-term commitment to funding public dentistry, among other things, but the Australian Dental Association (ADA) has slammed the report as “lacking credibility” on workforce recommendations, and described it as “under-researched and poorly prepared”.
The House of Representatives Health and Ageing Committee’s inquiry into adult dental services began last March, held four public hearings and received 46 submissions in its quest to identify priorities and inform the National Partnership Agreement (NPA) such that it can be framed to meet the particular and localised needs of each state and territory, as explained by committee chair Jill Hall MP when hearings began.
“With up to 400,000 adults currently on public dental waiting lists in Australia, the government needs to take action to improve accessibility to dental services for these individuals,” Bite reported Ms Hall saying at the time.
As a way of addressing perceived workforce shortages in regional and remote areas, the committee recommended that “The Department of Health and Ageing and Health Workforce Australia work with the Dental Board of Australia to amend the professional scope of practice registration standards to allow dental hygienists, dental therapists and oral health therapists to practice independently.”
It also recommended that “The Department of Health and Ageing investigate enabling dental hygienists, dental therapists and oral health therapists to hold Medicare provider numbers so that they can practice independently as solo practitioners within the scope of practice parameters stipulated by their professional practice registration standards.”
These recommendations appear to have upset the ADA, with President Karin Alexander saying, “With all due respect to the Parliamentary Committee, it has little, if any, expertise to evaluate any evidence upon which to base its recommendations. Allowing auxiliary dental care providers (some with as little as two years’ training) to provide dental treatment, without the supervision of a dentist, severely compromises the safety and quality of dental care delivery.”
“To allow these auxiliaries to provide services which can be potentially covered under Medicare may allow state and territory governments to employ less qualified people and shift the cost of services provided by public dental clinics from State budgets to Medicare,” stated Dr Alexander. “So instead of providing services by qualified and experienced dentists, working in a structured team with auxiliaries as they do now, many public patients will be treated solely by lower level providers – poor dentistry for poor people.”
The ADA pointed out that while the report makes a number of sensible recommendations about the delivery of sustainable dental services, in relation to workforce issues, it seems that despite the release of 2011 workforce data by the Australian Institute of Health and Welfare (AIHW) during the consultation period, the Committee has chosen to rely on out-dated data from 2006. The scenario presented in the 2011 study makes the basis of the Committee’s report fundamentally flawed.
“For example, the Report refers to 10,404 dentists in Australia when the 2011 study states there are in fact 12,734 practising dentists – the figure used in the Report is short by 22%! In 2013, with the increased number of dentist graduates and overseas trained dentists registering in Australia, the discrepancy is even greater. The ratios of dentist to population by remoteness area outlined in the Report are also out-dated and present an inaccurate picture of the public’s access to dentists,” the Association said in a press release.
“The Report of the House of Representatives Standing Committee on Health and Ageing demonstrates, yet again, that the Australian Government is not listening to those health professionals who best understand oral health issues,” stated Dr Karin Alexander, ADA Federal President. “The ADA presented at the Committee’s roundtable held in April. It was immediately concerned that only a small contingent of the members of the Committee even bothered to attend.”